Zimbabwe's health delivery system - ZimFact
Ngoni Mhuruyengwe
March 15, 2018
ZIMBABWE’S junior doctors are on a national strike since the beginning of March protesting against poor remuneration and unsatisfactory working conditions, leading to the closure of almost all central hospitals, children’s units, provincial hospitals and the cessation of emergency life saving procedures throughout the country, according to their representative body, the Zimbabwe Hospital Doctors Association.
According to the association, there are 300 junior doctors working in Zimbabwe’s health government institutions. Zimbabwe is a long way from the World Health Organisation’s recommendation of the minimum threshold of 23 doctors, nurses and midwives per 10 000 population.  By 2015, Zimbabwe was at 1.6 physicians and 7.2 nurses per every 10 000.
According to the Zimbabwe National Health Strategy (2016-2020), currently every district has at least 2 doctors, every primary health care centre has at least 2 qualified nurses, 59% of administrative wards are serviced by an Environmental Health Technician and 60% of villages have access to a village health worker.
The Zimbabwe Service Availability and Readiness Assessment Report of 2015 says that health studies and surveys that have been carried out in the country all point towards inadequacies in the six World Health Organization (WHO) Health System Building Blocks – human resources, medical products, vaccines and technology including infrastructure, health financing, health information, service delivery, leadership and governance – that are prerequisites for a functional health delivery system.
What is the status of Zimbabwe’s health delivery system?
At a glance
Zimbabwe has a population of 13 061 239 (2012 Census). The total fertility rate is estimated at 4.3 children per woman (15-49years), with the population growth rate estimated at 2.7% per year (source: National Health Strategy for Zimbabwe 2016 -2020 – NHS). The population is served by hospitals and primary health care facilities owned by government (inclusive of security sector – army, police and prisons health care centres), missions, private players and industry. The majority of the population is serviced by government, municipalities and mission care centres.
68% of the health care delivery in the rural areas is from mission hospitals and clinics. Nationally, the mission hospitals and clinics account for 35% of health care delivery. Of these, 22 mission hospitals have been designated district hospitals (source: www.zach.org.zw).
In Zimbabwe, 14% of the health facilities are located in urban areas while 86% are in rural areas. As of 2015, Zimbabwe had 1848 hospitals and primary health care facilities (NHS).
Life expectancy for men has increased from 34.4 in 2006 to 58.5 years in 2013, with women at 61.3 years (WHO, 2013).
Structure
The Health delivery system in Zimbabwe falls under the Ministry of Health and Child Care, with a budget allocation of $520 million for the 2018 financial year. The initial allocation had been $454 million and was increased after Members of Parliament in the National Assembly refused to pass the whole budget unless the allocation was increased.
Legislation
The Zimbabwe health delivery system is built on the constitutional right to health care in Section 76, sub-section 1-4, of the Zimbabwe Constitution, which states that:
The ministry also has a national health strategy in place for the years 2016-2020.
The Ministry itself administers several Acts as follows:
Statistics at a Glance
Malaria incidence   –  20 /1000
Maternal mortality rate – 614/100 000
Neonatal mortality rate – 29/1000
Under 5 mortality rate – 75/1000
Proportion of children under 5 stunted – 28%
HIV prevalence (15-49 years) – 14%
TB incidence – 269/100 000
Diabetes prevalence – 10%
Percentage of household members using improved sources of drinking water – 76.1%
Percentage of household members using improved sanitation facilities which are not shared – 35%
Percentage of household members with no facility –31.7%
Did You Know?
Section 4 (Application for Reception Order) of the Mental Health Act states that;
Section 56 (Publication of advertisements of cures) of the Public Health Act states that;
Factsheet compiled by Lifaqane Nare
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