CASE ANALYSIS

Healthcare System is the Coast Province: Problems and the Action Plan

Healthcare System is the Coast Province: Problems and the Action Plan

Introduction

The overall structure of Coast Province healthcare system is centralized. The prime responsibility lies with the Director of PHO (Provincial health officer). The provincial office controls the eight districts. Each district has a hospital and around 15 health units. The hospital superintendent and health centre supervisors report to the DMO (district medical officer). Structure-wise, the PHO is divided into three divisions: Finance and Administration, Public Health and Hospital Services. In the following paragraphs, the case will be analyzed to identify issues and develop a plan to improve the healthcare service in the Coast Province.

The Major Healthcare Problems in the Coast Province

Irresponsible Administration

The districts are supported through various programmers, which are funded by the donors. These programmes cover primary neonatal and maternal care, TB and HIV/AIDS. However, the donors are frustrated because of delay in implementation of these programmes through PHO. As a result, the donors units are dealing directly at district level in the Ministry of health (MoH), for provisions of supplies and funds, and support and supervision. The management of PHOs in other provinces is effective and; therefore, the donor units are working with them. In the Coast Province, the PHOs are not aware about the programme. Technical skills are not being used in this PHO. The District Medical Officers lack managerial training and perceive that decision should be made at the top level. Therefore, they just follow the decisions made at the top and lack participation in decision making.

On the other hand, the DMOs of other districts (Sheeling and Kepha) are performing better. These districts are supported through bi-lateral funding from donors. The performance is better in the area of service delivery with the same amount of financial resources, as provided to other districts. Other districts need to improve the administration of donor programmes; however, there other issues as well, which are discussed below.

Incompetent Management

The incompetence of management is highlighted thrice in the case study. As we have discussed above, the DMOs were not trained in management and as a result, there was poor management of donor-programmes. The other instance is Provincial Malaria officer. The provincial malaria officer the responsible for managing the malaria programme. However, the manger is reported to be out the city, most of the time. Others believe that the manger is incompetent. The third instance is the poor management and maintenance of vehicles. According to some District Medical Officers, the transport managers are not maintaining vehicles effectively. These issues highlight a lack of proper management and lack of managerial training in districts.

Working Conditions and Financial Constraints

Another significant problem quoted in the case is of poor-working conditions. It is a fact that one of the most motivating, or otherwise discouraging, factors is the working conditions. Poor working conditions are the result of lack of financial resources to renovate the work place. As a result, of shortage of money, the maintenance of health units is suffering ...