Build on gains in primary health services:  Phooko

Tsitsi Matope

THE former Minister of Health, Dr Motloheloa Phooko says the government should focus on building on the gains achieved over the years to strengthen the primary health service delivery in the country.

Dr Phooko, who served as the Health minister from 2002 to 2007, said it was disappointing to see some of the gains achieved over the years in the health sector being lost due to lack of continuity and improvement of programmes.

He said that since the early 2000s, successive ministers of health have invested in several programmes and the primary health care system can be improved by prioritising interventions that improve on those programmes.

“To a significant extent, we have failed to develop significantly from the gains we achieved in the health sector over the years,” Dr Phooko said.

“During my tenure, one of our biggest challenges was in human resources where there were shortages of nurses and doctors. One would expect the situation to have improved by now had the public health sector maintained initiatives we started.”

He said while it was commendable that the government built many clinics with funds from the Millennium Challenge Corporation, there was need to ensure that these facilities were adequately staffed.

“The problem is not only in the public service’s recruitment system but it is in the failure by the public health sector to appreciate the critical role played by nursing assistants.

“Having enough well-trained nursing assistants remains the core of primary healthcare delivery because you train and place them in the facilities and then provide sufficient oversight.

“If you put five nursing assistants in a clinic and have two nursing sisters and a clinician to supervise them, you will have a well-functioning team. You would then need a health inspector to go around the communities to assess the health situation.

“That way you can achieve a well-running primary health care system in the communities. But if you fail to do that, then your primary health care will become weak and your referral system will subsequently fail as is the case right now,” Dr Phooko said.

The nursing assistants’ training programme was terminated after Dr Phooko left the ministry to become minister in the former Prime Minister Pakalitha Mosisili’s office.

Dr Phooko had opened Tsakholo training facility in Mafeteng which had an intake of 24 nursing assistants before another training programme was started in Qacha’s Nek which had an intake of 35 nursing assistants.

“With the two institutions, we were sure that we would have a good flow of nursing assistants to form the core of the primary health care in the country. However, their closure shows that someone failed to see the immense benefits they were contributing to the health delivery,” Dr Phooko said.

He said the ministry also worked hard to introduce clinic-based training programmes for medical doctors, learning from experiences in Cuba. However, all arrangements made with the Cuban Government were reversed soon after Dr Phooko left the ministry.

Dr Phooko also cited the village health workers volunteer system, which suffered following the introduction of remunerated community-based health workers.

“The volunteers worked in the villages, monitoring health situations and at times they were also assigned to specific areas to help look after the communities and were doing very well,” Dr Phooko said.

He however, commended the moves to pay the village health voluntary workers.

“The government has realised the need to build on the village health worker initiative to make it perform better and improve on the retention of the volunteers.

“It will be good if they can sustain their efforts and further develop the programme to effectively cover the whole country. I am a strong proponent of the programme and this can improve the performance of the primary health delivery system,” Dr Phooko said.