Government of Zambia restructured the health sector in order to strengthen
linkages between Primary Health Care (PHC) and community development
health systems in 2012. PHCand local disease responsewere transferred
from Ministry of Health (MoH) to Ministry of Community Development. MoH
retained health sector coordination policy/strategy and central level disease
surveillance. To conduct a rapid assessment of the realigned health sector
and inform policy review. A desk review and focus group discussions and
key health sector stakeholders were interviewed. Although realignment
aimed at demand creation, inadequate preparation was confounding.
Continuum of services from central to community levels was constrained.
Functionality of the community health strategy was suboptimal.Preventive
outreach maternal and child health and community based care services
declined. Capacity in detecting and responding to disease outbreaks
underperformed. The noble idea was to strengthen disease prevention and
control. Instead the process yielded the opposite; weakening of PHC, due to
disjoint between community and health facility. The imminent deepening of
decentralization of health services need to be informed by lessons learnt
from the foregoing. The community health strategy needs to be revitalised
and change management introduced to beneficiary institutions prior to
devolution.