As we reach the end of 2023, there are many positives and negatives circling around many sectors of the economy.
The health sector is one sensitive sector that should be respected as any economic development that needs to occur usually bases on a sound health delivery system.
Health and development are symbiotic in nature. In 2023, Singapore dominated the ranking of the world health and health systems followed by Japan and South Korea.
Per capita healthcare spending is highest in the United States with Germany trailing behind.
Our country has scored some points on health service delivery although there are some other areas that need serious strengthening.
The Health and Child Care ministry now has a new minister Douglas Mombeshora who took over from Vice-President Constantino Chiwenga after the August harmonised elections.
A health system is an organisation of people, institutions and resources that deliver health care services to meet the health needs of the target populations.
A strong health system will ensure that everyone is able to access high quality healthcare without financial difficulty.
The Alma Ater Declaration of 1978 recognised health as a fundamental human right. A health system is better analysed through the 2007 World Health Organisation building blocks which comprise of six components namely health workforce, service delivery, leadership, health informatics, medicines and health financing.
Where are we as a country as we round off 2023?
For a long time, our central hospitals were running without functioning magnetic resonance imaging scans, computed tomography scans which have so far been installed at Parirenyatwa Hospital in Harare.
This is good news which will indeed add more value to diagnostics. The ministry should be applauded for working hard to have such scans at our hospitals because few people can afford to pay for such scans in private.
A new radiotherapy machine is currently being installed at Parirenyatwa, a major development that will bring joy to many cancer patients.
It would be prudent one day to have scans like computed tomography being installed in every provincial hospital so that the service is decentralised, thus a significant milestone for the country.
Zimbabwe has a hard-working health workforce and recently there was a team of volunteer medical professionals carrying out surgical procedures in Victoria Falls.
The team was led by Dr Sisimayi and Dr Mtambalika and more than 150 surgeries were performed on patients, thus bringing relief to patients, reducing financial burden and generally improving accessibility to health service.
The biggest asset of each and every organisation is the human resources and what matters now is to increase skills retention in the country.
There is mass exodus of skilled health personnel with more than 4 500 nurses being reported to have migrated out of Zimbabwe in the last 18 months.
The rate is alarming and government should work expeditiously to address the scourge that is threatening to destroy the health system.
The minister of health cannot succeed on stemming brain drain alone, instead, it requires the robust collaboration of other ministers who include the finance minister, local government minister to mention just but a few.
It is a pity that the Health and Child Care ministry only got 10.8% of the national fiscus for 2024, a figure I think is way far from expectations as the Abuja Declaration of 2001 earmarks health for at least 15% stake.
With many health expectations post-covid-19, health financing is grossly inadequate and it is an open secret.
Governance is one thing which can run down our health delivery system. A health system should have reputable and qualified people to run departments.
Meritocracy should characterise modern human resource management at the expense of patronage, favoritism and nepotism.
Are our public health facilities run by qualified people or it is by mere workplace seniority? Why would one become a hospital chief executive officer without a single management qualification?
Poor leadership can collapse the entire health delivery system.
We pray for a better 2024, a year we hope to contain the excessive brain drain, a year we hope to increase both intrinsic and extrinsic rewards to our employees, a year we expect greater cooperation between the public and private sector, a year we expect discipline among some errant medical aid societies.
It is either now or never!
- Dr Johannes Marisa is a medical practitioner, an educationist and a public health expert who can be reached on doctormarisa@gmail.com