Public Finance Management in the Health Sector

“When seven babies were stillborn on July 27, 2020 at Harare Central Hospital in Zimbabwe, after urgent treatment was delayed because of a nurses’ strike, it captured the heart-rending health crisis in the country”

This does not come as a surprise as stories of chronic drug shortages and preventable deaths have riddled Zimbabwe in the last decade. The onset of COVID-19 has worsened the situation.

Post-Independence health policy placed a focus on preventative health – provision of protected toilets, safe water supplies, immunisation against childhood diseases, and family planning. Rural health centres, while providing curative treatments, were also to become centres for health education in the villages, through the training of village health workers; the general development of the economy would help to lift people out of poverty.

Once lauded as a marvel in the region, the health sector in Zimbabwe is no longer an image of its former self.

This paper seeks to provide insights on how systemic weaknesses within the country’s public finance system play a contributory role in worsening the health situation. With a focus on highlighting entry points for health oriented Civil Society Organisations (CSOs) and legislative oversight (Parliament/ Parliamentary Committees), the paper serves as an information piece that may add another dimension of understanding the situation.

A key assumption underpinning the paper is that understanding specific aspects of the relationship between public finance management (PFM) and the health system and subsequent service delivery is critical to thinking through and implementing solutions.

The paper also seeks to stimulate multi-stakeholder conversation, engagement and collective responsibility aimed at creating an enabling environment for effective PFM that contributes to improved health outcomes in spite of the perceived impact of the COVID-19 pandemic.

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