Maternal, neonatal and child healthcare should be prioritised
By Byron Mutingwende
Jane Matanda (36) lives with her family at a farm compound in Beatrice, nearly 60km from Harare. With four children who are all at school, Matanda says the wages she gets from working on the farm together with her husband are not sufficient to provide adequately for their children’s health and educational needs.
The diminutive woman stays in a dingy, thatched two-roomed pole-and-dagga house and cooks in a plastic shade nearby. She is wearing a dirty, threadbare blue dress – a sign of poverty but she keeps on smiling, oblivious of the hardships she endures to keep her family together.
Her carefree attitude compelled this reporter to probe more about her lifestyle on the farm. With ease, Matanda revealed how with her husband, they gross just over $100 income in a good month – an amount which should be enough to send their children to school, feed and clothe them.
“Life on this farm compound is interesting for us because we were born and bred here. Despite our poverty, we always are ready to help each other. However, there are high incidences of sexually transmitted infections and many cases of unprotected sex even among children and married adults who indulge in extra-marital sex. Those caught in extra-marital affairs are usually tried at the local traditional kangaroo courts and often forced to pay small fines before re-joining their families. It’s not a taboo to engage in extra-marital affairs here as long as disputes are settled amicably,” Matanda said.
She revealed that there were worrying cases of inter-generational sexual relationships, sexual harassment and child marriages in the farming communities.
According to the UNAIDS 2015 HIV and AIDS estimates, Zimbabwe has the fifth highest HIV prevalence in sub-Saharan Africa at 14.7%. Thus at that time, 1.4 million people were living with HIV, including 77,000 children.
The UNAIDS (2016) Prevention Gap Report revealed that an estimated 790,000 women were living with HIV in Zimbabwe. Gender inequality was rampant within relationships and marriages, with only 68% of men believing that a woman has the right to refuse sexual intercourse if she knows he has sex with other women. The 2010-11 Zimbabwe Demographic health Survey said that only eight out of 10 women believed women had the right to ask their partner to use a condom if he had a sexually transmitted infection.
The Averting HIV and AIDS group notes that Zimbabwean HIV epidemic is largely driven by unprotected heterosexual sex although there were growing epidemics among key populations who are at higher risk of HIV.
To compound the problems in rural areas, particularly on the farms, there is a serious lack of health facilities and personnel. In most cases, a number of mothers die while giving birth while most children die during birth. Traditional midwives usually lack the technical knowhow on how to ensure safe delivery by pregnant mothers resulting in high maternal mortality rates.
The work of village health workers also becomes critical as they educate communities on safe health practices, distribute tablets and provide primary health care services like offering first aid and vaccination.
Primary healthcare facilities, particularly those in the rural areas should be equipped to provide integrated maternal, neonatal and child care services, the United Nations Children’s Fund (UNICEF) has said.
On Wednesday UNICEF handed over 3000 bicycles for Village Health Workers to scale up integrated maternal, neo-natal and child healthcare at primary health facilities and community level in Zimbabwe
The bicycles which were procured through funding from the German National Committee, under the theme “improving maternal, newborn and child health in rural communities in Zimbabwe”, were handed over to the Ministry of Health and Child Care at Beatrice District Hospital.
“One of the main barriers to affordable universal health care still remains the limited access to high-impact health interventions for those in rural areas and hard to reach communities,” said UNICEF Chief of Health, Dr. Nejmudin Bilal. “These bicycles are a component of the Village Health Worker kit that enables them to be mobile and efficient in accessing hard to reach areas that might not have access to health facilities.”
In a statement, UNICEF said that Village Health Workers have significantly contributed to the improvement of healthcare delivery in Zimbabwe through interventions that have resulted in: increased early antenatal care bookings, institutional deliveries and postnatal care visits; reduction in Maternal and infant mortality; increased immunization coverage; the reduction of communicable diseases through increased treatment adherence to antiretroviral treatment; and overall increased community participation and involvement in health matters.
“The Village Health Worker programme is at the centre of community health care services,” said the Director Curative Services in the Ministry of Health and Child Care, Mr. Sydney Makarawo. “The attainment of the Sustainable Development Goals may be attainable by providing health services to individuals, families and communities”
Besides procurement of bicycles UNICEF supports the Village Health Worker programme through procurement of the Village Health Workers medical kits and other tools of trade such as tennis shoes, payment of the Village Health Workers allowances and trainings of new Village Health Workers
As strategic partners, UNICEF and Government have been engaged in the formulation of the Strategic Direction Document under the Health Development Fund. Working with UNDP we hope to see an electronic database of all village health workers in Zimbabwe not only for payment purposes but improve coordination and tracking of village health workers for accountability.