Mission and State Health Institutions: “Invisible” Public-Private Partnerships in Zimbabwe, 1980–1999

Abstract

This article argues that Zimbabwe’s independence in 1980 marked not the end of the missionary era, but its high point. Government’s poor rural health infrastructure forced it to partner missionary health institutions in order to run preventive health programmes and improve access to health services for the majority of the population. Mission health institutions formed the mainstay of rural African health care needs in the colonial period and continued to do so in the post-colonial period; with 97 clinics and 70 hospitals, and 13 of the country’s 42 designated district hospitals compared to 1 032—largely small and urban based—government, council and private health facilities. Mission health institutions were regulated by the Ministry of Health and were partly funded by the government. However, the significance of the mission health endeavour was overshadowed by an overarching government development agenda and narrative. This study establishes the nature and forms of public-private health partnerships in the development of Zimbabwe’s public health system and highlights the importance of the church’s healing mandate. It also refracts on church-state relations and the broader development and policy issues during the 1980s and 1990s.