Zimbabwe

HEALTH SITUATION
The Zimbabwean health situation can be characterized as recovering after
unprecedented decline during the first decade of this millennium. There was
deterioration of infrastructure, lack of investment, poor remuneration of health
workers, shortage of essential supplies and commodities that led to the nearcollapse of the health sector in late 2008, and early 2009.
Life expectancy at birth in Zimbabwe has improved from a low of 35 years mid2000 to an estimated 58 years by 2012. According to 2012 census, infant and
under-5 mortality improved from 65 and 102 in the 1990s to 64 and 84 per 1000
live births respectively in 2012. Maternal mortality remains very high at 570 per
100 000 live births in 2012, though it has significantly dropped from a peak of 960
per 100 000 live births in 2010. Admittedly the country is not on track to meet its
health MDG targets 4 & 5.
However the country is on track to achieving its HIV and malaria targets in MDG 6.
Although the countrys burden of communicable diseases remains high, Zimbabwe
has made some positive strides with respect to reducing HIV prevalence from a
peak of 33% in mid 1990s to the current prevalence of 15% (2012).

http:// www.who.int/countries/en/
WHO region

Africa

World Bank income group

Low-income

CURRENT HEALTH INDICATORS

Total population in thousands (2012)

13724

% Population under 15 (2012)

40.24

% Population over 60 (2012)

Life expectancy at birth (2012)
Total, Male, Female

5.68
60 (Female)
56 (Male)
58 (Both sexes)

Neonatal mortality rate per 1000 live births (2012)

39 [22-66] (Both sexes)

Under-5 mortality rate per 1000 live births (2012)

90 [70-120] (Both sexes)

Maternal mortality ratio per 100 000 live births (2010)

% DPT3 Immunization coverage among 1-year olds
(2012)

570 [320-920]
89

% Births attended by skilled health workers (2011)

66.2

Density of physicians per 1000 population (2008)

0.056

Density of nurses and midwives per 1000 population

(2008)

1.035

Total expenditure on health as % of GDP

General government expenditure on health as % of
total government expenditure
Private expenditure on health as % of total
expenditure on health
Adult (15+) literacy rate total (2010)

HEALTH POLICIES AND SYSTEMS

The Ministry of Health and Child Care strategy is being guided by the 2009-2013
National Health Strategy whose life-span has been extended to 2015 to coincide
with the MDG year. The main focus remains working for quality and equity in
health whose aim is to improve the quality of life for Zimbabweans. The Right to
Health for every Zimbabwean was affirmed through the new constitution adopted
in 2013.
The weakened health systems resulting from decade long socio-political challenges
do require significant financial investment to reverse the considerable weaknesses
in human resources for health, health financing, health information, medicines and
equipment, leadership and governance and the overall service delivery. Concerted
efforts to make significant improvements remain constrained by national fiscal
space that remains small resulting in insignificant inflows into health budget.
Under the Government of National Unity set in early 2009, the Health Transition
Fund (HTF), a multi-donor pooled fund was set up to support the Ministry of
Health and Child Care. Since its launch in 2011, under the guidance of Zimbabwe
United Nations Assistance Development Framework (ZUNDAF) coupled with the
support from other donor funding i.e. Global Fund, USG and others, Zimbabwes
health system is now set on a recovery path to achieve planned progress towards
'achieving the highest possible level of health and quality of life for all
Zimbabweans'.

COOPERATION FOR HEALTH

92.2

Population using improved drinking-water sources (%)

(2011)

97 (Urban)
69 (Rural)
80 (Total)

Population using improved sanitation facilities (%)

(2011)

52 (Urban)
33 (Rural)
40 (Total)

Poverty headcount ratio at $1.25 a day (PPP) (% of

population)
Gender-related Development Index rank out of 148
countries (2012)

116

Human Development Index rank out of 186 countries

(2012)

172

Sources of data:
Global Health Observatory April 2014
http://apps.who.int/gho/data/node.cco

On the other hand, Zimbabwe is now facing an increasing threat of noncommunicable diseases like cardiovascular diseases (hypertension, stroke, heart
attacks); diabetes and cancer in particular cervical cancer in women.

The Global Fund remains one of the major funding partners to HIV & AIDS, TB,
malaria programs and Health System Strengthening in terms of human resource
retention, health information and service delivery. Increasingly the Health
Transition Fund that was launched in 2011 specifically to assist in maternal,
newborn and child health programs has become a more active channel where
donors are supporting MOHCC. The Principal Recipient for Global Fund continues
to be UNDP since the country is under the Additional Safe Guard Measures
instituted early 2009.
Other donors continue to assist through UN agencies mainly UNICEF, UNFPA,
WHO, UNAIDS and ECHO whilst some donor like EU, DfID, USG (through USAID,
CDC, RTI, MChip) are now directly implementing some programmes on the ground
through NGOs e.g. Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Absolute
Return for Kids (ARK) etc. Other channels through which the health sector
continues to get assistance is through Global Alliance for Vaccines and
Immunization (GAVI). UN agencies support to MOHCC is through the Zimbabwe
United Nations Development Assistance Framework (ZUNDAF) under a Joint
Implementation Matrix (JIM).

WHO COUNTRY COOPERATION STRATEGIC AGENDA (2008-2015)

Strategic Priorities
STRATEGIC PRIORITY 1:
Improved health systems
performance through strengthening
HRH, HMIS, health financing, health
systems research and partnerships

Main Focus Areas for WHO Cooperation

STRATEGIC PRIORITY 2:
Disease prevention and control
strengthened through scaling up
proven interventions, epidemiological
surveillance and measurement of
progress towards achievement of the
MDGs

STRATEGIC PRIORITY 3:
Health promotion and protection of
healthy environments

STRATEGIC PRIORITY 4:
Enhanced capacity for emergency
preparedness and response

HRH: Support development of national health policies and strategic plans; task-shifting; training
including mentorship
HMIS & Research: Support formulation, implementation, monitoring and evaluation of health
programmes including advocating for implementation research to generate evidence to influence
service delivery and policy
Health System Performance: Strengthen PHC as the strategy for health service delivery; support
quality assurance for health programmes; advocate for health to be put at the centre-stage of
national development and poverty reduction strategies
Partnerships and Coordination: Enhance capacity of MOH to effectively lead and coordinate
development partners
Communicable & NCDs: Support MOHs capacity to scale up and manage communicable and noncommunicable diseases; support effective integration and linkages across programmes; promote
the use of new medicines and technologies (PoC) and advocacy for more community involvement
in demand creation, prevention, treatment, care and support
MNCH: Support the implementation of the Maternal and Newborn Road Map and the Child
Survival Strategy to reduce maternal, newborn and child mortality
Mental Health: Support MOH to address mental health challenges and the prevention and control
of alcohol and substance abuse
Surveillance systems: Support strengthening of drug resistance surveillance systems for HIV, TB
and malaria and surveillance of diseases targeted for eradication and elimination
Health Promotion (Healthy Life-styles & ASRH): Support MoH to finalize and implement the health
promotion policy and strategy; integration of HP into different programmes; promotion of healthy
lifestyles; more coordinated involvement of the communities; assessing and implementing ASRH
programmes to address challenges being faced by adolescence
Environment and Health: support development of occupational health policy and strategies;
provision of safe drinking water and sanitation; water quality monitoring
Disaster Risk Reduction: Support vulnerability assessment and advocate for the inclusion of
disaster risk reduction measures into developmental programmes
Support implementation of the EPR of the 2005 IHR; surveillance and EW systems; coordination of
humanitarian action and resource mobilization

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The Country Cooperation Strategy briefs are not a formal publication of WHO and do not necessarily represent the decisions or the stated policy of the Organization. The presentation of maps
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delineation of its frontiers or boundaries.

WHO/CCU/14.03/Zimbabwe

Updated: May 2014