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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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Health experts fret over cholera resurgence

Credits: Newsday By Vanessa Gonye | Apr. 10, 2023

HEALTH experts have expressed concern over the resurgence in cholera cases, which they blame on poor sanitation and a lack of long-term planning for water supplies in urban areas.

Community Working Group on Health (CWGH) executive director Itai Rusike said cholera will continue to wreak havoc until there is a long-term plan on water sanitation and hygiene intervention.

“Prolonged water cuts in most urban areas are leading to use of unsafe alternatives such as unprotected shallow wells and faecal matter-contaminated boreholes. Local government earmarks revenue for waste collection, this should not be reallocated to other spending.  Residents should be brought into monitoring waste dumping. Residents and businesses can provide initial support with clean-up campaigns but routine waste collection, water treatment services and more reliable provisioning need to be improved as a public health priority,” Rusike said.

“The mainstay of prevention of cholera is the provision of safe water, adequate sanitation, good personal hygiene, case management, surveillance and community mobilisation. Cholera vaccination may be used to complement primary measures,” he said.

Cholera, a diarrheal infectious disease continues to cause high morbidity and mortality in Zimbabwe.

Without treatment, death can occur within hours.

Health policy specialist Tinashe Mundawarara said more investment is needed to deal with cholera.

“Investments are needed to detect, prevent, control and monitor cholera.  This is further compounded by the fact that cholera is now a protracted epidemic in this country. I am not sure if government has a cost-effective strategy for border screening given that it is resource intensive,” he said.

The country is currently experiencing a new wave of cholera infections, which emanated from Chegutu and has spread across the country, bringing to 17 new cholera hotspots.

Previously, there were only four hotspots.

The new cholera hotspots are Buhera, Chegutu, Chikomba, Chimanimani, Chipinge, Chitungwiza, Chiredzi, Harare, Gokwe North, Marondera, Mazowe, Shamva, Mutare, Murehwa, Mwenezi, Seke and Wedza.

Health expert Josephat Chiripanyanga said: “We encourage people to follow guidelines for cholera prevention so as to ensure that we limit the occurrence of cholera as much as possible. There is a need to practise proper waste (human included) disposal especially in the rural areas to reduce or prevent it from spreading. We all know the adverse effects of cholera and the country has had two serious outbreaks with devastating outcomes.  It will be equally bad if we lag behind on prevention.”

As of Thursday last week, there were a cumulative 382 suspected cholera cases, two laboratory-confirmed deaths, five suspected cholera deaths and 71 laboratory-confirmed cases reported.

Health experts have warned that if no action is taken, the cholera outbreak could lead to more fatalities.

 

 

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CONCERN OVER HYPERTENSION . . . prevalence estimated at about 30 percent of population

Credits: H-metro by Tanaka Mahanya 07 April, 2023

ZIMBABWE is experiencing a rise in non-communicable diseases with hypertension now top of the list.

The country joins the rest of the world in commemorating World Health Day.

It will be held under the theme ‘‘Health for All’’.

The theme resonates well with the growing global call for Universal Health Coverage (UHC), which seeks to ensure that people have access to the healthcare they need, without suffering financial hardships.

The Community Working Group on Health (CWGH) has called on the Government to ensure that health services are available, accessible and affordable to every citizen of Zimbabwe.

In a statement, CWGH executive director, Itai Rusike, said the country was experiencing a rise in non-communicable diseases (NCDs).

“Rapid, unplanned, unregulated urbanisation and changes in lifestyles as people migrate from rural to urban areas are causing an increase in the risk factors that cause NCDs and conditions such as injuries, disabilities and substance abuse.

“The prevalence of hypertension is estimated at about 30 percent of the total population, which is higher than HIV, tuberculosis and diabetes.

“Addressing the burden of non-communicable diseases constitutes an integral part of achieving good health and well-being.”

Rusike said targets had been set 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 five in the world. “Treatment costs for all cancers remain very high, inconsistent and unaffordable for most people.”

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Cholera: Experts call for access to clean water

Credits: Newsday By Lorraine Muromo and Vanessa Gonye | Mar. 30, 2023

health experts have urged government to ensure citizens have access to clean potable water to stop the spread of waterborne diseases such as cholera.

The country has witnessed a number of cholera cases with suspected cases in 10 provinces numbering 267, while 209 recoveries and two deaths were recorded. Cabinet on Tuesday approved a budget of US$24 168 353 for cholera preparedness and response plan.

Community Working Group on Health executive director Itai Rusike said to effectively deal with cholera, government should deal with fundamental public health issues like access to water.

“The current cholera outbreak is occurring in the context of frequent water and power cuts, and a breakdown of rubbish collection. Advice to boil water is difficult to follow during water and power cuts. The situation on the ground indicates that while water and sanitation infrastructure exists, these are old and malfunctioning and tariff structures are needed to protect poor households’ access,” Rusike said.

He said unsafe environments continued to be a health threat, particularly for poor households and should be more focused on high-density suburbs and rural areas, where significant gaps remain in terms of access to safe water and sanitation.

Medical and Dental Private Practitioners Association of Zimbabwe president Johannes Marisa said while government’s US$24 million pledge towards fighting cholera was welcome, water and sanitation issues should be prioritised.

“It’s needless to fight symptoms when the predisposing factors are dominant, water and sanitation should be robust and up to standard if we are going to contain cholera. Monitoring and surveillance is also important, as well as education on cholera and its symptoms.”

 

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Zimbabwe Cholera Outbreak 2023

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Zimbabwe Cholera Outbreak 2023.

The persisting and recurrent outbreaks of cholera gives a poor reflection of the health and development status of the country. 

Water and sanitation are essential for good health outcomes and sustainable development. 

Inadequate access to water and sanitation infrastructure is a major source of health challenges and disease outbreaks such as cholera. 

Poor and Inadequate water and sanitation is a leading cause of poverty, morbidity and mortality in a number of countries, while providing water and sanitation in schools is key to keeping girls and children in school. 

The reduced availability of safe drinking water impacts negatively particularly on girls as they are forced to walk long distances to fetch water in some cases from unprotected sources often affecting their ability to go to school. 

A cholera outbreak in late 2008 reflected this decline in living conditions and affected around 100,000 people. 

Interruption of water supplies, overcrowding of sanitation facilities and difficulties with urban waterborne sanitation during periods of water cuts means that urban households are very vulnerable to unhealthy environments. 

Urban Local Authorities are currently facing a range of problems that are limiting the daily supply of water such as the shortages of water chemicals as household rates are currently being charged in local currency whilst payment of water chemicals to suppliers is done in US Dollars. 

The aging and unrepaired sewer systems; waste put in sewers due to poor waste collection; illegal waste dumps; overflowing septic tanks; and frequent water and power cuts. 

Most sewerage reticulation systems and treatment works are in a state of disrepair, raising the risk of diarrhoeal diseases including cholera. 

I hope this will assist 

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

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Zim cholera cases rise to 98

Credits: Newsday By Vanessa Gonye | Mar. 17, 2023

ZIMBABWE recorded 31 new suspected cholera cases on Wednesday, bringing the total to 98, with health experts, calling on local authorities to improve access to water and sanitation to avert a national disaster.

In a daily situation report on Wednesday, the Health and Child Care ministry said there was one casualty, while three of the suspected cases tested positive to the diarrhoeal disease on the day.

“The 31 new suspected cholera cases and 3 laboratory confirmed cases were reported today (Wednmesday). These were reported from Centenary (15), Beitbridge (11), Chegutu (4) and Chivi (1),” the ministry said.

“Fourteen of the suspected cases and one suspected death brought in dead (BID) were Mozambican nationals from Kadunje Village who sought treatment at Chiwenga Clinic, Centenary district, Mashonaland Central province, bordering Mozambique.”

The first two cholera case were recorded in Chegutu last month.

“As of 15 March 2023, one case is hospitalised at Chivi District Hospital Cholera Treatment Unit (CTU), Masvingo province. Zimbabwe has 98 suspected cholera cases, eight confirmed cases, 97 recoveries and one death,” the ministry said.

The country’s worst cholera outbreak occurred in 2008, which left more than 4 000 dead and another 40 000 infected.

Community Working Group on Health executive director Itai Rusike said recurrent cholera outbreaks exposed lack of maintenance of the country’s water and sewer reticulation infrastructure.

“Inadequate access to water and sanitation infrastructure is a major source of health challenges and disease outbreaks such as cholera,” Rusike said.

“The aging and unrepaired sewer systems, waste put in sewers due to poor waste collection, illegal waste dumps, overflowing septic tanks and frequent water and power cuts are also causative factors. Most sewerage reticulation systems and treatment works are in a state of disrepair, raising the risk of diarrhoeal diseases including cholera.”

Tinashe Mundawarara, a health policy specialist said Zimbabwe needs to improve its access to water and sanitation.

“From a policy perspective, our health system will always be judged on its responsiveness, that is, will the Ministry of Health be able to stop the spread and at the same time ensure adequate health care provision for those with immediate need? The next few days will be critical on these two issues and funding will be an urgent need,” Mundawarara said.

 

 

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More men dying than women: ZimStat

Credits: Newsday By Priveledge Gumbodete | Mar. 15, 2023

ZIMBABWEAN men are dying more than women, latest statistics from the Zimbabwe National Statistics Agency (ZimStat) have revealed.

The report, based on the 2022 population and housing census, shows that 120 070 deaths were recorded during the census with 53,6% of the dead being men and 46,4% being women.

Last year, ZimStat preliminary national census results revealed that females constitute the majority of the population, numbering 7 889 421 or 52%, compared to the male population of 7 289 588 (48%).

This was also followed by another set of results showing that life expectancy for females now stands at 68 years compared to male life expectancy which is 61,2 years.

“A total of 120 070 deaths were recorded during the census. Male deaths constituted 53,6% of the total deaths recorded during the census. Throughout all age groups, males had higher mortality rates compared to females,” the report read.

Community Working Group on Health executive director Itai Rusike said health-seeking behaviour among men is poor compared to women.

Rusike said clients at health centres are often women and children less than five years.

“There is a particular focus in primary healthcare on women and children due to their vulnerability and the fact that their ill-health affects the wider community. Apart from the general inputs that all people need for health, women also need services to support safe reproductive health, prevention of mother-to-child transmission of infections such as HIV, child delivery and care, including nutrition during pregnancy,” Rusike said.

“The spread of health information, improvement of nutrition, safe living and community environments are key to disease prevention amongst men. Prevention and management of common diseases also depends on early detection and treatment. We are also aware that unhealthy lifestyles such as smoking cigarettes and alcohol abuse are a lot more prevalent in men compared to women.”

Zimbabwe Association of Doctors for Human Rights secretary Norman Matara said quantitative research is needed to establish why more men were dying than women.

Matara said women practice self-care while men are reckless.

“This is why most men died during the census period compared to women.”

Zimstats data also showed that 78 384 deaths constituting 64,7% were registered while unregistered deaths constituted 30,3% and 5,0% had an unknown status.