Zambia

There is no constitutional right to health.

Article 147 of the Constitution establishes a system of devolved governance under which "the management and administration of the political, social, legal and economic affairs of the State shall be devolved from the national government level to the local government level." Distribution of concurrent and exclusive functions are described in the Annex of the Constitution. With regards to health services, there is concurrent jurisdiction of the national and the provincial levels (Annex, part B "Concurrent national and provincial functions"). Local authorities are however exclusively responsible for district health services (Annex, part C "Local Authorities exclusive functions").

No current national health policy was located in the country.

The main goal of the "Zambia 2022-2026 National Health Strategic Plan" is to attain quality universal health coverage through decentralization, ensuring equitable access to quality healthcare for all in Zambia (Page i).

The strategic plan identifies several priorities and objectives, including strengthening prevention, primary health care, health promotion, public health security, and nutrition. It aims to reduce maternal and child mortality rates, combat communicable and non-communicable diseases, and improve healthcare infrastructure and human resources (Pages 1-2).

The document references numerous legislative and regulatory acts throughout the text, such as the Zambia Medicines and Medical Supplies Agency Act, 2019 (page 6); the Constitution (Amendment) Act, No 2 of 2016 (page 26); Termination of Pregnancy Act of 1972 (page 33); Mental Health Act No 6 of 2019 (page 55); Zambia National Public Health Institute Act of 2020 (page 64); the Medicines and Allied Substances Act No 3 of 2013, the Zambia Medicines and Medical Supplies Act No 9 of 2019, the Public Health Act, and the Zambia Medicines Regulatory Agency Act (page 93); National Health Insurance Act of 2018 (page 101); Nurses and Midwifery Act, Food and Safety Act, Zambia Public Health Institute Act, the Anti-Corruption Act (page 105); the Zambia Public Procurement Authority Act No 8 of 2020, the Public Finance Management Act of 2016 (page 107); Zambia Flying Doctors Service Act of 1967, the Food Safety Act of 1967, the National Food and Nutrition Commission Act of 1967 (page 129); Tropical Diseases Research Centre Act No 31 of 1982, the National HIV/AIDS/STI/TB Council Act No 10 of 2002, the Health Research Act No 2 of 2013 (page 130).

The strategic plan outlines specific actions to enhance the legal and regulatory framework for the health sector. This includes the strengthening policy and regulatory framework for PHC implementation in order to achieve Goal 5.1.1.3.2 of attainment of UHC by 2030 (page 30). The document also calls for the strengthening of normative guidance on Post-Natal Care (Strategic Intervention 2.1) and the revision of the Termination of Pregnancy (ToP) Act of 1972 (Strategic Intervention 4.2) under the Reproductive and Maternal Health Strategic Goal 5.1.1.4.1 (pages 32-33). Under the 5.1.1.4.4. Nutrition Strategic Goal, the plan defines the strengthening of infant and young child feeding programmes at all levels, including policy/legislation formulation and enforcement of supportive measures (page 43). Strengthening the legislation for mental health care (Strategic Intervention 1.5) is identified as one of the avenues for reaching the 5.1.1.6.2 Mental Health Goals (page 56). Under the Cancer Diseases Strategic Goals 5.1.1.6.3., the plan proposes Strategic Action 3.4 of drafting and enacting the Cancer Control Act to establish the National Cancer Institute of Zambia and Zambia National Cancer Registry by law (page 59). For the neglected tropical diseases Strategic Goal, Strategic Intervention 1.1. defines the strengthening of food safety by incorporating Hazard Analysis of Critical Control Points in the Food and Safety regulations (page 62). Furthermore, the plan provides for the enactment of the Ambulance Services Act (Strategic Intervention 10.4) (page 77). In order to strengthen the institutional and regulatory framework for adequate supplies of safe blood and blood products, the plan proposes to review and finalise the Blood Transfusion, Tissue and Transplant Act (page 80). In order to ensure a well-functioning health sector, the plan outlines objective 1: to make available relevant policies and legislation for effective governance and management of the health sector by 2026 (page 108).