Eric Salwin is a content marketing professional at CWGH, In charge of all digital platforms that help the organization attract visitors, digital advocacy, and conducting digital awareness campaigns. Previously, Eric worked as a customer relationship Technician for a tech startup for more than 5 years. He holds an IT technician specialist certification from University of Zimbabwe.
The Community Working Group on Health (CWGH) has embarked on a project to strengthen
accountability for COVID-19 resources and equitable access to vaccines as the country battles
with the pandemic that has claimed millions of lives across the globe.
The two-year project, Accountable and Transparent COVID-19 Finances and Equitable Access to
Vaccines in Zimbabwe, is meant to stimulate dialogue through advocacy to policy makers,
decision-makers in health and social services and the media to improve accountability for COVID19 and equitable access to vaccines in the country.
Funded by the Nigerian-based Africa Health Budget Network (AHBN), the project emphasizes on
improving health literacy, health financing and financial literacy to enhance appreciation across
all levels that a stronger and more resilient health system is better placed to respond to COVID19 pandemic challenges while ensuring continuity of operations to address other health needs of
the population.
Key issues affecting access to vaccines by communities will be raised and thus generating
evidence on bottlenecks and increase national dialogue with the view to influence policy
implementation for better access to vaccines. The evidence will be used to argue for improved
domestic funding for health in order to reduce health system fragility to better address the
current public health treats while adequately handling the disease burden.
The initiative is tailored to promote community-driven compliance and adherence to
recommended public health and social measures of COVID-19 while holding government
accountable for sustainable response to the pandemic. This involves monitoring disbursements
made to the Ministry of Health and Child Care (MOHCC) ensuring that the allocated resources are
used to respond to COVID-19 and assessing measures put in place to ensure continuity of other
health services mid-pandemic.
The media will be capacitated to play a key role in the implementation of this strategy to inform
the decision makers and communities and advance the desired changes.
Zimbabwe has to date 264,127 confirmed cases, 5672 deaths and a total of 13,491,312 vaccine
doses have been administered. The government has been a major funder of the response to
Covid-19 committing at least USD$100 million for vaccine procurement. However, donors and
partners including the World Health Organization, the World Bank, UNICEF and governments
such as China, the United Kingdom have also contributed significant amounts.
However, the government has failed to convincingly account for use of funds received in
responding to COVID-19. This is the part of the wider health/financial literacy deficiencies that
require urgent addressing if the response is to benefit the intended beneficiaries.
Civil society has been on forefront demanding accountability through the various platforms that
have been made available since the COVID-19 pandemic began.
The Community Working Group on Health (CWGH) is a network of national membership based civil
society and community based organization who aim to collectively enhance community participation in
health in Zimbabwe.
For further information, please contact:
______________________
Itai Rusike (Mr)
Executive Director
Community Working Group on Health (CWGH)
4 O’connor Crescent, Cranborne
Harare, Zimbabwe
Mobile: +263 77236 3991 / 0719363991
Tel: +263-242-573285|573286
Email: itai@cwgh.co.zw
Website: www.cwgh.co.zw
“Health is Your Right and Responsibility”
A RENEWED drive by Community Health Monitors (CHMs) to dispel myths and misconceptions on COVID-19 has gathered momentum with people in rural Matabeleland North warming-up to vaccination against the contagious disease.
Several people who spoke to our correspondent this week in Bubi district, Matabeleland North province expressed their willingness to get the COVID-19 jab. This was after CHMs raised awareness on COVID 19, including assuring them of the safety of vaccines.
Most people in Zimbabwe, especially in rural areas, consider Community Health Workers (CHWs) as dependable sources of health information and their relationship is based on trust.
The country’s vaccination drive, which began in 2020, had been hampered by fear and mistrust associated with COVID-19 vaccines. Such fears were fuelled by rumours, misinformation and disinformation mainly spread via social media.
Chief among the misconceptions are that COVID-19 vaccines reduce sexual drive in men and result in women experiencing irregular menstruations as well as fatalities two years after getting the jab.
“I realised these were all lies,” said 24-year-old Femaline Ndlovu as he got his first jab at Balanda Business Centre in Bubi district, where local CHMs with support from Community Working Group on Health (CWGH) and the Ministry of Health and Child Care (MoHCC) had organised a COVID-19 awareness campaign recently.The renewed community-centred vaccination drive is a brainchild of CWGH in partnership with the government with financial support from USAID.
Under the project, CHMs are trained to collect data (rumours and misconceptions) in their communities using the Kobo collect tool on android phones.
The data is then sent to a central hub where it is analysed and shared with other humanitarian actors. The rumours also inform community initiatives planned by the CHMs in partnership with other CHWs to increase knowledge levels and change attitudes and practices related to COVID-19 and other health issues.
Presently, the project is being implemented in Chiwundura in the Midlands, Masvingo city, Matabeleland North, Bulawayo and Mangwe in Matabeleland South.
Other than the campaigns, the CHMs also facilitate weekly sessions targeting women, youths, people with disabilities using one-on-one discussions, community platforms such as Health centre committees (HCCs) meetings and village assembly meetings and focus group discussions as well as other awareness activities where they utilise quiz competitions, drama, songs and dance.“The aim of the sessions is to respond to rumours and misinformation on COVID-19 by sharing quality information using our COVID-19 toolkit and IEC material to answer any questions from the community,” said Senzeni Nduna, a CHM from Ndovi village in Bibi district in Matabeleland North province.
Another CHM, Sifelani Tshabalala of ward 13 in Battlefields in Bubi said misinformation about COVID-19 is a serious threat to the government’s vaccination programme.
“Some men here say they cannot get vaccinated because they will not be able to satisfy their wives in bed,” she said. “This fear was so strong and it took a lot of great effort to convince them otherwise.”
Religious beliefs have also slowed down the COVID-19 vaccination uptake as some religious objectors do not allow their followers to get vaccinated against any disease. It is therefore prudent to target religious leaders as they have a strong impact on their respective groups.
“People are beginning to believe us. The fact that there are people who were vaccinated two years ago and are still healthy is a plus to us… they are living testimonies,” said Tshabalala, who takes every opportunity to talk about health
issues affecting the community even at funeral gatherings.The CHMs use an informative tool kit on COVID-19 prevention strategies adapted from the World Health Organisation (WHO) and MoHCC information packs. This has been translated into four languages; Shona, English, Kalanga and IsiNdebele to enable ease of understanding and ensure wider reach.
CWGH executive director, Itai Rusike emphasised the importance of monitoring COVID-19 rumours as it informs warning of possible disasters.
“The rumours should be investigated and only discarded when deemed as unimportant,” he said. “We need to define the rumours and fears but also for detecting public health emergencies.”
Because of fears that were associated with the vaccines, Zimbabwe failed to vaccinate at least 60% of the 10 million target population by 2021. Between January 2020 and March this year, Zimbabwe recorded 264 555 cases of COVID-19 with 5 681 deaths, according to WHO.
#CWGHinCOmmunites – Kicking Covid-19 rumours away – 3 local soccer teams provided entertainment during a CWGH Covid-19 awareness campaign at Balanda Centre in IN Bubi Matabeleland North province under the Rooted in Trust project supported by USAID through Internews
Time for Action: “Health for All” slogan must not be mirage
The Community Working Group on Health (CWGH) today joins the rest of the world in
commemorating this year’s World Health Day (WHD) calling on the government to ensure that health services are available, accessible and affordable to all citizens in the country. This year’s theme, “Health for All” resonates well with the growing global call for Universal Health Coverage (UHC), which seeks to ensure that people have access to the health care they need without suffering financial hardships. The country’s health sector has been facing numerous other challenges. The health sector was already facing deep structural challenges, even before COVID-19, and the pandemic worsened or only exposed those challenges. The sector has suffered from years of gross under funding and investments, with public health spending accounting for a relatively small proportion of total
government spending. The inadequate public financing of health has resulted in a poorly run, poorly performing health system with an over-reliance on out-of-pocket and external financing which is highly unsustainable and inconsistent with achieving UHC. For UHC and the empowered upper middle income economy goals to be realized, a lot more needs to be done to ensure domestic resources are identified and ring fenced for health. The prevailing macroeconomic situation has impacted negatively on the health sector in a variety of ways; especially in reduced access to health care services by the general population in both the public and private sectors. The closures of clinics and some hospitals, downsizing and redirecting of services as a control measure during the prolonged lock downs, and even in the aftermath of the movement restrictions did not result in resumption of services to pre-pandemic levels. Instead there has been downsizing of health care services at district, provincial and central hospitals and the results have been telling in the high levels of institutional and community deaths. Cemeteries are full and some have been extended, while in the rural areas the major get together are all around sickness and deaths, i.e. funerals, memorials and tombstone unveiling due to high numbers of deaths. Zimbabwe suffers from inadequate public infrastructure and ill-equipped hospitals. A number of patients have to travel inordinately long distances to access primary and other level health care facilities, which often have no basic temperature, blood sugar or blood pressure monitoring nor
medicines. Despite the “free healthcare” policy, most of the times the selected vulnerable groups still buy their own medication due to non-availability in both rural and urban public health facilities.This necessitates further travel to access pharmacies and laboratories at the districts or towns,thus impacting negatively on the access and placing hardship on those with limited or no means to travel further. Emergency medical services in Zimbabwe remain relatively under-developed and under resourced. The majority of the country’s 57 districts have just 2 or less ambulances serving the 20-50 clinics per district, thereby leaving the burden of transporting the sick to the communities,who have to contend with unreliable, unsuitable and unsustainable alternative transport. The situation is worse in most of the resettlement areas where communities still walk long distances to access the nearest health center. Meanwhile the country is experiencing rising incidence and burden of non-communicable diseases and conditions. Rapid, unplanned, unregulated urbanisation and changes in lifestyle as people migrate from rural to urban areas are causing an increase in the risk factors that cause non communicable diseases (NCDs) and conditions such as injuries, disability and substance abuse. For instance, the prevalence of hypertension is estimated at about 30%of the total population, which is higher than HIV, tuberculosis and diabetes, while the country has among the highest rates of traffic crashes, (RTAs) given the relatively small vehicular population. Addressing the burden of non-communicable disease constitutes an integral part of achieving SDG3, “Good Health and Well-Being”. The target set out in SDG 3 is to reduce premature mortality from non-communicable diseases, through prevention and treatment, by one-third by 2030. The country also suffers a high burden of cancer with the cervical cancer burden being within the top 5 highest in the world. Treatment costs for all cancers remain very high, inconsistent and not affordable for most people. The Community Working Group on Health (CWGH) is a network of national membership based civil
society and community based organisations who aim to collectively enhance community participationinhealth in Zimbabwe.
The persisting and recurrent outbreaks of cholera gives a poor reflection of the health and development status of the country.
Water and sanitation are essential for good health outcomes and sustainable development.
Inadequate access to water and sanitation infrastructure is a major source of health challenges and disease outbreaks such as cholera.
Poor and Inadequate water and sanitation is a leading cause of poverty, morbidity and mortality in a number of countries, while providing water and sanitation in schools is key to keeping girls and children in school.
The reduced availability of safe drinking water impacts negatively particularly on girls as they are forced to walk long distances to fetch water in some cases from unprotected sources often affecting their ability to go to school.
A cholera outbreak in late 2008 reflected this decline in living conditions and affected around 100,000 people.
Interruption of water supplies, overcrowding of sanitation facilities and difficulties with urban waterborne sanitation during periods of water cuts means that urban households are very vulnerable to unhealthy environments.
Urban Local Authorities are currently facing a range of problems that are limiting the daily supply of water such as the shortages of water chemicals as household rates are currently being charged in local currency whilst payment of water chemicals to suppliers is done in US Dollars.
The aging and unrepaired sewer systems; waste put in sewers due to poor waste collection; illegal waste dumps; overflowing septic tanks; and frequent water and power cuts.
Most sewerage reticulation systems and treatment works are in a state of disrepair, raising the risk of diarrhoeal diseases including cholera.
I hope this will assist
Itai Rusike, Executive Director, Community Working Group on Health (CWGH)
THE year 2022 was eventful in the health sector, where outbreaks of diseases considered medieval such as measles and polio overtook the two-year global pandemic, COVID-19, in terms of deaths in a short space of time.
The country also witnessed a reduction in maternal deaths, and introduction of the eye strategy in the wake of increased eye conditions, mainly catalysed by diabetes.
Below are some highlights of the health sector in 2022.
COVID-19
The year 2022 started off on a positive note as COVID-19 cases had dropped compared to the same period the previous year, where fatalities of the dreaded pandemic increased in the blink of an eye, with many deaths recorded from the onset of the pandemic.
As such, the year was quite stable regarding COVID-19 with cases fluctuating, but with decreased deaths.
Government, as of Wednesday June 22, 2022 scrapped the night curfew. Opening hours for shops, bars and restaurants were extended.
Masks were also scrapped during the course of the year for fully vaccinated individuals in outdoor settings. However, for indoors, they remained mandatory.
The lifting of the curfew and wearing of masks was for the first time since the onset of the pandemic in 2020, although the curfew had many variations depending on the magnitude of crisis over the two-year period.
However, towards year-end in December, cases of COVID-19 began to soar in the country.
During the final post-Cabinet briefing for 2022, Information, Publicity and Broadcasting Services minister Monica Mutsvangwa said over 200 new cases and six COVID-19-related deaths were recorded in the country in the previous week.
Government said it was on high alert and would increase testing and screening at ports of entry after reports that China had been hit again by a COVID-19 outbreak.
Measles
Four months into 2022, another health crisis emerged, this time originating from Mutasa district in Manicaland province, an area largely dominated by apostolic sect members.
Measles, a medieval disease whose return on April 10, 2022, raised questions over the country’s health security, was at the centre of the crisis.
The disease, that was considered long forgotten, re-emerged in the country, with a rapid and fatal spread.
It overtook COVID-19 in terms of fatalities, which were way above in comparison with the period of inception.
By September 2022, more than 750 children had died of measles, prompting authorities to hastily put a plan in action, which entailed introducing a measles vaccination programme that began in September.
This was after more than 2 000 people, including adults, had been affected by measles as of August 17, 2022.
By August, measles had claimed the lives of 157 children, all of them were not immunised against the disease.
During the immunisation programme, government mainly targeted apostolic sects, especially in the Mutasa area, where they dominate, encouraging them to warm up to vaccination, which they eventually did.
In October 2022, according to Manicaland provincial medical director Munyaradzi Mukuzunga, the province recorded zero measles cases.
There was a generally low incidence of measles for the same period countrywide.
Polio
In October, the country launched a polio vaccination campaign to guard against the disease that had been detected in neighbouring Mozambique, although no case has been reported locally to date.
A follow-up vaccination exercise was done from December 1 to 4 this year as the country sought to intensify immunity from the disease.
Diabetes
Cases of diabetes were on the rise during 2022, mainly Type 2.
Health and Child Care deputy minister John Mangwiro said: “General statistics show an increase because there is massive rural-to-urban migration. Westernisation of diets is also contributing to the increase. There is need to have a lot of awareness and campaigns and more stories about diabetes. There is need to encourage people to get tested and know how to deal with the condition.”
HIV and Aids
For 2022, the major highlight was the country winning the bid to host the International Conference on Aids and STIs in Africa to be held in December next year.
After winning the bid, National Aids Council chief executive officer Bernard Madzima said: “Winning the bid was a big step in the positive direction as we have been recognised in Africa as a leader in terms of the HIV programme. Our country also recorded successes as per the global HIV report, which says we achieved the 2025 targets of 95-95-95 midway through the projected time. We are very proud of that as a country. We are also happy that we managed to curtail and to incorporate issues of COVID-19 in HIV programming, thereby averting the anticipated increase in deaths due to the comorbidity of HIV with COVID-19.”
The other good thing that happened in 2022 was the Global Fund replenishment.
President Emmerson Mnangagwa pledged US$1 million funding for the Global Fund 2024-26.
“We have contributed to the Global Fund as a country and we are proud of that,” Mnangagwa said.
Overview of the health sector
Health expert Josephat Chiripanyanga said: “In 2022, our health delivery system generally improved. We look back to 2020 and 2021 and see the challenges that we had from the devastating COVID-19 pandemic. It was difficult for us to achieve some of the goals that we had in terms of achieving the Sustainable Development Goals for 2030 because most of the resources were being channelled towards COVID-19.”
He said with COVID-19 milestones having been achieved, there was now need to look after the elderly and chronic patients.
“Treatment has improved significantly and access to health facilities has improved. Generally, the health of our people has improved. In 2021, we had a significant number of neonatal and under five deaths which got to about 5 000 for the whole year, which was very high. We hope this year the figures will be lower than that because there has been an increase in access to health.”
Community Working Group on Health executive director Itai Rusike said: “Zimbabwe is currently grappling with a massive health worker exodus due to low remuneration and poor working conditions in the hospitals, among other health system challenges.
“The once well performing and envied health system is visibly failing to serve the needs of the citizens, as evidenced by closure of clinics and significant reduction in services offered at hospitals across the levels.
“Some central hospitals’ statistics now resemble district or lower-level facilities at a time when the need for health services has increased due to huge disease burden and population increase.”
Rusike said Zimbabwe’s health sector continued to be in the doldrums due to a plethora of challenges.
“The country’s health financing has consistently been well below the 15% proportionate funding from the fiscus since the Abuja Declaration of 2001. Regular power outages at health institutions have added to the disruptions in the few available health services, while at ports of entry there is scanty information available on public spaces about the disease profiles in the districts, provinces and the nation at large,” he said.
“There are continuous health worker strikes that impede access to health as people are not attended to when they seek health services at healthcare centres during strikes. Add to that, the institutions do not have adequate medicines due to inadequate supplies and pilferages as the poorly paid healthcare workers try to make a living within the workspace.
“The weakened and overburdened health system has benefited from the government wide response to COVID-19, but its frailty amidst the huge global challenge after COVID-19 emerged has proved a tough test to nation’s health security agenda.”
MATERNAL and neonatal mortality remains a health concern in Zimbabwe, Community Working Group on Health (CWGH) has said.
CWGH director Itai Rusike told NewsDay Weekender that the country remains off target towards meeting the 2030 United Nations (UN) goals to reduce maternal and neonatal mortality.
“Despite the high coverage of births by a skilled attendant and institutions delivery, maternal mortality remains high at 462/100 000 live births,” Rusike said.
“In addition, the high HIV rates among pregnant women at 14,3% increases the risk of mother-to-child transmission of HIV. Furthermore, neonatal mortality has remained stagnant for the past decade at 321/1 000 live births and under five mortality remains high at 65/1 000 live births.
“Likewise, besides being a priority, preventing the death of newborn babies remains a challenge and the country is off track to meet the Sustainable Development Goal (SDG) target by 2030, that every country should have a neonatal mortality rate of 12 or fewer deaths per 1 000 live births.”
Maternal mortality in Zimbabwe is 363 per 100 000 live births, according to the preliminary results of the 2022 housing and population census.
According to Rusike, while this is an improvement from the 614/100 000 live births for maternal deaths recorded in 2014, the slow rate of improvement indicates that Zimbabwe is unlikely to meet the SDG target for reducing maternal mortality.
Complications during pregnancy and childbirth are leading causes of death and disability among women of reproductive age.
“Most of these deaths are caused by a handful of conditions, from which death is largely preventable. Almost 95 % of our maternal and perinatal death cases are deemed to be avoidable,” Rusike said.
“This speaks to the issue of the quality of care at the point of care in our hospitals. This also highlights the importance of investigating the state of healthcare institutions with the view to devise probable interventions to improve quality of care.”
The Private Voluntary Organisations (PVOs) Amendment Bill, which has been criticized by opposition parties and civic groups for muzzling government critics and narrowing democratic space, has gone a step closer to becoming law after sailing through the Senate. It now awaits Presidential accent to become law.Opposition legislators and human rights activists want the controversial Bill canned amid fears that if passed into law in its current state will further shrink the country’s democratic space and lead to closure of several NGOs perceived as anti-government.However, in supporting the Bill, Zanu PF legislators described the Bill as a necessary tool to whip ‘rogue’ NGOs and CSOs into line.
#CWGHinCommunities– Community Monitors in Chiwundura and Masvingo receive training on the use of Kobocollect Application to collect data, analyse, engage & respond to rumours & misinformation on COVID-1,
