Author: clarency

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Increase funding to health for attainment of Universal Health Coverage

Increase funding to health for attainment of Universal Health Coverage

Government must allocate more funding to the health sector in the 2017 National Budget to ensure that the country achieves universal health coverage (UHC) that continues to elude the majority of Zimbabweans.
For years, inadequate funding for health care has meant that the country has been unable to realise its full potential for providing sufficient and quality services to people. With increased funding to health, Zimbabwe would be able to deal with the current disease burden, address human resources shortages, access to medicines and build more facilities to reduce the distance patients travel to seek health services.
The country needs to progressively move towards meeting the Abuja target of not only allocating 15 percent of the National Budget to health, but actually spending that allocated amount on the sector. It has been noted that in the past years, the Government would allocate funds to health, but would disburse much less to the sector to make any meaningful impact.
Fifteen years after African governments committed themselves to the Abuja Declaration in 2001, only six countries have been able to meet the target. These are Liberia, Madagascar, Malawi, Rwanda Togo and Zambia.
Rwanda, which was involved in a devastating civil war for several years, already spends at least 23,7 percent of its national budget on health care, a percentage that is three times more than what Zimbabwe allocated to healthcare in 2015.
Presently the Zimbabwe Government, which relies heavily on donor funding, has cited a shrinking fiscal space for failing to meet the Abuja target. It is therefore advisable for the country to seek innovative domestic ways of funding the health sector as relying on foreign funds is a national security risk should the donors withdraw support for any reason.
With a narrow revenue generation base, the Government must consider the introduction of “sin taxes” on commodities such as tobacco and alcohol not only as measure of raising funds, but a way of reducing the consumption of harmful products.
It should be emphasised that reaching Sustainable Development Goals (SDGs) requires a sustained momentum in funding the country’s health care system. The current resources nexus shows that the tertiary and central level health facilities attract more funding than the lower levels as a result of the intensity of their services.
While there has been some improvement in Maternal, Neonatal and Child Health (MNCH) indicators, infant, U5s and maternal rates remain a cause of concern as the current rates are too high compared to regional rates. The Government is far from achieving its target of 326 deaths per 100 000 live births by 2020 although maternal mortality declined from 960 live births in 2010 to 651 in 2015.
It should also be noted that poorer households continue to endure disproportionate losses in infant, child and mortality as compared to the richer households so more funding should go towards primary level care.
The current ratio of over 70 percent funding for curative services and less than 10 percent funding for preventive services will not see the country moving towards reducing further the rates of maternal and child mortality.
Lower levels of care handle more patients than the tertiary and central level facilities and it is therefore prudent that a significantly larger share of the budget should go to the district level. The idea of building district hospitals in areas such as Harare, Bulawayo, Wedza and other parts of the country to alleviate the burden of patients at the central level remains a critical requirement. This must be supported by increasing or reviving health grants to urban councils to lower their user fee charges to more affordable levels.
A huge number of patients in the country are still enduring unbearable long distances to access primary health care facilities. The Government therefore needs to increase funding for outreach services so that communities in remote areas and newly resettled areas can also have access to care.
It is also important to resuscitate community support structures such as ward health teams and ward development committees as well as remunerating community health workers well especially village health workers.
There is evidence which shows that socio-economic and geographic inequalities and inequities are hampering access to health services especially for non-communicable diseases (NCDs) such as cancer services.
The State should come up with a clear position on treatment of NCDs. It is important that the State decentralises services and subsidises their treatment costs to lessen the burden on the poor who are the majority.
The creation of a national health insurance (NHI), a process which started in 1991, remains a noble idea but it would be more appropriate if the management of this body is given to the National Aids Council (NAC) given their experience in managing the Aids Levy.
However, there is still need for more inclusive consultations with stakeholders to come up with a comprehensive Bill. Health insurance is currently dominated by a well-established but poorly regulated private sector, serving only 10 percent of the country’s population and is under threat due to increased job losses.
The cost of blood products has become expensive and inaccessible to many. A bottleneck analysis that was carried out by the MoHCC shows that 60 percent of secondary facilities were found to have no blood in their stocks.
Some facilities could not stock blood because of unavailability of fridges, electricity and general poor infrastructure. There is therefore need for the Government to consider other alternatives such as solar refrigerators for storing blood products.
Surveys on human resources and infrastructure have identified huge gaps in terms of human resources and health care technology availability. There is therefore a need to move towards ensuring that agreed normal levels and types of human resources are available and financed at the district level as well as ensure that the minimum healthcare technology is found at the district level.
For example, only 47 percent of facilities in the whole country have TB diagnostic testing equipment while 44 percent of facilities have functional glucometers and strips for diabetes testing and screening.
It is also important to review the staff establishment to reflect the current environment. Zimbabwe is still using a staff establishment of 1983 when the country’s population was 7.5 million but that has since doubled and the disease burden has also increased.
Therefore, there is urgent need to review the staff establishment in order to reduce work overload and burnout health workers.
With the current staffing scenario, the Ministry of Health and Child Care must be exempted from the proposed staff rationalisation which is being spearheaded by the Ministry of Finance and Economic Development to reduce the Government’s unsustainable wage bill.
The health ministry is understaffed and desperately needing to fill in critical staff posts for it to enable to provide basic health care services. For example, 23 percent of all provincial and central hospitals do not have a dentist, most district hospitals do not have four doctors as required in the current establishment system while some are manned by pharmacy technicians instead of degreed pharmacists.
Itai Rusike is the Executive Director of Community Working Group on Health.

September 27, 2016 Features, Opinion & Analysis
Itai Rusike Correspondent
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Health experts warn over SDG targets achievement failure

Health experts warn over SDG targets achievement failure

September 26, 2016

HEALTH experts have warned that Zimbabwe might fail to achieve its health sustainable development goal (SDG) targets as long as funding for the health sector remains below 15% of the national budget.

by VENERANDA LANGA

Itai Rusike, executive director of Community Working Group on Health (CWGH), said there was need to increase the health sector budget next year to deal with the disease burden, access to health facilities by all, address health sector human resource challenges, and deal with the issue of access to medicines by all.
In the 2016 National Budget, Finance minister Patrick Chinamasa allocated only $370,79 million to the Ministry of Health and Child Care, representing 8,3% of the total budget, a far cry from the 15% allocation recommended by the Abuja Declaration on Health.
“Given the current fiscal constraints, government should prioritise and focus on cost-effective health programmes and interventions,” Rusike said.
“Reaching the SDG targets requires a sustained momentum in financing our health care systems, and while progress has been made in improving our health indicators, there is need to sustain the momentum in funding of health care systems.”
Employment costs in the Health ministry were said to be consuming the bulk of its budgetary allocation, leaving little funds for operational costs and capital projects. The result was said to be over-reliance on donors to fund different health programmes such as HIV and Aids, maternal and child health.
“External funding has, somehow, become fungible and has, in most cases, replaced government funding instead of complementing it,” Rusike said.
According to a Unicef 2016 health and child care budget brief, off budget support to the Health ministry by development partners was projected to be approximately $400m, an amount which even exceeded government’s national budget allocation to health.
Most of the donor dependence in the health sector was said to be on medicines.
CWGH expressed disappointment over maladministration at some hospitals, where, in the past, the Auditor-General’s reports indicated expiry of medicines at some health centres, while some hospitals experienced shortages.
“NatPharm should be capacitated so that it can be able to provide regular, affordable and timely supply of essential drugs.”
CWGH also suggested medicinal support should be extended to the elderly and vulnerable groups suffering from chronic illnesses such as diabetes and hypertension as they cannot afford buying medicines that were usually available only at pharmacies.

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Myriad of problems compound Harare Central Hospital’s woes

OPPOSITION parties and health stakeholders have reacted angrily to the deteriorating standards of healthcare in the country, with some calling for a complete overhaul of the entire ministry presiding over the decay.

BY PHYLLIS MBANJE
a-nurse-seen-vaccinating-a-child-to-prevent-rubella-measles

Harare Central Hospital relies on on revenue from paying patients, but 40% of patients constitute the elderly and toddlers who are treated for free

The health crisis in Zimbabwe is deepening and taking on a frightening plunge, with shocking reports that the country’s largest referral hospital, Harare Central, has run out of critical and basic drugs.

So serious is the situation that last weekend, the hospital had to shut down most surgeries except in cases of emergency and those involving maternal cases.

 

But this is not the first time that the hospital, built in 1941 and catering for more than 1 500 deliveries and handling 6 000 causalities per month, has raised the red flag.

The hospital is now struggling to offer quality services. The leaking roofs, peeling floors and cracked walls that become a breeding ground of agents that cause infections, are exposing hundreds of patients to more diseases.

This week, there was outrage over the suspension of surgeries at the hospital, which handles over 60% of all referrals countrywide.

Harare Central Hospital, which is literally falling to pieces with massive leakages from pipes within the walls, is in a dire position.

“This (suspension) is a symptom of a Zanu PF government that is overstretched, unaccountable and overwhelmingly failing the suffering citizens of Zimbabwe,” MDC spokesperson, Kurauone Chihwayi said.

The party further emphasised that the suspension of surgeries at the hospital, due to lack of drugs, is a reflection of the sorry state of public hospitals countrywide and a glaring consequence of the misplaced priorities of government.

“We view this latest disaster as a death sentence to citizens desperately in need of medical attention, who unlike the First Family and Zanu PF chefs, cannot afford the privilege of seeking treatment in Singapore, India, South Africa or private hospitals locally,” Chihwayi said.

MDC accused the government of sustaining “President Robert Mugabe’s merry-go-round trips around the world, which gobble up millions of dollars” while the health sector literally shuts down.

“It is clear that government’s only concern now is Mugabe’s happiness and not the well-being of its suffering millions,” Chihwayi said.

The People’s Democratic Party (PDP) secretary for health and child welfare, Sibongile Mgijima, said the deplorable state of public healthcare in Zimbabwe shows how the government has abandoned its priorities.

“Public healthcare is now in the intensive care unit due to serious shortages of basic medical services and medicine such as aspirin and antibiotics,” she said.

Two years ago, during a tour of the hospital, Harare Hospital’s chief executive officer, Peggy Zvavamwe admitted that the situation was dire, with quotations to repair a single ward requiring over $30 000.

“Our financial situation is dire and if we do not get relief soon, the quality of services will be compromised,” she said.

The hospital’s clinical director, George Vera, who was part of the tour, however, said their precarious situation was compounded by the fact that 40% of their patients were those over 65 years and the under-fives, who do not pay for services rendered.

Since then, nothing much has changed and the situation is now critical.

“We rely mostly on revenue from paying patients, but our situation is that 40% constitute the elderly and the under-five, whom we treat for free,” he said. “The referral system does not exist, we now receive people from everywhere and these are coming to die here.”

Health and Child Care minister David Parirenyatwa recently urged Zimbabwe to swallow its pride, in the face of dwindling resources for the public health delivery system and engage donors, among them the United States, in order to mobilise funds for the sector.

Parirenyatwa said, although the government had reversed the near collapse of public health delivery system, the country had not yet met its set goals and targets.

Community Working Group on Health (CWGH) director, Itai Rusike said, for poor Zimbabweans, public health investments have an impact in reducing household spending through provision of accessible, equitable and affordable disease prevention, health care and consequent reduction in losses of time and costs of consumption due to ill health.

“There is need to progressively move towards meeting the Abuja target of not only allocating 15% of the national budget to health, but actual spending of 15% of all government expenditures,” he said.

In a position paper on budget allocations for the health sector, CWGH said domestic funding remained skewed towards employment costs leaving little funds for operations costs, and capital programmes.

“As a solution, there should be a shift to performance based financing and needs based budgeting system, which will likely result in the narrowing of the gaps between the have and the have-nots,” Rusike said.

Close to 90% of hospitals and clinics in the country are operating without essential medicines in stock, while 80% of the posts for midwives remain vacant in the public sector, and over 3 000 nurses do not have jobs.

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Curse of living with disability

Curse of living with disability

HARARE - Shunned because of the physical deformities they were either born with or acquired later in life, people with disabilities are often forgotten and ridiculed.
Loreen Chikoto was born with dwarfism, a genetic defect that makes her smaller than the average person.
When she started dating, people found it odd and when she got pregnant the comments and taunts were even worse.
“Often, I would hear people saying ‘ndiani akashinga kurara nekamunhu aka, haanzwewo tsitsi here? (who was courageous enough to sleep with such a person, do they not have any mercy for her?). Unbeknown to them is that I am married and was simply doing what most married people do,” she said.
According to Section 22 of the Constitution, the State, all institutions and government agencies must recognise the rights of persons with disabilities and must afford them the respect and dignity they deserve.
Section 83 also mandates the State to ensure that people with disabilities realise their full mental and physical potential through provision of State funded education, access to medical treatment and protection from abuse.
In September 2013, Zimbabwe ratified the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD).
Among some of the provisions of the Convention is the right to access justice, freedom from exploitation violence and abuse and protecting the integrity of the person.
Recently, government through the ministries of Social Welfare, Justice, and Women Affairs held consultations to align the Disabled Persons Act to the Constitution.
The exercise was aimed at mainstreaming disability issues as an integral part of the relevant strategies of sustainable development.
During the outreach programmes, some of the persons with disabilities complained that they are judged when seeking medical treatment for sexually transmitted diseases(STIs).
They said they are frowned upon and asked how they contracted the STIs when they visit clinics or hospitals.
Others explained how children with disabilities are deprived of education and often end up dropping out of school.
“Some parents with physically challenged children hide them from society, deprive them of education and infringe on their rights to associate with others,” said one woman.
Senator Anna Shiri told the Daily News on Sunday that there was a serious need for extensive advocacy on the rights and needs of people with disabilities.
She said very few people know how to handle or approach people with disabilities, prompting society to shun or ignore them in key decision areas.
Shiri said issues to do with people with disabilities are no longer a welfare issue but a human rights concern as such people do not require handouts anymore but need to be economically empowered to take care of themselves.
The senator said employment issues are very important as people with disabilities are not seriously considered for employment regardless of their qualifications.
“There is very little awareness on issues concerning people with disabilities. People think they will be a burden when they employ them despite being able to perform the tasks. In Senate, there are only two people representing people living with disabilities while in the Lower House there is none.
“People with disabilities find it very hard to get jobs because of the attitude society has,” she said.
Shiri added that people with disabilities often face the challenge of being wrongly diagnosed because of poor communication between the patient and doctor or nurse.
She said there are no information pamphlets in braille which can be used by the visually impaired or sign language interpretation often leaving these people in the dark on health related matters.
“Many public facilities are not friendly to people living with disabilities. Hospitals, schools and even churches are not accessible to people with disabilities.
“Toilets meant for these people are not one size fits all. Just because it can fit a wheelchair does not mean it was done properly.
“Different disabilities require different adjustments hence the need for specialist architects to build proper structures that can accommodate all.”
“There is need to mainstream disabilities because the Sustainable Development Goals clearly state that no one should be left behind.
“All developmental concerns should include people with disabilities. In 2015, only one disabled person in the whole country benefitted from the revolving loan fund and that is deplorable,” she said.
Shiri said people with disabilities are being abused everyday but their cases are not reported because society does not respect them as human beings.
She said people with disabilities should be self-represented and not have others assume what challenges they face.
The senator, representing people living with disabilities, said only if the UNCRPD is domesticated will the rights of persons with disabilities be upheld and respected.
“The entire legal process is traumatising to a person with a disability. For example, reporting a case can be a task for someone using sign language because a police officer does not understand sign language and when it finally goes to court, interpreters are not readily available,” Shiri said.
She said the National Disability Board members were not part of the government consultation process making it flawed.
Executive director for Community Working Group Itai Rusike said it is unfortunate that people living with disabilities still continue to experience shame, stigma and discrimination.
Rusike said as people living with disabilities constitute 10 percent of the population, the resource allocation to the sector does not reflect their growing need to be fully supported.
He added that people with disabilities are also sexual beings like able bodied people and must have access to information and resources to make informed choices on their sexual and reproductive health.
“The Sexual and Reproductive Health Rights (SRHR) of persons with disabilities are often overlooked by the communities and service providers yet they have the same needs for SRHR services as everyone else.”
“People with disabilities actually have greater needs for SRHR education and care due to their vulnerability to abuse, yet the country has not done enough to popularise and translate policy documents including IEC materials into the relevant materials understood by people living with various forms of disabilities,” he said.
Rusike also said the training curriculum for health personnel needs to have a human rights approach for people living with disabilities and must also include basic training in sign language, braille and provision of disability-friendly facilities in all our health centres.

Helen Kadirire • 18 September 2016
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Towards community centred health care

June 5, 2014 Musah Gwaunza

Health Centre Committees are a mechanism through which community participation can be effectively integrated to achieve a sustainable people-centred health system at the primary care level. In recent years there has been a shift from centralised management of government structures towards more devolved models that have seen community members being empowered to contribute to the development of their communities.

More recently, the community share ownership schemes have seen community members being active in decision-making in
line with resource allocation on development issues that affect them.

Although more still needs to be done, the trend has also shifted in development partners that have over the years been dictating projects in communities, without being sensitive to community needs and priorities.

One such community empowerment initiative is the Health Centre Committee (HCCs) introduced by Government to ensure that health facilities are sensitive to the needs of communities, including contribution by community members themselves to management of these facilities at primary level.

The Primary Health Care (PHC) provides the first point of contact between the community, village health workers and the
formal health delivery system, hence becoming the most important level in the health delivery system in any country.

Zimbabwe’s National Health Policy commits the Government to ensure that communities are empowered to take responsibility for their own health and well-being, and to participate actively in the management of their local health services.

The PHC approach that was adopted by the Government in 1980 seeks to build and depends on high level of ownership and
participation by the affected communities. HCCs are a mechanism through which community participation can be effectively integrated to achieve a sustainable people-centred health system at the primary care level.

They complement vital community level initiatives like community health workers, and mechanisms for public participation at all levels of the health system.

In Zimbabwe, HCCs were originally proposed by the
Ministry of Health and Child Welfare in the early 1980s to assist
communities to identify their priority health problems, plan how to
raise their own resources, organise and manage community contributions,
and tap available resources for community development.

The
Community Working Group on Health defines a Health Centre Committee as a
joint community–community health service structure at the primary care
level of the system covering the catchment area of that primary care
facility (usually a clinic). It usually covers a ward, but may be more
or less than a ward and constituting 11-15 people.

Although ward
health teams exist at local government level in both urban and rural
areas, the health centre committee exists to provide for participation
in the functioning of the health centre and the PHC activities in its
catchment area, clarifies the Community Working Group on Health.

Mr
Itai Rusike, Community Working Group on Health director, indicated that
about 80 percent of health centres in the country have constituted HCCs
although many only exist on paper.

He said: “Despite setting their roles and functions as early as the 1980s,
HCCs still do not yet have a statutory instrument that specifically
governs their roles and functions.

This is a gap in the formal
provisions on how communities should organise on health and PHC at
primary care (health centre) level. While PHC is not only an issue for
the health sector, and is thus taken up by more general local government
structures, it is necessary that mechanisms exist within the health
sector to align the health system to PHC and community issues, as well
as to link and give leadership input to these more general structures.”

The
Ministry of Health and Child Care 2009-2013 National Health Strategy
that has now been extended to 2015 recognised this gap and made specific
note of the importance of establishing health centre committees within
the health system.

The strategy identifies that “ . . . during the
next three years, communities, through health centre committees or
community health councils, will be actively involved in the
identification of health needs, setting priorities and managing and
mobilising local resources for health.”

In 2013, according to the
Community Working Group on Health, Health Centre Committees in two
districts in Mashonaland East province collaborated with village health
workers to mobilize expectant mothers to deliver at health facilities
nearest to them, contributing to improving maternal and neonatal
survival.

Other areas where the HCCs have made a difference in
health delivery in their committees include Chikwaka community in
Goromonzi district.

According to Mr Rusike, the HCC in this
community has from 2012 until today taken the lead in mobilizing
financial and material resources – bricks, quarry, river, pit sand and
labour – to construct a maternity waiting home at a primary care
facility in their ward. The developments in these and many other
communities are crystal clear examples of how HCCs are able to organise,
identify local health problems, tap into their own available resources
and take action for community development.

Apart from improved
service delivery, a 2012 Community Working Group on Health assessment on
PHC found HCCs being associated with higher levels of satisfaction with
services, attributed to the communication, improved understanding and
support for morale that they build between communities and health
workers.

“HCCs ensure the proper planning and implementation of
primary health care in coordinated efforts with other relevant sectors.
In doing this, they promote health as an indispensable contribution to
the improvement of the quality of life of every individual, family and
community as part of overall socio-economic development,” indicated the
Community Working Group on Health.

The Community Working Group on
Health has been working with the Ministry of Health to develop and
promote the adoption of training and guidelines for HCCs. The recently
enacted constitution now includes the right to health, which gives
greater leeway to push for legal recognition of HCCs.

While
community participation demands much more than HCCs, institutionalising
and giving a formal mandate to HCCs is critical and key to achieving a
sustainable people-centred health system in Zimbabwe.

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‘Health centre shortage affects reproductive health’

Pregnant women walk to a health centre in this file photo

‘Health centre shortage affects reproductive health’

June 12, 2015 Shingirai Huni Local News

Gender Reporter
Long distances to health centres continue to be a major impediment to the full enjoyment of Sexual and Reproductive Health Rights by communities in Matabeleland and Midlands provinces.
This was raised by participants at a workshop organised by the Community Working Group on Health (CWGH) in conjunction with Oxfam.
The two-day workshop which was held in Bulawayo recently, was meant to strengthen the capacity of the organisation’s partners in their response to sexual and reproductive health rights issues in communities in which they operate.
Representatives from different HIV/Aids grassroots based organisations and local authorities in Midlands and Matabeleland attended the workshop.
Some of the organisations represented at the workshop include, the Umzingwane Aids Network (UAN), Midlands Aids Caring Organisation (MACO), Hope for a Child in Christ and Youth for Today and Tomorrow (YTT).
“Failure to access sexual and reproductive health services facilities and archaic traditional practices, are some of the major barriers affecting the attainment of sexual and reproductive health rights in our communities.
“In most instances, people in Matabeleland and Midlands regions endure gruelling long distances travelling to health centres” said Nonjabulo Mahlangu (CWGH) Project Team Leader.
Mahlangu said what also clearly emerged from the workshop was that communities lack important information and knowledge on sexual and reproductive health issues.
“There’s clearly limited knowledge among communities on sexual and reproductive health issues. There’s a need to engage all stakeholders including Parliament to raise awareness on the issue” she said.
Mahlangu said her organisation will in future sponsor representatives of the organisations to meet MPs in Harare to discuss challenges they were facing.
She also encouraged the organisations to work closely with the government and local authorities in their programmes.
Most participants at the workshop also bemoaned the shortage of HIV viral load testing machines at government hospitals in Bulawayo.
“I think a lot more needs to be done in the provision of HIV testing machines. The whole of Bulawayo province is being serviced by one machine which is at Mpilo Central Hospital. The machine often breaks down thereby risking the lives of HIV positive people”, said one participant.

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Health literacy changes lives in Goromonzi

Health literacy changes lives in Goromonzi

March 5, 2015 in News

HEALTH literacy has helped improve standards of health in the Chikwaka rural area in Goromonzi district where community health workers (CHWs) are playing a leading role in encouraging locals to embrace best health care practices.

By Caiphas Chimhete

As a result of health literacy offered by CHWs such as villages health workers (VHWs), health literacy facilitators (HLFs) and health centre committees (HCCs), community participation in health programmes has also increased in the area.

Even the relationship between the community and staff at Mwanza rural health centre has greatly improved leading to an upsurge of the number of people seeking health services at the clinic.The clinic now attends to between 500 and 650 patients per month up from an average of 350 patients per month two years ago.

Unlike before, pregnant mothers now prefer to give birth at the health centre.

The local community, with the help from the Community Working Group on Health (CWGH), is currently building a waiting mothers’ shelter at the clinic to ensure that pregnant women nearing full term from the catchment can stay at the home while waiting to give birthin a clean and safe environment with aid of a skilled birth attendant.

The Mwanza Clinic waiting mothers’ home, an initiative of the community, is expected to open its doors to pregnant women this year.

Mwanza Clinic nurse-in-charge, Francis Nyakani said home deliveries in the area had significantly gone down as a direct result of intensive sensitisation efforts by CHWs on the importance of giving birth at a health centre. Presently, the clinic handles about 24 deliveries up from average of 15 deliveries per month two years ago.

“There has been a big improvement on health seeking behavior because of sensitisation efforts by community health workers,” said Nyakani. “Most women are now informed about the importance of delivering at a health centre and we give credit to our HCC members.”

He added that people living with HIV/Aids were no longer afraid of revealing their status because the community now treats the disease like any other illness.

“People living with HIV speak openly about their status in this community and they also have forums where they teach others about the importance of things like abstinence and protection,” he said.

Goromonzi is one of the districts where CWGH and Save the Children in partnership with the Ministry of Health and Child Care are implementing the three-year Strengthening Community Participation in Health programme.

The programme, which is being implemented in eight provinces in Zimbabwe, is designed to strengthen community participation in health for improved Maternal, Neonatal and Child Health (MNCH) outcomes by raising community’s awareness about their health entitlements.

“It is now easy to address our problems as a community because we were trained as HCC members starting in 2010 by CWGH,” said Mwanza Clinic HCC chairman Everisto Mupambawatye. “Ican safely say we have successful changed the people’s mindset in the surrounding communities. Pregnant mothers used to shun this clinic preferring to deliver at home but not now. Every pregnant mother is coming here.”

Most members of the community can make salt and sugar solution, they fetch water for drinking from safe sources such as boreholes, they have pit toilets at their homesand they are also aware of the “three delays”.

These are the delay in deciding to seek care, the delay in reaching a health facility and the delay in receiving appropriate care.

“Here pregnant women are registering before three months because we taught them the importance of doing so and we continue to encourage them to follow all the necessary steps until even after birth,” said Anna Takaendesa, chairperson of CWGH in Chikwaka. “Very soon pregnant women will come and wait to delivery in the waiting mothers’ shelter built by the community.”

However, the country’s maternal and child mortality rates remain worrying.

It is estimated that 10 women and 100 children die every day due to largely preventable causes. Health experts say lack of information and awareness on maternal and child also contribute to the deaths.

Mupambawatye said religious objectors still remain an impediment as they discourage pregnant women from seeking medical attention or deliver safely at a health centre.

CWGH executive director Itai Rusike said Goromonzi was one of the districts where the people are enjoying the fruits of community participation in health.He said there was evidence that community-based approaches are effective in improving the health of individuals and communities at large.

“The state of primary health care has greatly improved here as direct result of community participation and health education. People here value their health,” Rusike told a meeting of HCC members at Mwanza Clinic recently.

The concept of community participation is increasingly being recognised as essential for realising the right to health. It entails that communities are no longer inactive recipients of health care but participants in the creation of health care systems that serve their specific needs.

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A Study To Enhance Transparency And Accountability In The Management Of Health Related Issues In The Extractive Industries

A Study To Enhance Transparency And Accountability In The Management Of Health Related Issues In The Extractive Industries

CWGH with support from OSISA is undertaking this study in order to describe the current mining practices in Southern Africa including, Zimbabwe, Zambia, Mozambiuque, the Democratic Republic of Congo and Namibia with a special focus on community participation in mining. In this work, CWGH seeks to conduct a review of the use of health, social and environmental responsibility approaches to promote health-related actions in the operations of extractive industries – particularly relating to the health status of communities affected by the extractive industry. The review includes the effect of extractive industries on the health of surrounding communities, people employed in the industry and direct investment by extractive industries in health infrastructure and services for the communities they operate in through corporate responsibility.
The objectives of this work are:
I. To identify and analyse tools or mechanisms that are used to monitor the health impact of the mining sector in Zimbabwe.
II. To identify organizations which are directly or indirectly involved in the monitoring of health issues in the mining industries.
III. To propose areas for further research in an effort to understand the extent to which mining activities impact on the health of workers and communities.

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Accountability Loop Budget Advocacy (ALBA) Programme

Accountability Loop Budget Advocacy – Pushing Zimbabwe’s Reproductive, Maternal, Newborn and Child Health (MNCH) agenda forward
ALBA is being implemented through a partnership that includes Community Working Group on Health (CWGH), Actionaid and Save the Children with support from the World Health Organization (WHO). The aim of the Accountability Loop Budget Advocacy is to ensure that pregnant women and children under 5 years old in Zimbabwe have access to free healthcare services through budget advocacy.
The project seeks to add value to the on-going national advocacy and media strategies of improving MNCH services in Zimbabwe. All activities are geared towards building momentum for the implementation of relevant national health policies and strategies such as the National Health Strategy of Zimbabwe, fulfillment of the 15% Abuja target and also advocating for incremental MNCH budget allocation for 2016.