Community-based health cover best alternative for informal income earners — experts

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With only 6% of the population covered by health insurance in Zimbabwe, there is need for community-based health cover as an alternative for the informal income earners, health researchers and stakeholders have said.

By Phyllis Mbanje

The issue of access to health by people especially in the rural areas has remained a thorny one in the health sector as the bulk in this group are not formally employed and have no means to pay for medical cover.

Out-of-pocket payments lead to medical impoverishment and inequality and this has heightened the need for universal health coverage which is regarded as fundamental to poverty reduction strategies.

A research project by a team from the Bindura University of Science Education (BUSE) established that community-based health cover (CBHI) can be a sustainable means of financing healthcare of low-income households in Zimbabwe.

“There is scope for sustainability of CBHI as well as scope for expansion to widen risk pooling at ward levels which health authorities can then integrate into a national health insurance,” said Lazarus Muchabaiwa, a researcher with BUSE.

The conclusions were made after the project — which was implemented in Musana for three years to establish the feasibility and sustainability of CBHI — showed signs that the concept was viable.

Coverage of high risk groups like maternal and childcare, those over 65 and HIV and Aids has always been a mammoth task for the less privileged in the absence of a health cover to cushion them.

Despite the Zimbabwean government’s massive financial commitment and investments into improving health care delivery within the first 10 years of attaining independence in 1980, most of the gains have since been undone.

The director of Community Working Group on Health Itai Rusike said the country needed a strong commitment to reform its health financing system in order to achieve coverage of the entire population.

“This is done through the introduction of a national health insurance,” Rusike said.

He also noted that Zimbabwe’s maternal mortality of 640 deaths per 100 000 live births was cause for concern as it was one of the highest in Southern Africa.

“Sadly, Zimbabwe is not on track to achieve the health-related Millennium Development Goal,” Rusike said.

Recently the head of the European Union delegation Ambassador Phillipe Van Damme said the government needed to prioritise the sector and allocate more funds from the National Budget.