Zimbabwe’s Health Procurement Faces Persistent Weaknesses Despite Reform Gains — Audit Trend Report Reveals

A new trend analysis report on procurement performance in Zimbabwe’s health sector between 2020 and 2024 has revealed deep-rooted inefficiencies, despite modest gains in compliance and planning. The findings, drawn from Auditor General reports over five years, paint a picture of chronic underutilization of funds, poor documentation, and persistent governance failures undermining public health delivery.

According to the report, titled “Procurement Performance in Zimbabwe’s Health Sector (2020–2024)”, issues of budget underutilization and unspent funds remained widespread. Although spending efficiency improved briefly in 2023, under-spending surged again in 2024, with 21.4% of allocated funds left unused — a sharp reversal from the 5.5% recorded the previous year. The report highlights an unexplained US$3.1 million variance between Treasury and Ministry records in 2024, signaling ongoing weaknesses in financial reconciliation.

While procurement compliance rose from 40% in 2020 to 73% in 2024, the analysis warns that this improvement is largely procedural. “Formal compliance has improved, but operational efficiency remains weak,” the report notes, citing recurring cases of delayed tenders, overpayments, and incomplete supplier contracts.

One of the most striking concerns was poor documentation, described as “the most persistent procurement weakness.” Missing invoices, destroyed stock cards, and incomplete payment records were reported across all five years. At Esigodini District Hospital, auditors found destroyed stock cards spanning 2023–2024 — emblematic of the sector’s failing record management systems.

The report also spotlights supplier failures and project delays. Hospitals such as Gwanda and Gweru were cited for paying suppliers who failed to deliver goods or charged inflated prices. The long-stalled Lupane Provincial Hospital project, first initiated in 2003, remained incomplete by 2024, alongside 37 other delayed public health infrastructure projects valued at nearly US$98.7 million.

Audit opinions on the Ministry’s financial statements remained qualified in 2020–2021 and adverse from 2022–2024, confirming what analysts describe as a deterioration in governance rather than progress. “No unqualified audit opinion was achieved during the entire period,” the report emphasizes.

Despite the challenges, the analysis acknowledges positive trends in regulatory compliance and procurement oversight, particularly following the Ministry’s improved engagement with the Procurement Regulatory Authority of Zimbabwe (PRAZ) in 2023–2024. However, it warns that such compliance gains have yet to yield tangible improvements in healthcare delivery.

To address the ongoing crises, the report calls for a dual strategy combining financial stabilization and governance reform. It urges the adoption of forex risk mitigation measures, strategic sourcing for high-value medical supplies, and stronger anti-corruption enforcement. “Without decisive action,” it concludes, “Zimbabwe’s health sector risks continued inefficiency, jeopardizing access to essential medicines, equipment, and life-saving services.”