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For drugs, medical equipment safety

By Watipaso Mzungu:

ALERT—Stakeholders discuss health governance issues

Drugs and medical equipment worth over K900 million were stolen from public hospitals in 2018 alone.

Of course, the amount is lower than the K1.6 billion worth of drugs and medical equipment the government lost through pilferage and theft in 2016, the Ministry of Health says.

At least, 31 health workers from facilities across the country have been interdicted after being implicated in the vice. They are due to face justice in the courts of law once investigations are through, according to the Ministry of Health spokesperson Joshua Malango.

“As I speak, 31 people will be probed because we appreciate that drug pilferage and theft of medical equipment rank among the serious challenges leading to deteriorating health service delivery in the country,” Malango told The Daily Times recently.

According to the Ministry of Health, the vision of the health sector is to achieve a state of health for all the people of Malawi that would enable them lead a good-quality and productive life.

This vision is guided by legal frameworks and polices, which include the Constitution of the Republic of Malawi, the National Health Policy and the Health Sector Strategic Plan (HSSP) II.

HSSP II emphasises the need for all people in Malawi— including vulnerable populations from hard-to-reach areas—to receive the same high-quality healthcare services regardless of geographic location or socio-economic factors.

Furthermore, the Constitution guarantees all Malawians the right to enjoy highest quality healthcare services within the limited resources available.

But this has not been the case as theft of drugs and medical equipment continues to take a toll on the health sector.

Other than drug persistent stock-outs, drug pilferage and theft of medical equipment remain major factors leading to compromised service delivery in public health facilities and hospitals in Malawi, putting patients’ lives at risk.

Weak leadership, weak social accountability mechanisms, irrational use of medicines, drug leakage and pilferage are also affecting the quality of service in public health facilities.

A recent survey by Development Communications Trust (DCT) established that inadequate oversight roles and functions among community-level health governance structures in monitoring resource for health has been a conventional problem fuelling drug pilferage and theft of medical equipment in public health facilities.

The survey further revealed that limited participation of citizens in decision-making processes and demand for accountability in community health system and inadequate social accountability monitoring mechanisms also contribute to the problem.

DCT Monitoring and Evaluation Officer, Bettie Chumbu, says, although there has been significant efforts to ensure essential medicines and supplies are made available in all health facilities, cases of drug pilferage and abuse of medical supplies are still rampant.

“Other challenges include non-functionality of community-level monitoring mechanisms as well as non-participation of citizens to check utilisation of drugs at community and facility level and limited capacity among citizens to demand and enforce accountability and transparency from duty-bearers in health service delivery,” Chumbu explains.

She further blames citizens for being predominantly passive, and perceiving health workers as unquestionable authorities.

With K73 million from the European Union through Tilitonse Foundation, DCT has rolled out a project which aims to address the endemic problem of mismanagement of resources in public health facilities.

The project, ‘Influencing health governance through citizen participation against drug pilferage’ or Titeteze umoyo wathu, is targeting vulnerable groups of people such as women, youths, persons with disability and people living with HIV and Aids in Mangochi, Mchinji and Ntchisi districts.

And through the project, DCT has been mobilising citizens into action groups called Radio Listening Clubs (RLCs) at group village head level.

These action groups have vulnerable groups in their membership. The RLCs are leading the advocacy initiatives in influencing accountability in the utilisation of resources for health, including drugs.

The action groups are also key in mobilising masses to participate in various project activities, including community engagement meeting with duty bearers.

Chikhota Health Advisory Committee (HAC), which is under Traditional Authority Chilooko in Ntchisi District, is one such action group benefitting from this project.

The Chikhota HAC Chairperson, Bernard Chimbeleko, says they have introduced mobile phone facility at community levels, which is helping them expand their whistle-blowing capacity when reporting drug pilferage through short message services.

Chimbeleko adds that they also introduced drug accountability reporting boxes, which have been placed at health posts and clinics, to influence the implementation of guidelines and protocols for managing, distribution and utilisation of resource for health which were developed by the government.

“Periodically, we conduct drug utilisation tracking exercise through the use of developed tracking tools,” Chimbeleko explains.

Group Village Head Chikhota confirms that the tools they have developed through the project have helped end drug pilferage and theft of medical equipment in all he health centres under Chilooko.

Chikhota states that community governance structures such as area development committees, village development committees and HAC have eventually become vigilant in tracking drugs and medical equipment supplied through the Ntchisi District Health Office.

“We used to have vendors selling drugs in broad daylight in this area. Health Surveillance Assistants used to steal and sell our drugs without us questioning their actions. That is history now,” says the chief.

T/A Simphasi of Mchinji says the project has helped enhance the working relationship between health workers and community governance structures.

Malomo Health Centre Medical Assistant Noel Ngwata, hails the project, stressing it is sensitising and educating communities on the roles and responsibilities of health workers.

Ngwata observes that the majority of Malawians have wrong perceptions and expectations from health workers.

“This project has bridged the information gap that used to exist among service users on our roles and responsibilities and that makes us feel happy about it because we, too, used to suffer unfair accusation by service users,” he explains.

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