NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Monday, April 6, 2015

A new study reveals that while Zambia has made great progress against malaria over the past decade or so it was losing ground on many other health needs like basic child immunizations and maternal health care.

The findings, though limited to evaluating select health trends in one African country, may well become fodder in the long-running – but, lately, increasingly intense – debate over whether the global health community should continue favoring targeted or disease-specific interventions or shift its emphasis to more fundamental “health systems” improvements.

“Zambia has been recognized worldwide for its successes in improving childhood survival and tackling many deadly diseases, including malaria and HIV/AIDS,” said one of the lead authors, Emmanuela Gakidou, a researcher at the University of Washington’s Institute for Health Metrics and Evaluation. The study is published today in BMC Medicine.

But Gakidou and her colleagues, including researchers at the University of Zambia, found evidence that these disease-specific programs (which represent the lion’s share of most international health funding) may have undermined other forms of routine care.

“At the national and district level, Zambia achieved greater successes in newer, rapidly scaled-up interventions while gains in routine services delivery either stalled or declined,” the study authors report. Put simply, Zambia’s much-celebrated success against malaria may have come at the expense of de-emphasizing some aspects of basic primary care.