Website SolidarMed Zambia LTD
Introduction
SolidarMed is an international development organisation, registered as a non-profit in Switzerland to find long term sustainable solutions to systemic and contextual development challenges in the health sector. Our health programmes are developed in close cooperation with the communities and local health authorities across seven African countries in which we work.
Zambia’s country program works directly with the Zambian government to support the public health system through strategic investments in human resources for health. SolidarMed’s strong mandate to cooperate with the government on nurse education is captured in its memorandum of understanding with the Ministry of Health. SolidarMed Zambia is pursuing collaboration with local government and non-governmental partners and stakeholders. The Scaling up the Decentralised Education for Nurses and Midwives Program supports the Nursing and Midwifery Council of Zambia (NMCZ) and ten provincial colleges. Each college is targeted to become the lead college in scaling up the model nationwide.
Policy
Zambia’s health policy landscape reflects a concerted effort to decentralize healthcare delivery, enhance human resources for health (HRH), and develop a skilled workforce aligned with the nation’s health goals. The 2022–2026 National Health Strategic Plan (NHSP) emphasizes decentralization as a pivotal strategy to bring healthcare services closer to communities, thereby improving accessibility and responsiveness.
In tandem with decentralization, the National Health Strategic Plan (NHSP) outlines objectives to strengthen the HRH workforce, aiming to increase the health workforce from 48% of the establishment in 2021 to 70% by 2026. By 2024 the MOH establishment of 151,394, out of which 82,059 positions were filled (54%) (Annual Economic Report, 2024). This includes enhancing performance, expanding specialized training, and ensuring equitable distribution of health professionals across the country. The Human Resources for Health Planning & Development Strategy Framework further supports these goals by addressing challenges such as leadership and governance, institutional capacity, and the need for effective HRH strategies to meet the growing demand for healthcare services.
Moreover, the 2022–2026 Digital Health Strategy underscores the importance of integrating digital technologies into healthcare delivery. By leveraging digital tools, Zambia aims to enhance the efficiency and quality of health services, which is crucial for supporting decentralized training models and ensuring that healthcare workers are well-equipped to meet the needs of the population.
Collectively, these policies and strategies form a cohesive framework aimed at transforming Zambia’s healthcare system. By decentralizing service delivery, strengthening the HRH workforce, and integrating digital innovations, the country is working towards a more resilient and responsive health system that can effectively address the needs of its diverse communities.
Background
Zambia’s healthcare system faces a critical shortage of skilled health professionals, particularly in rural areas. According to the World Health Organization’s State of the World’s Nursing 2020-2025 report, the recommended nurse-to-population ratio for achieving Universal Health Coverage (UHC) is 83 nurses per 10,000 people. However, Sub-Saharan Africa, including Zambia, has fewer than 20 nurses per 10,000 people, highlighting a significant gap in nursing workforce density.
In Zambia, the nurse-to-population ratio is 13 per 10,000 people. This shortage is exacerbated by the maldistribution of healthcare workers, with 90% of trained healthcare workers located in urban areas, while 55% of the population resides in rural regions (NHSP,2017).
To address these challenges, Zambia has implemented a decentralized nurse and midwife training model, partnering large hospitals with rural healthcare facilities to provide education and practical training. This model aims to increase the number of trained professionals in underserved areas and improve healthcare delivery.
The State of the World’s Nursing 2020 report emphasizes the need for investment in nursing education, jobs, and leadership to strengthen the nursing workforce and achieve UHC. In line with this, Zambia’s decentralized training model incorporates elements such as blended learning, clinical training, infrastructure, systems strengthening and mentorship to enhance the quality of nursing education and practice.
However, scaling this model to meet the growing demand for healthcare professionals requires careful evaluation of various factors, including system capacity, resource availability, governance structures, stakeholder engagement and accountability. Understanding these elements will provide insights into whether the decentralized training model can be scaled up to accommodate more colleges implementing the training model and increase student enrolments without compromising the quality of education and healthcare delivery.
By systematically addressing these considerations, stakeholders can make informed decisions about the feasibility of scaling the decentralized nurse and midwife training model in resource-constrained environments, aligning with the recommendations of the State of the World’s Nursing 2020 report.
Objectives of the Evaluation
1. To evaluate the concept of the decentralized training model in Zambia with a focus on (i) its effectiveness including quality of training and service delivery; (ii) the feasibility and success criteria for scaling up the model; (iii) the implications on student enrolment considering current regulation systems.
2. To assess the quality of SUDEN phase III nursing and midwifery graduates between 2022-2024 and the NMCZ national cohort by comparing their academic performance, clinical competency, and practical skill levels, to inform program improvements and strengthen health workforce readiness.
3. To trace, analyse and compare the career trajectories of nurse graduates from St. Luke’s, Chilonga, and St. Paul’s Colleges (2020–2025 cohorts) with non-SUDEN institutions, with a focus on employment outcomes, geographic deployment, and professional development.
Scope of Work
1. To evaluate the concept of the decentralized training model in Zambia with a focus on (i) its effectiveness including quality of training and service delivery; (ii) the feasibility and success criteria for scaling up the model; (iii) the implications on student enrolment considering current regulation systems.
· Assess the conceptual soundness and scalability of the decentralized training model, including contextual adaptability, cost-effectiveness, and alignment with national health and education priorities.
· Review key performance indicators, baselines, and targets, using a desk review of published literature and secondary data, to understand the model’s progress and evidence base.
· Analyze infrastructure and resource capacity in current and potential future implementation sites to assess readiness for scale-up (desk review and secondary data).
· Evaluate the quality and consistency of clinical training and mentorship systems, including supervisory structures, student-to-mentor ratios, and learning outcomes (desk review and qualitative inquiry).
· Assess the financial sustainability of the intervention, including cost-per-student metrics, funding models, and resource allocation mechanisms.
· Examine stakeholder engagement and local ownership, including community support, institutional partnerships, and intersectoral collaboration (qualitative methods).
· Identify enabling and limiting factors for successful scaling, drawing on lessons learned, comparative models, and stakeholder perspectives.
2. To assess the quality of SUDEN phase III nursing and midwifery graduates between 2022-2024 and the NMCZ national cohort by comparing their academic performance, clinical competency, and practical skill levels, to inform program improvements and strengthen health workforce readiness.
· Clinical competency assessments (qualitative and quantitative)
· Practical skill assessment (qualitative)
· Student data integration and analysis (quantitative)
· Continuous quality improvement (secondary data- supportive supervision)
3. To trace, analyse and compare the career trajectories of nurse graduates from St. Luke’s, Chilonga, and St. Paul’s Colleges (2020–2025 cohorts) with non-SUDEN institutions, with a focus on employment outcomes, geographic deployment, and professional development.
· Human resource recruitment context analysis (e.g. involving national HRH needs, national number of paid health professionals, number of jobs on the market over time etc.
· Employment status and sector analysis: Graduate Tracer Survey (quantitative)
· Deployment mapping urban – rural (spatial analysis)
· Career progression and continuing education: Key informant interviews with SUDEN graduates and non-SUDEN cohorts (qualitative)
Deliverables
Objective 1: To evaluate the concept of the decentralized training model in Zambia.
Deliverables:
Evaluation report (including PowerPoint with summary of results, infographics, posters): A summary report assessing the feasibility and effectiveness of scaling up the decentralized training model.
Recommendations: Actionable recommendations for improving scalability and effectiveness.
Presentation: A presentation summarizing key findings and recommendations.
Objective 2: Assess the quality of SUDEN nursing and midwifery graduates
Deliverables:
Assessment report: A detailed report analysing academic performance, clinical competency, and practical skills of SUDEN graduates.
Data analysis: Integrated analysis of SUDEN and NMCZ student data to inform program improvements.
Quality improvement plan: A plan outlining strategy for continuous quality improvement based on assessment findings.
Objective 3: Trace and analyse career trajectories of nurse graduates (2020–2025 cohorts)
Deliverables:
Tracer study report: A report detailing employment outcomes of SUDEN graduates with defined representative sample size, geographic deployment, and professional development.
Spatial analysis map: A map illustrating the geographic distribution of SUDEN graduates.
Key informant interviews summary: A summary of insights from key informant interviews regarding career progression.
Timeline
Inception & Planning 1-2 Weeks – Inception Report (PPP)
Data Collection 3-9 Weeks – Raw Data + Emerging Findings Presentation (PPP)
Analysis & Drafting 10-14 Weeks – Draft Reports + Presentation Slides (PPP)
Finalization & Dissemination 15-16 Weeks – Final Reports, Executive Summary, Stakeholder Presentations (PPP)
Management and Oversight
The consultant will report to the SUDEN Program Manager and will receive technical support from:
– Ministry of Health (MoH)- Technical
– Nursing and Midwifery Council of Zambia (NMCZ)- Technical
– SolidarMed / SUDEN- Technical and Logistical (DSA and travel)
These partners will assist with access to stakeholders, data, and relevant institutions
Payment Schedule
The budget will be finalized in the contract. Payment will be disbursed in three tranches upon submission and approval of deliverables:
20% upon acceptance of the Inception Report
30% upon submission of the Draft Evaluation Report
50% upon approval of the Final Report and Policy Brief
Consultant Qualifications
The consultant (or team) should possess the following qualifications:
· A Master’s or PhD in Public Health, Nursing, Nursing/Midwifery Education, or a related field
· At least 10 years of experience in program evaluation, curriculum development, nursing education, or public health workforce development
· Proven analytical, research, and report-writing skills. Record of scientific publications preferred
· Strong communication and facilitation skills, especially with diverse stakeholders
Conclusion
This evaluation will serve as a foundation for evidence-based decision-making on the future of Scaling up the Decentralized Education for Nurses and Midwives. By identifying key strengths, challenges, and opportunities, the assignment will contribute to shaping a more effective, high-quality, and sustainable approach to nurse midwifery training and practice and ultimately workforce development in Zambia.
Work Location
During the period of engagement, the consultant will be flexible in virtual as well as in person facilitation and collaboration as needed and in discussion with SolidarMed’s Program Manager, based in Lusaka.
Submission of application
Proposals, CV’s, Methodology: Sample size (with calculation/explanation), planned statistical analysis and programmes to be used for data management, interview tool development including evidence of delivery on similar projects should be delivered no later than the 30th of July by 17.00 hours (CAT/Zambian time).
Interested consultants who require any clarifications may contact: zambia@solidarmed.ch
Eligible consultants/firms should submit their CVs with a cover letter detailing the methodology and a daily rate (inclusive of tax, per diems, travel and other incidental costs) electronically to zambia@solidarmed.ch
To apply for this job email your details to zambia@solidarmed.ch