The health sector, especially the public system, has been bedevilled by a lot of issues that have continuously affected health service delivery.
Leadership has been pinpointed as one of the six building blocks of a sound health system among financing, medicines, health workforce, health information systems and service delivery.
The health workforce has always complained about poor remuneration, lack of motivation, poor working conditions. The country continues to lose many of its skilled workforce to foreign countries that attract them with lucrative benefits.
It is sad that many African countries are suffering in terms of medical services because of incessant worker migration, a problem which can be sorted easily if we join hands as a nation. If everyone knows that health workers provide essential service, why then do we allow them to slip out of the country for the so-called greener pastures?
Our health delivery service falls under public or private care with the latter being accessed by those who can afford. Many of our citizens cannot afford private healthcare, which is unfortunate considering the poor health service offered by the public health system. Many people have often questioned why private health service is expensive in our country.
The reasons are many. It is very expensive to establish a private health centre. A majority of practitioners use their own resources, while those who sought loans will regret for the rest of their lives because of prohibitive interest rates.
Many private practitioners ended up closing shop because of skyrocketing overhead costs. It is quite surprising that there are very few organisations that want to fund the health sector but all those organisations realise the importance of the health institutions when they face a medical calamity. COVID-19 has shown the whole world how important medical facilities are hence the need to invest in this delicate field. Medical Aid Societies have often trampled upon medical practitioners, arrogantly refusing to honour claims.
The public health sector has been chastised for poor service with the people saying so much time is wasted while waiting. It is, therefore, imperative that queuing and waiting time analysis be undertaken if a robust evaluation of service delivery is to be undertaken. Capacity problems are very common in the public health system and these usually emanate from simple leadership incompetence, corruption, maladministration, poor funding or misplaced priorities.
It is sad that the country continues to lose lives because of mere incompetence and on February 27, 2021, the Newsday reported that a whole X-ray unit at Sadza District Hospital was idle for five years merely because there was no technician to fix it. The entire community had to suffer for such a long time because a technician could not come for five years to fix the X-ray machine. Action should be taken against those responsible. There are so many ills that affect the public health delivery service and the following are some of them:
- Bureaucracy has affected many operations in the public sector with office bearers sitting on important decisions. There are many decisions that have been abandoned because the last signature could not be appended, to the detriment of the entire community.
- Favouritism is still rampant in many public health institutions with office bearers favouring their friends and relatives even in job-related issues. Some hospital matrons or sisters-in-charge are still going to workshops that need clinically-practising nurses. All that is done mainly because there are allowances to be received by attendees. How then can the nurses be professionally grown when such things are allowed to happen? The young nurses are sent to workshops that have no post-course allowances. Complaints are often raised but because of leadership incompetence, nothing is done.
- Corruption is rampant in public health institutions and there are so many office bearers who have personalised some institutions. In 2013, the National Economic Conduct Inspectorate released a report on irregularities in the procurement of hospital requirements at Parirenyatwa and Mutare hospitals. Massive corruption was unearthed. How many lives were lost because the hospitals could not provide the necessary services? Recently, a former Parirenyatwa Hospital pharmacy sores controller, Russell Tatenda Mwenye, had his Ruwa house forfeited to the State after it was established that he had acquired it from the proceeds of sleaze.
- Lack of requisite qualifications is hampering good administration. Some officer bearers do not hold any management qualifications yet they are involved in management duties on a daily basis. Courses in financial management, leadership, human resources, change management et cetera are important for robust health delivery. Get the right people in positions of power. All of us should join hands for the benefit of the nation. Ills in medical practice should be eliminated if we are to have a sound health delivery system.