An audit of licenced Zambian diagnostic imaging equipment and personnel

INTRODUCTION: Estimates indicate that two-thirds of the world's population lack adequate access to basic medical imaging services integral to universal health coverage (UHC). Furthermore, sparse country-level radiological resource statistics exist and there is scant appreciation of how such data reflect healthcare access. The World Health Organisation posits that one X-ray and ultrasound unit for every 50,000 people will meet 90% of global imaging demands. This study aimed to conduct a comprehensive review of licensed Zambian radiological equipment and human resources. METHODS: An audit of licensed imaging resources, using the national updated Radiation Protection Authority and Health Professions Council of Zambia databases. Resources were quantified as units or personnel per million people, stratified by imaging modality, profession, province and healthcare sector, then compared with published Southern African data. RESULTS: Over half of all equipment (153/283 units, 54%) and almost two thirds of all radiation workers (556/913, 61%) are in two of ten provinces, serving one third of the population (5.49/16.4, 33.5%). Three-quarters of the national equipment inventory (212/283 units, 75%) and nearly ninety percent of registered radiation workers (800/913, 88%) are in the public sector, serving 96% of the population. Southern African country-level public-sector imaging resources principally reflect national per capita healthcare spending. CONCLUSION: To achieve equitable imaging access pivotal for UHC, Zambia will need a more homogeneous distribution of specialised radiological resources tailored to remedy disparities between healthcare sectors and provincial regions. Analyses of licenced radiology resources at country level can serve as a benchmark for medium-term radiological planning.