DFID’s Support to the Health Sector in Zimbabwe

Our report assesses DFID’s support to the health sector in Zimbabwe which has had a substantial and positive impact, most notably for those living with HIV/AIDS.

Since 2004, DFID has spent over £100 million in support to the health sector in Zimbabwe, mainly on the prevention and treatment of HIV/AIDS, support to maternal health and the supply of essential medicines. The purpose of this review is to assess how well that money has been spent and to make recommendations for the future.

DFID’s support to the health sector in Zimbabwe has had a substantial and positive impact, most notably for those living with HIV/AIDS. Overall, value for money has been good in the majority of the programme. The underlying health system, however, is still failing. DFID helped to avert a total collapse in 2007-09 but the likelihood that it can achieve sustained improvement in health outcomes will remain poor until there is a more secure political context.

Recommendations

Recommendation 1: As noted by the International Development Committee, DFID should support the Zimbabwe Ministry of Health to strengthen its capability to manage the health system.

Recommendation 2: DFID should plan to address the risk of falling value for money if funding is scaled up further. This should include identifying the major value for money risks and specifying how they will be managed and monitored.

Recommendation 3: DFID should continue its efforts to promote the removal of user fees for pregnant women and children under five and ensure that this is a core objective in future support to maternal health.

Recommendation 4: DFID should ensure more comprehensive reporting across the delivery chains, with clearer linking of funding to performance delivered.

Recommendation 5: DFID should take the lead in the donor community to agree a common definition of administrative costs and require implementing partners to report administrative costs on that basis.