Harare, Zimbabwe –

Ngoni Mutambalaro’s uncle, Steward Ganda, 60, spent his last months at home, trying to heal from a serious illness alone.

His condition caused severe leg pain, leaving him bedridden and unable to manage the small tuck shop he owned in Kambudsuma, a low-income area of Harare.

Like millions of Zimbabweans who lack health insurance and can’t afford hospital bills, he hoped to recover without seeing a doctor. However, as weeks dragged on, his health deteriorated.

Eventually, his family persuaded him to get medical help, leading to his admission at Sally Mugabe Central Hospital. Initially, doctors suspected he had suffered a stroke. Later tests indicated a possible kidney problem, requiring a nephrologist visit that would cost $600.

His family, lacking savings, spent a month trying to gather funds at the end of last year in a desperate attempt to save his life. Sadly, it seemed to be too late.

“We couldn’t raise that amount,” Mutambalaro, 39, shared. “He passed away just a month after being admitted.”

The funeral happened soon after. Ganda’s final months were filled with pain and relative poverty, yet his farewell service was quite respectable, complete with a coffin, a hearse, and a 65-seater bus to transport mourners over the 135-kilometer (85-mile) trip from Harare to Weza.

Despite not affording health insurance—averaging around $200 monthly—Ganda never missed a payment of $11 monthly to his funeral service, Nyaradzo Group. He had pre-paid for expenses related to his death.

Ganda’s situation is not unique. Data indicates that in Zimbabwe, more individuals are preparing for death than for survival, with funeral insurance now surpassing health insurance as the most commonly held financial product.

Health insurance can typically be acquired through employers, and monthly fees are deducted straight from paychecks. Unfortunately, there are fewer than 900,000 officially employed Zimbabweans.

According to the Zimbabwe National Bureau of Statistics, around 90% of the 16 million population lack health insurance and must cover medical costs out of pocket.

Experts argue that funeral policies represent an affordable and culturally significant form of support, especially in a society that often prioritizes the importance of honoring death over the preservation of life.

Of those with insurance, 30% have funeral coverage, and 30% health insurance, as noted in a 2022 report by Finnmark Trust.

“Life after death is also important.”

Many Zimbabweans view health insurance as a luxury and tend to stick with public services since private healthcare is often unaffordable. Public healthcare costs start at around $5 a month, yet government facilities are plagued by inadequate infrastructure, scarce drug supplies, and staff shortages, deteriorating the quality of care.

Private insurance rates begin at approximately $10 monthly, but for many families, this is financially out of reach, especially since about 60% of the population lives on under $3.65 per day.

Funeral insurance, on the other hand, is much more accessible and affordable. For instance, Ecosure offers policies starting at $0.75, with Zimnat beginning at $1.

“Funerals are urgent, unavoidable events that come with high societal expectations,” stated Innocent Tsuma from Doves Holdings Group.

He emphasized that Zimbabweans place immense value on dignity and respect in death, which is why funeral insurance, with its promise of cost certainty, is so appealing in a financially constrained environment.

Vivek Solanki, a physician in the Zimbabwe Medical Association, echoed these sentiments, stating, “In Zimbabwean culture, life after death carries significant weight, but thinking about it is often considered taboo.” He noted that for many, contemplating illness feels like inviting misfortune.

Additionally, he pointed to the legacy of post-independence policies that had once fostered reliance on government healthcare without concern for costs. However, the formal health system began deteriorating in the 2000s after Western sanctions were imposed.

“Now, even public hospitals require private funding for adequate care,” he stressed. “Handling financial burdens from emergencies and long-term illnesses is becoming increasingly difficult for many.”

The prevalent neglect of health insurance remains a significant hurdle in Zimbabwe, where 25% of people lack basic needs such as food, healthcare, and education. To remedy this, a national health insurance plan is set to launch in June, aimed at improving access to quality healthcare for all.

Itai Rusike, director of the Community Working Group on Health, emphasized the move’s importance. Yet, he remained skeptical about the government’s capacity to sustain it amid the ongoing challenges of high debt and economic instability.

“We must address the social determinants of health to realize the potential of this system,” he stated, identifying economic stability and education as critical factors.

Death insurance: “commodification of life”?

The public health system has been in disarray due to longstanding underfunding; with only 1.7 hospital beds available per 1,000 people, it contributes to a maternal mortality rate far higher than the global average.

In contrast, funeral insurance is increasingly sought after, accounting for 66% of total life insurance income in 2024.

According to EcoSure, funeral expenses in Zimbabwe generally range from $800 to $3,000, depending on several factors, making funeral insurance an appealing purchase for many.

However, Pearson Tingkei Malinda, an African spiritualist, views this trend as the “commodification of life,” suggesting that modern society pressures individuals to prepare for death rather than celebrate life.

In response to the commercialization of funerals, some families are now relying on community-based burial schemes to ensure dignified send-offs.

Elly Mlambo, who lost her father to heart disease last year, remarked that consulting traditional healers was significantly cheaper than hospital bills and medical insurance.

When her father passed, two burial savings groups made contributions to support the funeral, showcasing an innovative approach to community support.

In light of a recent case, Chomdisa Jegede, president of the Jegede Burial Society, noted the need for precautionary funeral plans, as the community’s response to death has evolved towards proactive planning.

However, he underscored that communities shouldn’t only focus on burial but also health insurance needs.

Mr. Solanki reinforced this idea, highlighting the importance of raising awareness about health insurance in a time when healthcare costs are rising.

He encouraged the Zimbabwean diaspora to support health insurance initiatives for their families back home, helping them appreciate its benefits more clearly.