The effects of poverty on health equity in Zimbabwe : the case of Chegutu Urban District

Abstract

This study employed a qualitative methodology to investigate the effects of poverty on health equity in Zimbabwe. The investigation was motivated by the fact that the effects of poverty on health in Chegutu District have not yet been examined systematically despite the fact that the focus on poverty and equity considerations dictates the opportunities for equal health for the marginalised people. The contemporary socioeconomic crisis in Zimbabwe has posed a serious challenge to the comprehensive and equitable health systems and wellbeing. There is mounting pressure globally to implement appropriate interventions that can contribute concretely to health institutions’ efforts to tackle poverty and health inequities. In Zimbabwe, the extent to which poor people, households and social groups are accessing the resources to be healthy strongly determines their health potential. The study also examined the role of the non-governmental organisations and the town municipality in addressing poverty and promoting health equity in Chegutu. It was established that the focus on poverty entails the broader commitment of the local government and NGOs to the achievement of greater equity in health using a human rights framework to consider both poverty and equity. In practice, all systematic differences in Chegutu could be regarded as unfair and avoidable, and therefore regarded as inequities. The evidence points to the existence of extensive and widening social inequities in Chegutu District which have escalated the unequal distribution of diseases and survival in the district. The complexity of poverty as it relates to the distribution of health in Chegutu demands new ways of understanding the growing rich-poor gap. Thus to understand this complexity the Capability Approach and the Sustainable Livelihood Approach were used as the basis for critical appraisal of the variables under study. This study advances the vii understanding of the urgent need to take action to reduce these inequities and their root causes. The study calls for new ways of thinking about the direction of policy and also calls for renewed vigilance in monitoring impacts, to make sure that no segment of the population is excluded. Their implementation is seen to be dependent on increasing the capacity and organisation of the poor to more strongly influence policy and resource distribution in the health sector. It is important that health services respond effectively to the major causes of preventable ill-health among the poor and disadvantaged so as to address these continuing inequalities.