Care groups: providing health support; building confidence

With encouragement and assistance from his care group and village health worker, a father becomes more self-assured in keeping his children healthy.

Craig Nyathi
Njabulo Ndlovu holds his daughter, Kimberly (4) while Village Health Worker, Nomsa Ncube, uses a middle-upper arm circumference (MUAC) tape to assess Kimberly's nutrition status.
UNICEF Zimbabwe/2019/Kennedy Fambarega

19 March 2019

MATABELELAND, Zimbabwe, – Njabulo Ndlovu is the proud father of four daughters ranging in age from 18 months to 10 years. However, lacking confidence in his child care abilities, he has always relied on his wife to take care of the household and the children’s nutrition. He recalls his agony six months ago, when his 4-year-old daughter, Kimberly, was admitted to hospital with malnutrition. It’s an experience he never wants to relive. That’s why when Ndlovu (45) was recently left to look after his children while his wife and youngest child were away, he was glad that he could count on his village care group for support and advice to keep his children healthy.

The care groups are a life saver!

says Ndlovu. “I can’t imagine what I would have done without this help. My wife is usually responsible for feeding the children. I am usually away looking for piece jobs.”

A community health information system

Ndlovu’s family was recruited into a care group following Kimberly’s hospital admission. Care groups each comprise ten families managed by one ‘lead mother’ who reports to the village health worker. This network creates a community health information system that gathers reports on malnutrition cases, pregnancies and deaths detected during home visits; and shares critical information that promote health-seeking behaviours.

The lead mother regularly visits care group members, like Ndlovu and his family, sharing what she has learned from the village health worker, and encouraging positive maternal, infant young child feeding practices at the household level.

The care group model is being implemented by the Government of Zimbabwe with support from UNICEF, and funding from UK aid from the UK government and Soccer Aid for UNICEF, through UNICEF UK.

With his wife away, Ndlovu reached out to the lead mother of his care group because he was fearful of his daughter becoming malnourished again. “Fortunately, I had the contact details of our lead mother,” said Ndlovu “so I called her and that same day she called back to tell me that our village health worker would be coming over.”

Within 24 hours, village health worker Nomsa Ncube visited the family to check on Kimberly and assess the young child’s nutritional status using a special tape which measured the circumference of her left upper arm. Ndlovu and Kimberly’s grandmother were also given advice on how to feed the children a minimum acceptable diet.

Ncube supports five care groups (50 families) in Maheche village, Matobo District. “Before the care groups were formed, I was failing to visit all my households and I would mostly cover those closer to my home,” said Ncube. “Now I meet with lead mothers every two weeks and communicate with them by phone. I focus my home visits on homes where lead mothers face challenges as well as those [where the children] have been admitted for malnutrition before.”


Village health worker, Nomsa Ncube (centre) teaches Kimberly's father and grandmother how to provide the children with a nutritious diet.
UNICEF Zimbabwe/2019/Kennedy Fambarega
Village health worker, Nomsa Ncube (centre) teaches Kimberly's father and grandmother how to provide the children with a nutritious diet.

Care group approach saves lives

Across Zimbabwe, the care group approach has saved lives. Before its introduction in Matobo District in 2017 only half the district’s children and women had access to comprehensive maternal and child nutrition services, and more than 10 per cent of malnutrition cases failed to complete treatment. Now some 80 per cent of the community receives support through care groups and most identified cases of malnutrition are treated successfully with full follow up.

In Matobo District, some 246 village health workers serve approximately 11,160 children under the age of 5 and 8,886 pregnant and lactating women. The care group approach is helping to alleviate the burden on overstretched village health workers; increasing contact between the community and the health system; and reducing the chance of vulnerable children and women being missed with lifesaving nutrition services.

With the encouragement and assistance of the care group and village health worker Ncube, Ndlovu is gradually becoming more self-assured in his parenting skills. “I am happy about this visit,“ he said. “We spoke about making sure Kimberly receives a variety of foods each day. Her tape also showed that she is in the green [well-nourished], so it’s all good so far!”

Village health worker, Nomsa Ncube records Kimberly's measurements on her Child Health Card
UNICEF Zimbabwe/2019/Kennedy Fambarega
Village health worker, Nomsa Ncube records Kimberly's measurements on her Child Health Card