Sweet and bitter pill for the health sector

Rwanda’s health sector has moved strides as many indicators show.On this front, the latest news has been Rwanda attaining MDG four of cutting down the number of under-5 mortalities ahead of the due date and probably the only country on the continent likely to meet this target.With three years left to the MDG deadline (2015), there’s no doubt that Rwanda will surpass the targets for the under-5 mortality rates and the same can be said of the two other health related MDGs that include reducing maternal mortality and combating HIV/AIDS, malaria and TB.On the ground, there has been remarkable progress with regard to rolling out basic infrastructure, hence bridging the geographical accessibility to health care. Mutuelle de Santé turned, now a household brand, has also tremendously cut on the gap of financial accessibility to health care.Very recently, Rwanda signed a landmark agreement with the US government, where for the next seven years, the Humana Resource for Health (HRH) programme will bring US teachers and mentors to train our doctors, nurses and midwives in different areas of specialisation. At the end of it all, we should have at least 500 specialists.But much as we recognise these landmark strides, the downside of our health care system has largely been on gaps in service delivery at our facilities. There’s still under-performance when it comes to patient/customer care in hospitals and health centres. The excuse fronted by many is lack of adequate equipment to facilitate service delivery.But on the contrary, the problem lies largely on attitudes and disrespect for professional norms. True, lack of adequate equipment might be an impediment but there are simple things our health care providers can do to make a big difference.Last week, I happened to escort the Minister of Health, Dr Agnes Binagwaho, in one of her routine visits to a district hospital. As she made a tour of the facility, the minister encountered cases of poor hygiene and sheer negligence that ultimately undermines the quality of service delivered in that facility.You will agree with me that one does not need state of art equipment or donor funds to ensure that the environment they operate in is clean enough. You certainly do not need hi-tech equipment to remind you that keeping a patient waiting for over five hours could result into a life threatening situation.We have all heard of incidents where a Doctor or Nurse discharges a patient and hardily before the patient leaves the hospital premises, he or she collapses. Many of us have heard or seen cases where some theatre objects are forgotten in a body of a patient after an operation.Much as we agree that these cases are on a steady decline, thanks to the strong whip from the central level, any case resulting from negligence should not be treated with soft hands because ultimately it breeds mediocrity. Yes, mistakes happen but there’s a difference between a professional mistake and mere carelessness resulting from failure to give due attention.The good news is that part of the prescription to these gaps is now underway. Early last week, the Minister of Health launched an accreditation process for all our district hospitals based on international standards.It is simple. It’s like imihigo but this time, with a more scientific touch. The process will include a set of 200 benchmarks against which the hospitals will be accredited and based on the score, then these facilities will be ranked. A five-star ranking will be given to any facility that scores above 95 per cent.Ultimately, the dividend for this kind of process is better services that meet acceptable international norms. It will also have a trickledown effect on the lower service providers at health centre level and the health post level because for districts to perform well, their catchment areas must be performing.But for a true revolution to emerge, the other prescription lies beyond accrediting our hospitals. It falls in the hands us, the public. We must understand that it is not a favour to be accorded good services. It’s your right. Therefore, any mismatch to that effect must be questioned.On twitter: @aasiimwe

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Sweet and bitter pill for the health sector