Our Work

Improving health care in rural Zambia

In order to bring about long-term change within the communities in which we work, On Call Africa addresses the root causes of poor access to, and quality of healthcare and strengthens community led programmes that are vital for remote rural communities.  As an organisation we strive to support the achievement of national strategic objectives, while ensuring that we listen to, and are responsive to the communities that we support. We are a learning organisation that openly shares findings to influence policy and practice in Zambia, and to expand our reach globally.

“We take an adaptive approach to our programmes to ensure that they respond to local needs and so that we can quickly respond to learning or changing contexts. Over the last few years we have been able to adapt our programmes to respond to rising cases of diarrhoea and malnutrition during a period of drought, and overhaul our programmes to meet the most pressing needs of the health system at the height of the pandemic.”.

Ben Margetts, CEO, On Call Africa


We work in partnership with the Ministry of Health, Rural Health Facilities, volunteer Doctors from the UK, and delivery partners to support the development of strong and effective rural health systems in Zambia. We also work with Rural Health Facilities that have been identified by the Ministry of Health as being in need of capacity building and support. With these Rural Health Facilities we map their catchment area, carry out in depth assessments of health facility needs, and the needs of their communities, and use these to work with the health facility staff to develop detailed quality improvement and implementation plans to improve access to and quality of healthcare. Once in place we work with the Ministry of Health, and our partners to deliver identified programmes of work.

We work with these health facilities and our partners to deliver 3 main areas of work:
  1.  Improve access to, and quality of healthcare at rural healthcare facilities
  2.  Strengthen community health programmes in Zambia
  3.  Influencing policy and practice at all levels of the Zambian Rural Health System

It is important to On Call Africa that we focus our limited resources on providing quality holistic support to communities and health systems that are in most need of support. However, we also work closely with the Ministry of Health at national level to support policy and guideline developments to improve rural health outcomes beyond the reach of our direct delivery. We aim to openly share all our resources, impact data and learning to support wider policy, and to promote shared learning between partners.

Improve access to, and quality of healthcare at rural healthcare facilities

On Call Africa aim to support the Ministry of Health in Zambia to develop, test and scale effective programmes that promote access to, and/or improve quality of healthcare in remote rural communities in Zambia. We are currently delivering the following key programmes:

  • Developing a standardised assessment tool to assess the functionality of rural health facilities
  • Supporting the development and piloting of a holistic model rural health system in Kanyanga and Chalimongela Rural Health Posts. This programme addresses the WHO six building blocks of health system strengthening
  • Installation of solar power into off-grid rural healthcare facilities, and productive use of energy to produce disinfectants for facilities
  • Working with WaterAid to support government led interventions to bring rural healthcare facilities up to the national standards for Water, Sanitation, Hygiene and Waste Management
  • Piloting the use of play to enhance health promotion
  • Piloting healthcare facility led mobile clinics to improve access to healthcare for remote communities
  • Capacity building and training of staff
Strengthen community health programmes in Zambia

On Call Africa aim to support the Ministry of Health to develop high quality, and highly functioning standardised community led health programmes that improve access to quality healthcare for rural communities. Our current priorities include:

  • Develop and pilot national standardised CBV packages in partnership with Ministry of Health. Packages to include: supervision, training, incentives, and transport
  • Support the enhancement and piloting of digital health tools at community level to further support CBVs with their
  • Build capacity of CBVs to effectively deliver successful innovations, such as health promotion through play or effective rural transport
  • Testing a community led income generation model to improve functionality of community health structures and contribute to healthcare facility operation and maintenance costs.
  • Supporting the development of national guidelines and training manuals for palliative care in Zambia, and adapting these for community level


Influencing policy and practice at all levels of the Zambian Rural Health System

On Call Africa strives to build evidence of highly effective rural health system strengthening interventions that can be scaled by MoH, to improve access to quality healthcare for rural communities in a cost effective and sustainable way.

We do this by working with Ministry of Health at national level to develop and test interventions, and by building robust evidence of what does and doesn’t work, so that this can be shared openly. We also build evidence of programmes identified by and delivered with health facilities and communities and share evidence to advocate for adoption by Ministry of Health or partners, or to promote learning from what hasn’t worked. Recent successes in influencing policy and practice include:

  • The development of national COVID-19 guidelines for CBVs, to promote safe continuation of essential services
  • The co-production of continuation of services protocols for TB services during the pandemic
  • The development of a national assessment tool/checklist to measure the functionality of rural health facilities against national standards
  • Supporting the Ministry of Health to achieve its objective of designing and testing a model health system at community level

Partnerships with local health authorities are made to identify the biggest public health concerns and support government led interventions such as COVID19 community senistisation.

If you’d like to volunteer your expertise we’d love to work with you. Visit our volunteer page to learn more about how you can help.