The Zimbabwe public health system is the greatest provider of health-care services with the aid of Mission hospitals and health-care, delivered by non-governmental organizations (NGOs), but the economic decline and a somewhat political instability have led to the reduction in health-care budgets, which affect provision at all levels.
The poor have suffered a lot. Zimbabweans continue to suffer from preventable diseases ranging from malaria, HIV and AIDS, tuberculosis, and vaccine-preventable diseases, such as, diarrhoea related diseases and health issues affecting pregnant women. According to research, 1 in every 11 children in Zimbabwe dies before his or her fifth birthday, on a yearly basis, and in other words 35 500 Zimbabwean children under the age of 5 years die each year.
Research has shown that one of the major causes of mortality of children under the age of 5 years in Zimbabwe is HIV and AIDS, which accounts for more than 20 percent of the deaths in this age group. In 2009, estimates showed that more than 1 million children in Zimbabwe had been orphaned by AIDS and 1.2 million people were leaving with HIV, while an updated estimation shows that 100 000 of this number are children. Tuberculosis is also one of the major cause of morbidity and mortality with a prevalence rate of 431 per 100 000 population, in 2009 alone.
It is a very sad situation, as the health sector is facing a lot of challenges ranging from a shortage of skilled professionals and health-care staff, eroded infrastructure with ill-equipped hospitals most of which do not have functional laundry machines, kitchen equipment and boilers, shortage of essential medicines and commodities.
The introduction of user fees is a barrier to basic health services for most vulnerable people in Zimbabwe. Government policy is to provide free-of-charge health services for pregnant and lactating mothers, children under the age of 5 years, as well as those aged 60 years and above, but this policy has proven to be very difficult to function, hence these days, without the substantial government financial support, fees paid by users helps to provide the main income for most of the health-care facilities, which leads to the provision of minimum services. Giving birth in a government or municipal facility has proven to be very costly for most women, who have been left with no choice, but to give birth outside the health system and it is estimated that more than 39 percent of women are delivering at home, which is sad, indeed.
If the responsible authorities try to look into health financing, which will improve access to basic medical equipment and essential medicines, attract and retain health workers in the public health sector, as well as laying the foundations for an investment policy to fund the rehabilitation and development of the health-services infrastructure the health sector will surely improve.