Pascalinah Kabi
THE Principal Secretary in the Ministry of Health, Lefu Manyokole, says his ministry has heeded Prime Minister Thomas Thabane’s call to come up with ways of improving service delivery by participating in the development of the Public Sector Improvement and Reform Programme (PSIRP II).
Mr Manyokole said his ministry’s participation in the programme which is funded by the European Union (EU) will help them to realise their goals of delivering quality health services to the communities through the proper management and utilisation of health resources.
Last August, Dr Thabane outlined his vision for a reformed public sector where he emphasised the need for all government ministries to empower district administrators and local councils to ensure that they are able to account for the design, implementation of service delivery programmes in line with the decentralisation approach to service delivery.
Dr Thabane’s declaration was followed by the issuing of a cabinet memo titled Delivering Better Services with the Current Level of Public Expenditure: Strengthening District Administrators and Councilors to Coordinate, Oversee and Account for Improved Service Delivery to the Ministry of Local Government and Chieftaincy.
The memo indicated that the cabinet had placed a responsibility on district administrators (DAs) and councils “to account for the design and implementation of the government’s service delivery programme in their respective districts”.
The cabinet further approved the setting up of a committee of principal secretaries accountable to the government secretary to develop a work plan to empower DAs and councils so they can effectively implement service delivery programmes.
While there has not been any discernible progress on the development and implementation of the collective work plan for all ministries, Mr Manyokole said this had not stopped his ministry which was working hard to effectively mobilise, allocate and efficiently manage health resources allocated to them.
He said Dr Thabane made it clear that the government should strengthen the co-operation between state and non-state actors in the implementation of an effective service delivery programme.
“It is under this understanding that the government has developed a new Public Sector Improvement and Reform Programme (PSIRP II) to address systemic challenges in the public sector.
“The PSIRP is being funded by the European Union to strengthen the Prime Minister’s office so that it can directly oversee, coordinate, and account for the functioning of the public sector for improved service delivery,” Mr Manyokole said.
Mr Manyokole said his own vision was to ensure that the Health ministry achieves its core business of delivering quality health services to the people.
“My quest is to ensure that we immensely contribute to the reduction of morbidity and mortalities in the country and further ensure that we mitigate physical, mental, and social deprivation. We also need to ensure that we increase access to quality promotive, curative, preventive, and rehabilitative health and social welfare on the basis of equity and social justice,” Mr Manyokole said.
He added that his ministry would also provide and administer an effective and efficient system of disease and catastrophes’ surveillance for local and global concerns.
Mr Manyokole said they would also seek to effectively coordinate partnerships, regulate, monitor, and evaluate delivery of health and services in the country.
Quizzed on what his ministry will do differently this time to improve health services, Mr Manyokole said there were intervention programmes in the health sector based on the desire for all interventions to be evidence-based.
“We also desire to ensure that all interventions adapt to the World Health Organisation (WHO)’s definition of a health system, health promotion and primary health care and also the desire for all interventions to be based on the ethos that espouses Dr Thabane’s call for a more transparent and accountable public sector,” Mr Manyokole said.
He said his ministry, in collaboration with its partners like the Pitsong Institute for Research Implementation, the Ministry of Local Government, Christian Health Association of Lesotho (CHAL), Health Finance Governance Project and Lesotho Red Cross Association, has already carried out a Comprehensive Health Systems Assessment to determine the strengths, weakness, opportunities and threats of the health services.
Funded by the United States through the Centre for Disease Control (CDC), the assessment study found that the biggest challenges to the Ministry of Health’s effectiveness was the lack of a proper strategy defining the ministry and its partners’ role in delivering quality health services.
“The absence of an effective service delivery strategy has meant that despite an increasing budget allocation to the Ministry of Health over the years, the ministry has failed to improve health services. A Health strategy should be defined and it should follow the WHO definition (all the organisations, institutions and resources that are devoted to producing health actions) of a health system, primary health care and health promotion.
“The absence of a strategic plan has had serious implications in terms of donor coordination and resource allocation, programme design and programme implementation. That a greater percentage of our budget resources is still not directed to the primary level where the Ministry offers over 60 percent of the services is a serious challenge. For example, health centres still do not have transport and they still have no direct access to their budgetary resources”.
While he admitted that the health system consists of all organisations, people and actions whose primary intent is to promote, restore or maintain health, Mr Manyokole said it was worrying that the Village Health Worker Programme is fragmented and uncoordinated and that the involvement of local government structures in health delivery remained very limited.
He said the provision of health services depends on the proper functioning of a health system which is made of the following building blocks: finances, health workforce, health management information systems, leadership and governance and medical products.
“A proper combination of the aforementioned building blocks improves equity, access, quality, efficiency and sustainability in the provision of Health. Health systems encompass all levels: central, district, community and household,” Mr Manyokole said, adding that health promotion was about enabling people to increase control over their own health.
He added: “People need to acquire the knowledge, skills and information to make healthy choices, for example, food they eat and healthcare services they need. They need to have opportunities to make those choices and they need to be assured of an environment in which they can demand further policy actions to improve their health.”
He said his ministry will focus on a primary health care informed approach that seeks to empower district councils, urban and community councils, and chiefs to better understand and define their roles in the health system as well as accounting for health outcomes.
