Thursday, September 17, 2020

The 'Bouze Fixe" or Grade F+ of our Health System

(Published in Weekly, Issue 418,17-23 Sep 2020)
The political elite does not give a damn about our concerns , our protests, on the need for practical solutions to our survival problems;ils rassemblent les mêmes et recommencent without the main actors, the main stakeholders, the grassroots...
For every new government or a new minister, there is a new plan document, a new vision, new workshop and seminar, a fresh report and most of the times,it is a copy and paste exercise. Well concocted reports ( with nice sound bites and catchy slogans like sus island, globalisation to glocalisation or work-life balance-A new working normal or creating a new synergy with Africa, the cradle of humanity or making healthcare a pillar of our economy , you name it…with the approval of some big shots from international agencies) which claim to take on board the most recent advances in the field and the latest technology, that could put to shame similar reports in some of the advanced economies. We have been through this recently in the world of finance with vain promises on Fintech-Blockchain-Crypto-assets but zero results. That’s our usual masquerade or pretence of performances with the end-result that most of these reports turn out to being useless, piling up in government lockers and gathering dust - simply, a waste of taxpayers' money.
The recent article “Musango, Godsend for a healthier Mauritius” by Dr Sukur, highlights our "bouze fixe" phenomenon -our inertia which seems to be activity, our regular show of so-called performances . Mr Sukur, who spent most of his career in scientific and medical research abroad, details out the bleak side-the bouze fixe- of our Health system in tackling the NCD (non-communicable diseases). He summarises it very succinctly as (a) the inertia and lack of transparency in our governmental healthcare system (b) the inertia and fear that foster a lack of incentive for pragmatic innovation (“True innovation cannot flourish in a system that is defined by opaqueness and obfuscation towards change agents") and (c) the lack of will by the political class which is at the heart of our NCD calamity.
Dr Sokur’s comments are based on the recent research paper “Assessing health system challenges and opportunities for better noncommunicable disease outcomes: the case of Mauritius” by Dr. Laurent Musango, Mauritius World Health Organization (WHO) Country Office Director and colleagues (Musango, Timol, Burhoo, Shaikh, Donnen & Kirigia-BMC Health Services Research (2020). The main conclusions of the research paper are indeed damning : “The top five health system challenges hampering scale-up of coverage of population-based NCD interventions in Mauritius were inadequate interagency cooperation; limited application of explicit priority setting approaches; inadequate change management; sub- optimal distribution and mix human resources; insufficient population empowerment; and insufficient political commitment.”
The top five health system challenges that were identified by the paper as constraining theexpansion in coverage of individual NCD services were a) the limited integration of evidence into practice, b) limited use of explicit priority-setting approaches; c) the inadequate application of information and technology solutions, d) insufficient population empowerment and e) sub-optimal distribution and mix of human resources. “The top five challenges for individual interventions had mean scores varying between 2.6 (integration of evidence into practice) and 1.7 (distribution and mix of human resources)."
From the data metrics of the paper, our health system receives a passing grade in only 17% of the 24 necessary health interventions and a passing grade in only 20% of the 15 services needed to decrease or better manage NCD. If there was such a thing, giving an F + failing grade to our healthcare system would be generous.
The author comments “When I first looked at the results of their analysis. It took my breath away in heartbreak. Here it was, why we have so much pain and suffering in every single family in the country from the NCD scourge.Think about it. In what universe would any society accept such outcomes in what constitutes one of most important services that a government can provide to its citizens ? These data meticulously compiled and analyzed. leave all of us nowhere to hide In complacency.”
Complacency, you say, that’s rather mild ; these arrogant and smug consultants on the 5th Floor of the Emmanuel Anquetil Building at the Ministry of Health and Wellness (MoHW) will be retorting back with the usual rhetoric that we have one of the best health care system in Africa and display such reports- like the discredited carefully orchestrated WB's “Doing Business Report”- that regularly shower praises on the diligent poster-boy for the international agencies.
We continue to be served with such lofty rhetorics rather than sweeping reforms or sensible policy decisions that deliver . Indeed, we get so carried away by our own rhetoric that we start believing in them and the clichés that we readily churn out -Medical Hub, Logistics Hub, Regional Hub, Bunkering Hub(sic)......Meanwhile we “bouze fixe” and end up with such calamities as the NCD management fiasco or the Wakashio oil spill or Le naufrage du remorqueur Sir Gaëtan...What's next?




Prakash Neerohoo, Harish Chundunsing and 3 others
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  • Manjusha Hurry
    Am very curious, can you post the link the report you are referring to? 
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    Manjusha Hurry replied
     
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Prakash Neerohoo, Harish Chundunsing and 3 others
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