Paper short abstract:

Changes in international development policy in the 1990s characterised by the liberal Structural Adjustment Programmes (SAPs) and the post 2000 Zimbabwean socio-economic crises resulted in a smaller role for the state and a greater role for non-state agencies, including church based NGOs.

Paper long abstract:

This chapter is about the role of mission health institution in Zimbabwe's public health delivery system. It argues that the new millennium marked a high point in the position and function of missionary provided health care since independence. The chapter posits that the re-emergence of mission hospitals in this period was not only de-facto but saw them assume a greater role in healthcare provision than the one they occupied during the colonial era, despite the lack of government appetite to widen their role. Changes in international development policy in the 1990s characterised by the liberal Structural Adjustment Programmes (SAPs) and the post 2000 Zimbabwean socio-economic crises resulted in a smaller role for the state and a greater role for non-state agencies, including church based NGOs. The Zimbabwean state became progressively more reliant on the services provided by these hospitals, as well as by the private sector. This chapter speaks to debates on the Zimbabwean crises and, in particular, enriches our understanding of how, despite all odds, Zimbabwe averted a human catastrophe in the post 2000 period. It refracts on institutional capacity to cope in a debilitating socio-economic environment characterised by budgetary deficits, a crumbling infrastructure, shortages of drugs and the flight of health personnel. Focusing on the operations of mission hospitals, the papers reveals the contemporary role of mission-related Christianity in Africa. In addition, the chapter also reflects on church based NGOs' purchase for policy in health issues as a prism for understanding the Church-State relations during Zimbabwe's turbulent years.