Health Care Delivery Patterns and Planning in Zambia: Colonial, Populist and Crisis Interventionist Approaches
E. SHAMILUPA KALAPULA
In studying health care patterns and planning in Zambia, a series of rather related themes run parallel to each other. To understand past and present patterns, a historical approach and analysis are necessary. Planning considerations, on the other hand, have to be derived from a basic paradigm in which the relationship of health and medical care services in the socio-political-economic system is clearly analysed. This chapter will show that three broad phases are identifiable in the country's pattern of health care. These phases reflect different official government policies. It is thus suggested that the colonial era will constitute one such phase, while for the postindependence period two phases are identified. Planning of health care and health services delivery in Zambia reached its zenith in the late 1970s. The chapter will thus relate the basic paradigm to the new approach based on primary health care.
This chapter comprises four major parts. The first part introduces Zambia, presenting basic statistics relating to area and population. Rifkin and Kaplinsky's ( 1973) basic paradigm is also presented in this section, and its major components are outlined. The second and third parts examine health care patterns. The health policies of the various governments contain specific objectives. Implementation of policies leads to effects that are manifested in the resultant differential patterns and relationships on the landscape ( Osborne, 1974, p. 345). Colonial and postcolonial health care patterns are discussed separately. The fourth part focuses on planning for health care in Zambia. Although drawing on colonial and postcolonial patterns and planning approaches, the section will nonetheless concentrate rather heavily on the adopted planning method of primary health care.