Paidamoyo Chipunza
Health Reporter
HARARE and Bulawayo Metropolitan provinces need at least six district hospitals each to effectively save their communities and decongest central hospitals, a senior Government official has said.

Health and Child Welfare deputy director policy, development and planning Mr Stephen Banda said a lot of minor cases, were referred to central hospitals at the expense of serious cases.
“Ideally, a clinic refers a patient to a district hospital, provincial and then to a central hospital unlike the current scenario in Harare and Bulawayo were patients are referred from a clinic straight to a central, hospital,” Mr Banda said.

There are five central hospitals in Zimbabwe — Parirenyatwa, Harare, Chitungwiza, Mpilo and United Bulawayo Hospitals — strategically positioned in the country’s two major cities for a smooth referral chain.
The referral chain is evident in cities outside Harare and Bulawayo where patients’ first port of call is a rural health centre or a clinic.

These clinics are usually manned by a nurse and nurse aids. But if a patient needs the attention of a doctor, the nurse refers the patient to a district hospital.
Mr Banda said in line with World Health Organisation there should be a district hospital for every 500 000 population.
“If there is a complication which requires the assistance of a doctor, the nurse then refers to a district hospital. It is at this stage that you start to see a doctor, according to our system,” Mr Banda said. He said with all necessary equipment, a district hospital should do general operations that

do not require services of a specialist doctor.

However, if the doctor feels the patient needs further management, he then refers to a provincial hospital where the patient meets specialist doctors for special ailments such as gynaecological problems.
Most of the equipment in both district and provincial Government institutions are obsolete and specialist doctors have since left the public sector for greener pastures.

This has left a few concentrated at central institutions.
“Faced with such a scenario, most district and provincial hospitals are now referring cases to central hospitals resulting in congestion and inefficiency of the central institutions,” Mr Banda said.

“This scenario could be eased if all district and provincial hospitals are better equipped and skilled health professionals are given an incentive that lures them back to the institutions.” Mr Banda said considering the population of Harare and Bulawayo and the magnitude of disease burden in today’s world, the cities need not less than six district institutions each to avoid minor cases congesting central institutions.

Harare City Council director of Health Services Dr Stanley Mungofa said there have been plans since early 1990s to have district hospitals for Harare. He, however, said council was considering building a hospital that caters for middle income earners.

“We are considering coming up with an institution that caters for middle income earners. There are other people who say they cannot go to council clinics because they are too cheap for them, but also cannot afford high costs charged by private clinics,” Dr Mungofa said.