“Mother, your baby could pass stool in the womb. If that happens, the child can die.”
The warning came as labour pains ripped through 27-year-old Rumbidzai Shoko (not her real name) inside the crowded maternity wing at Chitungwiza Central Hospital.
She recalls a nurse lowering her voice before explaining that the unborn baby could inhale the stool — medically known as meconium — causing a potentially fatal condition called Meconium Aspiration Syndrome.
“She told me if I wanted them to ‘clean’ me properly and monitor the baby closely, I had to ‘buy a drink’ for the nurses,” Shoko said.
In Zimbabwe, “buying a drink” is often coded language for a bribe.
Terrified for the safety of her unborn child, she handed over US$15 in cash; no receipt was issued.
“At that moment, I thought my baby’s life depended on it,” she said. Hours later, when she was wheeled into the theatre, another medical worker allegedly informed her there had been no sign that the baby had passed stool in the womb.
“That is when I realised I had been lied to,” she said quietly.
Investigations by Truth Diggers also revealed that pregnant women who arrive at Chitungwiza Central Hospital without prior antenatal booking are among the most vulnerable to exploitation by corrupt personnel within the maternity system.
Several mothers interviewed said unregistered expectant women are often told to procure basic delivery materials such as gloves, Betadine, and umbilical cord clamps — commonly referred to as “gold clamps” — before they can receive proper attention.
While some supplies may legitimately be required due to shortages, patients alleged that the process is frequently manipulated to create opportunities for extortion.
Expecting mothers also described a registration process allegedly designed to frustrate and pressure vulnerable patients into paying unofficial fees.
They said some nurses allegedly work in connivance with admission clerks to delay or complicate registration procedures for mothers who do not offer informal payments.
“The moment they realise you are desperate or not booked, they start making things difficult,” said one mother who delivered at the hospital earlier this year.
“You are pushed from one clerk to another until someone suggests you should ‘appreciate’ the staff”.
The investigation also uncovered allegations of bribery linked to caesarean section procedures. Several women claimed that nurses sometimes demand money to “facilitate” quicker access to theatre services, allegedly working together with doctors and theatre personnel.
“Patients who paid are at times prioritised ahead of others waiting for surgery,” said one mother.
Truth Diggers established that the practice operates less as isolated misconduct and more as a coordinated informal network involving multiple levels of hospital staff.
“There appears to be a well-established system where different workers benefit at different stages,” said a former nurse at the hospital.
Other allegations include cases where security personnel and nurses allegedly receive kickbacks to allow patients to leave the hospital without following official discharge procedures.
Some mothers also reported being pressured into paying for non-essential services linked to childbirth documentation and presentation.
These included demands to pay for baby cards to be covered or laminated, as well as unofficial charges for “first photographs” of newborn babies taken shortly after delivery.
Shoko’s experience is one of several testimonies gathered during a month-long investigation by Truth Diggers into allegations of informal payments, extortion, and systemic breakdowns within maternity services at Chitungwiza Central Hospital — one of the country’s busiest referral hospitals.
Hospital records show that the institution handled 3 046 deliveries during the first quarter of 2026, up from 2 864 recorded over the same period in 2025, representing a 6,4% increase in maternity cases.
According to the hospital’s maternity delivery comparison records for January to March, the increase was largely driven by a significant rise in caesarean section deliveries, while normal vaginal deliveries remained the dominant mode of childbirth.
The records indicate that 2 169 mothers delivered normally between January and March 2026, compared to 2 263 during the corresponding period in 2025.
Despite the slight decline in normal deliveries, they accounted for 74,4% of all births during the first quarter of 2026.
Caesarean section deliveries rose sharply from 601 cases in the first quarter of 2025 to 877 cases in the same period this year, reflecting an increase of 276 procedures, or nearly 46%.
Monthly figures show that the hospital recorded 1 038 deliveries in January 2026, compared to 895 in January 2025.
Hospital records further reveal that caesarean sections increased consistently across all three months. January recorded 287 caesarean deliveries, up from 197 the previous year, while February rose from 180 to 277.
Childbirth turned into a transaction
For many women arriving at Chitungwiza Central Hospital, childbirth is no longer just a medical event.
According to hospital sources, it has become a negotiation shaped by fear, desperation, and money exchanged in corridors and delivery rooms.
A myriad of mothers described being pressured to pay unofficial “facilitation fees” before receiving assistance.
The payments allegedly come disguised as “buying a drink,” “tokens of appreciation,” “urgent supplies,” “cleaning fees” and “speeding up treatment.”
The money, in most cases, is requested in cash and without receipts.
One nurse openly said: ‘Those who appreciate us are attended to first,’” said another mother from Seke who delivered at the hospital earlier this year.
She said she was forced to borrow money from relatives while in labour to avoid being ignored by staff.
Exploiting vulnerability in the maternity ward
The investigation found that some nurses allegedly weaponise medical terminology and emergency scenarios to pressure women into paying.
Among the conditions frequently mentioned was meconium aspiration — a legitimate medical complication that occurs when a baby inhales meconium-stained fluid before or during birth.
However, a retired nurse said no unofficial payment is required for medical staff to monitor or manage such complications.
“Monitoring foetal distress and handling meconium cases is standard obstetric care,” she said.
“You cannot simply ‘pay’ to stop a baby from passing meconium”.
Truth Diggers also established that expectant mothers were at times told to purchase basic medical supplies that should ordinarily be available in public maternity wards.
A hospital under pressure
The alleged corruption is unfolding against the backdrop of the country’s deepening public healthcare crisis.
Public hospitals have long struggled with chronic underfunding, drug shortages, equipment breakdowns, staff migration, poor salaries, and periodic industrial action.
Recent protests by nurses over wages and working conditions further strained maternity services across public hospitals.
At Chitungwiza Central Hospital, patients and some staff members described overstretched wards, exhausted nurses, and shortages of essential supplies.
A health expert warned that under-resourced systems at Chitungwiza Central Hospital create fertile ground for informal payment networks to emerge.
“When workers are poorly paid and systems collapse, corruption becomes normalised,” the expert said.
“But the burden ultimately falls on poor patients who are already vulnerable”.
Findings mirror anti-corruption reports
Truth Diggers’ findings mirror concerns raised in a 2022 Health Sector Corruption Report by the Zimbabwe Women Against Corruption Trust, which examined the experiences of women accessing sexual and reproductive health rights services in public institutions.
The report, based on engagement meetings involving 40 women, found that bribery and informal payments were often driven by frontline healthcare personnel who allegedly manipulate access to services to pressure vulnerable patients into paying.
According to the findings, some women and girls admitted offering bribes simply to receive medical attention faster, particularly in overcrowded public facilities where delays can become life-threatening.
One respondent quoted in the report said: “The actions of the health personnel speak louder than words,” describing how patients are often indirectly forced toward bribery through deliberate delays and obstruction.
The report noted that some healthcare workers allegedly prolong queues unnecessarily, delay attending to patients, or create artificial shortages of medication and supplies.
In some instances, patients reported being told that drugs were unavailable, only to later see the same medication being provided to individuals perceived to have paid informal fees.
According to gender and corruption researcher Sandra Matendere, women frequently pay bribes not because they are willing participants, but because they fear losing access to lifesaving treatment.
“Corruption in hospitals disproportionately affects poor women,” she said.
“When access to treatment depends on informal payments, healthcare stops being a right and becomes a privilege.”
Matendere said corruption in public health institutions is a serious issue, which costs the safety and sometimes lives of patients.
“There have been reports of informal payments, which are requested at public health institutions for pregnant women to access preferential treatment,” she said.
“Those who fail to pay may face delayed assistance, which might be risky to their lives. Despite the rampant corruption in the healthcare sector, several victims don't report their experiences due to fear of victimisation.
“Creating safer reporting mechanisms is crucial in giving confidence for victims to report. I speak about women because they are the ones who are affected by corruption the most due to their reliance on public health institutions to access sexual and reproductive healthcare services including maternal care.”
She said corruption deepens inequality by punishing low-income mothers who rely entirely on overstretched public institutions.
Anti-corruption watchdog weighs in
The Zimbabwe Anti-Corruption Commission (Zacc) has identified the health sector as one of the areas vulnerable to corruption due to high demand for services, weak monitoring systems and cash-based transactions.
The anti-corruption board’s communications manager, Simiso Mlevu, said Zacc has a dual mandate: combating corruption through investigations and putting in place preventive measures.
“When reports of suspected corruption are received, Zacc investigates the matter,” Mlevu told Truth Diggers.
“However, to prevent or detect corruption, the commission carries out compliance checks and reviews internal governance policies.
“We also conduct research to inform policy recommendations to the government.
“We conducted research on the health sector and our intervention resulted in changes in the recruitment of nurses.”
Zacc has repeatedly urged members of the public to report bribery and extortion in public institutions, though many patients fear retaliation.
Policy versus reality
The Health and Child Care Ministry maintains that maternal healthcare services should remain accessible and affordable to all women.
Zimbabwe has actively committed to reducing maternal mortality through international agreements like the UN's Sustainable Development Goal 3 and regional frameworks such as the International Conference on Population and Development.
These commitments aim to lower preventable deaths to less than 70 per 100 000 live births globally.
To meet these international obligations, the Health and Child Care ministry and international partners have localised these frameworks with actionable strategies, such as the development of overarching frameworks like the Reproductive, Maternal, Newborn, Child and Adolescent Health and Nutrition strategy to standardise care and expand primary healthcare services, as well as tracking and reviewing every maternal death via the maternal and perinatal death surveillance and response to continuously improve the quality of care and prevent future tragedies.
The government has introduced sweeping reforms in the health sector aimed at lowering operating costs, improving access to healthcare, and attracting more investment into medical services.
Finance minister Mthuli Ncube in May announced that Cabinet approved a series of fee reductions and regulatory changes affecting hospitals, laboratories, pharmacies, and healthcare professionals.
In March, Health Service Board commissioners and secretariat staff signed the integrity pledge, formally committing themselves to transparency, accountability, and ethical conduct.
The commission’s chairperson, Rugare Abigail Kangwende, underscored the commission’s unwavering commitment to promoting integrity within the health sector, noting that ethical leadership is fundamental to the delivery of quality healthcare services.
She said the signing of the integrity pledge was a practical commitment towards entrenching a culture of honesty and zero tolerance for corruption at all levels of the health service.
The accountability gap
Community Working Group on Health executive director Itai Rusike said corruption diverts much-needed resources away from healthcare delivery and reduces patient access to services.
“Despite the ‘free healthcare’ policy, most of the time the selected vulnerable groups still buy their own medication due to non-availability in both rural and urban public health facilities,” Rusike said.
“This necessitates further travel to access pharmacies and laboratories at the districts or towns, thus impacting negatively on access and placing hardship on those with limited or no means to travel further.
“Comprehensive reproductive, maternal, newborn, child and adolescent health and nutrition within universal health coverage is critical to support progress towards advancing health and well-being for all.
“The current health financing model remains unsustainable as it heavily relies on external financing as well as out-of-pocket financing”.
Rusike said many Zimbabweans still lack access to basic primary healthcare services like reproductive, maternal, and antenatal care, facility-based childbirth, and newborn nutrition.
He added that the situation is perpetuated by existing inequalities and limited ability for women to make informed choices about their health.
“Therefore, there is a need for the health sector to ensure the poor and vulnerable, who include women, newborn babies, children, and adolescents, are also able to afford quality health services, especially at the community level,” he said.
Chitungwiza Central Hospital public relations officer Audrey Tasaranarwo said the hospital has not received any formal complaints regarding patients being charged for services that are supposed to be provided free of charge.
“We encourage anyone with such concerns to report them through the appropriate channels so they can be investigated,” she said.
“Management is not aware of any such allegations. The hospital has placed notices on its notice boards encouraging clients to report any suspected corrupt practices or unethical conduct so that appropriate action can be taken”.
She added that in cases where employees have been found guilty of misconduct following disciplinary proceedings, the hospital has taken appropriate action, including dismissal from service.
Lives caught in a collapsing system
For many women, the financial demands arrive at the worst possible moment.
“You come to a public hospital because you cannot afford private care,” Shoko said.
“Then you are forced to pay money you do not even have.”
Zimbabwe continues to battle high maternal and neonatal health risks, particularly among low-income communities dependent on overstretched public hospitals.