Healthcare as an election agenda issue

HARARE - Healthcare delivery is a top election agenda issue.

This piece aims to evaluate the various party manifestos on their healthcare promises.

There is a general lack of statistical and financial data to support these promises. In 1985, the World Health Organisation declared that our healthcare system was among the best in the developing world.

Chapter 4, Subsection 75 of Zimbabwe’s Constitution clearly states that every citizen and permanent resident has the right to access basic health-care services.

In developed countries healthcare is consistently among the top three concerns of voters while here most voters go for the name and symbol of a party.

Now that various parties have rolled out manifestos it is time to unpack some of them:

Zanu PF:

President Emmerson Mnangagwa’s Zanu PF states that health remains a critical component of national economic development.

Zanu PF promises free medical treatment for cancer patients and reduce hospital fees by 50 percent, improvements in healthcare Infrastructure, attract skilled health personnel, Improve supply of critical drugs, adequately equip health institutions, health services for rural and resettlement areas, improve health service specialised skills manpower plan, building specialised high-Tech health facilities for a sub regional health tourism hub, affordable drugs manufacturing and supply to all areas, establish at least one hospital per every administrative district thus translating to 78 new hospitals by 2023.

Some detail on how the party intends to achieve this would have been more helpful, especially how it intends to finance universal healthcare delivery.

MDC Alliance:

Nelson Chamisa’s MDC Alliance promises a Sustainable and Modernisation Agenda for Real Transformation (SMART).

Under health, it promises to provide for twinning of hospitals, free maternity health care, dedicate 15 percent of the national budget towards health, legislate no one may be denied medical treatment.

It will introduce “Chamisa Care” Health Insurance Plan (HIP) that will be financed by the Aids levy, Psmas, Sin taxes as well as employer and employee contributions.

The “Chamisa care” is an idea borrowed from the Obamacare initiative in the United States which presents benefits to the poor.

The model is based on the Patient Protection and Affordable Care Act of the USA of 2010, generally referred to as Obamacare which extends health insurance coverage to the poorer estimated 15 percent of the US population who lack it.

These people receive no coverage from their employers and are not covered by US health programmes for the poor and elderly focusing primarily on health insurance coverage, health care costs, and preventive care.

In short, Obamacare affords marginalised poor Americans to be in charge of their health care through huge State subsidies financed from increased taxes.

The major concern is that this may further burden taxpayers or workers at a time there are many out of jobs and failing to put food on the table.

However, the MDC Alliance promises to leverage the country’s rich resource endowment to support the development of a state of the art health delivery system. The absence of specific statistics and financials to buttress these promises makes it difficult to measure viability.

MDC-T:

Thokozani Khupe’s MDC-T manifesto under the plan for Building an Economy that Supports Transformation (BEST)promises a fully functional basic health delivery system.

It will Introduce a patient centred approach in the delivery of health services, adequate budgetary allocation and disbursement to health according to the Abuja Declaration of 15 percent,  A fully equipped and adequately staffed clinic in each of the country’s 1 958 wards.

A fully equipped and adequately staffed hospital in each of the country’s 52 districts, A fully equipped and operational referral hospital in each of the country’s 10 provinces, Screening facilities for noncommunicable diseases at ward level e.g. cancer screening, TB screening, etc.

Establishment of drug rehabilitation centres, Intensify the fight to reduce maternal and child mortality rate, Improve maternal healthcare and zero user fees for maternal health care, Establishment of primary health care countrywide to ensure the prevention as opposed to the curing of communicable diseases.

Training of health personnel to cater for the special needs of people living with disabilities

Although the manifesto carries some good achievable promises the absence of universal health care and how it will work is a drawback.

Coalition of Democrats (CODE):

Elton Mangoma’s Coalition of Democrats (CODE) promises a health system that allows for private, government, council, community and religious institutions at all levels and be accessible to all. CODE will ensure that all citizens have access to primary healthcare and are served through local clinics.  All those suffering from communicable diseases will be treated as a matter of public health. This includes those affected by HIV/Aids. Measures will be put in place to reduce the stigmatisation and spread of HIV/Aids.

Children under five years, pregnant women, women giving birth and those aged over 65 years will access free medical attention.

CODE will create and encourage health tourism as foreign patients who come to seek very high level medical attention are accompanied by their loved ones who will also enjoy what the country offers.

This requires development of top-notch medical facilities, fitted with modern equipment and instruments, and manned by well-trained health personnel. CODE shall also strive to maintain a patient to doctor and nurse ratio, which is manageable, and health personnel shall be adequately remunerated according to their skills.

The manifesto talks about all the nice thingsbutlacks statistics and financials on how to make this a reality.

People’s Rainbow Coalition (PRC):

Joice Mujuru’s People’s Rainbow Coalition (PRC) manifesto the Blueprint to unlock Investment and Leverage for Development dubbed BUILD discusses healthcare in limited detail under cluster 5 in Social programmes under which is Health and others. It promises to ensure basic health hygiene, education and basic healthcare for all.

Ensure basic healthcare is fully resourced to address low morale, drug shortages and retool in line with regional and international best practice under BUILD.

Little attention was given to this important issue. Again the absence of statistical data and financials is a drawback.

Alliance for People’s Agenda (APA):

Nkosana Moyo’s Alliance for people’s Agenda (APA) under Human Development promises health delivery over specific time frames — short term, middle term and long term.

In the short term 0 – 24 months will address administrative and human and equipment resource needs of public institutions which it blames on poor leadership and administration than just poor resourcing. Refurbish and modernise health facilities.

Strengthen PHC outreach services by recruiting and training community health care workers. Introduce informed early screening and treatment of priority diseases — Diabetes, TB, HIV and Cancer to prevent illness and death.

In the medium-term plan 0 — 60 months it starts simultaneously with the short-term plan and focuses on strengthening the pharmaceutical sector so that essential medicines and products are regionally sourced. Explore co-tenancy of public and private services.

APA will explore the provision of private health care facilities within the tertiary hospitals. Increase training capacity for healthcare workers including specialists.

It omits the 15 percent Abuja budget allocation as an immediate source of funding.

What makes this manifesto different is its focus on specific timeframes but lacks a financial plan.

Build Alliance Zimbabwe (BAZ):

Noah Manyika’s Build Alliance Zimbabwe (BAZ) does not appear to have a specific and detailed healthcare section in their manifesto.

However under point number 8 of the 10 point plan there is a promise to build 10 world class district hospitals at strategic service centres and growth points in each province to serve rural communities.

The absence of detail on the health sector and healthcare is surprising because health is life.

The new government must incorporate the best ideas from the various manifestos and implement them.

We want to see compliance the with the 15 percent Abuja declaration to health.

We want to see it legislated and implemented to ensure none of our people are left to die because they lack the financial resources to save their lives.

This critique was prepared by health experts Gwinyai and Majongwe of Health Decisions Consulting (Pvt) Limited for the Daily News on Sunday.

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