URGENT FUNDING CONCERN
Funding from the Zambian government has been reduced due to cut backs of international grants that they used to fund health care in our district. This leaves us in an acute financial situation again, concerned about how we are will meet our costs for the coming month. The funding we get is inadequate to pay for salaries, fuel, cleaning supplies, food and medicine and leaves us with extremely difficult decisions about what to do without.
When the Zambian government introduced free health care at all hospitals and clinics throughout the rural areas of the country in 2006, the state promised to give monthly compensation to all these institutions corresponding to the monthly income through patient fees during 2005.
At the end of that year the hospital got just about half of the normal income for 2005 as compensation. On top of that in April 2006 the state decreased its regular monthly support to the health institutions in Zambia. In Mpongwe the support was decreased by 50%.
The number of patients MMH serves has increased drastically since 2005, a fact that shows the need for low cost care. This has of course let to drastically increased costs for the hospital. More patients require more drugs and more staff in order to meet the increased demands from the raising number of clients.
MBA, who owns and manages the hospital, pays the salaries for one third of the staff, medicine, food for patients, medical supplies, cleaning materials, stationery, fuel, maintenance etc.
The government seconds staff to hospitals and other health institutions covered by the Memorandum of Understanding. One third of the employees at MMH are seconded by the Government. Another third are employed by the Hospital. The government is contributing to their salaries through CHAZ. The Government is also giving the hospital a monthly grant of about ZMK 6,000,000 (about 12 000 SEK) per month. The grant has fluctuated very much. In addition to this MMH is getting medicine from the District Health Management Team when they have medicine in stock.
For 2008 the government decided to cut the support through CHAZ with 25% resulting in an even more difficult financial situation. Furthermore the direct funding from the government was reduced at the end of 2008 leaving the hospital with a negative result for the full year (if excluding the CHAZ programmes).
The situation today can in short be described as a greater dependence on financial support from the outside than before. The reasons for that are outside the control of the Hospital and of the people in Mpongwe. The state budget for 2009 has not been approved yet and we still do not know how much support we can receive from the government.
The financial support we get from current funding sources is so far below the costs we have so we are constantly faced with situations where we need to make difficult decisions about what to go without. Cleaning supplies? Medical Supplies? Food for patients? Minimal amounts of protein or vegetables once a week or not at all?
FOOD FOR PATIENTS
Patients with particular health conditions (wasting for example) are eligible for nutritional supplements when they are discharged. When we have maize for this program we can send them home with grain to make Nshima.
During their time at the hospital nutritious food is needed to enable healing. When we do not have funds to provide adequate meals to our patients it breaks our hearts. Our funding doesn’t allow us to serve vegetables or meat more than a limited number of days per week. When funding is low we have had to cut back from 2 meals a day to 1 meal of maize, unable to provide the necessary nutrients patients need for healing.
Patients’ families recognize inadequate food and provide meals. This is not an option for many patients who live far away or have no family to care for them.