HARARE — Zimbabwe’s Ministry of Health and Child Care has ordered the immediate dismissal of health workers found guilty of corruption, negligence or professional misconduct as the government moves to tighten control over public hospitals, clinics and the country’s pharmaceutical supply chain.
The directive was issued by the ministry’s permanent secretary, Dr Aspect Maunganidze, to senior public health officials and the leadership of the National Pharmaceutical Company (NatPharm).
It gives health authorities a clear instruction to remove workers whose conduct undermines patient care, misuses public resources or damages confidence in government hospitals.
The ministry’s zero-tolerance position comes amid growing concern over the theft and diversion of medicines, demands for unofficial payments, improper referrals and other forms of misconduct affecting patients across the country.
Officials have been told to act quickly when investigations establish that a health worker has abused public resources, failed in professional duties or engaged in behaviour that harms patients.
The government says the tougher approach is intended to restore public trust and ensure that medicines, equipment and other supplies bought with public funds reach the people they were meant to serve.
NatPharm has been placed at the centre of the directive because it is responsible for procuring, storing and distributing medicines and medical equipment to public health institutions across Zimbabwe.
Any weakness in that chain can affect hospitals and clinics nationwide. Medicines can be lost during procurement, storage or transportation before they reach patients who depend on public facilities for treatment.
The instruction followed a health-sector presentation that highlighted challenges affecting service delivery and the management of public resources. Health officials are expected to ensure that investigations into corruption, negligence and other offences are conducted without delay.
Among the corrupt practices reported in Zimbabwe’s health sector is the theft of medicines from public hospitals and clinics for resale through private pharmacies. Health workers involved in such schemes remove drugs intended for patients and redirect them into the private market, where they can be sold for profit.
Deputy Health Minister Sleiman Kwidini told the National Assembly in August that the government was losing millions of dollars through the theft of medication and hospital supplies by employees at public health institutions.
Kwidini said some health workers were stealing drugs meant for patients and reselling them to private pharmacies. He also acknowledged that public hospitals did not always have the medicines prescribed by doctors, forcing patients to buy them elsewhere.
“After buying medication, people steal from hospitals for resale in their pharmacies,” he said. “The President, Dr. E.D. Mnangagwa, has said those who steal should be arrested.”
The deputy minister said the government had introduced a tracking system to monitor medicines from NatPharm to hospitals and pharmacies.
“We now have a tracking system that has been installed. With this new system, we are going to ensure that our medication is protected in hospitals,” Kwidini said.
He warned that those involved in the theft of medicines would face prosecution.
Medicine diversion has a direct effect on patients. When drugs disappear from public hospitals, people who cannot afford private treatment are left without medication or are forced to pay for supplies that should have been available at government facilities.
Other reported practices include bribery and informal payments demanded before patients receive treatment or services. Some patients have been asked to pay money to secure faster attention, obtain medicines, receive treatment or access services that should be provided through the public health system.
In some cases, patients have reportedly been asked to provide goods instead of cash. These can include groceries, food, farming equipment or transport for health workers.
Absenteeism is another problem affecting public healthcare. Staff who fail to report for duty leave hospitals and clinics short-handed, increasing waiting times and placing additional pressure on nurses and doctors who remain at work.
Patients have also complained of overcharging, poor-quality services, false treatment and unnecessary medical procedures. Favouritism can affect who is seen first, who receives attention and who gains access to scarce medicines or hospital resources.
Kickback-driven referrals are another concern. These occur when health workers direct patients to private doctors, laboratories, pharmacies or other facilities in return for financial rewards or other benefits.
Some patients have been referred to private laboratories for tests that could have been carried out at public hospitals. The practice places a heavy burden on families, particularly pensioners and people without medical insurance.
Patients who arrive at public hospitals expecting affordable treatment can find themselves sent to private facilities and presented with bills they cannot pay. Some families are forced to borrow money or delay treatment to meet the cost of tests and medicines.
The concerns have increased pressure on hospital managers and professional bodies to examine relationships between public health workers, private laboratories and private medical facilities.
The latest directive means that health workers found to have used their positions to benefit themselves or private businesses could lose their jobs immediately after being found guilty.
The government is also moving to bring private hospitals, clinics and mission institutions into a single national reporting system.
Health Minister Douglas Mombeshora announced that Cabinet had resolved that private healthcare institutions must submit their health statistics and service delivery data directly to the Ministry of Health and Child Care.
For years, private hospitals operated largely outside the government’s national health information system. Their work in specialist treatment, training, infrastructure and patient care was not always reflected in official health statistics.
Speaking at The Avenues Clinic Post Graduate School of Nursing graduation ceremony, Mombeshora said the new reporting requirement was necessary to give the government a complete picture of healthcare in Zimbabwe.
“Private healthcare institutions have contributed immensely to Zimbabwe’s health outcomes through service delivery, specialist care, training, infrastructure and investment,” the Minister said.
“However, much of this contribution has not been adequately reflected in our national health statistics and reporting systems.”
Under the Cabinet resolution, private hospitals, clinics and mission institutions will be required to submit performance information through the ministry’s official channels.
The exact reporting requirements are still being finalised, but the system is expected to help the government monitor healthcare activity, patient outcomes and service delivery across the public and private sectors.
“This is an important step towards ensuring that our national health indicators reflect the full contribution of every player in the sector,” Dr Mombeshora explained.
“It will also strengthen planning, coordination, accountability and evidence-based decision making.”
The minister acknowledged that the reporting framework and template were still being developed. He said private institutions could raise practical concerns about the first version of the system but encouraged them to engage with the ministry as the framework was refined.
“The underlying principle is simple: we are one country and one health system, and we must report as one,” he said.
“Whether healthcare is delivered in a public, private or mission institution, it contributes to the health and wellbeing of the same Zimbabwean population. Our national achievements must therefore be reflected collectively.”
The two government measures — immediate dismissal for proven misconduct and compulsory reporting by private healthcare providers — form part of a wider effort to improve accountability in Zimbabwe’s health sector.
The reporting system is expected to give policymakers information from all parts of the healthcare industry. That could help the ministry plan services, identify gaps and track the performance of public and private facilities.
At the same time, the dismissal directive places greater responsibility on hospital managers to monitor staff, protect medicines and respond to complaints.
The government’s focus on NatPharm reflects the importance of protecting supplies before they reach hospitals, while the tracking system is intended to monitor them after distribution.
Doctors, nurses, pharmacists, administrators and other employees working in public health institutions could face dismissal if investigations establish that they took part in medicine theft, bribery, false referrals, absenteeism, overcharging, favouritism, negligence or other serious offences.
The measures also increase pressure on senior officials to ensure that misconduct is not ignored or covered up. Hospital administrators will be expected to protect patients, safeguard public supplies and ensure that disciplinary procedures are handled promptly.
For patients, the success of the new policy will be measured by whether medicines reach hospital shelves, whether services remain affordable and whether people can receive treatment without being pushed towards costly private alternatives.
The ministry has now placed responsibility on health-sector leaders to enforce the directive and protect the resources entrusted to them. The message to corrupt health workers is clear: anyone found guilty of abusing patients or public resources will no longer be protected by the system.