Moving forward in Zimbabwe - Brooks World Poverty Institute - The ...

Moving forward in Zimbabwe
Reducing poverty and promoting growth
about making sure that there is a set of accountable structures and
institutions around essential health service delivery. For Zimbabwe,
this will mean restoration of health programming and a return to
the primary health and curative health care strategies, with a focus
on quick win areas or quick impact programmes. Crucially, it is
about making sure that there is enough funding available to deliver
the service.
Phase 3: Rehabilitation
During this phase long-term planning can begin. It presupposes
that a return to the crisis is unlikely and all outstanding issues that
brought about the conflict have been resolved. During this phase
effective health information systems are a necessity.
7.3 Conclusion
This chapter has shown how far the health system has declined and
clearly a lot of investment will be required to restore it to its precrisis
levels, let alone improve on that. While ideas on what should
be done first are easy to outline, the ability to pay for the cost of
restoring the health system will prove the most difficult issue. On the
one hand the user-pays principle established under ESAP will make
health inaccessible to a majority of impoverished Zimbabweans.
On the other, free universal health will not be possible for the cashstrapped
IG, given the state of the productive sectors. While donors
might chip in to support specific programmes, in the end there
will need to be a political compromise that allows cost recovery,
especially among those income groups that can afford it. For the
majority, while the economy recovers, it might mean reliance on a
social protection system to provide for basic health services. It is to
this that we now turn.
Notes
1. Figures from WHO.
2. Silverman (2009). Officially the rate is still 15.6 per cent.
3. See Keane (1996) for Mozambique, and World Bank (2002) for Sierra Leone.
4. See Waters et al (2009).
94