Online Reporter
Rumbidzayi Zinyuke
Senior Health Reporter
ONGOING reforms to Zimbabwe’s medical aid regulatory framework have opened space for engagement between the Government and industry players, as stakeholders weigh in on proposed measures aimed at strengthening healthcare financing and service delivery.
The proposed amendments to Statutory Instrument 330 of 2000 are part of broader efforts to improve oversight of medical aid societies and align the sector with national health priorities, including universal health coverage and the planned national health insurance scheme.
Some of the key proposals under discussion include the prohibition of medical aid societies from providing healthcare services and the introduction of a risk-based capital model to enhance financial stability and supervision in the sector.
The Association of Healthcare Funders of Zimbabwe (AHFoZ) has welcomed the consultative process, while highlighting areas that require careful consideration to ensure reforms strengthen, rather than disrupt, existing systems.
AHFoZ chief executive officer Ms Shylet Sanyanga said medical aid societies’ involvement in service provision was historically driven by the need to ensure members could access care.
“When we look at the history of how medical aid societies ended up going into service provision, it was for that same reason that service providers at some point just all got together and they decided they were no longer going to be accepting medical aid cards. This is what forced the medical aid societies to then look for a solution for their members,” she said
Over time, some medical aid societies such as Cimas, PSMAS, First Mutual Health, among others, established clinics, pharmacies and other healthcare facilities to bridge access gaps, particularly when members faced challenges using their medical aid cards at private institutions.
Ms Sanyanga said these facilities had also supported the broader health delivery system by serving both members and non-members.
“If anything, those facilities are actually contributing to offering healthcare services, not only to medical aid societies’ members, but to any other patient seeking healthcare services. And we believe that by so doing, medical aid societies are also contributing towards universal health coverage, and that is in line with the national development strategy,” she said.
She added that reforms should focus on addressing identified challenges while preserving gains already made in expanding access to care.
“Under normal circumstances, we would have expected that perhaps we should be finding ways of maybe regularising, or actually solving the problems after we’ve identified what exactly the problem is. Maybe a bit of regulation might actually eliminate most of the problems instead of closing down, because closing down is destroying, in an era where we have a lot of problems, and we are building,” she said.
Ms Sanyanga said the association was advocating for the establishment of a dedicated regulatory authority to strengthen oversight of the sector.
She also underscored the need for a gradual and context-sensitive approach in implementing the proposed risk-based capital model.
“That is a significant change as it pertains to the way medical aid societies in Zimbabwe run business, and such a change needs to be introduced carefully. It shouldn’t be an event. There is need to actually allow the industry to evolve and also take into consideration our own economic environment,” she said.
Ms Sanyanga emphasised that medical aid societies play a broader role in promoting health and wellness, beyond financing care.
She said medical aid societies should not be confined to a space where they only collect and pay money.
“These are social services and therefore they (medical aid societies) are expected to get involved in ensuring that their members access healthcare services,” she added.
She noted that continued dialogue among stakeholders would be critical in shaping reforms that support both the sustainability of the sector and access to healthcare services across the country.
