Bringing lifesaving services to mother and baby in rural Zimbabwe
“I was pregnant, walking such a distance on the dusty road with a 2-year-old, just to get our vaccines. When you get to the clinic, you are also made to wait for hours due to long queues. It was too much for me.”
MATEBELELAND NORTH, Zimbabwe - Beauty Nkomezia, (24) no longer needs to trudge 13 km of rugged terrain in the torrid Binga District heat, to get her toddler to Sianzundu Rural Health Centre – the closest medical facility to the soon-to-be mother of 2. Beauty and her little boy now receive their routine immunization vaccines just a few steps away from their rural home located in the country’s Matebeleland North Province.
This is thanks to the integrated outreach services. This is a Ministry of Health and Childcare (MOHCC) initiative supported by UNICEF, aimed at providing preventive, rehabilitative and curative services during the COVID 19 outbreak. Through funding provided by the Health Development Fund (HDF), dedicated multi-disciplinary health facility teams spend their time in the community working closely with village health workers (VHWs) providing services. These include referrals of more complicated cases and access to MNCH services.
“I was pregnant, walking such a distance on the dusty road with a 2-year-old, just to get our vaccines. When you get to the clinic, you are also made to wait for hours due to long queues. It was too much for me,” says Beauty as she shakes her head while steadily placing her hands on her 6-month baby bump. “But now the health workers come to us and we get services in no time.”
That is why the integrated outreach services are so important. The trained health workers, who are members of the hard-to-reach communities, provide direct services such as immunization, antenatal and postnatal care for babies with disabilities or at-risk stickers due to birth complications and vitamin A supplements. The teams equally provide interventions such as counselling, active screening for malnutrition and HIV/AIDS testing, including follow-ups on exposed babies.
A COMMUNITY-BASED APPROACH
Esnath Ndhlovu is no ordinary village farmer’s wife. As her husband tends the sorghum and millet thriving under the brutal Hwange District sun, she equally tends to the community’s newborn babies.
The 49-year-old mother of 3 is serving as a Village Health Worker (VHW), providing preventive and promotive health services. These include promoting early antenatal care bookings, institutional deliveries, conducting post-natal care visits in the community, social mobilization and defaulter tracking.
Esnath’s work has been made easy using the ‘My Village, My Home’ strategy – a community level tool used to identify immunization coverage for children under 2.
“Because I live here, I know every child in my community by immunization status. The tool shows all information on children under 2 years of age in a community under the roof of a house and dates of vaccine are also indicated. I use this tool daily to track the babies. Our village heads are also involved in supporting us,” explains Esnath.
Maternal, neonatal and child mortality is still a major public health challenge in Zimbabwe. In a country with one of Africa’s highest under-5 mortality rates standing at 65 deaths per thousand lives according to the Multiple Indicator Cluster Survey (MICS) 2019, these community-based services are critical.
“I advise them on the benefits of immunization. I tell them to take all their vaccines to prevent the outbreak of vaccine preventable diseases such as measles. I educate them on the benefits of exclusive breastfeeding for the first six months after they give birth as well as COVID 19 prevention measures.” she concludes.
SAILING THROUGH THE PANDEMIC WAVES
For hospitals and clinics in the Matebeleland North Province, the COVID-19 pandemic presented its own set of challenges in implementing the MNCHN outreach strategy.
“Because malaria shows similar signs and symptoms to COVID-19, our VHWs became apprehensive about going to the communities as they felt that they did not know who to treat and who not to treat. They simply stopped going and we had to talk to our nurses to continue the outreach,” shares Sr. Rona Munkuli, the District Nursing Officer (DNO) based at Binga District Hospital shares.
As nationwide COVID-19 restrictions took their toll on the economy, fuel for hospital vehicles became costly. Other means of transport were simply out of reach due to lockdowns.
The District Nursing Officer explains that some provincial medical facilities in the Binga, Victoria Falls and Hwange districts came together with local partners to find solutions to reach the communities. Motorcyclists from the Hwange based animal rescue organization, ‘’Wild is Life’’ would carry nurses and vaccines to the villages to carry out routine immunizations. When Adventist Development and Relief Agency (ADRA) was carrying out its COVID-19 food relief drive, they would move with local district nurses to carry out health checks.
“We were not able to reach the 2020 target of immunizing 95% of our 5,964 children under the age of 1. However, thanks to the local partners helping with the outreach, our numbers were still good as we reached 89% of the children.” concludes the DNO.
Despite disruptions caused by the pandemic, the MNCHN outreach strategy is being successfully implemented in all of Zimbabwe’s 63 districts. As government and development partners continue to support the children of Matebeleland North from vaccine-preventable diseases, Sr. Munkuli is hopeful that health services will improve one mother and one baby at a time.