UNDP and Global Fund support to strengthen financial and risk management for the delivery of health services in Zimbabwe

Zimbabwe has made important strides in the last two decades to combat HIV, tuberculosis (TB) and malaria. New infections have dropped by more than 50% among adults and 80% in children born from HIV positive mothers over the last decade, and AIDS-related deaths have decreased by 60%. TB incidence declined by 67% between 2011 and 2019, from 633 to 210 cases per 100,000 people. Malaria incidence fell by 24% between 2015 and 2019, from 29 to 22 per 1,000 population at risk, with an increase in districts reporting less than 1 per 1,000. 

Despite notable progress, significant challenges remain. Zimbabwe is among the WHO’s list of 14 countries that are considered high-burden for TB, multi-drug resistant TB and TB/HIV coinfection. With a 13% HIV prevalence rate, it is home to an estimated 1.3 million people living with HIV. There are an estimated 39,000 new HIV infections each year, which disproportionately impact vulnerable and marginalized populations. Economic challenges impact health service delivery and access. Following a near collapse of the health system in 2008, economic growth remains slow. Reduced fiscal space has placed increased pressure on the system to finance infrastructure, health worker retention, and the supply of essential health products, among other needs. 

The Government of Zimbabwe has prioritized investments in its Public Financial Management System (PFMS) to promote transparent and effective budgeting and ultimately enhance the impact of public service delivery. Since 2015, with the support of UNDP, the Global Fund, and other partners, and in collaboration with the Ministry of Finance and Economic Development (MoFED), the Ministry of Health and Child Care (MoHCC) has played a lead role in operationalizing the PFMS Grant Management Module. Complementary to this, since 2009, the MoHCC has enhanced accountability in the delivery of health services by championing a risk-based approach to audits and fostering a common approach to risk management across all levels of the health care system. UNDP and the Global Fund have supported these efforts with financial and technical inputs, in alignment with national priorities. This brief outlines the progress to date on the roll-out of the Grant Management Module under the PFMS and the institutionalization of internal audit and risk frameworks by the MoHCC, as supported by UNDP and the Global Fund. It also highlights some initial impacts of these interventions on the management of critical health resources and programme delivery for HIV, TB, malaria, and other basic services. 

Read more in this brief which outlines the progress to date on the roll-out of the Grant Management Module under the Public Financial Management System and the institutionalization of internal audit and risk frameworks by the Ministry of Health and Child Care, as supported by the UNDP and Global Fund. It also highlights some initial impacts of these interventions on the management of critical health resources and programme delivery for HIV, TB, Malaria and other basic services.