Post-health sector reform era: The expectations

guest column:Johannes Marisa

IT was during the beginning of September 2020 when the new Health minister, Vice-President Constantino Chiwenga announced that he would be carrying out reforms in the health sector.

That was a welcome move considering that the health sector had been riddled with incessant corruption, intermittent job boycotts or strikes, understaffing, demotivated staff and massive brain drain.

The restructuring is meant to come up with a new sustainable funding model, far greater effectiveness and new work ethics for staff.

The remuneration of health staff is critical in the restructuring process.

We remain optimistic that so many things are happening behind the scenes in a bid to salvage our health delivery system.

The aim of the restructuring exercise is to ensure that everyone has equitable access to healthcare services of sufficient quality.

Health delivery everywhere in the world involves the patients and service providers as major pillars while players such as government, insurers constitute other support structures.

Equity and equality are attained when the major players in the health sector are actively involved in national health issues.

Failure to recognise the critical staff in the health sector can surely result in the failure of health policies, programmes or reforms.

Both intrinsic and extrinsic motivation thus play significant roles in the achievement of organisational goals and objectives.

We are not sure of the duration of the reforms, whether they will be radical or incremental.

However, everyone expects the following possible positive results from the exercise considering the delicacy of the health system in our country:

lThe end of the protracted acrimony between medical aid societies and service providers.

The feud has gone unabated for long with some of the medical insurance companies showing high levels of arrogance by openly refusing to pay service
providers.

We have examples of one big medical aid society that was in the newspapers for wrong reasons when its chief executive officer was taking home about US$500 000 a month while service providers were languishing in abject poverty.

Some of the medical aid societies act as bullies who dictate what they want.

They have to be reminded that health delivery mainly involve patients and service providers.

It is high time the Medical Aid Bill is passed into law. The Bill has been sitting at Kaguvi Building for years now.

lThe end of the war between government and its employees. The reforms should bring motivation and stimulus that will take the medical industry forward.

Our country has witnessed perennial strikes mainly attributed to poor working conditions. We now expect the introduction of car and housing loans for medical staff that include doctors, nurses, pharmacists, physiotherapists and many more.

Doctors and nurses have lately survived from hand to mouth earning meagre salaries that are not enough to buy 200 litres of petrol. It will be very good to have a robust health delivery system that has dedicated staff all the time.

In other countries, medical staff volunteer to return to work during emergencies like outbreaks. This has not been happening in our country because of bad blood between the employer and the employees.

lThe affordability of health services. Many people have lost their lives merely because of failure to access medical care. Hypertensive patients, diabetics, asthmatics have been victims of high costs of medical care resulting in serious complications especially in the rural areas. We expect affordable primary healthcare as outlined in the Alma Ata Declaration of 1978.

lThe arrest of corruption in the health sector. This scourge has proved to be the biggest pandemic in our country diversion of drugs, abuse of power, resulting in abuse of tender procedures and general disregard of corporate governance.

So many hospitals cannot manage to stock enough drugs because of corruption. Infrastructure has not been maintained well because of shady deals at central, provincial or district hospital levels.

We expect the minister to investigate the rampant abuse of government resources at many provincial medical directorates in Zimbabwe.

Fuel has often being diverted to personal use at the expense of service vehicles or generators. The reforms should bring sanity to the decaying health sector.

Same people have been in office for a long time and no new ideas have been introduced, leaving the health sector almost on its knees.

lThe development of new health infrastructure.

There are high expectations that since the establishment of Harare Central Hospital (now Sally Mugabe Central Hospital) (1958), Parirenyatwa (1974) and Chitungwiza (1984 as a provincial hospital), more hospitals needed to be constructed in order to cater for the increasing population.

With the envisaged addition of a new top layer in the national health delivery system which is a high level research and development hospital, more highly qualified staff is required to run such an institution.

More infrastructure is thus required with state-of-the-art equipment that will benefit the entire nation.

For our nation to progress, healthcare service provision should be at the forefront of government agenda since it has a symbiotic relationship with development

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