Zimbabwe needs to decongest public hospitals by making local clinics take the lead Hospital

Jacqueline Ntaka

ZIMBABWE’S public hospitals are often the first point of contact for many seeking medical care. However, this has led to overcrowding and a strain on resources, which can compromise the quality of care for those with critical needs. 

A potential solution to this challenge is to restructure the healthcare delivery system by prioritising critical cases in public hospitals while directing non-critical cases to local clinics and private practitioners. 

The sight of long queues at public hospitals is a stark reminder of a healthcare system under pressure. The key to alleviating this burden may lie in a strategic redirection of patients based on the urgency of their medical needs.

By reserving public hospitals for critical cases, we can ensure that life-threatening conditions receive immediate and specialised attention. This prioritisation not only improves the chances of recovery for critically ill patients but also allows hospitals to better allocate their limited resources, such as ICU beds, advanced medical equipment, and specialised personnel.

By encouraging non-critical patients to seek care at local clinics, the Government can significantly reduce the patient load on public hospitals. Clinics are often more accessible for routine health issues and can provide personalised care with shorter wait times. This shift can foster a more efficient use of healthcare infrastructure and personnel, promoting preventive care and early intervention.

Doctors in private care and healthcare facilities can absorb some of the patient overflow from public hospitals. While cost may be a barrier for some, a collaborative approach between the Government and private sector could lead to subsidised rates for less critical services, making private healthcare a viable option for a broader segment of the population.

The proposed restructuring can lead to a more balanced healthcare system, where public hospitals are not overburdened, and patients receive timely care. This can result in better health outcomes, reduced transmission of hospital-acquired infections, and a more sustainable model for healthcare delivery.

Finland has successfully reduced the number of hospital beds per capita by over 50 percent, mainly affecting long-term care and psychiatric care beds. This was achieved through hospital infrastructure restructuring, centralising services in a small number of hospitals and clinics, and providing a more limited range of services in smaller hospitals.

Zomba Central Hospital

Malawi’s healthcare system faced challenges similar to those in Zimbabwe, with central hospitals experiencing overcrowding. To address this, Malawi implemented a comprehensive decongestion strategy at Zomba Central Hospital. The strategy involved redirecting services, general Outpatient Department (OPD) and primary healthcare services were moved from the central hospital to health centres, also known as Gateway Clinics, around the hospital.

The Ministry of Health developed key strategic documents to guide the decongestion of central hospitals and the strengthening of gateway clinics. Efforts were made to improve the infrastructure and develop additional capacity at Zomba Central Hospital to better serve patients, including those with COVID-19.

The decongestion strategy ensured that all Malawians had access to quality tertiary healthcare services. By reducing the patient load, the hospital could provide more efficient and higher quality care. The strategy allowed for better use of medical equipment and staff, which is crucial in resource-limited settings.

Zimbabwe can learn from Malawi’s experience by crafting a clear plan for decongesting public hospitals and enhancing the capabilities of local clinics. The Government should also upgrade clinic facilities to handle an increased number of patients, especially for routine and non-critical care. While that is being done, the Government should inform and educate citizens about the new healthcare structure and the benefits of seeking non-critical care at local clinics.

As part of the decongestion strategy, Zimbabwe could also encourage uncomplicated births to take place in clinics, which would free up hospital resources for high-risk pregnancies and emergencies. This also benefits the patients as clinics are typically more cost-effective than hospitals, reducing the financial burden on the healthcare system and patients. Not forgetting that clinics can offer a more personalised and community-focused environment for childbirth, which is a plus for mother and child. 

By adopting a similar approach to Finland’s and Malawi’s, Zimbabwe can make significant strides in improving its healthcare system, ensuring that public hospitals are reserved for critical cases, and that all citizens have access to the care they need in a timely and efficient manner. This strategy not only addresses the immediate issue of overcrowding but also lays the foundation for a more resilient and sustainable healthcare infrastructure.

That said, this approach requires careful planning and public education to ensure a smooth transition. There must be clear guidelines on what constitutes a critical case and an effective referral system between clinics and hospitals. Additionally, investment in local clinics is crucial to equip them to handle the increased patient volume. The good thing is that Zimbabwe has clinics in almost every suburb. Implementing this will not be a herculean task. 

Jacqueline Ntaka is the CEO of Mviyo Technologies, a local tech company that provides custom software development, mobile applications and data analytics solutions. She can be contacted on [email protected].

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