This study explores the interaction between the political and economic aspects of health financing reforms in Zimbabwe since its independence in 1980. Health financing reform often involves complex interactions among many stakeholders of varying positions, power, and influence, within the health sector and beyond. This has implications on whether the reform enforces Universal Health Coverage (UHC) mandate of ensuring equity, quality and financial risk protection.
The study reports the following;
Reform priorities of the 1980s were influenced by socialist ideologies with an interest to address pervasive health inequities inherited from the colonial racial system.
The progress in equity realized in the 1980s was severely disrupted from the 1990s partly due to neo-liberal ideologies which steered interests towards market-oriented reforms.
The period from the 2000s is characterized by increasing donor influence on health financing and a cumulative socio-economic collapse that resulted in a sharp and protracted decline in health spending and widening of health inequities.
These results indeed show that the political economy heavily influences the health financing reform process in Zimbabwe which in turn favor certain financing arrangements over others with profound implications on health system performance and whether UHC goal of ensuring financial risk protection and equity in care are attained. It is therefore important for stakeholders involved in UHC to explicitly consider the politics of health financing reforms to implement feasibility of desired reforms
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