Socioeconomic Barriers to Universal Health Coverage in Zimbabwe: Present Issues and Pathways Toward Progress

Abstract

This article assesses Zimbabwean health services, using a social workers' social development paradigm to analyze the dynamics of Zimbabwe's Social Security program, focusing on universal health access for older persons, orphans, and vulnerable children. This article identifies the key factors that have done the most to shape health policy administration in the broader context of social policies and social security in Zimbabwe. The discussion is framed around the need for pro-poor social policies, social inclusivity, and the efforts to ensure universal health access. Despite numerous reports, newspaper op-eds and consultancy documents offering opinions on the state of social service delivery in the country, most critics lack empirical data and end up being very anecdotal as they critique the present system. The socioeconomic context of Zimbabwe is therefore analyzed here, with the best available statistical evidence provided, followed by assessment of social policy interventions. Current challenges to access health services are evaluated using a human rights-based social policy approach. The recent Zimbabwe Ministry of Finance-led consultative process crafted a 2016 document, the Poverty Reduction Strategies Papers (PRSPs), as an overall strategy for transforming the Zimbabwean health sector. The article concludes by recommending community-based health insurance approach as most appropriate intervention for ensuring health inclusivity and enhancing health for all in Zimbabwe.

Antenatal care coverage and early childhood mortality in Zimbabwe: new interpretations from nationally representative household surveys

“…In that same period, reductions in NMR were very small despite improvements in ANC coverage, a situation that requires further investigation. The slight declines in IMR and U5MR and the increase in NMR from 2015 to 2019 seem to match the economic challenges Zimbabwe has been experiencing since around 2015, which have negatively affected health financing and reduced healthcare access among many in Zimbabwe ( Nhapi, 2019 ). Yet, given that they were statistically non-significant, we interpret all changes in ANC coverage, NMR, IMR and U5MR from 2015 to 2019 in our analysis with caution.…”

“…The near-convergence of MICS 2019’s 5- and 2-year IMRs in Figure 1 was likely shaped by a contracting economy, health financing cuts and healthcare access declines ongoing in Zimbabwe since around 2015 ( Nhapi, 2019 ; Mhazo and Maponga, 2022 ). If left unaddressed, these 2- and 5-year mortality rates may converge or, worse, the 2-year rates may become higher than 5-year rates, similar to MICS 2009.…”

Childhood vision impairment and refractive error in Zimbabwe: A hospital-based retrospective study

“…In addition, the study's methodology and the availability of subjects may have contributed to its high incidence. Furthermore, people in rural areas of Zimbabwe are more inclined to wait for services provided by government-sponsored and non-governmental organization programs than people in urban areas because of the high expense of accessing health care ( 12 , 13 ).…”

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“…The other driver to private healthcare in Zimbabwe is technology that is possessed by private hospitals that is not available in public hospitals. Nhapi (2019) highlights that the Trauma centre Borrowdale was during the onset of Covid-19 the only hospital that had a ventilator and other technology that were recommended for critical patients with progressive Covid-19. Therefore, a lot of people end up choosing private hospitals over public hospital because of the availability of essential technology.…”