PUBLIC Health Experts and health economists have criticized the recently announced allocation of 11% towards healthcare, which they believe is still a far-cry from the required allocation of 15% in accordance with the Abuja Declaration.
By Michael Gwarisa
The government allocation on health and child care as a percentage of the total public expenditure increased from 10.6% in 2022 to 11.2% in 2023, making the Abuja target an elusive pipe-dream.
Giving an Analysis of the 2022 Budget, Community Working Group on Health (CWGH) Executive Director, Mr Itai Rusike said while some improvements in terms of allocation have been noted, the budget was uninspiring.
In nominal terms the health budget appropriation improved marginally from 10.6% in 2022 to about 11.2% in 2023. The budget remains grossly inadequate to fund the critical needs in the health sector. The current health financing model remains unsustainable as it heavily relies on external financing as well as out-of-pocket financing.
“In spite of the huge external support from development partners, there is still a huge financing gap in the health sector in the country which calls for greater innovation and commitment by the Government to sustainably address it. In line with the Presidential mantra that ‘nyika inovakwa nevene vayo,‘ it’s important to increase public spending in the health sector for the attainment of universal health coverage that ensures that no one and no place is left behind. In line with the regional and global best practice, government must bear the greatest burden in terms of health financing,” said Mr Rusike.
According to the budget, employment costs for health workers have been budgeted at ZWL$336,5 billion which accounts for 71% of the total health vote.
“While there has been a significant improvement in the compensation for health workers, we are still below a number of countries in the region. For instance, as at September 2022, the average net salary of a nurse comprised of ZWL$250,000 (US$330-403) and US$175.
“In South Africa, the average monthly salary for a nurse is about ZAR29,000 (US$1,600). Health infrastructure was allocated ZWL$37,2 billion which accounts for 7,9% of the total vote, while procurement of medical supplies was allocated ZWL$43 billion which constitutes 9% of the total health budget. ZWL$9,3 billion was allocated for rural health centers which constitutes about 2% of the total health budget.”
He applauded the increase in excise duty on surgery beverages but had reservations on accountability and transparency of the process.
“The excise duty on energy drinks which was introduced this year at a rate of US$0,05/litre, with a view to encourage responsible consumption of such products, as well as mobilise additional revenue to the Fiscus has been reviewed upwards to US$0.10 per litre, with effect from 1 January 2023. This is important and in line with regional and global good practices, there is however need to extend this to other sugary beverages.
“Additional funds generated from this must be ring-fenced and deployed towards the treatment and support of cancer, diabetes and hypertension patients through the Non-Communicable Diseases Fund. Transparency around this Fund can be enhanced by ensuring inclusivity and transparency in terms of its management in the spirit of leaving no one behind.
“These additional funds and the fact that the majority of Zimbabweans are either uninsured and/or underinsured medically, should provide a strong foundation and basis for the introduction of a national health insurance scheme to ensure universal health coverage. The proposal to redirect and ring-fence 20% of the Third-Party Insurance Premius collected from locally registered motor vehicles to the Consolidated Revenue Fund. These additional funds should provide financial assistance to victims of road accidents.”
Meanwhile, Development Economist, professor Prosper Chitambara said over reliance on donor funding was not healthy for the country’s healthcare sector.
