Argument: Resolving the health service crisis?

To what extent does the VDP resolve the lack of health service professionals in Zambia? Two caveats emerge.

Firstly, the project shows how intervention from international organisations can work against trade union demands and employment issues. The project is introducing a model of outsourcing. The medical staff do not need to be based in hospitals so reducing government costs and decentralising employees. Recent strikes by nurses [1] shows dissatisfaction with work conditions and overwork. It raises concern over the motives of the VDP. Is the VDP encouraging social protection and an ethical work environment for all medical professionals? Or is the VDP an escape mechanism to keep wages low and neglect demands made by working nurses? A majority of the expert ‘virtual doctors’ employed are volunteers. Ultimately then the government might consider the VDP a good excuse not to invest in training Zambian doctors.

Secondly, does the VDP resolve the issue of brain drain? Improved incentives and increased salaries are required for trained medical professionals, to motivate them to stay. The VDP may help educated doctors but it does not provide them with reasons to remain in Zambia, rather it gives them contacts with outside healthcare systems where their skills will be much better rewarded.

[1] See further readings: Kunda, 2013.

Candidate 1: "Figures showcasing the popular use of traditional practices, and medicine, do not show the reasons behind use. It fails to recognise the degree of choice and the nature of treatment provided. If people don’t have access to modern medicine then they will go to that which is available. The answer then is to increase access to modern medicine to provide the alternative."
Candidate 2: "Technology will only be required within the mobile clinics, to enable the VDP networks to be used. It is a key component, but not the only foundation of which the VDP is based on. This means that the clinics can carry equipment to ensure access to the internet remains – such as a satellite connection. Furthermore, significant developments have been made in Zambia’s technological revolution. Internet connectivity has improved in rural areas; and pioneering movements across rural areas - such as the implementation of solar-powered internet - means connectivity is spreading into rural, remote, Zambia."
Candidate 3: "The VDP is providing a number a solution to the lack of human resources within Zambia’s health sector. VDP is enabling the growth of local jobs, for Zambian nationals. Although there are no current figures to estimate the amount of jobs that will be provided within the health sector, the VDP has currently been rolled out into six sites and continues to expand. New clinics will be set-up across Zambia, as well as Tanzania, Malawi and Kenya. A growing body of health workers will be required to maintain the VDP network; reducing the doctor to population disparity in Zambia."
Candidate 4: "Today the inclusion of private stakeholders in providing access to health is proving to be a sustainable approach. To achieve developmental impact the public sector is no longer the key source or actor. Although increased support by the government - both financial and political - may be required in the future it is not fundamental for the implementation stage. The VDP can continue to grow and be sustainable through the work of private organisations and funders. The state can later step in and expand the system nationwide when it is fully demonstrated. Private partnerships are changing how health-care is provided and its sustainability."

The VDP is providing a number a solution to the lack of human resources within Zambia’s health sector. VDP is enabling the growth of local jobs, for Zambian nationals. Although there are no current figures to estimate the amount of jobs that will be provided within the health sector, the VDP has currently been rolled out into six sites and continues to expand. New clinics will be set-up across Zambia, as well as Tanzania, Malawi and Kenya. A growing body of health workers will be required to maintain the VDP network; reducing the doctor to population disparity in Zambia.
