Zimbabwe is landlocked and situated in Southern Africa with a total land area of 390,757
square kilometres. It is bordered by Mozambique to the east, South Africa to the south,
Botswana to the west, and Zambia to the north and northwest. The country’s estimated
population is 15.4 million, of which 40.4% are under the age of 15 years, 7.1% are above 60
years, 52% are females (48% males) and 69% reside in rural areas. The total fertility rate is
3,9 per woman and life expectancy is 60 years (61 years for females and 58 for males).
Population density on average is 38 people per square kilometre.
When the country got independence in 1980, it adopted its health policy termed ‘Planning for
Equity in Health’ (MoH, 1980). This was in response to the inequitable socioeconomic
situation that existed in the country then. This policy has guided health development since
then. This policy laid the foundation for Primary Health Care philosophy in the country. This
has been supported by five-year National Health Strategies, with the last two covering the
periods 2011-2015 and 2016 to 2020. The Vision for the 2016-2020 National Health Strategy
is to have the highest possible level of health and quality of life for all citizens. And the
Mission is to provide, administer, coordinate, promote and advocate for the provision of
equitable, appropriate, accessible, affordable and acceptable quality health services and
care to Zimbabweans while maximizing the use of available resources in line with the
Primary Health Care approach (MoHCC 2016).
In Zimbabwe, health improvement is hindered not so much by the lack of available
interventions to address the main causes of disease burden, but by limited resources and
weaknesses in health systems. These factors mean that important interventions are often
not provided for those who could benefit most when and where they need them. Better
priority setting and resource allocation to and within the health system has huge potential to
improve population health efficiently and equitably. This would be further reinforced by
effective institutional structures to assess competing demands and to evaluate the political
and economic constraints.
Investments in health care should ideally be directed with the goal of improving health and
well-being to the greatest extent possible, from available resources. To inform the best
allocation of resources, there is a need to understand the consequences of decisions. It also
requires strong partnerships between mandated policymakers and researchers; as well as
capacity strengthening in research and its use for policy. Through facilitating stronger
planning and preparedness in the country, the aim will be greater capacity for local
responses and ultimately better health care for all Zimbabweans in the medium to longer
term.
Senior policymakers in Africa, Zimbabwe included, have been demanding to receive more
research and analytical support to inform resource allocation decisions, particularly
recognizing key contributions from health economics and related disciplines. The aim is to
sustainably strengthen research capability and support policy environments for the
productive use of research; both informing and holding to account mandated policymakers.
The establishment of HEPUs by countries such as Malawi and Uganda with the support of
the Thanzi La Onse programme is aimed at addressing these issues.
The importance of a national health economics and policy unit (HEPU) in Zimbabwe and
how such a unit can be beneficial to the country’s health system, especially with regards to
issues around evidence-based policy making, cannot be over emphasized. Health issues
have been debated in recent years in Zimbabwe, with the use of processes to evaluate
health interventions and technologies as inputs to budget decision making. Yet there
remains relatively low coverage of highly cost-effective health interventions, co-existing with
public spending on high-cost, less effective or sometimes even ineffective care. As more
health and population demands grow, efforts to support priority-setting in health are
increasing but the institutional structures to assess competing demands and to evaluate the
political and economic constraints require strengthening. This is further compounded by the
pressures ascribed by some external bodies (e.g., international donors), which can further
complicate national-level policymaking and resource allocation, hence the need to have
Health Economics and Policy Unit (HEPU) established to support the country in its
endeavours to improve the quality of health service it delivers to the citizens.
Study Objectives
The main objective of this brief study report is to ascertain demand for the establishment of a
national health economics and policy unit (HEPU) in Zimbabwe and how this can best take
shape in the institutional and policy context of the country.
Objective of establishing Health Economics and Policy Unit (HEPU) in Zimbabwe
The objective is to guide how research-to-policy partnership and capacity strengthening in
health economics could take shape in Zimbabwe. HEPU will go a long way in strengthening
practical policy solution(s) to health issues in Zimbabwe and it will also galvanise capacity
strengthening for research, and policy engagement, for health care resource allocation and
will aim to move towards the improvement of health and wellbeing of Zimbabweans by 2030,
as being advocated by the country’s vision of becoming a middle-income country by 2030
Published: March 2021