Zimbabwe: Upgrading community health care well underway
Everyone needs basic services, and about the most basic is access to health care, which is one of the reasons why most rural district councils have used their decentralization budgets to over the past two years to add more clinics to their networks, fill the gaps so that communities are not dependent on a clinic 20 km away.
During the 1980s shortly after independence, the establishment of a network of clinics to provide primary health care was one of the main achievements of the government, with local authorities supplementing this in urban areas by developing what they inherited from the colonial era.
But then enthusiasm waned, even as populations grew, more and more areas were intensely settled under land reform, and towns expanded to new suburbs and new towns sprang up from the veld.
So the spectacular achievements of the 1980s, which saw infant mortality rates plummet and most people have somewhere to go when they were sick or gave birth, were seen as a box that had been checked, whereas Quite obviously what had been done was put into the minimum necessary for the population of the time.
There were a few additions, in new district and provincial hospitals, but not enough and health coverage expansion programs came to a halt during times of inflation and surviving under dollarization.
Even the maintenance of existing facilities was allowed to be ignored.
The Second Republic changed that. To begin with, a serious effort was made to catch up on maintenance, to restore what we had and improve it if necessary; this accelerated when Covid-19 hit Zimbabwe, budgets were increased, communities were mobilized and the private sector stepped in.
So quite quickly what existed in part of the public health sector was fully functional, although some clinics in the city remained closed due to their poor municipal administration and needed improvements, such as nursing beds intensive, have been added.
The morale of the professional staff has improved considerably as they have had access to working materials and adequate supplies of consumables and medicines.
Now the government, which is already seeing improvements through decentralization in rural areas, is bogged down in expanding the network of public health facilities, with that program accelerated through a $200 million loan facility. of Britain, another sign President Mnangagwa noted last week of the successes of Second Republic re-engagement efforts.
This would have been unthinkable a few years ago, but it helps today, especially in the proper equipment of new installations, which require imported equipment.
The design and construction of the new set of clinics is being carried out by Zimbabweans, with the British contracting company involved in the purchase of the equipment, a reasonable division of labour.
Thus, the Second Republic is in the midst of a campaign for 30 new clinics and five new district hospitals, with President Mnangagwa stressing that the timeline for the accelerated program largely depends on how quickly Zimbabweans build.
Funds are released in phases as each set of clinics are completed, which is fair enough, and presumably the Second Republic administrative reforms of zero corruption and shiny accounts mean no keys can be thrown away in the works.
Whether we use taxpayer money, special loans or private donations, everyone wants every dollar to count and be counted. It is therefore absolutely essential to have high administrative standards.
All the reforms of the Second Republic impact each other and make life much better.
The 30 new clinics are spread across the country, starting where they are most needed, and without any attempt to score political points, the only criteria being access to healthcare.
So the first of the first batch of four, the one opened last week by President Mnangagwa, was in Stoneridge, the center of the new South Harare suburb which exceptionally poor planning by the Harare City Council allowed to develop without services, which include roads, sewers, water pipes, power lines, schools and clinics.
The government is stepping in, already promising title deeds, now making sure there is a decent clinic and with the president making it clear, after having to drive on the lanes that pass for the roads to open the clinic, that the delays continuous implementation in at least the basic roads, access to clean water and proper formal schools was simply not acceptable.
The government is starting its share of the development needed but obviously everyone needs to be involved in sorting out the mess of the southern suburbs of Harare where at least there were development plans before the land barons stepped in , so title deeds are fairly easy once a basic survey is done, an ongoing process.
But the president still hopes his next visit to the south will see significant progress in transforming these settlements into real suburbs. Hopefully, its high demands will allow those responsible to act much more quickly.
The other three clinics in this first batch of four are in Bulawayo, Cowdray Park, Mataga in Mberengwa and Runyararo in Chimanmani, a fairly reasonable geographic distribution and urban-rural split.
Again, the president insisted, wanting the teams responsible for these three projects currently under construction to move at deliberate speed, so that funding for the next phase can be released. We don’t want shortcuts, but we don’t need delays.
The other major health move on Friday in Stoneridge was the commissioning of a fleet of 40 new ambulances, 32 purchased by the government with the UNDP impressed enough to add eight more, and again using our own resources rather than relying on aid, it means that aid agencies are more willing to contribute to make taxpayers’ money work.
A hundred more are in the pipeline, and obviously someone in the Department of Health and Child Care made sure, when setting the specifications, that the base vehicle that would be fitted of ambulance body and equipment would not be held up or derailed on poor roads.
A good solid chassis, decent wheel clearance and something close to off-road capability means the Ambulances will be able to enter almost any farm or use the worst roads, a practical requirement.
The 140 must be spread across all provinces, but this provides a sizable fleet in each, and even most districts.
The construction and upgrading of clinics and district hospitals requires that the sick and injured can reach them, and those who need to be moved up the referral chain from clinic to district hospital to district hospital. provincial hospital to a national referral hospital can be moved quickly.
The double, of a significant extension of the network of clinics and of a fleet of ambulances, shows the seriousness of the government policy of providing a decent public health system, which is improving considerably.
Even when the 30 new clinics, five new district hospitals and 140 ambulances are on the road, no one should consider that the government is going to slack off.
He has already shown that he is now ready to ensure that existing and new facilities are maintained and equipped, as well as continuously improved, and all of these steps, maintaining what we have and expanding it as quickly as possible, mean that we are on a sustainable path to the kind of first-class public health care system that we deserve.