Cardiovascular Journal of Africa: Vol 31 No 4 Supplement (July 2020)

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AFRICA
Cardiovascular Journal of Africa • Volume 31, No 4 August 2020 S54
Strengths
Considering various sources, the data from STEPS 2017
were regarded most accurate to be included in this report. 7
The NHSP of 2017, along with the Seventh National
Development Plan, identified strategies and programmes that
should contribute to a healthy nation, ensuring all Zambians
have access to quality health services by 2030.21,36 In a
communique, the government is committed to establish and
strengthen multi-sectoral plans and policies to prevent and
control NCD in the Zambian population.40,41
A comprehensive national multi-sectoral tobacco
co-ordination and control plan has been introduced through
the WHO FCTC, although it does not include the banning
of advertising, promotion and sponsorship or clear, visible
warnings on more than 50% of the packaging.25
May Measurement Month (MMM), a global initiative
that was introduced in 2017 to raise awareness of raised BP
in sub-Saharan African countries has opened opportunities
for workplace screening of hypertension and related CVD
risk factors.39
Threats
As in most sub-Saharan African countries, the burden of
NCD, which is related to risky lifestyle behaviour and
consequent morbidity and mortality is increasing in Zambia.21
The increasing burden of premature mortality from NCD is
a cause for concern, especially since after saving the young
from dying prematurely from communicable diseases, they
die prematurely from NCD.
Tobacco use among Zambian adolescents is higher than in
most other African countries under investigation, especially
in females and calls for urgent intervention (Table 1).
As mentioned, overweight and obesity tend to be a
problem in most African countries, although in Zambia,
these figures are lower than the global data at 38.9 and
13.1%, respectively.7 Another reason for concern is the
high percentage of young people who are insufficiently
physically active. 4
Weaknesses
Health services in Zambia are fragmented and unevenly
distributed, with the result of them being inefficient and
ineffective. Therefore, many rural and peri-urban residents
have inadequate access to healthcare services.30 In a study on
hypertension management in rural primary health facilities,
similar findings were reported.20
The inconsistent supply of essential medicines is a
crucial problem in Zambia, which is attributed to various
factors, particularly inadequate funding and difficulties with
procurement, distribution logistics, and storage management,
among other things.30
Priorities
According to Chiluba et al.,38 many opportunities exist for
developing interventions for optimal screening, treatment
and prevention of CVD in Zambia. Oelke et al.,19 in 2015,
suggested initiatives to increase access to health education
to reduce the risk of developing hypertension, improve early
detection, and encourage lifestyle changes and medication
adherence. In another study, facilitating regular and
systematic data reviews to improve hypertension diagnosis
and management, shifting the focus on performance indicator
development and validation in low-resource contexts had
been recommended.20 Policy makers need to engage with
communities more effectively to develop successful public
health strategies to prevent, detect and manage hypertension,
primarily in rural areas.19
In 2018, the committee on health, community
development and social services of the National Assembly
of Zambia published their findings in a Report with about 23
recommendations addressing NCD.37 Some of these advise
the government to:
• prioritise the prevention and control of NCD through more
robust community sensitisation and awareness
• invest as a matter of urgency in capacity building of human
resources, especially in cardiac surgery, endocrinology
and cardiology, among other areas
• undertake routine screening for sugar levels as for BP
measurement at all health facilities
• put in place measures to strengthen health systems in the
country to help prevent and control NCD through primary
healthcare and universal health coverage, in line with the
WHO Global NCD Action Plan 2013–2020.42
This publication was reviewed by the PASCAR governing council and
approved by the president of ZAHESFO.
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