To ask the Secretary of State for International Development if he will take steps to facilitate the provision of healthcare free at the point of access in (a) Zimbabwe and (b) Rwanda. (145590)

DFID is committed to helping countries that want to remove charges at the point of delivery. DFID made a commitment in the recent White Paper to help partner governments abolish user fees for basic health services and help them tackle other barriers to access, including discrimination against women.

In Rwanda, the Government and major aid donors are conscious that financial barriers are inhibiting poor people from accessing health services. DFID is therefore working closely with the Government to investigate how DFID aid and technical assistance can best be provided to reduce the level of out-of-pocket expenditures on health services. In particular, DFID is looking at various options to specifically address the needs of the very poor that are most adversely affected by present patient charges.

In Zimbabwe, access to health services is rapidly decreasing as the economy contracts, inflation surpasses 4500 per cent. government capacity to maintain services diminishes and travel for most people becomes harder. User fees are currently charged for most health services other than preventive care to children under five and HIV treatment services. Where commodities have been donated, the Ministry of Health policy is that these should not be sold through fees but passed on for free. We are all aware of the situation in Zimbabwe which prevents a development partnership between DFID and the Zimbabwean government. However, DFID engages whenever the opportunity arises to discuss the adverse effects of user fees. DFID provides technical assistance and financial support for research in order to strengthen the evidence base and support the policy process.

To ask the Secretary of State for International Development what support his Department provided to health systems in (a) Zimbabwe and (b) Rwanda in each of the last five years. (145650)

DFID suspended all development assistance to the Government of Zimbabwe in 2002.

Since then, DFID Zimbabwe has provided over £63 million through NGOs to ensure the poorest people continue to access essential health services. Support has been provided for reduction in preventable deaths (vaccination programmes, malaria prevention); mother and child services (including antenatal care, maternity services, prevention of mother to child transmission and emergency obstetric care); sexual and reproductive health (including family planning services, treatment for STIs); and HIV/AIDS (including prevention and treatment, behaviour change and care for orphans).

The total assistance in each of the past five years was:

In Rwanda the majority of DFID current spending is through budget support. DFID bilateral expenditure on health in Rwanda from 2002-03 to 2006-07 was:

This includes a notional proportion of DFID’s general budget support.