A new report has found that a dearth of operational planning has negatively impacted the ability of the Ministry of Public Health (MoPH) over the last 50 years to continuously provide comprehensive care and may have also led to unnecessary spending.
This is according to the Pan American Health Organisation\World Health Organisation (PAHO\ WHO) report on the progress of health from 1966 to 2016 in Guyana. The Health @ 50: Progress Health Report 1966-2016 notes that the development of strategic plans, which is one of the core functions of the MoPH, has on many occasions been driven by donor requirement to access funding.
According to the report, documents, such as National Health Plans as well as National Strategic Plans for specific diseases, outline the broad strategies to assist the MoPH to achieve its goals. It added that the operationalisation of these strategies necessitate short (1-3 years), focused and target driven Operational Plans in whose absence the annual budgets for the various departments of the Ministry were sometimes not aligned with the programme due to the lack of costed implementation plans. “The lack of operational plans would lead to some activities that may not respond to the strategic plan.
In that regard, budgetary requests and allocations may not have been in sync with the true health needs of the population and the strategic plan. Additionally, this could also lead to a lack of coordination of activities, and would impact negatively on the continuum of comprehensive care and influence unnecessary expenditure of financial resources,” the reports states.
It further explains that while the focus of the Planning Unit in the MoPH has been on the budgeting aspect of programmes, there is hardly any monitoring and evaluation of programmes and little operational research to determine cost effectiveness or cost efficiencies of various initiatives and programmes.
According to the report, this lack is compounded by the absence of adequate and quality data management, which is a critical prerequisite for planning. “While the MoPH has data collection systems in place, detailed analyses are not always conducted at all the various levels across the system. Evidence-based and informed decision making will allow for improved programme planning, monitoring and evaluation and programme refinement,” the reports says, adding that “there is a lack of human resources, skills and competencies in many programmes and especially at the regional levels, to analyse and interpret data. These result in information not often being utilised in real time, especially at the regional levels, to influence changes to programme implementation.”
Other challenges identified include the inability of the ministry to retain a sufficient number of adequately trained and skilled staff. According to the report, even as the minister continues to offer various opportunities for training, a shortage persists as “Guyanese have been recruited by other countries from all of the disciplines that personnel have been trained [and] numerous reasons have been given for this brain drain including difficult working conditions, inadequate remuneration and perceived lack of interest on the part of government about the welfare of workers.”
Noting that from the early 1970s, there has been a gap in terms of doctors (both general practitioners and specialists) and these shortages have been supplemented by bilateral agreements with the Cuban and Chinese governments to have their nationals strengthen Guyana’s health system, the report advises that “a Human Resource Strategy that includes the attraction, retention, capacity building and succession planning of human resources is critical but even more important, are the implementation and sustainability of this strategy.”
Efforts to contact Minister of Public Health George Norton and Chief Medical Officer Shamdeo Persaud for comment on the report’s conclusion proved futile as Norton’s phone went unanswered and Persaud said he was unable to comment as he was not in office.