Category: Programmes

Programmes executed by CWGH

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DECLARATION BY THE PARLIAMENTARIANS TASKFORCE ON DOMESTIC RESOURCE MOBILIZATION FOR HEALTH IN AFRICA ON THE SIDELINES OF THE AFRICAN UNION SUMMIT

THE NAIROBI DECLARATION 2023

PREAMBLE

We, Parliamentarians from Cameroon, Côte d’Ivoire, DRC, Ghana, Kenya, Niger, Rwanda, Senegal,

Zambia and Zimbabwe, gathered in Nairobi on 11th & 12th July 2023 at the sidelines of the

African Union Summit, to reflect and discuss health financing in Africa.

Cognizant of the need to formalize genuine collaboration between parliamentarians and Civil

Society, we propose for an effective advocacy program on sustainable domestic resource

mobilization for health in Africa, through a platform for exchanging information, sharing best

practices, strengthening political and synergies.

Our recommendations, resulted in the creation of the Parliamentarian Task Force on Domestic

Resource Mobilization for Health in Africa, with the objectives of engaging parliamentarians in

their respective countries on issues such as the mobilization of national resources for health;

strengthening of community health; universal health coverage; and addressing gaps in funding

for the fight against HIV, Tuberculosis and Malaria. We, therefore, unite our voices in support of

this declaration:

CONTEXT

The African Union member states have subscribed to a solid normative legal framework on the

right to health; they have committed to its Agenda 2063, whose aim is to transform the potential

threat posed by the expected doubling of its young population by 2050, into a «demographic

dividend», bringing economic growth and higher living standards, and they also subscribed

to the Sustainable Development Goals (SDGs), which aim to significantly increase the health

budget to ensure that everyone benefits from universal health coverage (UHC).

Heads of state and government have also made declarations and commitments on health

financing, notably at the 32nd Ordinary Conference of the African Union in Addis Ababa in

February 2019, during which they endorsed the deliberations of the African Leaders’ Meeting

(ALM) and adopted declarations in favor of mobilizing domestic resources for health financing

in Africa.

Notably, many African states are struggling to meet their commitments to mobilize domestic

resources, yet investing in health is investing in human capital, creating stable jobs, stimulating

economic growth and reducing inequalities.

While investments in community health programs are cost-effective, we note with concern the

lack of prioritisation and adequate budgets for the same. These investments contribute to the

reduction of health inequalities, ensuring access to basic services for vulnerable and marginalized

populations; they deliver high quality services and improve overall health outcomes and hence

need to be prioritised.

We acknowledge the support and collaboration of these partners.COMMITMENTS

We are committed to advocate for :

  • Domestic resource mobilization for health including push for the move from commitment

to action, co-financing of Global Fund and other development partners programs for HIV,

TB and Malaria, to build equitable and resilient health systems, focused on people centered

approach and integrated health services (addressing HIV, TB and Malaria and other health

issues based on people’s needs and disease burden);

  • Community Health system strengthening, including ensuring a recognized status for

Community Health Workers, financing of Community Health Strategy, support for community

led responses, and incorporation of community, rights and gender considerations in HIV, TB

and malaria programming;

  • Incorporating universal health coverage as a goal in national health policy frameworks,

strategically connected to broader inter-ministerial priorities such as emergency

preparedness, social stability, climate, economy and finance;

  • Bridging financial and implementation gaps of HIV, TB, Malaria, Health Systems Strengthening,

Pandemic Prevention Preparedness and Response and Community Health Systems in the

National Strategic Plans for the countries;

  • Establish a space for exchange and sharing of good practices among parliamentarians from

different regions of Africa;

  • Create synergies with civil society on Domestic Resource Mobilization for Health in Africa.

RECOMMENDATIONS

That African governments, in a multi-sectoral approach, work in concert with parliamentarians,

civil society and the private sector to implement sustainable strategies for mobilizing domestic

resources and for a significant increase in health budgets, given that a healthy nation is

indispensable to Africa’s socio-economic transformation, as envisaged in Agenda 2063.

African governments, with the aim of achieving universal health coverage by 2030, accelerate

the institutionalization of community health agents to ensure the sustainability of their actions.

This means formalizing their integration into health systems, professionalizing their training and

mobilizing the resources needed to pay them.DECLARATION_MP_Nairobi_ENG

Nairobi, July 12, 2023

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CWGH Director Itai Rusike Joins High-Level National Dialogue on Health Financing , Switzerland

The CWGH Director, Mr. Itai Rusike, was invited to and attended a panel discussion on domestic health financing in Africa with the theme “Advancing Health Financing Reforms through Inclusive Dialogue: National Health Financing Dialogue in SADC Countries”. The event was attended by Ministers of Health, policymakers, development partners, and other CSOs. It took place on May 25th, 2023, in Switzerland.In his words he said “We are pleased to have had the opportunity to hold a productive dialogue meeting in partnership with the Parliament of Zimbabwe, civil society, and the Zimbabwe Union of Journalists. Our delegation from civil society included representatives from various constituent groups from across the country, as well as traditional leaders who serve as custodians of primary health at the community level, and community health workers who have a direct interface with the community. In Africa, community health workers play a crucial role as trusted team for health interests. The media was also invited to this meeting to help prioritize health stories and understand health financing processes. We have come together to issue a joint statement that we hope to present at the international dialogue. It is important for Zimbabwe to continue holding inclusive high-level national dialogues, and we look forward to further follow-up from Parliament and the media. Any support to push for this national level effort would be greatly appreciated.” Watch the video

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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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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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Call for equitable health access

Credit Venessa Gonye : Zimbabwe Independent

HEALTH experts have called for equitable health access for marginalised groups such as rural people, women and children.

This comes as the world yesterday commemorated the International Universal Health Coverage (UHC) Day, which falls on December 12 annually.

Community Working Group on Health executive director Itai Rusike said a country’s health system should work for everyone regardless of their financial status.

“Equitable health coverage puts women, children, adolescents, and the most vulnerable first because they face the most significant barriers to essential care. We all deserve a health system we know will be there for us throughout our lifespan. Trusted health systems provide high-quality services in primary care clinics and hospitals, equip and support frontline community health workers, and offer transparent health,” Rusike said.

He said Zimbabwe was affected by a decline in standards at the country’s major referral hospital, as well as the brain-drain in key personnel.

 

 

“UHC goes hand-in-hand with empowering communities to build healthy environments that promote holistic physical, mental and social well-being. Investing in #HealthForAll is the backbone of a prosperous society. Increasing public financing for health and reducing out-of-pocket health costs save lives, build resilience against pandemic threats, and advances Sustainable Development Goals beyond health.

World Health Organization (WHO) director AMR Global Co-ordination Haileyesus Getahun said challenges threatening a “healthy future for all” could not be addressed by the healthcare sector alone, but by a united and collaborative multi-sectoral response to ensure health security for everyone.

“The one health approach is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems. It recognizes that the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and interdependent,” Getahun said.

In August this year, WHO expressed concern over Zimbabwe’s slow pace in improving UHC, which is part of an initiative to ensure everyone has access to proper health services.