THE 2008 Kampala Declaration on the Global Health Workforce Alliance points to the need to ensure adequate incentives and an enabling and safe working environment for effective retention and equitable distribution of the health workforce.

GUEST COLUMN:Johannes Marisa

In many low-income countries like Zimbabwe, the health system is under serious stress due to resource constraints, resulting in challenges in providing good quality health services.

In 2007, the World Health Organisation came up with building blocks for a robust health system and these include service delivery, health workforce, health information systems, essential medicines, financing and leadership.

The fragility of one block in the system results in a shaky building that threatens the lives of many.

Zimbabwe has faced numerous healthcare challenges since time immemorial, but the problems seem to be worsening everyday with the growth in population, increase in unemployment rate, inflation, poor budgetary support and climate change.

This results in demotivated staff, shortage of essential medicines, poor data collection which eventually culminate in poor service
delivery.

For any country to have a sound and attractive health delivery system, we should consider the above mentioned pillars carefully not forgetting that they should be integrated to produce results.

The health worker remains a key unit in the structure. It is thus imperative to engage health workers in an amiable manner that encourages them to report for work.

Putting policies or laws that seem to target health workers alone is not the solution as the health workforce is only a building block among five others.
Problems in the health system in Zimbabwe should surely not be blamed on workers alone but all stakeholders like government and management for failing to maintain the required infrastructure.

We need collective effort as a nation if we are to resuscitate our health delivery system.
It is public knowledge that health workers have been fighting running battles with government over remuneration.

Nurses went on strike for almost six months and some doctors joined them.

The Health and Child Care minister, Vice-President Constantino Chiwenga promised to address their grievances and sanity is slowly returning to our public hospitals.

Salaries for medical personnel have surely been ridiculously low to the extent that payment of bills like electricity and water is now threatening to consume the entire month’s salary.
Why does government allow electricity charges to continue going up while consumers’ salaries remain stagnant?

Councils are tormenting citizens with unprecedented increases in charges which are beyond the reach of many. So it means a health worker cannot make phone calls, use electricity and afford cheap accommodation?

Our economy seems to be stabilising lately possibly because of the stability of the exchange rate and it is high time that unnecessary price increases are nipped in the bud.
We understand government does not provide enough budgetary support for the health sector.

The Abuja Declaration of 2001 pledged about 15% of the annual budget to improve the health sector of African countries.

This then means the health sector deserves the biggest chunk of the budget as it deals with life and death matters.
Donor countries were also called upon to scale up support for African countries that are saddled with many diseases, poverty, drought, corruption and poor governance.

While we applaud government for unveiling the US$500 to be paid to each and every civil servant posthumously, it is my belief that capacitation of the health sector should take precedence.

Government employees face challenges in accessing medical care because of the meagre contributions made to their main medical aid society, PSMAS.
The poor the premiums paid to PSMAS, the poor the service rendered to the members by the service providers.

During times of economic stability, service providers scrambled for PSMAS card holders.

So many service providers have done well because of the same medical aid society which unfortunately has been seriously affected by low premiums.
Can the donor community come to the rescue of the medical sector?

Our resources are never enough as a nation and this is the time for international friends to show their love for our people. We need collective efforts in resuscitating the gasping health delivery system of our nation.

We have non-governmental organisations which successfully ran some projects and programmes in Zimbabwe. Examples include Population Service International, USAid, Humana People to People, Development Aid from People to People, Unicef, WHO to mention just a few.

It was good news that the Health minister launched ground and air ambulance services a few days ago.

The service has, indeed, been lacking for a long time, resulting in unnecessary losses of life, especially after accidents as patients could not be ferried quickly to hospital.
We thank Redan Petroleum for the donation, which shows that indeed we can make it if we combine efforts. Zimbabwe is for us all and your health is my health.

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