Impact of Health Financing on Maternal Mortality in Zimbabwe (2010-2019)

Background: Maternal mortality Ratio (MMR) is an important sentinel indicator of health of a nation and a proxy for women’s health in any nation. MMR remains high in Sub Saharan Africa (SSA), Zimbabwe included and various factors has been postulated to explain this phenomenon. Research on the effect of health care financing on MMR in Africa shows varied results across nations. As such it is imperative to conduct robust empirical analysis of the determinants of MMR in Zimbabwe. Methods This paper attempts to ascertain the effects of health care financing on MMR in Zimbabwe using the ordinary least square (OLS) regression model, utilising data from the World Bank, for the period 2010 to 2019. Discussion This study found that government health expenditure and out of pocket expenditure were significant predictors of MMR, whereas external health expenditure was not found to be statistically significant in influencing MMR. The model had high explanatory power, with R-squared of 0.972 and high predictive power, with R-squared adjusted 0.958 at 5% significance level. This study found that 97, 2% of variation in maternal mortality is explained by government expenditure on health per capita, out of pocket expenditure and external health expenditure. Further, government health expenditure had a positive effect on MMR whereas out of pocket expenditure was found to have a negative impact on MMR at 5% level of significance. As such this study shows that a unit change in maternal mortality is explained by a 0.02 unit drop in government health per capita expenditure, ceteris paribus. Additionally, a unit change in maternal mortality corresponds to a 3.1 unit change in out of pocket per capita expenditure, holding other things constant. However, external health funding was not found to be significant in affecting MMR. Conclusions To ensure attainment of SGD3 of good health and wellbeing, this study infers that increased governemnt health financing and reduced out of pocket expenditure reduces MMR. As such it is imperative for Government of Zimbabwe to explore innovative domestic health financing, such as sin tax could expand the fiscal space and scale up financial risk protection efforts such as mandatory health insurance could be explored. This will address the challenge posed by user fees at the point of accessing health care, which are fuelling out of pocket expenditure (OOP), and increase access to institutional delivery attended by skilled and trained health workers, thus contribute to the significant reduction of MMR.