Transformative Education
for Health Professionals

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Zambian Associate Clinicians

David Lusale, Registrar, Chainama College of Health Sciences, Nadia Cobb MS, PA-C

In Zambia clinical officers provide essential primary care to all parts of the country especially in rural district health facilities and are about 2000 in service with about 300 graduates every year. The WHO Zambia health profile reports 0.7 physicians per 10,000 population.

Full project description: 

Zambia trains two types of Associate Clinicians/ Clinical Officers. The first, being the Associate Clinician. This professional is defined as a clinician with basic competencies to diagnose and manage common medical, maternal, child health and surgical conditions. They may perform minor surgeries and are generally trained for 3 to 4 years post secondary education in established educational institutions since 1936. The Clinical Officers are registered and the national regulatory authority regulates their practice.

The second cadrette trained in Zambia is the Medical Licentiate Practitioner. These are professional clinicians with advanced competencies to diagnose and manage most common medical, maternal, child health and surgical conditions, including obstetrics and gynaecology and surgery practice. Advanced associate clinicians are trained for 3 years post associate clinician initial training and or 4 years post secondary education for direct entrants in established educational institutions. Medical Licentiate Practitioners are registered and the country regulatory authority regulates their practice.

Zambia started training Medical Licentiate Practitioner in 1989 in Tanzania and later established her first programme in 2002 at Chainama College of Health Sciences , an affiliate of University of Zambia, School of Medicine.

There are currently two training institutions training medical licentiate practitioners at bachelors’ degree level with an output of 30 graduates annually.

The Zambian government’s recognition in the late 1980s that there were not enough doctors to meet the needs of the majority of their people who were living in rural areas began a process that led to the creation of the Medical Licentiate Practitioner cadre with about 200 produced since then.

Medical Licentiate Practitioners were established with the purpose of being deployed to the Level 1 Referral District Hospitals, to provide paediatric care, medical care, selected general surgery including Comprehensive Emergency Obstetric Care in areas that have very little access otherwise (90% in rural areas). Recent survey shows that Medical Licentiate Practitioners are distributed in all the 10 provinces of Zambia with more than 95% retention of more than 3 years at one hospital (Chainama College 2013). They provide medical services close to populations that need the service most and are a vital member of the health team and community


World Health Organization. WHO recommendations: optimizing health worker roles to improve access to key maternal and newborn health interventions through task shifting. Geneva, Switzerland:WHO;2012//Available at:].

WHO Zambia: Health



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