Working Towards Universal Health Coverage

*By Bishow Parajuli and Dr. David Okello

The Government led by the Ministry of Health and Child Care launched a five-year national health strategy plan for 2016-2020 last week in a health facility in Murewa.

Having the launch on the grounds of a health facility provided participants with the opportunity to reflect on achievements made so far, challenges encountered in the health sector in Zimbabwe –including inadequate funding base for service delivery, and health personnel and staff shortages.

The strategy is an important document that lays out the Government’s vision for health and well-being of the Zimbabwean people and provides the basis for the UN and Development Partners to play their role in supporting national efforts.

In 2016, the UN family spearheaded by UNICEF, UNFPA and WHO together with the Government turned the corner from transition towards a medium-to-long term health programmes by launching the Health Development Fund. The Fund aims to mobilise $680 million with some resources already committed from partners such as the Governments of UK, EU, and Sweden.

As such, the launch of the national strategy is timely to steer ongoing health programmes including Health Development Fund and build on the gains achieved over the last five years.

For example, the programme support facilitated by UNFPA, UNICEF and WHO on reproductive, maternal, neonatal, child and adolescent health has contributed to the reduction of maternal mortality by 50% in the last 5 years.

Government, with support from UNDP and the Global Fund, currently provides free HIV treatment to nearly one million Zimbabweans, resulting in steady reduction of prevalence rate.

WFP and UNICEF have been supporting efforts in nutrition, water, hygiene and sanitation combatting malnutrition and water-borne diseases, respectively.

These results were made possible by the generosity and strong partnership of donors, including: Australia, Canada, European Union, Ireland, Japan, Sweden, UK and the Global Fund. As the result of the concerted efforts under the cardinal principle of national ownership and leadership, we have noted, child and maternal mortality and other health burden indicators have been in decline in the last few years.

Notwithstanding the achievements, health challenges including in the areas of reproductive and sexual health, child and maternal health, HIV, TB, water-borne diseases as well as emerging non-communicable diseases remain huge.

As such, our resolve to strengthen national health systems that ensure effective, quality and equitable prevention, comprehensive diseases surveillance and mitigation must continue unabated.

As we commit through this new national health strategy to build on the positive gains made so far, we would like to share the following perspectives:

First, addressing access to safe and adequate water as well as sanitation and hygiene services for those who lack them would do much to reduce health burden, particularly water-related diseases. Studies have consistently shown that improvements in water and sanitation coverage – including the implementation of low-cost, simple technology systems – can reduce the incidence of diarrhoea, cholera, typhoid and other water-related diseases which are rearing their ugly heads in some parts of Zimbabwe. Furthermore, providing water and sanitation confers multiple benefits beyond reducing water-related diseases, including alleviating the time and economic burden of having to collect water contributing to human dignity particularly women.

Second, we should pay special attention to looming health burdens as the result of traffic accidents, obesity, tobacco use, Gender Based Violence, counterfeit medication and effects of climate change. We must and can easily tackle these with intelligent use of legislation, public education, regulation and enforcement.

Third, revisit the human resource establishment for health care. The current establishment in use were from 1980s. As you know the population has expanded and the health problems have also increased. Human capital is directly useful in a production process. Human capital increases a worker’s productivity in all tasks hence investing in health is synonymous to creating a wealth for a nation.

Fourth: improving quality and coverage of health services must be addressed across all health programmes and interventions. To this end, it is absolutely critical that the Quality Improvement Policy and Strategy are implemented as a matter of utmost urgency. Zimbabwe’s vision towards universal coverage cannot be achieved without addressing equity gaps as a matter of priority.

And most importantly, to accomplish the outlined issues, there needs to be an increase in the share of Government spending in the health sector and continuously strive to ensure value for money through enhancing the efficiency of ongoing health progammes. This is particularly important now when global economic constraints and competing global crisis have resulted in budget cuts across the board. In 2015, according to Ministry of Health and Child Care the Government and Local Authorities provided about $426 million for the health sector, while the donors and other partners provided some $511million.

While commending the strong support from development partners including the Global Fund, we wish to call on all our development partners to stay the course. Our goal is to see an improvement in the health status of every Zimbabwean, to see Zimbabwe achieve its national health goals and fulfil its commitment the Agenda 2030 and the Sustainable Development Goals.

As the old adage goes – a healthy nation is a wealthy nation. Without health there is no peace, no success, no development. A person with bad health, a community or a country with troublesome health indicators is doomed to live in the vicious cycle of poverty.

Let’s, therefore, work together under this new national strategy with a great sense of urgency to ensure universal and quality health coverage for all Zimbabweans at all times.

*Bishow Parajuli is the UN Resident Coordinator and Dr. David Okello is the WHO Representative in Zimbabwe.