Health Talk: Public health system needs transformation

Health and Child Care minister Douglas Mombeshora has an insurmountable task to return public health service to track.

The public health system continues to face problems that are hindering health service delivery.

Many people have since lost confidence in the public health system as the state of some infrastructure is solemn; there is shortage of essential drugs as well as a demotivated health workforce.

The 2007 World Health Organization health system framework talks of six building blocks of a strong health delivery system namely health workforce, financing, governance, information technologies, service delivery and medicines.

Health and Child Care minister Douglas Mombeshora has an insurmountable task to return public health service to track.

The minister is a revered public officer, long viewed as a listening someone who dedicates most of his time to duty.

The country needs ministers of such caliber especially in the health sector where life should be a priority.

Reforms are sustained, purposeful and fundamental changes that will have an impact on organizational performance. Zimbabwe trains some of the best medical personnel in the world, alas, health service delivery is very poor.

Questions have been asked about why the public health system is faltering and the answers are not even complex.

 There are many contributing factors to the collapse of the public health system and some of them include incessant corruption, maladministration and inadequate health financing among other factors.

The biggest asset of any organization is the human resource and failure to satisfy employees on performance management will just spell disaster.

Organizational performance becomes plaintive without adequate motivation.

It is not a secret that maladministration plays a significant role in the collapse of the public health system in our country.

There is a good number of office-bearers who have been working for some years but yielding nothing.

Recruitment and selection should be based on meritocracy and not on nepotism, favoritism or patronage.

The Health ministry has many office-bearers who have been occupying opulent offices for long.

Their aim is no longer to deliver the best healthcare service but for self-aggrandizement.

Positions of leadership or management should consider somebody with at least a management qualification.

How can someone run a central hospital, without the necessary management qualifications?

Skills and qualifications audit should start from the directors at the head office, some of whom have been at the helm of the Health and Child Care ministry for a time immemorial.

Such people use the rule of thumb and seem blank on strategy, both on formulation and implementation.

Do all these directors have the prerequisite qualifications to be in those demanding offices or it is merely because of favoritism? We have a whole director of TB and Infectious Diseases but some clinics and hospitals are currently running short of TB drugs.

The last time I visited Ruwa Clinic, there were only a few packets of the FDC RHZE, the tablets used for the first 2 months of the intensive phase of TB treatment.

What exactly does such a director do if our citizens are under threat of increased mortality, drug resistant TB or even multi-drug resistant TB?

Our National Pharmacy (Natpharm) is another organization that should  live to its expectations.

Stocks of essential drugs should be readily available.

Central hospitals are not performing as expected.

Many of the problems are traced to incompetent management and it does not surprise me that the heads of such hospitals do not have the necessary experience and qualifications.

You hear Chitungwiza Central Hospital is being headed by a surgeon, Parirenyatwa by a gynaecologist, Mpilo by a gynaecologist, Sally Mugabe by a physician, yes they may be educated in their own fields but are they qualified to be in management positions?

The Health minister has a huge task ahead of him if our public health system is to wake up from slumber.

President Emmerson Mnangagwa wants all of us to achieve Vision 2030 and we all need to support his noble cause.

Universal Health Coverage is possible but do we have the right people who will be the flag-carriers for Vision 2030 or we only have opportunists who only want to line their pockets?

Our hard-working Health minister should not be sabotaged by his subordinates, some of whom have overstayed at Kaguvi building.

Radical revamping of the entire system should be a priority at this juncture!

  • Dr Johannes Marisa is a medical practitioner, an educationist and a public health expert who can be reached on [email protected]

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