Use of mobile hospitals to improve access to health services and promote primary health care: lessons from Zambia (2011-2018).

Background: Mobile hospitals play a critical role in serving difficult to access populations. In 2011, they were introduced by the Zambian government to improve access to health care. However, little is known about and/or documented about their use in Zambia, and other similar settings where people rely on them to access critical health care, or have to travel long distances to the nearest health centre. Objective: To understand the use of mobile hospitals in Zambia and share lessons on their implementation that may be useful for similar settings. It describes their design, implementation, and challenges. Methods: The qualitative research employed document review, key informant interviews with 15 respondents, and observation of the operations of the mobile hospitals in the field. Results: The research finds that while they help to reduce inequities associated with accessing health services, there needs to be careful resource planning and addressing of the major issues in health care such as human resources, infrastructure, and disease prevention before long term use. Conclusion: The research not only highlights conditions that must be considered for the effective implementation of mobile hospitals, but also the need for engagement of various key stakeholders during agenda setting in order to build trust and buy in, which contribute to smoother implementation.