Restructuring affects primary health care

The recent restructuring by Harare City Council has hit the primary health care service delivery after critical nursing staff were forced into early retirement, leaving many clinics understaffed.


Mufakose Polyclinic, a crucial health centre in dispensing anti-retroviral treatment (ART) to 3 400 people, is one of the institutions which was worst affected by the restructuring exercise.

The clinic, which is supposed to have a staff compliment of 25 nurses, is currently being manned by 18.

During a visit to the facility by Health Journalists’ Association of Zimbabwe members this week, the sister-in-charge, Kelvin Sithole, said the clinic, whose catchment area covers a population of 60 000 people, was facing serious challenges in serving patients.

1-women wait to be attended to at a makeshift clinic

“That area has caused us problems because the restructuring left us with open vacancies and we are burdened as we now have to do more work,” he said. Ads

According to one of the senior nurses, Definite Mupavaenda, the shortage of staff has also meant that patients on ART have to wait for longer hours before accessing treatment, with nearly 70 patients being served in six hours.

“We have one nurse at the opportunistic infections unit and that person will be doing consultations, testing and dispensing of drugs and this takes a long time and from 8am to 1pm we will have served 70 patients,” she said.

The clinic, which is one of the few health care centres that have benefited from the United States Presidential Emergency Plan for Aids Relief (Pepfar), has since June 2013 adopted electronic patient monitoring services for patients on ART, a programme put in place to improve quality of health care delivery in HIV and Aids.

National HIV quality improvement specialist with the Health ministry, Bekezela Khabo, said the ministry was now more focused on improving quality service in line with UNAids guidelines, which insist on a 90:90:90 ratio by 2020.

The ratio means 90% of people living with HIV should know their status, of that, at least 90% should be retained on ART, while 90% should be monitored to ensure drugs are achieving viral suppression in the patients.

Khabo said four nurses at the facility had been offered quality training in data collection, but the four had since been moved to other clinics following the restructuring exercise by Harare.

Sithole said the electronic system, since its implementation, had improved retention of ART patients and tracking them down within 24 hours of missing their treatment.

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