Category: Press Statements

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CWGH strengthens accountability for COVID-19 and equitable access to vaccines in 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”

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CWGH Workers day press statement

May1, 2023

CWGH Workers’ Day Statement: Government must reward health workers.

As the World celebrates the Workers’ Day today, the Community Working Group on

Health (CWGH) calls upon the government to remunerate the health workers well and

improve their working conditions to curb the current brain drain that has quickened the

collapse of the sector. Let us also make sure that health workers are provided with all

the necessary tools of the trade, health institutions are well equipped with the essential

medicines and modern medical equipment.

One of the major challenges facing the Zimbabwean’s public health care system is brain

drain. Doctors, nurses and pharmacists have left and continue to leave the country to

destinations like South Africa, United Kingdom, New Zealand and Australia to name just

a few. In fact, Zimbabwean health professionals are found in nearly all countries,

including non-traditional destinations such as Turkey, United Arab Emirates and Spain.

The country has failed to stabilize the brain drain, and some health facilities are

operating with skeletal staff due to lack of staff thereby overwhelming the few health

workers that have remained resulting in staff burnout and low staff morale. Health care

workers (HCWs) continue to be trained but fail to fill the posts established in the 1980s,

let alone the posts and establishment required to deal with the current population,

disease epidemiology and health and development targets. They have continued to

enrich other establishments and countries while the gap they leave in the country’s

institutions continues to glare. The current economic downturn characterized by the high

cost of food prices as well as spiraling inflation has unfortunately worsened the

situation.

As we celebrate May 1, we must remember that many workers are being injured or

dying in avoidable work-related incidents. The CWGH expresses its solidarity with all

workers in formal, informal, rural, urban and domestic employment in Zimbabwe.

_____________________

Itai Rusike (Mr)

Executive Director

Community Working Group on Health

  1. (CWGH)
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Renewed drive to dispel COVID-19 rumours, misinformation

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.

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Press Statement on the World Health Day, 7 April 2023

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.

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‘Zim likely to miss SDG target for reducing matenal mortality’

File picture: Pregnant woman

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.”

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Concerns over amendments to the Health Services Act.

Credit : Newsday

THERE are fears that the recently signed Health Service Amendment Act could trample on the rights of health workers.

Speaking to NewsDay, Community Working Group on Health executive director Itai Rusike  said the Act is neither democratic nor consultative.

He said workers in the public health sector  are now disadvantaged in several ways, since now they cannot strike and bargain collectively.

“It is unfortunate that health workers are caught in the middle of a system that is slow to respond to their needs and ethical pressures not to take collective job action,” Rusike said.

“The unpopular Health Services Act will most likely exacerbate the exodus of health workers from the country thereby putting extra pressure on those who will remain on their jobs.”

He urged government to address the conditions of service for health workers to plug the brain drain.

While there are no exact statistics on the number of health professionals who left the country in 2021, the Zimbabwe Nurses Association put the figure at just over 2000.

Last year, government announced plans to ban doctors and nurses from embarking on job action lasting more than three days under new proposed amendments to the Health Services Act.

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2023 Health Budget insufficient

HEALTH experts yesterday said Finance minister Mthuli Ncube’s $473,8 billion budget allocation towards the provision of health care services was grossly inadequate to fund the sector’s critical needs.

Ncube announced a $4,5 trillion budget on Thursday with 11% going towards health. Community Working Group on Health executive director Itai Rusike said the health sector remains grossly underfunded.

“The health budget remains grossly inadequate to fund the critical needs in the health sector,” Rusike said.

“The current health financing model remains unsustainable as it heavily relies on external financing as well as out-of-pocket spending.”

“In spite of the huge external support from development partners, there is still a huge financing gap in the health sector in the country which calls for greater innovation and commitment by the government to sustainably address it.”

Dental Private Practitioners Association of Zimbabwe president Johannes Marisa said: “The health sector budget is an improvement from last year but of course when you are benchmarking with the Abuja Declaration you still realise that it falls short of the stipulated 15%.

“We hope the budget is going to address the mass brain drain that is underway in Zimbabwe where we are losing experienced and skilled workers to greener pastures.”

In April 2001, African Union countries met in Abuja and pledged to allocate at least 15% of their annual budgets to improve the health sector and urged donor countries to scale up support.

Years of underfunding of the country’s health sector was laid bare when COVID-19 hit the country as acute shortages of critical and lifesaving equipment such as ventilators and intensive care beds were exposed.

 

Some South African officials have accused Zimbabweans of straining that country’s health sector.

In his 2023 national budget, Ncube the allocation to health was meant to improve health provision.

 “In 2023, the budget has set aside 11% of total expenditures towards the health sector notwithstanding financial constraints, Government is committed to the provision of quality health services, as evidenced by the ongoing construction and rehabilitation of health facilities,” Ncube said.

 “In 2023, the budget has set aside 11% of total expenditures towards the health sector and the objective is to eventually meet the Abuja Declaration of 15%. This is necessary to attain Vision 2030 of becoming an upper middle-income economy.”

“In 2023, the sector is projected to receive US$212,9 million from the development partners towards the same areas.”

Ncube admitted that the health sector has been hard hit by mass exodus of health professionals.

“Government is, however, addressing this challenge through continuous review of both monetary and non-monetary incentives in order to attract and retain medical personnel.”

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Brief Post Budget Analysis 2023 CWGH

 

The 2023 Health Budget allocation of only 11% has remained largely uninspiring given that it has not addressed the critical issues that we raised in our Pre-Budget position paper. It falls far short of the Abuja Declaration Target of 15%.

Unfortunately the health budget remains grossly inadequate to address the critical needs in the health sector such as the current exodus of health workers, drug shortages, inadequate ambulances, and obsolete equipment.

The inadequate public financing of the health sector has resulted in an overreliance on out-of-pocket and external financing which is highly unsustainable.

We hope that the funds allocated will be timeously and fully disbursed to the health sector and that the Ministry of Health will also utilize the funds effectively and in a transparent manner.

I hope this will assist

Itai Rusike, Executive Director, Community Working Group on Health (CWGH)