DEJECTED, helpless and confused—these three words perfectly capture how heavily pregnant Nothando Tshuma felt when she was told by a cashier that her credit card did not have enough credit to buy baby diapers.
Tshuma had gone to a baby store in Bulawayo expecting to purchase items for her unborn bundle of joy, only to find out that she had to pay a 2% intermediated money transfer tax (IMTT) on top of the 15% value-added tax (VAT).
This left her credit card amount of $130 000 insufficient to pay for the items.
"But I have $130 000 on the card, how am I unable to purchase items for $127 000?" she desperately argued with the cashier.
Tshuma is not alone in this unfortunate situation.
Almost all pregnant women in Zimbabwe are gravely impacted by this unfair tax burden.
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The high taxes and additional charges imposed on pregnant women put them at a disadvantage, making it more difficult to provide for their unborn children.
The VAT, which is now 15%, is levied on clothing and other products that expectant moms buy for their unborn babies.
It doesn't stop there.
The pay as you earn (PAYE) and the 2% IMTT taxes also affect those who are employed and make purchases online.
Transactions between $10 and $500 000 are subject to a two cents per dollar tax under the 2% tax regime.
Furthermore, the 30% withholding tax makes it more difficult for women to take on extra jobs to increase their incomes.
The effects of these taxes can be especially harsh for pregnant women.
A caesarean section, a medical procedure in which a baby is delivered through a cut made in the mother's abdominal wall and uterus, requires extra fees that are significantly greater than those of other medical procedures.
But, with public hospitals in Zimbabwe lacking the necessary supplies to do the surgery, women must make the necessary purchases for themselves.
It is time for Zimbabwe to address this tax injustice and ensure pregnant women are not unfairly penalised for making necessary purchases for their unborn child, tax justice advocates opine.
“Most hospital theatres cannot meet the demand as the initial infrastructure was not built for the large numbers of patients presenting at the hospitals.
“We must fight for better access and more equitable taxation for all women in Zimbabwe,” said Itai Rusike, executive director of the Community Working Group on Health.
“There is inadequate equipment, such as incubators, piped oxygen, and visual inspection with acetic cameras (VIAC) to achieve set objectives, which compromises quality.”
Despite the overwhelming burden placed on pregnant women, public health care delivery and infrastructure investment in Zimbabwe has been declining.
There is a severe shortage of doctors and medical supplies at hospitals, including anaesthetics, sutures, and other necessary materials, leaving hospitals unable to perform even the most basic procedures.
This is because the government does not adequately subsidise the healthcare industry.
Health professionals are dissatisfied with their working conditions and pay, and some have left the country in search of better opportunities elsewhere, notably in western nations.
This has resulted in the high rate of infant, neonatal, and child mortality, as well as a worrying maternal mortality rate of 363 per 100 000 live births (1 589 maternal deaths per 437 478 live births), according to the Zimstat preliminary results of the 2022 Housing and Population Census in Zimbabwe.
Zimbabwe's Maternal Mortality Ratio (MMR) is significantly higher in rural areas than it is in urban areas, making the health situation for rural women and girls particularly bad.
Home births are reportedly on the rise as well, which has led to an increase in difficulties and injuries related to childbirth, including obstetric fistula.
Unfortunately, MMR is still well beyond the additional objective set by the Sustainable Development Goals (SDGs) for individual countries of MMR that does not exceed 140 by 2030.
This means that many pregnant women and girls are left vulnerable to these devastating injuries that have the potential to alter their lives.
The risk of life-altering childbirth-related injuries such as obstetric fistula, is a reality for pregnant women and girls in Zimbabwe due to inadequate healthcare infrastructure, high hospital costs, and cultural norms that favour home births.
“Clearly, tax justice has a bearing on women and girls’ reproductive freedoms and wellness and consequently creates other interconnecting and multiple social and economic challenges for them,” said Samukeliso Khumalo, founder and executive director of Women's Institute for Leadership Development Trust.
According to her, the government should create a national budget that is supportive of the poor and mainstream and prioritizes issues relating to gender justice and women's rights.
This would result in increased funding for healthcare, with special emphasis on maternal health care services and infrastructure.
Amnesty International discovered that the government of Zimbabwe has failed to allocate sufficient resources to the health sector and, despite declaring a policy of free maternal services, has not funded or operationalized relevant initiatives.
“The lack of ambulances and high fuel prices further compound delays that women and girls experience reaching and receiving care at health facilities,” the organisation said.
Social and economic justice activist Mukasiri Sibanda, who is also the Stop The Bleeding Consortium coordinator, said: “You find that women by nature have special health needs like maternal health care, for instance. They also do unpaid care work.
“So, if we have poor services in terms of health and education, it is women that normally plug in to subsidise the government in terms of this unplanned care work of taking care of the sick.
“Unpaid care work of taking care of the sick and also plugging in gaps where the education system is not working very well, among other responsibilities.”
According to the Global Alliance Tax Justice, women spend 2,5 times more time performing unpaid care and domestic work than men, which has been valued at US$10 trillion a year, or some 13% of global gross domestic product.
Tshuma asks God to save her from any labour complications.
“I pray for a natural birth because the cost of a C-section is beyond my means,” she said.