The Zimbabwe Democracy Institute (ZDI) recently launched a report titled 'Locking Down Democracy In Zimbabwe's Covid-19 Era: The State of Human Rights And Accountability In The Health Sector.
The objectives of the study were:
1. To interrogate the state of human rights in the public health sector in the context of Covid-19;
2. To document citizen oversight and perception outcomes on corruption, transparency and accountability in the public health sector in the context of Covid-19;
3. To interrogate the extent of impartiality in staffing and deployments in the public health sector in the context of Covid-19.
Below is the summary of the key findings of the report;
The study reveals that the public health sector in Zimbabwe suffers political institutional designs and institutional weaknesses that inhibit quality service delivery in the context of the Covid-19 pandemic.
Institutional weaknesses identified in the study are traceable to patronage networks that have enabled rampant corruption and poor service delivery in the health sector. The study posits that instead of plugging the gaps of corruption in the sector, the government has resorted to creating political institutional designs that have worsened the challenges of poor service delivery and incapacitation in the public health sector.
These institutional designs include patronage networks, identity politics and militarisation of the public health sector.
Militarisation has been done in three related approaches – militarisation by recruitment, militarisation by deployment and militarisationby appointment. It is exposed in this study that the political institutional designs put in place have led to incapacitation of the public healthcare that manifests in form of a de- motivated, intimidated and disgruntled workforce, industrial action, brain drain due to the exodus of skilled workforce in the sector and linguistic barriers to healthcare delivery.
Perceptions on efforts done by public health institutions to raise Covid-19 awareness
•Public health institutions‘ efforts in raising awareness on rights in the context of Covid-19 were found lacking. 43% of the sampled respondents think that efforts by public health institutions in raising awareness on rights in the context of Covid-19 are poor. Of this 43%, 77% constitute people residing in rural areas whilst the remaining 23% come from urban areas. On the other hand, 41.5% of the respondents think the efforts are satisfactory.
•The study found that 88% of 14.5% of the total sampled respondents who think the efforts by public health institutions to raise covid-19 awareness are satisfactory reside in urban areas whilst 12% come from rural areas.
•Respondents from rural Zimbabwe noted that citizens in rural areas appear to be sidelined in the Covid-19 information dissemination processes. 43% of the sample stated that efforts by public health institutions to raise Covid-19 awareness are poor and those in rural areas are not well informed. Perceptions on the state of the right to access healthcare services during Covid-19
•The state of right to access healthcare services in Zimbabwe was found pitiable. 40% of the sampled respondents are of the view that the state of their right to access healthcare services in the context of Covid-19 is poor while 17% perceived it to be satisfactory. Of this 40%, 67% are in the rural areas suggesting that medication in rural clinics and hospitals is not available and, in some cases, in short supply.
Perceptions on corruption in the public health sector
•Regarding management of public resources related to Covid-19, 59.9% of the research participants noted that the health sector is corruption-ridden while 14% dismissed the claim stating that there is no corruption in the health sector.
•The study shows that urbanites have more access to information pertaining to the day-to-day running of healthcare institutions as compared to their compatriots in the rural areas. People in rural areas have limited interaction with healthcare institutions hence their minimal exposure to corrupt practices. On the other hand, people in urban areas are more exposed to the daily activities of public health institutions as hospitals and clinics are more concentrated in these areas. Perceptions on public health expenditure and conduct of public health officials
•The study finds out that there is lack of accountability and transparency in the running of the public health sector in Zimbabwe. For instance, 53.5% of the research participants noted that public health officials are unaccountable and opaque with regards to public health expenditure while only 15% of the respondents noted that the conduct of public health officials is transparent and accountable.
•The survey submits that the management of public healthcare resources is corruption ridden. 59.9% of the respondents noted that the management of public resources related to Covid-19 in the health sector is corruption ridden while 14% dismissed the claims stating that there is no corruption in the health sector.
Perceptions on human resources deployments in the health sector in Zimbabwe
•The study reveals that patronage and militarisation are key features defining the human resource deployments in the public health sector.
•On human resource deployments in the health sector, the majority of the sampled respondents (51%) indicated that human resource deployments are patronage-ridden and politicised while 26% of the research participants highlighted that there is militarisation in deployments of public healthcare human resources. A small section of research respondents (13%) among whom rural dwellers constituted 67% perceived the health sector‘s human resource deployments as transparent, apolitical and professional whereas 10% said they ̳don‘t know‘.
•Findings reveal that there is a conflation between the state and ZANU-PF thus, public institutions operate as an extension of ZANU-PF leading to unfair and unjust recruitment methods. On this aspect, two competing rational motives were identified by research participants: (i) political clientalism and (ii) identity politics.
•Above 51% of the overall sampled research participants noted that human resource deployments in the health sector have been distinguished by identity politics prevailing in the country.