ZIMBABWE has a population of about 16 million people, a significant increase from 1980 when there were about seven million people in the country.
The country is medically serviced by public hospitals, private healthcare facilities and mission hospitals.
The government hospital system includes six central hospitals, eight provincial hospitals and 63 district-level hospitals.
At least 50 private hospitals are registered in the country.
Health financing has been a topical issue in the country with government playing a critical role through the Health and Child Care ministry.
The Health ministry receives funding from the fiscus.
However, the funds fall short of the stipulated Abuja Declaration of 2001, where it was agreed that governments should apportion 15% of their national budgets to the health sector.
Donor funding has been providing significant financial support to specific health programmes, often channelled through multilateral organisations like the Global Fund and bilateral partnerships.
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Private medical insurance is still dormant in the country, with at least 10% of the populace being covered under medical aid societies, while a larger chunk of the population depends on out-of-pocket payments.
Today, there are about 36 registered and functional medical aid societies in the country, a 150% increase from the 1980 number.
The medical aid industry is one of the most stagnant industries in the country, with very few people subscribing to it despite the ever-increasing population.
If we talk of 10% of the population being medically insured, that is a ridiculously low percentage considering the prevalence of diseases that we are encountering.
Medical aid societies are being created every year and what we have witnessed is a fight for the same-size cake, with patients being shunted from one medical aid society to the other.
If medical aid societies were providing the required services, I guess by now, at least 40% of the population would have been covered under some medical aid society.
The situation is pathetic, with many service providers shunning medical aid card-carrying patients because of non-payment — failure to honour claims.
Many medical aid societies are accused of bully behaviour towards service providers, a situation which only aggravates an already volatile relationship between health funders and service providers.
The Health and Child Care ministry as the regulator is supposed to blow the whistle and issue yellow or red cards in cases of suspected foul play, alas, no significant action is taken.
Premier Service Medical Aid Society (PSMAS) has been in the Press for the wrong reasons yet it caters for at least 80% of civil servants who include teachers, nurses, doctors, police, army and prison officers.
Failure by PSMAS to timeously honour claims from service providers spells disaster for the lowly-paid civil servants, who are forced to raise extra money for shortfalls.
I had the shock of my life when I realised that PSMAS had the temerity to pay some of the claims I sent in 2024 using the old rate, with some claims being cleared for merely ZiG53, an amount which can be exchanged for US$2 using the bank rate.
How exasperating it is to witness such daylight robbery in a country steeped in macroeconomic instability.
It is undeniable that we have some medical aid societies that are performing well, with FBC, Northern Alliance, UltraMed and Cimas coming to mind.
These honour claims timeously and many practitioners have confidence in their operations.
What is needed is respect for service providers if the acrimony between health funders and service providers is to be reduced.
Government should increase surveillance on medical aid societies and all loopholes should be plugged in order to have the desired health service.
Medical aid societies that misbehave should have their licences revoked if investigations show they are incessantly on the wrong side of the law.
Clients should not be hoodwinked into joining fly-by-night medical aid societies that may be there for self-aggrandisement.
- Johannes Marisa is a medical practitioner who is the current president of the Medical and Dental Private Practitioners Association of Zimbabwe.
