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Herald Reporter
SOME senior Government officials have been paying themselves significant monthly allowances from a fund established to subsidise underprivileged pregnant women who cannot cover their own medical costs, The Herald has established.
The Health Transition Fund was created to cover consumables such as blood for transfusions, maternity necessities, essential drugs and to incentivise midwives.

It is a multi-donor facility launched in 2011 with a US$430 million budget for a five-year period and is administered by Unicef.
Some Government officials were getting as much as US$1 300 monthly from the fund while midwives were paid as little as US$59.
Many nurses at rural health centres did not even get a cent.

The officials include three principal directors, 11 directors, 13 deputy directors and 13 managers from the Ministry of Health and Child Care and the Health Services Board.

In addition, all provincial medical directors, provincial pharmacists and at least five health executives from each province also benefited from the fund.

Between July and September last year, the three principal directors and eight provincial medical directors alone gobbled US$36 858 as “critical staff allowances”.

Directors and deputy directors for finance, conditions of service and public relations, administration, manpower planning and development, environmental health, nursing services, quality assurance, family planning and accountants were among the beneficiaries.

Health Services Board executive director Ms Ruth Kaseke could not shed light on the payment criteria, referring all questions to Health and Child Care Secretary Dr Gerald Gwinji, who was not answering his phone last night.

Ms Kaseke said the board agreed that all nurses assisting with childbirth should be paid whether or not they had midwifery qualifications.
“The board together with the Ministry of Health are moving towards making the framework all inclusive so that everyone benefits from the funding. It should be noted that health is teamwork and everyone in the channel is crucial,” she said.

Incentivising ministry officials who are not on the ground when it comes to reducing maternal mortality was deliberated on at a Health Services Board board of directors meeting on September 26, 2012, with some people present questioning the logic.

“Though the justification was provided for established posts, more discussion was needed on consideration on why director level positions were to be considered for the critical level,” reads part of the minutes.

But the Health Ministry subsequently justified the payments saying implementation of the fund would not succeed if officials were not paid.
Some of the “justifications”, according to documents seen by The Herald, include the position that the officials give “direction, guidance and co-ordination” to the whole programme, regardless of the fact that this is expected of them as salaried public officers.

While these payments are being made to Government officials, some pregnant women in rural areas covered by the fund are still paying user fees they ill-afford.

The majority of the clinics are owned by rural district councils, which need the money to keep operating.
Under the fund, all clinics are to get US$750 monthly to cover maternity costs for those who cannot afford them.

The subsidy is regardless of the average patient burden the clinic deals with every month.
According to a Health Transition Fund joint review mission last year, some clinics experienced erratic distribution of emergency obstetric drugs including oxytocin, magnesium sulphate and antihypertensive medication.

A shortage of blood and blood products, and essential equipment such as sterilisers were also noted.
On nurses and midwives incentives, the review said: “Most of the respondents noted inequitable distribution of incentives for health workers and have asked the (Health Ministry) and (Health Transition Fund) steering committee members to relook at these issues of salaries and allowances to ensure that all health cadres can benefit from the HTF incentive system.

Meanwhile, Government has released US$500 000 to the National Blood Services of Zimbabwe.
During a tour of United Bulawayo Hospitals and Ingutsheni Central Hospital last Friday, Health Minister Dr David Parirenyatwa said the money was to capacitate the national blood bank to reduce the cost of units for transfusions.

“Blood products are ranging between US$130 to US$200 depending with the institution. This makes blood products inaccessible to the poor. We have provided the NBSZ with US$500 000 to capacitate it so that we can regulate the blood price,” he said.