Stakeholders Launch Inclusive Service Agreement to Tackle Corruption Risks in Zimbabwe’s Public Healthcare System
Tendai Nyambara
BULAWAYO – Transparency International Zimbabwe (TIZ) has launched a multi-stakeholder initiative aimed at strengthening accountability and improving transparency in Zimbabwe’s public healthcare system amid concerns over corruption risks, discrimination, and barriers affecting vulnerable patients.
The initiative, known as the Inclusive Service Agreement, was introduced during a dialogue in Bulawayo involving representatives from the Zimbabwe Anti-Corruption Commission (ZACC), Zimbabwe Gender Commission (ZGC), Youth Innovation Trust (YIT), medical professionals, civil society organisations, and youth representatives.
The framework seeks to address gaps that allow vulnerable communities, including marginalised groups, to face challenges when accessing healthcare services.
Speaking during the dialogue, Head of Programmes from TIZ, Nqobani Tshabangu said institutional corruption within healthcare typically involves three elements: an individual in a position of authority, a deliberate departure from professional standards, and personal benefit.
He said corruption is not limited to financial gain but can also involve the misuse of influence, professional authority, or access.
Tshabangu highlighted concerns raised by communities, including alleged diversion of medicines, informal payments demanded from patients, and possible conflicts of interest involving referrals to private healthcare providers.
Participants heard reports of patients allegedly being denied services or medicines at public facilities before being directed towards private alternatives. Concerns were also raised over informal “tokens of appreciation” allegedly demanded from patients seeking medical attention.
Addressing the issue of referrals, Nyasha Muchenje, Principal Investigations Officer at ZACC, clarified that referring patients to external specialists or healthcare providers is not automatically an act of corruption.
He explained that referrals can be part of normal medical practice when based on a patient’s condition and the availability of specialised services.
However, Muchenje said corruption occurs when healthcare workers create referral systems designed to generate personal financial benefits.
“It becomes corrupt when doctors or nurses establish a system where they refer patients to each other at a cost,” he said.
He also raised concerns about alleged private pharmaceutical activities operating within public health institutions, saying healthcare workers who are not authorised to sell medicines should not use state facilities to conduct private businesses.
Representing Youth Innovation Trust (YIT), Christine Dube highlighted challenges faced by vulnerable patients, including concerns surrounding the implementation of the Assisted Medical Treatment Order (AMTO), a government support programme designed to assist those unable to afford medical care.
Dube said YIT had received reports from communities where patients with AMTO support struggled to access medicines and treatment.
She said some patients reported being told that medicines were unavailable at public facilities, only to allegedly be offered the same medication through private arrangements.
Dube also raised concerns over alleged over-prescribing, saying unnecessary prescriptions could increase financial pressure on patients and contribute to shortages within public health facilities.
The discussion also examined gender-related barriers within healthcare spaces, with Dalubuhle Sibanda from the Zimbabwe Gender Commission (ZGC) saying the commission continues to receive complaints involving discrimination and exploitation.
Sibanda encouraged citizens to report cases of discrimination or unfair treatment through the commission’s toll-free reporting platform, 855.
Participants further discussed concerns raised through local research in Bulawayo suggesting that some women seeking maternity services encounter pressure to make unofficial payments before receiving assistance.
The dialogue also acknowledged the role citizens sometimes play in sustaining informal systems of corruption by offering money or using personal connections to bypass standard procedures.
Delegates said while patients often resort to these practices because of frustration with long waiting times and limited resources, such actions undermine efforts to create fair and transparent healthcare systems.
Providing insight into healthcare administration challenges, Bulawayo Metropolitan Provincial Medical Director Dr Maphios Siamuchembu said improving accountability requires addressing both governance and supply chain weaknesses.
He explained that Zimbabwe’s healthcare system involves multiple administrative structures that require cooperation between institutions.
Siamuchembu also highlighted medicine supply challenges, noting that Zimbabwe relies on external sources for many pharmaceutical products.
“The first thing that we need to understand is that in this country, the government of Zimbabwe does not manufacture any medicines,” he said.
The dialogue concluded with calls for stronger digital systems to improve transparency, including electronic medicine inventory tracking that would help monitor availability and reduce opportunities for manipulation.
Stakeholders also recommended increased use of digital platforms to educate communities about patient rights, reporting mechanisms, and corruption risks.
ZACC indicated plans to establish a dedicated Bulawayo office focused on public education, information sharing, and community engagement on corruption prevention.
The Inclusive Service Agreement is expected to serve as a framework for promoting transparent, accessible, and accountable public services.
