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MOST HEALTH PROBLEMS OUTSIDE MINISTRY’S JURISDICTION - LIZZIE

03/01/2022 08:57:00 BY KHULILE THWALA

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MBABANE – Most of the problems facing the public health system in the country are outside the jurisdiction of the Ministry of Health.

This was said by the Minister of Health Lizzie Nkosi and the secretary general (SG) of Swaziland Democratic Nurses Union (SWADNU) Mayibongwe Masangane when reflecting on the ministry’s highlights and lowlights for 2021. The year 2021 really tested the Ministry of Health’s service delivery and placed the ministry in the spotlight. With the ministry trying to recover from the emergence of COVID-19 and the effects thereto from the year 2020, the recovery process was disrupted by the civil unrest, which resulted in major procurement issues as medical supplies deliveries were delayed with trucks, for a period of close to a month, failing to enter the country due to fear of being burnt.

Controversy

However, despite being riddled with controversy, the ministry remains resolute and determined to have a more productive 2022. Nkosi stated that the situation was complex as it spoke to the whole supply chain embedded in the government systems beyond health. “The measures aimed at reducing wastage and arrears have many checkpoints and controls that can cause delays in the procurement system. Having said that, the ministry is working closely with the central agencies to address areas of inefficiencies, and improve performance. “We have a fully-funded plan in the ‘health systems strengthening project’ to address some of these concerns. We will see improvement in 2022. One of the strategies includes procurement of children’s vaccines and selected essential medicines through a United Nations (UN) prepaid pooled procurement system,” stated the minister.

In light of concerns previously raised by SWADNU concerning the hiring of nurses on a temporary basis, the minister was further questioned as to how the ministry would respond to the calls to hire nurses permanently instead of on a contractual basis. To which the minister stated that in the past two years, the ministry had been responding to the COVID-19 pandemic, hence most of the staff hired on contract basis were for this response. This includes nurses and many other cadres of health professionals.

“When responding to an emergency or epidemic, hiring additional temporary staff is normal to create the required surge capacity. Unfortunately in this case, COVID-19 is dragging on unpredictably because of the nature of the virus, which keeps mutating. All the same, the health system and budget cannot absorb the short-term staff permanently,” she said.

The Mbabane Government Hospital (MGH) recently experienced an unprecedented invasion from a gang of men who sought to avenge the death of one of their own. The minister was further asked on how best the security issue would be handled in health facilities to ensure the safety of the staff as well as the patients.
“In general, we have a few isolated security incidences in our health facilities. However, following the recent security incident at MGH, it is clear that we need to review security services provision across all health facilities, and improve the scope of these services. Staff and patient safety remain our priority as a ministry. The event mentioned above is regrettable, and we need the whole nation to work with us to keep our hospitals safe. Health facilities should be easily accessible to all, as well as a safe environment to all,” responded the minister.

Security

She was further asked on whether contractual issues between the security companies and government could have been the major cause of the security breach at the hospital to which she responded to the negative. Masangane was reached for comment to ascertain the union’s reflection on the ministry’s service delivery this year as well as what the union hopes the ministry will focus on in the new year. He highlighted that most of the problems which were faced by the public health system in the country were outside the jurisdiction of the Ministry of Health.

“As a union, we engaged the ministry on internal issues and resolved some. But same were outside their scope like employment of nurses on contracts, the inadequate supply of personal protective equipment (PPE), the poor infrastructure, shortage of drugs and medical supplies,” said Masangane. He stated that the only issue they failed to resolve, yet it was an internal one, was the shortage of food and that of security within our health facilities. “The union expects the ministry to focus on the personnel welfare and ensure by all means necessary that there is adequate medical supplies, drugs, food for admitted patients and improved infrastructure going forward,” said the secretary general.

The minister was further asked on how best the ministry was aiming to mitigate the issues it faced in 2021 for the new year, to which she responded that the ministry would continue to focus on health systems strengthening as this was key in ensuring a resilient health system that will be ready to take any strain without collapsing. “Our response to NCDs (non-communicable diseases) needs a lot of strengthening. All pillars of the response have been greatly exposed by the current pandemic. We have observed that most of the comorbidities that exposed COVID-19 infected patients to complications and death are NCDs. For that reason attention to long-term management of the diseases will ensure a healthier nation with a better chance to improve our health outcomes. Ultimately this will reduce the burden on our health system, especially hospitals.”