Zambia
Zambia addresses Alzheimer’s disease in a highly resource-constrained environment, where the absence of a national dementia strategy is compounded by a severe shortage of specialists. To overcome these systemic bottlenecks, initiatives like the Z-CHAD project are pioneering task-sharing models that train community healthcare workers to administer culturally adapted cognitive screenings directly within rural areas. This community-driven approach is further helped by the country’s leading non-governmental organisation (NGO), Alzheimer’s Disease and Related Dementias in Zambia (ADDIZ). The organisation not only advocates for necessary policy reform but plays a vital role in providing caregiver support and combating entrenched cultural stigmas that frequently misinterpret neurological symptoms as spiritual phenomena.
AD Rating
Diagnostic Pathway
Specialized Care
Caregiver Support
National Policies
Access to ATT-s
Highlights
Population
Median age
Health expenditure (% of GDP)
Diagnosis
Diagnosis
Show moreDementia diagnosis in Zambia remains largely clinical because specialist shortages, limited imaging capacity, and the absence of a standardised national pathway restrict comprehensive assessment. Culturally contextualised tools, including IDEA, the Community Screening Instrument for Dementia, and 10/66 screening, support cognitive evaluation. Neurology appointments may involve waits of around 58 days. NHIMA covers specialist consultations, CT, and MRI for registered members, but imaging remains geographically concentrated. PET is unavailable, while routine Alzheimer’s genetic, CSF, and blood biomarker testing has not been identified, substantially limiting advanced diagnostic confirmation.
Diagnosis pathway
Dementia diagnosis in Zambia is hindered by the absence of a standardised national pathway, limited specialist capacity, and restricted access to advanced diagnostics. Symptoms are often attributed to normal ageing, contributing to delayed assessment and potential misdiagnosis. Clinical history and culturally contextualised tools, including the 10/66 protocol and Community Screening Instrument for Dementia, form the basis of assessment. MRI and biomarker testing remain largely inaccessible because of cost, equipment, and workforce constraints. Training community healthcare workers offers a developing pathway towards earlier recognition and preliminary cognitive screening.
No publicly available national clinical guideline or standardised diagnostic pathway for Alzheimer’s disease was identified for Zambia. The diagnosis pathway for Alzheimer’s disease in Zambia is deeply impacted by resource limitations and a critical shortage of specialized medical personnel. Early symptoms of cognitive decline are frequently dismissed as a normal part of aging, which means people typically do not seek medical care until the condition is severe, leading to frequent misdiagnoses. When individuals do attempt to navigate the healthcare system, obtaining a formal diagnosis is exceptionally challenging due to the scarcity of specialists. With only 12 practicing neurologists for a population of approximately 20 million people, the bottleneck for specialised care is immense. To address this gap in primary and specialized care, emerging initiatives are focusing on training community healthcare workers to recognize early symptoms and administer preliminary cognitive screenings directly at the community level.
Clinicians and researchers utilise culturally contextualised instruments, such as the Community Screening Instrument for Dementia and the 10/66 dementia screening protocol. These specific tools are deployed to ensure that cognitive impairment can be accurately assessed across varying levels of formal education and linguistic backgrounds.
Following clinical and cognitive evaluations, the ability to utilise neuroimaging to support an Alzheimer’s disease diagnosis is highly constrained. Although structural imaging like magnetic resonance imaging (MRI) is theoretically useful to rule out alternative neurological conditions, its practical application is severely limited by a lack of equipment, specialised radiologists, and high out-of-pocket financial costs for patients. Because advanced diagnostics and routine biomarker testing are largely unavailable in routine care, healthcare providers must rely almost exclusively on clinical history and adapted cognitive assessments to diagnose Alzheimer’s disease in Zambia.
- https://www.gbhi.org/news-publications/when-there-no-plan-filling-gap-dementia-advocacy-zambia
- https://www.gbhi.org/projects/establishing-peer-led-dementia-care-support-network-lusaka-zambia
- https://medresearch.umich.edu/labs-departments/centers/mneuronet/research/zambia
- https://alz-journals.onlinelibrary.wiley.com/doi/abs/10.1002/alz.092555
Wait times
Neurology patients at Lusaka’s University Teaching Hospital waited approximately 58 days for appointments, reflecting Zambia’s severe shortage of specialist neurological providers.
A prospective study assessing outpatient neurological care at the University Teaching Hospital in Lusaka, Zambia, tracked patient wait times and clinical flow. The researchers documented that patients waited an average of around 58 days just to be seen by a neurologist after making an appointment. This prolonged delay is directly attributed to a profound paucity of providers.
Diagnosis cost
Zambia’s mandatory national health insurance scheme covers GP and specialist consultations, CT scans, and MRI scans for registered members at accredited healthcare facilities.
The National Health Insurance Management Authority (NHIMA), operational since 2019, provides a mandatory health insurance scheme that covers a comprehensive package of services. For registered members seeking a diagnosis for Alzheimer’s disease, the scheme officially covers general practitioner (GP) and specialist consultations, as well as essential diagnostic tools like CT and MRI scans, at accredited public and private facilities.
Cognitive tests
The Identification and Intervention for Dementia in Elderly Africans (IDEA) cognitive screen has been utilised and evaluated for older hospitalised adults in rural Zambia to detect major cognitive impairment, including dementia and delirium. There is no evidence of Zambia-specific validation studies for commonly used cognitive screening tools such as the Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA).
Imaging tests
Computed tomography (CT) and magnetic resonance imaging (MRI) are available in Zambia but access is limited and geographically skewed. A 2020 national audit of licensed diagnostic imaging equipment revealed that while the public sector manages three-quarters of the country’s equipment inventory to serve the vast majority of the country, these resources are heavily concentrated in specific areas. Over half of all imaging equipment and nearly two-thirds of radiation personnel are located in just two of the ten provinces. Consequently, advanced diagnostic tools are directly accessible to only about one-third of the population, leaving significant gaps in coverage across the rest of the nation. There was only one public-sector MRI scanner, located in Lusaka, resulting in even more restricted access. The audit also reported no PET scanners in Zambia, indicating that PET imaging is not available for the routine diagnosis of Alzheimer’s disease. Private-sector CT and MRI services are available but are concentrated mainly in Lusaka and Copperbelt provinces.
Genetic tests
There is no evidence that genetic testing for Alzheimer’s disease is routinely available in Zambia.
Biomarker tests
There is no evidence that cerebrospinal fluid (CSF) biomarkers (Aβ42, total tau or phosphorylated tau) or blood biomarkers for Alzheimer’s disease are routinely available in Zambia.
Cognitive Tests
Cognitive Tests
The Identification and Intervention for Dementia in Elderly Africans (IDEA) cognitive screen has been utilised and evaluated for older hospitalised adults in rural Zambia to detect major cognitive impairment, including dementia and delirium. There is no evidence of Zambia-specific validation studies for commonly used cognitive screening tools such as the Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA).
Imaging Tests
Imaging Tests
Computed tomography (CT) and magnetic resonance imaging (MRI) are available in Zambia but access is limited and geographically skewed. A 2020 national audit of licensed diagnostic imaging equipment revealed that while the public sector manages three-quarters of the country’s equipment inventory to serve the vast majority of the country, these resources are heavily concentrated in specific areas. Over half of all imaging equipment and nearly two-thirds of radiation personnel are located in just two of the ten provinces. Consequently, advanced diagnostic tools are directly accessible to only about one-third of the population, leaving significant gaps in coverage across the rest of the nation. There was only one public-sector MRI scanner, located in Lusaka, resulting in even more restricted access. The audit also reported no PET scanners in Zambia, indicating that PET imaging is not available for the routine diagnosis of Alzheimer’s disease. Private-sector CT and MRI services are available but are concentrated mainly in Lusaka and Copperbelt provinces.
Genetic Tests
Genetic Tests
There is no evidence that genetic testing for Alzheimer’s disease is routinely available in Zambia.
Biomarker Tests
Biomarker Tests
There is no evidence that cerebrospinal fluid (CSF) biomarkers (Aβ42, total tau or phosphorylated tau) or blood biomarkers for Alzheimer’s disease are routinely available in Zambia.
Treatment & Care
Treatment & care
Show moreZambia has minimal specialised dementia infrastructure, with services concentrated in urban psychiatric and neurological departments and limited palliative care outside tertiary facilities. NHIMA covers eligible treatment through accredited providers, although dementia medicines have no dedicated reimbursement scheme, and uninsured patients may face personal costs. Government financial assistance specifically for caregivers is unavailable despite substantial unmet needs. ADDIZ provides important non-financial support through counselling, dementia education, caregiver training, meetings, webinars, and support groups, partially addressing gaps in formal services.
Specialized facilities and services
Dedicated dementia services, including memory clinics, day centres, and home-care programmes, are largely unavailable in Zambia. Specialist care is concentrated in urban hospitals, while limited palliative services primarily address cancer and HIV/AIDS through tertiary facilities and hospices, with minimal rural accessibility.
In Zambia, there is no evidence of specialised infrastructure such as memory clinics, dedicated adult day centres, and formal home care programs tailored for individuals living with Alzheimer’s disease. Services are virtually non-existent on a national scale, and any specialised diagnosis or treatment is generally confined to general psychiatric or neurological departments in major hospitals within the capital, Lusaka, and a few other large urban centers.
Palliative care in Zambia is available but highly constrained and primarily concentrated in tertiary hospitals and a few faith-based hospices, such as Our Lady’s Hospice in Lusaka. These services are disproportionately geared toward oncology and HIV/AIDS and remain largely unavailable at the primary healthcare level or in rural areas.
Approved medication
| Generic Name | Trade Name | Used for |
|---|---|---|
| Donepezil | Aricept, Aricept ODT, Adlarity, Eranz, Memac, Alzepil, Davia, Donecept, Donep, Donepex, Donesyn, Dopezil, Yasnal, Memorit, Pezale, Redumas, Zolpezil, Namzaric* | Donepezil is indicated for the symptomatic treatment of mild to moderately severe Alzheimer’s dementia. |
| Memantine | Namenda, Namenda XR, Ebixa, Memary, Axura, Akatinol, Maruxa, Nemdatine, Namzaric* | Treatment of adult patients with moderate to severe Alzheimer’s disease. |
*Namzaric = combination of Donepezil and Memantine
Treatment cost
For insured patients, NHIMA covers Alzheimer’s treatment through accredited healthcare providers, while uninsured individuals rely on public facilities or pay privately. Dementia medicines have no disease-specific reimbursement scheme, with prescription coverage instead depending on national essential medicines and the general NHIMA benefits package.
In Zambia, the cost of treatment for Alzheimer’s disease is primarily covered through the National Health Insurance Scheme (NHIS), administered by the National Health Insurance Management Authority (NHIMA), for individuals enrolled in the scheme. NHIMA finances healthcare services delivered through accredited public and private providers, while uninsured patients generally rely on publicly funded health facilities or pay out of pocket for services received outside the public system., Medicines for Alzheimer’s disease are not reimbursed through a disease-specific program. Instead, NHIMA covers prescription medicines that are included in the National Essential Medicines List and prescribed in accordance with the NHIMA benefit package.
Caregiver support
Dementia caregivers in Zambia receive no dedicated government financial assistance, despite significant unmet care needs. Support is primarily provided by ADDIZ through counselling, education, training, caregiver meetings, webinars, and support groups.
Zambia does not have government financial support specifically for care partners of people living with Alzheimer’s disease. Research conducted in Lusaka found that people living with dementia and their informal carers have substantial unmet care needs, including limited access to healthcare services, caregiver education, and community support.
Some support, although not financial, is available primarily through the Alzheimer’s Disease and Related Dementias in Zambia (ADDIZ), a non-governmental organisation (NGO) and member of Alzheimer’s Disease International (ADI). ADDIZ provides caregiver meetings, counselling, dementia care training, educational resources, support groups, webinars, and training for carers.
Policy
Policy
Show moreZambia lacks both a national dementia strategy and publicly announced plans to develop one, with Alzheimer’s addressed mainly through the Mental Health Act 2019. Although this provides broader protections concerning rights, consent, capacity, and discrimination, dementia-specific provisions and specialist services remain limited. Cultural beliefs associating symptoms with witchcraft or spiritual causes can contribute to stigma, concealment, exclusion, and delayed care. Strong expectations of family caregiving further place considerable emotional and financial burdens on informal carers.
National dementia plan
Zambia does not have a standalone national Alzheimer’s disease or dementia strategy.
Upcoming plans
There is also no publicly announced national dementia strategy currently in development.
Policy gaps
Legal barriers
Dementia policy in Zambia operates without a dedicated national strategy or specific legislation. The Mental Health Act 2019 provides broader protections concerning consent, capacity, discrimination, community care, and awareness, but does not address many dementia-specific legal and social needs. Limited specialist services further leave care reliant on general healthcare and families.
Zambia does not currently have a national dementia or Alzheimer’s disease strategy, and there are no dementia-specific legal provisions addressing issues such as diagnosis, long-term care, supported decision-making, driving, or advance care planning. Instead, people living with Alzheimer’s disease are covered by the broader Mental Health Act (2019), which represents a substantial improvement over the previous legislation by explicitly protecting the rights of people living with mental illness or cognitive impairment. The Act prohibits discrimination and degrading treatment, requires informed consent where possible, establishes the National Mental Health Council, and specifically mandates policies to reduce stigma and improve public awareness of mental health. However, because the legislation is designed for mental health broadly rather than dementia specifically, it provides limited guidance on the unique legal and social needs of people with Alzheimer’s disease, leaving many aspects of dementia care dependent on general health services and family support. For example, although the Act recognises informed consent, mental capacity, community-based care, and protection from discrimination, Zambia has relatively limited specialist dementia services, memory clinics, and trained geriatric professionals.
Cultural barriers
Traditional interpretations of dementia symptoms as witchcraft, possession, or curses contribute to stigma, social exclusion, potential violence, and delayed care in Zambia. Families may conceal affected relatives, while cultural expectations surrounding filial responsibility discourage external assistance. Consequently, informal caregivers, particularly younger women, often bear substantial emotional, physical, and financial pressures.
Socio-cultural stigma in Zambia heavily isolates people living with Alzheimer’s disease, largely driven by widespread, entrenched traditional beliefs that misinterpret neurological symptoms as spiritual phenomena. Due to a profound lack of public awareness, advanced behavioral symptoms of Alzheimer’s disease may be attributed to witchcraft, demonic possession, or ancestral curses. This superstitious framing exposes vulnerable elderly citizens to severe social exclusion, societal hostility, and threatened or actual physical violence. To escape communal shaming, reputational ruination, or the dangerous accusation of being a witch, families routinely hide affected individuals away from public view, a dynamic that actively prevents timely healthcare-seeking behaviors. Additionally, deeply rooted cultural norms demand that families absorb the physical and economic weight of caring for the elderly, viewing external support as a failure of filial duty. Because seeking professional psychological or institutional intervention is highly stigmatised as a shameful abandonment of parents, informal carers — who are predominantly younger women — go through emotional and financial challenges in silence.
Research
Research
Show moreZambia’s emerging dementia research ecosystem combines academic and teaching hospitals, ZAMRA clinical-trial oversight, PACTR registration, and Z-CHAD research into prevalence, risk factors, community screening, and referrals.
Selected academic institutions
Clinical trials and registries
The Zambia Medicines Regulatory Authority (ZAMRA) is the statutory body responsible for approving and overseeing all clinical trials, ensuring they adhere to national legislation and international ethical standards. Pan African Clinical Trials Registry (PACTR) is the primary World Health Organization (WHO)-recognised registry for the continent, and it serves as the best database to search for any interventional or observational studies taking place in Zambia.
Selected innovative methods
Z-CHAD investigates dementia prevalence and risk factors while training community health workers in screening and referrals, offering a task-sharing model for resource-limited settings.
The Z-CHAD project is the first large-scale study designed to estimate the prevalence of dementia and identify its risk factors in Zambia. Through the Z-CHAD study, community health workers receive specialised training to administer validated dementia screening tools, collect information on risk factors, and refer suspected cases for further evaluation. This task-sharing approach expands access to dementia care in areas with few neurologists and could serve as a model for other low-resource countries.
Support
Support
Show moreZambia lacks dedicated domestic dementia foundations and specialised media outlets. ADDIZ therefore leads national advocacy, education, awareness, and community engagement, using social media and events, while its EU-funded LEADS initiative promotes stakeholder coordination, research, caregiver support, professional training, and outreach.
Selected national associations, patient family associations, NGOs:
Selected initiatives
ADDIZ’s EU-funded LEADS initiative brings together healthcare, academic, civil society, and policy stakeholders to identify dementia care gaps and strengthen coordination across research, advocacy, professional training, caregiver support, and community outreach.
LEADS Initiative
Dedicated media outlets
There are no dedicated media outlets or news portals in Zambia that focus exclusively on Alzheimer’s disease. Instead, news, advocacy updates, and educational resources are primarily driven by the national association, Alzheimer’s Disease and Related Dementias in Zambia (ADDIZ). ADDIZ relies on its Facebook page and community events—such as local symposia and Dementia Awareness Days—to share updates and combat the local stigma often associated with the disease.
