The Zimbabwean government has hiked user fees at public hospitals by 1 748%, stoking fears of an upsurge in home deaths.
New adult and children consultation fees are now US$12 and US$6, respectively, which are an equivalent of $3 696 and $1 848 in the local currency using the official exchange of US$1:$308.
Hospital fees were last increased in January 2020, with adults and children respectively paying $200 and $100 in Zimbabwe dollars at the time.
Amid an unrelenting economic crisis, analysts fear that most Zimbabweans may fail to afford basic health care, which is more expensive in private health facilities.
“This is too expensive for civil servants and other ordinary citizens. This will lead to many people dying at home. People will die unnoticed, and people will die with conditions that can be saved if they manage to go to the hospital. It’s an unfortunate scenario,” Zimbabwe Nurses Association president Enock Dongo said.
Public hospitals are also plagued by an acute shortage of drugs, dilapidated medical equipment and persistent strikes over poor remuneration by health sector professionals. The hike in user fees could deal a heavy blow to a health sector already on its knees.
Community Working Group on Health (CWGH) executive director Itai Rusike said the new hospital fees barred access to equitable health care services for most ordinary citizens.
“The CWGH is concerned that the new hospital fees will increase the barriers to use of services and inevitably bar access to equitable healthcare services by the majority of poor people that depend on the public healthcare system. These user fees are not affordable to many, defeating the point of having the right to health in the Constitution,” Rusike said.
“We understand that the hospitals are facing severe cash constraints. However, we are concerned that the situation at present is one in which the public is not being adequately informed on what exactly to expect at hospitals and thus cannot adequately budget and plan for their visits to these services,” added Rusike.
The notice says patients may pay the new fees at the interbank rate, which is $325 to US$1.
Patients were paying nearly half in user fees before the latest increase.
“Reference is made to the hospital user fees circular dated April 19, and the Exchange Control Exclusive Use of Zimbabwe dollar for Domestic Transactions Amendment Regulations, 2020 no 3 (Statutory Instrument 185 of 2020).
“Following the release convergence of the Exchange Control Directive No 3 of 2022, in line with the convergence of the auction exchange rates and the interbank willing-buyer willing-seller exchange rate, you are being advised to implement user fees in line with the current interbank exchange rates,” Health and Child Care ministry secretary Jasper Chimedza writes to health officials.
Following the directive, consultation fees for adults are now at US$12 and children US$6. Ward fees for adults are set at US$12, and US$8 for children.
“Ambulance fees per kilometre US$1,60. Intensive/coronary care unit per day — adults now at $US16. Intensive/coronary care unit per day — children now at $US10. Consultation fee is valid for seven days and chronic consultation fees are valid for one month,” reads a notice to the public hospitals.