In Zimbabwe, millions choose funeral insurance over pricey medical cover

Harare,
Zimbabwe
– Ngoni
Mutambararo’s
uncle,
Steward
Ganda,
60,
spent
the
last
months
of
his
life
at
home,
trying
to
recover
from
a
severe
ailment
on
his
own.

Ganda
suffered
from
severe
pain
in
his
legs
that
left
him
confined
to
bed
and
unable
to
tend
the
small
tuck
shop
he
ran
in
Kambuzuma,
a
low-income
suburb
in
Harare.

Like
millions
of
Zimbabweans
without
health
insurance
and
unable
to
cover
hospital
expenses,
he
had
hoped
to
soldier
through
and
get
well
without
medical
attention.
But
as
the
weeks
and
months
passed,
his
condition
deteriorated.

Eventually,
family
members
convinced
him
to
consult
a
physician,
and
he
was
first
admitted
to
Sally
Mugabe
Central
Hospital.
Doctors
initially
suspected
he’d
suffered
a
stroke.
But
on
further
inspection,
they
told
the
family
he
may
have
a
kidney-related
issue
and
needed
to
see
a
specialist,
a
nephrologist
whose
consultation
fee
was
$600.

With
no
savings,
Ganda’s
family
spent
a
month
late
last
year
trying
to
gather
the
money,
hoping
it
would
save
his
life.
But
it
was
too
late.

“We
couldn’t
raise
that
amount,”
Mutambararo,
39,
told
Al
Jazeera. “He
died
barely
a
month
after
the
admission.”

Soon
after,
the
funeral
was
held.
And
while
Ganda
had
spent
his
last
months
in
pain
and
relative
poverty,
the
service
that
bid
him
farewell
was
enviable:
a
casket,
a
hearse,
burial
equipment
and
a
65-seat
bus
to
carry
mourners
on
the
135km
(85-mile)
journey
from
Harare
to
his
hometown
of
Wedza.

While
Ganda
could
not
afford
health
insurance,
which
averages
about
$200
per
month
and
would
have
covered
his
diagnosis
and
treatment,
he
never
missed
his
$11
monthly
payment
to
a
funeral
services
company,
Nyaradzo
Group,
which
paid
his
post-death
costs.

Ganda
is
no
exception.
In
Zimbabwe,
data
show
more
people
are
preparing
for
death
than
for
survival
as
funeral
insurance
has
eclipsed
medical
cover
to
become
the
most
widely
held
financial
product
in
the
country.

Although
health
insurance
is
accessible
through
employers
and
monthly
premiums
are
deducted
automatically
from
salaries, fewer
than
900,000
Zimbabweans are
formally
employed.

About 16
million
people,
or
roughly
90
percent
of
the
population,
have
no
health
insurance
and
must
fund
medical
care
out
of
their
own
pockets,
according
to
2023-2024
data
from
Zimbabwe’s
National
Statistics
Agency.

At
the
same
time,
experts
said
funeral
policies
offer
a
cheaper,
culturally
resonant
form
of
support,
especially
in
a
society
in
which
dignity
in
death
often
takes
precedence
over
safeguarding
life
itself.

Of
all
insured
Zimbabweans, 72
percent hold
funeral
insurance
policies
while
30
percent
have
health
insurance,
according
to
a
2022
report
from
the
financial
inclusion
nonprofit
FinMark
Trust.

‘Life
after
death
is
important’

For
most
Zimbabweans,
medical
cover
is
a
luxury
they
cannot
afford,
so
they
forgo
private
healthcare
for
government
services.
Public
health
fees
can
start
at
about
$5
per
month,
but
government-run
facilities
suffer
from
poor
infrastructure,
limited
drug
supplies
and
staff
shortages
caused
by
the
migration
of
healthcare
professionals,
which
many
said
lead
to
low-quality
care.

Although
some
private
insurance
premiums
start
at
about
$10
per
month,
others
run
into
tens
and
even
a
few
hundred
dollars,
putting
plans
beyond
the
reach
of
many
households
in
a
country
where 60
percent of
the
population
lives
on
less
than
$3.65
a
day.

In
comparison,
funeral
insurance
plans
are
widely
accessible
and
relatively
low
cost.
The
funeral
cover
provider
Ecosure,
for
instance,
offers
plans
starting
at
$0.75
while
Zimnat’s
policies
begin
at
$1.

“Funerals
are
immediate,
unavoidable
events
that
come
with
significant
financial
and
communal
expectations,”
said
Innocent
Tshuma,
the
public
relations
manager
at
Doves
Holdings
Group,
a
funeral
services
provider.

“In
contrast,
access
to
comprehensive
medical
aid
remains
limited
due
to
affordability
challenges,
exclusions
and
unpredictable
out-of-pocket
costs.”

He
argued
that
Zimbabweans
place
deep
importance
on
dignity,
respect
and
collective
responsibility
at
times
of
death
and
funeral
insurance
offers
certainty
in
cost
and
service
delivery,
“which
explains
its
strong
appeal
in
an
environment
of
constrained
household
incomes”.

Vivek
Solanki,
a
physician
and
member
of
the
Zimbabwe
Medical
Association,
agreed.

“In
Zimbabwean
culture,
the
aspect
of
life
after
death
is
very
much
important,
and
it’s
actually
not
a
financial
one,”
he
told
Al
Jazeera.

On
the
other
hand,
he
added,
“it’s
almost
a
taboo
to
think
about
how
and
when
[someone
is]
going
to
get
sick
…
because
it’s
like
you
are
attracting
bad
things
to
happen.”

Solanki
also
attributed
the
low
numbers
of
people
with
health
insurance
to
a
legacy
of
post-independence
policies
when
citizens
relied
on
government-funded
healthcare
and
rarely
worried
about
costs.
But
things
have
been
deteriorating
since
the
public
system
began
collapsing
in
the
2000s
after
Western sanctions were
imposed.

“But
today,
even
to
receive
proper
healthcare
in
public
hospitals,
private
funds
are
required,”
Solanki
said.
“For
many
people
in
Zimbabwe,
covering
the
financial
burden
of
emergencies,
chronic
illnesses
and
noncommunicable
diseases
has
become
extremely
challenging.”

Low
prioritisation
of
medical
insurance
remains
a
significant
hurdle
in
Zimbabwe,
where 25
percent lack
access
to
basics
like
food,
healthcare
and
education.
To
address
this,
the
country
plans
to
launch
a
national
health
insurance
scheme
in
June
as
it
aims
to
expand
access
to
quality
healthcare
for
all.

Itai
Rusike
–
the
director
of
the
Community
Working
Group
on
Health,
a
network
of
civic
organisations,
and
a
public
health
activist
–
said
the
initiative
“affirms
the
government’s
commitment
to
ensure
universal
health
coverage”.

However,
he
expressed
concerns
about
the
government’s
capacity
to
sustain
the
programme,
given
the
current
challenges
of
high
public
debt,
currency
fragility
and
persistent
inflation
facing
Zimbabwe.

“To
fully
achieve
the
full
potential
of
a
National
Health
Insurance
scheme,
actions
to
address
the
social
determinants
of
health
must
be
implemented,”
he
said.
“These
include
economic
stability,
community
and
physical
environment,
education
and
social
context,
and
the
healthcare
system.”

Death
insurance:
A
‘commercialisation
of
life’?

The
public
health
system
currently
is
in
a
state
of
collapse
after
years
of
chronic
underfunding.
With
just
1.7
hospital
beds
per
1,000
people
and
a
maternal
mortality
rate
of
462
per
100,000
live
births
compared
with
a
global
rate
of
197
deaths
per
100,000
live
births,
thousands
are
locked
out
of
essential
care.

Funeral
insurance,
on
the
other
hand,
is
accessible
and
booming
with 66
percent
of
all
life
assurance
revenue in
2024
coming
from
funeral
policies.

According
to
EcoSure,
funerals
typically
cost
$800
to
$3,000
in
Zimbabwe
depending
on
the
city,
number
of
attendees
and
type
of
service.
For
many,
this
makes
funeral
insurance
a
worthwhile
investment.

However,
African
spiritualist
and
traditionalist
Pearson
Takaingei
Marinda
calls
the
trend
a
“commercialisation
of
life”.

“Culturally,
we
appreciate
and
celebrate
life
and
transition
[death],
but
in
the
modern
day,
we
are
forced
to
prepare
for
death
more
than
life,”
Marinda
told
Al
Jazeera.
“Traditionally,
funerals
and
burials
are
facilitated
by
the
society
and
the
deceased
would
be
buried
covered
in
animal
skin,
but
due
to
commercialisation,
people
are
forced
to
pay
for
coffins.”

In
line
with
newer
traditions,
those
who
cannot
afford
formal
funeral
policies
are
turning
to
informal,
community-based
burial
schemes,
joining
grassroots
efforts
to
ensure
their
families
can
preserve
dignity
in
death.

Ellie
Mlambo,
whose
father
died
last
year
after
a
long
battle
with
a
heart
condition,
spent
nearly
a
year
consulting
traditional
healers
and
prophets
because
their
services
were
far
cheaper
than
medical
insurance
and
hospital
bills.

When
he
passed,
two
burial
savings
groups
–
Chirongwa
Chemadzimai
Chekuviga
and
Tashinga
Burial
–
attended
Mlambo’s
father’s
funeral
in
Machavangu,
100km
(62
miles)
southeast
of
Harare,
supporting
her
bereaved
mother.
The
former
collects
$1
per
member
per
month
and
helps
contribute
to
eventual
funeral
costs
while
the
latter
collects
$2
per
member
monthly
and
contributes
$120
towards
a
coffin.

“My
mother
paid
up
for
two
burial
savings,
but
since
my
father
was
on
my
funeral
policy,
the
money
was
given
to
my
mother
for
other
uses,”
Mlambo
told
Al
Jazeera.

Some
informal
burial
groups
often
go
beyond
covering
funeral
costs
and
provide
mealie-meal,
a
traditional
corn-based
dish,
vegetables
and
cooking
utensils
to
support
the
bereaved.

In
Jegede
village,
a
rural
area
in
Zaka,
community
members
established
the
Jegede
Burial
Society
last
year
after
an
elderly
woman
died
without
the
means
to
afford
a
coffin,
a
proper
burial
or
food
for
those
attending
her
funeral.
Traditionally,
the
bereaved
family
would
provide
for
the
funeral,
and
neighbours
would
simply
gather
to
offer
moral
support,
but
the
community
now
helps
ensure
basic
needs
are
met.

The
chairperson
of
the
Jegede
Burial
Society,
Chomudisa
Jegede,
said
the
incident
reminded
the
community
of
the
importance
of
having
a
contingency
plan
for
funerals.

“Our
community
responded
well,
and
we
are
now
made
up
of
44
members
and
each
is
obliged
to
contribute
$10
when
a
member
dies,”
he
told
Al
Jazeera.
“It
is
working
very
well
because
so
far
we
have
managed
to
assist
some
five
members
during
funerals
of
their
immediate
families.”

However,
Jegede
noted
that
the
community
needs
to
go
beyond
death
and
also
focus
on
the
need
for
health
insurance.

His
sentiments
were
echoed
by
Solanki
from
the
Zimbabwe
Medical
Association.

“Education
and
public
awareness
on
the
importance
of
medical
insurance
and
providing
funds
towards
healthcare
is
the
way
to
go
in
an
era
where
health
is
no
longer
free,”
he
said.

He
also
urged
Zimbabweans
in
the
diaspora
to
contribute
to
the
initiative,
noting
that
their
experience
with
health
insurance
in
the
countries
where
they
work
gives
them
a
clearer
understanding
of
its
benefits.

“Perhaps
the
diasporians
could
fund
or
pay
towards
health
insurance
of
their
families
in
Zimbabwe,”
he
said,
“I
think
that’ll
be
one
of
the
ways
to
encourage
people,
educate
them
and
create
awareness
of
the
essential
need
for
health
funding
in
case
of
any
emergency
or
health
ailments.”