By Kudakwashe Pembere
As Finance Minister Professor Mthuli Ncube prepares to present the 2026 National Budget, concerns persist over Zimbabwe’s failure to fully utilise health allocations, despite the Ministry of Health and Child Care consistently receiving less than 15 percent of the national budget.
According to the 2025 Mid-Term Budget and Economic Review, the Health Ministry had spent only 25 percent of its allocation by mid-year, compared to the Ministry of Transport and Infrastructural Development, which had already spent 116 percent of its budget. Health Minister Dr Douglas Mombeshora has blamed delayed disbursements for the low expenditure.
Sources within the Ministry of Finance confirmed that the challenge of underspending in the health sector is long-standing.
It points to this issue of procurement modalities which they (Ministry of Health) are failing to cope with. After seeing the underspending, most of the time we end up asking them to return the money so it can be redirected to other ministries,” said one official who spoke on condition of anonymity.
A Trend Analysis on Public Procurement in the Health Sector by Transparency International Zimbabwe (TIZ) shows that the Ministry of Health has consistently underspent over the past five years, citing delayed disbursements, limited absorptive capacity and bureaucratic procurement hurdles.
“Issues of budget underutilization and unspent funds were consistently raised from 2020 to 2024, showing a recurring pattern of inefficiency. Underspending rates fluctuated, 20.3 percent (2020), 22.8 percent (2021), 10.4 percent (2022), 5.5 percent (2023), and 21.4 percent (2024). The Auditor General also flagged unreconciled direct payments and arrears in all years, with 2024 highlighting an unexplained US$3.1 million variance between Treasury and Ministry records. Despite temporary improvement in 2023, the issue resurfaced in 2024, showing that financial efficiency remains weak,” said TIZ.
TIZ further observed that the health sector’s underperformance reflects broader systemic inefficiencies in public financial management. “Compounding this operational failure is the recurring problem of financial reconciliation gaps between 2020 and 2024, which undermine accurate financial planning and the effective delivery of essential services,” the organisation said.
While the government continues to prioritise infrastructure development, the imbalance in spending has become evident. In contrast to the underfunded health system, the transport sector’s overspending comes amid a rise in road traffic accidents. According to the Zimbabwe National Statistics Agency (ZimStats), 15,350 accidents were recorded during the second quarter of 2025, resulting in 624 deaths and 2,926 injuries. This represents a 19.8 percent increase from the first quarter.
“During the second quarter of 2025, the number of vehicles registered for the first time increased by 15.2 percent, from 18,214 in the first quarter to 21,128,” said ZimStats. “The number of light motor vehicles registered for the first time increased by 18.1 percent from 13,631 to 16,095. Road traffic accidents increased by 19.8 percent during the second quarter of 2025 compared to the first.”
These figures highlight the growing public health burden from road injuries, which strain an already under-resourced health system. Hospitals continue to face drug shortages, staff shortages and inadequate emergency response capacity, all linked to inconsistent funding.
Experts argue that the health sector’s inability to absorb funds stems from rigid procurement procedures and unpredictable disbursements. Treasury’s irregular releases make it difficult for the ministry to plan or implement key programmes, leading to delays in the purchase of essential medicines and the maintenance of facilities.
Civil society organisations have called for greater transparency and reform. “When health budgets remain underutilised, it signals inefficiency and neglect,” TIZ stated. “Strengthening public financial management, improving procurement transparency and decentralising budget control to hospitals could improve outcomes.”
Analysts also warn that chronic underspending in health undermines public confidence. Communities continue to witness new road networks and other visible infrastructure projects, while nearby clinics remain poorly equipped and understaffed. The resulting service gaps lead to preventable deaths, high out-of-pocket expenses and worsening health indicators.
To address the issue, experts recommend predictable disbursement schedules, capacity building within the Health Ministry, and improved coordination with Treasury. Allocations should be guided by disease burden and population needs, with real-time tracking of expenditure to enhance accountability.
