daniel chigunwe
Economy Uncensored with Tapiwanashe Mangwiro
The Minister of Finance, Investment Promotion and Economic Development presented the 2024 National Budget yesterday and everyone was eager to see what they will gain or lose as the minister makes adjustments. This week we will not talk about the entire budget, but will put light on one of the most delicate issues that has been bedevilling us as a nation, the health sector.
As a country, we should remember these two quotes whenever we are dealing with such an important sector, “The first wealth is health,” by Ralph Waldo Emerson and “Healthy citizens are the greatest asset any country can have,” by Winston Churchill.
Finance Minister Professor Mthuli Ncube always believes in the Abuja Declaration amount of 15 percent of the total budget as is the African standard, but surely it is not enough to cover for the mess that we are currently in.
However, the shortage of it will not trouble the minister’s mind as there is a heavy external or private hand in the health sector that is helping keeping it afloat. Donors have played a critical role in funding the country’s health sector and the numbers are there to support the assertion.
Total health spending has averaged US$668 million over the period 2016 to 2023. While health spending from external partners remained stable at around US$433 million per year, National Budget health spending declined sharply from US$321 million in 2016 to US$96 million in 2019 before picking up to the current US$684 million.
Over the eight-year period spanning 2016–2023, on average development partners contributed 55 percent of total actual health spending while the budget contributing only 45 percent.
However, in the past three years, Treasury has ramped up funding of the sector as it moved closer to the Abuja Declaration and it now contributes 57 percent of funding with external partners contributing 43 percent.
The health budget increased by 508 percent from US$112 million ($6,6 billion) in 2020 to US$664 million ($54,7 billion) in 2021, which is what it has averaged since. Thus, the health sector budget as a share of the total budget increased from 7 percent in 2019 to 10 percent in 2020, 13 percent in 2021 and 15 percent since then.
Compared to other sector ministries, health sector in 2023 had the second highest budget, just below that of Ministry of Primary and Secondary Education, which was allocated US$690 million.
A total of US$1,2 billion was earmarked go towards financing health sector interventions in 2023 and out of the available total financing, domestic resources from the budget will account for 57 percent (US$684 million) and external financing 43 percent (US$496 million).
The health sector gets a lion’s share of Development Partner support because as a share of total development partner support, the health sector was projected to get US$499 million in 2023, which is equivalent to 59 percent of total external financing to Zimbabwe.
It is no secret that our health sector faces significant challenges, characterised by inadequate infrastructure, a shortage of healthcare professionals, and limited access to essential medical services.
To address these issues and enhance the overall health system, there is a pressing need for comprehensive reforms and some are discussed below.
Investments in healthcare infrastructure are crucial as upgrading existing facilities and building new ones would help meet the growing demand for quality healthcare services. Adequate infrastructure ensures that medical facilities are well-equipped and accessible, contributing to better health outcomes.
There is need for health workforce strengthening through either luring back expatriates or try and improve working conditions of the ones already around. It also involves not only increasing the number of trained doctors and nurses, but also providing ongoing training and support to enhance their skills.
A robust health workforce is fundamental to delivering effective and efficient healthcare services.
Ensuring a consistent supply of essential medicines is essential and this requires efficient procurement and distribution systems to prevent shortages and guarantee that patients receive the medications they need. Access to medicines is a cornerstone of a functional healthcare system.
Promoting public health education is crucial for preventive care. By raising awareness about health issues and encouraging healthy lifestyles, the burden on the healthcare system can be reduced.
Prevention is often more cost-effective than treatment and contributes to overall community well-being.
Engaging in partnerships and collaborations with international health organisations can bring additional resources and expertise. This can include financial aid, technical support, and knowledge exchange, all of which can contribute to the improvement of the health sector.
In conclusion, addressing the challenges in the Zimbabwean health sector requires a multi-faceted approach that involves infrastructure development, workforce strengthening, improved access to medicines, public health education, and international collaboration.
Prioritising health not only enhances the well-being of the population but also contributes significantly to the economic growth and stability of the nation.
Tapiwanashe Mangwiro is a resident economist with the Business Weekly and writes in his own capacity. @willoe_tee on twitter, Tapiwanashe Willoe Mangwiro on LinkedIn and [email protected]
Bongani Ndlovu