Online Reporter
Dr Abigail Kangwende
THE Health Service Commission is mandated to develop and implement policies to ensure the availability and retention of adequate numbers of well-qualified and well-motivated health workers, with the right skills mix, equitably distributed across the country to provide health services to all population groups in Zimbabwe.
That is quite a task.
The commission is implementing an ambitious programme to expand the health workforce by an additional 14 069 posts across all categories of workers.
The Government, through Treasury, has authorised the creation and filling of these posts towards meeting the country’s workforce needs.
The majority of these posts were allocated to operationalising the new and expanded Ministry of Health and Child Care organisational structure. At least 2 000 posts will support the progressive transition of partner-supported positions onto the Government payroll as and when the employment contracts expire.
This ensures continuity of services and resilient and sustainable systems.
Some of the posts are being allocated to support staffing requirements of front-ended institutions such as rehabilitation centres and this includes cadres such as social workers, clinical psychologist and therapists.
Challenges
We face persistent challenges in filling posts for cadres that are not already available on the labour market. These are much-needed cadres, but they are not available on the labour market. They include specialist doctors, specialist nurses, pharmacists, radiographers and medical laboratory scientists.
The filling of these particular posts requires a coordinated national effort by the academia, regulatory authorities, other ministries, departments and agencies, development partners and many others.
Deployment efficiency
A new digital registration and deployment management system has been developed to improve transparency and efficiency in posting new recruits and also to reduce delays in onboarding them. This system will support the absorption of new graduates and streamline deployment to underserved areas. It also helps in easily accessing and analysing health workforce data as part of the commission’s thrust to build a human resources information system for data-driven decision-making.
Management and governance
The commission is rolling out leadership, management and governance training for hospitals.
The aim is to ensure that, as workforce numbers increase, management capacity also keeps pace, particularly in areas of human resource management, financial stewardship and performance monitoring. This programme supports the commission and the ministry’s drive for a professionalised, accountable and high-performing health leadership. We acknowledge with gratitude the technical and financial support that we have received from partners to advance this particular agenda.
Rural health worker shortages
Two-thirds of the health workers are in urban areas to serve one-third of the population. This is because of the different situations obtaining in the rural and urban areas.
The commission is developing an objective, data-driven, scientific three-tier classification system for health institutions that we call the “Red, Amber and Green” categories.
These categories are set according to the level of hardship in the areas where the health facilities are.
It could be road conditions; it could be electricity and many others.
It is a composite index of many different variables. This classification will enable implementation of evidence-based workforce attraction and retention strategies.
It will also assist with targeted deployment of personnel to hard-to-reach areas.
It will improve equity in workforce distribution. This three-tier categorisation system will guide the Government and partners in prioritising staff incentives at health facilities historically shunned due to remoteness and resource limitations.
We acknowledge and thank the partners who have been supporting us in the ongoing rural retention scheme.
Partner-supported health workers
We pay tribute to our partners who have supported the health workforce in one way or another, and deeply appreciate their guidance and cooperation as we transition to a fully Government-supported health workforce.
The commission and the Ministry of Health and Child Care are committed to ending fragmented health workforce employment arrangements.
By the end of January 2027, all partner-supported health workers will be formally absorbed into the Government structures and payroll. They will be accountable to the Health Service Commission and to the Minister of Health and Child Care; and they will be fully integrated into the National Human Resources for Health System.
This change will strengthen governance, harmonise conditions of service and ensure resilience and sustainability of critical services previously reliant on non-Government contracts.
Community health workers
The commission, the ministry and Treasury acknowledge the central role played by community health workers in community healthcare surveillance, health promotion, disease prevention and treatment of some conditions. The commission is, therefore, advocating for village health worker allowances to be included in the 2027 National Budget.
This marks a shift towards sustainable Government financing; improved motivation and retention of village health workers; and ownership and strengthening of community health systems. We hereby express our gratitude to the partners who have supported us thus far in this space of village health workers.
Conclusion
The commission stands ready to work with all partners to close critical workforce gaps, especially in specialist disciplines and in the deployment and retention of the health workforce in marginalised and underserved communities.
Second, workforce expansion must be matched with leadership capacity building, facility readiness and sustainable financing.
Thirdly, the commission welcomes collaboration on health workforce training pipelines, specialist development and digital human resources for health information systems.
Fourth, the absorption of partner-supported staff onto Government systems is a major milestone towards coherent national workforce governance. And lastly, Government support for village health workers is essential for strengthening the health workforce, strengthening primary healthcare and advancing universal health coverage.
Dr Abigail Kangwende is vice chairperson of the Health Service Commission. She delivered these remarks at the High-Level Health Sector Coordination Forum held in Harare recently.
