Health professionals, especially medical doctors, were required by statute to serve the country for at least three consecutive years, thereby improving coverage in underserved rural areas. The main constraints included haphazard admission policies and selection procedures, inability to apply acquired knowledge and skills in the working situation due to lack of modern equipment, the absence of a national body for continuing education, the lack of an accreditation system at national and local levels to ensure standards and quality, the disparity in remuneration between medical service and private enterprise which lures medical graduates into business and managerial posts in private sector companies, and weak coordination between supply and demand in health manpower development and planning processes. Due to inflation, however, in real terms there has been no increase. Due to rising medical costs, alternative health care financing is among the new national health policies. This includes provision of paying wards in government hospitals and community cost sharing for essential drugs at government institutions.
Physical infrastructure Upgrading of hospitals at all levels is an integral part of health policy.
In many instances, physical requirements could not be provided due to financial limitations. There are no specific regulations on the quality, safety and efficiency of physical assets in government hospitals. The logistics of supply and management of medical equipment, supplies and drugs is found to be wanting. To renew the strategy for HFA, a comprehensive health manpower development plan and a comprehensive health care technical service will need to be developed. The further development of the public-private mix strategy for financing of health care will be encouraged, but with equity, quality and sustainability as central issues.