Evaluating Implementation and Governance of Zambia’s Policy Response to Selected non-Communicable Diseases Risk Factors: A Policy and Systems Analysis Approach
The Zambian Government has initiated various policy measures to address NCD prevention over the years. Few studies have evaluated the implementation of policy activities to address primary prevention of NCDs in Zambia, particularly around reducing the modifiable risk factors.
This study seeks to work with key policy actors at the Ministry of Health, other ministries, cooperating partners and civil society organisations in evaluating Zambia ‘s policy response to NCDs, with particular focus on implementation and coordination of policy interventions aimed at reducing alcohol abuse and tobacco use.
Participating departments and units at Umeå University
This study will employ a mixed methods design with both secondary data collected from the 2017 STEPS survey and primary data collected through qualitative Indepth and Key informant interviews. The study proposes to use a policy analysis as well as the governance frameworks.
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The World Health Organisation reports that more than 70% global annual deaths were due to non-communicable diseases (NCDs) in 2015. Over 85% of these NCD deaths are premature and are mostly recorded in low and middle-income countries. In Zambia, the probability of dying from CVD, diabetes, cancer and chronic respiratory diseases between ages 30 and 70 is estimated to be 18%. Local health systems report several gaps in primary health care capacity to provide NCDs services. Despite the challenges, government has initiated various policy measures to address NCD prevention over the years.
A limited number of studies have evaluated the implementation of some of the proposed policy activities to address primary prevention of NCDs in Zambia, particularly around reducing the modifiable risk factors. The policy framework falls short of the targeted interventions to address socioeconomic inequalities that drive NCD risk factors. Other challenges include governing and coordinating the policy response to address commercial determinants, and fostering multisectoral action. This study seeks to work with key policy actors at the Ministry of Health, other line ministries, cooperating partners and civil society organisations in evaluating Zambia ‘s policy response to NCDs, with particular focus on implementation and coordination of policy interventions aimed at reducing the two common modifiable risk factors—alcohol and tobacco abuse.
This general objective of this study is to evaluate implementation and coordination of Zambia’s policy response to non-communicable diseases. The study has four specific objectives. Firstly, to assess changes in socioeconomic inequalities in modifiable non-communicable disease risk factors between 2008 and 2017 in Lusaka province, Zambia. Secondly, to evaluate governance and coordination of multisector action response to modifiable non-communicable disease risk factors in Zambia. Thirdly, to identify barriers and facilitators to implementation of policy interventions to prevent modifiable non-communicable disease risk factors at national level and fourthly, to assess integration into health systems of policy interventions to reduce selected modifiable NCD risk factors at district level.
This study will be critical in assessing the adequacy of Zambia’s policy response to addressing modifiable NCD risk factors. The findings will serve to inform future national NCD policy initiatives and enhance implementation of strategies meant to reduce modifiable NCD risk factors. It is envisaged that the findings of this research will provide evidence that will feed into the next NCD-Strategic Plan to ensure that population-specific and implementable strategies are adopted.