Source: Poor governance hurts health delivery | The Herald June 27, 2016
Elita Chikwati Senior Reporter
Poor governance at local health institutions resulted in loss of lives and poor health service delivery at some major hospitals, while equipment purchased under the targeted approach programme has been lying idle over the past three years.
This was revealed by Auditor-General Ms Mildred Chiri in her report for the financial year ended December 31, 2015 on appropriation accounts, finance accounts, revenue statements and fund accounts.
In the report which was made public last week, Ms Chiri expressed concern over poor service delivery in the health institutions.
“I noted with concern the unavailability and poor management of vital, essential and necessary medicines which are critical to service delivery to the ministry.
“This was due to poor prioritisation and weak internal controls on medicines management,” she said.
The report reveals that during 2013, poor health delivery was observed at Masvingo Provincial Hospital where cases of negligence by staff resulted in the loss of lives.
An examination of the hospital’s misconduct register revealed that three midwives did not attend to a patient in the labour ward which resulted in the death of the newly born baby due to cold.
“Two registered nurses also neglected a patient who was critically ill who later died under the care of a nurse aid. This was in violation of the Constitution of Zimbabwe Amendment (no 20) Act 2013 read in conjunction with the Health services Regulation 2006,” Ms Chiri wrote.
On the issue of equipment which is still lying idle, Ms Chiri wrote: “Equipment purchased under the targeted approach at a cost of $295 553, more than three years ago was lying idle at Ngomahuru Institute for the mentally challenged. The equipment has not been installed and commissioned.
“At Mutare Provincial Hospital various equipment purchased under the $3 million targeted approach facility had remained idle for over a period of three years. The equipment had also not been installed and commissioned.”
The report also states that Kwekwe District Hospital failed to account for 80 boxes of 10×2 millimeters promecethazine injection vials, while Gweru Provincial Hospital had run out of vital and essential medicines. Tsholotsho District Hospital was said to be operating without vital and essential medicines.
Chinhoyi Provincial Hospital had unqualified staff dispensing medicines, while Bindura Provincial Hospital did not have a standard unit of measurement in recording and issuing of medicines.
The risk is that service delivery could be compromised if health institutions were operating without essential medicines. Weak internal controls could also result in medicine pilferage.
The ministry acknowledged the error and said it was planning to standardise the stock card recording with the national pharmaceutical units of measurement.
The ministry attributed the shortage of medicines to budgetary constraints.
The report also revealed that there was poor management and implementation of Government programmes.
The audit found out that service delivery at Karoi District Hospital, Kariba District Hospital, Bindura Provincial Hospital and Tsholotsho District was greatly compromised adversely affecting the achievement of the Ministry’s functions as outlined in the Public Health Act.
The audit revealed that obsolete hospital equipment, excessive electricity power cuts, inadequate funding for the procurement of new equipment, medicines and facilities and unavailability of alternative water sources affected service delivery at these institutions.
The Ministry was recommended to ensure that Chinhoyi Provincial Hospital has a dedicated electricity line to avoid excessive power cuts as loss of lives could occur if the hospital operations are disrupted by power cuts.
“The ministry was also advised to consider drilling boreholes at Masvingo Provincial Hospital as an alternative source of water at the institution, reads the report.
The Auditor-General’s office also stated that there was need to tighten controls on supervision of staff to ensure that professional conduct and due care is practiced by all its employees when carrying out their duties and responsibilities to mitigate against loss of life.
The ministry acknowledged the dilapidated state of equipment and facilities which affects service delivery.
The ministry said it had always improvised to deliver with limited resources or outsource the required services.
“Plans have been made to construct, replace and refurbish equipment and facilities. Disciplinary action had already been taken on health workers who were found negligent and supervision had been tightened at Masvingo Provincial Hospital,” the Ministry wrote in its response to the report.
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