AHFoZ Pushes Back as Government Tightens Grip

From Contributions to Shortfalls, The Math Doesn’t Add Up…

By Shingirai Vambe

In Zimbabwe, falling ill is no longer just a health concern, it is increasingly becoming a financial crisis. For many citizens, being confined to a hospital bed is synonymous with a slow and painful drain on already strained resources, raising a troubling question: has access to healthcare become a privilege rather than a right?

Across the country, patients and their families are grappling with a system that demands payment at every turn. A visit to the doctor is rarely straightforward. Even for those subscribed to medical aid schemes, the experience is often marked by an all-too-familiar phrase, shortfall. Whether at private hospitals, consulting rooms or pharmacies, patients are routinely required to top up payments, sometimes significantly, despite contributing regularly to medical aid funds.

The situation has been exacerbated by currency instability and the persistent erosion of value, particularly under the Zimbabwe Gold (ZiG) framework. While contributions may appear substantial on paper, their real value often falls short when translated into the cost of actual healthcare services. As a result, patients are forced to bridge the gap out-of-pocket, further deepening financial hardship.

Findings from the 2025 conference of the Private Hospitals Association of Zimbabwe (PHAZ) highlight growing tensions within the healthcare ecosystem. The report points to systemic challenges between healthcare funders and service providers, including delays and inconsistencies in the disbursement of funds. In some cases, payments are not reaching their intended recipients in full or on time, straining relationships between insurers, hospitals and practitioners.

These challenges have drawn the attention of the Insurance and Pensions Commission (IPEC), which is now pushing for increased regulatory oversight of the sector, including the operations of the Association of Healthcare Funders of Zimbabwe (AHFoZ).

In response, AHFoZ has mounted a firm defence of its position through a detailed policy paper on the proposed IPEC Amendment Bill. The association argues that medical aid societies are fundamentally part of the health sector, not purely financial institutions, and should therefore remain under the purview of the Ministry of Health and Child Care.

According to AHFoZ, medical aid societies have historically played a critical role in Zimbabwe’s healthcare system, covering approximately 1.7 million people, about 10 percent of the population, and contributing up to 80 percent of private healthcare providers’ income. This support, the association says, has been instrumental in sustaining private healthcare services, retaining skilled professionals and complementing government efforts, particularly during national health crises such as HIV/AIDS and Covid-19.

However, the association acknowledges that governance gaps exist within the sector, necessitating reform. Its preferred solution is the establishment of a dedicated Medical Aid Societies Regulatory Authority under the Ministry of Health, rather than transferring oversight to a financial regulator.

AHFoZ further argues that misconceptions persist around the nature of medical aid. Unlike traditional insurance products, such as motor or funeral cover, medical aid involves frequent and ongoing claims, making it uniquely complex and closely tied to healthcare delivery rather than purely financial transactions.

Yet, critics remain unconvinced. Concerns continue to mount over transparency, accountability and the protection of contributors’ funds, particularly in an environment where economic instability has weakened both savings and confidence in financial systems.

In an effort to interrogate these issues, The Post On Sunday reached out to AHFoZ Chief Executive Officer, Shylet Sanyanga, with a series of questions exploring the sustainability of the medical aid model, the impact of currency volatility and the broader implications of weak banking culture on the sector.

Among the issues raised were whether the contribution-based model remains viable in an economy characterized by shrinking disposable incomes and increasing informalization, and whether challenges in the banking sector have had a ripple effect on medical aid societies’ ability to retain value and honour claims.

Further questions probed the association’s resistance to IPEC oversight, with critics arguing that stronger financial regulation could enhance transparency and safeguard members’ contributions. Others questioned whether the sector risks becoming increasingly exclusive, serving only a shrinking formal workforce while leaving the majority of Zimbabweans without meaningful coverage.

However, Sanyanga declined to provide detailed responses.

“Hello Shingie, sorry yesterday was busy and today I am at a family event. The questions you sent are too many and require undivided attention which I can’t give at the moment. Regrettably I will not be able to respond,” she said.

Her response leaves many of the pressing questions unanswered at a critical moment for the sector.

Meanwhile, legislative developments continue to gather pace. The contentious bill seeking to amend the regulatory framework governing medical aid societies has already been passed by Parliament and now awaits presidential assent before it can be gazetted into law.

For ordinary Zimbabweans, however, the policy debates and regulatory battles offer little immediate relief. The reality on the ground remains severe, accessing healthcare is becoming increasingly unaffordable, even for those who have diligently contributed to medical aid schemes.

The Central Bank has, however, responded to this publication on a separate matter. The Governor insists that efforts to restore confidence in the financial sector are underway, pointing to increased financial stability, improved exchange rate predictability, and the introduction of the Zimbabwe Gold (ZiG) currency as key milestones in rebuilding trust, trust that had been severely eroded over years of currency volatility and policy inconsistency.

As the country grapples with economic uncertainty, weak incomes and a fragile financial system, the sustainability of Zimbabwe’s healthcare funding model hangs in the balance, whether the solution lies in regulatory reform, economic stabilization or a complete overhaul of the system, without urgent intervention, the cost of falling sick may continue to rise beyond the reach of many.

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