Preparedness of Zimbabwe’s Health System to respond to Emerging and Reemerging Infectious Diseases; Focus on Parirenyatwa and Mpilo Hospitals

Abstract

Infectious diseases are responsible for a large number of deaths worldwide with Africa being the most affected. More than half of all deaths, 56 %, in low-income nations in 2016 were as a result of “Group I” conditions, which encompass communicable diseases. Some of these are emerging in countries where they were previously unknown such as Zika virus disease while others such as malaria are re-emerging. Recent outbreaks of plague in Madagascar and Marburg virus in Uganda have pointed to the need for health systems that are prepared to respond to infectious diseases, both emerging and re-emerging. The plague in Madagascar had 2348 confirmed cases and 202 deaths (case fatality rate 8.6 %) a situation, which may be extrapolated to other countries due to globalization. The study focus was to assess the preparedness of Zimbabwe’s Health System to respond to emerging and re-emerging infectious diseases. To determine the preparedness of the health system, the research sort to establish the readiness of Mpilo and Parirenyatwa health facilities to respond to emerging and reemerging infectious diseases, to establish the readiness of health personnel, to ascertain the availability of medicines and to determine relevance of protocols for reemerging and emerging infectious diseases at the hospitals. An explanatory convergent mixed methods approach was employed in data collection. Only health workers were included in the study, those that are exposed and work with patients that are suffering from emerging and reemerging infectious diseases. 257 respondents were interviewed and a questionnaire administered using purposive and stratified random sampling methods. Research findings indicated that the health system was severely compromised and could not respond to emerging and re-emerging infectious diseases. Although the country is ready to respond to infectious diseases in terms of enough bedding to handle the influx of patients, 30.7% of respondents representing the majority disagreed that the hospitals had efficient and active communication systems. Altogether, 46.7% indicated that the hospitals were not ready to respond to both emerging and re-emerging infectious diseases whilst 33.5% indicated that the hospitals were ready. Lack of adequate human resources, shortage of qualified and health staff in infectious diseases, inexperienced and poorly motivated health personnel were highlighted by the study.The study found that medicines for emerging and re-emerging infectious diseases are not always readily available, accessible and affordable. All responses relating to the perceived availability of medicines for emerging and re-emerging infectious disease response attained a mean composite score of 2.80 which implied that medicines for infectious disease response are not always readily available. A low composite index score for perceived relevance of protocols for re-emerging and emerging infectious diseases was calculated; the study concluded that protocols for re-emerging and emerging infectious diseases are irrelevant and inadequate for infectious diseases such as cholera, Ebola and Zika virus disease. The study concluded that the health system of Zimbabwe is not prepared for emerging and re-emerging infectious diseases. It is recommended that strategic frameworks for prevention and early warning and detection systems for infectious disease outbreaks are developed.