HOME ABOUT US OUR VALUES AREAS OF FOCUS CONTACT US EMERGING ISSUES
     

OUR VALUES
  • Integrity
  • Professionalism
  • Innovation
  • Mutual respect
  • Principled leadership
  • Evidence based solution
  • Team work

  1. Health Institutions
  2. Professional Disciplines
  3. Location of pharmaceutical companies
  4. Wholesalers
  5. Training institutions
  6. Donors and Funders and NGOs in the region

EMERGING ISSUES

 

Male Circumcision

Zimbabwe is on a major male circumcision campaign which has seen at least 30 000 males being circumcised since the campaign began back in 2009. Zimbabwe’s target is to have circumcised around three million males by the year 2015. Zimbabwe should consider developing a policy that focuses on infant circumcision probably as a routine procedure in hospitals. Available evidence strongly supports infancy as the optimal time for male circumcision, conclude the authors of an analysis published on 28 February in BMC Pediatrics. Compared to male circumcision during adulthood or adolescence, infant male circumcision is safer, less costly, and is associated with lower risk of many conditions and infections, including penile cancer, HIV, genital herpes, and urinary tract infections. The authors recommended that countries worldwide develop evidence-based policies on the feasibility of infant male circumcision so as to support a recommendation of male circumcision in infancy, to provide unbiased information to parents about infant male circumcision and to facilitate access and affordability.

It is interesting to note that there are new innovations on how to carry out circumcision faster and less pain than the conventional surgical method. The two devices being researched are namely Prepex and Shang ring. A current study is being conducted on the safety and viability of these devices in Zimbabwe and it is hoped to bring out results by the end of 2012. Such innovations would greatly increase the number of males circumcised and thus attain the target well in time.

Condoms in Prisons

Although condom use is among the top HIV prevention methods, condoms are regarded as contraband in prisons. In most African countries, including Zimbabwe, homosexuality is a criminal offence and as such placing condoms in prisons would imply allowing homosexuality in prisons and thus be in contradiction to national law. However findings of research conducted in countries like the USA, Zambia and Zimbabwe have revealed that MSM in prisons is a reality. HIV and AIDS experts are strong advocates of condom use in prisons as there is evidence that HIV prevalence in prisons ranges from two to fifty times higher than the general population and such strong prevention measures should be taken. They further insist on policy formulation that addresses MSM in prisons.

Prison officials on the other hand are not for condoms in prisons as they say MSM is a criminal offence. They argue that instead of placing condoms in prisons prison rules should just be made more stringent and punitive measures increased against those involved in MSM.

National Health Insurance schemes

For some time now quite a great deal of controversy has continued to surround the introduction of government-run mandatory health insurance not only in Zimbabwe but throughout the world.
Government-run mandatory health insurance could make an important contribution to health care financing however the success of such a scheme would depend on three core health care financing functions namely, collection of revenues, financial risk management, and spending of resources on providers. Each of these functions have quite a number of different determinants that determine their viability, for instance under collection of revenue comes the issue of how to formalise the informal sector, which largely constitutes the greater population. Considerations for financial risk management would include the size of risk pools which depends on willingness of people to join. Spending of resources on providers has to do with questions such as from whom to buy? This being against a general trend of ambulatory sector dominated by private providers and inpatient sector dominated by public hospitals.

No one mechanism is likely to succeed by itself in securing all the objectives of health financing systems: mobilizing resources to pay for needed services, protecting populations against financial risk and spending wisely on providers. Rather, a multi-pillar approach that combines various instruments – including subsidies, insurance mechanisms, contractual savings and user fees is more likely to succeed in meeting these objectives in resource constrained environments with weak institutions, organizational arrangements and management capaicty.

User fees at Health institutions

User fees were introduced in Zimbabwe in 2009 as a bid to avail funding for health institutions which had become dysfunctional due to severe deterioration of the country’s economy. Proponents of user fees point out that charging attaches value to a service, i.e. increasing demand by increasing perception of quality and deterring inadequate use of health care services. While free services reduce utilization because of inefficiencies leading to poor quality and because of low value attached to services. Those that oppose the use of user-fees have argued that fees reinforce the poverty trap by decreasing service utilization by the poor. However since the inception of this system, no substantive analysis has so far been made regarding the impact of user fees on health care delivery in Zimbabwe. There is therefore a need to conduct various feasibility studies on user-fees and on how best to charge them i.e. whether some services can be for free while others are charged and thus allow for cross subsidation. Also studies can be conducted to find out the services for which people have a high willingness to pay against those they regard as necessary. This should then be the basis for policy formulation which should either leave user fees as a stand alone policy or have it complemented with other financing mechanisms.

Health Financing

Zimbabwe like other developing nations is working on finding methods of sustainable health financing which is not donor dependant. This requires government to commit to increasing budget allocation to the health sector by providing at least 15% as advised by W.H.O., to the Ministry of Health and Child Welfare.

Business Investment in the health sector

One of the key arguments why business investment in health is low, is that health is seen as a service that should be free of charge. Proponents of this idea then discourage the idea of for-profit activities in the health sector. While those against it claim that business investment should indeed be allowed in the Health sector to allow for cross subsidation and quality improvement in healthcare delivery.

 

 

 

 

 

 

 

 

 

Go to Top

Diet Tips
Make your weight loss goals come true. These tried-and-true diet tips really work.
>> Read more


Hair Dye
Do you color your hair? Better read this.
>> Read more


Always Late?
Lateness and procrastination may be signs of ADHD.
>> Read more

  • Prevention is cornerstone to Primary Health Care approach.
  • Prevention of HIV and Aids, Cancer and Communicable diseases
  • Water and sanitation
  • Child Welfare issues etc.
  • These are important issues.
  • CHEST will seek strategic approaches with stakeholders.
ADVOCACY

CHEST will offer

  • Training
  • Advocacy
  • Consultancies
  • Interactive seminars and conferences on Health related issues.
Copyright © CHEST 2012 - Powered by SADACNET.COM