Harare — THE year comes to an end on a positive note after the health delivery system has begun showing signs of recovery.

Beginning the year at its lowest ebb that was punctuated by the menacing cholera epidemic, shortage of drugs and absenteeism by health professionals who could not afford to commute to and from work, the situation has started normalising.

Various programmes that have been instituted by inclusive Government have started to realise positive gains that need to be sustained in the following year.

The Health Ministry is one of the ministries that got a new leadership comprising Minister Henry Madzorera, Deputy Minister Douglas Mombeshora and Secretary Dr Gerald Gwinji but the transition did not affect operations in the sector.

The inclusive Government's 100-day plan saw the introduction of the targeted approaches aimed at refurbishing all health institutions in the country.

Under the programme health institutions that had either closed or working far below capacity where targeted for revival.

The programme saw central hospitals ,such as the Harare Central Hospital, reopening their doors to the public.

Although the hospital is still to regain its status as one of the leading referral centres it has shown that, given adequate funds, it can retain its lost glory.

Harare Hospital has managed to reopen the children's hospital and maternity section that had been closed due to shortage of essential drugs and accessories.

The hospital has also seen the refurbishment of the laundry equipment that had been defunct for the past three years.

The refurbishment exercises also helped in improving operations at Parirenyatwa Group of Hospitals, Mutare Hospital and United Bulawayo Hospital.

Owing to the positive improvements at the targeted institutions, Government has vowed to continue with the approach for the 2010 financial year. Health financing for the year 2009 was on the positive side as Government, for the first time honoured, its global obligation to allocate 15 percent of the national budget towards the health sector.

Government did not only honour the obligation but surpassed it by 0,7 percent --- a development hailed by health professionals.

This commitment by the Government is being carried forward into 2010 as evidenced by the 12,7 percent allocation towards the ministry.

Although the allocation is slightly below the United Nations 15 percent target, it is, however, double compared to the US$121 million that the ministry received in 2009.

Health officials have, however, argued that it is not the allocation that matters but the actual disbursements, which makes a difference in the health sector.

Still on health financing, the Global Fund to Fight HIV and Aids Tuberculosis and Malaria approved Zimbabwe's proposal of US$180 million to fight the three diseases.

The funding, which will come into the country under Round Eight, is expected to reverse the brain drain through motivation of community health workers, sustaining running HIV and Aids, TB and malaria programmes in the country.

Once again, Zimbabwe managed to further reduce its HIV and Aids prevalence rate from 18 percent in 2006 (demographic health survey) to 13,7 percent this year.

However, health officials were quick to warn people not to relax over the decline, as there were threats of washing away gains made through the years.

The threat is necessitated by high sexually transmitted infections coming from antenatal clinics as well as other health institutions. However, the year had its challenges some, which were carryovers from the previous years. Carry over challenges from 2008 include the cholera outbreak that claimed more than 4 000 lives and left nearly 100 000 infected. Conditions that led to the epidemic in 2008 continued in 2009, as city authorities failed to supply residents with clean water and good sanitary facilities. Although the epidemic was officially declared over in June, new manageable outbreaks characterised the whole year. Currently, over 140 people have so far been treated of cholera in various districts and five people have since died of the disease.

The year also saw the return medical aid that had been rendered useless by the hyperinflationary conditions that rocked the country in the past years.

The return of the medical aid, which accounts for the greater share of health financing in the country's health system also meant that the majority of the country's workers particularly the civil servants now had access to health services that had gone beyond the reach of many.

To cushion civil service that until October were only receiving a US$100 allowance, the government introduced a free medical aid contribution for its workers.

Despite the challenges affecting the health delivery system, the country managed to mitigate the effects of the deadly swine flu (Influenza H1N1A) virus that continues to rock the globe.

Zimbabwe recorded more than 300 cases of the flue but contained the disease without casualties.

Although new outbreaks of swine flu have characterised the end of the year, the system is working flat out to minimise the impact.

The health delivery system, however, remains under threat from low financing both from the national fiscus and private donors.

Although the donor community has come in handy by giving the sector humanitarian assistance to the country, help towards the capital projects has not been forthcoming stalling a number of projects aimed a resuscitating the sector.

Because Zimbabwe has not been generating more revenue coupled with the illegal economic sanctions imposed on the country, the fiscus has not been able to increase funding to the sector with ministry getting only 11 percent of its total requirement for the year.

The cholera threat continues to cast a dark shadow over the country with the disease on the resurgence again.

Efforts should be taken to make sure the disease does spread across the country like what happen last year.

Cholera outbreak left more than 4 000 people death and affecting nearly 100 000 people in the period spanning from august 2008 to June this year.

Although the drug situation has improved over year, their levels in most central hospitals and the national stores remain worrisome with National Pharmaceutical Company putting the national stock levels at between 55 and 60 percent.

This drug shortage has resulted in some outbreaks taking time to control for instance recent cases of diarrhoea and measles.

Most unfortunately to the health delivery system has been increase in fraudulent behaviour among workers in the health sector.

In the past month a number of government officers have been arrested for swindling their employer thousands of US dollars and were brought before the courts on fraud charges.

The funds could have been used to improve the health sector.

In spite of all the effort by Government and private sector to avail information to people, it is disturbing that some sections of the community still refuse medical attention on religious grounds.

The Makoni district measles of outbreak therefore calls on government and its health partners increase information dissemination to communities to avoid unnecessary loss of life.

As 2010 beckons hope is that the recovery mode that the health sector has taken will be sustained for the good of the country and its people.