BY Johannes Marisa
HEALTH and development are symbiotic in nature and poor health is deleterious to sound national development.
Universal health coverage is desired and the outcome is better attainment of health deliverables like increased life expectancy, reduced patient mortality which includes maternal mortality, neonatal mortality, incidence and prevalence of specific diseases.
COVID-19 is still a menace, threatening to strike even today with another wave.
Each and every country, therefore, requires a sound health delivery system in order to remain afloat in the face of catastrophic pandemics that include the heinous coronavirus.
In 2007, the World Health Organisation proposed a framework describing health systems in terms of six components which include service delivery, healthy workforce, health information systems, access to essential medicines, financing and leadership.
A sound and prolific health delivery system is built on the six building blocks and the absence of any of them can lead to a shaky and cracked building under serious threat to collapse.
Primary healthcare in any country should be stronger than granite. In 1978 in Khazakhstan, the Alma Ata Declaration was pronounced where primary healthcare was viewed as the gateway to archiving the objective of health for all the people of all nations. This was supported by the United Nations High-Level Political Declaration on Universal Health Coverage on September 23 2019. According to the Universal Declaration of Human Rights, health access is a fundamental right.
The economic blueprint for Zimbabwe, the National Development Strategy 1 has 10 strategic focus areas and health is one of the key areas. It was just last week when the President of Zimbabwe opened a state-of-the-art clinic in Stoneridge, south of Harare.
The clinic is supposed to offer maternity services, X-rays, Ultrasound scans, outpatient services, admission and surgery services. More of such clinics are supposed to be constructed in Zimbabwe and if the objectives of the blueprint are archived, then there will be better health access in the country.
Infrastructural development is thus a positive step for the attainment of universal health coverage. The president has a vision to spread the wings of health to all corners but he has to be wary of the challenges that may impede his goal. From the 2007, World Health Organisation framework, four key blocks should always be borne in mind and these are a healthy workforce, access to essential medicines, financing and leadership.
A healthcare facility without the required workers can lie idle for a long time and everyone should appreciate that the biggest assets for any organisation are the human resources. Zimbabwe has suffered severe brain drain to many countries with the United Kingdom being the biggest beneficiary.
The year 2021 saw at least 2 100 healthcare workers deserting Zimbabwe for greener pastures, 1 800 of which were nurses. A lot of experienced health workers have packed their bags for the developed world, leaving clinics and hospitals understaffed. The reasons for high public institution staff turnover are numerous, ranging from poor remuneration, maladministration, lack of incentives, lack of job security and lack of motivation.
The hostile economic environment has been a thorn in the flesh with runaway inflation, high interest rates, devaluation and depreciation of the local currency. Many healthcare workers are struggling and the sad reality is that they cannot afford to send their children to school.
What a predicament, a skilled worker who spent many years at school undergoing training, long hours trying to defend Zimbabwe especially during the peak of the dreaded COVID-19 pandemic finds themselves in.
Health service delivery has also been crippled by corruption and theft. There are multiple reports of drug and equipment pilferage at clinics and hospitals, flouting of tender procedures prejudicing the country at large resulting in poor health service delivery.
While the President is doing his best to deliver health to the populace, it is prudent that reliable manpower is in place to complement his efforts. Diligent directors, administrators should be engaged to move the country forward, not greedy and corrupt leaders or managers who are for self-aggrandisement.
We will not be surprised if Stoneridge clinic becomes derelict in a few months to come. We do not want to see white elephants when only 40% of the population is accessing primary healthcare.
Government should, therefore, deal with the human resource issue, administration, financing and other resources if healthcare service delivery is to be as sound as expected. Corruption should be eliminated from all sectors of the economy. The dedicated health workforce should be recognised and appreciated in this country.
- Johannes Marisa is president of the Medical and Dental Private Practitioners Association of Zimbabwe. He writes here in his personal capacity.