Project Management Strategies for Improving
Affordability and Accessibility in Zambia
FEATURED PAPER
By Lillian Muyunda
Graduate School of Business
University of Zambia
Lusaka, Zambia
Abstract
Telemedicine is an emerging solution for expanding healthcare access in Zambia, especially in remote and underserved areas. However, its adoption is hindered by challenges such as poor infrastructure, high costs, limited digital literacy, and fragmented regulatory frameworks. This narrative review explores how structured project management approaches such as Agile, Lean, Six Sigma, and Public-Private Partnerships, can enhance affordability and accessibility of telemedicine. Agile methodologies enable iterative serve improvement, Lean principles optimize resource use and reduce costs, and Six Sigma enhances service quality and standardisation. Additionally, PPPs foster investment in infrastructure and innovation, bridging gaps between public and private sector efforts.
The review highlights the need for coordinated, multi-stakeholder approach to overcome existing barriers and ensure telemedicine’s scalability. It also emphasizes that while Zambia has made progress in telehealth and telemedicine through government and donor-supported initiatives, its regulatory framework is derived from multiple national documents rather than a single, cohesive strategy. This fragmented approach, while providing guidance through instruments such as the Zambia Digital Health Strategy 2022-2026 and the Health Professions Council of Zambia’s telemedicine guidelines, presents challenges in coordination and implementation potentially limiting the overall impact of telemedicine services.
To achieve sustainable telemedicine expansion, Zambia must address socio-economic and digital literacy challenges, implement targeted training programs, and establish comprehensive legal frameworks. These strategies will facilitate the integration of telemedicine into national healthcare system, improving healthcare delivery and making it more accessible to all population groups.
Keywords: Telemedicine, affordability, accessibility, project management, Zambia
Introduction
Telemedicine, which involves utilizing digital communication and information technologies for remote healthcare access, has become an important aspect of contemporary healthcare delivery (Ezeamii et al., 2024; WHO, 2024). By enabling virtual consultations, remote diagnostics, and ongoing patient monitoring, telemedicine improves the efficiency and reach of medical services, especially for individuals in remote or underserved areas (The Virtual Doctors, 2024). Its rapid adoption has been propelled by global health emergencies such as the COVID-19, innovations in technology, and the growing need for affordable, easily accessible healthcare options.
Despite the availability of evidence that shows telemedicine’s potential to increase access to healthcare and improve health outcomes (Bashshur et al., 2014; Global Strategy on Digital Health 2020-2025, 2021; Kvedar et al., 2014; Scott Kruse et al., 2018), efforts to expand telemedicine continue to face considerable barriers regarding affordability and accessibility. In many low to middle-income countries, such as Zambia, infrastructural limitations like inconsistent power supply, inadequate internet access, and the high costs associated with virtual consultations impede broad adoption (Dodoo et al., 2022; Kala, 2023). These challenges are worsened by limited digital literacy and the inadequacy of regulatory frameworks (Kala, 2023; Nosike, 2024), which further restrict the effective implementation of telemedicine solutions. In Zambia for instance, literature shows that adoption of telemedicine is very low (Khondowe & Mwila, 2018) as its hindered by several interconnected issues. A primary barrier is the inadequate infrastructure, especially in rural regions, where unstable electricity and limited internet access prevent the implementation of telehealth services (Chabala, 2024; Chanda & Shaw, 2010; Mupela et al., 2010).
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How to cite this paper: Muyunda, L. (2025). Scaling Telemedicine for All: Project Management Strategies for Improving Affordability and Accessibility in Zambia; PM World Journal, Vol. XIV, Issue IV, April. Available online at http://pmworldlibrary.net/wp-content/uploads/2025/03/pmwj151-Apr2025-Muyunda-Scaling-Telemedicine-for-All.pdf
About the Author
Lillian Muyunda
Lusaka, Zambia
Lillian Muyunda is a Capacity Development professional with over 20 years of experience in the education, health and development sectors, specialising in organizational capacity strengthening, program design and management, project implementation, program quality and compliance monitoring, grant management, stakeholder engagement, and community health systems strengthening. She holds a Master’s in Development Studies from the University of Free State, South Africa, and a Bachelor of Arts in Education from the University of Zambia, where she also earned a Postgraduate Diploma in Counselling. Lillian is currently pursuing a PhD in Management and Business at the University of Zambia, focusing on telemedicine. She has held key roles in the public and NGO sectors, including management roles in International NGOs (INGOs) implementing projects in Zambia. Her interests include telemedicine, community health systems strengthening, organizational capacity strengthening, grant management, guidance, counselling and youth development. She can be contacted at lillianbyers@gmail.com
