ZIMBABWE’S per capita health spending is expected to increase by 100 percent from US$20 in 2022 to US$40 this year which however remains far less than what other countries are spending on their people, a leading health economist has said.
By Kuda Pembere
In a Community Working Group on Health (CWGH) 2023 budget analysis for the health sector, Dr Prosper Chitambara said the country is still spending less of its gross domestic product on health in comparison to other countries. Zimbabwe’s per capita spending on health is still about twice as much afar from what other lower middle income countries are spending.
Government spending on health and child care as a percentage of total public expenditure is projected to increase from 10.6 percent in 2022 to 11.2percent in 2023. The Abuja target still remains an elusive target for the country.
“The Government also spends a relatively small share of its gross domestic product (GDP) on health care projected at 2.2percent in 2023 up from 1.7percent in 2022. Per capita health spending on health is however expected to increase to US$40 in 2023 up from US$20 in 2022. No country has made significant progress towards universal health coverage (UHC) without relying on a dominant share of public funds to finance health,” he said.
Inasmuch as there may be a projected increase to US$40 from last year’s US$20, Zimbabwe’s projections for per capita expenditure are still low in contrast to what other lower middle income countries are spending.
“On the other hand, health spending per capita was US$119 in lower-middle income countries and US$472 in upper-middle income countries. Most of the countries with low health spending were in South Asia and Sub-Saharan Africa, while most of the countries with high health spending were in Europe, North America and East Asia.
“The WHO estimates that an additional US$ 41 per person per year in health spending, on average, is needed in low and middle income countries to make progress towards the health targets of Sustainable Development Goal (SDG) 3 by 2030.
“This implies more than doubling current health spending in low income countries and a 34 percent increase in lower-middle income countries.
“Health spending relative to the size of the overall economy (GDP) also varied across income groups. For example, health spending as a percentage of GDP in 2019 ranged from 4.9 percent on average in lower-middle income countries to 8.2percent in high income countries,” Dr Chitambara said.
At a time when over 90 percent of Zimbabwean households use United States dollars for healthcare services with about 9 percent using local ZWL$ currency according to Zimbabwe Statistical Agency (Zimstat), Dr Chitambara finds the country’s dependence on out-of-pocket funds untenable.
“The inadequate public financing of health has resulted in an over-reliance on out-of-pocket and external financing which is highly unsustainable. Health spending in low-income countries was financed primarily by out-of-pocket spending (OOPS; 44%) and external aid (29%), while government spending dominated in high income countries (70%) (2021 Global Expenditure Report on Health).
“The 2023 National Budget Statement, revealed that development assistance towards the health sector was US$408.3 million during the first 9 months of 2022, and it is projected at US$496.6 million for the year 2022. In countries that are highly dependent on external aid, health priority in government spending tends to fall in line with the increased aid,” he said.
In a statement commemorating World Health Day, CWGH said the health sector has been reeling under gross underfunding by the Government which has resulted in poor performance of the sector.
“The sector has suffered from years of gross underfunding and investments, with public health spending accounting for a relatively small proportion of total government spending.
“The inadequate public financing of health has resulted in a poorly run, poorly performing health system with an over-reliance on out-of-pocket and external financing which is highly unsustainable and inconsistent with achieving UHC,” said CWGH.
