IMPROVING the allocation of public health spending could yield gains in both service quality and outcome efficiency and steps should be taken to reduce the relative size of the wage bill, the World Bank has said in its 2016 Zimbabwe Economic Update report.
BY VICTORIA MTOMBA
The report states that in the early 2000s, the country’s health sector was among the most efficient in sub-Saharan Africa and during the 2000-2008 period, the performance deteriorated, but in 2010, the performance shifted back toward the middle of the pack.
“While Zimbabwe’s health outcome still exceeds what its level of health spending would predict, further improving the sector’s efficiency will require spending increases targeting non-wage and capital investment. In order to safeguard the sector’s fiscal sustainability, growth of the wage bill must be contained,” the report shows.
The World Bank said gains made in the health sector illustrated the importance of government leadership in laying out a clear vision and framework for maternal and child health and combating HIV and Aids and in galvanising international development partners and private firms to help realise that vision.
The report suggests that policymakers face challenges, including the persistence of communicable diseases and the rising incidence of non-communicable diseases.
“In a context of limited fiscal space, constrained aid flows and modest private sector health investments, the government must maximise the efficiency of sectoral resources in the short term, while progressively reforming the sector to address its evolving long-term needs.
“This rapid increase in the proportion of health spending financed by user fees has important equity implications and affected the sector’s ability to serve poorer households. The rising trend in out-of-pocket expenditures ran contrary to the goals of government’s health strategy, which focused on promoting equitable access to high-equality services.”