2023, a year of ups and downs in the health sector

A health system is an organisation of people, institutions and resources that deliver healthcare services to meet the health needs of the target populations

AS we approach the end of 2023, there are many positives and negatives in all sectors of the economy. The health sector is one sensitive sector that should be respected as economic development usually depends on a sound health delivery system. Health and development are symbiotic in nature. In 2023, Singapore dominated the ranking of the world health and health systems followed by Japan and South Korea. Per capita healthcare spending is highest in the United States of America, with Germany following behind.

Our country has scored some points on health service delivery although there are some areas that need serious strengthening. The Health and Child Care ministry now has a new minister, Douglas Mombeshora, who took over from Vice-President Constantino Chiwenga after the August harmonised elections.

A health system is an organisation of people, institutions and resources that deliver healthcare services to meet the health needs of the target populations. A strong health system ensures that everyone is able to access quality healthcare without facing financial difficulty. 

The Alma

A health system is better analysed through the 2007 World Health Organisation building blocks which comprise of six components namely health workforce, service delivery, leadership, health informatics, medicines and health financing. Where are we as a country as we round off 


For a long time, our central hospitals have been running without  functioning magnetic resonance imaging scans, computed tomography scans which have recently been installed at Parirenyatwa Group of Hospitals in Harare. This is good news which will indeed add value to diagnostics. The ministry should be applauded for working hard to have such scans at our hospitals because few people can afford to pay for magnetic resonance imaging scans in the private sector. 

A new radiotherapy machine is currently being installed at Parirenyatwa, a major development that will bring joy to many cancer patients. It would be prudent one day to have scans like computed tomography installed in every provincial hospital so that the service is decentralised, thus a significant milestone for the country.

Zimbabwe has a hard-working health workforce and recently there was a team of volunteer medical professionals carrying out surgical procedures in Victoria Falls. 

The team was being led by Sisimayi and Mtambalika and more than 150 surgeries were carried out on patients, thus bringing relief to patients, reducing financial burden and generally improving accessibility to health service. The biggest asset of any organisation is the human resource and what matters now is to improve skills retention in the country. There is mass exodus of skilled health personnel with more than 4 500 nurses reported to have migrated out of Zimbabwe in the last 18 months. 

The rate is alarming and government should work expeditiously to address this scourge that is threatening to destroy our health system. The Health minister cannot succeed in stemming brain drain alone. Instead, it requires collaboration with other ministers who include the Finance and Local Government ministers to mention just but a few. It is a pity that the Health and Child Care ministry only got 10,8% of the national budget for 2024, a figure I think is far below expectation as the Abuja Declaration of 2001 stipulates a threshold for health allocation of at least 15%. With many health expectations post-COVID-19, health financing is grossly inadequate and it is an open secret.

Governance is one thing which can run down our health delivery system. A health system should have reputable and qualified people to run it. Meritocracy should characterise modern human resource management as opposed to patronage, favoritism and nepotism. Are our public health facilities run by qualified people or their promotion was based on seniority? Why would one become a hospital chief executive officer without a single management qualification? Poor leadership can collapse the entire health delivery system.

We pray for a better 2024, a year we hope to contain the excessive brain drain, a year we hope to increase rewards to our employees, a year we expect greater co-operation between the public and private sectors, a year we expect discipline among some errant medical aid societies. It is either now or  never!

  • Johannes Marisa is president of the Medical and Dental Private Practitioners Association of Zimbabwe. He writes here in his personal capacity.

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