The Health Services Department is headed by Dr Prosper Chonzi. His office is at Rowan Martin Building. The Health Services Department is charged with the responsibility of providing Primary Health Care services to the residents of Harare and ensuring the general health of residents. With its Head Offices situated at Rowan Martin Building (RMB) and its major services provided at two Infectious Disease Hospitals (Wilkins and Beatrice Road Infectious Disease) and a network of clinics that span the whole city. The department's growth or formation is traceable to 1915 when it was known as the Sanitary Department with a thrust on the control of flies and mosquitoes.
The City Health Services Department to provide WORLD CLASS PRIMARY HEALTH CARE SERVICES by 2025.
To provide world class primary health care services through the provision of comprehensive health services, education and promotion of good health, environmental health management, curative and rehabilitative care targeted at the most health vulnerable residents of Harare.
The department will be driven by the following core values:
Strategic focus is the ability of an organisation to harness and direct all resources in one chosen direction. In order to achieve the vision as stated above, the department will focus or start moving in the following strategic direction.
Strengthening and Capacitating Districts
Service delivery in the department is hinged at district level and the department believes that it will leverage and maximize the health impact of various programmes if it capacitates the districts.
The department will only become world class when it provides a quality service. The department plans to match and exceed international quality standards. It will seek to ISO certify most of its procedures and practices and all sections will be encouraged to benchmark with the best. The department will require, as a minimum, all sections to have standard operating procedures.
Mainstreaming Child Health
The department will work towards a deliberate strategy aimed at achieving an Integrated Management of Childhood Illnesses (IMCI). Already the opening of a paediatric opportunistic infection clinic at Beatrice Road Infectious Diseases hospital is a first step towards a child HIV/AIDS health care service that will be rolled out to all the clinics.
The HIV/AIDS Challenge
HIV/AIDS is the biggest health challenge facing the country and the city. It is the single biggest direct and indirect cause of morbidity and mortality. HIV/AIDS is also an important factor in almost all health programmes and this plan recognises the importance of a integrated approach.
Priority Health Issues
The department recognises that the city is facing numerous environmental challenges and that the city is sitting on numerous public health time bombs. Priority will therefore be given to strengthening the disease surveillance and epidemic preparedness and response capacity of the department and the city. The strategic plan also recognises the need to intervene to address the high morbidity and mortality due to cardiovascular diseases and malignancies, the need for more effective management of these conditions in a district hospital set up, the need for secondary level of care (district hospitals), the need to have a viable programme or mentally ill patients and the need to keep malaria out of Harare.
Access to Essential Drugs
Access to health would be meaningless if patients leave the health institution without the requisite drugs. This plan recognises the importance of ensuring and sustaining 100% availability of vital drugs and 80% essential drugs in all the computerised stock management system.
Organisational Development an Transformation
The successful implementation of this plan presupposes that the department fundamentally changes or transforms the way it transacts business with particular thrust on the following:
- Every employee should do what he or she is expected to do.
- The department needs to clearly define the city health way of doing things.
- The department will work like clockwork and do the right things right at the right time and work with surgical precision in all its operations.
- There are several skills or core competencies that the department has mastered over time. There is need to deliberately work on developing these organisational capabilities.
The department envisages the expansion of the city's health infrastructure in the next five years to address the "new health demands". This development will address the following areas:
- Address the new health demands of the low and medium density suburbs through the conversion of the Family Health Services to Satellite Clinics.
- The health care needs of the Central Business District (CBD) through the provision of a Satellite and Maternity health care service in the CBD.
- The refurbishment of existing infrastructure and equipment.
The department has:-
- 12 polyclinics – (three clinics in one with Maternity Unit, Primary Care Clinic and Family Health Services Clinic). These are located predominantly in the high density areas.
- Seven Primary Care Clinics
- 15 satellite clinics. These will soon be 16 with the opening of Budiriro Phase 5 Clinic.
- Six Family Health Service Clinics
- Four Dental Clinics.Gershon Dental at BRIDH is the largest and the rest are located within the polyclinics. Ideally each polyclinic should have a Dental Unit.
- Two Infectious Diseases Hospitals. Beatrice Road and Wilkins Hospital.
Two specialist services:
- Medical Examination Centre which is critical diagnosis and treatment of communicable diseases. The City intends to take over the issuing of Food Handlers Certificates and this will be performed at MEC.
- Genito-Urinary Centre – an ideal clinic for the treatment of Sexually Transmitted Infections. We have recently opened a Cervical Cancer Screening Clinic here.
Strengthen The Utilisation of The Health Service Fund
Experience in the public sector has shown that retention and use of user fees at local level enhances the effectiveness of the health system. The city has a policy where it retains clinic fees for emergence and essential requirements. This policy has worked very well to ensure that the clinics and hospitals are kept functional. In fact it is partially through such policy that the city health service delivery remained functional when other services in other departments had grind to a halt in the past few years. However lately there has been a policy reversal.
Cooperating Partners Policy and Role
There is a renewed interest in health by various development partners. The department welcomes cooperating partners. Efficient coordination of the efforts of the various partners is important in ensuring optimal use resources. The entry and exit point for all partners in the department is the Director of Health Services' offices in Rowan Martin Building (RMB). Partners are expected to work within the department's vision and mission and the parameters set out in this strategic focus. Partners will operate with express written approval or Memorandum of Understanding from the department. The department will establish a one stop shop office under the Director of Health Services that will handle timeously all issues to do with partners. The department has identified several project and programmes it is working with partners and would want to further develop this partnership. These are include and are not limited to the following:
- Supply, procurement and distribution of drugs, vaccines and other medical sundries.
- Research and development.
- Health promotion, preventive health services, epidemic preparedness and response.
- STI/HIV/AIDS/TB prevention and treatment.
- Utilisation of Training Facilities at the Genito Urinary Center for STI and other health issues.
- Procurement and distribution of nutrition products and programmes.
- Procurement of equipment and other hospital/clinic supplies.
- Human resource development and organisational development programmes.
- Completion of buildings in Kuwadzana phase five clinics, Budiriro phase four clinic and Wilkins Hospital wards.
- Expanding and diversifying the service provisions at all council clinics especially those in the low and medium density suburbs.
- Setting up a mobile health service.
- Development of a Central Business District health service.
- Utilisation of excess capacity at the city health institutions.
Complimentary Role of The Private Health Sector
A Significant proportion of Harare resident access private health care. The city has a fairly developed private healthcare industry that currently complements the public health sector. However, this industry has been largely self-regulating and over time the industry structure has developed some monopolistic an oligopolistic tendencies and allegations of profiteering have been made. While the department recognises the important role of the private health sector in the provision of health services in the city, the City Health Department as the health planning authority in the city, needs to work closely with the Ministry of Health and Child Welfare to regulate and ensure an efficient private health care industry.