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Zim receives new US$15m health grant – NewsDay

Mombeshora also said the project enhanced the capacity of the health workforce through training and mentorship programmes, resulting in improved clinical skills and increased staff motivation.

Health and Child Care minister Douglas Mombeshora has hailed the results-based finance (RBF) model which focused on maternal and neonatal healthcare as a success.

He said the programme led to a reduction in maternal deaths and linked challenges.

Mombeshora also said the project enhanced the capacity of the health workforce through training and mentorship programmes, resulting in improved clinical skills and increased staff motivation.

“Another notable innovation was the quality focused RBF initiative implemented in selected central and provincial hospitals and has contributed to improved quality of maternal and neonatal services as evidenced by improvement in clinical quality indicators, improved availability of medicines and sundries resulting in reduction of the time it takes to conduct Caesarean sections after a decision is made and increased staff motivation and teamwork which is partly attributable to staff incentives that are given,” he said while speaking at the end of the Health Sector Development Support Project in Harare.

“We would like to acknowledge the contribution of Harare and Mombeshora also said the project enhanced the capacity of the health workforce through training and mentorship programmes, resulting in improved clinical skills and increased staff motivation. cities, through the innovative urban RBF programme and demand-side maternal health voucher scheme.”

The RBF, introduced in 2011 by the government in collaboration with the World Bank, was designed to support the Health and Child Care ministry in increasing the availability, accessibility, and utilisation of quality health care services to improve maternal, newborn, and child health.

Mombeshora said the success of the RBF programme would not have been possible without the dedication of healthcare providers, administrators and support staff.

“The close-out of the Health Sector Development Support Project does not mark the end of our efforts, but rather the beginning of a new chapter,” he said.

“While the gains made thus far are commendable, there is a need to keep the momentum.”

The close-out marked the commencement of a renewed relationship through a new US$15 million essential health services grant.

The grant seeks to strengthen the health sector through capacitating about 25 secondary care facilities countrywide.

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Remembering the Zimbabwean health care system’s heyday – The Zimbabwe Mail – The Zimbabwe Mail

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WARDS bustling with highly motivated health care workers, readily available medication, decent salaries, a thriving teaching hospital network — this defined Zimbabwe’s health care system in the 1980s. Back then, it was considered a model of efficiency and effectiveness in Africa.

Today, however, the system is broken. Shortages of medical supplies, a crumbled infrastructure, and a mass exodus of health care workers have left the country unable to meet the needs of its people.

Among those left questioning the decline is Stella, who worked as a nurse in Zimbabwe in the 1980s and witnessed the system’s heyday.

She, like many others, wonders: What went wrong? Stella, who chose to be identified only by her first name for fear of stigma, was 19 when she packed her bags to join St. David’s Bonda Hospital, a nurse training institute in Nyanga, east of Harare near the border with Mozambique.

This was in 1959, 21 years before the country gained independence from British colonial rule and four years after her mother died. In fact, it had been her mother’s idea that she join nursing school. “[She] told me that I would be able to take care of myself if I became a nurse,” she says.

Soon after graduating, Stella moved to Zambia (then Northern Rhodesia) where she worked for two decades as a nurse at a copper mine hospital. Once Zimbabwe gained independence in 1980, she returned home and secured a job as a nurse in the capital of Harare.

Working in Zimbabwe immediately after independence was a stark difference for Stella compared to what she witnesses today. Health care workers had the resources to treat patients. “Ambulances were readily available,” says Stella, who also worked as a midwife at a local clinic.

Felix Manyimbiri, a retired teacher, also remembers the good days. For him, it was the 1960s. “I had pneumonia when I was around 10 years and at that time there were no clinics in our rural home. I was ferried in a Scotch cart to Ndanga District Hospital and got admitted for four days.

I received good medical care; the doctor was on call 24/7,” the 70-year-old says. His wife, Moudy Manyimbiri, 62, remembers giving birth to their first child in 1980 at what was then Gweru General Hospital, a public hospital.

“The nurses were there and provided a service I loved, all the necessities like cotton wool [and] Betadine [topical antiseptic], among others, were provided for,” she says, a smile plastered on her face. The rewards for health care workers must have been good too, she says.

“Nurses could afford to buy cars.” Zimbabwe’s health care system even gained a reputation as a medical tourism destination within the region, says Dr. David Parirenyatwa, who served in the Ministry of Health and Child Care as a deputy minister (1998-2002) and minister (2002- 2009, 2013-2018).

In fact, members of the Central African Federation, an economic and political alliance between Southern Rhodesia, Northern Rhodesia and Nyasaland (now Zimbabwe, Zambia and Malawi, respectively) considered Zimbabwe their health hub, Parirenyatwa says.

“The capital of the federation was Salisbury, now Harare, so things were happening here. The University of Rhodesia was the [training] university for the whole federation,” he says, adding that citizens from the federation countries sought treatment at Andrew Fleming Hospital (now Parirenyatwa Group of Hospitals) and Harare Central Hospital (now Sally Mugabe Central Hospital). “It was more like the medical tourism center,” he says.

This was a significant revival from the country’s colonial past. During Ian Smith’s rule, who served as prime minister of what was then called Southern Rhodesia, from 1964 to 1979, health care favored the white minority population.

For example, government funding to private services, which catered to whites, was five times more than public medical services in cities — and 36 times more than public funding in rural areas. Urban areas were staffed by 389 doctors, compared to just 11 doctors in the rural areas where 80 percent of the population lived, according to figures from Zimbabwean researcher Neddy Matshalaga.

But Robert Mugabe — who became Zimbabwe’s first post-independence prime minister — would soon overhaul the system. In 1975, Mugabe led a civil war against the white minority regime and in 1980, the country gained independence. Mugabe soon invested in health care, especially in rural areas, to address disparities.

He allocated more resources to health care, built more facilities and increased immunization programs, to mention a few efforts. In 1978, 134 World Health Organization member states — including Zimbabwe — had made a commitment at the Alma-Ata conference in Kazakhstan to protect and promote health for all people around the world. Parirenyatwa says that in the early and late 1980s, several countries provided Zimbabwe with aid.

“There was a lot of goodwill, health grew, and Zimbabwe was a center for all,” he says. “We became top-notch.” This didn’t last long. Zimbabwe’s health care system began to crumble. The terms of the Lancaster House Agreement, signed in 1979 to abolish the white-dominated regime and pave the way for an independent Zimbabwe, were expiring.

The most significant of the terms was white farmers’ right to retain the land they occupied for 10 years, and in return the British would fund half the cost of a resettlement scheme for black farmers. “Talk of taking the land back started, things started to go on a downward trajectory,” Parirenyatwa says. Sanctions followed. Funding to health care was reduced.

Parirenyatwa’s voice drops to a murmur as he recalls that time. “In 2000s, people [black majority] started taking their land back. 2002 sanctions were put in place. Things started going haywire.” Aid organizations stopped funding the health care system. For example, in 2002, the European Union withdrew its funding.

Some groups packed up and left incomplete projects, Parirenyatwa says. The consequences of Zimbabwe’s dependency on donors became evident. In the 2000s, the economy in Zimbabwe also deteriorated, causing both a surge in skilled health worker emigration and a reduction in public spending, particularly in the social sector, including health care, according to recent research on Zimbabwe’s health financing policy.

As a result of reduced health spending, the government implemented both formal and informal user fees, decreasing the population’s access to health care. In 2006, as Zimbabwe’s economic crisis intensified — marked by inflation surpassing 1,000 percent — Stella says she began to notice changes. Salaries were low. Staff morale plummeted.

Medical staff no longer upheld ethics. “I felt hurt and sad knowing that people were being made to buy [supplies] that they should get for free,” she says, frowning in disgust at the memories. Things got even worse. Damaged beds remained unrepaired. A ward that previously accommodated 10 beds could only accommodate six, leading to premature discharge of new mothers to accommodate incoming patients. “It was a disaster,” she says as she folds her hands across her chest.

Some of her colleagues migrated to the United Kingdom and Ireland. However, some returned after an inclusive government between Zimbabwe’s ruling ZANU-PF party and the opposition in 2009 adopted a multi-currency system as a measure to restore economic stability and curb hyperinflation.

A period of social, economic and political stability followed. The idea of migrating again was no longer an option for Stella because of her age. “If it wasn’t for age, I would have left again,” says Stella, who officially retired from nursing in 2012 due to age and ill health. Parirenyatwa says signs of the migration of health care workers began around 2002, as the country was going into a crisis due to land reforms.

“Zimbabwean borders became literally porous for our health staff. “South Africa and Botswana were the easiest destinations at the time. Up to now, a lot of our health people are in South Africa. Later on, it was not just South Africa, it was now other areas of the diaspora,” he says. He adds that around 2006, it became severe.

“We began to lose our own specialists, especially in the nursing field — intensive care nurses, theatre nurses,” he says as he leans on his chair, tilting his head. Although there was an increase in doctor positions in 2022, rising from 1,657 to 1,724, 147 doctors still terminated their services, according to data from the Health Service Commission. The nursing sector experienced a decline, with 1,454 nurses leaving their positions.

“Due to attrition, the number of public sector health workers has been reduced by at least 4,600 since 2019, despite increased recruitment,” says Tryfine Rachel Dzvukutu, the deputy general manager of public relations for the commission.

In 2023, the World Health Organization listed Zimbabwe as one of the 55 countries that face the most pressing health workforce challenges related to universal health coverage. “There are a lot of patriotic Zimbabweans who are leaving, but they are not staying partly because of our conditions of service. I don’t know what we can do to satisfy that.

“We need to make sure those cadres who train have got a future that they can see, promote our own research and fund it — it will keep our people here,” Parirenyatwa says. The five most important elements of any health system, Parirenyatwa says, are human resources, drugs and medicines, infrastructure (buildings and hospital equipment), communication (including ambulances) and financing.

When he worked in the ministry, Parirenyatwa says he advocated for the improvement of conditions of service for health workers and it led to the formation of the Health Services Board in 2005. “That alleviated pressures a bit, but because there were other things like infrastructure and equipment that were not in place, the frustrations continued to be there,” he says.

To specifically address health worker migration, he says it’s important for the government to address the causes first. “Without addressing these causes, we are going to keep having these problems. So it means massive funding in the health sector,” he says.

He adds that the country should at least meet the 15 percent Abuja Declaration threshold for health budgets, as it would bring significant amounts of resources into the health sector. The Abuja Declaration is a commitment that was made in 2001 in Abuja, Nigeria, by African Union heads of state, who pledged to allocate at least 15 percent of their national budgets to their health sectors.

To meet this commitment in 2024, Zimbabwe would need to allocate approximately 8.73 trillion Zimbabwean dollars (448 million United States dollars) from its 58.2 trillion Zimbabwean dollar (2.98 billion-US dollar) national budget to the health sector.

Instead, it has allocated 9.2 percent to the Ministry of Health and Child Care. Meanwhile, the government is offering financial incentives to retain health workers, including regular adjustments to basic salaries to accommodate the rising cost of living and salary-based allowances, some of which are indexed in US dollars to hedge against inflation, says Dzvukutu, the Health Service Commission spokesperson.

Despite numerous challenges, not everything is broken. Zimbabwe’s health sector has shown progress in some areas, particularly in its response to the HIV/ AIDS epidemic. The country was among the worst affected by the epidemic.

It is now one of the few countries in the world that has achieved the 95-95-95 targets at a national level, according to a 2023 report by the Joint United Nations Programme on HIV/AIDS, known as UNAIDS. This means that 95 percent of people living with HIV are aware of their status, 95 percent of them are on medication, and 95 percent of those on medication have a suppressed viral load. For Stella, the recovery of the country’s health care system hinges on proper remuneration.

“Most are leaving because they can no longer take care of their families, and general nurses are leaving a lot. I know of a number of people who have left,” she says. “People are leaving for greener pastures. If the pastures become greener here, we will be able to retain our workforce,” she says. —Global Press Journal

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Muswere calls on media to support Zim’s new currency – The Herald

Muswere calls on media to support Zim’s new currency

Conrad Mupesa Mashonaland West Bureau
THE successful adoption of Zimbabwe’s new currency Zimbabwe’s Gold ( ZiG) , is hinged on the positive coverage given by media practitioners, Information, Publicity and Broadcasting Services Minister, Dr Jenfan Muswere has said.
Addressing members of the media attending a two-day workshop on HIV/AIDS in Chinhoyi organised by the National Aids Council (NAC), Dr Muswere challenged journalists to be ethical and tell the country’s story in a positive way.
Minister Muswere added that while the media continue to play a critical role in disseminating information to curb pandemics like HIV, Covid-19 and cholera, some alarmists in the fraternity have been on a drive to discredit the newly-introduced currency.

“Let’s all support the Zimbabwe Gold (ZiG). That’s our currency and the country comes first. It is good to discuss, to explore and to seek clarity because it’s all constitutional in terms of freedom of expression but, the panic and the alarm around doom and catastrophe should not be part of journalism.

“Journalism should have ethics, to be able to tell the correct story which is factual, where there are negatives and positives, stories that are credible,” he said.Turning to the issue of HIV and Aids, Dr Muswere said Zimba

bwe had managed to attain the 95/95/95 target in reducing HIV/AIDS infection rate and recorded low deaths during the 2020-2022 Covid-19 era due to media personnel’s efforts.

The media’s participation in informing and educating the community had also resulted in Zimbabwe winning the battle against the disease.

On Tuesday, Cabinet announced that 10 districts had been declared Cholera-free.
It was therefore important to tell Zimbabwe’s story correct, said the Minister.

With Zimbabwe edging towards an upper-middle-income-economy by 2030, Dr Muswere challenged journalists to play a critical role in national development.

“Journalists have a role to play in health matters and nation building because the health of the population defines the past, the current circumstances, the challenges, the opportunities and the resilience, the dedication and commitment of Zimbabweans. The health of the nation defines the future of our country and journalists have a role to play,” he added.

He challenged journalists and the citizens to draw lessons from the tale of a young lawyer and author, Mr Kensington Marufu who has defied the odds despite his circumstances.

Mr Marufu is living positively with HIV.
Mr Marufu who tested positive to HIV in 2000, struggled and persevered through the hardships of life and stereotyping only to graduate as a legal practitioner.
The author gifted Dr Muswere with his book entitled ‘Touched by Grace’ which chronicles his life with the disease.

Speaking at the same occasion, NAC chief executive officer, Dr Bernard Madzima said the proper flow of information on HIV and AIDS required a mutual partnership between the media and his organisation.

“That partnership should facilitate deliberate sharing of information and accurate as well as responsible reporting, spurred by national interest and the pursuit of a development agenda anchored on the ideals of the National Development Strategy 1,” he said.
Zimbabwe has an estimated 1.3 million people living with HIV, a global pandemic which has 37.7 million infected globally.

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Zimbabwe introduces injectable HIV drug – The Herald

Zimbabwe introduces injectable HIV drug

Rumbidzayi Zinyuke-Senior Reporter

ZIMBABWE has introduced Cabotegravir long-acting (CAB-LA), an injectable pre-exposure prophylaxis drug, to add to the HIV prevention regime in the country.

The drug, an ARV designed to suppress any infection as it occurs, is for HIV-negative people who have a high risk of becoming infected with HIV.

It is the third pre-exposure prophylaxis (PrEP) product to be introduced in demonstration sites under a study for catalysing access to new prevention products to stop HIV (CATALYST).

The study has introduced the dapivirine ring and oral PrEP as HIV prevention choices for women and CAB-LA becomes the third product to be made available.

Speaking at a health communicators forum in Harare yesterday, the HIV prevention clinical officer in the Ministry of Health and Child Care’s AIDS and TB Programme, Dr Idah Moyo, said Zimbabweans could now access the injectable PrEP at the 15 demonstration sites.

“CAB-LA is a long-term injection for pre-exposure prophylaxis that is meant to prevent the acquisition of HIV for people that are HIV negative and are at a substantial risk of acquiring HIV. Since it is meant to prevent HIV in people who are at substantial risk, this intervention will be implemented in the demonstration sites which means we will get learning insights from those sites and that will inform the country in the roll out of the CAB-LA in the whole country,” she said.

Dr Moyo stressed that healthcare providers would equip clients who came to the sites with the knowledge to be able to make informed choices from the available PrEP products and for them to choose a relevant and appropriate method according to their needs, preferences, and lifestyles. 

In 2021, the Medicines Control Authority of Zimbabwe (MCAZ) approved the use of the dapivirine ring and in 2022, it approved CAB-LA, making Zimbabwe the first country in Sub-Saharan Africa to approve the product.

Dr Moyo said the injectable PrEP would add to the already existing packages and would be used alongside other prevention methods like condoms as it does not protect anyone from contracting STIs and getting pregnant.

“CAB-LA is an ARV which reduces the ability of HIV to replicate itself. Whilst research findings are there, the country still wants to learn more through the demonstration projects, so the learning will inform the roll out.  The healthcare providers in these 15 selected sites have been capacitated on CAB-LA so that after the implementation and demonstration projects, we learn from those to facilitate the roll out in the country. The injection is only administered by clinicians,” she said. Those who are eligible to access PrEP include sero-discordant couples (where one partner is HIV negative), adolescent girls and young women, pregnant and lactating women in relationships with men whose status is not known, are HIV positive or whose viral load is not suppressed.

 It is also available for people who use and inject drugs, key populations like sex workers, high-risk men, and the transgender among others.

Since its implementation in 2016, the country has made significant strides with about 217 461 people being initiated on PrEP. Zimbabwe also reported the ninth-highest number of new initiations among the 120 countries that are reporting on oral pre-exposure prophylaxis.

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