The health sector in Zimbabwe is still recovering from decades of significant challenges including inadequate financing, shortages of qualified staff, poor infrastructure and obsolete equipment amongst a host of others.
Maternal and child mortality remains high at 651 per 100,000 and 69 per 1,000 live births respectively.
Newborn deaths, approximately 29 deaths per 1000 live births according to the latest MICS, account for approximately 42% of all under 5 child deaths. A closer analysis of this data shows that complications due to prematurity are the leading cause of death. According to WHO global data, Zimbabwe ranks 4th in the world in terms of rates of preterm births, roughly 16.6 pre-term births per 100 live births. Around 14,000 neonates die every year, mainly from preventable causes. The rate of decline of these key indicators leaves the country off track to meet many of the targets set by the sustainable development goals by 2030.
High coverages of standard maternal health packages such as antenatal care (93%), institutional deliveries (78%) skilled birth attendance (80%) and post-natal check within two days (57%) are indications that access to care is improving. However, the stagnating mortality rates imply that there is still much to be done in terms of the equitable provision of quality maternal and child services. Discrepancies exist in access to and provision of services between rural and urban populations.
Reaching one’s full potential in life begins before birth and is a fundamental right of every child. Every child should be brought into this world and raised in a healthy and protective environment, one in which all their health and nutrition needs can be met. Essential health services before, during and after birth together with caring, affectionate and stimulating interactions are the fundamental beginnings for families and their children. The UNICEF health programme, funded in larger part through a pooled donor funding mechanism “the Health Development Fund”, is focused on improving access to quality maternal, newborn and child health services, from both the supply and demand side. The UNICEF health programme supports the Government with such interventions as clinical mentorship to improve emergency obstetric and newborn care, the development and adaptation of key guidelines and job aids for antenatal care as well as essential newborn care for all babies, and promoting routine maternal and perinatal death surveillance reporting so that underlying causes of preventable deaths are better understood to inform policy and corrective measures put in place to improve future service provision. Support to improving immunization coverage remains at the core of reducing under 5 child deaths, through the procurement of vaccines, expanding the cold chain system, introducing new vaccines and vaccination outreach.
With respect to increasing demand for and participation in health service delivery, the UNICEF Health Programme technically supports the MoHCC in sustainably establishing a vast network of community health volunteers. These community health volunteers are an important resource for the country, bringing basic maternal and child health services and information closer to the people. In addition, the Programme is pursuing innovative interventions to accelerate the achievement of results, such as using digital and mobile phone platforms as well as other advances in medical technology and renewable energy. The programme seeks to strengthen the health system through support to the procurement and distribution of essential medicines nationwide. Operational costs for the health facilities are being provided through results based financing whose focus was recently shifted from payment for quantity to quality performance as a way of addressing some of the above-mentioned challenges. All these are guided by various policy frameworks most of which are produced with support from the programme.
By 2020, the UNICEF Health Programme has set the following targets:
- Skilled birth attendance increased to 85%
- Provinces and districts conducting quarterly maternal death reviews increased to 90%
- National immunization coverage increased to 75%
- Postnatal coverage in the first two days increased to 85%
- Proportion of children under five treated appropriately for common childhood illness (pneumonia, diarrhoea and malaria) increased to 90%
- Access to comprehensive emergency obstetric and newborn care increased to 85%