Health minister says shortage was not malpractice

Kalumbi Shangula

Minister of health and social services Kalumbi Shangula says the shortage of medical equipment in hospitals does not equate to negligence or malpractice.

Shangula was responding to Popular Democratic Movement parliamentarian Winnie Moongo on the shortage of cardiotocography (CTG) papers at Windhoek Central Hospital.

“How does the ministry plan to address concerns regarding potential malpractice allegations against healthcare professionals who might be forced to make critical decisions without adequate CTG documentation?” Moongo asked Shangula.

Shangula on Thursday confirmed the shortage fell between 29 February to 6 March 2024.

“This matter was brought to the attention of the hospital’s management team and it was noted that there was a delayed supply from the supplier.

I am pleased to report that the CTG papers were delivered on 7 March,” he said, adding that in the long-term, it is worth noting that the world is shifting away from paper-based CTGs.

The CTG is a continuous recording of the foetal heart rate obtained via an ultrasound transducer placed on the mother’s abdomen.
CTG is widely used in pregnancy as a method of assessing foetal well-being, predominantly in pregnancies with increased risk of complications.

Moongo says that since December last year, Katutura Intermediate Hospital has been receiving the wrong papers for the CTG machines, which give inaccurate readings.

“The absence of proper documentation compromises the healthcare process, leaving both medical professionals and patients in a precarious position,” Moongo says.

However, Shangula said the treating clinicians recommended a safer option, a repeat caesarean section, while the CTG papers were not available.

He said informed consent was obtained. This included disclosing that, due to missing CTG papers, they could not guarantee foetal safety at the time. It also covered aspects of adequate capacity and voluntariness.

“All affected patients agreed to a repeat caesarean section,” Shangula said, adding that they do emergency procurement if shortages of health products occur.

“On the ground, our clinicians also exercise the best clinical judgement when managing patients, to ensure that patient care is not adversely affected due to the shortage in stock of a particular health product,” he said.

Moongo questioned how medical professionals ensure proper documentation of critical interventions, such as emergency caesarean sections necessitated by pathological CTG findings.

“The CTG is the cornerstone of foetal heart monitoring for high-risk patients. The shortage impacted the work of the clinicians at Windhoek Central Hospital considering that the hospital receives and manages high-risk patients referred from district hospitals nationwide.

“However, the attending clinicians on the ground were still able to appropriately manage patients based on clinical judgement,” Shangula said.

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