Zimbabwe's medical aid coverage crashes to just 4%

Zimbabwe's healthcare system faces a deepening crisis as health insurance coverage has plummeted to an all-time low, with just 4% of the population currently enrolled in any form of medical aid. The startling figures, drawn from the newly released 2023–24 Zimbabwe Demographic and Health Survey (ZDHS), paint a sobering picture of a country where over 14.8 million people are left without financial protection against illness.

This marks a dramatic decline from previous estimates, with coverage dropping by 60% from around 1.6 million people in the 2010–2020 period to approximately 640,000 today - in a country of more than 16 million.

According to the ZDHS, only 8% of women and 7% of men currently report having any form of health insurance, while 94% of men and 92% of women said they had no coverage whatsoever. These numbers indicate that Zimbabwe's long-standing goal of achieving broader health access through insurance remains far from reach.

Grace Chaora, a statistician with the Zimbabwe National Statistics Agency (ZIMSTAT), confirmed the downward trend:

"We asked people about health insurance, and the majority reported that they had none," Chaora said. "Only a small fraction of respondents reported coverage, mostly through employers."

The survey revealed that employer-based health insurance is the most common form of coverage, though still minimal - only 4% of women and 3% of men reported receiving insurance through their jobs. Social security-based insurance remains even less common, covering just 2% of the population.

Health insurance coverage briefly improved between 2010 and 2015, rising from 7% to 11% among women and from 9% to 12% among men. However, those gains have since eroded, dropping back to 8% for both genders by 2023–24.

Experts warn that the continued decline in health insurance coverage threatens to overwhelm Zimbabwe's fragile healthcare system. With the vast majority of citizens relying on out-of-pocket payments, the risk of financial ruin due to illness is rising.

"Without coverage, many Zimbabweans are forced to delay care or avoid it altogether," said a Harare-based public health analyst. "This has long-term consequences for both individual health and national productivity."

Rising healthcare costs, economic instability, and weak public investment have all been cited as contributing factors.

The crisis comes amid stalled efforts to introduce a National Health Insurance Scheme - a long-discussed government policy aimed at expanding access. Though still in the planning stages, implementation has lagged, leaving millions of Zimbabweans without a clear path to affordable care.

Health equity advocates argue that bold reforms are urgently needed to halt the decline and begin rebuilding trust in the healthcare system.

"This is not just a health financing issue. It's a question of human dignity and national resilience," one health economist noted. "Without urgent action, Zimbabwe risks permanently excluding its most vulnerable citizens from the right to health."

As Zimbabwe grapples with economic headwinds and rising demand for healthcare services, the ZDHS findings serve as a wake-up call. With over 90% of the population lacking health coverage, the country is far from achieving universal health coverage, a key goal of national and global health policy.

Unless comprehensive and inclusive reforms are enacted soon, Zimbabwe's dream of health for all may remain out of reach - leaving millions to face sickness alone, without the protection they desperately need.