Seed Global Health, 2023
Implementing Partners: Seed Global Health, University of Zambia, Zambian Ministry of Health, Chilenje Hospital
Published In: COP28 Prospectus of Climate-Health Solutions, 2023
Seed Global Health, 2023
Implementing Partners: Seed Global Health, University of Zambia, Zambian Ministry of Health, Chilenje Hospital
Published In: COP28 Prospectus of Climate-Health Solutions, 2023
In Zambia, the impact of climate change is being felt deeply across a health system that already faces several challenges. Rising temperatures and natural disasters across Africa lead to a double burden of disease, involving endemic infectious and non-communicable diseases. Low- and middle-income countries face 24 times higher mortality rates due to limited healthcare resources, and climate-induced events like cholera outbreaks and food shortages exacerbate these health challenges. Direct investment is needed to improve both the quantity of skilled healthcare workers and the quality of health services in communities impacted by climate change. Less than seven percent of global health aid between 2000 and 2020 was invested in the health workforce despite a global shortage, and despite a return on investment (ROI) as high as 10:1 for investing in healthcare workers.
Zambia’s first-ever training program for family medicine physicians started in 2019 through a partnership with Seed Global Health and The University of Zambia. The partnership worked with local universities, governments, and professional associations to advance new curricula and standard of care guidelines for primary care and family medicine. Seed Global Health leveraged its teaching hospital model to train emerging practitioners on how to provide a continuum of care that is comprehensive and community oriented. Family medicine physicians provide holistic, comprehensive, and patient centered primary care for individuals across all ages in the community. The program educates versatile family medicine physicians who will help Zambia better withstand future climate shocks. As the growing impact of climate change on human health is felt in these neighborhoods, Seed Global Health’s family medicine trainees will be among the first line of defense and support for the community. Although this approach has been successful in higher resourced environments like South Africa, this innovative program in Zambia is among the continent’s first in lower resourced health systems.
This partnership is unique for its cross-sectoral and inclusive approach, with partners including Seed Global Health, Zambia’s Ministry of Health, The University of Zambia School of Public Health, Chilenje Hospital, and the Association of Family Physicians of Zambia all working in tandem. This partnership approach has been a key enabler of the program’s success. The initiative is in line with the Ministry of Health’s priorities for Zambia and the overall national health strategy and is supported by a diverse community of philanthropic partners from the private sector and family foundations across the globe.
When well trained and supported, family medicine physicians can address the rapidly evolving health impacts of climate change by strengthening primary care delivery, improving access to services, and identifying, reporting, and addressing disease outbreaks in communities earlier and more accurately. Also, family medicine doctors provide care right in the community, which reduces the need for long distance travel, increases access to health services, and reduces carbon emissions.
Research shows that countries with strong primary healthcare systems, centered on skilled family medicine physicians, have better patient outcomes, increased patient satisfaction, and lower costs. A family medicine doctor is trained to diagnose and treat about 80% of patient cases that typically present in a district facility, and to refer only the more advanced cases to specialists in centralized hospitals. A family medicine doctor therefore provides comprehensive care close to patients’ homes and creates efficiency in overstretched health systems.
In 2019, the entire country of Zambia had virtually no family medicine physicians in the public sector. Today, the University of Zambia has celebrated its first graduate doctor and has more than 20 future physicians in the pipeline. Seed Global Health is working closely with The University of Zambia to support new faculty so that the program can continue long after Seed has completed its work. In 2023, permanent teaching faculty will be created for the program by the university, increasing the chance that the family medicine specialty program is sustained well into the future.
In addition to teaching, Seed Global Health places embedded educators, who serve as attending physicians and clinical mentors at Chilenje District Hospital. Chilenje Level 1 hospital serves a community of over 300,000 people but does not have any full time attending physicians on the adult or pediatric ward. Seed Global Health educators provide bedside clinical mentorship to family medicine students. In the last year, the partnership has also developed protocols and reference resources for faculty, students, and hospital staff to better manage common chronic conditions such as diabetes and heart disease.
Over the next five years, Seed Global Health plans to take its lessons learned and expand the partnership by increasing the number of graduates from the program, and by expanding the clinical teaching sites to all five Level 1 government hospitals in Lusaka. Seed Global Health will continue to work closely with the Ministry of Health on policy efforts nationally to ensure that the government’s broader plans for building a climate-resilient health workforce are met.