A traditional leader turns to Village Health Workers to dismantle cultural and religious practices

In a deeply conservative and patriarchal community, a traditional leader incorporates Village Health Workers into village routines – a partnership that is helping boost demand for and acceptability of RMNCAH & N services by women and adolescent girls.

Tongai Chipiro , 51years. Village Headman garnering support for community based health care services ,  Chimanimani
27 January 2022

Chimanimani, Zimbabwe - In a deeply religious and conservative village in Zimbabwe’s eastern Chimanimani district, a traditional leader has added an item on the list of village taboos: holding a meeting or any public gathering without a Village Health Worker (VHW) present.

For Tongai Chipiro, 51, the headman for Chipiro Village, a meeting, funeral or even wedding is never complete without an address by a VHW in an area where religious practices, norms, values, and beliefs often act as barriers to women and children’s access to modern medicines. Chipiro is one of the 30 community leaders and also a Health Centre Committee member who have received orientation and training on community engagement and social accountability under the Zimbabwe Idai Recovery Project (ZIRP) – a World Bank funded project implemented by multiple UN Agencies.

“I see change, there is progress.”

Tongai Chipiro

“I give the VHW a chance to address the gathering each time I hold a meeting in the village so that people can appreciate the importance of health issues. Once she makes a statement people take note, people listen when the VHW tells them to seek hospital services,” said the traditional leader.

Witnessing religious practices that violate the rights of women and children, including banning them from accessing modern medicines and gender-based violence, troubled Chipiro for years but he felt powerless to do anything about it.

So, after becoming village head four years ago, Chipiro introduced a new routine for all the village meetings and ceremonies he presides over by making the VHW a permanent feature.

With the emergence of COVID 19, the VHWs have another vital function at public events, enforcing COVID-19 prevention measures such as hand washing, mask wearing and social distancing.

Animated and authoritative when speaking about vaccines and RMNCAH& N issues, Chipiro uses his power as a traditional leader to deepen community networks by working hand in hand with health service providers such as VHWs and clinic staff.

Such partnerships are taking firm root in many of Zimbabwe’s rural areas where traditional leaders weld  strong influence and authority over local populations. They are helping boost demand for and acceptability RMNCAH & N services by women and adolescent girls in areas where they have been the main victims of norms, beliefs, and practices driven by some religious groups and patriarchy.

Villages were thrilled when they heard that a local woman, Plaxedes Gwenzi, was going for training as a VHW in 2020

Chipiro said VHWs have assisted in reducing the burden of people who, instead of walking for up to 20 kilometres to the nearest health facility, now receive assistance from VHWs who live close to them – in their communities. Their regular addresses at public events on issues ranging from hygiene to pregnancy danger signs, childcare, child marriages, gender-based violence and COVID-19 have resulted in a change of attitudes.

“Most churches are adhering to the wearing of masks, they are allowing their members to seek services at hospitals, they are beginning to condemn child marriages and gender-based violence while mothers are taking their children to the VHWs or to hospital for check-ups,” he said, adding: “I see change, there is progress.”

Under the Zimbabwe Idai Recovery Programme, 983 new VHWs were recruited, trained, and deployed  in cyclone affected districts covering all aspects of essential community-based health care including sexual and gender-based violence, child safeguarding and prevention of sexual exploitation and abuse including COVID-19.

VHWs are a critical primary element in the healthcare system across Zimbabwe and through support via UNICEF from ZIRP and the Health Development Fund receive support such as allowances, bicycles, uniforms, training, and medical items that they distribute.

Ellah Matsveta, 33, and others from Chimanimani’s Gato village were thrilled when they heard that a local woman, Plaxedes Gwenzi, was going for training as a VHW in 2020.

“We don’t have to go to Mutambara (Hospital) each time a child gets a fever or flu anymore. Life is easier now. The most difficult time for a woman is during pregnancy but our VHW is always there to check on us and provide comfort,” said Matsveta, who, like other residents here, used to walk about 15 kilometres to the hospital if she didn’t have US$2 bus fare. “The VHW also teaches us about COVID-19, helping to prevent our village gatherings from becoming spreaders of the virus.”

I didn’t even know the importance of going to hospital, but there was a world of difference when I started giving birth at the hospital

In Tonhorai village in the same district, 38-year-old Margaret Mhlanga delivered four of her six children through unsafe home births, until she met a VHW who warned her of the dangers associated with such a practice.

“Everything changed when I was pregnant with my fifth child. The VHW came to me and insisted I register at the hospital. I didn’t even know the importance of going to hospital, but there was a world of difference when I started giving birth at the hospital. I get professional help throughout the pregnancy and after the baby is born,” said Mhlanga, holding her newest child, a five-month-old son called Canaan.

For Chipiro, the traditional leader, such testimonies underline how VHWs have become an integral part of the village leadership structures.

“We are nothing without VHWs, they are at the core of the health issues in Chimanimani, so I make sure they get all the respect and access they need to effectively do their work,” said Chipiro.