Over the past two decades, Zimbabwe's health sector has faced significant challenges.
While many factors have been associated with the malaise in the sector, sanctions imposed on the country by the West have primarily exacerbated the situation.
While these sanctions purported to be targeted at individuals and certain companies to address political concerns, they have had far-reaching economic consequences including a decline in healthcare services.
The Impact of sanctions
Secretary for Health in the Politburo Dr Douglas Mombeshora, who is also Minister of Health and Child Care said while many people do not understand the real impact of sanctions, it was important to clarify that Zimbabwe became a cash economy after their imposition and this caused huge disruptions in the economy.
"The first thing was to squeeze the economy of Zimbabwe by denying it access to cheap funds. What it has resulted in is that Zimbabwe became a cash economy, and no country can function as a cash economy. Most countries rely on loans from these multilateral institutions, and as a result, if there is not enough money in the country or if the money is expensive, then it becomes difficult, especially to take capital projects. Now, in the health sector, it means we cannot have money to buy the drugs that we require, we do not have enough money to purchase diagnostic equipment; talk of x-rays, ultrasound scanning machines, CT scans, MRI scans. We do not have cheap money to also construct infrastructure," he said.
This means that this scarcity has limited Government's ability to provide adequate healthcare services, particularly in hard to reach areas.
The economic challenges created by sanctions have driven healthcare professionals to seek better opportunities abroad, contributing to a shortage of skilled personnel within the country.
On Friday, Zimbabwe will commemorate the fifth anniversary of the Southern African Development Community (SADC) Anti-Sanctions Day.
The day, which was declared in August 2019, is an occasion when SADC member states collectively voice their disapproval of sanctions on Zimbabwe.
This year's event is running under the theme "Embracing Innovation towards Vision 2030: The Relentless Fight against Illegal Sanctions".
While the day is of important significance, it would be amiss to think that Government has been folding hands as the sanctions take over the economy all this while.
A lot has been done to address the arising challenges.
Innovative changes and positive outcomes
In the health sector, the Government has implemented various strategies to strengthen the health sector and improve access to healthcare services.
One key strategy has been to strengthen partnerships with development partners as well as the private sector enabling Government to leverage on their resources and expertise to improve healthcare delivery.
For instance, PPPs have been used to establish clinics and hospitals in underserved areas and to provide specialised medical services.
To ensure equitable access to healthcare, President Mnangagwa's Government undertook to construct health centres closer to the people.
A total of 30 22-bed health centres and five 60-bed district hospitals are being constructed across the country.
The construction of the health centres is wholly funded by the Government through a US$210 million facility.
To facilitate this, the Ministry of Health and Child Care and the Ministry of Finance, Economic Development and Investment Promotion contracted NMS Infrastructure Limited for the design, construction and equipping of the health centres and hospitals.
To date, facilities have been completed in Harare, Bulawayo, Mberengwa, Chimanimani with construction of one hospital already underway.
Another important initiative has been the Government's focus on human capital development.
The Government has invested in training healthcare professionals, including doctors, nurses, and community health workers to address the skills flight that saw a huge chunk of health workers leaving for other countries.
Last week, the Health Workforce Strategy (2023-2030) was launched to transform the capacity of the country's human resources for health.
In conjunction with this strategy, the Health Workforce Compact (2024-2026), was also signed underscoring a commitment to accelerate investments in health workforce development.
The compact is expected to address the key challenges affecting the health sector such as inadequate training, insufficient remuneration, and limited resources.
Furthermore, Zimbabwe has actively sought international cooperation to mitigate the impact of sanctions.
The Government has been closely working with international development partners, such as the World Health Organisation (WHO), UNICEF, and the Global Fund, to secure funding for health programme and to access essential medical supplies. These partnerships have been instrumental in ensuring that basic healthcare services continue to be provided to the population.
The combined efforts have also contributed to significant improvements and progress has been made in areas such as maternal and child health, HIV/AIDS prevention and treatment and immunisation.
Despite the challenges faced in the health sector, there have been many innovative responses over the past years.
The Government has implemented strategies to ensure that essential medicines are available in public health facilities, even in the face of supply chain disruptions.
Recently, the National Pharmaceuticals Company (Natpharm) completed the implementation of an enterprise resource management (ERM) system which seeks to improve the management of vital medicines in the country.
Natpharm procures medicines and medical supplies for all public health institutions and mission hospitals in Zimbabwe and has six warehouses in Harare, Bulawayo, Chinhoyi, Gweru, Masvingo and Mutare.
However, owing to an outdated system, the organisation was experiencing challenges that included drug leakages, stock outs as well as expiry of medicines before they were dispensed.
The system has improved inventory management and accountability to the last mile as a result of reduced stock variances.
To strengthen disease surveillance systems, the Ministry of Health and Child Care has rolled out the Electronic Health Record (EHR) system which improves the country's capacity to detect and respond to outbreaks of infectious diseases.
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The EHR is a data collection and management system which seeks to improve the efficiency of healthcare delivery and reduce errors, particularly in areas where paper records are still in use.
The system allows for the collection, analysis, and dissemination of health data which can help to identify health trends, track diseases outbreaks, and inform healthcare policy.
Over the past two decades, there has been a noted improvement in maternal and child health outcomes through targeted interventions. This has resulted in reduced maternal and child mortality rates, particularly in rural areas.
These are just a few of the programmes that have been implemented despite the burden of sanctions.
However, it is important to acknowledge that the challenges facing the health sector remain substantial.
Ongoing efforts are needed to address the root causes of these challenges, including poverty, inequality, and limited access to essential services.
By continuing to prioritise health as a national development priority and working collaboratively with development partners, Zimbabwe can build a more resilient and equitable healthcare system for its people.
Through investing in human capital development, strengthening public-private partnerships, and seeking international cooperation, Zimbabwe can take more strides in improving healthcare access and outcomes.
While the challenges posed by sanctions persist, the country's commitment to providing quality healthcare services remains unwavering.
