Zambia is a country with a high disease burden, which is compounded by high poverty levels and HIV/AIDS prevalence of HIV/AIDS. Since 1992, the Zambian Government has been implementing significant health sector reforms, aimed at improving health service delivery and the health status of Zambians. The vision of the reforms has been to: “...provide the people of Zambia with equity of access to cost-effective, quality healthcare as close to the family as possible…”.

Since the commencement of these reforms, the public health sector in Zambia has taken significant steps towards meeting the objectives of the reforms, particularly in improving access to health care, affordability of health services and health systems strengthening. These achievements have led to some improvements in health service delivery as witnessed by the trends in the main health service delivery indicators. However, these achievements have not resulted into the desired reductions in the disease burden and performance against the Millennium Development Goals (MDGs) has been below the expected levels. The country has therefore remained under significant pressure to reduce the disease burden and improve the health status of Zambians. This plan is therefore an attempt to significantly impact on the disease burden and accelerate the attainment of the MDGs and other national priorities. In line with this approach, the theme of the National Health Strategic Plan (NHSP) is “…Towards the Attainment of the Millennium Development Goals (MDGs) and National Health Priorities…”.

This National Health Strategic Plan (NHSP) is the fourth in the series of the strategic plans implemented under these reforms. The plan presents a major departure from the past strategic plans, in that, while it is recognized that all health care interventions are important and should continue to receive the necessary levels of support, prioritization of interventions is of critical importance as the resources and capabilities available are significantly constrained. The plan will therefore focus at achieving the national health priorities, which will include: resolving the human resource crisis; addressing national public health priorities, including the MDGs; and ensuring that priority support systems and services receive the necessary support.

The NHSP has been prepared at a time characterised by significant changes and challenges, including: the high disease burden; critical shortages of health personnel; deteriorating health infrastructure; on-going restructuring of the health sector; the new National Decentralisation Policy; a weak economy; and inadequate funding to the health sector. The Ministry of Health (MOH) is committed to reorganize and manage the sector in an efficient, effective and prudent manner that would significantly improve health service delivery.