Knowledge spans from general to specifics; interventions range from unstructured to structured. Health Sector is an industry perfected to provide structured interventions, ranging from preventive to curative health services, to the general public in the General Environment. Intrinsically, Education Sector is designated to produce a specified quantity and quality of health professionals, of specified tranches, for Health Sector. In Zambia, the situation is very outlandish; the Higher Learning Institutions, in cahoots with the Regulatory Bodies and some quislings, from Health Sector, have arrogated to themselves the rights to produce any quantity and quality of health professionals. Concurrently, they have added spurious tranches of professions; causing a cacophony in the sector. In effect, the Health Sector has been ritualised and lost its essence. Below is a buttressed argument for apologists of truth.
The Health Sector is anchored on health systems. In order for the health systems to be effective, in meeting the health needs of the population, six interrelated key elements must be jockeyed into position: (i) Leadership, management and governance, (ii) Health finance, (iii) Human resources for health, (iv) Healthcare products inventory, (v) Health infrastructure and (vi) Health intelligence. The sector is expected to be under the control of MoH and superimposed Regulatory Bodies for uniformity. In Zambia, the sector is off the rails; below is why:
– Instead of coalescing, the sector is in wrack and ruin because the putative nonpareil profession has chosen money to be larger than life. The MoH has failed to put the house in order, let alone reeling off specifications to Education Sector. Consequently, unspecified tranches of health professions and uncontrolled prodigious number of substandard health professionals are being funnelled into Health Sector.
– In a normal scheme of things, every health profession has a specific role to play. Rule of thumb: areas of responsibility abut, but they don’t overlap. If they overlap; the organisation lacks leadership, it is a source of disorder, and that the quality of its services is vitiated. In Zambia, the Health Sector has violated the rule; it has incorporated the following professions without unique mandates: Public Health (Dip and BSc), Clinical Medicine (BSc), Public Health Nursing (Dip and BSc) among others. Below is an enunciation for the moot point raised.
Preventive Medicine is a first line of defence and a proactive approach to Public Health. Its role is to improve and prolong lives of the people by ways of preventing diseases and promoting healthy lifestyle. Environmental Health profession is the custodian of the Preventive Medicine.
In order to be competent in this field, one must comprehend the sphere of Environmental Health. From there, operational skills obtained are applied to forestall health stressors from entering the living environments: home, work and recreational environments intersected. Environmental Health Profession has a full knowledge quality parameter. The following are the core pillars of Environmental Health: Food Safety and Hygiene, Occupational Health and Safety, Community Health, Built Environment and Pollution Control. Therefore, to join the club, one must satiate the prescribed standards and criteria.
From the above, it is clear that Environmental Health is the only profession from the Health Sector to penetrate entire government sphere in order to lead a developed country. However, going by what is prevailing, on the ground, this field has been alienated due to paucity of knowledge among leaders at various levels. Hence, Zambia is seething with a litany of preventable health problems.
Curative Medicine is at a receiving end and a reactive approach to Public Health. Its role is to provide care and treatment to patients. With a full knowledge quality parameter, Curative Medicine comprises of the following key professions: Human Medicine, Nursing, Biomedicine, Pharmacy, Physiotherapy, Radiography and Dentistry.
In Zambia, Curative Medicine has managed to wangle political support. Despite having an invidious political support, it is a source of confusion in the sector. Here is why:
– Human Medicine (HM) and Clinical Medicine (CM) are logically standing on the same carpet and CM is expected to be a fodder for HM. By now, BSc. HM should have been the only advanced level from Dip.CM, instead of having two degrees of the same mandate.
– The new-fangled training in Public Health Nursing (at lower levels) by Education Sector is not supported by Health Sector. Nursing has a special role to play and before any advanced specialisation, every Nurse must have the same knowledge base. Therefore, introduction of Public Health Nursing at Dip and BSc level is a non sequitur.
Public Health is a discipline that straddles preventive and curative services; the two sides of the same coin are intersected by epidemiology, biostatistics, health stressors among others. Public Health is offered at Masters level and above, andis exclusively for health professionals from both sides. Note that, Public Health is not for every health professional, let alone Non Health Professionals. It is for selected few that sate the standards and criteria set for one to be part of the Pantheon of Public Health Specialists.
In Zambian, the situation is off kilter; the Higher Learning Institutions are busy funnelling undefined Public Health Professionals (at Dip and BSc) into Health Sector. Simultaneously, Non Health Professionals are allowed to specialise in Public Health at Masters level. For this to happen, does it mean responsible officers, for responsible institutions, are somnambulists or suffering from Destinesia?
Conclusion and Way Forward for Zambian Situation
It is conspicuous that Zambian Health Sector is a quintessential example of a failed industry and the health services it provides are travesty. Education Sector in harness with venal regulators and turncoats from MoH are responsible for this; therefore, they all need to be given a new lease of life. The following actions are vehemently recommended:
– All professions with no unique mandates must be disgorged out of Heath Sector forthwith and the miscreants must be given a condign treatment.
– The confusion highlighted above is a clarion call to overhaul Health Sector, Education Sector, and Regulatory Bodies responsible.
– Education Sector must be working in concert with the Health Sector for quality and quantity purposes.
– There must be parity between the two arms of Public Health for the health systems to have a desired impact.
– Never allow Non Health Professionals to specialise in MPH; such a qualification is invalid.
Carpe Diem: strike while the iron is hot; time and tide wait for no man.