A village health worker’s mission to end unsafe deliveries

Chikomba, Zimbabwe-It took the tragic death of a close relative while giving birth to push Foro Kuzanga to train as a village health worker and to be the champion in the fight against maternal deaths in the community.

Kuzanga from Kaguru Village in Chokomba District, Mashonaland East, was chosen by her community to serve as a village health worker in 2010, and she believes the job was her calling.

The family tragedy drove her to take the lead in influencing the community to move away from traditional practices that led to many women dying while giving birth, such as the reliance on traditional midwives.

“Before l trained as a village health worker, there were many things l didn’t know, and if I knew, then I would have helped to save many lives in our community,” Kuzanga said.

“For instance, l had a pregnant relative, and when she started bleeding, the elders brushed it aside, saying it was a sign that she would, give birth to twins.

“She started bleeding profusely until she died.

“During training, we were taught that whenever a pregnant woman starts bleeding, it’s a danger sign, and that person must be taken to a health facility immediately.

“When the community chose me to be a village health worker, I saw it as an opportunity to raise awareness in the community about the need to stop unsafe home deliveries and to guarantee the health of children from birth until they grow up to be adults.

“I am here to save the lives of friends and relatives as well as my own.  Thanks to the training l got, l now understand health issues better, and I have become a champion in the community.”

Kuzanga boasts that traditional midwives have become rare in the villages she serves; incidents of failed deliveries are now very few because of the awareness campaigns she conducts regularly and her reputation as the go-to person for pregnant women.

Kuzanga’s routine includes making follow-up visits to pregnant women and mothers of newborns to ensure that they religiously make neonatal and post-natal clinic visits and take immunisation and vitamin A supplementation of their children seriously.

Zimbabwe has one of the highest maternal mortality rates in the world, which stands at 363 per 100 000 live births, according to the preliminary results of the 2022 housing and population census.

Complications during pregnancy and childbirth are leading causes of death and disability among women of reproductive age in Zimbabwe, a crisis that Kuzanga has been tackling in her community passionately.

She provides primary health care in the Gava, Kaguru, Madzokera and Hwindingwi villages.

Kuzanga is one of the thousands of village health workers throughout Zimbabwe supported by the Health and Child Care ministry, UNICEF and its partners, including donors of the Health Resilience Fund – the European Union, Ireland and the United Kingdom – as well as Gavi, the Vaccine Alliance.

Her duties revolve around disease prevention and providing community care at the primary level in the four villages. 

She is also the key link between the community and the formal health system, especially in hard-to-reach areas.

The grandmother of two is also passionate about children and considers protecting them against preventable diseases to be at the heart of her work.

“As a mother, I love children, and I am passionate about their health,” Kuzanga said.

“My job involves ensuring that mothers take their children for immunisation and encouraging them to monitor their children from birth closely, so they don’t fall victim to common diseases.”

She cited the recent COVID-19 that affected the whole country and the measles outbreak as some of the biggest challenges she has faced as a village health worker.

Several people in her community belong to indigenous churches that discourage their members from seeking health care. Health workers like Kuzanga had a torrid time encouraging people to vaccinate against COVID-19.

Some parents also hid their children from outreach teams carrying out measles immunisation campaigns during the outbreak.

“During COVID, mothers stopped bringing children for their Vitamin A dosages, and I had to make home visits to administer them,” she said.

“Some people on antiretroviral (ARV) HIV drugs also started defaulting on their medication because of movement restrictions imposed to stop the spread of COVID- As a village health worker, it became my duty to make home visits to encourage treatment adherence.

“There were also challenges around some religious groups that discouraged their members from accessing medical treatment.

“It became a big problem, especially during the measles outbreak where children’s lives were threatened. Fortunately, because of the awareness campaigns and the health education I have conducted in this community, we did not have any deaths due to the disease.”

Kuzanga performs some of her duties, such as weighing children and administering Vitamin A at her homestead. For outreaches, she takes advantage of community gatherings to talk to fellow villagers about hygiene, the importance of immunisation and vitamin A supplementation and disease prevention.

She cycles for distances of up to six kilometres twice weekly to bring health services closer to the people.

 “I love doing what I do because it has earned me respect in the community,” Kuzanga said.

“It has also helped me as a person. As you can see, I have a very clean homestead.

“As village health workers, we have to lead by example when it comes to hygiene so that what we teach makes sense to everyone.”

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The Ministry of Health and Child Care, UNICEF and partners work in close partnership to empower the frontline health workers – including the village health workers and the professional nurses at the local primary health facilities – to deliver essential health services to the people of Zimbabwe entitled to.  Current and past partners in the health sector include the donors of the Health Resilience Fund - the European Union, Ireland, the United Kingdom and Gavi, the Vaccine Alliance – as well as Australia, Canada, China, France, Japan, the Netherlands, Norway, Sweden, United States Bureau for Humanitarian Assistance, Eli Lilly Foundation and Rotary.