By Fanuel Chinowaita
Zimbabwe has only two doctors nationwide capable of performing obstetric fistula repair surgery, Amnesty International Zimbabwe has said, raising concerns over access to treatment for women suffering from a largely preventable childbirth injury.
The organization through some of its members raised the issue during the 2027 National Budget consultations held at Queens Hall in Mutare, where it called on the government to allocate 15 percent of the national budget to health in line with the Abuja Declaration, with 10 percent directed towards primary healthcare.
The call for increased health funding comes amid concerns about the availability of specialist medical services and the ability of the country’s healthcare system to prevent and treat complications associated with childbirth.
The Abuja Declaration, adopted by African governments in 2001, commits countries to allocating at least 15 percent of their annual national budgets to improving the health sector.
During the budget consultation process, Mutare residents also called for increased government spending on healthcare delivery, highlighting the need to strengthen public health facilities and ensure that adequate resources reach essential services.
One resident, speaking during a Mutare budget hearing, said: “We need more funds to be allocated to healthcare delivery. Of the eight percent allocated to healthcare, 42 percent is going towards salaries, meaning there is a deficit when it comes to primary healthcare. Hence, we need the full 15 percent to go to healthcare under the Abuja Declaration of 2001.”
The concerns raised during the consultations underscore the debate over how national resources should be distributed to improve access to healthcare, particularly for vulnerable communities.
Obstetric fistula is a serious childbirth injury that develops when an abnormal opening forms between the birth canal and the bladder or rectum, causing the uncontrollable leakage of urine or faeces through the vagina.
The condition most commonly results from prolonged, obstructed labour when a woman cannot access timely emergency obstetric care. Sustained pressure during labour damages tissue around the birth canal, potentially leaving a woman with persistent incontinence.
Early marriage and teenage pregnancy can increase the risk because girls whose bodies are not fully developed may face greater difficulties during childbirth. However, the condition can largely be prevented through access to quality antenatal care, skilled birth attendance and timely emergency interventions, including Caesarean sections when medically necessary.
Women living with obstetric fistula may experience recurrent infections, psychological distress, stigma and social isolation. Some are rejected by their partners or families because of the persistent leakage associated with the condition.
In its 2021 report, “I Never Thought I Could Get Healed From This”: Barriers to Treatment and Human Rights Abuses Against Women and Girls with Obstetric Fistula in Zimbabwe, Amnesty International documented barriers to fistula prevention and treatment in the country.
The reported shortage of doctors capable of performing fistula repair surgery raises concerns about access to specialist treatment, particularly for women in remote communities who face financial and geographical barriers to healthcare.
Amnesty International Zimbabwe’s call for 15 percent of the national budget to be allocated to health, alongside its proposal for 10 percent to go towards primary healthcare, places the prevention of maternal complications within the wider debate on healthcare financing.
Increased investment in primary healthcare could strengthen antenatal services, improve early identification of pregnancy complications and facilitate referrals to hospitals equipped to manage complicated deliveries. Additional resources are also needed for specialist training, emergency obstetric care and surgical services.
As Zimbabwe prepares its 2027 National Budget, the challenge will be to ensure that allocations translate into accessible services, adequately staffed facilities and timely treatment for women and girls.
For women affected by obstetric fistula, access to specialist surgery can mean the difference between years of preventable suffering and the opportunity to recover their health and dignity.