Limpopo hits snags ahead of roll-out

2012-06-02 17:14

Hospitals face arduous task to meet the required standards

The Vhembe district in Limpopo has a long way to go before it can confidently say it is ready to roll out the National Health Insurance (NHI) scheme.

Apart from having some of the oldest hospitals in the province, which appear to have received very little attention in the past few decades, it is battling with staff shortages, drug shortages, cleanliness and long queues.

As Robert Sirwali, acting district manager of health, points out, “there would be no need to pilot NHI if everything was in order”.

He says: “The NHI pilot project is about improving quality of healthcare at district level and making sure that systems are in place before the full implementation of the scheme.”

However, Sirwali admits there is no excuse for any clinic or hospital to be dirty.

“Things like cleanliness and staff attitude do not need to be fixed by the NHI. It is something that we should always strive for,” he says.

Albert Ramukumba, hospital services manager, agrees.

He says: “Cleanliness is one of the non-negotiables of NHI and if we want this project to work we have to improve on it.”

The district recently appointed a compliance officer who is responsible for ensuring that all facilities meet the six core standards of NHI: cleanliness, staff attitude, infection control, safety and security of patients, reduction of long queues and prevention of drugs shortages.

As is the case with most public healthcare institutions in South Africa, admission areas in hospitals around Vhembe are always packed to capacity.
Some patients wait for hours before receiving medical attention.

Ramukumba says long queues happen because people believe “hospital care is much better than clinic care”.

“Patients bypass clinics and flock to hospitals because they want to be treated by a doctor. While some of our clinics are visited by doctors at least once a week, most are not,” he says.

The Vhembe district is planning to expand its network of private doctors who have agreed to work at clinics whenever they have time.

Ideally, all clinics in South Africa are supposed to be visited by a doctor at least once a week. However, this has not been the case in most districts – particularly those in rural settings.

In Mutale local municipality in Vhembe, for instance, there are 21 clinics but only one is visited by a doctor.

This means that for the 90?000-odd people living in this northern part of Limpopo, it is only possible to see a doctor if they go to Mutale community healthcare centre on a particular day. There is no hospital in the area.

The nearest hospital, Donald Fraser, is in the neighbouring Thulamela local municipality – about 70 kilometres from Mutale.

Dr Munyadziwa Kwinda, who heads the NHI pilot project in the district, says: “The situation in Mutale is very sad and it shows the severity of shortages of medical professionals in South Africa.”

He says: “There are only three private doctors in Mutale and they already have contractual agreements with the district to work in Mutale CHC whenever they have time.”

“Donald Fraser Hospital is supposed to be sending doctors to clinics around Mutale local municipality but it is difficult because the hospital is also experiencing a doctor shortage,” Kwinda says.

Kwinda admits that rolling out the NHI will not be an easy task; some things, like drug shortages, are beyond his control.

Limpopo has recently been hit by a critical drug shortage.

“There are critical drugs that all healthcare facilities should always have. However, in recent months we have found ourselves without them,” he says.

Kwinda blames the situation on poor planning in provincial drug depots.

It’s not all doom and gloom for Vhembe: the district is a step ahead when it comes to appointing district clinical specialist teams.

The teams – which consist of an obstetrician, paediatrician, family physician, anaesthetist, advanced midwife, paediatric nurse and advanced primary healthcare nurse – are supposed to strengthen clinical governance of maternal, child and neonatal health services at a district level.

Kwinda boasts that the district had appointed paediatricians and family physicians before the pilot project even started.

He says: “We are hoping to fill the other posts very soon.”

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