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Title:Decontrolling or entrenching ministerial oversight in the Zambian health services system: the case of the Medical Services Act of 1985
Author:Lungu, Gatian F.ISNI
Periodical:Zambia Law Journal
Notes:biblio. refs.
Geographic terms:Zambia
Central Africa
Subjects:health policy
Zambia. Medical Services Act (1985)
public health
Health services
Abstract:The IMF and the World Bank have been urging the Government of Zambia to decontrol, or even privatize, the present publicly funded health care system. Zambian policymakers, however, are hesitant about the privatization option, and have settled on a moderate course, namely decontrolling health services within the public sector, as stipulated in the Medical Services Act of 1985. This paper determines the extent to which the Act has decontrolled public health services in the direction of more effective and efficient management under the proposed parastatal medical boards. Although a study of the provisions of the Act shows that these boards have been instituted as entities separate from the Ministry of Health, a close examination reveals numerous instances of ministerial control, to the point that the proposed boards sound like new departments of the Ministry of Health. Ministerial control is evident in the very creation of the boards, in the fields of appointments and financial provisions, and, notably, in the regulation of the charging of fees. As an alternative solution to the current problems in the State-run health services system, the author proposes the development of a pluralistic system of health services in which various sectors at national and local levels are involved, either singularly or in partnership. To this end, a more comprehensive legal instrument, covering the development not only of parastatal hospitals but also of other institutions, is required. Notes, ref.