Climate change refers to the long-term shifts in temperatures and weather patterns.

These shifts

may be natural, such as through variations in the solar cycle. But since the 1800s, human

activities have been the main driver of climate change, primarily due to burning fossil fuels like

coal, oil and gas (United Nation). The consequences of climate change now include, among

others, intense droughts, water scarcity, severe fires, rising sea levels, flooding, melting polar ice,

catastrophic storms and declining biodiversity. Climate change is causing unprecedented, and

irreversible changes and damages to the earth’s ecosystem. It impacts wide range of sustainable

development goals such as health, food security, employment, livelihoods, gender equality,

education and housing particularly to people living in small island nations and other developing

countries like Zimbabwe. The main thrust of this paper is on the direct and indirect impacts of

climate change on the health system of Zimbabwe and possible solutions to building a more

sustainable climate change resilient health system.

The Republic of Zimbabwe is a non-coastal country in southern Africa. It is divided into eight

administrative provinces, two cities with provincial status, and 62 districts. An estimated 15.2

million people live in the country, with an annual population growth rate of 1.48 percent

(Worldometrer 2022). The country’s population is largely young: the median age is 18.8 years,

and about 40 percent of the population is under the age of 15 (World Bank 2012).

According to recent figures, 72% of Zimbabweans live below the national poverty line.

Approximately two-thirds of the population resides in rural areas where poverty is much which is

attributed to the adverse climate and environmental conditions that disrupt

Approximately two-thirds of the population resides in rural areas, though urbanization is

projected to rise

Zimbabwe is a democratic nation where the President is the head of state. The executive power is

controlled by the government, while the legislative arm is under the government and parliament.

The country experienced a coup in 2017 where the sitting president Robert Mugabe was removed

from power, and a new president Emmerson Mnangagwa took over. There are claims of great

corruption in the country with riots taking place due to people’s distrust in the government's

operations.

Population growth is estimated to have stalled (World Bank

2010), likely because of an adult HIV/AIDS prevalence rate estimated at 15.3 percent (World

Bank 2010) and high levels of outmigration (World Health Organization [WHO], United Nations

Program for HIV/AIDS [UNAIDS], and United Nations Children’s Fund [UNICEF] 2008). An

estimated three million of Zimbabwe’s total population are currently living outside the country.

. Zimbabwe’s high dependence on rain fed agriculture and climate sensitive resources makes it

particularly vulnerable to climate change. The rural folks are the hardest hit as they solely rely on

agriculture for their survival due to sky rocketing levels of unemployment and lack of adequate

resources and income to supplement their food

security. T
agriculture, the main livelihood activity in areas where most people live

Climate change is likely to set back economic production in

Zimbabwe in two main ways: increasing degradation of the natural environment on which so

many of its people depend for their livelihoods, and fluctuating rainfall in Zimbabwe and

beyond its borders, reducing the volume of water in Kariba dam and so restricting the generation

of hydroelectricity on which industry depends. The natural regeneration of forests that supply

firewood will be reduced as rainfall patterns change and extreme temperatures intensify the

spread of wildfires.22 As crops fail, people are likely to turn to other sources of income,

including

activities such as brick molding and sale of firewood, which add to the demise of forests.
https://www.worldometers.info/world-population/zimbabwe-population/the

https://www.un.org/en/climatechange/what-is-climate-change

SWOT ANALYSIS

Strengths

1. An existence of institutions responsible for setting standards of care.(MOHCC)

2. Some health professionals.

3. Existence of some clinical treatment and infection control centers.

4. Well established proficiency testing system for laboratories.

Weaknesses

1. Underfunding of health services – rely on outside assistance and out of pocket payment

2. Low staffing as compared to the high workload - because of the population density

3. Inadequate support and supervision systems for health workers

4. Lack of public health insurance - Private insurance schemes are doctor-led and urban-

based
 5. Access to health care – although more than half the population live in rural areas most of

the health facilities are urban centered

6. shortage of skilled professionals

Opportunities

1. Prioritizing health as a basic human right

2. Prioritize communities

3. Development of comprehensive health strategies that targets the greatest/ most prevalent

health problems.

Threats

1. Dependence on donors for funding.

2. Lack of empowerment - education and knowledge of the patient’s charter

3. Resistance to change among providers and managers

Recommendations
Training and capacity building

Health insurance

Advocacy and increase political engagement

Increase budgetary allocation to health

Improve healthcare infrastructure

Increase collaboration among stakeholders to address health issues

Improved capacity to prevent and control diseases

Leadership and management training

Monitoring and evaluation of healthcare services

Better remuneration of health workers

Recruitment of healthcare workers

Health system reforms and research

Enhance implementation research

Increase investment in most impactful interventions

collaboration between institutions and ministries of health

Accountability

Integration of vertical programs

Prioritization of health intervention

Use of expert managers

Increase healthcare facilities

Upgrading and equipping training institutions

Strengthen health management information system

Use of technology

Revising training curriculum

Strengthen regulatory capacity

Mental and academic decolonization

Poverty alleviation

Community mobilization

Resource mobilization

The Zimbabwe Health Service Board (ZHSB) was created through the Health Services Act. 28 of
2004. The vision of the ZHSB was to provide efficient, effective and responsive health services
through a well-motivated, trained and dedicated staff and its mission was create, promote and
develop a conducive working environment for the health services human resources. in order to
overcome the brain drain from the health sector and provide client satisfaction.
However, in recent times, Zimbabwe has experienced an unprecedented decline in health service
provision, worsened by the of skilled health workers, in particular from the public sector.
According to the government's Health Service Board, more than 2,200 health workers left to take
jobs in the US, UK, Australia and neighboring states. More than double the number of doctors,
nurses and pharmacists who left last year, and three times the number that left in 2019.
A study done by Regional Network for Equity in Health in east and southern Africa showed that
the main reason for out migration of health workers were- the failing economy, bad working
condition, low wages.
According to the MoHCC, Zimbabwe has an overall, 36,477 health workers working in the
public, mission and council facilities, including management and support staff. Only 25% of the
425 doctor posts in the state medical system are filled, according to official figures. Less than
13% of provincial specialist posts are filled whereas just 22% of hospital specialist posts are
occupied.

Strengths
 Availability of a Human Resource health (HRH) department or directorate in the ministry
of health (MoH) responsible for developing, implementing and monitoring HRH
strategies.
 Some trained and skilled personnel ( administrators, doctors, nurses)

Weaknesses
  The World Health Organization (WHO) recommends a minimum of 23 doctors
per 10,000 people whoever a survey was done in by World Data bank in 2015
revealed there was an average of just 1.6 doctors per 10,000 people in Zimbabwe.

 Most recently, Healthcare workers were disproportionately affected by COVID-

19. In low- and they were particularly impacted by the underfunded health
systems, lack of personal protective equipment, challenging working conditions
and barriers in accessing personal healthcare.

 Poor salaries, low allowances and poor conditions of service, poor work
environment, An average worker in the public sector takes homes less than $200 a
month, while in the UK - which relaxed visa restrictions for health workers in
2020 - earn 10 times as much.

 Low staffing in health facilities as compared to the high workload - because of the
population density

 Low staffing as compared to the high workload - because of the population

density

 Limited supervision and human resource management capacity.

 Inadequate education and training capacity

 Lack of health workforce regulation mechanisms and limited availability of health

workforce information

Recommendation for increasing the resilience of the health workforce

 Employ retention incentives eg, training

https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?locations=ZW

Health is central to human happiness and wellbeing. A nation’s people in good health essentially
live longer and become better prospective to advance in education. This makes them more
productive and better contributors to national income. Consequently, climate change has had
significant impacts on health and human development in Zimbabwe, which is causing their
health system is deteriorate at an alarming rate. The budget allocations to the health sector
mirrors the weak economic environment that limits government spending in general. As a result,
Zimbabwe’s health sector relies heavily on off-budget development support, as well as out-of-
pocket payments to access health care. The health care system has become unsustainable and
has maintain inequality in access to health.
including temperature related morbidity and mortality caused by extreme temperatures and those
caused by extreme weather events such as water-borne, as well as food borne and vector-borne
diseases,.

The current state of the health sector and it

Climate change is predicted to have a wide range

of impacts on