‘Healthcare will operate on shoestring budget’

By Gamuchirai Nyamuziwa | Dec. 6, 2024

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.

“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. (The Zimbabwe Independent)

CWGH calls for increased funding for health in 2025

Government must commit to allocating and spending at least 15% of the total budget towards the health sector in the 2025 national budget in line with the Abuja Declaration target. The current health financing model also remains unsustainable as it heavily relies heavily on external financing as well as OOP financing. Notwithstanding the huge external support from development partners, there is still a huge financing gap in the health sector in the country which calls for greater commitment by the Government to sustainably address it. In line with the Presidential mantra that ‘nyika inovakwa nevene vayo’, it’s important to increase public spending in the health sector for the attainment of universal health coverage (UHC) that ensures that no one and no place is left behind. Empirical evidence has shown that government financing is the most efficient and equitable way to fund health coverage.

Zimbabwe Issues Mpox Alert

By Vanessa Gonye

GOVERNMENT has issued a public warning about the outbreak of Mpox, formerly known as monkeypox, in several non-endemic countries, including neighbouring South Africa.

The alert highlights the risks associated with the rare viral infection, which is typically found in central and west Africa, but has recently spread to new regions.

CWGH Executive Director, Itai Rusike

Health and Child Care minister Douglas Mombeshora outlined measures to prevent the virus from entering the country, although no cases have been reported.

The symptoms of the disease include fever, rash, headache, muscle aches, swollen lymph nodes, chills, exhaustion and respiratory issues.

“Healthcare structures have been placed on high alert and preparedness and response activities are underway to ensure a swift and effective response if Mpox cases are detected in Zimbabwe,” Mombeshora said in a statement.

He advised the public to take preventive steps, including avoiding contact with infected animals or materials, isolating infected individuals, practising good hand hygiene and using personal protective equipment when caring for patients.

“We are committed to safeguarding public health and are prepared to take all necessary actions to prevent the spread of Mpox in Zimbabwe,” he said.

With Mpox cases on the rise in neighbouring South Africa, there is concern locally over the high traffic between the two countries, particularly considering that Zimbabwe’s health sector is already overburdened by several challenges that include shortages of drugs and medicines.

The World Health Organisation has declared the surging Mpox outbreaks a global emergency.

On Tuesday, the Africa Centres for Disease Control and Prevention said there were more than 22 800 Mpox cases and 622 deaths on the continent and that infections had jumped 200% in the last week.

Harare Institute of Public Health principal Amos Marume said: “If exposed, there is need for self-quarantine and also use of masks which work in minimising the spread of Mpox. In the interest of public health, people should excuse themselves from work and public spaces if they are diagnosed with Mpox.”

Community Working Group on Health executive director Itai Rusike said the co-ordination of Mpox response should incorporate lessons learnt from the COVID-19 pandemic.

“As the country’s health system faces a new strain of Mpox, community health workers will be key in responding to this new outbreak as they are the trusted sources of information for educating the community, identifying cases, linking patients to care,” he said.

Last week, Zimbabwe Association of Doctors for Human Rights secretary Norman Matara said given the country’s poor healthcare system, keeping Mpox out was better than trying to contain it after cases appear.

“It saves the nation a lot of money because treatment is always expensive,” he was quoted as saying.

“It also prevents us from unnecessary lockdown restrictions of movements . . . like what we saw with COVID-19.”

Added Matara: “At the moment, we have not recorded any case of Mpox. . . We just need to increase our health surveillance so that anyone with symptoms can be isolated and they can be screened and any case can be easily identified and minimise the virus spreading in the country.”

CWGH: Driving stronger advocacy and accountability for better health outcomes

• In Zimbabwe, the Community Working Group on Health rallied voices to shape a powerful domestic health financing position paper. Previously, budget decisions were exclusive to government officials, leaving out community perspectives. This advocacy secured an increase in health spending from 10.6% to 11.2% from 2022 to 2023, demonstrating the power of community-driven change.

Read more: https://www.globalfinancingfacility.org/partnership/csos-youth

Part of the team that makes it happen