Strengthening the Mental Health System in Zimbabwe: A Scoping Review of Policy and Health System Barriers to Achieving SDG 3

Mental health is crucial for achieving Sustainable Development Goal 3 (SDG 3), yet it remains overlooked in many low- and middle-income countries. In Zimbabwe, the burden of mental disorders is increasing despite the existence of a national health strategy, raising concerns about the readiness of the health system to deliver equitable and effective mental health care. This scoping review synthesises evidence on the policy and health-system barriers influencing progress toward SDG 3 mental health targets in Zimbabwe. Guided by the Health Policy and Systems Analysis (HPSA) framework and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines, 12 peer-reviewed studies published between 2014 and 2025 were reviewed. Data were charted and analysed across key HPSA themes, including governance, financing, workforce, service delivery, and health information systems. The review identified several persistent system-level challenges. Although mental health policy frameworks exist, their implementation is limited by weak accountability mechanisms, insufficient decentralisation, and fragmented leadership. Chronic underfunding, combined with reliance on donor support, undermines the sustainability of services. Shortages and uneven distribution of skilled mental health professionals restrict access to care, particularly in rural areas. Task-sharing initiatives have improved access but remain inadequately supported and are not fully integrated into the health system. In addition, weak mental health information systems limit the use of data for planning and monitoring. Broader challenges, including stigma, urban–rural inequalities, and poor intersectoral coordination, further constrain progress. Progress toward SDG 3 mental health targets in Zimbabwe requires stronger governance and accountability, increased domestic financing, investment in community-based mental health workforces, and better integration of mental health indicators into routine health information systems. Zimbabwe’s experience offers useful lessons for other resource-constrained settings.