In 2017, General Bae, as was he daubed by Zimbabwe’s Social Media, Rtd. General, Constantino Chiwenga, the Vice President of Zimbabwe is back with “Operation Restore Legacy”, and the hospital school bells shall ring.
In April 2018, he abruptly fired all the striking nurses, a clear sign of not being able to tolerate nonsense. As Julius Malema would say “that is Nonsensical”; is what many are expecting the Rtd. General to say in coming medical board meetings with public and private stakeholders of the Health Sector. Many are expecting fireworks, but most importantly expecting a restoration of order by discipline and decisiveness.
There is need to restore order in Zimbabwe’s health sector, and much of it can be achieved by re-calibrating several things in the value chain.
Removal of Red tape
The insightful entrepreneur and business executive in Harare, Spencer Madziya, commented on a Facebook post, saying “it might cut the red tape to funding with government, I don’t see how he will personally drive the ministry, but he has a competent Deputy to do the work,at least we might see treasury being directed straight from the executive to release funding without too much red tape!“. And optimistic and interesting comment, because there has been many scandals and reports of misappropriations of funding coming from Government for the sector. A removal of red tape will allow the public health sector to restore its legacy.
The Health sector has two facets, being public and private. The public health sector is suffering not only funding issues, but also from mismanagement of public companies such as pharmaceuticals, equipment, hospital and clinic management. Just the presence of Rtd. General Chiwenga sends chills down those who would in times past thrive. The health sector in Zimbabwe requires funding, and there is need to explore diverse funding models that allow “Public Private Partnership” relationships in order to restore legacy and make the sector have order.
Reality in Public Hospitals
To give birth in a public facility is now a health challenge, not to mention expensive for the common folk, hence there is an increase in traditional midwives (Mbuya Nyamukuta), who in themselves need support with basics. The Covid 19 pandemic has just exposed the danger of the public facilities, all needing immediate attention with a literal revolutionary approach, to overhaul the public hospitals, as people are falling victim when it can be prevented. Health in Zimbabwe must become free for all citizens, and that is not up for debate, as health is a basci human right.
Meanwhile in Private Sector
The health private sector in Zimbabwe is thriving, despite the obvious challenges of Zimbabwean Economics. The sector has more medical facilities now than ever, and has more private practice start-ups, and much more pharmacies. The general consensus however is that, the cost of services and products to the consumers is a bit hefty, and though market forces dictate, there may be need to bring in a bit of order.
Human Resources for Health Profile
According to a WHO report, in Zimbabwe in 2008, 65% of health care services were provided by the public sector. The severe social and economic challenges since that time have resulted in an unprecedented deterioration of health care infrastructure, loss of experienced health sector personnel, and a drastic decline in the quality of health services available for the population (Human Resources for Health Profile, 2009).
Currently, there are 1.6 physicians and 7.2 nurses for every 10,000 people (Zimbabwe Ministry of Health and Child Welfare, Human Resources for Health information sheet, 2010). Lack of staff for medical education training, and high drop-out rates in public sector health care posts have resulted in vacancy rates of over 50% for doctors, midwives, laboratory, and environmental health staff (National Health Strategy for Zimbabwe 2009-2013). Some more recent data suggest a slight decrease for some of these categories (Human Resources for Health Profile, 2009), which may be a positive result of an Emergency Retention Scheme created in 2008.
The current National Health Strategy identified key issues such as failure to contain and manage the loss of health sector personnel due to unattractive retention incentives; poor and unequal distribution of health workers within the sector; low outputs from training of health workers; and an absence of bilateral/international agreements relating to HRH recruitment.
What to Expect of the Rtd. General
Based on his published decisive leadership style, there shall be heads rolling, reduced corruption, and increased productivity. Whether by fear or by love of their job, there shall be a serious shift in the sector, public and private.
Sources: WHO
