Rebuilding Health Services after a Health Workforce Crisis in Zimbabwe
Author: Ministry Of Health and Child Welfare
Towards the end of December 2008, Zimbabwe faced an unprecedented health and human resource crisis: a cholera outbreak that eventually claimed almost 4,500 lives was ravaging the country, while the number of health workers available for duty had shrunk to less than 20% of the initial number. Zimbabwe’s economic challenges peaked in 2008, with inflation reaching 231 million percent. This caused an unprecedented deterioration of health infrastructure, loss of experienced health professionals, drug shortages and a steep decline in the availability of health services for the population.
In December 2008, the Government of Zimbabwe approved a retention package for all health workers. The retention scheme, supported by development partners and donors, resulted in a significant reversal of the health worker crisis and formed a building block of capacity for future management of HRH, in accordance with the Agenda for Global Action and Kampala Declaration. Several steps were taken in this direction, including:
- Effectively leveraging bilateral and multilateral aid for getting the workers back to work. A standardized national health worker retention policy, pooling together all available resources, like The Global Fund (GFATM), European Commission (EC), Expanded Support Programme (ESP) and Department for International Development (DFID) in a harmonized scheme, was launched in December 2008 and played a significant role of attracting striking health workers back to work.
- The government granted an “amnesty” to encourage the return of striking/ resigned health workers who had left government service during the crisis. Bonding of newly qualified health professionals was also introduced in 2006.
- Computerization of the Zimbabwe health workforce information system; software was designed to capture essential information and produce reports which are now presented quarterly to management, enabling informed decision making.
- “Health Matters” magazine was recently introduced by the Ministry Of Health and Child Welfare to encourage dialogue within the health sector and to highlight topical issues on HRH. The Ministry’s website was also activated and updated.
- The number of community and mid-level health workers was increased by the introduction of many regular cadres.
Zimbabwe is making a concerted effort to address the HRH crisis by adapting recognized solutions and developing new ones, with tangible results:
- Since January 2009, there has been a steady increase in the proportion of health posts filled.
- Posts have largely been filled by returning Zimbabwean health workers previously in other employment or other parts of the region.
- Large-scale return of health workers from resource-rich countries such as the UK, USA and Australia has yet to be seen, but efforts are being made to attract this key group.
- This has led to improved access to the health workforce and associated health services.
Staff retention and management are critical for the success of health systems, and should be paid attention to at all times. During crises, immediate steps may need to be taken to attend to urgent health needs. Although Zimbabwe has been successful in recovering from the health workforce crisis of 2008, through a combination of measures, it is essential to ensure staff motivation and compensation to prevent the onset of such unrests.