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Zim’s new health services law puts citizens in danger

Opinion & Analysis
David Adetula

THE Zimbabwean government believes that doctors and nurses share the blame for the country’s declining healthcare. Health workers in the country frequently embark on strike action because of poor health infrastructure and pay. Lawmakers have amended the health services law to address the incessant work boycotts by the country’s health workers.

The amendment criminalises any strike action by health workers that lasts longer than three days. The new law does not only seem ineffectual; the draconian law will further destroy the country’s healthcare. More doctors and nurses dissatisfied with the new law will leave the country. The brain drain in the country’s health sector will worsen, and ultimately Zimbabweans will be at the receiving end.

The Legislature should reverse the new law to save the country’s healthcare. President Emmerson Mnangagwa can also cut spending on the running costs of his office and Cabinet to fund health infrastructure and workers’ demand for a salary increase.

In 2018, the government paid health workers about US$540 per month. Since the country’s economy worsened, many health workers now earn less than US$100 per month. The government’s inability to meet its former financial commitments has caused a massive brain drain in Zimbabwe’s health sector.

Health workers, who have stayed to work in government hospitals, protest poor pay by going on frequent strikes. The situation in the country needs urgent intervention. But not anything like the new health services law.

The government must be willing to engage health workers to resolve their concerns. As a commitment to a diplomatic resolution, Zimbabwe lawmakers should commence the amendment of the new health services law. A harsh law like the new health services law deprives health workers the right to protest against poor working conditions and remuneration.

The review of the law should restore the right of healthcare workers to demand better working conditions. Lawmakers need to involve health workers in the amendment process. It will help  to bring their perspectives into consideration.

The government’s continued negotiation with the health workers while the law remains puts the  professionals under unnecessary pressure. Such engagements with health workers are unlikely to yield a sustainable solution.

The government must commit to improving health workers’ welfare over the coming years. For instance, the government could sign a memorandum with the labour unions of doctors and nurses. The signed agreement should state percentage increases in health workers’ salaries over the next five years. If such commitment is missing in new negotiations, the current seeming peace instilled by the new law would be short-lived.

Since 2021, Zimbabwe has lost more than 4 000 health workers. Most of the doctors and nurses emigrated because of poor remuneration. Nurses in neighbouring countries like Namibia and South Africa earn 10 times more than their counterparts in Zimbabwe. Zimbabwe needs to pay its health workers better.

Zimbabwe complains about lack of funds to pay health workers better salaries, but the government can readjust its spending priorities to meet the demand. For example, for 2023, Zimbabwe budgeted US$250m for the Office of the President and Cabinet, while the budget for the country’s Health and Child Care ministry stands at US$977m.

Mnangagwa should cut down on the budgeted spending for his office to ensure access to quality healthcare for over 16 million Zimbabweans. The government can use the money saved through the president’s expenditure cut to fund an increment in the salary of health workers.

Zimbabwe currently plans to spend 10,5% of its annual budget on health and child care. The percentage represents a 4,4% decrease from the country’s 2022 health budget. Zimbabwe should design subsequent budgets to meet its commitment to the 2001 Abuja Declaration of 15% health budgetary allocation. More allocation to health would provide necessary funds for health infrastructure and an increment in the salaries of health workers.

Beyond the budget, the government must prioritise the health sector when it disburses allocated budgets to various agencies. As of September 2022, the Health and Child Care ministry had reportedly spent only 42% of its annual budgetary allocation. Meanwhile, as of June 2022, the President’s Office had overspent its budget by 10%. 

The disparity in budget performances for these offices suggests where the country’s priorities lie. The health sector is crucial to the overall wellbeing of the citizens. As such, it should have the required funds to run efficiently.

It is easy but unacceptable for the government to present the dire economic situation in Zimbabwe as an excuse to take away the protesting rights of health workers. If the government places the deserved premium on healthcare, it will save Zimbabweans from the danger that the new health services law portends.

The government must reverse the new law and resolve issues with health workers diplomatically. A repressive law like the new health services law in Zimbabwe should not be allowed to set a terrible precedent that authoritarian leaders may replicate in their countries.

  •  David Adetula is a writing fellow at African Liberty. He writes here in his personal capacity.

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