HSB Calls For Adequate Health Sector Funding

WITH Parliamentary preparations for the 2019 National Budget heating up, Health Service Board feels the allocation of adequate funding to the Health Sector can alleviate shortage of hospital staff and equipment needed at public health institutions.

By Kudakwashe Pembere

During an HSB Harare Central Hospital tour on Tuesday, nurses and doctors bemoaned the incommensurate human resources and inadequate hospital amenities.

HSB members toured the Children’s Clinic, Casualty, Maternity, Renal and General wards where they were told of a deficit of some ventilators used for ICU, intravenous antibiotics to mention the view.

Doctors and nurses at these wards complained of the low patient to staff ratio where some stations would be unmanned, a single nurse would attend to three or four patients hence the need of an extra hand.

HSB chairperson Dr Paulinis Sikosana told journalists that it was necessary for Government to improve the allocation of funds towards the Health sector on the national budget.

“It’s been a long time since we have had a comprehensive procurement of equipment or the updating of equipment basically due to the shortage of resources. I think as a government, we need to increase the fiscal space for allocating resources to the health sector,” he said.

He noted that the country is yet to meet the Abuja declaration requirements.

“What we are spending on health is inadequate for instance we are not meeting the Abuja declaration of 15percent of government expenditure going to health sector. And also the per capita expenditure on health should have a minimum of about $86 per person per year and we are spending way below that.

“The global budget using all that should really be a minimum of about $900 million to the health sector. I think we are only achieving $400 million approximately which is half. You can imagine you need about a billion and you are spending almost half that it is impossible to meet staffing requirement.
Dr Sikosana added that the wage bill in the health sector would be reduced if more funds were to be given towards health.

“One of the issues that people have floated about is that age bill in particular the health sector takes about 84 percent of the budget but it’s basically because we are not spending enough.

“If we have the $900 million or so that is required, those staff costs will be around 40 to 50 percent which is really the average that you expect from the public health sector.
“That’s the global allocation that is expected inclusive of the wage bill, inclusive of implementation of the various programs in order to meet the certain population health demands,” he said.

He noted how a nation like Zimbabwe can achieve the Universal Health Coverage goals by 2030 they need to spend over $200 per person per year.

“Now the Government has committed itself to implementing the sustainable health demands, universal health coverage. Recent studies have indicated that for a country like Zimbabwe, were to achieve universal health coverage of 2030, we need to spend $271 per person per year. And we are at less than the minimum $83 per person per year. So you can imagine the slow rate we are moving,” he said.

He said prioritisation and rationalisation of health sector remains key despite the economic hardships.

“I think you are aware of the economic situation that the country is facing so there have to be rationalisation and prioritisation. We have to live within the means of what is available,” Dr Sikosana said.

HSB recently toured Manicaland Province’s public health institutions which had similar challenges to Harare Hospital. The health ‘employer’ promised to pile up pressure on Ministry of Health to address these problems.

“Our main objective is to see the shop floor where our employees are actually working. One of the demotivating factors in the health sector currently is the work environment. People are well trained, they know what to do but because of the working environment, there is no equipment, there are no drugs, and it frustrates the health workers more than the remuneration we give them. So we want to add voice to the ministry of health where we will discuss how best to remedy the situation of critical inputs for the health worker,” Dr Sikosana said.

Harare Central Hospital (HCH) Chief Executive Officer Dr Nyasha Masuka spoke of the obtaining staff deficit at their institution.

“The issues that came out mainly are the issues of staff shortages. I think this is very clear I think the staff complement we have right now the one that Harare Hospital got in 1980 at independence and has not increased despite the increasing disease burden, and despite the increase in population, despite the new diseases that we are getting and so forth. We also saw shortage of critical staff in critical areas like the intensive care unit that were highlighted by the health workers themselves,” he said.

He added that the situation needed Finance ministry officials who time and again fail to meet the Health Sector expenditure requirements, to witness the prevalent challenges the hospital faces.

“There are critical shortages of critical equipment needed in those departments and I think the message is very clear we had hoped the Ministry of Finance had come here to see for themselves what it means to have a hospital a central hospital which cannot perform at its full capacity because of staff shortages and equipment shortages,” said Dr Masuka.
Dr Masuka said they have been sending patients away to buy their own medicines which are unavailable at the hospital.
“There is also the issue of medicines, surgical and medical consumables and commodities. I think you heard in most departments that they don’t have the basics to use. This has been worsened by the current scenario where in the market, prices have changed or some suppliers want United States Dollars in cash.
“We have run out of critical items such as cannulas that we use to put up your IV line to put up your drip. Patients have to go out and buy. Some of the critical medicines that are used to resuscitate patients, we are sending them out to buy. So it’s a very dire situation that we have right,” he added.

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