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Marina right of reply

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Reference is made to the article “Probe into Marina Crucial – Analysis” that appeared in The Botswan Gazette of Wednesday 15 – 21 February 2017.  The article outlines a number of issues bedevilling the Ministry.  We are aware of these issues.  We will never deny them.  We continue to reassure the public and concerned health workers that work towards resolving these issues is on-going.  The country (not only as Botswana but the world) is seeing an unprecedented challenges economically (talk of credit crunch), and socially.  All these factors affect the development of nations.  And it is our hope that eventually most of them if not all, will be resolved if we collectively work together.
However, as a country we need to introspect and look back to where we come from. The Botswana health care system has seen a dramatic growth from what it was to what it is today; ability to perform complicated procedures, presence of specialists in district hospitals, increased access to health care services and employment of highly skilled and committed workforce are testimony that it has grown. And there is no doubt that Botswana’s health care system continues to be one of the best in the continent.  It is undeniable though that the health system faces many challenges.    Government and Ministry leadership commitment to mitigating these challenges as raised in the article include:
Accreditation- accreditation is a holistic and on-going exercise where all units of the facility are expected to comply to standards of set different service elements before it is awarded. The accreditation program run by COHSASA is ongoing in 16 facilities so far, Princess Marina Hospital (PMH) included. Health Care Standards (Patient safety; Security; Infection Control; SHE; Waste Management) have also been developed. It is worth noting that already 6 health facilities have gained accreditation.
The Ministry continues to make progress towards achievement of the Health Related (MDGs) by reducing under – five mortality from 76/1000 (2008) to 28/1000 in 2011.  The maternal mortality was also reduced from 189/1000 (2008) to 134/1000.
De-congestion of PMH to ease capacity at the hospital is ongoing.  Public education regarding the referral procedure is conducted through Health Pitso’s and Kgotla meetings.  There is also an expansion of services in primary hospitals and clinics to improve the referral procedure. Some minor services such as maintenance and micro procurement have also been decentralised to DHMT’s. The referral guidelines have just been reviewed and will be operational once ready.
We continue to experience shortage of staff, especially medical personnel in health facilities.  However, to address this shortage clinics and health posts are clustered for effective management. Strengthening collaboration and partnership also helps us address challenges of manpower in the health sector.
We continue to identify various options of improving human resource challenges.  There have been significant strides in this area; the introduction of a 10% post basic allowance for nurses and upgraded headship position for allied health care professionals in the Ministry.
After realising that the ministry did not have enough capacity and requisite skill for maintaining equipment, maintenance of medical equipment such as X-ray machines, Anaesthetic equipment, ventilators, autoclaves and CT scans was outsourced.  The Supply Chain Management for improved availability of medical commodities (medicines, laboratory reagents, and medical supplies), medical equipment & devices at required levels in our facilities was also revamped.
Doctor patient ratio/ nurse patient ratio -The nurse-patient ratios are available for different levels of care, however the ministry has a challenge in meeting these ratios because of global demand for health workers. In order to curb this challenge, the ministry has employed health care assistants who participate in day to day patient care services. Furthermore, initiatives such as clustering and task sharing have been introduced to address HR challenges.
Establishment of the health Ombudsman – Following organisational restructuring of MoHW emphasis will be on strengthening the development of oversight policies/guidelines at central level and implementation at lower levels.
Despite the current challenges MoHW assures the public that the health care system remains committed to providing quality health services. It further encourages Batswana to adopt a pro-active approach to their health; regular check-ups, regular exercise and healthy eating habits and access to health information.  For enquiries and feedback please call the ministry’s toll free number: 0800 600 740.
Shenaaz El-Halabi
Permanent Secretary, Ministry Of Health

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