All health services are the responsibility of the Ministry of Health, which covers 50% of total health care expenditures provided by local authorities (with Ministry of Health grants), mission churches (also with grants), and industrial organizations and private services. The government has declared its intention to provide free medical services for all. Prior to independence, facilities for Africans were free, but these were greatly inferior to those available to Europeans. Zimbabwe has been focusing on building and/or upgrading rural health care centers and district hospitals and expanding rural health programs, such as immunization, control of diarrheal diseases, training of health care workers, and improving the supply and affordability of essential drugs. The local pharmaceutical industry is well developed. The Ministry of National Supplies operates the Government Medical Stores, which procures goods on behalf of the Ministry of Health. There were four tiers of health care delivery in Zimbabwe as of 1992: 56 rural hospitals and 927 health centers (public and private) providing preventive and curative services; 55 district hospitals; 8 provincial and 4 general hospitals; and 5 central hospitals located in major cities. As of 1999, there were an estimated 0.1 physicians and 0.5 hospital beds per 1,000 people. About 85% of the population had access to health care services in 1992. In 2000, 85% of the population had access to safe drinking water and 68% had adequate sanitation.
As of 2002, the crude birth rate and overall mortality rate were estimated at, respectively, 24.6 and 24 per 1,000 people. As of 2000 about 54% of married women (ages 15 to 49) were using contraception. The fertility rate was 3.8 births per woman in 2000. Infant mortality was 69 per 1,000 live births in the same year, and life expectancy was only 40 years. Maternal mortality rates in 1998 were high with an estimated 695 per 100,000 live births in 1998 and the disease pattern for mothers and children was one of mainly preventable diseases. The government of Zimbabwe paid for 80% of the routine immunizations in 1995. The immunization rates for children under five in 1997 were as follows: diphtheria, pertussis, and tetanus, 78%; polio, 79%; measles, 73%; and tuberculosis, 82% in 1994.
Guinea worm incidence has decreased from 1,570 cases in 1991 to 257 in 1995. Commonly reported diseases were malaria (877,734 cases in 1994) and measles (5,619 in 1995). Tuberculosis has been a major health problem (562 reported cases per 100,000 people in 1999). Local campaigns are under way to control schistosomiasis, which affects a large percentage of the African population. In 1989–95, 16% of children under five years old were considered malnourished.
The AIDS epidemic is among the worst in the world. At the end of 2001, the number of people living with HIV/AIDS was estimated at 2.3 million (including 33.7% of the adult population) and deaths from AIDS that year were estimated at 200,000. HIV prevalence in 1999 was 25 per 100 adults. Demographic surveys project that AIDS may increase child mortality rates nearly threefold by the year 2010 in Zimbabwe.