A Report on Corruption in the Public Health Sector in Zimbabwe

Executive Summary

Zimbabwe has a diversified health care facility system which has seen the participation of various actors such as the government, rural and urban councils, and the private sector delivering health care services such as primary health, reproductive health and specialised treatments. Sadly, the existence and performance of this wide range of facilities are affected by bad governance, corruption and illicit financial flows.

Corruption within the health care sector is a global concern. It deepens inequality and disenfranchises low-income individuals and households from accessing basic health care rights. The extent of corruption remains self-evident in developing countries and during public health crises as has been noted during the COVID-19 pandemic. Zimbabwe continues to face a declining public health system characterised by severe brain drain and shortage of basic medicines and equipment.

This report by Transparency International Zimbabwe explores the nature and impact of corruption within the public health care sector. The report underlines the existence of various forms of corruption and gross inconsistencies that affect access to quality health services. These include public procurement corruption, nepotism, theft of essential medicines, bribery and absenteeism by medical health workforce. These and other forms of corruption prevalent in the health sector contribute to the lack of trust in the health care sector. 75% of the respondents in the study expressed a lack of confidence in Zimbabwe’s public health care sector and 81% pointed out that they have witnessed or experienced various forms of corruption.

There are also leakages in the handling and management of essential medicines. There has been a proliferation of a parallel health care sector or grey market led by medical practitioners. Users of public health care systems are at times diverted by the health practitioners to purchase medicines outside the formal channels. The study further indicates the emergence of nonmonetary forms of bribery in the health care sector, such as sextortion.

Key Messages

• The COVID-19 pandemic has amplified the impact of corruption on the overall performance of health systems.
• Corruption has been normalised in Zimbabwe as evidenced by everyday practices in health-related services which many do not consider as corruption. However, their accumulation and acceptance by various stakeholders has a detrimental cumulative effect on the performance of the public health-care system.
• Despite being a signatory to the Abuja Declaration, Zimbabwe’s total budget towards the health care sector remains below the stipulated 15% of its national budget.
• The most common forms of corruption noted include corruption in public procurement, theft and sale of essential medicines on the grey market, bribery, favoritism and false referrals.
• Addressing corruption in the health sector is urgent and requires a multifaceted approach from the government and other stakeholders.
• There is need for the development of systems of detecting and responding to all forms of corruption in the health care sector chain.
• Transparency and accountability are crucial anti-corruption tools in mitigating corruption in the health sector.

Read the full report here(6MB PDF)

Source: Transparency International Zimbabwe