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.
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 Community Health Unit, supporting the achievement of their strategic objectives. During Covid-19 in 2020 our volunteers supported the development of national protocols for Community Health Workers, ensuring the safe continuation of services. Guidelines for the continuation of TB services were also developed. Throughout 2021 our aim is to support the Community Health Unit with the development of a model rural health service package. As well as ensuring community health data is available to inform decision making, and address the fragmentation of Community Health Worker programmes in Zambia.
We work with the Southern Province Health Office 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.
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. Volunteer Doctors work alongside health workers and CBVs in the facilities, to see patients, carry out community mapping and assess the overall functionality of the facilities. Over the period of their placements, volunteers 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.
Through our partnerships with health facilities we carry out community mapping and assessments within their catchment area to better understand common health problems and the root causes of poor health. We work with the facilities to develop public health to bring about long term improvements to health outcomes.
Assessments help to identify the needs for Community Health Worker and National Health Committee training, and gaps in supervision, incentives and delivery for community health programmes. We work with Ministry of Health to deliver training to address identified gaps and barriers and support the roll out of digital health solutions that enhance deliver and improve data flows to inform decision making at all levels of the health system. Our aim is to transition from doctor led, to Community Health Worker led service provision as we build local capacity.
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.