Stakeholder participation
Effectiveness of district health boards in interceding for the community
Strengthened capacity, community involvement and attention to gender needed in Zambian District Health Boards
Authors:
M. Macwangi; A. Ngwengwe
Publisher:
EQUINET: Network for Equity in Health in Southern Africa, 2004
This study, produced by the Institute of Economic and Social Research (INESOR) at the University of Zambia, aims to assess the effectiveness of health governance structures, in the form of District Health Boards (DHBs) in enhancing equity of access and community participation in the delivery of health care services in Zambia. The study finds that, despite the presence of health governance structures, the community is not aware of their existence and roles. The community would like to participate in health issues but lack of knowledge limits their participation. Other findings include that: governance structures are not effective due to weak links between the community and governance; and gender issues are not adequately addressed.
The study outlines a number of recommendations. It calls for a review of selection and appointment procedures in favour of general community members and women. Communication systems between and within governance structures and the community should also be reviewed in order to make the health system more responsive. There is a need for well-tailored community education programmes about the role of the community and how it can participate in health planning. Finally, the study argues that the capacity of DHBs to perform their roles and functions should be strengthened through leadership training and by giving them their own operational budgets. [adapted from author]
