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WHO regional Director pin points Health problems

Publishing Date : 24 October, 2017


World Health Organisation (WHO) Regional Director Dr. Matshidiso Moeti has stated that the biggest problem facing the Botswana health sector is shortage of personnel.

She said she realised this during her official visit to Botswana this week where she met Acting President Mokgweetsi Masisi and high powered delegation from Ministry of Health and Wellness comprising Minister Dorcas Makgato, her assistant Phillip Makgalemele and Permanent Secretary Shenaaz El-Halabi. According to the first female WHO Regional Director who is also a first native Motswana to occupy the lucrative and influential international position, Botswana hospitals and clinics are capacitated by few personnel.

“I think the biggest challenge that I have identified is that of a few capacity or lack of enough personnel in the health sector,” she told Weekend Post on the sideline, shortly after press conference in Gaborone this week. She highlighted that this notwithstanding that Botswana is still a country that imports a significant number of health care workers. “We have gaps in the number of doctors and number of nurses because we are a country with small population with a highest numbers of people who need health services,” she told this publication.

She admitted that there are also many other doctors and nurses flying out of the country for greener pastures particularly to the United Kingdom (UK). In light of those going out for greener pastures she pointed out: “Yes I am aware of that” while adding that it is a serious challenge although “it should be looked into a context of a country’s economic situation.” She said brain drain as it is called is also a challenge and she thinks government is working towards different ways to addressing the issue particularly with regard to the departure of some local specialists that have been trained locally and abroad.

“So these things like remuneration constantly needs to be considered, in terms of how you can retain your people, how can you motivate them, and things like the pay rise. They need to come up with ways to retain the health workers and improve their conditions of service,” the WHO representative highlighted. On his part, the Botswana Nurses Union (BONU) President Obonolo Rahube echoed the WHO Regional Director’s sentiments that the biggest problem in the country’s health sector remains lack of adequate staff in clinics and hospitals.

He said there is burden of patients as nurses’ patient ratio is very high. “Yes I can confirm that we have a serious issue of lack of personnel in our health facilities. Our main issue is that we have approximately 1000 vacancy positions and also that we have only 300 graduates who are now roaming the streets but could be filling the positions but it’s not happening,” Rahube said. He stressed to this publication that “we believe that these nurses should be absorbed into the market because of the already burden of nurses patient ration.” He also pointed out that nurses are no longer progressing to higher scales.

To justify this he said “nurses start the profession on C4 or C3 salary bands and then they move to C1 as per parallel progression. But then from there, they become stagnant and rarely move to the next notch. This notwithstanding that there are posts in the ministry and are not filled as we pointed out.” However when commenting on the matter on behalf of government, the Permanent Secretary in the Ministry of health and Wellness, Shenaaz El-Halabi confirmed the shortage of personnel in the health facilities although downplaying the magnitude of the issue.

“Absolutely, we have a shortage of Human Resource. But sometimes it is not so much of shortage sometimes it is a misconception. But don’t get me wrong, there are genuine cases where we have shortage but sometimes it is how we utilise staff that is there,” the PS told Weekend Post past the same press briefing. So, she added that they have been working on workload assessment in terms of ideally how many people they should be having in a certain area (health facility). In terms of the personnel, she insisted that Shortage of staff is a challenge throughout the world (and Botswana is not an exception).  

“So we continue to train, our medical school is there to train, our Institute of Health Sciences there as well and others on specialization. We also work on our strategies to make sure that they are able to attract and retain staff that is there.”
The Ministry of Health and Permanent Secretary also revealed that they are working on strategies to improve nurses’ salaries and conditions of service to attract and retain them in the profession which will also address the issue of limited staff in which some depart for good paying countries.  

“The good news is that we are also working on attraction and retention strategy. We are working on a new strategy that we have submitted to Directorate on Public Service Management (DPSM) as we have identified areas that we believe we can actually strengthen to be able to address this issue of retention of staff.” El-Halabi explained that there are number of issues that they will be looking at such as remuneration of health workers so that they don’t go out for greener pastures, and issues of pay structure.
“Minister also mentioned this before at a parliamentary committee on supplies that there is need to look at our remuneration package for our health workers.”

On facilities she said she is aware they are congested and that there is need to work towards de-congesting them. “That’s why we have an amazing project that just started on de congesting Princess Marina Hospital. We have started decongesting the maternity wing at the hospital. Not everybody that is delivered in Marina needs to be delivered there. We have maternity clinics across the country. Now they are asked to deliver in other clinics where there is maternity ward other than Marina. Mid wives deliver them. In the event of emergency they can be refereed to Marina. So since this initiative we have seen congestion decreasing.”

She also said as a ministry they also need the nurses to multi task (multi skilling) so that they are able to consult, prescribe and dispense medication (treatment) including on HIV/AIDS. This is essential particularly as we have limited number of nurses and doctors, she highlighted. Some patients have had to die and others continue to die at the hands of doctors and nurses at health facilities across the country because of congestion and lack of adequate staffing.



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