3 ZADHR News The Ministry of Health and Child Welfare’s Health Action Plan for the First 100 Days Getting the Zimbabwe Health Care System Moving Again - Health Action Plan for the First 100 Days: March—June 2009 is a plan formulated by the Ministry of Health and Child Welfare in March 2009 following a two day Emergency Health Summit held from 5 to 6 March at the Crowne Plaza Hotel in Harare. The 100 day plan (commencing on the 10th of March 2009) is a proposed starting point for restoring functional basic health services in Zimbabwe. The conceptual framework below summarizes the key elements of the plan and is in line with the ‘six essential building blocks of a health system’ (WHO, 2007). The Conceptual Framework of the Plan: The plan notes the current situation in the health sector regarding leadership, organisation and management, health financing, health workforce, medicines, vaccines and medical equipment, infrastructure, transport and communications and health technology and then recommends actions to be undertaken in these areas between March and June 2009 to begin to address prevailing challenges. In the long term, the plan is intended to be the foundation for the rehabilitation and reconstruction of health infrastructure and restoration of health services. Specific policy issues covered in the plan: • Poor people and vulnerable communities do not • • have access to foreign currency therefore a review of the policy on user and cost recovery is required. The budget allocation for the health sector needs to be increased in tandem with efficient and responsible use of existing resources to avert shortages of service inputs such as essential drugs, supplies and human resources. There is need to adopt a human resources policy that will encourage retention of health workers. • Provincial and central hospitals must rationalize their services through combining service delivery within and between service departments as well as within geographical areas due to limited availability of resources. • The Ministry of Health and Child Welfare (MoHCW) should enter memorandum of understandings (MOUs) with various partners such as local government institutions, NGOs and missions to strengthen partnerships in service delivery. • Corporate management principles at central and provincial hospitals must be improved. • Government should adopt a Sector Wide Approach (SWAp) to health development. This move is likely to send a strong signal to development partners that the government is committed to the principals of partnerships in health development, transparency and accountability in the utilization of its own resources and those flowing as development assistance. Monitoring Implementation of the Plan A monitoring committee consisting of stakeholders in the health sector was set up to monitor the implementation of the plan. Members of the Implementation Monitoring Committee include representatives of the MoHCW, the Health Professions Authority, the Health Services Board, the Zimbabwe College of Public Health Physicians (which is serving as the secretariat), the Association of Healthcare Funders of Zimbabwe, the Community Working Group on Health representing community groups, NANGO representing civil society, a representative of the donor community and a representative of training institutions. The Monitoring Committee is supposed to meet once a fortnight to review progress on implementation of the plan commencing with a first meeting on 31 March 2009. Delays in implementation are to be acted on by the Minister of Health and stakeholders in the health sector. Progress Implementation of the ambitious plan has been slow and it is not likely that it can be completed within 100 days. The plan is also to be aligned with other plans developed by the MoHCW and the plan that came out of the Cabinet Summit held in Victoria Falls in April. Availability of resources remains a major constraint to implementation with a donor conference scheduled to be held in May. A further update on implementation of the plan will be featured in the June issue of ZADHR News. If you would like to receive a copy of the Health Action Plan for the First 100 Days email us at zadhr@mweb.co.zw or write to us at PO Box CY 2415, Causeway, Harare