Zimbabwe made tremendous progress between 1980 and the late 1980s in the provision of Health Services and according to most indicators of the health status of its people Zimbabwe had been rated amongst the best in Sub-Saharan Africa.  It was in the early 1990’s that major problems in sustaining the progress made started to show.  In order to arrest this decline in health services the Government of Zimbabwe started to look at the possibility of introducing a National Health Insurance Scheme in the country.

At its Twenty-Ninth Ordinary Session, the Government of Zimbabwe requested that the possibility of establishing a National Health Insurance Scheme under one of the enabling Acts of the Ministry of Public Service, Labour and Social Welfare be examined.  A subsequent meeting of the Government directed that a feasibility study be undertaken.  In 1991 the Government of Zimbabwe in association with the British Government’s overseas Development Agency (ODA) commissioned a study on the relevance and feasibility of introducing a National Health Insurance Scheme for all those employees in the formal sector in Zimbabwe and to make recommendations which would form the basis of a national policy.  The study concluded that a case existed for the establishment of a National Health Insurance Scheme in Zimbabwe.  The Government of Zimbabwe, at its meeting held on 18 January 1993, accepted the recommendation that a National Health Insurance Scheme be established in Zimbabwe and that the proposed scheme should be introduced by the National Social Security Authority (NSSA) after adequate consultation with the Ministry of Health and Child Welfare.  The rational behind the approval of the National Health Insurance Scheme by the Government of Zimbabwe was to redress inequities in coverage, to improve quality of health care and to introduce greater transparency in the Government of Zimbabwe financing of health care.

A further study was carried out in 1995 after USAID commissioned KPMG to carry out two studies relating to the possibility of introducing a Social Health Insurance (SHI) scheme in Zimbabwe.  The first study related to the definition and costing of a SHI scheme and the second study was related to the ability and willingness of people of Zimbabwe to pay for such a scheme.  Again the objective of government was to redress inequities in coverage, to improve the quality of health care, to introduce greater transparency in Government of Zimbabwe financing of health care and to separate the roles of purchasers and providers of health care services.  The study made recommendations that are contained in the KPMG final report of 1996.

Following all the studies that took place from 1991 to 1996 NSSA has now been asked to implement this scheme.  As the first step towards the implementation of the scheme a policy document was drawn in consultation with the Ministry of Health and Child Welfare and was presented to the Poverty Eradication and Social Services Delivery Development Action Committee (PESSA).