ZIMBABWE’S nurses this week pushed for a raft of crucial measures to end protracted suffering in Zimbabwe, as a new Health Services Commission (HSC) came into office amid waves of cholera cases, which have killed hundreds in over 20 000 infections.
The epidemic is the second serious outbreak to test the resilience of a system that has been battling to shake off effects of two straight years of a Covid–19 outbreak that killed over 5 000.
Problems in the health system have been compounded by the flight of professionals to other countries.
The HSC was established through the Health Service Amendment Act of 2022.
It replaced the Health Services Board and its role is to administer the conditions of service of its members in public health delivery. Drug shortages and lack of funding are among major factors confronting Zimbabwe as upheavals continue on the economic front.
In the latest of a series of big changes effected since the August 2023 polls, President Emmerson Mnangagwa last week approved the appointment of a new seven member HSC to help drive the troubled sector during tumultuous times.
Led by former public service commissioner Vincent Hungwe, members of the new HSC include
Abigail Rugare Kangwende, Edward Makondo, Engelebert Mbengwa, Josephine Mwakutuya, Mercy Sibongile Gwaunza and Gerald Gwinji. All of them have proven records in health and public administration.
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Friday’s appointments were meant to help tackle the deepening crisis in Zimbabwe’s health delivery system, where many walk long distances to access treatment.
But even if they reach health facilities, they find hospitals and clinics without drugs.
There, they are forced to buy from expensively priced private sector outlets.
But over 90% of Zimbabweans not formally unemployed, according to United Nations estimates.
For many years, Zimbabwe’s government has been warned about the effects of mismanagement in the country’s health delivery system and experts hope that the new HSC will hit the ground running, playing its part in addressing glaring deficiencies within its scope of work.
In an interview with the Zimbabwe Independent, Enock Dongo, president of the Zimbabwe Nurses Association (Zina), described the composition of the commission as ‘balanced and fair’, but warned that the year ahead would be tough, as the health system tries to navigate many hurdles.
He said poorly remunerated nurses were continuing to leave in droves, while drug shortages had become endemic – issues requiring immediate attention by everyone working in the public health system.
“On Friday last week there were new service commissioners which in our view are balanced and fair people,” Dongo said, before noting that nurses must be rewarded in line with the important role they play in society.
“We expect that our remuneration will be reviewed and our USD salary will be increased. We expect that there will be improvements in resources, drug shortages and all our institutions are well equipped. Currently, Zimbabwe is short of staff because of the declining economic situation.
So the government needs to improve, especially on our salaries so that our nurses and doctors will be motivated and those out of the country can return,” Dongo added.
His views were share by Itai Rusike, executive director, at the Community Working Group on Health.
“These workers require the tools of the trade, which in turn must be effective and efficient, be the infrastructure, medicines, equipment, ambulances, service vehicles, and new technologies to make their work less tedious than it currently is” Rusike said, referring to nurses, doctors and other public health professionals.
“Managing a professional workforce requires skill and capacity that we find missing in the public health sector and this largely accounts for the mass exodus of our highly trained health workers to offer their young productive lives elsewhere,” said Rusike.
Hamadziripi Dube, a medical doctor, reiterated that Zimbabwe’s health system was in shambles, which required tougher actions, including a complete overhaul, to address the many hurdles that confront the sector. According to Dube, this year government needs to improve on special areas like national blood transfusion services, remuneration and welfare of health workers.
He said government must introduce more specific allowances to stop the high staff turnover and brain drain.
“Working conditions and conditions of service for health workers must be revamped and given a complete change. Health workers need monetary and non-monetary benefits as a way to stop the exodus of specialised workforce” he said.
He said Zimbabwe must digitalise the health system.
