The Healthcare System in Zimbabwe: What a French National Should Know

Zimbabwe’s health system is under the authority of the Ministry of Health, whose address in Harare (Kaguvi Building) is given by the World Health Organization; the WHO also reports the creation of a Zimbabwe public health institute. France Diplomatie describes a public sector limited in effectiveness and resources, severely tested by the Covid-19 pandemic, where access to quality care and the supply of medicines, even common ones, are not always guaranteed.

Private clinics exist, but they are very costly, as are medicines in pharmacies. Health expenditure recorded by the WHO is about 63 US dollars per capita, or less than 3% of GDP.

For an expatriate, the practical consequence is twofold: plan for immediate financial access to care (a deposit in dollars) and a medical evacuation organised by an assistance provider. The page guide to healthcare systems offers a comparison method.

The pages read for this guide describe no compulsory national health insurance accessible to expatriates: cover rests in practice on direct payment, employer provident arrangements and private insurance contracts. The exact conditions should be checked with the Ministry of Health and the employer.

Zimbabwe is not on the CLEISS list (the French liaison centre for international social security) of States bound to France by a social security agreement: the Carte Vitale opens no rights, periods cannot be added together and only the seconded employee keeps the French scheme, reimbursed on French rates according to Assurance Maladie (the French national health insurance).

France Diplomatie stresses that, without insurance, access to care may be refused, even in a life-threatening emergency, and that the French embassy on the spot cannot under any circumstances cover these costs. See healthcare reimbursement in Zimbabwe.

No facility is recommended by name by France Diplomatie. The rule it recalls is financial: a sometimes large deposit is requested on admission, in cash and in US dollars, whatever the public or private status of the facility and even when an insurance card is presented. You must therefore have a cash reserve or, better, direct payment organised by the insurer, who guarantees the costs to the facility.

Families settled in Harare or Bulawayo identify, before any emergency, a nearby care centre, check its admission conditions and payment method, and keep the address of several facilities to hand. The glossary explains direct payment and prior authorisation.

Outside the towns, degraded roads and fuel shortages slow down emergency services; France Diplomatie advises not driving at night outside built-up areas and reporting any incident to the embassy duty line (+263 8677 00 71 54).

No local emergency number is published on the France Diplomatie health and safety pages, which give only the contact of the French embassy in Harare. It is recommended, before departure, to save the assistance numbers provided by your insurer, to check the extent of the evacuation cover and to register with Fil d’Ariane (the ministry’s alert service).

An evacuation takes place in several stages: stabilisation on site, the assistance provider’s decision, medically supervised transport and admission to a reference facility. The guide medical repatriation describes the steps.

For risky activities (adventure sports near Victoria Falls, hiking, safaris), check your insurance and your physical condition, do not hike alone, and never get out of the vehicle during a safari. Swimming is to be ruled out in lakes and rivers.

France Diplomatie recommends taking only what is strictly necessary, in the original packaging with the labels and a prescription giving the international non-proprietary name, checking that the medicines are authorised in Zimbabwe and never taking medicines bought on the street, because of the risk of counterfeits. Importing medicines requires an import licence.

For a chronic treatment, building up a stock before departure and asking a local doctor about equivalents reduce the risk of running out, in a context where the supply of the public sector is not always guaranteed and where pharmacies are costly.

Dental and optical care fall under insurance contracts and the CFE (Caisse des Français de l’étranger, the French social security fund for expatriates): see expat health insurance.

The French vaccination schedule must be up to date for adults and children alike. Depending on the length and conditions of the stay, France Diplomatie additionally cites yellow fever (mandatory for travellers arriving from endemic zones, ideally ten days before departure), hepatitis A, typhoid fever, hepatitis B, rabies, chikungunya, dengue and mpox.

Malaria carries a year-round risk in low-altitude areas, along the Zambezi valley, from the north-west (Hwange, Victoria Falls) to the south-east (Beitbridge), notably in the Hwange, Mana Pools and Gonarezhou parks; the central plateau, with Harare and Bulawayo, is not affected. Cholera is an endemic disease: running water can be contaminated by sewage, and many neighbourhoods in the towns, including Harare, are without it; residential areas generally have boreholes, which reduce this risk.

Other risks are flagged: dengue, Zika (consultation before travel for pregnant women), typhoid fever, hepatitis A, poliomyelitis, rabies, Marburg virus disease (a few rare cases identified), mpox, and trypanosomiasis at low risk at Mana Pools. HIV remains a major health problem, with more than a million people affected.

Drink only bottled water, sealed drinks or water made drinkable (filtration, boiling or disinfectant). Cook food thoroughly, peel or wash fruit and vegetables carefully, avoid raw vegetables, shellfish and cold buffets, and wash your hands frequently.

Against mosquitoes: covering clothing, repellents, treated mosquito nets, removal of stagnant water. Other risks flagged: road safety, contact with animals (wash and consult a doctor in case of a bite), envenomation, heat and sun.

Before departure, consult a doctor or an international vaccination centre early enough, then compare the CFE or private insurance.

France Diplomatie describes an assistance or insurance contract covering all medical costs (surgery, hospitalisation) and medical repatriation as essential. Three routes are open to the expatriate: the CFE, with membership before departure or within three months of settling in for immediate cover; international first-euro insurance, with direct payment and evacuation; or the protection of secondment for an employee sent by their employer.

The choice is made on the coverage area, hospitalisation ceilings, the treatment of maternity, evacuation and the medical questionnaire; see coverage area. In a context where the deposit is paid in cash, checking that the insurer accepts direct payment is a priority criterion.