Vusumuzi Dube
Robin Muchetu, Senior Reporter
ROBUST public finance mechanisms should be adopted in the revamping of the primary healthcare systems in Zimbabwe as part of efforts to achieve universal health coverage as the country strains towards meeting the Sustainable Development Goals, an expert has said.
If well-funded, the health sector is capable of witnessing a reduction in the movement of patients from Zimbabwe to foreign countries to seek medical attention which has come at a huge cost for locals some of whom end up succumbing to conditions that could be treated after falling short of travel expenses.
In the context of public health provision, the disease burden in Zimbabwe is mostly non communicable diseases (NCDs) and also communicable diseases but the thrust is on the NCDs due to lifestyle preferences of the communities.
Principal Consultant of the African Centre for Global Health Innovation and Research (ACGHIR), Mr Lemson Machibiza, a WHO-certified implementation research scientist and public health expert said public health financing could change the face of health care in Zimbabwe.
“We are aiming to have universal health coverage so that each and every patient access health services wherever they are. So, for that to become possible we need a robust public health financing mechanism that will in turn allow people to afford these services.
“These should be available from our primary health care facilities all the way to central hospitals and by their nature, provincial and central health facilities must provide specialised care. For them to do that we need sophisticated equipment that will allow diagnostics as well as the management of the conditions,” said Mr Machibiza.
He was quick to point out that a number of patients were incurring huge costs for the treatment of heart ailments and cancers in India and South Africa while Zimbabwe has the potential to harness local expertise, capacitate them and offer the services locally.
He added that the costs for healthcare services lead to impoverishing or catastrophic health expenditures which was contrary to the SDGs on health and the thrust of achieving universal health coverage with financial risk protection.
“In as far as the expertise is concerned, we have them and we also have teaching hospitals in Zimbabwe such as Sally Mugabe Hospital, Parirenyatwa Group of Hospitals, UBH and Mpilo Central Hospital. Experts also need to be motivated enough to enable them to render their assistance.
“In countries like Cuba and India, they followed the primary health care approach and they have specialised equipment available at their different levels of care because of the health financing mechanisms that are publicly funded. The services can be offered at a price that is affordable to their citizens and globally competitive to attract patients from other countries. It does not happen overnight but it is possible,” he said.
The public health expert said institutions and equipment might be available locally but there was a need to provide remuneration that meets the expectations of the experts which was also competitive in the region.
“If our public health financing meets the Abuja Declaration of having at least 15 percent of the National Budget allocation to health care, we may be able to fully capacitate our health institutions with the advanced technology that we need for specialised medical health interventions. Whilst some of the equipment may be available, the absence of specialist’s repair technicians and failure to acquire spare parts for these machines may render them non-functional further eroding the supposed gains we may have obtained. If we get some of these to function then we can build on that foundation,” he added.
He noted that health was dynamic in nature and it was possible that the equipment acquired in the previous years may no longer be relevant to meet current demands and the diagnostics that were required now.
He added that the few high-technology devices and equipment that were available at private health facilities were beyond the reach of many because they would be financed by the private sector.
“This retooling of hospitals needs financial provision in this effect which ideally should come from the public health sector and when it is provided by the government it will be available to the general population and there may be subsidies to ensure they can afford it.
“There are some international organisations that are willing to partner with local institutions in Africa through public private partnerships (PPPs). These organisations do specialised surgical procedures abroad and a large number of their clients are coming from Africa but they do not have any representation locally. With the new dispensation’s Zimbabwe is open for business mantra, these opportunities can be explored as they create local employment, bring the services closer home in addition to bringing medical tourism to our country. So, it is a work in progress, and in the near future we will be able to carry out complex procedures and patients will not need to travel to India, UK or South Africa for treatment and this will really reduce the cost of treatment for locals,” he said.
Looking at the cost of medical aid in Zimbabwe Mr Machibiza said it was beyond the reach of many.
“Our economy is more informally driven, so we need a way of embracing the informal sector so that they have access to medical aid services and finance their health care. We should revise the manner in which we recruit people for medical aid and try to include those that are informally employed as well.
“The percentage of those that are informally employed is more than those in the formal sector. It’s a market that needs to be explored for the benefit of the medical aid companies themselves and the people too. It is in line with our thrust for equity in health and universal health coverage where everyone should have access to quality health care services with financial risk protection” he added.
Staff exchange programmes are also vital to capacitate our local health personnel.
“As low to medium income countries (LMICs) we have an inherent technological lag and these staff exchange programmes for our key health personnel will go a long way in capacitating them with the modern-day technological requirements and methods of giving health care services. Previously we had specialists’ visits from Cuba, India and the US to capacitate our local personnel and we also sent our key personnel abroad through staff exchange training programmes. But now the challenge is that the probability of experts returning to Zimbabwe after acquiring a new skill and standard of doing things abroad then becomes debatably low. That said staff exchange programmes are a noble intervention we should continue to explore as a country,” added Mr Machibiza. @NyembeziMu
Online Reporter