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Health Talk: A well-functioning health system needs apt funding

Hospitals are now seen as death hubs with no drugs

A strong health system is a prerequisite for sound economic development. It is undeniable that health and development are symbiotic in nature.

The World Health Organisation put forward six building blocks that constitute the health system and failure of one pillar means a shambolic and a shaky structure.

Many Zimbabweans are continuously losing confidence with the public health system which has been characterised by poorer service delivery emanating from drug shortages, demotivated workforce, obsolete equipment, maladministration, corruption to mention just but a few.

The problems seem to be perennial and it now requires diligent and dedicated leadership if solutions are to be found easily.

Health financing has remained topical in the country with the health sector getting far less than its expectation.

In 2022, budgetary allocation to the health ministry was around 10.6% while in 2023, it stood at 11.2% of the national fiscus.

These figures are not convincing considering the Abuja Declaration that for African countries to make health milestones, at least 15% of their national budget should be allocated to the health sector.

If capital budgeting is considered, then Treasury should be serious with the health sector. Arguments may arise that the health sector has an excess of US$200 million yearly through the donor community but sustainability of any programs cannot depend on donor support. Donors can withdraw anytime if they feel uncomfortable.

There is a myriad of challenges in the health sector and chief among them is the incessant brain drain which is threatening our health system.

Health workforce is a powerful building block of a health system. Media sources claim that at least 5000 nurses have emigrated to greener pastures.

This is disturbing news and it is an insurmountable task for the incoming health leadership that is trying to contain the migration nemesis.

Hospitals are now seen as death hubs with no drugs, personnel, tools of trade. The country requires an excess of US$16 million per month for drugs only and more millions to cater for the available 57 000 workers.

The same workers are demotivated, morale is at its lowest and government should move with speed to curb brain drain.

The country is a sweet training ground for workers, only to lose them to developed countries which poach from our nests after having gobbled millions of dollars of the taxpayer’s money.

Questions still linger as to why there is no permanent solution to our crisis in the health sector.

Many ministers have come and gone, many directors are in offices, new chief executive officers have come, alas, no notable change in health service delivery is witnessed.

The biggest asset of any organization is the human resources and failure to pay attention to health workforce is tantamount to complete destruction of the health sector.

Government has capacity to stimulate its workers but the implementation stage is where failure comes.

Salaries should just be competent or comparable to the Southern-Africa region and no one would leave our country to work in Namibia.

It calls for seriousness on the part of government to incentivise its workers with vehicle loans, residential stands, farming land, duty-free facilities.

It has now been a chorus for such considerations but for years, responsible ministers have only paid lip service.

The ministry of Finance should be at the forefront of restoring the health of the nation as the country continues to suffer from morbidity and mortality rate.

We continue to suffer from outbreaks of embarrassing diseases like Cholera, a simple stone-age disease that should not find space in the 21st century.

Strengthening our water infrastructure remains critical with observance of good sanitation if the diarrheal disease is to be contained.

It is time the Finance ministry takes a serious look at the health ministry if we are to be a country with a sound health system.

Vision 2030 should be made easier by funding the health sector which is possible if government expenditure is reduced. Universal health coverage for all of us sooner than later!

Dr Johannes Marisa is a medical practitioner, an educationist and a public health expert who can be reached on doctormarisa@gmail.com

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