Hon MP Kwidini, Now Deputy Minister of Health , When he was a Member of the Parliamentary Portfolio
Committee on Health making a contribution at the CWGH
The Community Working Group on Health (CWGH) and the Africa Health Budget Network (AHBN) cordially invite you to Webinar on “How we can Ensure Public Health Resilience for the Next Pandemic?”
Date: August 2, 2023
Time: 10 AM (CAT) Harare, Pretoria
8AM (WAT) Lagos/Abuja
Join Zoom Meeting
In 2001, African Union heads of state committed to allocating 15% of their annual budgets to health sector financing through the Abuja Declaration. However, in 2022, Zimbabwe’s health budget was only 10.6% of total spending. Inadequate public financing for health means Zimbabweans are largely forced to pay out-of-pocket — if and when they have the personal funds to do so — in order to access health care. The country’s health sector is also extremely fragile given its reliance on foreign aid and shifting donor priorities, which the World Bank reports accounted for nearly 56% of health expenditures in 2020. No country has made significant progress toward universal health coverage without relying on public funds to support the dominant share of health sector costs. Given these financing gaps, many Zimbabweans lack access to basic primary health care services like reproductive, maternal and antenatal care; contraception; and newborn and child nutrition (nearly one in four children under five experience stunting).
Bringing Civil Society into Health Financing
For decades, the Harare-based Community Working Group on Health (CWGH) — a network of Zimbabwean civil society and community-based organizations — has been working to change this paradigm and improve government accountability by expanding community participation in public health policies, and participating in the development and monitoring of health budgets. In its role as the host and coordinator of the World Bank’s Global Financing Facility (GFF) Civil Society Organization (CSO) platform in Zimbabwe, CWGH has worked to ensure that CSOs and youth-led organizations (YLOs) are at the table with government to shape and inform the development and implementation of Zimbabwe’s investment case to mobilize domestic resources for sexual, reproductive, maternal, newborn, child and adolescent health and nutrition (SRMNCAH–N).
Impact of the Work
Since 2021, the GFF has provided CWGH with grants to support its advocacy work, including developing Zimbabwe’s GFF 2022-2025 CSO Strategy, which is comprised of a shared work plan and a monitoring and evaluation framework that facilitates member collaboration, evidence-based advocacy and alignment of advocacy efforts.
In 2022, CWGH gathered community and civil society inputs to develop a domestic health financing position paper that was submitted to Parliament, the Ministry of Finance and the Ministry of Health and Child Care and advocated for increased health spending in the national budget. Traditionally, the national health budget has been formulated by technocrats at the ministerial level without direct input from the community. Participation at the community level in budget formulation gives greater depth to the discussion and facilitates achieving the country’s overall health goals. Thanks to the community participation enabled through CWGH’s position paper, Zimbabwe’s government increased spending on health and child care from 10.6% of total public expenditure in 2022 to 11.2% in 2023.
The GFF CSO platform has also enabled civil society to provide input into Zimbabwe’s 2021-2025 National Health Strategy (NHS), which identifies 11 health priorities, including SRMNCAH-N and health financing reforms that rely more on public financing and the creation of a national health insurance scheme. To pay for the implementation of the NHS, CWGH also facilitated civil society engagement in developing the investment case for the National Health Strategy (2021-2025). These strategies are essential for domestic resource mobilization and transitioning Zimbabwe’s health system from one dependent on external financing to a self-sustaining and equitable system.
In 2023, CWGH received a new GFF grant to continue its advocacy work on domestic resource mobilization for SRMNCAH-N services and maintain civil society’s role in monitoring the implementation of the NHS and investment case.
Zimbabwe wins top post at the Africa Union Summit:
Parliamentarians from various African countries gathered to discuss health financing in Africa. The meeting, held on 11th and 12th July 2023 in Nairobi,At the sidelines of the African Union Summit resulted in the creation of the Parliamentarian Task Force on Domestic Resource Mobilization for Health in Africa. The task force aims to engage parliamentarians in their respective countries to mobilize national resources for health, strengthen community health, achieve universal health coverage, and address funding gaps for HIV, Tuberculosis, and Malaria.
Zimbabwe was represented at the meeting by Hon MP Dr Mathew Nyashanu, Hon MP Dr Ruth Labode, Hon MP Daniel Molokele, and Mr Itai Rusike. Hon MP Daniel Molokele from Zimbabwe was elected as the Co-Chairperson of the Parliamentarians Task Force on Domestic Resource Mobilization for Health in Africa, alongside Senegal.
The donor community is advocating for sustainability and wants countries to prioritize health as a national development goal. They aim to drive political will and encourage governments to allocate a larger share of their budgets to the health sector while decreasing reliance on external aid. This shift towards a sustainable and self-reliant health financing model is spearheaded by GFAN Africa, which prioritizes the long-term development and resilience of countries’ health delivery systems. This initiative will help countries respond better to future health emergencies like COVID-19.
THE NAIROBI DECLARATION 2023
We, Parliamentarians from Cameroon, Côte d’Ivoire, DRC, Ghana, Kenya, Niger, Rwanda, Senegal,
Zambia and Zimbabwe, gathered in Nairobi on 11th & 12th July 2023 at the sidelines of the
African Union Summit, to reflect and discuss health financing in Africa.
Cognizant of the need to formalize genuine collaboration between parliamentarians and Civil
Society, we propose for an effective advocacy program on sustainable domestic resource
mobilization for health in Africa, through a platform for exchanging information, sharing best
practices, strengthening political and synergies.
Our recommendations, resulted in the creation of the Parliamentarian Task Force on Domestic
Resource Mobilization for Health in Africa, with the objectives of engaging parliamentarians in
their respective countries on issues such as the mobilization of national resources for health;
strengthening of community health; universal health coverage; and addressing gaps in funding
for the fight against HIV, Tuberculosis and Malaria. We, therefore, unite our voices in support of
The African Union member states have subscribed to a solid normative legal framework on the
right to health; they have committed to its Agenda 2063, whose aim is to transform the potential
threat posed by the expected doubling of its young population by 2050, into a «demographic
dividend», bringing economic growth and higher living standards, and they also subscribed
to the Sustainable Development Goals (SDGs), which aim to significantly increase the health
budget to ensure that everyone benefits from universal health coverage (UHC).
Heads of state and government have also made declarations and commitments on health
financing, notably at the 32nd Ordinary Conference of the African Union in Addis Ababa in
February 2019, during which they endorsed the deliberations of the African Leaders’ Meeting
(ALM) and adopted declarations in favor of mobilizing domestic resources for health financing
Notably, many African states are struggling to meet their commitments to mobilize domestic
resources, yet investing in health is investing in human capital, creating stable jobs, stimulating
economic growth and reducing inequalities.
While investments in community health programs are cost-effective, we note with concern the
lack of prioritisation and adequate budgets for the same. These investments contribute to the
reduction of health inequalities, ensuring access to basic services for vulnerable and marginalized
populations; they deliver high quality services and improve overall health outcomes and hence
need to be prioritised.
We acknowledge the support and collaboration of these partners.COMMITMENTS
We are committed to advocate for :
- Domestic resource mobilization for health including push for the move from commitment
to action, co-financing of Global Fund and other development partners programs for HIV,
TB and Malaria, to build equitable and resilient health systems, focused on people centered
approach and integrated health services (addressing HIV, TB and Malaria and other health
issues based on people’s needs and disease burden);
- Community Health system strengthening, including ensuring a recognized status for
Community Health Workers, financing of Community Health Strategy, support for community
led responses, and incorporation of community, rights and gender considerations in HIV, TB
and malaria programming;
- Incorporating universal health coverage as a goal in national health policy frameworks,
strategically connected to broader inter-ministerial priorities such as emergency
preparedness, social stability, climate, economy and finance;
- Bridging financial and implementation gaps of HIV, TB, Malaria, Health Systems Strengthening,
Pandemic Prevention Preparedness and Response and Community Health Systems in the
National Strategic Plans for the countries;
- Establish a space for exchange and sharing of good practices among parliamentarians from
different regions of Africa;
- Create synergies with civil society on Domestic Resource Mobilization for Health in Africa.
That African governments, in a multi-sectoral approach, work in concert with parliamentarians,
civil society and the private sector to implement sustainable strategies for mobilizing domestic
resources and for a significant increase in health budgets, given that a healthy nation is
indispensable to Africa’s socio-economic transformation, as envisaged in Agenda 2063.
African governments, with the aim of achieving universal health coverage by 2030, accelerate
the institutionalization of community health agents to ensure the sustainability of their actions.
This means formalizing their integration into health systems, professionalizing their training and
mobilizing the resources needed to pay them.DECLARATION_MP_Nairobi_ENG
Nairobi, July 12, 2023