EXPERTS in the health sector have said Zimbabwe’s deteriorating health delivery system is causing anxiety in the southern African region as the country continues to be the epicentre of the deadly cholera disease, with cases now jumping borders.
Two laboratory-confirmed cholera cases linked to Zimbabwe were recently recorded in South Africa, prompting the neighbouring country to issue an alert to its citizens in its Limpopo province bordering Zimbabwe.
According South Africa’s department of health, the first confirmed case was of a 43-year-old male patient in the Musina sub-district in Vhembe district. The patient has since been discharged from Musina Hospital.
“The second case is a 27-year-old man, also from Zimbabwe, who presented at Hellen Franz Hospital under Capricorn District Municipality with a history of abdominal cramps, watery diarrhoea and vomiting that started on January 11,” the report read.
In an interview with NewsDay, Community Working Group on Health executive director Itai Rusike said the health sector was already facing deep structural challenges, long before COVID-19, and the pandemic exposed and worsened those challenges.
“The sector has suffered from years of gross underfunding and poor investment, with public health spending accounting for a relatively small proportion of total government spending, with health sector allocation standing at 10,8% in 2024 down from 11,2% in 2023,” he said.
“This chronic underfunding has resulted in reduced access to healthcare services for the general population, both in the public and private sectors. Inadequate public health infrastructure and ill-equipped hospitals further compound the problem.
“Patients often have to travel long distances to access primary healthcare facilities that lack basic measurements and necessary medicines. This creates hardships, particularly for those with limited means of transportation”
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He indicated that Zimbabwe’s rural clinics face water, sanitation and electricity challenges, as well as a shortage of healthcare staff due to a relentless brain drain. To address these issues, Zimbabwe needs prioritise the primary health care, universal health coverage and reduce health inequalities.
“There is a critical shortage of healthcare staff, with a low ratio of health workers to the population. This shortage is further exacerbated by brain drain, with many healthcare workers leaving the country. The remaining health personnel often work under difficult conditions with dwindling real incomes and poor working conditions,” he said.
“To address these challenges, Zimbabwe needs a renewed commitment to health and well-being for all, based on universal health coverage (UHC). Primary health care should be seen as a necessary foundation to achieve UHC. Additionally, an economical order that prioritises health and reduces health inequalities is crucial for the overall socio-economic development of the country.”
Meanwhile, Westview Medical Clinics medical director, Johannes Marisa said cholera prevalence in Southern African Development Community countries is being exacerbated by inadequate clean water supplies and sanitation infrastructure, affecting beyond Zimbabwe.
“One specific issue discussed is the prevalence of cholera, which should be preventable and controllable. However, the lack of clean water supplies and proper sanitation infrastructure contributes to water contamination and the spread of cholera. This problem extends beyond Zimbabwe and affects many countries in the Southern African Development Community.”
He added: “In terms of the health delivery system, there are six building blocks outlined by the World Health Organisation: Health workforce, service delivery, health financing, governance or leadership, medicines and drugs and health information systems. Unfortunately, Zimbabwe’s health delivery system, including primary healthcare, is not up to standard. Health financing and workforce are poor, leading to understaffing and brain drain. The allocated budget for the health sector is consistently below the recommended Abuja target of 15%.
“Overall, improving the health sector in Zimbabwe requires addressing issues of funding, infrastructure, staffing, corruption and a focus on universal health coverage. By investing in these areas, Zimbabwe can work towards a more equitable and effective healthcare system that provides essential services to its population.”
