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CWGH National Annual Meeting and AGM

CWGH 23rd National Annual Meeting and AGM

CWGH 23rd National Annual Meeting and AGM

The Community Working Group on Health (CWGH) is holding its 23rd National Annual Meeting and Annual General Meeting (AGM) on the 16th and 17th of November 2016 respectively at the Rainbow Towers Hotel in Harare. The meeting will run under the theme "Leaving no one behind in National Health: What should Zimbabwe's contribution be?"

The CWGH will use the opportunity to review national health issues of concern and propose strategies for enhancing the health sector and in particular community participation in health. The CWGH is a strong advocate of primary health care and preventative health, and strengthening district health systems.

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CWGH nominated to influential national health committees

CWGH nominated to influential national health committees

The Ministry of Health and Child Care (MoHCC) has nominated the CWGH to the National Maternal Deaths Surveillance and Response (MDSR) committee and the National Reproductive Maternal Neonatal Child and Adolescent Health (RMNCH-A) following the organisation’s sterling work in improving maternal and child health in Zimbabwe.

Some of the functions of the MDSR committee include reviewing maternal deaths reported in the last quarter as captured by the MDSR system and HMIS with the aim of assessing timely identification, notification/reporting, review and response as well as making focused, geography and stakeholder specific and actionable recommendations that are linked with avoidable factors based on the analysis of maternal deaths in the past quarter.

The purpose of the RMNCH-A committee is to oversee and coordinate the national RMNCH-A programme with the aim of bringing efficiency, complemmentarity and effectiveness in programme management, implementation and monitoring.

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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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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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Primary health care concerns mount

Primary health care concerns mount

November 27, 2011 

Speaking at CWGH’s 18th national meeting last week, the organisation’s executive director Itai Rusike said there was potential for rebuilding Zimbabwe’s health system from the bottom up.

“Putting in place a national PHC strategy, backed by clear service entitlements, with resources effectively applied to community and primary care levels of the health system could be an entry point to wider PHC oriented changes,” said Rusike.

“And for the communities and local health workers, it’s a matter of common sense to address health where it matters most — as close to the people as possible.”

Rusike noted that health delivery has been undermined by HIV and Aids, poverty and economic decline, social inequalities and political discord.

“As a result, despite stated policy commitments to health, communities have experienced outbreaks of epidemics and falling service quality,” he said. “At independence, the country founded its interventions in the health sector on policies of equity in health and PHC.

“This meant that not only would attention be given to treating illness, but also to promoting health, and ensuring that people do not get ill.”

Parliamentary Portfolio Committee on Health chairperson Blessing Chebundo (pictured) said the participation of communities was vital in improving the country’s health outcomes and systems.

“Despite this, participation is still loosely designed policy wise and hardly evaluated for its contribution to health outcomes,” he said.
He said there are currently 17 pieces of health legislation in Zimbabwe, some of them which have become outdated.

Delegates at the meeting recommended that the country should invest in community health workers for improved health outcomes at grassroots level regarding such issues as immunisation and enforcement of public health law.

Among their recommendations, they called for the production of a simplified booklet to popularise public health law information to communities and vulnerable social groups, for example people living with disabilities.

Delegates also recommended that legislation on access to free public user friendly toilets, particularly for the disabled, should be enforced while privatisation of public services and social amenities should be challenged.

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Cancer advocacy budget wins plaudits

Cancer advocacy budget wins plaudits

 Wendy Muperi • 9 January 2014

HARARE - Government has won plaudits for allocating funds for cancer advocacy in the 2014 National Budget.
Itai Rusike, Community Working Group on Health (CWGH) executive director, said the allocation was a positive development.
“A new line item, Cancer Advocacy has been allocated $500 000,” Rusike said in a post-budget analysis, describing it as a positive development in government’s latest financial plan.
Junior Mavu, Cancer Association of Zimbabwe (Caz) general manager, said the country will have to maintain the momentum in the fight against cancer.
“It is a good start for the country,” Mavu said.
“Cancer is killing a lot of people. We however, hope more funds will continue to be availed in the future.”
Finance minister Patrick Chinamasa, in his 2014 budget, allocated $337 million to the Health and Child Care portfolio, and a separate envelope for $500 000 for Cancer Advocacy.
According to the Zimbabwe National Cancer Registry, at least 5 000 people are diagnosed with general cancer every year while cervical cancer accounted for 15 percent of all cancer deaths in 2010.
Despite the ravaging effects of cancer in a country where treatment costs are a top-line ripple for most patients, stakeholders felt the scourge was not being given the attention it deserved.
Mavu said 100 percent decentralisation of services was the best way to curb the disease.
“We applaud government for embarking on decentralising cancer services,” she said.
“We do not want a situation where we celebrate Harare successes while a lot of people in other cities and rural areas are suffering.
“Total decentralisation of testing services will help a lot in early diagnosis and treatment.”
She said the Harare population was responding laudably to cancer screening, evidence that awareness campaigns were being received well.
“Since Caz started screening cervical and prostate cancer in May and July last year respectively, the turn up of people has been very good. Our 10 slots per day are normally fully booked.
“Though the cases testing positive are lesser in percentage than negative ones, they are more than enough to worry the country,” she said.
Cancer causing factors include polluted air, dirty drinking water, alcohol and tobacco.
Chemotherapy costs from $100 and $1 000 per cycle depending on the cancer stage while every patient may need a minimum of six cycles and a maximum of 12. Radiotherapy costs between $3 000 and $4 000.