Amref Cautions on Health Funding Gaps
By Francis Maingaila ♥️
Lusaka, Zambia — (15 December 2025) – Amref Health Africa in Zambia has warned that persistent gaps in health financing are driving inequities in access to sexual, reproductive, maternal, newborn, and child health (SRHR and MNCH) services, and has called on the government and key stakeholders to adopt long-term, sustainable financing strategies to ensure equitable access to essential healthcare for all Zambians.
The warning was issued during a healthcare financing workshop held at Twangale Hotel, which focused on Zambia’s health financing, planning, and budgeting processes.
Presenters Godfrey Chewe and Mulenga Ching’ambo highlighted Zambia’s heavy reliance on donor funding, which contributes approximately 40 percent of the national health budget. They cautioned that continued over-dependence on external support threatens the stability and sustainability of essential health services.
“While donor support has played a critical role, Zambia must strengthen domestic resource mobilization to ensure fair and consistent access to essential health services, particularly for women and children,” Chewe and Ching’ambo said.
They emphasized that achieving Universal Health Coverage (UHC) requires equity, quality healthcare, and financial protection for all citizens.
“Without predictable and adequate domestic financing, these objectives will remain unattainable,” the presenters stated.
Chewe and Ching’ambo outlined Zambia’s key healthcare financing sources, including general tax revenue, private insurance, social health insurance under the National Health Insurance Management Authority (NHIMA), user fees, and donor-funded programmes.
They observed that fragmented private insurance systems, low NHIMA enrollment, and persistent out-of-pocket payments continue to widen disparities in access to healthcare.
“Efficiency gains, improved budget execution, and better pooling of resources through health insurance mechanisms are essential to prevent households from falling into poverty due to healthcare costs,” they added.
The presenters further called for the adoption of innovative financing mechanisms such as the World Bank-led Global Financing Facility (GFF), alongside strengthened domestic resource mobilization to sustain SRHR and MNCH services.
“The health of our mothers, newborns, and children should not depend on fluctuating funding or administrative delays,” they stressed.
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Levy Mkandawire, Programmes Manager at Amref Health Africa Zambia, elaborated on the organization’s strategic approach to strengthening health systems and improving health outcomes.
Working in partnership with the Partnership for Maternal, Newborn & Child Health (PMNCH) hosted by the World Health Organization, Amref focuses on building community-led, people-centered health systems while addressing social and environmental determinants of health.
“Our mission is to drive lasting improvements by ensuring that vulnerable populations, including women and young people, have access to quality healthcare,” Mkandawire said.
He added that Amref is committed to strengthening community health systems, building the capacity of the health workforce, and supporting civil society to hold health systems accountable.
Mkandawire described Amref’s approach as twofold. One platform focuses on strengthening community-based health systems, enhancing workforce skills, and engaging civil society to achieve sustainable impact.
The second platform addresses broader social determinants of health through education initiatives, policy advocacy to improve livelihoods, and targeted interventions to respond to emerging challenges, including climate-related health risks.
He also highlighted Amref’s use of digital innovation to improve coordination among stakeholders. Between October 2024 and March 2025, the organization launched an interactive digital platform that allows Members of Parliament and health partners to plan interventions and monitor activities in real time.
Amref’s 2025 programmes in Zambia focus on maternal, newborn, and child health, malaria elimination, tobacco control among young people, and education initiatives supported by Mastercard.
“These programmes are being implemented in Lusaka, Central, Western, Southern, Northwestern, Copperbelt, and Luapula provinces,” Mkandawire said.
He called for expanded access to health facilities, recruitment of adequate medical personnel, increased domestic health financing, alignment of national policies with international commitments, stronger private sector engagement with accountability, and effective use of Constituency Development Funds (CDF) to support local health initiatives.
“These actions align with Zambia’s SDG Transformation Commitments and the outcomes of the Global Forum for Adolescents 2023, which seek measurable improvements in adolescent wellbeing,” Mkandawire said.
“By investing in people, strengthening health systems, and leveraging partnerships, we can achieve lasting positive change across communities in Zambia.”
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Meanwhile, Mkandawire urged the government to take urgent action to address Zambia’s persistently high maternal mortality rates and rising teenage pregnancies.
He underscored the critical role of the media and civil society in strengthening advocacy, shaping public awareness, and driving community engagement.
Zambia continues to record an estimated 195 maternal deaths per 100,000 live births, most of which are preventable, he noted.
“Such losses are unacceptable. Stronger collaboration is needed to address the challenges women face during pregnancy and childbirth,” Mkandawire said.
Teenage pregnancy remains a major concern, with 28 percent of young girls affected nationwide, according to current statistics.
Mkandawire said addressing maternal mortality and teenage pregnancies requires coordinated action among the media, civil society, and government institutions to avoid fragmented interventions and strengthen sexual and reproductive health advocacy.
He explained that discussions at the workshop were guided by a collaborative advocacy action plan developed by civil society organizations, with Amref Health Africa serving as the coordinating partner.
“Promoting the health of mothers and young people is vital to the future of this nation. Healthy girls today will shape Zambia’s productivity and wellbeing in the years ahead,” Mkandawire said, calling for increased domestic health financing as external support continues to decline.
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Mkandawire also raised concern about the growing impact of climate change on public health. He said floods and displacement are disrupting access to health services, while recurring cholera outbreaks continue to threaten many communities.
He emphasized the need for coordinated health responses, improved water and sanitation infrastructure, and stronger community engagement in hygiene practices.
“Communities must work with stakeholders to manage waste effectively, practice proper handwashing, and uphold sanitation standards to prevent diseases such as cholera,” he said.
Workshop participants also discussed gaps in SRHR and MNCH service delivery resulting from limited domestic investment, high out-of-pocket costs, and low health insurance coverage.
They emphasized that UHC goes beyond treatment and includes preventive measures such as public health campaigns, epidemic preparedness, and inclusive social initiatives.
The meeting, attended by members of the media and civil society, identified five priority areas, including reducing maternal mortality, preventing teenage pregnancies, and improving access to quality healthcare services.
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