ZAMBIA GEORGE B. SAMPA CHIEF PROSTHETIST /ORTHOTIST Demographics: - PDF document

2015/06/18 Policy and Practice Review: ZAMBIA GEORGE B. SAMPA CHIEF PROSTHETIST /ORTHOTIST Demographics: Prevalence ZAMBIA Prevalence: Numeric value: Comments / Additional Notes: Total population size: 14,638,505 Total Zambian population 2014 estimates No. people with physical disabilities 73,192 Representing 0.5% WHO estimates of total population Aetiology / Causes: % 1. Trauma 39% Retrospective survey of clients who were attended to Road traffic accidents from 2010 to 2014 at 3 P&O centres Occupational injuries Animal bites 2. NCDs 36.8% Diabetes has a higher % Diabetes Cancer/Tumours Stroke 3. Congenital Deformities 20% Congenital Talipes Equino Varus is prominent 4. Infections 10% Gangrene, Osteomyelitis, HIV/AIDS 1

2015/06/18 Demographics: Prevalence ZAMBIA 14% 39.40% 10.00% Trauma NCDs Infections Congenitals 36.80% Demographics: Mobility Solutions ZAMBIA Mobility Solutions: Number: Comments / Notes: No. people with physical disabilities needing 54,894 75% of the total number of PWD solutions No. people with physical disabilities 18,298 (25%) Gap analysis by SINTEF study 2006 currently utilising Mobility aids / solutions indicated that 75% People with physical impairment did not receive prosthetics and orthotics devices Types of aids / solutions: No. of people • Walking aids No data available • Wheelchairs “ • Prosthetics “ • Other “ 2

2015/06/18 Policies and Strategies: ZAMBIA Policy Overview re: Persons with Disabilities: National Health Policy • Policy provides comprehensive framework that amalgamates existing polices in the health sector Rehabilitation Services Objective • To provide comprehensive medical rehabilitative services at all level of care Measures • Strengthen and expand provision of medical rehabilitative services • Strengthen public awareness on rehabilitative services Policies and Strategies: ZAMBIA National Health strategic Plan 2011-2015 Rehabilitative Services Objective • To provide optimal care by taking into consideration client needs, organizational and professional considerations. Key Strategies • Develop and disseminate Rehabilitation Standard Operating Procedures for all levels of care. • Establish procurement plan for essential equipment and consumables. • Train rehabilitation professional at all levels of care • Purchase basic equipment, consumables and other accessories for rehabilitation services. 3

2015/06/18 Policies and Strategies • Provide appropriate infrastructure to support rehabilitation services. • Create adequate positions for professionals in all rehabilitation services. • Sensitise the public on rehabilitation National Policy on Disability 2012 • Government recognizes that persons with disabilities ought to have equal rights and opportunities as people without disabilities • Specific framework to comprehensively respond to needs and challenges of PWD Objectives • Prevention of Disability • Develop and Promote programmes that prevent and reduce incidences of disability • Habitation and Rehabilitation • Promote and provide access to technical aids, assistive devices, equipment and facilities habitation and rehabilitation of PWD Policies and Strategies National Social Protection Policy  To protect and promote the livelihoods and welfare of people suffering from critical levels of poverty and deprivation Overall Objective  To contribute to the well being of all Zambians by ensuring that vulnerable people have sufficient income security to meet basic needs and protection from worst impacts of risks and shocks Disability Objective  Safeguard and promote the realisation of the right to an adequate standard for people with disabilities  Ensure equitable access to opportunities by persons living with disabilities 4

2015/06/18 Disability Support Service Delivery: ZAMBIA Overview of Health System and how services are structured and care delivered for Rehabilitation and Disability Support National level • Prosthetics & Orthotics unit is under rehabilitative services which sits under the Directorate of Clinical Care and Diagnostic services • Rehabilitative services unit comprises Prosthetics & Orthotics, Physiotherapy and Occupational therapy Functions of the Unit • Develop and disseminate national technical guidelines • Plan and coordinate the provision of Prosthetics and Orthotic services • Monitor and evaluate the implementation of Prosthetic and Orthotic services • Initiating of continuous professional development Disability Support Service Delivery Provincial / Regional level • No representation at this level • Representation at Hospital level is through Head Clinical Care District / Local level • Not represented at this level • P&O services are found only at tertiary and 2 nd level hospitals • Physiotherapy services are available from health centre to tertiary level • Faith based organization compliment government at local level – - Cheshire home society, - Fly spec Zambia involved in outreach and supported by NGO, 500 miles • The highest level of Prosthetist employment in Government is Chief Prosthetist/Orthotist and he/she is involved in policy determination 5

2015/06/18 Ministry of Health: Functional Organisation Structure 6

2015/06/18 Ministry Of Health: Directorate of Clinical Care and Diagnostic Services DIRECTOR, CLINICAL CARE & DIAGNOSTIC SERVICES MDS/1 Deputy Director, Deputy Director Deputy Director Deputy Director Laboratory Services Clinical Care & Clinical Medical Imaging Pharmaceutical MDS/2 Support Services - MDS/2 MDS/2 Services - Deputy Director MDS/2 Nursing Services GSS/2 Medical Rehabilitative Clinical Care & Equipment Quality Assurance Chief Chief Services Unit Unit Unit Biomedic Biomedic Chief Chief al al Nursing Nursing Chief Chief Scientist Scientist Services Services Medical Medical MS/1 MS/1 Officer Officer Imaging Imaging MS/1 MS/1 Officer Officer Mgt & MS/1 MS/1 Practice Chief Chief Chief Clinical Physiothera Prosthetist Principal Pharmacist Principal Medical Care pist MS/1 Orthotist Logistics Management Pharmacist Equipmen Specialist & Administration Pharmaceutical MS/1 t Officer MDS/3 MDS/3 Care & Rational MS/1 Drug Use MDS/3 7

2015/06/18 Disability Support Resource Allocation: ZAMBIA SERVICE DELIVERY UNIT Total Number Ratio of Persons Resource Type: with Disabilities: Units Total Units None Full workshops with Academic link 6 12000:1 Full workshops with no Academic link 4 18000:1 Satellite Unit Service Delivery Units 8

2015/06/18 Disability Support Resource Allocation: ZAMBIA HEALTH CARE PROFESSIONAL Number of Posts Number of Resource Type: Incumbents 3 3 Prosthetist / Orthotist holding Degree qualification 6 7 Prosthetist / Orthotist holding Diploma qualification Technician holding certificate 4 6 qualification Bench / Workshop Assistant holding 10 10 no formal qualification Disability Support Service Delivery: ZAMBIA Known Gaps or Challenges in Service Delivery and Resourcing for persons with disabilities: 1. Inadequate trained human resources 2. Inadequate service delivery points Measures Taken  A position paper for training in P&O was developed  Currently 4 officers are in Tanzania for BSc and diploma training  Pre-service training is receiving active attention 9

2015/06/18 Estimated distribution of Trained P&O personnel versus provinces/ population (2010) PROVINCE Population Currently Required number of trained Required training level of coverage available P&O P&O staff qualifications trained staff* Lusaka Province 1,654,579 Nil 2 Degree (category 1-ISPO) University Teaching Hosp 5 6 Diploma (category 2-ISPO) Copperbelt Province 1,911,572 1 2 Degree (category 1-ISPO) Hospital Arthur D, Hosp 1 8 Diploma (category 2-ISPO) Southern Province, 1,483,654 1 1 Degree (category 1-ISPO) Livingstone Central Hosp 1 6 Diploma (category 2-ISPO) Northern Province 1,586,753 Nil 1 Degree (category 1-ISPO) Kasama Gen hospital Nil 7 Diploma (category 2-ISPO) Eastern Province, 1,632,583 Nil 1 Degree (category 1-ISPO) Chipata Gen hospital 1 7 Diploma (category 2-ISPO) Western Province 901,299 Nil 1 Degree (category 1-ISPO) Lewanika Gen Hosp. Nil 4 Diploma (category 2-ISPO) Luapula Province 945,868 Nil 1 Degree (category 1-ISPO) Mansa hospital Nil 4 Diploma (category 2-ISPO) Central Province 1,237,251 Nil 1 Degree (category 1-ISPO) Kabwe Gen. Hosp Nil 5 Diploma (category 2-ISPO) Northwestern Province 711,127 Nil 1 Degree (category 1-ISPO) Solwezi Gen.Hosp Nil 2 Diploma (category 2-ISPO) 10 60 11 at degree level and 49 at Total diploma 10