ZIMBABWE’S budgetary allocation of ZiG28,3 billion to the health sector for 2025 is insufficient to address the severe challenges facing the public health system, experts have warned.
Last week, Finance, Economic Development and Investment Promotion minister Mthuli Ncube allocated 10,2% of the national budget to the Ministry of Health and Child Care, falling significantly short of the Abuja Declaration target, which calls on African nations to dedicate at least 15% of their budgets to healthcare.
Itai Rusike, executive director of the Community Working Group on Health, expressed concern over the declining share of health spending in government expenditure.
He noted that the allocation of 10,2% represents a drop from 10,6% in 2024.
“Health spending as a share of total government expenditure is an indicator of the priority given to health,” Rusike said.
He stressed the need for increased investment in building a robust and accessible health system.
Achieving Universal Health Coverage (UHC), which aims to ensure access to quality health services without financial hardship, requires strong public funding and a commitment to treating healthcare as a fundamental right. The government’s healthcare spending, projected at 2,1% of gross domestic product (GDP) in 2025, has fallen sharply from 4% in 2024.
This is far below global averages, as highlighted in the World Health Organisation’s 2023 Global Expenditure on Health report, which showed high-income countries spent an average of US$4 001 per capita on health in 2021, compared to US$45 in low-income countries like Zimbabwe.
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“Increasing health expenditure in tandem with the increased population, disease burden and new national development goals remains a challenge to the health sector,” Rusike said.
“No country can make significant progress towards universal health coverage without relying on a dominant share of public funds.
“It is therefore critically important to ensure that the health system is adequately resourced and that resources are efficiently and optimally utilised.
“Government also spends a relatively small share of its GDP on health care.”
Rusike said the allocations fell short of what is necessary for a transformative impact on health care delivery.
“The budget earmarks funds for vital interventions: ZiG3,5 billion for the construction and rehabilitation of health facilities, ZiG290 million for medical equipment, and ZiG150 million for ambulances,” Rusike said.
“Moreover, given the unstable macroeconomic situation, it is important that allocations be disbursed timeously.
“This is critical especially given the fact that by the first half of 2024, the Ministry of Health and Child Care had only received 26,9% of its total allocation for the year; and by September it had received 52,6% of the total budget,” he added.
Rusike said the budget lacked adequate provisions for sexual and reproductive health services, particularly for women and adolescents in rural areas.
Edinah Masiyiwa, executive director at Women's Action Group, said the budget should have prioritised a well-funded post abortion care programme, among other important issues.
"I call upon the Ministry of Health and Child Care to invest enough resources in health centres so that women can access quality services," she said.
"A study carried out by the Guttmacher Institute revealed that health centres did not have essential supplies for post-abortion care such as misoprostol, blood and antibiotics. It is important for the national health budget to ensure all the supplies are available for post-abortion care if we are serious about saving lives," Masiyiwa noted.
This oversight perpetuated existing inequalities and limited women's ability to make informed choices about their health and family planning.
“The sector is confronted with ensuring that the poor and vulnerable who include women, new-born babies, children and adolescents are also able to afford quality health services,” he said.
l Exchange rate as at December 3, 2024: US$1: ZiG25,6
