1. HEALTHCARE DELIVERY AND COSTS: The consumer’s perspective
Presented by Rosemary Siyachitema
CCZ Executive Director
1 October 2009 – Troutbeck Inn
Nyanga

2. Healthcare Delivery and Costs: The consumer’s perspective
To adequately deal with the topic that you have given me to present under the conference theme of
“Revisiting Healthcare Delivery and Financing in Zimbabwe: The Springboard to Tomorrow” , it is
important to situate this discussion in the general development of our country and the world as a
whole. In September 2000 at the United Nations Millennium Summit, 189 Nations adopted the
Millennium Declaration and was signed by 147 heads of state and governments, including our own
Zimbabwe. At the Millennium Summit, 8 millennium development goals were adopted, to be achieved
by 2015 and these include:
1. Goal 1: Eradicate Extreme Hunger and Poverty
2. Goal 2: Achieve Universal Primary Education
3. Goal 3: Promote Gender Equality and Empower Women
4. Goal 4: Reduce Child Mortality
5. Goal 5: Improve Maternal Health
6. Goal 6: Combat HIV/AIDS, Malaria and other diseases
7. Goal 7: Ensure Environmental Sustainability
8. Goal 8: Develop a Global Partnership for Development
And of particular focus for us are Goals 4, 5 and 6 which are health related goals.

3. Continued:
To further anchor my topic to consumers under the 8 Basic Consumer Rights which are:
1. Basic needs: this covers all other basic needs including healthcare
2. Safety: which included protection from services that are hazardous to health and life
3. Information: the right to be protected against dishonest or misleading advertising or labeling. And the right to be
given the facts and information needed to make an informed choice
4. Choice: the right to choose products and services at competitive prices with an assurance of satisfactory quality
5. Representation: the right to express consumer interests in the making and executor of government policy
6. Redress: The right to be compensated for misrepresentation
7. Consumer Education: the right to acquire the knowledge and skills necessary to be an informed consumer
8. Healthy Environment: the right to live and work in an environment which is neither threatening nor dangerous and
which permits a life of dignity and well-being
It is therefore very apparent how the topic of “healthcare delivery and costs” is a business of consumers and they
have a right to have a perspective on how health delivery should be given to them and at what cost.

4. Healthcare Funders
It is therefore essential and correct that as Association of Healthcare Funders of
Zimbabwe (AHFOZ) you have continuously acknowledged the importance of the
consumer’s voice by asking Consumer Council of Zimbabwe (CCZ) to present at your
Conferences so that you hear what consumers are saying and as health funders you can
tailor make your services from an informed position.

5. Setting the current scenario
I do not feel that it is necessary to belabor the point about the economic environment we are just
emerging from – it is common news and is well documented. Suffice to say that in the area of
medicine, health delivery and service, the issue of access, affordability, information and redress, these
are areas that have been severely challenged, and those who have been on the receiving end of the
backlash, have been consumers.
The result of it all was that very few could afford medical care or subscribing to medical insurance. If
our healthcare system, during this time gone by, was a child in school writing a “Patients Charter”
examination, healthcare would had failed dismally with 20 out of 100% marks.
This time, we all believe now we are in a new era in Zimbabwe’s development. A multi currency
system has been introduced, our hospitals and pharmacies can now access the much needed
medicines, services should be easier to cost, we need to go back to basics where health funders and
health service providers are able to provide a service that consumers can access, afford, get the right
medical information and get redress when they feel that their rights have been trampled on.

6. Continued:
It is widely accepted that for healthy development any nation needs to have a good
health system and here we are not only talking about providing the services for those
who have money, but for those also at the lower end of the spectrum. For health funders
this means that therefore, you need to have a wide range of benefits that suit every
pocket. Because we have moved away from the environment of distortions,
irregularities,' burning’ and parallel market dealings, consumers want to see stability in
The cost of health insurance, consultation fees, medicines and such related costs.
Through CCZ food basket researches for 2009 we have seen the stabilizing of food
prices from January 2009 up to now (see figure 1).

7. FIGURE 1

8. Continued:
At the beginning of the year the wild fluctuations that were experienced with the
Zimbabwean Dollar were transmitted into the United States Dollar regime
resulting in a very expensive food basket in comparison to the source market
and the rest of the region (see figure 2). As the Zimbabwean society has
started to understand the worthiness of the United States Dollar and
competition has set in, we have observed lowering of prices and ultimate
stabilization. This is what consumers are expecting in all other sectors
including health funding and services.

9. FIGURE 2

10. Who owns Medical Schemes (if this question is answered, then consumers would not be disgruntled about the way some services and schemes work)
By paying into a particular scheme, consumers become share holders of these funds and therefore,
must have a say in how these funds are used. Consumers will only be satisfied if they receive
adequate information and are invited to Annual General Meetings (AGM’s) where key decisions are
made. Unfortunately, that has not been the case in Zimbabwe. Consumers want to see their funds
working to their benefit. It is therefore incumbent upon health funders, the service providers and
other related stakeholders to ensure that adequate information and redress is given to consumers.
In Conclusion
I want to reiterate the following, that in funding health and related services, let us be guided by:
1. Over arching national development goals as articulated by the Millennium Development Goals,
national health policy, the Patients Charter and consumer rights.
2. And, the elements of accessibility, affordability, adequate information dissemination, and giving
redress to the aggrieved.

11. THANK YOU, TATENDA, SIYABONGA
THE END
THANK YOU, TATENDA, SIYABONGA