High cost of blood hampers access to health: CWGH

The Community Working Group on Health (CWGH) has lamented the high cost of blood and said it was one of the major barriers that prevent ordinary Zimbabweans from accessing and enjoying their health entitlements and rights as enshrined in the country’s constitution.

“Faced with worsening economic challenges and growing unemployment, Zimbabwe continues to lose precious lives daily due to the steep cost of blood, which remains beyond the reach of many people. The Community Working Group on Health (CWGH) is concerned by the increasing number of people who are dying in public hospitals because they cannot afford to buy blood and equally worrying is that families are having to dispose their priced possessions for a song to save the lives of their loved ones,” said Itai Rusike, the CWGH Executive Director.

Zimbabwe faces a high demand for blood transfusion due to bleeding related to pregnancy and child birth, high traffic accidents and other types of injuries. However, the most affected are pregnant women who require the life-saving commodity. About half a million pregnancies are expected in Zimbabwe and some of these suffer excessive blood loss, requiring transfusion of at least three pints.

Rusike said timely blood transfusion prevents maternal deaths which in Zimbabwe stands at 614 women dying per very 100 000 live births. For donating blood, donors only enjoy a drink and biscuit. However, it is also not a guarantee that if you are a blood donor you get blood at no cost when you need it.

“CWGH therefore urges National Blood Services Zimbabwe (NBSZ) and the Ministry of Health and Child Care (MoHCC) to urgently devise sustainable ways of ensuring that the cost of blood is affordable so that the ordinary person is not denied his/her basic right to health. This may include lobbying for subsidies from government and or inviting donors to chip in.

“Though the unit of blood, which is 250ml, was last year reduced to US$100 from US$135 in government hospitals and costs US$125 on average in private institutions, it remains too high and unaffordable to many Zimbabweans. What is however baffling is that the same amount of blood costs far less in neighbouring countries. For example, a pint of blood costs US$50 in Zambia and US$42 in Malawi, which is less than half of what it costs in Zimbabwe. What other screening procedures are done on blood in Zimbabwe that are not done in Zambia or Malawi? Other than affordability, there is also a problem with accessibility.”

A bottleneck analysis that was carried out by the Ministry of Health and Child Care shows that 60% of secondary facilities were found to have no blood in their stocks. Some facilities could not stock blood because of unavailability of fridges, electricity and general poor infrastructure.

The health advocates said it is was for the government to consider other alternatives such as solar refrigerators for storing blood products. To turn around the fortunes of NBSZ, which currently operates as a non-profit making company and whose funding is based on cost recovery fees, it is important to shed that status to be able to attract donors, a situation that would result in reduced blood costs.

Rusike said the issue of blood is a national issue which should attract the interest of donors especially at this point in time when the country is experiencing an economic meltdown. He said it cannot be left to be managed by a non profit making company that has a board of directors.

“CWGH believes in universal access to health services that includes accessibility of blood without restricting the principle of good governance and accountability, which we believe must be the most important criterion by which NBSZ performance is assessed. However, CWGH is worried about reports of alleged poor governance and alleged poor accountability within the institution of NBSZ, alleged corporate tags that drive away potential donors.”

“It is worrying that issues of governance and accountability continue to crop up once the name NBSZ is mentioned. There is need to set limits of term of office for Board members as well as set out clear parameters of their duties to avoid interference in the day-to-day operations of the institution a move that prevents smooth execution of work by the management. The board must have a functional constitution and only people of professional integrity must sit on the Board.”

He attacked the situation whereby one person chairs the board for 38 years and called for a appointment of board members with sound curriculum vitae and employment and service history. Board members fired or who resign from mainstream boards should be allowed to sit in the NBSZ board without due diligence has been made that they are clean, he added.

Presently, there are no term limits, no skills mix, no direct election of Board members from the blood donors. There are allegedly no clear policies that define Board members’ duties and board charter. There is a general view that sitting allowances should be abolished and replaced with a basic token of appreciation.

It appeared that basic tenets of good governance and accountability suffer when one stays too long in one position. Representation in the board must also reflect the current gender and racial dynamics in the country. Out of the 17 Board members, there are no females save for one female Chief Executive Officer.

CWGH was appalled by reports that the only director at NBSZ is 74 years old and while others are being retired for reaching retirement age he is being kept.

“Why? When in Zimbabwe we have competent medical practitioners who are young. To attract donors to fund the institution, the financial books and accounting procedures of NBSZ should be public matter. Further the auditors should be changed at stipulated intervals for accountability reasons. The grants that NBSZ receives from the government should publicly be accounted to ensure that potential donors gain confidence in the institution. The parliament and MoHCC should also play pivotal oversight roles to make sure that recommendations of the Auditor General are implemented for the improvement of governance and accountability purposes as well as for benefit of the ordinary Zimbabweans that cannot afford the cost of blood.

“CWGH believes the NBSZ urgently needs a structural and operational overhaul so that it can respond the tenets of good governance and accountability for the benefit of the ordinary Zimbabwean who presently cannot access or afford the cost of blood. In this regard, CWGH would urge MoHCC to urgently institute investigations into the operations of NBSZ and make recommendations that promote proper operations to avoid preventable and unnecessary loss of lives. We demand that this be done as a matter of urgency, failure of which CWGH shall take legal recourse against the NBSZ and call all board members to resign,” Rusike added.