1. A Conspectus of the Philosophy of Health Professions and Public Health
A rational reconstruction of the health team of African health sector is the position of this philosophy. A blanket restructuring is inalienable for the health sector to assume its veridical status of purpose. The process starts with Zambia.
To all intents and purposes, health sector is the key to development; ‘health in lockstep with development’. According to the Philosophy of Health Professions and Public Health, health sector is there to protect, promote and improve public health by purveying safe, effective and efficient health services to general public. As a discipline, public health is a two-pronged polity: leadership and management. Insofar as to have befitting public health outcomes, amity must exist between the two branches of the management science of public health – the preventive arm and curative arm. The preventive arm of public health is there to make incursions and nip the public health threats in the bud, and the curative arm of public health is there to react and rescue the hapless individuals from public health threats that may have been inadvertently missed.
Due to contorted perspective held by Africans, Africa is ablaze with repugnant health services, and abysmal stewardship, within the health sector, accounts for this unenviable standing. Intriguingly, one aliquot, within the curative arm, engendered the preventive arm of public health to be upstaged by the curative arm of public health. In the process, the leadership was unceremoniously purloined by the same one aliquot. Consequently, the African population is plunged into public health threats, so much so that Africa is brimming with ill health population, and this has militated against its prosperity. True to form, ‘ill-health in lockstep with poverty’. Africa is the second largest continent; be that as it may, it is the poorest of all. It is heart-rending to realise that, despite being endowed with abound resources, Africans are failing to make their own health-care paraphernalia; this is a litmus test for atrocious health services, being rendered, to the vulnerable and benighted population. It stands to reason, therefore, that Africa is a ludic environment for oligarchies, and it provides a viable market for charlatans and unscrupulous entities with unconscionable health services, products and equipment to the detriment of the ‘great unwashed’.
As a cog and meronym of Africa, Zambian health sector is a quintessential example of the failed African health sector. Here is the veracity of what is obtaining in Zambian health sector:
a) Owing to paucity of prescience, by the senior managers, the preventive arm of public health has been defenestrated, thereby reducing the revered Ministry of Health to a subpar reactive ministry. Deliberately, the ministry has no structure to accommodate the knowledge quality parameters of the preventive arm. In a bid to put it in the shade of the curative arm, the ministry has continued on its humdrum-repulsive trajectory of employing rudimentary practitioners for preventive section; meanwhile its qualified and advanced practitioners are on a hiding to nothing. As an alternative to take up the slack, the ministry has encamped unqualified practitioners, from the curative section, to, ostensibly, lead, but the animus is to subjugate, the rudimentary practitioners. This is tantamount to malfeasance, and the perpetrators deserve a condign prosecution.
b) Without a scintilla of guiltiness, the Ministry of Health, in harness with the Training Institutions and the Regulatory Bodies, approved some fictitious training programmes with outlandish knowledge base. Also the health sector, through the Ministry of Health, approved a spurious structure for ill-fated exodus of some health workers to the Ministry of Local Government and Rural Development. The intention is for the medical doctors to hold court at the expense of the authority of public health – the discipline responsible for their undesirable ubiquitousness – abdicating their responsibilities and leaving the goal of life unguarded.
c) Without a twinge of conscience, the Ministry of Health has institutionalised a prejudicial discrimination where conditions of service for health practitioners are concerned. For instance, medical doctors are heftily paid whereas the rest of the health practitioners are paid a pittance. This is a clear lineament of a dysfunctional health team, and it must not be allowed to subsist.
d) Unhealthy homogeneous leadership imposed on heterogeneous health team. The Ministry of Health has tagged the leadership positions at district, provincial, and national level for one aliquot from curative section; medical doctors. The ceremonious and moral thing to precede is comity between preventive and curative arms of public health, and then equity amongst the light bearers of respective professions proceeds. So, what is currently obtaining is unlawful.
e) The health sector has sanctioned the Regulatory Bodies and the Higher Institutions of Learning to extort money from the general public. The ruck is inveigled into pursuing professions that are obsolete and should have been proscribed. Professions like Clinical Medicine and other Diplomas in health sciences should have been ceased by now. Due to lack of innovation and creativity, the Regulatory Bodies are basking in illegitimate practices. Sadly, unemployed health professionals are incessantly beguiled and dragooned into paying for their practicing licences even when employment is a mirage for them. This is malversation and highly corrosive to our country.
What is insufferable is that Zambia is oozing with preventable communicable and non-communicable diseases and psychosocial health problems, but its health team has no solutions to lull the situation. Zambia is awash with skimpflation and shrinkflation, affecting its gross domestic product (GDP) and the gestalt of African economy negatively. Thereat, Zambia is infamous for ‘fake news’ and ‘false testimonies’ because of illegitimate science the Zambian scientists represent. There is a great deal of epistemic degradation in Zambia; what a misnomer for a Christian nation!
In light of the above, a total restructuring of African health sector begins with Zambia. Hence the need to enlist your unflinching support as we undertake the rational reconstruction of the Zambian health team.
2. A Prologue to The Philosophy of Health Professions and Public Health
The world is divided into continents, and the continents are divided into countries, and these countries are further subdivided for easy leadership, management and governance. Geopolitically, each of these countries holds a unique position and is endued with abundant primeval resources for sustenance and longevity of its people. Zambia is a country; therefore, it must be in a position to sustain and prolong the lives of its people. In order to enjoy and get the best out the natural resources, there are two inherently intertwined fundamentals that must be imbibed by the citizenry of any country, viz.: the universal truth and the law of nature; the dyad is highly dispassionate and impassive. It denotes that your conventional wisdom and governing laws are subordinate to them. Thus, the dyad remains the true touchstone upon which you measure the accuracy of your acquired knowledge and achievements from that knowledge.
The ineluctable requirement to develop a country is to have the natives be productive, and for them to be productive, they must be healthy. It means, health and development complement each other; as such, it is impossible to overstate the importance of having an improved health sector in a country. Unfortunately, the infamous reality about Zambia is that its citizens have failed to pull themselves up by their own bootstraps despite being abound with natural resources to their disposition. Zambia, and the rest of Africa, is seething with impecunious and unhealthy populace whose resources are in hock with lenders. This is a lucid indication that the health sector is off the rails and has lost the scepter of authority. Indubitably, the sector has failed to cause the expected developmental kinesis. As a potent measure to upend the situation, the Philosophy of Health Professions and Public Health was orchestrated.
The philosophy is poised to give the health sector a privileged status that will actualize the altruistic intention of Alma-Ata Declaration of 1978, ‘Health for All’, which has eluded the African community ever since. In order to achieve the aforementioned, the philosophy took into account the five action areas of Ottawa Charter, of 1986, dedicated to empower people to have full control of their own health.
3. The Philosophy of Health Professions and Public Health (PHPPH)
In order to fully benefit from the health sector, the stakeholders must have a full comprehension of what the health sector entails, and the solution to that is philosophy. Broadly construed, philosophy is the love of wisdom; a strong desire of humans to acquire knowledge and apply it correctly. On that score, the Philosophy of Health Professions and Public Health is dedicated to parse the health sector and present the veridical picture of it, for the stakeholders to fully comprehend and benefit from it.
As a necessary being, the health sector is commissioned to cause development by ensuring that health is made a universal value for production. On that note, on no account should the health sector falter to protect, promote and improve the public health. Interestingly, there are six strata under the rubric of the health sector, and the sixth stratum contains a sheaf of health services called public health service, which is responsible not only for its existence but also for its fame or infamy. Here is the order of the strata: (1) Health Professions, (2) Health Sciences, (3) Health Professionals, (4) Health Team, (5) Health Systems and (6) Health Services. Revel in as the philosophy ebulliently elucidates.
Health professions, in and of themselves, exist as noumena, but as they are cognized and intuited, by the designated community that is turned into professionals, they appear as phenomena. The individuals that are metamorphosing into professionals must be willing to be the true light bearers of the professions on behalf of the entire population. Moreover, the erudite officials must be masterful during the process of transferring and absorbing the knowledge since there are manifold possible outcomes – ranging from the actual reality to contorted one – of which Africa is a victim. The African community is embroiled in this imbroglio because of the African vices; people are unbridled in a bridled environment.
The health professions are organized into a compendium of scientific fields or disciplines known as the health science. Under normal scheme of things, these scientific disciplines must have the overall leadership of themselves, by themselves and for themselves. As a result of that the bevy of health sciences has two intrinsically intertwined approaches: (i) the what approach; the epidemiological section (ii) the how approach; the management science. As a scientific discipline, public health is the intersection between the epidemiological section and the management science (preventive and curative). It means that public health discipline has the imperium over other disciplines. Therefore, public health discipline bears the overall leadership. So, it must be a rare course at postgraduate level and under no circumstances should it be pegged down to a level of undergraduate -> for more detail, check the knowledge quality parameters section.
What Is Public Health?
Public health is the what and the how of the health team in the health sector; it seeks to understand and act on that understanding. It is the discipline that deals with health at population level.
The health team must understand the population health holistically. As the what part of public health, epidemiology makes it happen through research and surveillance. Epidemiology is the backbone of public health, and it is used by the health team to understand the causal-effect relationship between exposures and outcomes so that the pattern of distribution and the magnitude of health conditions are understood. This insight is very important for planned interventions targeted at promoting, protecting and improving the health of the public.
The gained understanding, by the health team, on population health, actuates the how part of public health. The how part of public health is called management science. It is the one that gets things done. The management science of public health has two prongs with their specialized functions: (i) the preventive arm; with the mandate to maintain and promote health and (ii) the curative arm; with the mandate to restore health.
The health team is a vector, with direction and magnitude. Then our interest must be in its capability and capacity. It means the health team must own the interventions, and these interventions must be desirable and ablaze with palpable results. Here we see an unsurmountable health team, with normalizing power – in a well-balanced and advanced health systems – ready to be the champions. Is this replicated in the Zambian health team or the African health team? the answer is no. This philosophy has given a synthetically true position of the Zambian health sector as shown below:
Health Problem Versus Health Solution: A Football Match on the Pitch; Who Wins?
The Zambian health team has failed to gain control over the public health threats, mainly, because the health professionals are continuously misrepresenting their health professions. Due to fissiparousness within the health professionals, the health team is lowest on the totem pole. The health team is bursting at the seams with fake scientists masquerading as health professionals. This claim is upheld by reality, which is our true yardstick.
A Light in a Room: A Solved Health Problem; Which Light of the House is More Important?
The Zambian health team has failed to recognize that health professions are peculiar lights assigned to specific principal rooms of the house for the household. Consequently, it has failed to recognize that health professionals are the light bearers of the health professions. The concept paper highlighted that each health profession is a solved health problem, and that all professions are unique, and that none of them is more important. Zambian health sector has the lowest version of health team because the health professionals have failed to work with the best of both worlds, which is the kernel of a winning team. As a result, the health team is falling apart at the seams.
Zambia to Winnow out Some Health Professions: The Doyen to Rock the Boat
The Zambian health sector has failed to normalize its health team. The health sector has no paradigmatic canons to govern the epistemically diversified community. Here is what is obtaining on the ground: (i) the approval of fictitious health professions with outlandish knowledge base, (ii) the approval of the specious structure for personal gain, (iii) the approval of employment of health professionals with low and outdated qualifications, thereby fobbing off the health professionals with improved and relevant qualifications. This is a signal that the health sector is still in a pre-paradigmatic phase, which is untenable.
In view of the above, the philosophy is providing an irresistible opportunity, for the senior managers, to call time on an immemorial bandwagon fallacy, which is stemming from a post-truth science. The creation of scientific paradigm, with normalizing power, is the moral step to take for the health sector to be normalized.
4. Knowledge Quality Parameters
A knowledge quality parameter is a standard level of knowledge established by a stringent set of criteria within a fixed framework of horizontal and vertical variables for specified purpose. In order for a profession to be the core member of the management science of a particular epistemic community, it must be complete. A complete profession has a full knowledge quality parameter (KQP). A full KQP has three KQPs; moving from general to specific: BSc, MSc and PhD. Requirements: A profession must be unique, relevant and with clear mandate. If a profession does not have the full KQP, then it is either an auxiliary or a fictitious one.
What do we know? This is an ontological question. How do we know that we know what we claim to know? This is an epistemic and logic question. Why should we know? This is an ethical question.
By design, nature is configured to maintain order. In order to do that, it cuts both ways. Nature supports and prolongs life, that is its primary purpose, but it also harms and lays waste to. It means, nature rewards and sanctions. Its responses correspond to actions of the actuators. Therefore, understanding of how nature works, thereafter guiding the actions, is unavoidable and is the only way for humans to be safe. This calls for real knowledge into perspective.
A. What Is Knowledge?
Knowledge is a belief connected with a fact, known in the right way. It means that knowledge is acquired through a reliable method, and that knowledge requires justification and justification is internal. It is also worth mentioning that facts are hierarchical; some facts are more important than others, and so is knowledge. As such, approach to knowledge inquiry must be two-pronged: epistemic rationality and practical rationality. Knowledge, therefore, is intrinsically and instrumentally valuable, and it is for objective value and never for subjective value. Below is the general order of knowledge for a thriving society or country:
a) General Knowledge
Actually, Knowledge begins here and ends up here. This is commonsense knowledge acquired through the university of life, and it is meant for everyone but never given. This knowledge is there for the utilization of rough-and-ready solutions.
b) Structured-General Knowledge
This knowledge seam is organized and directed in specific directions. The purpose is to enhance the general knowledge and maintain normalcy. This type of knowledge is obtained through formal educational system. It is the antecedent to the structured-specific knowledge.
c) Structured-Specific Knowledge
This knowledge seam is highly organized and is for structured-specified interventions, meant to normalize any aberration to our desired reality.
For this tract, the focus is on knowledge-quality parameters of the structured-specific knowledge of a profession. The interest thereof is to unpack the profession for the intricacy of what makes it to be legitimate and approved as a training programme for higher institutions of learning.
Inviolable Conditions for Inclusion: Health sector has a compendium of health professions. Individually, a health profession must be necessary and universal; collectively, the health professions must be sufficient for a health team to be necessary, universal and sufficient for intended purpose. The profession has a sheaf of courses. Individually, a course must be necessary; collectively, the courses must be sufficient for the profession to be necessary.
B. Compendious Coverage of a Profession
What Is a Profession?
A profession is a field of study with a specific viewpoint of the whole perspective; it has both horizontal and vertical dimensions. A profession is also a vector with direction and magnitude.
The design of a profession is, firstly, deductive and, secondly, inductive – Deductive-Inductive Design (DID). For the purpose of training, the design is deductive; moving from general to specific. The deductive structure is for safety and security of the profession, and it is there to forfend against extraneous interpolations. Effectively, the deductive design is responsible for making inductive science a reality. For the purpose of interventions, the design is inductive; moving from specific to general. The inductive structure is inspired by recondite knowledge; positing that the fundamentals of nature are designed with purpose, universality and regularity and with minor aberrations. This position is confirmed from ubiquitous understanding, showing, that humans have the same basic needs. It is from there that we have inductive science with interventions that are extrapolated; making it highly economical.
As given above, a profession is deductive-inductive by design, and the overall design of it is governed by deductive design. Moving from general to specific position, below are particulars of the knowledge-quality parameters of a profession:
a) A Bachelor’s Degree (BSc) Qualification
A Bachelor’s Degree is a general qualification obtained by the professionals of that ilk. It is the first level, with the general knowledge of the profession. Horizontally, the BSc defines the profession. It is the one with full coverage; containing all the fundamentals or courses of the profession that are necessary and sufficient for its intended purpose. It can be posited that the BSc is the flag bearer and is the only legitimate qualification for anyone to be a legitimate member of the profession. The principal reason, for the given posture, is that the BSc is the only one with true insignia of the profession.
What happens to a Diploma qualification? A Diploma is a provisional qualification; it is incomplete and does not represent the profession. The BSc subsumes a Diploma. Once the country has started producing enough BSc holders, thereat the Diploma qualification is rendered obsolescent, and the Diploma holders are deemed incompetent. Thus, insisting on employing, retaining and promoting anyone incompetent is immoral and illegal.
b) Master’s Degree (MSc) Qualification
The Master’s Degree is the second-highest academic degree. This is a second layer, deeper, into one of the core courses or fundamentals of the profession. At this level, the professional is intentionally exposed to advanced scientific accoutrements, for the purpose of enhancing the competences in a more specified direction. What it means is that the professional is being forged into a specialist for efficiency and effectiveness. The unalienable prerequisite is, for the would-be specialist, to hold a prepossessing first Degree in the same profession. No shortcuts, like postgraduate Diploma, when normal procedures are available.
c) Doctor of Philosophy – PhD
The Doctor of Philosophy is the highest academic degree a professional can obtain. This is the third layer, deeper, into one of the subjects of the precursory mastered course of the same profession. At this level, the specialist is intentionally exposed to more advanced scientific methods, theories, concepts, among others, that govern the scientific paradigm of that profession. The objective is to enhance the capability and capacity of the specialist. The specialist is expected to cleanly identify, analyze and define problems and be in a keen position to procure efficacious-corresponding solutions that douse the problems. The specialist of that ilk should be heavily submersed in contents creation – contributing to the scientific body of knowledge. This professional must be highly dependable and able to contribute, positively, to their country and beyond. Their illustrious works should speak for them. The inalienable prerequisites: the BSc and MSc in the same profession.
d) A Professor
A professor does not denote a qualification. It is an academic staff grade; it denotes the most senior. This status is attained as a result of illustrious experience corresponding to sterling contributions. The sine qua non: the contributions must be relevant and contextual; they must be within the area of the profession specialized in. Their works must be laden with palpable and far-reaching impacts on people’s lives; no rodomontade. This scintillating achievement is only possible when the specialist remains disciplined and royal to their area of specialization. They are not expected to be predisposed to peripatetic professionals and turned into quockerwodgers.
C. Nature and Your Knowledge is Your Reality (N x YK = YR)
Within a profession, each knowledge level is a member of the antecedent knowledge quality parameter. And each profession is a member of a specific group of professions with specified mandate for the general public. It denotes that reality is domiciled in general knowledge. Thus the general knowledge is the one to accept or reject any good or service from these peculiar groups of professions. A rapt attention is required to glean what is being posited below.
By design, humans are vulnerable beings; therein lie their needs. Fortunately, nature is laden with solutions that correspond to their needs, however, on condition that they grasp how it works. Propitiously, humans have the same basic needs; notwithstanding that no one, under the sun, meets all their needs without collaborations. This demands unit in diversity for purpose; working with the best of both worlds is the lexicon. It means, human beings are useless without knowledge about nature -> ‘We know to do for our needs’.
Savvy that knowledge is both horizontal and vertical. There are horizontal and vertical movements during knowledge acquisition; the two are intertwined. The Horizontal one is for leadership and the vertical one is for management; they are glued together by logic. The knowledge quality parameters of a profession focus, more, on the vertical movements, the management component. The vertical movement is in two, opposite, directions; the downward ratcheting and the upward ratcheting. The downward movement is for knowledge acquisition and the upward movement is, the one, for goods and services as guided by the acquired knowledge.
This system is governed by the, highly dispassionate and impassive, universal truth and the law of nature. It accurately discriminates ignorance from knowledge, fake goods and services from genuine ones. It is perfected to show whether the people, community, society, country, or continent have gotten it right or not, with their acquired knowledge. It helps to distinguish between the learned ones and charlatans, through their goods and services. This system is there to help human beings improve themselves; hence knowledge is the intrinsic value of morality.
If it has become conspicuous that people have gotten it wrong, the moral thing to do is to stop; ‘if you are in a hole, stop digging’. Identify where the problem is, and thereafter remediate it. If people continue without remedying the unwanted situation, there will be a grave degradation of epistemic environment, leading to impregnable dystopia. It is for this reason that the earlier expatiated knowledge quality parameters are offered and attained in the structured and formal settings. This is wherefore each country has a formalized education system; colleges and universities are structured institutions for the purpose.
These higher institutions of learning have a guarded portal of entry and a guarded portal of exist. The guarded ingress and egress are there to ensure that only suitable candidates, in goodly numbers, are enlisted for a degree, and that only the candidates that satiate the conditions of the knowledge quality parameter of that degree are certified, and that only the most qualified candidates are employed for the limited positions, and that the performance of the employed professionals is constantly monitored and assessed for feedback.
The emphasis is on the need to have a strong-collaborative relationship among stakeholders for quality assurance and control: the higher institutions of learning do their part, the regulatory bodies do their part, and the general public, the owners of everything, do their part – by giving feedback on goods and services from the knowledge bearers. This relationship, with collective responsibility, is called tripod relationship with value, respect and confidence.
Africa, however, is a ‘different kettle of fish’, such relationship does not exist. Africans have sacrificed knowledge, hard-work and morality on the altar of ignorance, laziness and immorality; decadence is at its crescendo. The formal education systems have failed the African continent. Consequently, their qualifications are counterfeit. It makes no sense to have everyone, formally, educated, but the educated ones are with no commonsense knowledge. The moral thing to do is not only to abase the African colleges and universities but also to annihilate majority of them because they do not have befitting trappings. By extension, their degrees and graduates must be debased and most of them be disqualified since their capabilities belie their qualifications. For instance, the preponderance of the Professors and PhD holders must be degraded to BSc or Diploma level. Hark back to the Zambian health sector.
D. Zambia to Winnow Out Some Health Professions
Below are the odd ones out:
a) Public Health – Diploma and Bachelor’s Degree
As elucidated, public health is all health professions writ small; it is the leader of all health professions. For a profession to be the overall leader, it must be part of the management science. Public health is the nexus between preventive medicine and curative medicine, both thereof are the management science of the health sector. So, public health is a postgraduate degree and is exclusive to a limited number of the health professionals, from both sides of the management science. In other words, public health does not exist at undergraduate level, but if it did, it is a fictitious profession with outlandish knowledge base. Therefore, employing professionals of that ilk is immoral and illegal. Unfortunately, Zambia is guilty of this atrocity. In view of the above, Zambia is exhorted to squelch such a profession.
b) Public Health Nursing
Nursing is a noble health profession, restricted to curative arm of public health. The principal mandate of the nursing professionals is to provide care to patients. Fathom that nursing is a supportive profession because it is without a full knowledge quality parameter. As such, it is inconceivable to witness such a profession spiraling out of control in full view of the core professions. Blatantly, nursing professionals have been allowed to foment a cacophony within the health sector by creating an erroneous undergraduate profession, with outlandish knowledge base, in the name of public health nursing. Once again, Zambia must jettison such a profession because employing professionals of such knowledge base is immoral and illegal.
c) Clinical Medicine – Diploma and Bachelor’s Degree
Clinical medicine is a provisional health profession. It is exhilarating to posit that clinical officers and medical doctors occupy the same knowledge base. The only difference is that, in the presence of the medical doctor, clinical officer is eclipsed. It means that medical doctor subsumes the clinical officer. When a country starts producing adequate number of general medical doctors, thereat clinical officers are rendered obsolescent. Auspiciously, the country is not expected to continue training and employing such inferior professionals. Such undertakings are considered immoral and illegal. Sadly, Zambia is guilty of this abominable act.
After the perambulation of the health sector, Zambia is adjudged guilty of training and employing professionals from the odd ones out, health professions, such as: undergraduate public health, public health nursing and clinical medicine. Zambia is also guilty of insisting on diploma holders in face of elaborate professionals. Consequently, Zambia is plodding on. This can only betoken poor leadership, management and governance within the Zambian health sector and beyond.
5. Leadership, Management and Governance
A utilitarian 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. Leadership, management and governance constitute one of the components of the health systems. Understanding them, individually and collectively, is ethically important.
a) Leadership is about vision and policy direction.
b) Management is about getting things done. The focus is on efficiency and effectiveness.
c) Governance is about the rules of the game. It is concerned with value and accountability – it is the nervous system of the leadership and management.
The triad are intertwined, hierarchical and fractal; from individual to national level, national to continental level, and continental to global level.
Here is how they are fused:
Leadership is the horizontal dimension of knowledge, and management is the vertical dimension of knowledge. The two are fused together by logic and governance; to have them is wisdom. Governance is the moral part of the system; people ought to know and do what is required.
Here is how it works:
As a human being with commonsense, know your basic needs because your basic needs are everyone’s needs. Understand that no human being meets all their needs without collaborations. This necessitates unity in diversity for purpose. And teamwork, with the best of both worlds, is the way to go for people with success in mind.
Here is the key to unlock the enigma:
As a human being, know your qualified capabilities, and know how they are linked with the rest of the qualified capabilities of others, and then savvy how they work, collectively, towards the common goal. Note that you are disqualified to lead any group, organization or a country when you are not involved in management. Management is in two forms: unstructured intervention and structured one. As highlighted earlier, leadership is hierarchical and fractal. At national level, there are three levels of leadership that are linked to management: (i) Personal Leadership, (ii) Institutional Leadership (professional) and (iii) General Leadership (politics). These levels are not mutually exclusive. Those involved in three tiers of leadership, they are also part of the social structure: family, church and traditional leadership.
Requirements:
With impeccable and traceable records, individuals, at personal level, must prove that they can lead, manage and govern themselves before making attempts to lead, manage and govern a group, organization, or a country, etc. Thereafter, be tethered to an acceptable range of responsibilities as per their capabilities.
In Zambia, however, the abnormal has been turned into normal. People with questionable characters – people that cannot lead, manage and govern themselves – are in charge of the country. As a result, Zambia has been turned into a hotbed of corruption; a cesspool of iniquity. What is regular is to have the disciplined be the ones to discipline the undisciplined, and not the other way round. How can a country see development when poachers are turned gamekeepers? This foible has permeated the institutional leadership as well. People that are Incompetent are being employed and promoted. This is the main reason Zambia is awash with substandard goods and services. Thus, Zambia is economically embarrassed.
This leitmotiv is writ large in the health sector. For instance, medical doctors, in cahoots with politicians, are illegally ‘hogging’ the leadership and management of the health sector. Unfortunately, for them, nature has exposed that they are not weaved to provide leadership. Under their arrogated leadership, the health sector has been a poster child of a failed sector. What is peculiar about their leadership is the hegemonic control of tagging positions. These position of leadership at district, provincial, and national level, within the Ministry of Health, are given to medical doctors that are very wet behind the ears. Thereby, the human resources for health are wasted.
6. Conclusion
Right and wrong things are not mutually exclusive, and they will always be there with us. Notwithstanding that right things will never transmogrify into wrong things, and that wrong things will never metamorphose into the right things. Consequently, divagation and homologation will always be part of our lives to keep the two unconfounded.
Arguing from the vistas of necessity, design and gradation, the health sector has been found to be harmful to the stakeholders. Brazenly, the senior managers are allowing wrong things to slip through and unethical practices to be institutionalized as praxis to the detriment of the health practitioners and the general public. This is happening because the stakeholders have a distorted reality due to lack of knowledge. Thus the philosophy of health professions and public health has been perfected to expose what has been misconstrued and set the record straight, and procure potent solutions for health sector. In light of that the philosophy has propounded that the only way ‘out of the woods’ is to have a rational reconstruction of the health team, and this entails overhauling the health sector and education sector.
