Health Institution Governance: An Imperative to Enhance Public Health Services

Health Institution Governance: An Imperative to Enhance Public Health Services

Copyright: © 2021 |Pages: 19
DOI: 10.4018/IJPAE.2021100101
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Health institutions are essential for an economy to grow and develop and moreover in case of emerging economies, it is imperative. However, health institutions, in general, do not meet the expectation of the public in terms of quality health services in many countries. This may be due to many reasons like shortage of doctors, hospitals, beds, infrastructure, and governance. Hence, the objective of this paper is to do a critical analysis of governance in public health institutions with an emphasis on developing and strengthening corporate culture and leadership in health institutions to strengthen the public health sector. Adopting an exploratory approach with an in-depth literature review, the aim of this paper is to critically analyze corporate governance in public health institutions in Zimbabwe. In the process, key issues or problems are identified and analyzed. Further, an attempt is made to provide a range of solutions to overcome the trepidations and issues. Based on the alternative solutions suggested, an array of recommendations is made, and also an implementation plan for the suggested recommendations is provided.
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The vision of the Zimbabwe Ministry of Health and Child Care is to have the highest possible level of health and quality of life for all its citizens. The National Health Strategy 2016-2020 Equity and Quality of Health: Leaving No One Behind sets out the strategic direction for the health sector over the next five years in order to attain this vision. The 2016-2020 National Health Strategy builds on the 2009-2013 strategy and its extension in 2014-15 by addressing existing gaps and, more importantly, seeks to sustain the gains achieved thus far through a comprehensive response to the burden of disease and strengthening of the health system to deliver quality health services to all Zimbabweans. The strategy lays out the health agenda for 2016- 2020 considering the broader policy context that is largely defined by the Zimbabwe Agenda for Sustainable Socio-Economic Transformation (Zim-Asset) and the Sustainable Development Goals.

Zimbabwe health system comprises both public and private players. The total number of health facilities in the country is one thousand eight hundred and fort-eight. (MoH, 2016). Out of these, six are central hospitals, eight provincial hospitals, forty-four district hospitals, sixty- two mission hospitals, sixty-two rural hospitals, thirty-two private hospitals, and one thousand six hundred and thirty-four clinics and rural health centers. Public health institutions in Zimbabwe are the largest health services providers in the country. There are four governance levels through which public health services are delivered. These levels are primary health care comprising rural health centers or clinics and the community. The second level is secondary constituting district hospitals and are the first level of referrals. Third level is the tertiary comprising the provincial hospitals. The fourth level is the quaternary level comprising central hospitals.

Zimbabwe public hospitals are run by management boards entrusted with the responsibility of upholding corporate governance principles such as accountability and transparency (MOHCC, 2015) While boards governing private sector are evaluated on maximization of shareholders’ profits, the success of public health institutions is measured in terms of the ability of the board to cost effectively implement programs in accordance with government regulation and policies. Boards in Public institutions are expected to evaluate how their organizations are achieving the qualitative aspects of their missions (McFarlan, 1999) in terms of enhancing access, quality, social equity, reducing costs and identifying distinctive value-based patient care services (Weil, 2003).

In view of the above, (Ministry of health and Child care Zimbabwe, 2016) indicated that public health system is faced with a plethora of challenges characterized by poor service delivery and poor performance in health indicators. Some of the challenges include inequitable distribution of health care service, shortages of medicines and over expenditure among others (MOHCC, 2012). These challenges prompted the research. Adopting an exploratory approach with in-depth literature review, the aim of this paper is to critically analyses corporate governance in public health institutions at Zimbabwe and identify the lapses if any resulting in improper corporate governance and provide recommendations in the form of action plan.

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