Zambia’s Country Approach

Ministry of Health

What Do We Focus On ?

• Integrated Program with both targeted interventions and system strengthening– HIV/AIDS (MTCT,VCT,OVC, X Border, etc)– Child Survival (vit A, EPI, IMCI, Growth

Monitoring)– Infectious Diseases (Malaria)– Reproductive Health (Family Planning and

Maternal Health)

What…..

• Systems Strengthening– Health Policies

– Health Financing and Planning

– QA

– HMIS

– Health Planning

– Drug Logistics

– Communication

– SPA

What…..

• Focus on both government sector, NGOs, and for-profit businesses– SPA, Global Fund, TA to MOH/CBOH,

District Plans– NGO - Hard-to-Reach Populations– NGO Strengthening– Face AIDS, Zambia Sugar, Netmark, FP in the

Workplace

How Do We Do Business?

• PAST - – Three separate “vertical” agreements and over 25

CAs

• NOW - – One program with 4 bilateral agreements

(ZIHP)– Churches Health Association of Zambia– SPA– Field Support CAs to fill the Gap

ZIHP:Who are they?

Johns Hopkins CCP

John Snow, Inc.

Abt Associates

Society for Family Health

Other Partners: CARE, AIDS Alliance, Manoff, Pathfinder,Initiatives, Inc, Africare, AMEG, UNZA, JHPIEGO, MOST, QAP,LINKAGES, BASICS II

ZIHP Plus

Profile of ZIHP Organizations

Component Total Budget(4 Years)

Total Staff Tech. Staff

ZIHPCOMM $7.7 M 32 18

ZIHPSERV $13.2 M 32 15

ZIHPSOM $12.3 M 100 30

ZIHPSYS $9.3 M 21 8

TOTAL $42.5 M 185 71

How did we build the program?

• Transitional Overlap Period

• One Name

• One Place

• One Joint Workplan and Annual Report

• One Joint Management Meeting every two weeks with COP

• Combined Retreats every 6 months

• CTO’s share cross-cutting issues

How….

• Central CAs fill gap in bilateral program

• Development of MOU between CAs and ZIHP

• Abt responsible for coordination of ZIHP as well as “expanded team” through ZAMCAM

• Have 4 Technical Working Groups to focus on Impact with all components participating

Factors Associated With Cooperation

• Good relationships between key individuals• Shared importance & holistic thinking of

results• Willingness to compromise• Co-location• Clearly defined leader• USAID vision for one ZIHP• Focus on same client/institution

Factors Associated With Unrealized Cooperation

• Parties could not agree• Failure of mechanism to resolve conflict• Immediate gain of participation not clear• Misperception and poor communication• Different degrees of importance• Big egos and personality clashes

How Do We Work With Other Partners ?

• MOU signed by 15 Cooperating Partners

• One Hour Friday Cooperating Partner/GRZ Meeting

• Quarterly Health Sector Steering Committee Meetings

• Bi Annual Consultations between CPs and GRZ

• Ad hoc Meetings on Specific Topics

How...

• Technical Groups (Expanded HIV/AID Theme Group, Malaria Coordination Group, etc.)

• ZAMCAM - Quarterly meeting of all CAs - Issue Focused

• Special Relation with Japan - Common Agenda

Key Issues for the Future

• Hard-ware vs. Soft-ware• Human Resource Development• Food Security Issues• Appropriate Engagement with MOH/CBOH• Where to Target• How do we approach Scale-Up• How best to strengthen NGOs• Future of Basket Funding

Summary

• Need to have balance of technical and system strengthening but this is an Art

• A strong bilateral helps in supporting and targeting central CAs.

• USAID must play an active leadership role in CA coordination

• Personalities often drive collaboration