Village Health Workers fight malnutrition in Zimbabwe

Children in Zimbabwe have long suffered from chronic malnutrition, but health workers are helping to reverse the situation in their communities

Yulu Pi
Thembekile Mthuthuk, 32, feeds her baby son with free porridge provided by the clinic.
UNICEF Zimbabwe/2019/Yulu Pi

08 July 2019

“I have never thought about giving up being a village health worker” Bugalo says as she sits and chats with me under the shade of a house. She has just finished her regular report at the clinic and is preparing for the one-and-a-half-hour bicycle ride home in the scorching 35-degree heat.

Bugalo is a village health worker (VHW) in remote Gotshombo village in Bulilima District, in the South of Zimbabwe, along the border with Botswana. She became a VHW over 11 years ago, and she helps the nurses of Hangwa Clinic - the nearest health facility in this area - to collect the information of people's health status from the community and report it regularly.

“I have never thought about giving up being a village health worker”

Based on the information provided by Bugalo, nurses can quickly respond to cases of malnutrition in infants and young children. Once a child is referred to the clinic by a VHW, nurses can do further health assessments on the child and provide appropriate life-saving treatment for malnutrition using supplies available at the health facilities.

According to the Zimbabwe 2018 Nutrition Survey report launched by the Food and Nutrition Council, the national rate of child stunting, a manifestation of chronic malnutrition, is 26.2 per cent in Zimbabwe, which means nearly one in every three children are chronically malnourished. But VHWs are working very hard with parents and care givers of children under the age of five, to reverse the situation.

A role model among mothers

Bugalo is a role model among mothers in Gotshombo, providing nutrition advice to them and helping to screen for malnourished children. “Most women in the village prefer to come to me first if they face any health challenge, I am very proud of this.” she says.

“Most women in the village prefer to come to me first if they face any health challenge, I am very proud of this.”

Village health workers like Bugalo conduct sharing sessions on health, nutrition, and hygiene two or three times a month; go door-to-door to communicate with mothers about the importance of exclusive breastfeeding for the new born; and explain how to prepare a balanced diet for the family. All these efforts are beginning to pay off.  

In the past, villagers had limited awareness of the importance of exclusive breastfeeding and a healthy balanced diet, but as Bugalo says “Behaviour change is not instant, I persistently convey health education to the women, and now mothers are more aware of health issues.”

“Behaviour change is not instant, I persistently convey health education to the women, and now mothers are more aware of health issues.”

Breaking the cycle of malnutrition

There is at least one VHW in each village in Bulilima. They are trained by facility- based health workers at the clinic, with collaborative support from UNICEF and the Ministry of Health and Child Care and with funding from the multi-donor Health Development Fund (HDF) supported by UK aid, EU, SIDA, Sweden, Irish Aid and Gavi, the Vaccine Alliance.

These village health workers deliver health services to the villagers by conducting health sessions in the clinic, sending nutrition-related messages in WhatsApp groups, and conducting domestic visits to screen children for malnutrition.

Thembekile Mthuthuki, 32, and her 20-month-old son Luyolo Sibanda, in Dombodema, Bulilima district, benefited from the services of the VHW.

By regularly attending group discussions, Thembekile received vital health and nutrition information for her family. She goes to the clinic every month for Luyolo’s free growth-monitoring check-up. "I don’t mind walking one hour to get to the clinic because I know that it is important to receive the growth monitoring for my young baby," says Thembekile.

In January, when Thembekile took her son to the clinic for his usual check-up, Luyolo was diagnosed with severe acute malnutrition (SAM). He received urgent treatment.

Thandi, a nurse in Dombodema clinic, shows how they use handmade maps to plan door-to-door visits in the community.
UNICEF Zimbabwe/2019/Yulu Pi
Thandi, a nurse in Dombodema clinic, shows how they use handmade maps to plan door-to-door visits in the community.

“We gave Luyolo’s mother therapeutic food supplies and advised her to give him the food four or five times a day. Now he has gained a little more weight and his health has improved a lot,” explained Thandi, a nurse in Dombodema clinic.

After spending one-day interacting with these health workers, I admire the work they do in the hardest-to-reach areas. They know who is most in need, and they do not hesitate to help them, leaving no one behind no matter how hard it is. They are the real heroes in rural Zimbabwe.