Zimbabwe has finalised its National Health Insurance Bill, set for Cabinet approval and rollout by 2026. Funded through earmarked taxes, it guarantees full primary care coverage and scales up at higher levels, aiming to reduce out-of-pocket costs and ensure equitable, sustainable health access.
Zimbabwe has finalised its long-awaited National Health Insurance (NHI) Bill, which is now ready for Cabinet approval and is expected to become operational by 2026. Hailed as a transformative step for the country’s healthcare system, the NHI is designed to advance Universal Health Coverage (UHC), enabling all citizens to access essential health services without risking financial hardship. Speaking at the Association of Health Care Funders of Zimbabwe annual conference, Minister of Health and Child Care Dr Douglas Mombeshora stressed that the NHI is built on the principle of protecting households from impoverishment due to healthcare costs, aligning with the National Health Strategy’s vision of achieving equitable and quality healthcare for all.
Health financing sustainability is at the heart of the proposed scheme, especially as donor support has declined in recent years. To counter this, Zimbabwe has opted for a non-contributory financing model, funded through earmarked taxes such as the AIDS levy, airtime taxes, and planned levies on fast foods, sugar, tobacco, alcohol, and possibly the mining sector. This approach aims to strengthen health sovereignty and reduce dependency on external aid. Government health allocations have already increased from US$117 million in 2020 to over US$463 million annually between 2021 and 2023, representing a significant step toward domestic resource mobilisation.
The NHI benefit package guarantees full coverage at the primary and community care levels, ensuring access to fundamental healthcare for all, while progressively scaling benefits upwards — 80 percent at district hospitals, 60 percent at tertiary, and 40 percent at quaternary facilities. This incremental system is designed to address Zimbabwe’s dual burden of communicable and non-communicable diseases while ensuring affordability and equitable access, particularly for vulnerable groups.
By pooling resources and spreading risk, the NHI seeks to shield families from catastrophic health expenditures — a significant barrier especially for women, 64 percent of whom report cost-related challenges in accessing care. Dr Mombeshora emphasised that the NHI represents a home-grown, sustainable solution to Zimbabwe’s financing crisis, building on past progress such as reduced maternal mortality and advances in HIV and TB control. He underscored its potential to reshape the country’s health sector by embedding equity, affordability, and financial protection at its core.
