The government should increase its allocation to the health sector in the National Budget, Hon Daniel Molokele, the legislator for Hwange Central, who is also the Chairman of Parliament’s Portfolio Committee on Health has said.
Hon Molokele is also the Chairperson of the African Parliamentary Taskforce on Domestic Resource Mobilisation.
He made the remarks today at a meeting organised by the Community Working Group on Health (CWGH) that also delivered its Position Paper on the 2024 National Health Budget. The meeting also gathered community views and inputs on the budget.
“The growing demand for health services in the country owing to the increase in population and the structural changes in the economy necessitates an improvement in public spending. It is important to ensure that the health system is adequately resourced and that those resources are used efficiently and optimally through increased prioritization of the health sector and enhanced public health investments. This should entail allocating at least 15% of the National Budget to the health sector in line with the Abuja Declaration target,” Hon Molokele said.
Commenting on the same issue, Mr. Itai Rusike, the CWGH Executive Director said the COVID-19 pandemic was a wake-up call to roll out and make Universal Health Coverage (UHC) a reality.
Mr. Rusike is Zimbabwe’s focal person of the Global Fund Advocates Network for Africa. He is a member of the Civil Society Engagement Mechanism for Universal Health Coverage 2030 Advisory Group.
“National health insurance is critical for the achievement of universal Health Coverage (UHC). This is important in a country where currently only about 7% of Zimbabweans have medical insurance. Sustainable progress toward UHC requires that a country’s health financing system consistently generate sufficient, largely domestic resources. Empirical evidence has shown that government financing is the most efficient and equitable way to fund health
“A strong health workforce is the cornerstone of every health system and is essential to ensuring Universal Health Coverage (UHC) and achieving the SDGs. It is important to review the health staff establishment to reflect the current demographic and macroeconomic trends. Appropriate incentives must be designed to ensure equitable distribution across urban and rural areas ensuring access to the under‐served,” Mr. Rusike said.
He noted that primary health care is the frontline of Zimbabwe’s health system. Primary health care is usually the first point of contact people have with their health care system, and ideally should provide comprehensive, affordable, community-based care throughout life.
A strong, well-funded, and accessible primary health system keeps people healthier and out of hospital by supporting them to manage their health issues, including chronic conditions, in the community. This reduces Zimbabweans’ reliance on costly acute care, such as specialists, emergency departments, or other hospital services. It is therefore vital to specifically budget for primary health care.
“There is a need for the government to increase investment in the PHC sector since it is an essential component in improving UHC and overall health outcomes. The district and community health systems are the foundation of the national primary health care system.
“Thereis a need to combat the scourge of non-communicable diseases (NCDs). Focusing on lowering the risk factors linked to NCDs is an effective method to control these diseases. Reducing significant modifiable risk factors include cigarette use, hazardous alcohol consumption, poor diets, and lack of physical activity. The government can use a variety of strategies to minimise NCDs, for instance, enactment and enforcement of tobacco, alcohol, and sugar taxes with a concurrent ban on the advertisement of tobacco and alcohol; in a bid to discourage harmful alcohol and tobacco use. It’s also important to ensure, the integration of NCD management into primary healthcare services. Additionally, since NCDs are linked with the social determinants of health; the government should ensure sustained and inclusive economic growth to prevent them,” he added.
Mr. Precious Shumba, the Director of Harare Residents Trust, said in view of the resurgent Cholera outbreak, the country must improve public investments in water, sanitation, and hygiene. The Global Task Force on Cholera Control considers water, sanitation, and hygiene investments as the foundation for meeting the goal of reducing cholera deaths by 90% by 2030.
“Several water, sanitation and hygiene interventions can be implemented rapidly and cost-effectively. These include point-of-use water treatment and safe storage, community action to end open defecation, provision of soap, and promotion of handwashing,” Mr. Rusike said.
The United Nations Children’s Fund (UNICEF) and World Health Organization (WHO) Joint Monitoring Programme report that a number of low-income countries, such as Cambodia and Ethiopia, have made rapid progress in eliminating open defecation, which has led to a significant reduction in diarrhoeal diseases.
Renowned economist, Dr. Prosper Chitambara said increasing health expenditure in tandem with the increased population, disease burden, and new national development goals remains a challenge to the health sector.
“Similarly, the sector is confronted with ensuring that the poor and the vulnerable including women, newborn babies, children, and adolescents are also able to afford quality health services. No country can make significant progress towards universal health coverage (UHC) without relying on the 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,” Dr. Chitambara said.
He said the current health financing model remains unsustainable as it heavily relies on external financing as well as out-of-pocket (OOP) financing.
“In line with regional and global best practices, Government should urgently explore a number of options and strategies for innovative mobilisation of resources. The key determinants of health must be addressed holistically and comprehensively in order to improve the conditions of health and development.
“The government must allocate funds towards improving basic health infrastructure in the urban, resettlement, and rural areas. Priority must be on strengthening the referral, district, and community health centres to promote preventive health care (as opposed to curative interventions). Funding for mobile outreach services so that communities in remote areas and newly resettled areas can access primary health care also needs to be increased,” Dr. Chitambara added.
The main challenges weighing down on the sector include low levels of productivity and capacity utilisation; high unit costs; limited access to and high cost of finance/credit; limited access to technology; antiquated equipment; fragmented and poor procurement and supply chain systems; low purchases by Natpharm; cumbersome registration procedures; low investments in research and development as well as intellectual property; and low public spending on the health sector in general.