Zimbabweans prioritize funeral cover over health insurance

As Zimbabwe grapples with shrinking donor support for healthcare, experts have warned that a deeply rooted cultural paradox is undermining efforts to build a sustainable health system: millions of Zimbabweans readily pay for funeral policies and burial societies but remain unwilling or unable to invest in healthcare.

The concern was raised during a webinar hosted by the Community Working Group on Health (CWGH) and the African Health Federation (AHF) on July 7 under the theme "Financing Zimbabwe's Health Future: Domestic Resource Mobilisation in an Era of Declining Donor Support."

Health experts, labour representatives, youth organisations and legislators painted a sobering picture of a healthcare system under mounting pressure as international donor funding continues to decline, arguing that Zimbabwe must increasingly finance its own health services.

Presenting on behalf of the Consumer Council of Zimbabwe (CCZ), Taremedzwa Moyo said the reduction in donor support had shifted the financial burden directly onto ordinary households through rising out-of-pocket medical expenses.

"As donor-funded medicines, diagnostics and services become less available, patients are increasingly paying for consultations, laboratory tests, medicines, medical supplies and hospital fees.

"When donor support declines without being fully replaced by domestic resources, the service chain breaks, leaving consumers to bear the cost," Moyo said.

She said the decline in donor funding had contributed to shortages of medicines and medical supplies, reduced access to healthcare in rural communities, longer waiting times, overcrowded facilities and growing financial hardship for families.

"Consumers are borrowing money or cutting spending on food and education just to pay for healthcare. This pushes many households deeper into poverty and widens inequality," she said.

Although the Government allocated ZiG30.4 billion to health in the 2026 National Budget—equivalent to 15 percent of total expenditure and meeting the Abuja Declaration benchmark—the CWGH has previously argued that the allocation remains insufficient to adequately fund primary healthcare services.

Meanwhile, out-of-pocket healthcare spending continues to rise, with an estimated 90 percent of Zimbabwe's population—about 16 million people—lacking medical insurance and paying directly for treatment.

A recurring theme during the discussion was the contrast between spending on funeral cover and investment in healthcare.

According to a 2022 FinMark Trust report, 72 percent of insured Zimbabweans have funeral insurance, while only 30 percent hold health insurance policies.

Funeral costs in Zimbabwe typically range between US$800 and US$3,000 depending on location and the scale of the service, while comprehensive health insurance can cost around US$200 per month, placing it beyond the reach of many households.

Women's Action Group executive director Tambudzai Loveness Rukuni said women and girls bear a disproportionate burden when healthcare systems fail, often sacrificing their own medical needs to care for children and elderly family members.

Representing the International Youth Network, Natasha N. Dube said young people were among the hardest hit because high unemployment leaves many unable to afford healthcare.

"We are young, we are unemployed, and we cannot pay for healthcare that should be free. Government must prioritise young people in health financing decisions," Dube said.

Luckmore Pamhidzai of the Young People's Network on Health and Well-being warned that declining donor support had severely affected HIV and sexual and reproductive health programmes targeting young people.

"We are seeing programmes that were keeping young people alive shutting down. If we do not act now, we risk losing a whole generation," he said.

Zimbabwe Congress of Trade Unions (ZCTU) head of Occupational Safety and Health Michael Kandutu called for the establishment of a National Health Fund to pool resources and reduce out-of-pocket healthcare costs.

"Workers are paying for healthcare twice—through taxes and again when they seek treatment. We need a National Health Fund that guarantees access to essential health services for every Zimbabwean," Kandutu said.

Professor Davison Munodawafa of Midlands State University said the country's dependence on donor funding was no longer sustainable.

"We cannot continue relying on donors who are steadily withdrawing. Domestic resource mobilisation is no longer an option—it is a necessity," he said.

Parliamentary Portfolio Committee on Budget, Finance and Economic Development member Edwin Mushoriwa said Parliament was considering measures to strengthen domestic health financing, including ring-fencing health-related taxes.

"We are exploring options such as sugar taxes and the AIDS Levy to create predictable and sustainable funding for healthcare. However, public support will be critical. Zimbabweans must also be prepared to invest in their own health," Mushoriwa said.

Acting Deputy Director of Policy Planning and Health Economics in the Ministry of Health and Child Care, Gwati Gwati, said Government remained committed to expanding domestic health financing and was accelerating work on a National Health Insurance Scheme.

"We are fast-tracking the National Health Insurance Scheme, which will provide free access to essential health services—from consultations to surgery—through financing supported by targeted health-related taxes," Gwati said.

Participants agreed that while increased Government funding and innovative financing mechanisms are essential, changing public attitudes towards health insurance and preventive healthcare will be equally important if Zimbabwe is to build a resilient health system capable of withstanding declining donor support.