Bachelor of Science in Health Services Management and Planning · Second Year · HSM 2310
Health Policy and Management
Examines health policy formulation and management principles essential for effective governance of health services.
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Public Policy and Health Governance in Zambia
This topic provides Zambian tertiary students with a comprehensive understanding of public policy and health governance, focusing on the Zambian context. Students will explore the foundations of public policy, including its definition, characteristics, and types such as distributive, redistributive, regulatory, and constituent policies. The module examines the policy cycle—problem identification, agenda setting, formulation, adoption, implementation, and evaluation—using Zambian case studies like the Social Cash Transfer Program. Key actors in the policy process, including government officials, NGOs, international organizations, media, and citizens, are analyzed for their roles and influence. Theoretical frameworks such as institutional theory, rational choice theory, systems theory, and critical theory are applied to understand policymaking dynamics. The topic also covers Zambia's governance framework, including the Eighth National Development Plan and Vision 2030, and addresses challenges like capacity gaps, funding constraints, and political interference. This knowledge is essential for students pursuing careers in health policy, public administration, or governance, equipping them to engage in evidence-based policy analysis, advocacy, and reform in Zambia's health sector.
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Health Sector Reform: Concepts and Applications
Health Sector Reform (HSR) involves fundamental changes to improve health system performance. This topic provides Zambian tertiary students with an understanding of HSR's goals: increasing access, improving quality, reducing costs, and promoting equity. You will examine key reform areas such as governance (e.g., decentralization), service delivery, financing (e.g., health insurance), and resource generation. The topic also addresses challenges like political resistance, limited resources, and system complexity. With Zambia implementing reforms such as decentralization and the National Health Insurance Scheme, this knowledge is essential for analyzing policy changes and contributing to future health system improvements. For students in health management and policy programs, understanding HSR equips you to evaluate reform outcomes, engage in policy debates, and support the development of more efficient and equitable health services in Zambia.
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Topic 12
Government Regulation and Intervention in Health
Government Regulation and Intervention in Health examines the economic rationale for and forms of state involvement in healthcare markets, a key subject for Zambian students in health policy, management, and economics programs. The topic analyzes market failures—including monopoly power, public goods, externalities, and incomplete markets—that justify government action. It explores various policy instruments such as taxes, subsidies (e.g., on insurance), public provision of services, transfers, and direct regulation, as exemplified by bodies like the Health Professions Council of Zambia. Crucially, the module also covers the concept of 'government failure,' where intervention may worsen outcomes. For Zambian learners, this topic provides the theoretical framework to understand and critique current health policies, from NHIMA's structure to public health regulations and subsidy schemes. It prepares students for examinations and careers where they must balance efficiency and equity objectives, design effective regulations, and navigate the complex interplay between public and private sectors in the Zambian health economy.
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Topic 13
Stakeholder Analysis and Management Strategies
Stakeholder analysis and management are critical skills for Zambian tertiary students in health policy and management. This topic covers methods for identifying, analyzing, and engaging stakeholders to support policy processes. Students will learn how to map actors based on power and interest, develop strategies to build support and offset opposition, and apply persuasion techniques such as lobbying. The module includes practical tools for assessing one's own power, building alliances, and navigating political environments. Through Zambian and international examples, learners will explore how to manage stakeholder dynamics to advance health policies and system reforms. This knowledge is essential for effective policy implementation, advocacy, and leadership in Zambia's health sector. By mastering stakeholder analysis, students enhance their ability to design inclusive policies, foster collaboration, and achieve sustainable health outcomes. This topic is vital for university examinations, project work, and professional readiness in health administration and policy roles.
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National Health Research Act and Regulatory Framework
This topic examines the National Health Research Act of Zambia (2013), a critical legislative framework for tertiary students in health policy, law, and public health. It covers the establishment and functions of the National Health Research Authority (NHRA) and the National Health Research Ethics Board (NHREC). Students will learn about the regulatory processes for approving, monitoring, and accrediting health research, research institutions, and ethics committees within Zambia. The module addresses key provisions regarding ethical approval, informed consent (including for minors and vulnerable groups), handling of biological materials, clinical trials regulation, and intellectual property rights. For university and college students, understanding this Act is essential for conducting legally compliant research in Zambia, serving on ethics review boards, or engaging in health policy analysis. It provides the legal and ethical groundwork for ensuring that health research in Zambia is conducted responsibly, prioritizes national needs, and protects the rights and welfare of all participants.
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Topic 15
Agenda Setting and Policy Windows
This topic explores the critical process of agenda setting and the concept of policy windows within health policy, tailored for Zambian tertiary students. Agenda setting refers to the mechanisms through which certain issues gain priority on the policy agenda, while policy windows are opportune moments when conditions align to enable policy change. Students will examine Kingdom's Multiple Streams Model, which identifies problem, policy, and politics streams, and learn how policy entrepreneurs couple these streams to advance their proposals. The module includes case studies such as the passing of Zambia's Mental Health Act of 2019 and the development of the voluntary health insurance system in Lebanon, illustrating how focusing events, political shifts, and advocacy create windows of opportunity. Understanding these dynamics is essential for health policy practitioners in Zambia to strategically influence policy priorities and capitalize on moments for reform. This knowledge is vital for university examinations, policy analysis projects, and effective advocacy in Zambia's health sector.
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Street-Level Bureaucracy and Policy Implementation
Street-level bureaucracy is a key concept for Zambian tertiary students studying health policy implementation. This topic examines the role of frontline workers, such as teachers, nurses, and community health workers, as de facto policymakers who interpret and adapt policies during delivery. Based on Lipsky's theory, the module explores how street-level bureaucrats exercise discretion due to resource constraints, ambiguous guidelines, and client interactions. Students will analyze coping strategies—such as rationing services, bending rules, or rigid enforcement—and their impact on policy outcomes. Using case studies like the implementation of Comprehensive Sexuality Education in Zambian schools, learners will understand how local norms, limited guidance, and teacher discretion shape program effectiveness. This topic is crucial for designing realistic policies, improving implementation fidelity, and supporting frontline workers in Zambia's health and education systems. Mastery aids exam performance and prepares students for roles in program management, monitoring and evaluation, and health system leadership.
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Topic 17
Health Equity and Social Determinants in Health Systems
Health equity and the social determinants of health are central themes for Zambian tertiary students in public health and health policy. This topic addresses the principles of equity as a fundamental human right and examines how social, economic, and environmental factors create health disparities. Students will explore the role of health systems in reducing inequities through allocative and regulatory policies, service delivery redesign, and pro-poor financing. The module highlights Zambia's challenges and opportunities in achieving equitable health outcomes, linking equity to broader development goals and poverty reduction. Learners will analyze frameworks for assessing health inequities and designing interventions that address root causes. This knowledge is essential for advocating for just health policies, planning inclusive health services, and evaluating system performance from an equity lens. Mastery of this topic supports success in university assessments and equips students to contribute to Zambia's efforts toward universal health coverage and health for all.
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Topic 18
Health Technology Assessment and Rationing
Health Technology Assessment (HTA) and Rationing addresses the profound economic and ethical challenges of allocating scarce healthcare resources, a paramount issue for Zambian health policy students and practitioners. This topic delves into the methodology of HTA, which evaluates the clinical effectiveness, cost-effectiveness, and broader impact of medical technologies. It confronts the reality of rationing—making explicit decisions about what care will not be covered due to resource constraints—as practiced by bodies like the UK's NHS or inherent in benefit package design for schemes like NHIMA. Students will engage with contentious issues such as valuing a quality-adjusted life year (QALY), setting cost-effectiveness thresholds, and the role of age, equity, and social value in decision-making. This knowledge is indispensable for future leaders tasked with making or informing transparent, evidence-based, and ethically defensible priority-setting decisions within Zambia's health system, ensuring that limited public and pooled funds achieve the greatest health benefit for the population.