Young Child Survival and Development

Young Child Survival and Development




Young Child Survival and Development

UNICEF Zimbabwe/2008
© UNICEF Zimbabwe/2008

Key Issues

The once robust health system has dramatically declined over the past 15 years. Zimbabwe spends less than $34 USD per capita on health as recommended by the Ouagadougou Declaration on Primary Health Care and Health Systems in Africa (2008).

Under-five mortality has increased by about 20 per cent since the 1990 MDG baseline year, from 79 to 94 children dying out of every 1,000 live births. Most of the children die soon after birth. Newborn disorders account for one third of all under-five deaths; paediatric HIV accounts for a further 20 per cent.

Even more disturbing is the maternal mortality rate, which has more than doubled since 1990. Today, out of every 100,000 live births, some 790 women die during childbirth. The main reasons for this increased mortality are HIV, the decline in the primary health care system and the imposition of user fees for maternal and child health services. Today, 40 per cent of deliveries, mostly from the poorest in society, are not assisted by a skilled birth attendant.

Despite major progress in improved adult access to antiretroviral therapy (ART) and increased coverage of Prevention of Mother to Child Transmission (PMTCT) of HIV, treatment coverage for qualifying pregnant women and children, especially under the age of two, is negligible.

Immunisation coverage has also fallen, especially among some religious groups, resulting in outbreaks of measles. Today measles accounts for eight per cent of child mortality and is the fifth biggest child killer.

Undernutrition has become a major public health problem, particularly amongst the poorest in society. Some 34 per cent of children under five are stunted. Reasons for this include an unbalanced diet, low rates of exclusive breastfeeding and diarrhoea.

Key goal

Improve quality and usage of health facilities and improve the nutritional status of children and women, so that under-five mortality is reduced by half and maternal mortality by a quarter by 2015.

Health Transition Fund

Under the HTF UNICEF has contributed to:

  • Improving the capacity of health centers to provide basic emergency obstetric and neonatal care (EmONC). The HTF has up-skilled 250 primary care nurses in midwifery and is sponsoring the training of 900 midwife students; 
  • Ensuring that every district has a health professional capable of performing a Caesarian Section. The HTF is providing ‘top-up’ allowances to at least 3 doctors in every district, bringing the total number of doctors supported countrywide to 107;
  • Revitalizing the Health Services Fund (HSF) by providing grants to health facilities to cover selected running costs: USD 750 per month to government rural health centers, council-owned rural health centers, and mission rural health centers; USD 1,500 per month to district hospitals, designated district hospitals, and mission hospitals; and USD 2,000 per month to provincial hospitals. USD 1,000 per month is provided to all provincial and district health executives and rural hospitals. 
  • Providing rural health centers with basic equipment and consumables to enable them undertake basic EmONC. These include all the necessary lab equipment and reagents, more than 1,000 midwifery kits, 600 sets of resuscitation equipment, and 500 delivery beds; 
  • Strengthening delivery of maternal, newborn and child health and nutrition services at community level. The HTF has supplied 5,000 sets of uniforms and 5,000 sets of medical kits with essential equipment (respiratory timer, Salter scales and thermometers) to village health workers; 
  • The availability of essential drugs and medicines in public health facilities. A  March 2013 survey found that 83 per cent of health facilities had 80 per cent of selected medicines for maternal and child health; 
  • Vaccinating infants against Pentavalent. Through HTF, close to 500,000 children were vaccinated in 2012;
  • Achievement of 90 per cent coverage with Vitamin A supplementation for the first dose.





Slide show: Health Transition Fund

Fact sheet: Health Transition Fund

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