Zambia Emergency Health Service Delivery Project

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The Zambia Emergency Health Service Delivery Project provides emergency support for meeting the crisis in the delivery of core public health services caused by the debt crisis and the COVID-19 pandemic. As part of the World Bank’s support to the Government of Zambia to maintain critical social sector spending that has been impacted by the COVID-19 pandemic, the project will help ensure the continued delivery of frontline health services in the provinces and districts of Zambia, which otherwise face the serious prospect of being disrupted. The project is envisaged as a “bridge” that will enable the Government of Zambia to cross over the current crisis and onto the road to long term recovery and sustainable health service delivery.The operation will support Zambia’s fiscal adjustment and debt restructuring programs to restore macroeconomic stability and debt sustainability while protecting social spending. Zambia applied for debt treatment under the G-20 Common Framework in January 2021. Correspondingly, the new government has committed to a fiscal consolidation program that will see the fiscal deficit decline from a projected 16.5 percent of GDP in 2021 to around 5.0 percent of GDP by 2024, whilst protecting social spending. This operation is embedded in this medium-term fiscal framework. Specifically, the medium-term fiscal framework envisages that health expenditure will increase by 0.7 percent of GDP between 2021 and 2024, to meet both the near-term requirements for responding to the COVID-19 pandemic as well to address longer-term needs for strengthening the health sector. The operation will thus provide the necessary liquidity to ensure timely funding of health expenditures such that health service delivery is not disrupted as the government undergoes a fiscal adjustment amidst the COVID-19 pandemic. The medium-term sustainability of this spending is ensured through the fiscal program that will accompany the debt restructuring under the CF, complimented by budget monitoring through the planned IMF program and World Bank’s development policy operation.The project is part of the World Bank’s broader support to Zambia’s response to the COVID-19 and debt crises. As such, it is also complementary to and coherent with other World Bank financed operations both past and present. The project is part of a set of interlocking interventions supported by the World Bank to enable the government of Zambia to address the shocks resulting from the COVID-19 pandemic and the debt crisis.