Outreach campaigns bring health services closer to marginalised communities
Thanks to outreach campaigns, children, adolescents, young mothers and older people in marginalised communities enjoy access to essential, quality healthcare
Bulawayo, Zimbabwe – Sihle Jubane, 43, left her plastic shack early in the morning to catch her place on the line as a team of health workers set up camp on an open ground at Killarney informal settlement, in the peri urban area of Bulawayo Metropolitan.
She was checked for Blood Pressure and provided her monthly dose of BP and asthma treatment. Next to her, a doctor examined an elderly man and children opened their mouths wide open for oral Vitamin A supplementation from nurses.
A Village Health Worker tried to calm a fidgeting boy on a height measuring board, while others received the tetanus, diphtheria vaccine. Standing in a separate line, a group of girls giggled and chatted excitedly while waiting to receive HPV vaccines.
“It’s just like we are at a hospital. I no longer worry about how I will get my next asthma medication or BP pills, it’s all here,” said Jubane, whose two children were vaccinated against measles. She said she is unemployed and, like most of the 400 residents of the settlement, cannot afford costs to take her family to the clinic for regular services.
Consisting of a community health nurse, a doctor, an HIV testing and treatment team, an expanded program for immunisation nurse, a psychologist, a health promotions officer and community health workers who are essential for mobilisation and community feedback, the team visits the informal settlement once each month.
The visits are part of integrated primary health care outreach programmes being undertaken by the Ministry of Health and Child Care in partnership with UNICEF and funded by the Gavi, the Vaccine Alliance (with funds from the Government of France). They are part of a raft of interventions aimed at ensuring that people in hard-to-reach places and vulnerable populations receive primary healthcare closer to their homes.
“These people ordinarily would not be able to afford the cost of visiting a doctor, so we make sure to include one as part of our team to examine and treat patients on site. We are bringing a team that can offer a full range of services including specialist services” said Community Nursing Officer and team leader, Nomusa Nyathi.
Nyathi said initially the services focused on the Expanded Program for Immunisation (EPI) targeting children under five before being scaled up into an integrated approach targeting entire populations residing 10 kilometres from the nearest health facility in 2023.
The integrated outreach programme is being rolled out in 11 districts, namely Harare, Chitungwiza, Bulawayo, Sanyati, Kwekwe, Gokwe South, Mutare, Chiredzi, Gutu, Mwenezi and Umguza.
In areas such as Umguza district in Matabeleland North province, and Mwenezi in Masvingo province, people who stay dozens of kilometres away from health facilities say the outreach programmes are their only chance at accessing quality healthcare.
The integrated outreach programme, which aims to reach 1, 5 million people, saw close to 600,000 women, children, adolescent boys, and girls as well as men receive integrated essential services within their communities across the 11 districts by the end of 2023. Immunisation coverage increased from an average of 68 percent in December 2022 to at least 95 per cent in 2023, with 10 out of the 11 districts achieving a coverage of 85 per cent and above. Over 26,000 adolescent girls were vaccinated for HPV1 in 2023 compared to 3,338 girls in 2022, while HPV 2 increased from 2,162 to 15,055 girls vaccinated during the same period.
Uptake of Td (Tetanus, Diphtheria) vaccine at 5 years increased from 7,896 in 2022 to 24,799 children in 2023, while for those at 10 years it shot up from 2,492 in 2022 to 28,005 children in 2023.
Procurement and distribution of 44 tricycles is empowering health facility teams to deliver services to the doorsteps of people in need.
“We are leaving no one behind. We have realised that marginalised settlements were being left out but we are now giving them the whole package. We want to ensure that people get the same services without discrimination,” said Kelton Ncube, the Bulawayo City Health Promotions Officer. He was speaking at Hyde Park Primary School on the peri-urban outskirts of the city where another outreach point was established.
Schoolchildren were fascinated as an Early Childhood classroom was transformed into a temporary medical facility.
Desks were taken up by mid-upper-arm-circumference-measuring-tapes, scales, height measuring boards, BP testing machines, vaccine cooler boxes, drugs and medical registers. The teacher’s room had been turned into a doctor’s office.
Children, adolescents, mothers with infants in their backs and the elderly walking with the aid of sticks trooped in for services ranging from early infant diagnosis of HIV exposed infants, HIV testing and treatment for older people, psychosocial support health education, vaccination, child nutrition, treatment of minor ailments, screening for delayed milestones/ disabilities and non-communicable disease services among other essential services.
Health personnel started by gathering community members for a session on health education on recommended neonatal and postnatal practices, nutrition and sanitation and hygiene.
For many people such as 24-year-old Sandisile Dube, the intervention is a lifesaver.
“We are getting everything we need here, from the children to us mothers and elderly people. Some of us don’t have money for taxis to travel to the clinic, walking is dangerous because we always hear of cases of robbery,” said Dube, who tested for HIV and received birth control pills, while her four-year-old child received overdue Vitamin A supplementation.
