Community Monitoring and Health Advocacy in Zimbabwe

Maternal deaths are on the increase, according to a Ministry of Health Child Welfare study of 2007, this being attributed to increased HIV prevalence and a deteriorating health system. Demographic characteristics and events which occur during the antenatal, intrapartum and postpartum periods also contribute to the deaths.

The Community and Home-based Care program for mothers and newborns being implemented in UMP and Chikomba Districts, has the capacity to increase community participation which is an effective tool for behaviour change around health care-seeking behaviour. The program is directly targeted at pregnant women and mothers as well as the family unit and community as a whole. Communities will be provided with information to be better prepared on issues to do with maternal and neonatal health. Village Health Workers, the cadre identified by the Ministry of Health and Child Welfare as appropriate, will be trained in community management of the mother and newborn including early detection of pregnancy complications and referral to a health facility. They serve as the connector-outreach workers between the health service providers and the communities to promote health among groups of people who traditionally lacked access to adequate care. Under this programme, we seek to:

  1. Promote good health seeking behaviour for pregnant women so as to reduce chances of neonatal and maternal mortality
  2. Create platforms for community dialogue on maternal and child health.
  3. Strengthen community capacity to develop and implement locally driven action plans in response to maternal and neonatal mortality
  4. Promote community level campaigns on maternal and neonatal health, particularly supporting positive behaviour change amongst the youth, men and women
  5. Enhance communities’ appreciation of maternal health as a gender issue

Our primary aim is to reach at least 85% of women, men and young people in these two districts with information on care of mothers and newborns. Trained VHWs would provide post natal care within 3 days to 90% of mothers and newborns including referral for clinical management of complications. We are complementing government efforts to scale up and ensure success in the improvement of maternal and neonatal health in Zimbabwe. Approximately 50,000 women of child bearing age and their families including men and young people will be reached. We fully acknowledge the financial support being provided by UNICEF, without which the programme would not be possible.

Recent activities

Stakeholder Sensitization Meetings in the two districts (Chikomba & Uzumba Maramba Pfungwe (UMP) have been held with members from the local authority, traditional leaders and Civil Society Organisations to update them on the key components of the programme and gain commitment to support the programme.

A training of trainers workshop was also held in Marondera during the week of 26-30 May 2010 were a total of 20 trainers from the two districts were trained. The training focussed on community management of the mother and the newborn, home based care of the premature infant and low weight babies, support for initiation of early feeding including exclusive breastfeeding where appropriate, management of neonatal illnesses and referral for mothers and newborns that are sick. It also looked at the role communities can play in reducing maternal and infant mortality. The trained trainers are now equipped to train the Village Health Workers (VHWs) in their districts.

Current Activities

The day to day training of VHWs has begun in the Uzumba Maramba Pfungwe (UMP) district. A total of 90 VHWs are being trained at three centres, namely Mutawatawa Hospital, Dindi School and ,with each centre having 30 participants.