Should government transfer DHOs to arrest drug pilferage?

Minister of Health Peter Kumpalume in January this year made a chilling revelation that K5 billion (about $7.6million) worth of medical drugs and supplies are stolen from public hospitals every year.

The minister’s disclosure during a meeting at Nsanje District Health Office (DHO) comes against the background of increased reports of drug pilferage, in some cases involving medical professionals, and concerns from donors about the malpractice.

The K5 billion value represents a third of Ministry of Health (MoH) annual drug budget of K17 billion (about $25.9million), according to Kumpalume who warned of stiffer punishment to culprits.

In the short-term, ‘in an attempt to arrest’ rampant drug smuggling business, the ministry has embarked on transfers of key health personnel, especially DHOs.

According to a circular from MoH Weekend Nation has seen, about 24 District Health Officers (DHOs) will be be moved across the sector.

However, these transfers have raised a lot of questions one being: Will wholesale relocation of DHOs not affect the delivery of quality health services in the affected districts?

When faced with the question whether such unprecedented cross-facility postings would paralyse operations of various health facilities affected by the movements, chief of health services at MoH Dr Charles Mwansambo doused any fears of disruption in service delivery.

“What you have to know is that these movements are normal and are aimed at improving efficiency within the ministry. In fact they are strategic and should only be seen as such,” Mwansambo said.

He said some of the DHOs are going for further studies, hence, government has to replace them while some need to be moved to referral hospitals.

“There is nothing wrong in this and it will not affect operations in any way because the transferred personnel do not work in isolation. They collaborate with others at district level such as district nursing officers and administrators,” Mwansambo explained.

He was quick to dismiss the transfers were an effort by the ministry to shift problematic staff to other areas.

However, health rights expert Maziko Matemba bemoaned the behaviour of some key health personnel when it comes to sound administration of drugs.

“The problem that I see in the health sector also goes down to attitude and behaviour of some health workers in providing service.

This is supposed to be checked by those in authority which unfortunately is not always the case. I am of the view that the reforms being implemented in the public sector need some approaches that are people-centered. There are situations where some health facilities especially in rural areas are opened at 10 am and patients are kept waiting the whole morning,” he said.

Matemba said another challenge which he sees in the health sector is that management roles in hospitals are given to qualified medical personnel.

“Currently, we have more that 30 well qualified doctors in management roles in Malawi.

“Probably the shift should try to put these resources into frontline health activities instead of wasting them in management in which most of them are not experts,” he explained.

Balaka-based resident Catherine Chisuse has commended the ministry for effecting the transfers saying they would inject a new lease of life to health facilities that were choking under some DHOs.

“I think it is alright to shift the DHOs because somehow the transfers will make them (DHOs) meet new people in the new environment which will make them stop their behaviour if they were involved in any drug pilfirage.

“But basically those DHOs that have been involved in bad behaviours are a shame to the health sector and should be disciplined,” she said.

These sentiments are share by Martha Ngosi who is based in Karonga. She urged government to be strict in monitoring of hospitals to avoid service challenges in public health facilities and not relent on moving staff that are not effective.

“Somehow when DHOs have overstayed in one district they tend to develop a bad attitude towards work, therefore, government should be commended for effecting the changes. This should be a wake-up call to other health workers.

“Most public hospitals have poor service because of DHOs who do not take their responsibilities seriously,” Ngosi says.