Introduction

The Health Task Force co-chaired by the Permanent Secretary for Health and the Vice President Health Professions Authority meets regularly is to carry out an assessment of the state of the country's health care sector through presentations by the key stakeholders namely: Ministry of Health and Child Welfare, Medical Professional Associations, Medical Councils, UZ School of Medicine, Private Hospital Associations, Private Medical Laboratories Association, pharmaceutical manufacturing companies, Medical Aid Societies, AFROZ, consumers etc.

1. Key problem areas in the current status of the health sector operational environment
   
   The Zimbabwe Health sector delivery system is cause for grave concern. The sector is characterized by the following:
   
   
   1. Overall failure by the public sector hospitals to perform their intended functions resulting in excessive strain on the private sector health delivery system leading to the collapse of the entire sector. Furthermore, failure by public hospitals to function has led to the failure by the Medical school to offer clinical practical teaching to medical students from year three on wards to the extent that after two years all medical students leave the country to regional institutions and abroad in order for them to complete the medical degree programme. At the end of the day, most do not come back but are absorbed in those country's health system. Zimbabwe is the biggest loser.
   2. Failure to retain our local, well-trained health care professionals due to unattractive remuneration, poor working environment and, most importantly, the current retention packages. Furthermore, the tools of trade are dilapidated and non functional.
   3. Inability to recapitalize/re-equip the entire health sector by the state coupled with unstructured procurement systems for supplies right across the board.
   4. Inability to provide reliable and consistent basic supplies of medicines worsened by poor services in such vital utilities such as water, communications and electricity.
   5. Inability to Maintain, Upgrade, Develop, and Implement a sustainable health professional training policy to ensure production of quality skills at all levels including the special services care such as maternity, ICU, Theatre, Environmental Health etc...
   6. Inadequate coverage of benefits by health care insurance providers amid calls for an urgent review of statutory instruments that governs the functions of Medical Aid Societies to ensure that they stick to their core business.
   7. Failure to carry out regular preventive vaccinations (even for the infants group) for known diseases including dealing with seasonal malaria and water borne diseases.
   
   These highlights are some of the major challenges being faced by the Health Sector in its entirety. The Task Force therefore urges for immediate steps to be taken to address this untenable situation given that health delivery is a human right and adversely impacts on all other economic sectors.



2. Present situation in the health sector
   
   The health of the nation is vital to the economy and this report is prepared against the background of a totally collapsed health care delivery service. It is not surprising that as one goes through this report they have taken or are on medication of some sort. It is for this simple reason that the nation must be fully conscious of the status of national health delivery system. The mostly affected are the referral hospitals which are unable to perform such functions as referral centers. It is saddening to see many pregnant mothers loose their babies or their lives due to lack of basic facilities. Delivering mothers are now expected to bring their own gloves during delivery at clinics across the country or else medical personnel will not attend to them if available at all. If one is involved in a serious accident and break bones there are no facilities to deal with such cases currently. If available, the cost is so exorbitant that many are dying quietly at home. There are no pins anyway to restore the bone structure. One is expected to buy and bring them into hospital. In short, all that the public sector is now providing is the basic infrastructure and very little personnel.



3. Infrastructure
   
   Most hospital infrastructure is dilapidated and there is urgent need to repair existing hospitals. Most of the dilapidation is due to failure to maintain existing structures commonly found in most hospitals. Amongst them are the following:
   • Nonfunctional and obsolete systems such as air conditioning systems,
   • Mortuary refrigeration systems;
   • Boilers;
   • Medical equipment including laboratories;
   • Building structures;
   • Hospital furniture and fittings etc.