Health Fund long overdue

Conrad Gweru
Lack of access to healthcare services is the major cause of high death rates in many African countries, Zimbabwe included. The most affected are old people, women and children. The recent call by legislators to introduce a cancer levy is a great idea in principle which but itself rather pointing the wrong direction.

Practically though, it echoes on the limited funding towards health, which is common in any other sector of the economy.

Cancer is among the non-communicable diseases which include cardiovascular diseases, eye conditions, diabetes, chronic respiratory diseases that have now become a burden not only in Africa but globally. Over and above cancers and other non-communicable diseases are other diseases and conditions such as TB, Malaria, Uro-related, and other outbreaks which need funding.

Here are a number of diseases and conditions that are burdening the community and contributing to slow development as the workforce that is supposed to be working may be unnecessarily burdened.

To then imagine a pay slip with more than two or three levies on health will be a complete reflection poorly on the legislature.
The worker is over burdened by tax and today is always looking up to Government and other worker representatives for an increase in salaries and wages.

To then tax the worker when the majority are earning below the poverty datum line will not go down well with the employee.

Zimbabwe’s health service could do with a major overhaul which should address availability of medication and drugs in clinics and hospitals, improving the standards of service delivery, consumables for operations and surgeries, infrastructure development, construction of new clinics and hospitals in undeserved communities, human resources development and retention, incentives for health cadres in rural areas, provision of specialist services amongst many other areas that require concentration.

Services are currently scrappy: a district level health institution in Gokwe may not be rendering desired service for a district health institution compared to a district level clinic in Gwanda, for example.

Zimbabwe’s health service delivery should get to a stage where services at stages from primary to tertiary level are uniform.

As an alternative, legislators should call for the introduction of a health fund which is perhaps long overdue.

The Abuja Declaration recommended that 15 percent of the total budget should go towards health and of late Zimbabwe has failed to reach the projected percentage due to lack of adequate resources within the country’s wallet.

Stakeholders should also note that funding towards a disease should not be based on its contribution to the death rate only, but also its effect to the economy if not prioritised.

Lack of adequate Human Resources for health has led to some conditions such as non-communicable diseases becoming burdensome due to lack diagnosis and treatment.

The burden that is caused by some of these diseases can be reduced by early detection and treatment at the primary level.

That means health institutions have to be adequately equipped and at the same time health workers have to be trained in using some of the equipment.

The rapidly increasing burden of a number of diseases and conditions in different households in the country are a true reflection that the health sector needs a major facelift.

The idea is to put in place systems, mechanisms and make priorities that when funding is availed, no matter how little, it will make a huge difference.

A good example that can point to lack of planning and coordination could be the cancer/HIV issue which some stakeholders have indicated that 60 percent of cancer cases are related to HIV.

Now with the Aids Levy in place, one may question what percentage of the Aids Levy has been set aside to address early detection of cancer or has been set aside for medication and treatment of cancer patients living with HIV and Aids.

A diabetic patient may for example end up with eye problems out of lack of knowledge.

The blame is mainly on the health service provider who should not only concentrate on monitoring sugar levels but should also refer the patient to a Primary Eye Care nurse or an ophthalmic nurse to be checked for eye diseases which are common in diabetic patients.

Legislators need not to jump the gun; they should look at grave concerns with the intention of recovering and shaping the health delivery which require funding to address a chain of issues.

There may be need for legislators in Zimbabwe to quickly shift from the excitement of introducing a cancer levy, which if happens may reflect a responsible august house but truly reflecting a lack of critical analysis of health issues affecting the populace today.

Their analysis should especially be inclined to issues of access by most at risk populations together with disadvantaged and poor people, human resources for health and total integration of primary health care. The lack of reference to the massive social and economic impacts of some diseases and conditions against their contribution to the death rate has led to their lack of prioritisation within the health delivery system.