A functional Health Sector is meshed with well-balanced health systems. The health systems are synchronized permutations, within the health sector infrastructure, whose primary purpose is to meet the health needs of the population. In order to be effective and efficient, the health sector has a Framework and a configured Methodology for the Health Team. This tract is for use by key stakeholders, for easy understanding of the Philosophy of Health Professions and Public Health (PHPPH), as it is poised to shape the African health sector, for befitting public health outcomes.

Background and Purpose

After a boatload of observations and a serious cogitation, for over 10 years, into health sector, it has been made intelligible, repeatedly, that the intrinsic tripod relationship of the health service providers, the general public and the regulatory bodies has been ruptured. The health team is dishevelled; the players are at daggers drawn; unnecessary battle of wills amongst the health professionals resulting in abysmal services for the general public. Unenviably, the general public are benighted and have lost their ownership to public health services being provided; concurrently, the regulatory bodies have failed to homologize and cause alignment in the health sector. Consequently, the health services being purveyed are diametrically opposite of what should be the case, and if nothing is done, about it, Zambians will be down and out.

An edacious desire for safe, effective, and efficient health services gave birth to the Philosophy of Health Professions and Public Health. The intention is to make the complex and counterintuitive health sector and its environing problems intuitive for all stakeholders, and to procure potent and economic corresponding solutions. In other words, it is a light to dissipate the stygian darkness within the health sector.

It is vital to underscore that this philosophical model is transcendental; it is applicable to any health sector across the globe; especially, the African health sector that has been punching below its weight since time immemorial. Patently, Zambia is privileged to be a trailblazer, for African continent, as Africans begin the process of redefining and taking possession of their own health sector.

The Purview of the Philosophical Schema

The Philosophy of Health Professions and Public Health is upheld by two Magnum opera concept papers and one supernumerary. This philosophical tract employs critical thinking, a priori knowledge, and a posteriori knowledge. The nub is to streamline the health sector, and to cause order and alignment within the health team, and to restore a lost tripod relationship, with value, respect and confidence.

Overview of What Is in The Health Sector

According to Philosophy of Health Professions and Public Health, the health sector is there to protect, improve and promote public health, through an evenhanded interplay between proactive and reactive means. The health sector has health professions, health professionals, and health team. It is the health team that is saddled with direct responsibility to safeguard the health of the public, against public health threats. This paradigm gives to us that the health professionals are the players, in the health team, holding specific and special numbers called health professions. Fathom that the individual professionals, the light bearers, are contingent beings, whereas the health professions, the actual lights, are necessary beings. The take home message is that, if not careful, the country will end up with a travesty of a profession, in the professionals, and Africa is teeming with this problem; hence the magic bullet in this philosophical model.

a) What Is Public Health?
Apophatically, public health is not a portmanteau word; cataphatically, it is a compound polysemy: It can be used as an uncountable noun, a modifier and or an adjective; a general health of the people, a discipline, and or the services offered. The Philosophy of Health Professions and Public Health posits that public health is a dyad of preventive medicine and curative medicine; a concourse of all health professions, a confluence of preventive health services and curative health services. it denotes that the health sector, through the health team, renders public health services to the general public.

b) Who Is a Leader Between the Two Arms of Public Health?
As provided, when collated, the health sector has two specialized disciplines with two specialized services: preventive medicine, offering preventive health services, and curative medicine, offering curative health services. When conflated, the two disciplines culminate into one discipline called public health, offering public health services.

Indubitably, life is dialectical: it is either light or darkness, man or woman, positive or negative, right or wrong, proactive or reactive; always one of the two is a leader. Despite being the antipode of each other, light, man, positive, right, and proactive are the leaders of their counterparties. The same applies to the two arms of public health.

Far be it from anyone to overstate the importance of both prevention and cure; however, when they come face-to-face with each other, they do not carry equal-weight-view. Prevention is proactive and better than cure. Below is a well corroborated defence for the given posture:

By design, the preventive medicine is both vertical and eminently horizontal. It means that the professionals in this section are weaved to penetrate the entire government orb; they are perfected to nip the public health threats in the bud. Their training is rich in leadership skills. On the other hand, the curative medicine is highly qualified; it is both vertical and horizontally Lilliputian. It indicates, the professionals in this tranche are confined, and this is dictated by nature of their work. In other words, their training does not equip them to lead a variegated group; if that happens, it will be a sheer waste of human resource for health; they remain in insulated places, and not in public places.

The lucid difference between the two arms of public health is the yawning gap on horizontal coverage where leadership is domiciled. The preventive medicine is gigantically wider, horizontally, to an extent of subsuming the curative medicine, in that the patients and the curative health practitioners are still part of the entire population that need inter alia: safe food, potable water, built environment, waste management, occupation health and safety, which is the terrain of the preventive medicine. It is also within the ambit of the preventive medicine to make incursions into the curative medicine to forfend against iatrogenic conditions and nosocomial infections. Accordingly, preventive arm of public health must provide, the much needed, leadership.

c) What Is Obtaining in The Health Team
What is obtaining in Zambian health team and most of the African health teams is that medical doctors have arrogated to themselves the rights to lead the dappled health team; thereby abdicating their core responsibilities. As a lineament of ignorance and poor leadership, medical doctors are undermining the public health discipline and attempting to pierce its carapace. Consequently, the health team is in wrack and ruin. The entire population is plunged into great incognita. To crown it all, Zambia and most of African countries do not produce any of healthcare products (drugs and equipment) to assuage the population encumbered with ill-health. Therefore, the Kairos for change in African health sector is now.

Conclusion

The ethos of this philosophy is on the effectiveness and efficiency of the health team, in managing the health of the general public. The health team must be sufficient, and each number held must be necessary. The keynote is that each player, within the health team, holds a unique and necessary position and the purpose is to work with the best of both worlds and defeat the public health threats, and become the champions; all eyes on the ball. In order for that to happen, there must be parity among players; as all health professions, the numbers held, are worth their weight in gold, and each player must know their job and be seen adding value to the entire team. Therefore, leadership, governance, and monitoring and evaluation are sine qua non to this balanced equation.

Way Forward for Health Sector

The Philosophy of Health Professions and Public Health has revealed that the health sector is a necessary being, as such, it must be useful and not harmful to the owners. For Zambia, the health sector has been found harmful to the people; therefore, the tract is avidly recommending the following steps to have it back on track:

a) Total restructuring in the health sector is a must. The health sector must be streamlined and be seen achieving its intended purpose. There must be a clear, fair, and firm Framework and Methodology for the health team to operate and deliver as expected. The restructuring undertaking must also include the tripod relationship, viz: The Ministry of Health, The Regulatory Bodies and The Ministry of Education.

b) Parity in the conditions of service, for all core health workers, a must. The health sector has a health team and each member of the health team is unique and holds a special position for the good of the entire health team. Any negative discrimination will cause dismemberment within the team, and this will result in turmoil, and atrocious health services will be the reward to the consumers, as is the case in Zambia and the rest of Africa.

c) Suspension of postgraduate training in public health (in all higher learning institutions), and the immediate need to proscribe and scotch the undergraduate training in public heath, for it is a fictitious and illegal discipline. There is need for rational reconstruction of the profession; the public health has been misconstrued by all players. By extension, the establishment and existence of The Zambia National Public Health Institute (ZNPHI) is questionable, for it is a “boondoggle” for Zambia.

d) The local government and rural development structure, for health workers, for decentralization process, is spurious and must be thwarted forthwith. It is ill-fated structure for Zambia; the proponents of this structure have an axe to grind. Hence the need for rational reconstruction of the structure.

e) The exigent need to have ONLY one Health Professional Body to accommodate and homologate all health professionals and their services. The health professionals must be housebroken and semper fidelis, and learn to work with the best of both worlds; highly economical for the country. On that note, the nursing profession must join the Health Professions Council of Zambia (HPCZ) without any resistance. In the same vein, the nursing profession must abort the illegal training program in public health nursing, for its knowledge base is outlandish. Also the HPCZ must stop charging and collecting illegal licence fees from unemployed health professionals. Therefore, the moral thing to do is for the HPCZ and Nursing and Midwifery Council of Zambia (NMCZ) to return the money illegally obtained from unemployed health professionals with interest, without fail.

f) Zambia to winnow out some health professions without unique mandate, inter alia: Public Health; Diploma and Degree, Public Health Nurse; Diploma and Degree, and a Degree in Clinical Medicine. These professions are excrescences to public health. Also, it must be blazoned that any postgraduate bona fides, in public health, bestowed on a non-health professional must be treated as counterfeit, and such professionals should never have a purple patch in the health sector. Any essay to employ professionals of that ilk will be tantamount to malfeasance.

g) When it comes to employment, retention and promotion, the processes must be guided by the purpose, Ironclad standards, procedures, and criteria. It is cardinal to savvy that every organization established, by provisions of the governing laws of the land, is regarded as a necessary being, with fixtures in need of fittings; however, its success or failure depends on the contingent beings, the fittings or the professionals. It denotes that the educated populace must be distilled so that only the sharpest knives in the drawers are prioritized, since the positions are highly limited.

h) Monitoring and evaluation mechanisms must be in place; ensuring that every entity exists for its intended purpose, and every employee, as a contingent being, is worth being part of that entity.

i) The urgent need to constitute a Special Team to keep the service providers and other key stakeholders, such as ministry of education and the regulatory bodies, honest.

Coda:

A Rational Reconstruction of African Health Sector Begins with Zambia: Leave Zambians and Africans to Their Own Devices

The author has been initiated into the masquerade of the universal truth; he has come face-to-face with the universal truth; he comes as a purveyor of the universal truth.