By Nathan Guma
CIVIL society has urged government to prioritize sustainable funding for the health sector to improve access to sexual and reproductive health services.
The country is preparing for the 2025 national budget, with calls growing for the government to prioritize the social services sector amidst evidence of underfunding in the health services sector.
In November last year, Finance Minister Mthuli Ncube presented a ZW$58.2 trillion (US$10.6 billion) 2024 budget with the health budget allocation pegged at 10.8%. This is below the recommended 15% threshold by the Abuja Declaration.
This week, the Southern Africa AIDS Dissemination Service (SafAIDS) said that the government should set aside a specific budget to cater for sexual reproductive health services.
“I think for us as a country to promote access to SRHR, in both urban and rural centres, there is a need for increased budget allocation toward the health sector,” said Lloyd Dembure, SafAIDS head of resilience diversity and sustainability.
“I know the government committed to setting aside 15% of the budget towards health, but we still have to call on it to honour that commitment.”
“The government has to increase healthcare funding. This will also reduce the risk of the country becoming overly dependent on donors. Currently, much of the investment comes from donors.”
Dembure said that while donors have been scaling down their funding, the government should prioritize pooling resources with the private sector to promote sustainable funding of the health sector.
“Donors have been scaling down their funding to countries. So, that also leaves the burden on the country to take ownership, to ensure that the increased allocation is balanced toward human resources, improved infrastructure, and medication for healthcare facilities,” he said.
“Currently, we are seeing a gap and a shortage in basics in hospitals. Also, if the infrastructure itself in some centres is dilapidated, we need to revitalize the healthcare institution as a whole - the system itself.”
Dembure also urged the government to revive public-private partnerships (PPPs).
Public-private partnerships allow large-scale government projects to be completed with private funding. These partnerships work well when private-sector technology and innovation combine with public-sector incentives to complete work on time and within budget.
“I still feel it (PPPs) is a good initiative launched by the government, where it was encouraging private players, companies, to invest in health. But, I have seen this more like it is now lying idle, the concept is no longer embraced as it was. I think it is good to reflect on that,” Dembure said.
Oversight Dembure said that there is a need for the government to promote transparency, which will help retain donors operating in the country.
“I think that’s also a gap that we have seen in some sectors, especially now, the resources are spent. Especially if you read the Auditor General’s report, it shows a number of gaps, or misuse of funds, or non-delivery of some of the items that have been purchased using public funds,” he said.
“So it is important to plug those gaps to ensure that the little resources that we have are put to good use. So, this is one of the things I also promote. The initiatives that also came into play, like the cancer levy, and the sugar tax, can go a long way if they are used accordingly. Now, I think what is not clear is how much has been raised, and how it has been spent.
“So, it is important to promote transparency as it encourages other investors who want also to invest in various sectors including health. “I think generally funding also for prevention interventions is very key.”
Budget Priorities under Scrutiny
The country’s budget priorities have already been under scrutiny, with findings from the mid-term review presented by Finance Minister Mthuli Ncube showing that departments that do not directly impact people’s livelihoods over-utilized their funds, while oversight and social welfare departments have remained underfunded.
An analysis of the review shows that only nine out of 39 sectors had utilized over 50% of their allocated resources.
Government departments that used most of their funds include the Finance, Economic Development and Investment Promotion Ministry, with 84.8%, while the Ministry of Local Government and Public Works used 72.2%.
The Ministry of Lands, Agriculture, Fisheries, Water and Rural Development used 69.1%, while the Public Service Commission spent 67.2%.
During the same period, the Zimbabwe Electoral Commission (ZEC) used 55% of its funds, while the Ministry of Home Affairs and Cultural Heritage spent 54.7%.
The review also showed that oversight institutions have been heavily underfunded, with the Zimbabwe Anti-Corruption Commission (Zacc) using only 37.2% of funds, the National Prosecuting Authority (NPA) 31.8%, the Parliament of Zimbabwe 24.4%, and the Audit Office spending a meagre 8.6%.
About Author
