Just when most of the country is affetced by dwindling standards of health service delivery, Chitipa District Health Office (DHO) can brag about its success story, thanks to introduction of standard operating procedures (SOPs) by Open Society Initiative for Southern Africa (OSISA) under Catholic Commission for Justice and Peace (CCJP) of Karonga Diocese.
Formulated and introduced three years ago, the SOPs are empowering the community members to demand disclosure of information from the district health office and monitor drug administration.
Communities around Nthalire Health Centre, almost 115 kilometres from Chitipa District Hospital applauded the improved health services delivery.
Nthalire health centre’s management committee (HCMC) chairperson Maxwell Kayira said the SOPs had restored doctor-patient relationship.
“In the past, we did not have privacy at all as two or three patients could be allowed into the consultation room at once. Patients failed to explain their real ailments. For example, a patient with sexually transmitted infection [STI], could hide his problem. All this is now history,” he said.
Nthalire health governance chairperson Rodrick Kaonga concurs with Kayira on various reforms at the health centre.
“Right now there is no pilferage of drugs as HCMC members are able to follow administration of drugs right from delivery,” he said.
Members of the community have also come in to help.
Area Development Committee (ADC) chairperson Kalulu Mtambo said in 2017 the community members moulded 20 000 bricks for construction of a waiting shelter for expectant women at the centre.
In 2013, they contributed money to buy iron sheets and painted the health centre’s laboratory after strong winds destroyed it.
In cases of emergency, the community also contribute money for fuel for the ambulance.
The health centre’s in-charge Emmanuel Salima is now a household name.
“When I came here in 2012, the first thing that I did was to ensure that issues are made clear to patients and that we are always honest,” he said.
Opened in 1978, Nthalire Health Centre now serves about 34 306 people from 80 villages.
Just like any other border district, these commendable efforts are being hampered by Zambians who come to seek medical attention at the facility.
Another challenge facing the health centre is poor communication.
The heath centre is connected to Chitipa through a 115-kilometres dusty road.
“The road is a challenge when it comes to emergency medical services. Expectant women with complications cannot be rushed to Chitipa Hospital due to the bad road,” said Salima.
Chitipa District Hospital Management Committee (DHMC) chairperson Sydney Simwaka while acknowledging wonders that SOPs have performed, bemoaned lack of orientation for both DHMC and HCMC members to equip them with skills that will enable them discharge their watchdog role professionally.
Chitipa District Health Officer (DHO) Dr. Ted Bandawe said the secret behind success story was that his staff knows of their job descriptions and stick to guiding principles, including human rights, transparency and accountability.
“At Chitipa DHO we strive for provision of high standards of health services. We ensure that we observe working hours, clients waiting time, quality customer care, availability of all drugs for essential health packages [EHP] and above all infection prevention [IP] which is our slogan.,”he said.
True to this, Chitipa has achieved a rare feat of not registering any cholera case for 15 years and was recognised in 2012 for best practices of salt monitoring. In 2014, it was also recognized for excellently implementing IP standards.
However, despite all these success stories, there are challenges experienced at district level.
Bandawe bemoans long distances and poor road infrastructure from health centres and referral hospital in case of emergency; poor network coverage in some hard-to reach-areas.
Most health centres have inadequate houses for members of staff.
Shortage of medical staff and mobility problems in terms of ambulances and utility vehicles also act as stumbling blocks in their quest to offer the best high health services.
But project officer for Osisa Health Governance Project at CCJP Karonga Diocese, Olbert Mkandawire, said they so far are impressed with the SOPs.
“We are glad with the response that SOPs has received from Chitipa DHO. The document is working wonders. We are keeping our fingers crossed that Karonga district commissioner should append his signature to the document as soon as possible because the health system in Karonga is on a sick bed,” Mkandawire said. n