WATCH: Community health workers strengthen primary health systems

Robin Muchetu, Senior Reporter

MONGI Tshuma , turned up at a rural clinic in his district of Gwanda with a spear lodged in his thigh. 

His nightmare, however, was that there was little help that he got from there due to incapacitation in the supply of medicines and personnel. He had to travel in an ox-drawn cart to the nearest district health centre to access help.

Many like Mongi have had a similar experience where their first port of call could not render the much-needed critical care but the Government, through the Ministry of Health and Child Care, has stepped in to address gaps that existed in the healthcare care delivery system by fully integrating primary healthcare, community healthcare workers and volunteers into the mainstream health sector and capacitating them adequately.

Provincial Medical Director for Matabeleland South Province Dr Andrew Muza said the Ministry of Health and Child Care is implementing the community healthcare strategy.

“The overarching goal is to try and improve primary care, this is the care that is offered to the patient at the first point of contact with the health care system. There has been a lot of investment in strengthening community healthcare services. Last year we trained the community healthcare workers and capacitated them with the provisions of the health care strategy. This is one of the interventions that we are working on as a ministry with significant support from its partners,” said Dr Muza.

According to the WHO, access to community health services can prevent millions of deaths annually and substantially reduce patients’ out-of-pocket costs.

Ms Sebenzile Nkomo, a village health worker from Matobo Village in Bulilima is one of the targeted community health workers who have been capacitated by the Ministry of Health and Child Care. She tirelessly renders services to her community.

“I am a village health worker, we look after children in the village, we work a lot with them and we assist in weighing the babies and administering Vitamin A during outreach programmes. We teach the mothers about diseases that will be prevalent in the areas we live in and we refer them to clinics for further treatment if we see that their children have those symptoms. There have been significant changes in the health-seeking behaviours of villagers after we talked to them. Some elderly caregivers who are left in the custody of young children can hardly walk to the clinic with the children. So when there are outreaches we give them all the information they need and they do come and seek services,” she said.

Ms Nkomo said they were working hand- in-hand with nurses from the clinics who also provide information about pregnant women in the communities and they check on them regularly as they draw closer to delivering.

They are then sent to Plumtree District Hospital for management at the waiting mother’s shelter.

Last week Matabeleland South Province held an integrated outreach services, which is also another component of service delivery under the community health strategy.

“In this concept, we are trying to reach out to people closer to their homes and identify where we have gaps. It may be nutrition, reproductive health, tuberculosis, or HIV, our village health workers can go into the communities, look for patients that need assistance in those areas and are referred to some outreach points where a multi-disciplinary health team goes out to provide services,” said Dr Muza.

He said these are some of the tenets of the Community Health Strategy where services are available right where the people are and when they need them.

Last week a health team that was stationed at Nyele Community Hall in Bulilima District was offering services that were not available at the clinic level such as laboratory services, X-rays, Visual Inspection with Acetic acid and Camera (VIAC) services, dental services, and medication to name a few.

The Government of Zimbabwe launched the Health Resilience Fund in 2023 with the main objective being to support the Ministry of Health and Child Care to provide health care services to the people in the country. 

The ministry has been working with partners that include the European Union, Unicef, Gavi, World Health Organisation (WHO) and other governments that have come on board.

The fund that has been pulled together has been assisting the Ministry of Health to fund healthcare service provision in the country.

“Over the years one of the targets that we thrive or that we want to attain is a reduction in maternal deaths. Our institutional maternal mortality rate is around 71 per 1 000, we have noted a gradual decline in maternal deaths and that is one of the things we have benefited from the implementation of the HRF,” said Dr Muza.

He said some of the programmes they have been running within the province in terms of strengthening maternal and child health is that community health care workers go out into the community and identify pregnant women that may be at risk and refer them early to healthcare facilities.

“When they come, healthcare workers have been trained in essential skills through the support that has come from HRF together with some of the medical equipment, sundries and medicines that we use when we carry out the actual deliveries. We also get some of those from the pulled fund,” said Dr Muza.

The other area he noted was nutrition.

“As a province, when you look at our cure rate for acute malnutrition, last year we had around 76 percent and we were above the global target of about 75 percent. We may not want to attribute all the success to one programme, remember this is a pulled fund with various partners coming together. Some of the benefits that come from the HRF in the nutritional field is that we also have procurement of nutritional supplementary feeds that we give to children who are malnourished. We also have had training of health care workers on management of cases of malnutrition and other programmes as well,” said the PMD.

@NyembeziMu