BY Johannes Marisa
THE last two weeks have been miserable for many Zimbabweans as load-shedding was up-scaled by the Zimbabwe Power Company. Some areas are going for more than eight hours of darkness, a development which is detrimental to economic growth.
Musami District Hospital was in the news for experiencing the deleterious effects of load-shedding as the standby hospital generator is not working.
Many lives can be lost as a result of incessant power cuts if urgent action is not taken to address electricity supply issues in healthcare facilities.
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.
Electricity is a scarcity at the moment, with many hours of load-shedding, a development which is calamitous for healthcare facilities that do not have strong power back-ups. The end result is that service delivery becomes poor and attainment of health deliverables becomes a taboo.
Quite few researches have been carried about the impact of power outages on healthcare facilities, yet power is a critical component of good health delivery.
In 2007, the World Health Organisation proposed a framework describing health systems in terms of six components which include service delivery, health 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 one of them can lead to a shaky and cracked building with a 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 achieving 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 Universal Declaration of Human Rights, health access is a fundamental right.
Zimbabwe’s economic blueprint, the National Development Strategy 1 (NDS1) has 10 strategic focus areas and health is one of the key areas. Several clinics are under construction, while many others have already been opened.
It needs dedication from all stakeholders to make sure we write a success stories. Power outages have worsened in the last weeks and healthcare facilities have not been spared, thus putting the health of many at risk.
Power is needed in healthcare facilities for drug storage, especially drugs that have to maintain the cold chain like vaccines, for example, Hepatitis, COVID-19, anti-rabies, anti-tetanus vaccines. Many hospital units require uninterrupted power supplies.
The critical care units need heavy machines like ventilators to keep running. Neonatology units are equally affected when there are power outages, while surgical operations are derailed.
While many people may not see power as an important utility for a robust health delivery, it should be emphasised and understood that electricity is a very critical input to reducing both morbidity and mortality. Infrastructural development is thus a positive step for the attainment of universal health coverage.
It is thus imperative to have enough energy power in the form of electricity if healthcare facilities are to function smoothly. Victory against treatable diseases is certain with good infrastructure that is supported by technological development. Electricity is key in healthcare facilities.
A healthcare facility without power back-ups in the face of incessant power outages can face numerous challenges that may have deleterious effects on service delivery. Mortality can go up, overhead costs can sky-rocket, patients can have delayed diagnoses, while patient confidence wanes. Imagine just losing power in the midst of a surgical operation or having a power outage when a patient is on a ventilator when there is no reliable back-up.
How many drugs lose their potency when there is power loss and subsequent loss of the cold chain? It is thus imperative that alternative power sources are installed at healthcare facilities so that there are reliable substitutes in case of sudden power cuts.
Generators with adequate fuel and competent personnel to operate them should be available. Installing solar equipment at healthcare facilities is another option which is cheaper, especially when light machines are used.
The provision of lights is important in healthcare facilities as darkness can impede the administration of drugs to patients. Electricity shortage should not be treated lightly.
Some studies have concluded that there is at least 30% increase in in-patient mortality with power outage duration of over three hours per day. What a catastrophe! How many rural clinics have back-ups of power? What, therefore, happens to those healthcare facilities without power back-ups?
Health service delivery has also been crippled by corruption and theft. There are multiple reports of drug and equipment pilferage from clinics and hospitals, flouting of tender procedures with prejudicing of the country at large, hence poor health service delivery.
While President Emmerson Mnangagwa is doing his best to deliver health to the populace, it is prudent that good and reliable people are put in place to complement his efforts.
Diligent directors and administrators should be put in place to move the country forward, not greedy and corrupt leaders or managers who are for self-aggrandisement.
Government should, therefore, make sure healthcare systems have uninterrupted power supplies or they have reliable power back-ups in order to smoothen health service delivery. Electricity is key for healthcare facilities.
- Johannes Marisa is president of the Medical and Dental Private Practitioners Association of Zimbabwe. He writes here in his personal capacity.