By Wanangwa Tembo

Kasungu, June 4, Mana: On a veranda of an old cracked structure that leaks and creaks under the weight of time in Traditional Authority Mnyanja in Kasungu District, patients have queued on a wooden bench seeking healthcare services.

Most of them are women cuddling babies tightly to their chest to protect them from the harsh weather as the day is cloudy and cold with intermittent drizzles. 

Being on a busy trading centre and by the road side, the place is not only noisy with revving motorcycles passing by, but it is also infested with vendors plying their businesses a few metres away, compromising the privacy of the patients.

Regardless of its dilapidated form that tells a story of neglect and struggle, Ofesi Health Centre remains a place of hope for the 20,000 people in its catchment and beyond.

Tobias Mtonga, chairperson for the Health Centre Management Committee, says communities in the area have for a long time struggled to access proper health services owing to the state of the clinic.

“This structure was built long time ago and it is not fit to be a health centre. It is small and dirty, and when it rains, it leaks.

“Additionally, it does not give the needed privacy to clients, especially those seeking ART [anti-retroviral therapy services],” he says.

Mtonga says the state of the clinic has been a huge compromise on the delivery of quality health services in the area.

Nevertheless, communities in T/A Mphomwa in the district’s west constituency look at the situation at Ofesi as a story of ‘half a loaf is better than none’. They themselves have no health facility nearby.

“Since hospitals are far away from here, the culture has been that if you are sick, you stay home. You only go to the hospital when the condition is changing from bad to worse.

“This kind of approach puts our lives, especially those of children, at risk. Imagine a child getting sick at night and you do not have money to travel that long distance, what happens?” wonders Clara Phiri, a resident of Mphomwa.

The communities at Mphomwa are served by health facilities that are located at far away distances, often at great cost.

“It’s expensive. The quickest transport, especially at night would be a motorcycle and the charges are far high for most of us,” Phiri adds.

For some time, access to quality and affordable healthcare services for many communities in the district had been a challenge owing to long distances, a growing population and aging infrastructure.

However, amidst this gloom, a glimmer of hope emerges to change the narrative following government’s huge investment in constructing new facilities.

In the past three financial years beginning 2021/22, Kasungu District Council has received at least K3.4 billion in Performance Based Grant (PBG) under the World Bank-funded Governance to Enable Service Delivery (GESD) Project.

So far, the council has invested about K1.2 billion, representing at least 35 percent of the PBG, to construct new health facilities and associated infrastructure to plug the gap in healthcare service delivery.

The funds were earned after passing the Local Authority Performance Assessment (LAPA) which is a tool designed to determine councils’ qualification for assessing the grant upon satisfying performance related parameters, including public finance management and service delivery.

Principally, GESD, a five-year US$100 million project aims to strengthen local authorities’ institutional performance, responsiveness to citizens and management of resources for quality service delivery, and through the LAPA, the project awards good performance.

The impact of this investment is palpable because at Ofesi for instance, the council has completed erecting a K100 million new facility, replete with solar reticulated water system, and it stands in stark contrast to the old structure,

“It has been a long wait, but we are excited that we have a new health facility now, which is not only roomy, but also conveniently located, ensuring the privacy of clients.

“Our appeal is that authorities should hasten the procurement of furniture and related medical equipment so that the structure is open for use as soon as possible,” Mtonga says.

He adds: “Even the health workers will now be motivated to work under a structure that is modern and secure.”

The facility is surrounded by 16 Group Village Heads and also serves communities from Mzimba South, Mphomwa and Kaomba.

Similarly, there is also excitement at Mphomwa where the council has invested K220 million in health infrastructure, including a new dispensary, staff house and solar reticulated water supply system.

“We are excited with this facility, reflecting on the challenges we have encountered to access health services.

“We have been asking our leaders to help us with a clinic to cut the long distances that we travel to get treatment,” says Agnes Banda, a resident in the area.

The two facilities are part of the wider GESD-funded health infrastructure investment that has also seen the construction of maternity structures, staff houses, rehabilitation of guardian shelters, solar power and water supply and the procurement of medical equipment for old and newly constructed facilities.

Completion of the K839 million paying ward at Kasungu District Hospital is another milestone in the district’s endevour to providing quality care.

Director of Health Services for the district, Emmanuel Golombe says apart from being an income generating activity for the council’s health sector, the project is also a response to people’s demand for paying services to suit their interests.

“We want to generate revenue as a sector because this time, we have no means of raising funds apart from the subventions from the central government.

“We sometimes have funding gaps which compromise service delivery. So, this initiative will help us raise resources to buy important items like fuel, critical drugs and others,” he says.

Golombe notes that the district has many clients who have been requesting to have pay services.

“Kasungu District Hospital serves many clients in a day. Those rushing for work, or are on medical schemes or can just afford to pay for private services find it difficult to wait on queues.

“This project properly responds to their needs. Actually, it is for everyone that can afford, including those coming outside the district,” he says.

Kasungu District Hospital also receives clients from communities such as Jenda in Mzimba and Malomo in Ntchisi, making it the fourth busiest district facility in the country.

Magie Sinda, a resident of Mayadi Township hails the project as a game-changer for the district’s health delivery.

“It’s a huge relief that we finally have a better facility for those seeking pay services. It’s actually long overdue,” she says.

Senior Planning Officer for National Local Government Finance Committee, Charity Kaunda advises that district councils must ensure that they are delivering on the projects as per the agreements under the PBG.

“Our desire is to see that councils are able to utilise the resources to address the community service gaps by implementing projects that can stand the test of time, and implemented to the desired quality by adhering to specifications, and completed within the given timelines,” Kaunda says. 

She says GESD is about enhancing inefficiencies in the delivery of services in the councils.

“So, it’s not just about the projects. It’s about supporting the councils to embrace a performance culture in every area of their intervention.

“They must also comply with the principle of delivering a complete service package, that once projects are completed, they should be functional.”

District Commissioner, James Kanyangalazi, says GESD has helped change the face of Kasungu, especially in the provision of health services.

“In the just ended financial year, we have constructed several health facilities and their staff houses, among other projects.

“We cannot talk of poverty alleviation when there is no infrastructure development so communities should expect more of the same this financial year,” Kanyangalazi says.

He adds that the council will strive to serve the people diligently, not only to qualify for PBGs, but also to fulfill its obligations of delivering quality services.

The council’s commitment to deliver quality healthcare is also evident in its plans to spend K3.9 billion this financial year to fight morbidity and mortality.