Health Development Fund – Results Based Financing Programme - a catalyst for better health in rural

The waiting mothers’ shelter at Jeka Rural Hospital was refurbished with the support of the Health Development Fund through the Results Based Financing initiative (HDF-RBF).

Kholwani Nyathi
UNICEFZimbabwe/2021/Kudzai Tinago
02 July 2021

Heavily pregnant Julie Matutu feels comfortable at Jeka Rural Hospital in Zimbabwe’s Mberengwa District where she is waiting to deliver her fourth child.

The waiting mothers’ shelter at Jeka Rural Hospital was refurbished with the support of the Health Development Fund through the Results Based Financing initiative (HDF-RBF).  The HDF is supported by the European Union, UK Aid, Sweden, Ireland and Gavi.

Matutu (31) is among a group of expecting mothers accommodated at the facility to avoid walking several kilometres to the hospital to give birth, which exposes them to risky deliveries.

“We are being looked after very well here,” the mother of three girls said.

“The reason I came here is because our home is very far from the hospital and it would be risky to come here when I am already in labour because there is no reliable transport, and the roads are very poor.

“The nurses always make sure that we are comfortable, and the waiting mothers’ shelter is well kept.”

Matutu’s three children were delivered at the Jeka Rural Hospital nestled in a mountainous part of Mberengwa in the Midlands Province where the movement of people is restricted by poor roads and bridges that were washed away during previous rainy seasons.

The situation was even worse during the last rainy season due to the COVID-19 lockdown.

But unlike in some urban areas, services at Jeka Rural Hospital remained accessible and Matutu is grateful that she was taken in at the health facility’s waiting mothers’ shelter.

Jeka is one of several rural health centres across Zimbabwe being supported by the HDF-RBF programme to build and run shelters or maternity waiting homes to help reduce maternal and perinatal mortality.

UNICEFZimbabwe/2021/Kudzai Tinago

The centres help improve access to skilled birth attendance and emergency special care.

Some of the numerous benefits provided by the shelters to pregnant women in rural areas include ante-natal check-ups, new-born care and early detection of problems during labour.

They also help prevent maternal deaths by preventing haemorrhage, one of the major contributors of deaths for women during delivery.

Vimbainashe Maphosa, the nurse in charge at Jeka Rural Hospital, said the waiting mothers’ shelter helped save lives, especially during the COVID-19 lockdowns.

“The HDF-RBF assistance was helpful to us because we were able to prevent the death of mothers while giving birth as we continued offering services during COVID-19 lockdowns,” she said.

“This facility never closed down even for one day during the lockdowns.

“We even went a step further by intensify our integrated outreaches to provide the community with information on COVID-19 and other health services such the Expanded Programme on Immunisation (EPI), nutrition screening, ante-natal care (ANC), pre-natal care (PNC), treatment of minor ailments, and resupplies for chronic diseases.”

The Jeka success story is also shared by both health workers and expecting mothers at Mberengwa District Hospital and Wanezi Rural Health Centre as well as Maphisa District Hospital in Matabeleland South Province, which are all beneficiaries of the HDF-RBF programme.

Mberengwa District Nursing Officer Mavis Munengiwa said the availability of HDF-RBF assistance ensured that expecting mothers continued to receive antenatal care services at all health facilities.

“I would say continuous service provision in maternal and child health services was a major milestone,” Munengiwa said.

“Mothers continued to receive antenatal care services at all our health facilities and centres, deliveries were conducted at institutions. We actually recorded zero maternal deaths in the district in 2020, which was a major milestone.

UNICEFZimbabwe/2021/Kudzai Tinago

“Mothers continued accessing family planning services to reduce unwanted pregnancies and managed to conduct outreach services while observing the COVID-19 guidelines,” she said.

Her sentiments were echoed by Matobo District Medical Officer Dr Matthew Mthunzi who said the Health Development Fund (HDF) assistance helped the district fight the scourge of women dying while giving birth and prevent killer diseases among children under five.

According to the Multiple Indicator Cluster Survey of 2019, Zimbabwe’s maternal mortality, which stands at 462 deaths per 100,000 live births, and a neonatal mortality rate of 32 deaths per 1000 live births.

The RBF programme in Zimbabwe is being implemented in all districts across the country with 42 districts being funded by the Health Development Fund (HDF).

The other 18 districts being funded by the Government of Zimbabwe. 

Activities under the HDF - RBF include the payment of RBF subsidies to a total of a total of 966 rural health facilities, 67 hospitals, 42 district health executives (DHEs) and eight provincial health executives (PHEs).They also include building the capacity of the Ministry of Health staff to manage the RBF programme field visits to verify utilisation of the subsidies, assisting facilities to improve their internal control systems and providing guidance on how facilities can improve earnings.