Village health workers break barriers in accessing healthcare in rural Zimbabwe
By Richard Nyamanhindi
September 2013 - Susan Mavhunduke aged 40 is a village health worker in Wedza District – Mashonaland East Province in Zimbabwe. Susan and other village health workers have helped Zimbabwe raise its immunization coverage in the last four years to more than 90 percent, protecting millions of children against malnutrition, measles, pneumonia, polio, and other diseases.
Every day, Susan rides her bicycle for kilometres, in a community that is both disadvantaged and affected by HIV/AIDS. She goes from door-to-door, navigating the dirt roads under the scorching sun, in the rain and sometimes crossing flooded rivers.
Susan and her co-workers also counsels’ men and women on health, hygiene and HIV related issues. They go where doctors cannot, where medical institutions are hard to find and where trained nurses are few.
In Wedza, easily preventable diseases continue to kill a significant number of children under the age of 5. And a significant number of births continue to take place at home, without professional assistance from skilled attendants.
In 2009 following years of economic challenges and a collapse of the health sector, 25 women in the district, including Susan, stepped up to create a band of village health workers as part of the Infant and Young Child Feeding project.
The project is being implemented in some of the hardest to reach districts in Zimbabwe. Supported by UNICEF, the programme aims to create awareness about maternal, neonatal and child health in underserved communities in which these workers are the only point of contact for families in need of health related assistance.
Susan, a mother of four and a successful subsistence farmer, serves five villages in her community.
“I love my job and it gives me a lot of gratification, especially when I know that I am helping people that are in need of the assistance that I provide. This is why I do this everyday of my life.”
“When I became a health worker and moved from house to house a lot of people did not trust me – especially men. I sensitized women on nutrition related issues, maternal health and HIV testing, but the community treated me with mistrust… the situation was even worse with men,” explains Susan.
“Some men, predominantly those of the apostolic sect did not allow their women to register with health institutions when they fell pregnant. Men were also against various family planning methods,” she says.
Over the years trust has been growing between the communities and the village health workers resulting in an increased number of women now registering at health institutions in the district and men equally participating in the health of their wives and children. As noted by Susan, it is the village workers’ understanding of their communities that has given them an advantage.
“This change did not take place overnight. We had to work very hard for it. It was only when fathers and the elderly saw that our counsel was saving lives, when children with diseases such as pneumonia and malaria returned from hospitals fully recovered, that they began to trust us,” says Susan.
In addition, Susan and her co-workers promote HIV and nutrition integration which is essential for new-borns and provide information about HIV testing and hygiene. They also encourage immunization and ensure that every newborn in their assigned area of work is fully vaccinated before her or his first birthday.
Village health workers also conduct sessions that bring young mothers, elderly women and community leaders together. Trained by UNICEF’s local partners OPHID Trust and J.F Kapnek Trust, village health workers have taught women good breastfeeding practices and the warning signs of illnesses.