ZIMBABWE’S healthcare system is facing a significant crisis, with healthcare coverage dropping by 40% in recent years, according to a report by the Zimbabwe NGO Forum, amid calls for increased budget allocation to the sector.
The report, titled Zimbabwe State of Human Rights Report, highlights the government’s failure to uphold citizens’ constitutional rights to basic healthcare services as guaranteed under section 76 of the Constitution.
The decline in healthcare services has been attributed to inadequate budget allocation and a mass exodus of healthcare workers.
The Finance, Economic Development and Investment Promotion ministry’s 2023 budget for health was only 11% of the total, far below the 15% target set by the Abuja Declaration.
“This allocation is uninspiring and does little to address the many challenges our healthcare system is facing,” the report said.
In the 2024 budget, allocation to health dropped to 9,2% of the total purse.
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According to the report, major health concerns in the country include cholera, malaria, tuberculosis, and other vaccine-preventable diseases impacting mostly the pregnant women and newborns.
Hospitals across Zimbabwe are also facing critical shortages of essential equipment, with Parirenyatwa Group of Hospitals, the country’s largest referral facility, lacking functional cancer treatment machines.
“The mammography machine at Parirenyatwa has been broken for 15 years, making it impossible for women to get timely breast cancer diagnoses,” the report adds.
The migration of healthcare workers to countries like the United Kingdom (UK) has further worsened the situation as a result of poor conditions of service and remuneration.
The report indicates that 2023 saw a 169% increase in healthcare workers leaving for the UK, with over 20 000 Zimbabwean healthcare workers employed there.
“Zimbabwean health professionals are leaving in large numbers due to poor working conditions and low wages,” the report points out.
Despite the launch of the Health Resilience Fund in 2023, which aims to support essential health services, the problems persist.
The fund, supported by the government and international partners such as the European Union and the World Health Organisation, UN agencies, for instance United Nations Population Fund and Unicef, have not been able to cover the gaps in healthcare delivery.
The report also noted the tragic death of rising Afro-pop star Garikai Mapanzure in 2023, which it said highlighted the healthcare system’s failures.
After sustaining serious injuries in a car accident, Mapanzure was unable to receive adequate emergency care, leading to public outcry on social media.
The inadequate public financing of health has resulted in a poorly run, poorly performing health system with an overreliance on out-of-pocket and external financing, which is highly unsustainable and inconsistent with achieving Universal Health Coverage.
Community Working Group on Health executive director Itai Rusike said Zimbabwe’s health sector was struggling because donor funding was dwindling owing to global economic constraints.
He said the dwindling taxable formal sector was also contributing to limited domestic resources revenue raising capacity and constraining the public sector health financing in the country.
“The country’s macroeconomic situation has impacted negatively on the health sector in a variety of ways, especially in reduced access to health care services by the general population in both the public and private sectors.
“Zimbabwe’s health system has since suffered considerable reversals mostly due to major decisions that have not considered health and the key determinants of health as being central to a nation’s development,” Rusike said.
He said the sector was also facing numerous challenges.
“The health sector was already facing deep structural challenges, even before COVID-19, and the pandemic worsened or only exposed those challenges.
“The sector has suffered from years of gross underfunding and investments with public health spending accounting for a relatively small proportion of total government spending,” Rusike said.
“The Abuja benchmark of 15% allocation to health has remained an elusive target for Zimbabwe. The current situation is such that the capacity of public health facilities to screen, diagnose and manage diseases and conditions has declined to all time low levels and remains weak in this challenged health delivery system.”
Rusike said Zimbabwe could reclaim its rightful place if the right actions, such as the proposed introduction of the National Health Insurance Scheme, are adopted.
“To right all the wrongs within the health delivery system and address the key determinants of health, the country must spend at least US$271 per capita in order to achieve universal health coverage by 2030,” he said.