Research for stronger health systems during and after crisis

Rebuilding the foundations for universal health coverage with equity in Zimbabwe

In Zimbabwe, the Training and Research Support Centre (TARSC) and the Ministry of Health and Child Care (MoHCC), together with national and international partners, took forward a programme of work on health financing policy and on Universal Health Coverage (UHC), funded under the ReBUILD Responsive fund.

This research built on a wider body of work by TARSC and its national and international partners implementing research to support policy dialogue and decisions on the technical design around elements of equitable health financing.

This work included efforts to strengthen stakeholder mechanisms to analyse and review Zimbabwe’s performance on equity in health; to guide processes towards equity in universal health coverage (UHC) within a comprehensive policy framework on health financing, using an updated Essential Health Benefit (EHB); and building on work done on options for improving domestic revenue mobilisation.

TARSC, MoHCC, the Royal Tropical Institute (KIT) and the Zimbabwe Economic Policy Analysis and Research Unit (ZEPARU) have collaborated to implement this ReBUILD work to:

(i) Identify and describe measures that support implementation of options for adequate and equitable health financing of the essential health benefit in Zimbabwe, specifically the measures for the equitable allocation of resources; and for the institutional, governance and purchasing arrangements and mechanisms for fund management.

(ii) Identify, analyse and use strategic information on equity in access, coverage, and financing to support policy and stakeholder dialogue on equity in UHC.

Specifically the team has:

  1. Taking into account prior work on the essential health benefit (EHB) and equity in resource allocation, identified options for integrating measures of risk or health need and gap analysis on delivery of the essential health benefit (EHB) in the allocation of pooled central funds to districts and purchasers (led by TARSC )
  2. Identified and described organizational, institutional and governance (and accountability) arrangements and procedures for managing funds in the public health system – (led by KIT and ZEPARU).
  3. Identified options for improving the purchasing arrangements between central and local government, and between government and private (not for profit) providers of primary care and district services (led by MoHCW)
  4. Set and tested a framework for annual tracking and reporting on progress in health equity using the health information system data and through a 2014 Zimbabwe Equity Watch (Led by TARSC/EQUINET and MoHCW).
  5. Convened a national Technical Working Group (TWG), MoHCC management and stakeholder forums for technical and stakeholder review of evidence, learning, policy options and knowledge gaps (Led by MoHCW and TARSC).

The main findings and proposals from this work summarised in a policy brief Evidence and proposals for advancing equity and universal coverage of health services in Zimbabwe.

All outputs from this programme of work are accessible from here.