2023 Annual Report

We are thrilled to let you know that our 2023 Annual Report, which includes our audited accounts, is now published.

“I look back on 2023 with great pride in what On Call Africa has achieved with rural communities in Zambia. We have worked closely with communities, the Ministry of Health (MOH), and partners to refine our efforts and focus on programmes that have the greatest impact.”

Dr Kirsty Tolmie, Chair of Trustees

After experiencing a 331% increase in our income in 2022, the start of 2023 brought some unexpected financial challenges. In March 2023, our WASH and maternal health project with WaterAid Zambia ended earlier than anticipated due to their budgetary challenges caused by exchange rate fluctuations and high inflation rates. At this critical juncture, On Call Africa took the opportunity to conduct an in-depth review of our work. We made the strategic decision to move away from standalone WASH, maternal health, and solar health facility infrastructure improvements, and focus on core areas: Facility-Based Quality Improvement (FQIP), Community Health Worker (CHW) training, and a more holistic approach to infrastructure improvements in high-need facilities where we are building capacity.

This decision was made because, while we recognise the importance of WASH, maternal health, and solar infrastructure in improving the quality of care, we know that a single intervention alone can only achieve so much. Having provided access to maternal health infrastructure in facilities without power and installed solar in facilities without water or adequate staffing, we understand the importance of a holistic approach to strengthening health systems. We will now only improve infrastructure where we are also building capacity within the health system and bringing all health facility infrastructure up to national standards.

Despite this strategic shift, we are proud to have successfully completed our WASH and maternal health programme and our Solar Programme in 2023, delivering work in 23 healthcare facilities across two provinces. This effort also led to the establishment of a chlorine production unit in Kazungula District, which now provides a sustainable source of disinfectant to 27 healthcare facilities.

This strategic decision has allowed us to focus more time, energy, and resources on areas where we can have the greatest impact. It has also enabled us to increase our level of engagement with partners and the MOH, with great success. In 2023, we supported the MOH in developing the Community Health Strategy for Zambia, played a key role in the new national CHW Programme, worked with Dtree and the MOH to design digital tools to enhance CHW programme delivery, and continued our active role in the Zambia Hospice and Palliative Care Alliance (ZAHPCA).

We have also achieved great success in delivering our core programme areas. We began the first pilot of the new national CHW programme in partnership with the MOH and finalised the new national rural health facility assessment tool through our FQIP programme. On Call Africa has also delivered our new holistic approach to improving health facility infrastructure in facilities where we are building health worker capacity, with great success. We are now focused on continuing to test, learn from, and generate evidence of impact from these programmes. We are incredibly excited about the potential impact these MOH-led programmes could have at scale.

For more information and highlights of the year please see our full 2023 Annual Report here: