On Call Africa was set up by a group of doctors and international development experts, all with a shared desire to improve access to healthcare and health outcomes within rural communities. In particular looking to support communities with traditionally poor access to medical professionals and amenities – Zambia was selected due its low ratio of doctors to people. Following a consultation with the Ministry of Health, the Southern Province was selected as the starting point.
Our approach
We ensure all of our programmes improve access to rural healthcare, and health outcomes for marginalised communities, in a way that builds capacity within the health system. Aiming to develop programmes that can be replicated by the Ministry of Health, or partner organisations, to maximise and sustain impact.
On Call Africa operates at each level of the health system, helping to shape policy and design quality programmes. While also piloting and testing programmes at rural health facility, and community level, to build evidence of what does and doesn’t work.
We work at a number of levels to ensure that we are taking a holistic approach to building capacity within the health system. We understand that building capacity at community level will only have a limited impact if health facilities are unable to treat patients who have been referred. Taking a top-down approach to shaping policy will not allow for community voices to be heard, it’s important they are included in the decision making processes. Piloting and learning help us to understand which approaches are most effective.
Our work at National level:
On Call Africa collaborate with the Zambian Ministry of Health, supporting the achievement of their strategic objectives. During Covid-19 in 2020 our volunteers supported the development of national protocols for Community Based Volunteers, ensuring the safe continuation of services. Guidelines for the continuation of TB services were also developed. In recent years we have supported the Community Health Unit to develop a new national community health service package, as well as a new standardised Community Based Volunteer programme for Zambia, which we will support them to pilot over the next three years. We are also working with numerous directorates within MOH to support the development of standardised approaches to assess and improve the quality of rural healthcare facilities.
Provincial level
We work with the Southern and Western Provincial Health Offices to identify Districts that are most in need of support and capacity building. As well as identifying capacity building gaps where they would benefit from support of volunteers. Whether that be through virtual placement in COVID-19 incident management teams, or more formal placements within the health office to support a specific task.
District level
Working in close partnership with District Health Offices to identify Rural Health Facilities that will benefit from our programmes. We also support strategic planning sessions with the Districts, identifying the biggest health concerns in their region, developing both strategic and implementation plans for public health interventions. Our aim is to support the piloting and roll out of these interventions, building evidence for adoption across the districts.
Rural Health Facilities
Identifying how best to support the improvement of quality of care at the health facility. Whether that be through training and support, data management, or the provision of infrastructure and medical equipment. Our team work alongside health workers and CBVs in the facilities, to assess the overall functionality of the facilities and develop plans for quality improvement and capacity building. Over the period of our health facility partnerships, we work with MoH, communities and the facilities to develop detailed action plans which outline the roles of different partners. On Call Africa then work with partners and MOH to deliver these plans and assess impact, before handing over the facility to the relevant District health office to ensure sustainability.
Communities
We work closely with MOH to deliver high quality training, support, supervision and incentives to Community Based Volunteers (CBVs) to ensure that quality healthcare is accessible as close to the home as possible. We are proud to have supported the development of a new national Community Based Volunteer programme for Zambia that ensures CBVs are trained, equipped, incentivised and supported to deliver high quality care, and excited to support the first pilot of the integrated package of care. Over the next three years we will pilot the programme and generate evidence for wider national adoption.
Alongside CBV training, we provide training, support and guidance to Neighbourhood Health Committees (NHCs) that are responsible for supervising CBVs, reporting on disease outbreaks, mobilisng community support for healthcare improvements and holding the health facility and MOH for the quality of care provided to the community. High functioning NHCs are critical to the success of a highly functioning rural health system, and we ensure they are informed of their roles and responsibilities and supported to carry them out effectively.
Through our partnerships with health facilities and communities, we work with community members to better understand common health problems and the root causes of poor health. We work with the facilities and CBVs to develop public health to bring about long term improvements to health outcomes.We use learning from our community programmes to help inform national policy, as well piloting national programmes at community level.
To find out more about what we do visit here.
