Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697708591890.pdf (Zimbabwe)
December 2022 Issue 41 Maternal Mortality Declines In Zimbabwe HEALTH Matters 41 EDITOR’S NOTE As the year of 2022 is coming to an end, this is a time to reﬂect and look back as well as look into the future.

First, we want to thank the Editorial team for their diligent and dedicated work, contributing their expertise and quality standards that made the progress of the magazine.

Particular thanks also go to our partners for the support rendered to make our Ministry's publication a reality.
Reﬂecting on our accomplishments and challenges in the past year, we are grateful for Vice President and Minister of Health and Child Care, Hon.

General (RTD) Dr. C.D.G.N.

Chiwenga's investment drive as part of the renewed pharmaceutical industry, job creation and economic growth.
Signiﬁcant stepladders towards achieving that target included establishing a high-level team to identify opportunities, giving conﬁdence to investors and investment conferences that took place during 2022 Donald Mujiri Despite the many headwinds, there are several milestones that the ministry has reached amount which are, provision of modern training and cost-eﬀective specialist healthcare services to the public, In view of the above health facilities were constructed, solarized, and beneﬁtted from the borehole water project.
The procurement of medical equipment is part of the initiative by the Ministry of Health and Child Care to retool its hospitals The Ministry of Health and Child Care has secured funding from the Global Fund and the Chinese government to construct state-of-the-art Natpharm warehouses across all provinces.
Zimbabwe is set to become a hub of pharmaceutical manufacturing for international and regional consumption following the joint venture agreement between global medical consumables manufacturing giant Intrapharma (UAE) and the Government.

Covid-19 has had some devastating impact on the country.

We remember loved ones lost, businesses forced to close, economic devastation, and the longing for shared experiences.

But there are reasons for hope.

We have learned and innovated.


Truly, I hope this 2023 brings you not just joy and fulﬁllment but a sense of calm.

As a collective ethos is that we are” an inclusive platform for all voices.

With sincere thanks and best wishes for the future.

“This month shall be unto you the beginning of months: it shall be the ﬁrst month of the year to you” (Exodus 12:2).
Letters To The Editor IN THIS ISSUE THE MINISTER’S DESK IN THE NEWS ZIMBABWE LAUNCHES A COMPREHENSIVE NATIONAL EYE STRATEGY MATERNAL MORTALITY DECLINES VP HEALTH DESK PS MOHCC UPDATES LAUNCH NATIONAL SURGICAL, OBSTETRIC AND ANAESTIHESIA STRTEGY (NSOAS) IRAN MEDICAL SPECIALISTS MALARIA UPDATE MILESTONES IN THE HEALTH SECTOR HEALTH TRIVIA c copyrights Reserved Editorial Team Issue 41 Chief Director Public Health: Dr. M. Dobbie Chief Director Health Inspectorate: Dr.
I. Dube Designed & Production by Malik Printworks 0780 020 000 The comments and views published in health matters do not necesarily represent the views of the MoHCC and its Partners.

1 MATERNAL MORTALITY DECLINES IN ZIMBABWE Zimbabwe has made commendable progress in the provision of Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) services at all levels of care.

Population-based surveys bear testimony to this.


Findings from the Multiple Indicator Cluster Survey (MICS 2019) and 2022 Population and Housing Census bear testimony to the successes of the decade long investment by the government and its partners into the RMNCAH programme.
Except for new-born health, the programme has been performing well with notable increases in the coverage of Family Planning, Ante Natal Care (ANC), delivery and Post Natal Care (PNC) services and a decline in maternal mortality from 525 deaths/100,000 livebirths in 2012 to 363 deaths/100,000 live births in 2022.

(Census 2022) However, an outbreak of the COVID-19 pandemic in 2019 has threatened to erode the gains made in the delivery and utilization of RMNCAH services in the country.
Lockdown restrictions would be pronounced throughout 2021 based on the resurgence and severity of new infections/variants of COVID-19.
The pandemic has slowed down the delivery and utilization of essential RMNCAH services; compromised quality of care through health worker burnout; reduced or altogether stopped the implementation of selected life-saving and high impact health care interventions; increased the occurrence of cases of Sexual and Gender Based Violence (SGBV) during lockdown and reduced funding for RMNCAH programming as funds were reprogrammed to ﬁght the COVID-19.
Travel restrictions due to COVID-19 induced lockdowns, health facilities scaling down on routine services to focus more on the COVID19 response, fear of infection contraction at health facilities by clients, anxiety, and fear of infection by health workers all contributed to a decline in the delivery and utilization of RMNCAH services in 2021.
This notwithstanding, the Ministry of Health and Child Care (MoHCC) adopted alternative ways of delivering health services to people including use of digital platforms and conducting integrated outreaches among others.

Operational guidelines were also developed and rolled out to assist health professionals to provide quality care in a safe manner.

Credit goes to all the front-line health care providers who put their lives on the block, providing RMNCAH services to the citizens of Zimbabwe.
2 ZIMBABWE LAUNCHES A COMPREHENSIVE NATIONAL EYE STRATEGY t one time in Zimbabwe little attention was Abeing paid to Non Communicable Diseases (NCDs), but it was later realised that NCDs were equally dangerous just like Communicable Hospitals on 3 November 2022, Vice President and Minister of Health and Child Care, Hon.

Gen. (Retd) C.G.D.N.

Chiwenga noted that the thrust of the strategy was to eliminate preventable blindness Diseases (Cds).
The advent of the Second Republic through synergies between Government and its took a diﬀerent course of action in executing health issues in the country.

The launch of the subsequently the National Health Strategy (2021- 2025) covering the health component of the NDS1.
The vision of the National Health Strategy (2021- 2025) is to have “The highest possible level of health and quality of life for all citizens and permanent residents of Zimbabwe by 2030”.

Cases of eye disease are on the increase in the country leading to blindness in some cases.

In Zimbabwe, the causes of blindness according to the Zimbabwe National Eye Health Strategy (2014 to 2018) are congenital cataracts, glaucoma, eye trauma, measles and retinoblastoma.
Addressing attendees on the launch of the National Eye Strategy (2021-2025) at Parirenyatwa Group of health development partners.

“The National Eye Health Strategy is coming in to address the burden of eye conditions.

The strategy's main objective is to direct Zimbabwe's Government in eliminating preventable blindness by providing all citizens with sustainable eye care delivery services that are promotional, preventive, curative, and rehabilitative.
To achieve this, the Government, its development partners and the populace must understand that preventing and controlling blindness are not optional actions, but rather essential to ensuring everyone in the nation has access to good health and well-being for the sake of the common good in national development,” said Dr Chiwenga.In terms of statistics which show the worldwide depth of eye disease, some two billion people suﬀer from this.
The World Health Organisation (WHO) reported in 2019 that at least 2.2 billion individuals around the world were blind or have visual impairment, and one billion of those have vision impairment that might have been avoided or is still untreated.
3 • In addition to those with moderate to severe distance vision impairment or blindness, brought on by untreated refractive error aﬀecting 123.7 million; cataract (65.2 million); glaucoma (60.9 million); corneal opacities (4.2 million); diabetic retinopathy (3million) and Trachoma (2 million).

Relatedly, this One-Billion-person population also includes those with near vision impairment brought on by untreated presbyopia aﬀecting one million (1m).
The World Health Organisation Regional Oﬃce for Africa estimates that approximately Twenty-Six point Three Million people in Africa have a form of visual impairment.

Whereas some countries in Africa like Ghana and Kenya are approaching the World Health Organization's minimum requirements for eye health personnel.

Most countries in sub- Saharan Africa including Zimbabwe, remain under resourced.
In Zimbabwe, the burden of eye diseases is huge and dire, and this is conﬁrmed by Rapid Assessments of Avoidable Blindness conducted in Manicaland Province in 2016 and Masvingo and Matabeleland South Provinces in 2019.

Estimates show that 8 000 children below 16 years of age have childhood blindness due to congenital cataracts and glaucoma, eye injuries, measles and retinoblastoma.

Research has reported a strong correlation between the prevalence of childhood blindness and under ﬁve mortality rates.
Based on an under-ﬁve mortality rate of 80 to 100 out of 1 000 live births, childhood blindness is estimated to be 7 out of 10 000 in Zimbabwe.

VP Chiwenga said the aforementioned had resulted in countries including those in the Sub-Saharan region to develop National Eye Health Strategies to address the burden of diseases related to eye conditions.

He added that Zimbabwe had become one of the few countries in Africa to have a comprehensive strategy for eye health services.
“I am happy to inform you that as Zimbabwe, by launching this strategy we are showing our commitment and taking a positive step in meeting our international obligations.

What is now left, is the implementation of this strategic document into tangible action”.

“As we launch this National Eye Strategy for the period 2021 to 2025, the Government is fully aware of the ﬁnancing constraints that bedevilled the predecessor strategy.
The constraints result in the eye health care programme being heavily dependent on unsustainable funding from national and international development partners,” said VP Chiwenga.

Dr Chiwenga was delighted to report that the screening for refractive errors using the Portable Eye Examination Kit system started in 2019, initially, as a school screening programme in Harare and Bulawayo Metropolitan Provinces.
In fact, the introduction of the portable eye examination project facilitated the setting up of community screening programmes in Manicaland, Mashonaland West and Masvingo Provinces.

This initiative helped to generate community level data on refractive errors.

Major highlights of the National Eye Strategy The emphasis in strategy is ﬁve-fold, focusing on: i. People-centredness; ii.

Vision as a Human Rights issue; iii.


Integration of primary eye care into primary, secondary and tertiary health care levels; iv.

Workload Indicators for Staﬃng Needs and; v. Evidence-based eye health care service provision.

Other major takeaways in the policy document are: Evidence based information for decision-making, policymaking, resource mobilisation and resource allocation.

In fact, evidence-based information for eye health service delivery is critical for programming.
4 · Advocating for the establishment of a national eye health database, m o n i t o r i n g a n d e v a l u a t i o n mechanism and eye health research.

· That failure to utilise evidence-based information in policy development and programming, will not only risk a w a s t e o f r e s o u r c e s , b u t a l s o compromise the much-needed quality health service provision and care.
Acknowledgement The launch of the National Eye Strategy was done alongside the Free Adult Cataract Eye Surgery which was done at Parirenyatwa Group of Hospitals from 30 October to 3 November 2022.

VP Chiwenga took the opportunity on behalf of the Ministry to thank those who made the free eye surgery a success.
“The Ministry of Health and Child Care is grateful to, World Health Organisation, Christian Blind Mission, Zimbabwe Council for the Blind and Sightsavers for the ﬁnancial support that facilitated the evaluation of the p r e v i o u s e y e h e a l t h s t r a t e g y a n d development of this current eye health strategy.
“The VP then called upon health development partners and all relevant stakeholders including the private sector to rally behind and complement the Government of Zimbabwe's eﬀorts in addressing morbidity and mortality from non-curable diseases in general and to eye conditions, in particular,” said VP Chiwenga.
Additionally, Dr Chiwenga thanked SateWave Technologies which is complimenting the Ministry of Health's eﬀorts to provide eye screening and treatment and for donating medical consumables worth US$21 416.10.
END VP Health Matters Desk HAVING already ensured that most Zimbabweans who want access to family planning have that access and having taken ever more eﬀective action against abusers of the rights of women and girls while improving women's health, Zimbabwe wants the world to redouble its eﬀorts in the same direction.
Speaking brieﬂy after the oﬃcial opening of the International Conference on Family Planning, Vice President and Minister of Health and Child Care, Dr Constantino Chiwenga, said Zimbabwe and indeed many other countries were doing their part in population management, the availing of sexual reproductive health services to citizens as well as the general improvement of meeting the health needs of girls and women.
However, noted the VP, desired results need a concerted global approach from all member states and the ICFP on full should be a platform for global re-commitment and a global pledge to achieving the desired goals.

“After this meeting we must all carry home a message that no more should there be child marriages,” said VP Chiwenga.

“No more should there be gender-based violence.

No more should there be any deaths recorded whilst one is giving birth.
“To do this we all have to carry a message of educating our people throughout the world.

The communities where we are going to be working, on how we should protect young girls and women.

But we need also to bring in the boys and men so that this sinks home.” In his oﬃcial speech, VP Chiwenga highlighted some of the intervention strategies that Zimbabwe is employing in its sexual reproductive health strategy which others might consider employing.
These include, but are not limited to increasing access to family planning services for people living with disabilities as well as assessment of access to and uptake of integrated menstrual health and hygiene management services by women.
He also highlighted that there needs to be international collaboration on addressing the trend of developing countries' losing skilled health personnel to the developed world after spending resources on training.World Health Organisation Director General Dr Tedros Ghebreyesus, who addressed the conference virtually, said reproductive healthcare is a key component of primary healthcare and urged governments to treat it seriously.
“Quality family planning and reproductive health and rights are essential components of universal health coverage and primary healthcare,” said Dr Ghebreyesus.

“WHO is working round the world to support countries with family planning programmes including supporting 96 countries to update their national clinical practice guidelines.

“We remain committed to working with all of you to expand access to services for family planning and reproductive health.”.
6 VP Health Matters Desk UNFPA hails Zim progress Vice President and Minister of Health and Child Care Dr Constantino Chiwenga chatting with the United Nations Population Fund (UNFPA) Executive Director Dr Natalia Kanem (left), while the agency's Deputy Executive Director Ms Diene Keita (center) looks on, at the ongoing International Conference on Family Planning in Pattaya, Thailand.
THE United Nations Population Fund (UNFPA) has commended Zimbabwe for its commitment to fulﬁlling population management and for ensuring the ever improving sexual and reproductive health services are available in the latest international endorsement for the work that is being done by the Second Republic.
The commendation came from UNFPA deputy executive director Ms Diene Keita after Vice President and Minister of Health and Child Care Dr Constantino Chiwenga, delivered a presentation on the work Zimbabwe is doing in population management and in sexual and reproductive health at the International Conference on Family Planning (ICPF).
Zimbabwe, said Dr Chiwenga, had adopted a holistic approach to sexual and reproductive health services anchored on President Mnangagwa's “whole of government, whole of society approach” to problem solving.

Ms Keita said the UN agency is keen to reinforce its collaboration work with Zimbabwe.

Other member states, she noted, also stand to learn and beneﬁt from the lead provided by Zimbabwe.
“We are all very grateful, we were very honoured to be in that room and as the UNFPA deputy executive director, I was happy to listen to that and we hope to reinforce our commitment and our joint work in Zimbabwe.

“We are so proud of Zimbabwe for that, and very grateful,” she said.

Asked if Zimbabwe's processes can be the yardstick for other countries to benchmark their strategies, Ms Keita was emphatic.

“Absolutely, I hope Zimbabwe would continue to do that, and we will support all the processes.
7 “I hope to see Zimbabwe at the commission for population and development next year at the highest level possible and we will welcome him (Dr Chiwenga) in New York; I hope to see Mr Vice President.

We are so proud and honoured,” she said.


Her sentiments were further buttressed by UNFPA executive director Dr Natalia Kanem who said Zimbabwe is a “powerhouse in public health” and that the UN agency is pleased with the central role the sexual and reproductive health needs of women and youths have being accorded.

“From my perspective, Zimbabwe, which I knew very well being a medical doctor myself, has been a powerhouse in public health,” she said.
“Investing in young people, their education, their job training, their digital ability to participate is going to be very crucial.
So, I think some of the measures that Zimbabwe has been taking in terms of strengthening the youth contingent in the country show us that the adolescent girl proposition has to be strengthened.” Earlier on, VP Chiwenga had told delegates that Zimbabwe was forging ahead with fulﬁlling its obligations to international undertakings on population management and sexual reproductive health.
VP Chiwenga said this is further buttressed by the appointment of national agencies and taskforces to push for the attainment of these goals with President Mnangagwa personally monitoring their work.

“To show how seriously we take this human rights issue of family planning .

.

.

may I hasten to say, ladies and gentlemen, that the Head of State and President of the Republic of Zimbabwe takes the performance of agencies such as the Zimbabwe National Family Planning Council seriously,” said the VP.
“In this regard, the board chairperson and the chief executive oﬃcer sign their annual Performance Contracts in front of His Excellency the President, with quarterly appraisals done, in order to track performance.” Zimbabwe's population is still growing, although the birth rate is now close to replacement levels.

This is because of other health initiatives that have seen more people living longer, so there are a lot of people born when birth rates were far higher who are still middle-aged.
Zimbabwe's birth rates fell as a direct result of the major eﬀort made in the 1980s to ensure all girls had a full secondary education, coupled with access to reproductive health services and good primary health care for babies and toddlers.

There was no compulsion but UNFPA has noted that educating girls and women and ensuring they have access to the health services they want for themselves and their children means that women are able to make decisions and to act on what they decide.
Thailand is keen to scout for investment opportunities in Zimbabwe and will soon start working on modalities to achieve the goal.

Thailand Deputy Minister of Public Health, Dr Sathit Pitutecha, said after meeting Vice President and Minister of Health and Child Care, Dr Constantino Chiwenga on the sidelines of the recently ended International Conference on Family Planning (ICPF) that his country was keen on investment.
The Thai interest becomes the latest frontier responding and keen on bringing investment into the country on the back of President Mnangagwa's investment promotion thrust.

Thailand is already listed as an upper middle- income economy by the World Bank having registered rapid economic growth in recent times.
Zimbabwe is on a drive to attain the same status by 2030 and thus has a lot to gain from cooperating with Thailan Agriculture, public health and energy as some of the areas the 2 countries are keen to have a look at.

“The Vice President (Dr Chiwenga) gave us information and data of Zimbabwe,” Dr Pitutecha said.
“He mentioned diﬀerent opportunities where Thailand and Zimbabwe can cooperate in terms of trade and investment in energy, agriculture and I would like to express my gratitude to the information provided by him.” “We thank him for mentioning opportunities in the future.
I will study all the information provided by him to identify further cooperation to diﬀerent opportunities in future in relation to investment in public health and universal health coverage as well as family planning and other matters raised by him.” Thailand, with a US$506 billion gross domestic product, is now one of the eight largest economies in Asia.

Its economy is anchored on agriculture, manufacturing, tourism and electronics.
With Zimbabwe on a drive to boost its information and communication technology sector, collaboration with Thailand could come in handy.

Looking at new frontiers like Thailand is in sync with President Mnangagwa's diplomatic thrust of engagement and re-engagement and Zimbabwe being a friend to all and an enemy to none.
Government, in the New Dispensation, has been primed to further economic development and improving people's lives in all its engagements.It is against this background that while VP Chiwenga was primarily here for a conference on population and sexual reproduction, he couldn't miss an opportunity to pursue further economic opportunities.
8 VICE PRESIDENT AND MINISTER OF HEALTH AND CHILD CARE DR CONSTANTINO CHIWENGA DISCUSSES WITH THAILAND DEPUTY MINISTER OF PUBLIC HEALTH, DR SATHIT PITUTECHA, WHILE AN INTERPRETER (CENTER) ASSIST WITH INTERPRETATION IN THAILAND Zimbabwe has registered major strides in population management, putting itself in prime to adequately manage and distribute its resources as well as improving people's quality of life, Vice President and Minister of Health and Child Care, Dr Constantino Chiwenga has said.
VP Chiwenga made these remarks when he made a presentation at the 19th edition of the International Inter-Ministerial Conference The ICFP is scheduled to be oﬃcially opened later today and up to 125 countries have sent delegates to the conference.
VP Chiwenga said in response to the targets set by the population and development conference in 2019 at its Nairobi conference, Zimbabwe had proceeded to set up a National Taskforce for Population and Development (NTFPD) in a bid to accelerate the attainment of set goals.The ICPD Nairobi committed itself to making bold steps to transform the world by ending all maternal deaths, unmet need for family planning and gender-based violence and harmful practices against women and girls by 2030.
VP Chiwenga said in response to the targets set by the population and development conference in 2019 at its Nairobi conference, Zimbabwe had proceeded to set up a National Taskforce for Population and Development (NTFPD) in a bid to accelerate the attainment of set goals.

The commitments sit well with the society that Government is fostering under the Second Republic thus the need to setting up of a national taskforce to accelerate the realisation of these goals.
“In recognition of the commitments which were made during the Nairobi Summit held in 2019, the Government of Zimbabwe set up a National Taskforce for Population and Development (NTFPD) which is a key tool for implementing the commitments .

.. .,” said VP Chiwenga.

“Furthermore, the Government of Zimbabwe has ensured a budget line of contraceptive commodities of $627 million in 2022 and procured contraceptive commodities worth US$1, 5million,” he said.
Vice President and Minister of Health and Child Care Dr Constantino Chiwenga revealed this at the end of the International Conference on Family Planning (ICPF) yesterday.

The oﬀer comes on the back of Zimbabwe having made a huge impression on its global peers which drew commendation from the United Nations Population Fund and several other players.
9 VICE PRESIDENT AND MINISTER OF HEALTH AND CHILD CARE DR. CONSTANTINO CHIWENGA CHATS WITH OTHER DELEGATES ON THE SIDELINES OF THE INTERNATIONAL CONFERENCE ON FAMILY PLANNING THAT ENDED IN THAILAND VP Chiwenga said in response to the targets set by the population and development conference in 2019 at its Nairobi conference, Zimbabwe had proceeded to set up a National Taskforce for Population and Development (NTFPD) in a bid to accelerate the attainment of set goals The ICPD Nairobi committed itself to making bold steps to transform the world by ending all maternal deaths, unmet need for family planning and gender-based violence and harmful practices against women and girls by 2030.
VP Chiwenga said in response to the targets set by the population and development conference in 2019 at its Nairobi conference, Zimbabwe had proceeded to set up a National Taskforce for Population and Development (NTFPD) in a bid to accelerate the attainment of set goals.

The commitments sit well with the society that Government is fostering under the Second Republic thus the need to setting up of a national taskforce to accelerate the realisation of these goals.
“In recognition of the commitments which were made during the Nairobi Summit held in 2019, the Government of Zimbabwe set up a National Taskforce for Population and Development (NTFPD) which is a key tool for implementing the commitments .

.

.,” said VP Chiwenga.

“Furthermore, the Government of Zimbabwe has ensured a budget line of contraceptive commodities of $627 million in 2022 and procured contraceptive commodities worth US$1, 5million,” he said.
Vice President and Minister of Health and Child Care Dr Constantino Chiwenga revealed this at the end of the International Conference on Family Planning (ICPF) yesterday.

The oﬀer comes on the back of Zimbabwe having made a huge impression on its global peers which drew commendation from the United Nations Population Fund and several other players.
Zimbabwe has been oﬀered the chance to host the High Level International Consultative Conference leading to the International Conference on Population and Development (ICPD) 30 as part of the international community eﬀorts to tap into the country's population and sexual reproductive management interventions.

Now, with a view to take global attention even closer to the Zimbabwean example, the UN agency has oﬀered Zimbabwe hosting rights next year.
Speaking to journalists after the ICPF closing ceremony, VP Chiwenga said Zimbabwe stood ready to welcome its peers.VP Chiwenga spoke on the misconception that population management and family planning was about reducing the number of the populace, saying instead what Zimbabwe needed was a structured programme to grow and balance its population.
He said the conference had aﬃrmed the position that sexual reproductive health was not a women and girls issue, but something that also needed man and boys to come on board.
10 s e t a d p U C C H o M S P MINISTRY OF HEALTH AND CHILD CARE AND DONOR ORGANIZATIONS (MODO) STRATEGIC PLANNING MEETING The Ministry of Health and Child Care and Donor Organizations (MODO) held strategic planning meeting in Victoria Falls from 13-14 November 2022.The purpose of the meeting was to review the performance of the health sector and to develop strategic interventions.
The Secretary for Health and Child Care, Air Commodore Dr Jasper Chimedza opened the meeting and commended the health sector for considerable achievements despite several challenges to be addressed.

Zimbabwe, like many other countries in sub-Saharan Africa, has been aﬀected by skills ﬂight of health workers in the public sector.

Attrition of health professionals from public health sectors is found to be a barrier to eﬀectiveness of health systems and to provide essential health service to population.
The attrition was aggravated by the COVID-19 pandemic as outbreak increased demand for health workers in the West.

Addressing the participants Dr. Chimedza said: “During the past 2-3 years under review, the Ministry experienced record high attrition of staﬀ and this compromised our service delivery capacity”.
“The skills ﬂight was triggered by the COVID-19 pandemic as outbreak increased demand for health workers in the West and as a result, they oﬀered higher salaries than the most African countries”, said Dr Chimedza.
The government introduced monetary and non-monetary interventions to stem prevalence of health professionals’ attrition from public health s e c t o r. “ T h e G o v e r n m e n t m a d e s o m e interventions such as provision of tools of the trade, review of sector speciﬁc allowances, provision of transport (buses being bought and vehicle loans for duty free), staﬀ canteens, MDL and staﬀ training, government also acquired ﬂats through the Ministry of National Housing and Social Amenities in Mufakose, ﬁnalising the procurement of ﬂats in Manresa, a block of ﬂats is expected to be purchased in Baines Avenue targeted at the workers”, said Dr. Chimedza.
The meeting was attended by Government line Ministries, Agents, and Development Partners.

The commissioning of renovated ﬂats at Mpilo Central Hospital is expected to be launched any time soon.

A facility is expected to be made available at Ingutsheni Central Hospital, in a bid to accommodate health workers from UBH and Mpilo Central Hospitals.

The government embarked on an initiative to purchase ambulances to cater for centres that are in dire need.
This program is also being complemented by additional ambulances being funded by development partners.

According to Dr Chimedza the government continues to prioritise the availability of emergency services, 32 ambulances have been bought and distributed to District hospitals across the country and 68 are expected to be procured and delivered before the end of the year targeting hard to reach areas.

Government also plans to have highway ambulances placed at tollgates across the country.
The Secretary for Health and Child Care appreciated support from development partners.

“The Ministry continues to be grateful for the continued support from our development partners.

Your support has been critical and timely as we continue increased funding and sustainable disbursed in 2024”.“I am delighted that evidence from our resource mapping exercise is pointing to a positive direction where we are starting to witness increasing domestic funding for health” 11 VP and MoHCC Minister, Hon.
Gen. (RETD) (DR) C.D.G.N Chiwenga Launched the National Surgical, Obstetric & Anaesthesia Strategy (NSOAS) 2022-2025 As Government walks the path towards achieving vision 2030 of realising a prosperous and upper-middle- income economy by 2030, Zimbabwe continues to witness various innovations across a number of sectors of the economy and health is no-doubt one of them, as a key enabler for the fulfilment of this vision.
As a result, Government recently launched the National Surgical, Obstetric and Anaesthesia Strategy (NSOAS) 2022-2025 on 30 September 2022, in a move targeted at addressing the challenges facing the country in the provision of timely, affordable, safe and quality surgical services.
The strategy that was launched in Victoria Falls during a conference organised by the Surgical Society of Zimbabwe and the Zimbabwe Anaesthetic Association, is the first of its kind to be launched in Zimbabwe in the medical field in question.
The NSOAS is aimed at promoting access to surgical services across all levels of the national health care delivery system, in a move that would strengthen primary health care given the fact that, 83% of key tracer surgical operations in Zimbabwe were previously being performed at central and provincial hospitals only.

Nonetheless, implementation of the NSOAS would enable surgical service delivery to be accessed at the lowest level such as District Hospital level.
Additionally, the strategy seeks to address infrastructure and equipment related shortcomings existent in essential surgical care as these play a critical role in the provision of the service.Officiating the launch, Vice President and Minister of Health and Child Care, Dr Constantino Chiwenga, indicated that the move to introduce the NSOAS was in line with resolutions of international conventions and bodies.
“By launching this strategy as Zimbabwe, we are showing our commitment and taking a positive step in meeting our international obligations.

What is now left is the implementation and translating this strategic document into action,” said Vice President Dr Chiwenga.

The World Health Assembly resolution 68.15 resolution recognizes the central role of surgery and anaesthesia care in achieving Universal Health Coverage (UHC).
Vice President Dr Chiwenga also implored development partners and private sector actors to complement Government efforts towards health issues amenable to surgical care as guided the strategy document.

He further highlighted the importance of surgical interventions in the treatment and care of patients affected by most Non Communicable Diseases (NCDs) adding that the new strategy will address the burden of diseases amenable to surgical care in Zimbabwe.
12 A report published by the Lancet Commission on Global Surgery in 2015, revealed that Approximately 70 percent of the world still lacked access to safe, affordable emergency and essential surgical obstetric and Anaesthesia care when needed.

This resulted in countries moving to develop, National Surgical, Obstretric and Anaesthesia plans to address the burden of diseases that are amenable to surgical care.
The NSOAS came against a background of a Zimbabwe dealing with a double burden of both communicable and NCDs, with NCDs being among the top 10 leading causes of death in the country.

The launch of the NSOAS strategy in the country saw Zimbabwe become the 5th Country in the SADC Region and 9th in Africa to develop and launch such a medical strategy.
On his part, WHO Country Representative, Dr Alex Gasasira, in a speech read on his behalf by Technical Officer Dr Thenjiwe Sisimayi urged leaders to rally together to ensure that the necessary resources needed for the implementation of the strategies are put in place.

“I would like to call upon leaders at all levels to mobilize resources to support the implementation of this strategy to benefit the patients in need of surgical care,” said Dr Thenjiwe Sisimayi.
The development of the NSOAS was instantiated in 2018 while led by the Ministry of Health and Child Care (MoHCC) leadership.

To ensure an inclusivity in the development of the strategy, MoHCC adopted the Whole of Government and Whole of Society Approach, which saw the coming together and strong participation of various stakeholders in the various processes leading to the formation of the strategic policy document.
Partners such as WHO and the SDG3 GAP Signatory Partners (UNICEF, UNFPA, The World Bank/GFF), SADC SOA Technical Experts Working Group (TEWG) and various professional associations in the field of SOA provided the much needed financial and technical assistance.

The NSOAS is aligned to the National Health Strategy (2021 -2025) which seeks to achieve the highest possible level of health and quality of life for all people in Zimbabwe by 2030.
The implementation of NSOA strategy is going to ensure that all people in need of Surgical, Obstetrics and Anaesthesia (SOA) services receive quality and timely care at all levels of the healthcare system.

In addition, improving access to surgical services will not only save lives but improve human capital, thus contributing substantially to economic growth in Zimbabwe and the region.
13 Iran Medical Specialists Charmed by Zimbabwe's Health Sector The Ministry of Health and Child Care on 17 October 2022, received a delegation of 12 Iranian medical specialists.

The delegation came as part of a medical exchange programme between the Government of Zimbabwe and Islamic Republic of Iran.
The visit by the delegation follows a series of meetings that were held between the Iranian Ambassador to Zimbabwe, His Excellency Abbas Navazani and Ministry of Health and Child Care Deputy Minister, Dr John Mangwiro on 13 April 2022 where it was agreed on an exchange programme in Health Policy and Health System Management for all levels of the health delivery system.

During their stay in Zimbabwe, the Iranian medical specialists were operating from United Bulawayo Hospital and Mpilo Central Hospital.
To note is that these Iranian medical specialists were paired with local doctors.

Welcoming the delegation to Bulawayo at UBH, UBH Acting Clinical Director, Dr Harrison Rambanapasi said “We are very happy to receive the delegation of specialist doctors from Iran and I would like to thank the MoHCC for such an initiative.

This is part of a Government initiative where the two countries are trying to create a platform for exchange of ideas,” said Dr Rambanapasi.
Dr Emadi announced the purpose of their visit on behalf of the Iranian delegation where he emphasised on knowledge sharing, promotion of health and safety of people.

“This is an important mission for us because we believe health and safety is not only for Iran or a speciﬁc country.

The purpose of our visit is to share knowledge and expertise because we believe the health and safety of our people is important and can only be improved when medical practitioners exchange ideas,” said Dr Emadi.
14 The Iranian medical specialists paid a visit to NUST Faculty of Medicine Executive Dean Professor Elopy Sibanda and his staﬀ at Mpilo Central Hospital grounds with a view to get an appreciation of the operations of the medical school.

Prof Sibanda expressed their willingness to learn from the Iranian experience.

“We are pleased to host a delegation of 12 specialists from Iran.

We were notiﬁed about their presence yesterday by the Ministry of Health and Child Care.
We are quite happy to host them and learn from them as we share experiences.

“We want as a young university to work together with for example University of Tehran which is about 600 years old.

They have a lot of experience and as such we will beneﬁt a lot by working with them,” said Prof Sibanda.

The NUST Dean of Medicine was quick to point out that they would like their students to beneﬁt by bringing in medical specialists such as those from Iran to train them.
“We want to beneﬁt from the expertise of the Iranians and others through bringing in specialists into the country so that people do not seek specialist services in other countries.

Our students are very bright and many qualify to train specialist doctors,” said the Dean.
Meanwhile, Iranian surgeon Prof Mahdi Mesgarani Torghabeh said they were eagerly looking forward to working with the NUST Medical School, especially in specialist training of medical students so that they could ﬁll the gap of the much needed medical specialists in the country.

“We can work to make it better in diﬀerent specialties and we talked about this with our colleagues but the Ministry of Health and Child Care and our Embassy will give direction on the way forward,” said Prof Torghabeh.
Bidding farewell to the Iran medical specialists, Dr Rambanapasi spoke about the experiences that were shared between the two parties and the opportunities that exist in pharmaceutical production, research and medical teaching, among other areas of interest.

“For us it has been a hectic and exciting week.

Our Iranian friends were working with us in wards, outpatients' clinic and theatre.

I have received reports from the specialists in both hospitals.
They tell me it's been a week of learning, a week of enlighten learning from the Iranian experience.

“I wish the attachment had been longer.

There are pharmaceuticals, research, medical education and equipment,” said Dr Rambanapasi.
On his part and on behalf of the entire Iranian delegation, Dr Emadi as the head of the delegation said it was a learning and sharing experience between Zimbabwean and Iranian doctors towards satisfactorily serving patients and that he was excited to re-start the skin clinic in Bulawayo.

“We came here for mutual collaboration to give them knowledge and experiences and to receive from them knowledge and experience.
We exchanged our knowledge with them on how to treat, diagnose, follow up and manage the patient.

“Since there was no Dermatologist in the City, this is the ﬁrst time that we really tried to re-activate the skin clinic here,” said Dr Emadi Partners such as WHO and the SDG3 GAP Signatory Partners (UNICEF, UNFPA, The World Bank/GFF), SADC SOA Technical Experts Working Group (TEWG) and various professional associations in the ﬁeld of SOA provided the much needed ﬁnancial and technical assistance.
The NSOAS is aligned to the National Health Strategy (2021 -2025) which seeks to achieve the highest possible level of health and quality of life for all people in Zimbabwe by 2030.

The implementation of NSOA strategy is going to ensure that all people in need of Surgical, Obstetrics and Anaesthesia (SOA) services receive quality and timely care at all levels of the healthcare system.
In addition, improving access to surgical services will not only save lives but improve human capital, thus contributing substantially to economic growth in Zimbabwe and the region 15 MALARIA UPDATE NOV 2022 Malaria remains a major public health disease prioritized for elimination.

Zimbabwe has made remarkable progress in the ﬁght against malaria.

Overall national malaria incidence declined by 93% between 2000 and 2021.
The malaria incidence declined from 136/1000 population in 2000 to 9/1000 population in 2021.

However the road has not been smooth as natural disasters including cyclones (Dineo (2017), Idai (2019) and COVID-19 pandemic 2020) threatened to reverse the gains as the events were associated with increases in malaria incidence.
However, the Ministry of Health and Child Care with support from other partners and funders ensured that the community continues to get malaria prevention and elimination commodities for free.
Zimbabwe uses World Health Organization certiﬁed malaria control and elimination strategies, including vector control (indoor residual spraying (IRS), use of long-lasting insecticidal nets (LLINs) and to a limited extent larval source management (LSM), use of eﬀective medicines to treat only conﬁrmed malaria cases, epidemic preparedness and response, advocacy and Social and Behaviour Change, intermittent preventive treatment in pregnancy (IPTp) and surveillance, monitoring, and evaluation.
Vector control remains one of the most important strategies for prevention, control and elimination of malaria.

Using these strategies the country is now implementing malaria elimination activities in 30 districts.

Malaria elimination activities are implemented in districts that have reached malaria transmission incidence of 4 cases per 1000 population.

What is malaria?

Malaria is a disease caused by a parasite that is spread by a bite from an infected female anopheles mosquito.
The female anopheles mosquito does not make noise when ﬂying.

Approximately 67.5% of the population reside in malaria risk areas and everyone is at risk.

However, pregnant women, children under the age of 5 years, the elderly, those living with chronic conditions and travelers from non malaria transmission areas are more vulnerable to malaria due to reduced immunity.

These groups of people are at an increased risk of developing severe malaria which can lead to loss of life.
In Zimbabwe malaria transmission increases from November through to May with a peak transmission from February to May.

This coincides with the rain season which increases the mosquito breeding sites (mosquitoes breed in stagnant water).

What has the country done to ensure the community is protected against malaria during the 2022/2023 Malaria Season?
The Ministry of Health and Child Care (MOHCC) through the National Malaria Control Programme (NMCP) uses the World Health Organization (WHO) recommended interventions to prevent, control and eliminate malaria in Zimbabwe.

These interventions include: a) Vector control strategies - targeting the mosquito Spraying the inside of houses (IRS) - in 25 districts targeting to protect a population of 2.8 million.

The country also rotates the chemical used for IRS to manage and prevent IRS chemical resistance.
Currently the MOHCC is conducting IRS.

targeting to spray We urge all the communities in areas that going to be sprayed participate actively during spraying IRS by: § allowing the spray operators to spray the inside walls of your homes provide 20 litres of clean for the spray operator to use for mixing IRS chemical § Prepare the rooms to be sprayed by removing food items from the room to be sprayed and other properties.

Big items to be moved to the centre of the room and covered.
§ After spraying people and domestic animals should not enter the sprayed room for 2 hours.

The windows and doors of the sprayed rooms should remain closed for that period to allow for the chemical to dry on the walls.

After that open windows and doors and stay outside for another 30 min to allow airing of the room.

§ After that wipe the door and window handles with a dry cloth to remove excess chemical.
Sweep all the dead insects (coachroches, bedbugs, ants), throw in a pit toilet or dig a hole and burry the insects.

§ Sleep in a sprayed room daily § stay outside for another 30 min to allow airing of the room.

§ After that wipe the door and window handles with a dry cloth to remove excess chemical.

Sweep all the dead insects (coachroches, bedbugs, ants), throw in a pit toilet or dig a hole and burry the insects.
• Distribution of long lasting insecticidal nets (LLINs) for free in low malaria transmission districts (implementing elimination activities).
LLINS are eﬀective in preventing malaria only when one sleeps under the LLIN every day • Use of repellents - apply traditional/modern repellents to exposed parts of the body to prevent mosquito bites when outdoors between dusk and dawn a) Case management – All suspected cases of malaria are tested and only positive cases of malaria are treated with eﬀective medicines.

This is done at all levels of health care from community level to central hospitals.
At community levels community based health workers have been trained on how to recognize signs and symptoms of malaria.

Adequate medicines have been procured and prepositioned in all districts of the country to ensure prompt treatment of malaria cases at all levels including at the community b) Prevention of malaria in pregnancy – Pregnant women in moderate to high transmission areas are given medicines to prevent malaria during pregnancy.
In low transmission areas all pregnant women are given LLINs on the ﬁrst antenatal care visit.
Pregnant women are urged to book early before 12 weeks of pregnancy and receive at least 3 doses of medicines to prevent malaria in pregnancy 16 c) Advocacy and community mobilization is done to increase involvement and participation of communities and other stakeholders in malaria control initiatives Malaria cases from week 1 - 43 Table 1: Comparison of Malaria Cases and Deaths 2020 to 2022 (Week 1- 43) Year 2020 2021 2022 Cumulative Malaria Cases Cumulative Malaria Deaths 381,583 100,864 94,013 390 123 156 A reduction of 7.2% in malaria cases was noted in 2022 as compared to 2021 during the same period under review.
A total of 156 malaria deaths were reported in 2022 as compared to 123 reported in 2021.

Manicaland, Mashonaland East and Central provinces are the most aﬀected provinces accounting for 84% of the burden.

It is important to note that the cases recorded in Bulawayo and Harare are referrals to the tertiary hospitals for complicated cases.

Those above 5 years age is the most aﬀected.

This could be attributed to outdoor activities during mosquito biting times (between sunset and sunrise).
The presence of at least one of the following signs and symptoms indicates severe malaria: o Very high fever o severe vomiting o severe body weakness (inability to walk or stand) o yellow eyes (Jaundice) o Anaemia (paleness of palms and eyes) o Confusion o multiple convulsions/ﬁt Drowsiness or loss of consciousness o passing very little dark urine (coca-cola urine) or not passing urine at all Severe malaria is a medical emergency and the patient has to be managed in hospital.
Prevent mosquito bite by: o Sleeping under a long lasting insecticidal net (LLIN) correctly everyday o Sleeping in a house sprayed with an insecticide that kills mosquitoes (In areas that sprayed Table 2: Cum ulative M alaria Cases W eek 1 to 43 of 2022 by Province Province RDNS - Positive M alaria % Contribution o Wearing clothes that cover most of the body between sun set and sunrise (dusk and dawn) o Applying lotions/creams or traditional herbs that repel mosquitoes o Burning mosquito coils · · · Reducing malaria breeding sites around homesteads by closing pits and other places that can hold water where mosquitoes can breed Pregnant women in living moderate to high malaria transmission zones should book early for antenatal care to receive medicines to prevent malaria during pregnancy The community sensitization meetings to increase knowledge on causes, signs and symptoms of malaria, treatment and prevention M ash Central M ash East M anicaland M asvingo M ash W est M at North M idlands M at South Harare Bulaw ayo Total 35,500 28,251 15,461 5,019 4,059 4,268 541 534 281 99 38 30 16 5 4 5 1 1 0 0 94,013 100 What people should know and do during the malaria season Malaria is transmitted by a bite from an infected female anopheles mosquito.
The most eﬀective method to prevent malaria is to prevent mosquito bite.

· Know the malaria signs and symptoms.
These include: o fever /hot body o headache o hot and cold spells (sweating, chills and shivering o joint pains and general body weakness o nausea, vomiting and sometimes diarrhoea What to do when one suspects malaria o Seek early testing and treatment within 24 hours of illness from your village health worker or nearest clinic o Complete the treatment course for complete cure and to avoid further transmission to others If malaria is not treated early, it will progress to complicated malaria which is a life threatening condition.
·The following signs and symptoms indicates severe malaria 17 n o i t a s i n u m m I o i l o P MILESTONES IN THE HEALTH SECTOR DEVELOPMENT The attainment of Independence in 1980 b r o u g h t m o r e t h a n m a j o r i t y r u l e t o Zimbabweans, as it also saw citizens' access to healthcare facilities and ancillary services improved on through the Government's commitment to the provision of social security to the previously marginalized black people.
Rhodesia's system was skewed in favour of whites, which created income inequalities and disparities in the provision of healthcare facilities.Colonial injustices led to the establishment of two economies in one country: the white people's economy and the black people's one.

Rather, there existed two nations: the European nation and the African nation.
The European nation, determined by whiteness, was urbanized, and had many facilities matched by high concentration of health personnel, especially professionals.

The African nation on the other hand, was ruralised, and was marked by inadequacy in terms of arable land, rains, schools, health facilities, roads, and sustainable livelihoods.

Independence, therefore, ushered in a new era in economic and social reforms for the betterment of citizens' livelihoods.
A new healthcare approach was adopted to address a plethora of discrepancies that Rhodesia's system fed on.

The excess mortality, and the associated morbidity, amongst the Rural and African population was due overwhelmingly to nutritional deﬁciencies, communicable diseases, maternity-related and neo-natal problems.

Accordingly, the government devoted to completing the exercise of restructuring and reorganizing the Ministry to enable it to take the above problems.
The publication of “Equity in Health”, reinforced ministry's strategy of “centralizing policy and decentralizing implementation” through the adoption of the Primary Health Care Approach.

In 1983, the foundation for an intersectoral approach towards “Health for All by the year 2000”, were ﬁrmly laid through the provinces.

Many Ministries contributed towards the implementation of Health and Development programmes.
To achieve its target, the Government, through the Ministry of Health (now the Ministry of Health and Child Care) partnered private stakeholders after Independence to bring together resources to create a vibrant economic base ideal for the provision of healthcare services for all citizens.

At the helm of the Ministry is Vice President Dr Constantino Chiwenga, who is deputised by Dr John Mangwiro.

Air Commodore Dr Jasper Chimedza is the Permanent Secretary.
The mandate of the Ministry of Health and Child Care (MoHCC) is to promote the health and quality of life of the people of Zimbabwe.

The Ministry's purposes are to: achieve equity in health by targeting resources and programmes towards the most vulnerable and needy in Zimbabwe; facilitate primary healthcare provision for health development; identify priority health problems and allocate resources to alleviate them.
The National Health Strategy (NHS) 2021-2025 was developed taking into consideration the challenges that the country has gone through.

These include the economic instability since 2008, the change over from the ﬁrst Republic, and the onset of the COVID 19 pandemic.the National Development Strategy 1: 2021-2025 (NDS1), provided the national perspective to health and wellness in Zimbabwe.

The NDS 1 [2021-2025] identiﬁed ten (10) national outcomes for the National priority on Health and Wellbeing.
These ten outcomes formed the basis of the priorities in the National Health Strategy (NHS) 2021-2025.

The Country's Health Sector Strategic focus is guided by the overall Vision 2030 that seeks to transform Zimbabwe into a middle income economy by 2030 and the National Development Strategy 1: 2021-2025 (NDS1).

18 commensurate with that of a middle income country, through attainment of speciﬁc health impact targets.

The strategic directions are structured around 10 outcomes, and 4 key result areas.
Leadership and governance are critical factors in ensuring eﬃcient and eﬀective direction and management of the health sector.

The performance of the sector in the area of leadership and governance is analysed along the following key areas: public policy, legislation and regulation; organisation and management; planning and resource mobilisation; transparency and accountability; and monitoring and evaluation.
The main sources of health care ﬁnancing in Zimbabwe are, government budget appropriations and donor funding with household health expenditure coming through out-of- pocket expenditure.

Total government health expenditure (TGHE) as a proportion of total expenditure has been slightly improving over the years from 2015.

External support is currently targeted towards vertical programs such as HIV and AIDS, malaria and TB.
Vertical donor support is characterised by certain rigidities and cannot be moved to other priority areas less favored by donors.

The private health insurance is also in existence in Zimbabwe and is characterised by several employer based and voluntary medical schemes.

To bridge the ﬁnancing gap, the Government is currently working on the establishment of a National Health Insurance (NHI) as a complimentary source of health ﬁnancing.
Child mortality indicators, infant mortality rate and under ﬁve mortality rate have shown some signs of declining over the same period.
Generally, the coverage of Reproductive, Maternal, New-born, and Child Health (RMNCH) interventions have been improving over the 5-year period from 2014 to 2019 and has varied from 71.4% (4 ANC visits) to 82% for mothers and 91% for new born baby (PNC) (MICS 2019) National immunisation coverage has shown that the proportion of children who received Penta 3 below one year rose from 89% (ZDHS 2015) to 90.6% (MICS 2019).
Districts with DTP3 coverage >80% increased to 59/63(93.6%) in 2018 up from 54/63 (86%) in 2017.

Dropout rates for all antigens remained below 10% in all antigens except for MR1 – MR2 that was 11% Zimbabwe as a country has made signiﬁcant progress towards the 95-95-95 targets.

In 2019, 91% of people living with HIV (age 15 years and older) knew their status, 93% of these were on antiretroviral therapy (ART) and 86% of those on ART were virally suppressed.
The estimated TB incidence in 2018 was 210 per 100,000 population (Global TB Report 2019).

Two thirds (62%) of notiﬁed patients were co-infected with HIV in 2018.

Males bear the brunt of disease burden, particularly the economically productive 25-44-year age category due to smoking behaviour and work environment.

Malaria continues to be a key driver of morbidity and mortality rates in Zimbabwe.
Malaria transmission intensity has seasonal and geographic variation corresponding closely with the country's rainfall patterns and topography.

19 Transmission is perennial in malarious areas, seasonal increases occur annually, with most transmission occurring during or just after the November to April rainy season.

There is higher malaria transmission in the northern and eastern border regions, with more limited transmission in the central and south-western portions of the country.
At the national level, annual incidence (cases per 1,000 population) has decreased substantially over the last 15 years, from 153 in 2004 to 19 in 2018.

Non-Communicable Diseases (NCDs) aﬀect people of all ages and classes, and are currently the leading cause of deaths in the world.
NCDs have similar risk factors, which are mainly attributable to lifestyles, such as physical inactivity, unhealthy diets, tobacco use, drugs and alcohol abuse In response to the challenges posed by non- communicable diseases, government has set up a NCDs Department at the Ministry of Health and Child Care.

The Ministry endeavours to provide appropriate and accessible high-quality care and facilitate health promotion programmes aimed at disease prevention.
It aims to; keep as many citizens as possible in good health; provide appropriate quality services; provide high quality hospital services at the appropriate level for all citizens; and mobilise resources for the provision of healthcare services, distribute the same equitably and ensure proper ﬁnancial management and control of funds.

Malaria continues to be a key driver of morbidity and mortality rates in Zimbabwe.
Malaria transmission intensity has seasonal and geographic variation corresponding closely with the country's rainfall patterns and topography.

Transmission is perennial in malarious areas, seasonal increases occur annually, with most transmission occurring during or just after the November to April rainy season.

There is higher malaria transmission in the northern and eastern border regions, with more limited transmission in the central and south-western portions of the country.
At the national level, annual incidence (cases per 1,000 population) has decreased substantially over the last 15 years, from 153 in 2004 to 19 in 2018.

Non- Communicable Diseases (NCDs) aﬀect people of all ages and classes, and are currently the leading cause of deaths in the world.
NCDs have similar risk factors, which are mainly attributable to lifestyles, such as physical inactivity, unhealthy diets, tobacco use, drugs and alcohol abuse In response to the challenges posed by non-communicable diseases, government has set up a NCDs Department at the Ministry of Health and Child Care.The Ministry endeavours to provide appropriate and accessible high-quality care and facilitate health promotion programmes aimed at disease prevention.
It aims to; keep as many citizens as possible in good health; provide appropriate quality services; provide high quality hospital services at the appropriate level for all citizens; and mobilise resources for the provision of healthcare services, distribute the same equitably and ensure proper ﬁnancial management and control of funds.
THE SPRAY OPERATORS PREPARE FOR THEIR DAILY WORK, THE SAFETY GEAR IS TO PROTECT THE SPRAY OPERATORS FROM THE INSECTICIDE AS THE BATTLE ONE OF ZIMBABWE’S DEADLIEST ENEMIES THE MOSQUITO.

Since Independence in 1980, the Government's immediate task was to enact legislation that would put in place policy frameworks to correct colonial injustices in healthcare provision, among a litany of other inequalities.
In colonial Rhodesia, Andrew Fleming Hospital, now Parirenyatwa Group of Hospitals, was the largest health institution.

Named after the ﬁrst medical director appointed to the Rhodesian Health Service, the hospital served the white community.

Blacks had Harare (Gomo) Central Hospital (now Sally Mugabe Central Hospital), which relied on equipment and drugs deemed as excess baggage at Andrew Fleming Hospital, built for them.
Following Independence in 1980, the hospital was renamed in honour of Tichafa Samuel Parirenyatwa, who was the ﬁrst black Zimbabwean to qualify as a medical doctor.

The institution encompasses Mbuya Nehanda Maternity Hospital; Sekuru Kaguvi, which specialises in eye treatment, an annex for psychiatric patients and several specialist paediatric wards.

It also houses the University Of Zimbabwe College Of Health Sciences.
Notwithstanding economic challenges, the group of hospitals has continued to provide quality and cost- eﬀective specialist healthcare services to the people of Zimbabwe.

It has also remained consistent in the provision of modern training and research facilities for health personnel.
In the early 1980s, Zimbabwe's health delivery system was enhanced through Government and private sector partnerships, which gave citizens access to aﬀordable healthcare due to increased numbers of clinics and hospitals constructed countrywide.

In the mid-1980s, the Ministry of Health partnered with the World Bank to establish a family health project to expand and upgrade selected district hospitals across the country.
20 President E. D. Munangagwa commisioned “Stoneridge Health Centre”-Harare As a member of the United Nations (UN), Zimbabwe also partnered with other stakeholders that include World Health Organisation (WHO), United Nations Population Fund (UNFPA), World Food Programme (WFP) and United Nations Children's Fund (UNICEF) to achieve its objectives.

In its endeavour to provide healthcare facilities for all Zimbabweans, the Government was supported by the Church through construction of mission hospitals.
The Zimbabwe Association of Church- related Hospitals (ZACH) partnered the Government in running national programmes aimed at expanding facilities on both preventive and curative health issues.

More than 65 provincial and district hospitals, among them, Chinhoyi, Chitungwiza, Guruve, Shamva, Murehwa and Hwedza, opened their doors after 1980.

The bias towards construction of more hospitals and clinics continued through the 1990s to the early 2000s and beyond.
As a way of mitigating challenges associated with access to healthcare, in September 2020, President Mnangagwa said the Government had earmarked funds for the Cowdry Park Health Centre - Bulawayo second of the 30 World class medical facilities programme signed With NMS in 2019. construction of 6 600 clinics to ensure that no one travels more than 10km to reach a healthcare facility.
In its quest to give all Zimbabweans access to healthcare, from 1980 the Government provided free services to those earning less than $150 per month.

Special programmes were also initiated in the early 1980s to close the yawning chasm colonialism opened between urban and rural areas regarding healthcare provision.

For instance, before 1980 immunisation programmes were conﬁned in urban areas.
To address colonial disparities, in 1982 the Government initiated an all-encompassing immunisation programme against infectious diseases among children, and tetanus among pregnant women.

The programme, whose objective was to make immunisation available and accessible to every child by 1990, considerably beneﬁted children in rural communities.

Almost 80 percent of children below the age of 12 months were successfully vaccinated by the end of 1990.
According to the World Health Organisation's estimates, the Expanded Immunisation Programme prevented more than 80 000 deaths of children under the age of ﬁve every year.

Prioritisation of diarrhoeal diseases control in 1982 paid dividends as by 1988 over 90 percent of mothers were conscious of oral rehydration therapy.

Also, rural-urban discrepancy in antenatal care was signiﬁcantly reduced.
Zimbabwe plans to maintain the elimination status for maternal and neonatal, tetanus and polio-free certiﬁcation status until they have been eradicated.

21 Mpilo Central Hospital Doctor,s quaters Rehab complete ($5,2m) to be commissioned By the early 1990s, the country had attained the highest rate of contraceptive use in sub- Saharan Africa.

A nutritional programme was started to help feed over 250 000 children to mitigate the impact of drought at the peak of the 1980s and early 1990s.
To date, in collaboration with donors and the private sector, the Government of Zimbabwe runs nutritional programmes aimed at feeding children and other vulnerable groups in rural and urban communities.

Moreover, Zimbabwe achieved elimination status for maternal deaths in 2000, and is in the pre-elimination phase for measles, and achieved polio-free certiﬁcation status.
In March 2020, the Zimbabwe National Statistics Agency (ZIMSTAT) circulated wide- ranging ﬁndings from the Multiple Indicator Cluster Survey (MICS 2019) indicating a decline in maternal deaths.

This shows that the country is in the right direction towards eradication of the scourge.

In the latest MICS report, Zimbabwe recorded a decline in maternal mortality from 614 to 462 maternal deaths per 100 000 live births since 2014, and a surge in full immunisation coverage to 85 percent.
The country has remained committed to its pledges at the 2019 International Conference on Population and Development (ICPD25) in Nairobi, Kenya.

Halving maternal deaths from 614 to 325 per 100 000 live births by 2030 topped the list of Zimbabwe's pledges at the summit.

As Sachiti (2020) notes, the reduction in maternal deaths has also been necessitated by Government's policies on healthcare provision.
These are, among others, 23 Milestones in the health sector development construction of mothers' waiting homes, scrapping of maternity fees in public hospitals and issuing of free blood coupons.

The donor community's eﬀorts, in collaboration with the Government's, have also contributed to the decrease in maternal deaths.

We have come in handy to rural women who, in some cases, had to endure long distances to access healthcare facilities.
Shelters or maternity waiting homes help in the reduction of maternal and perinatal mortality by facilitating access to skilled birth attendance and emergency specialised care for women, especially those in rural communities.

They also arrest the three delays; delay in decision to seek care; delay in reaching care and delay in receiving suﬃcient healthcare.
Development partners like the United Nations Children's Fund under programmes such as the H4+ and Health Transition Fund (HTF), and the United Nations Population Fund (UNFPA), provide funding for mothers' waiting shelters through technical and ﬁnancial support to the Ministry of Health and Child Care.
Direct and quantiﬁable causes of deaths in pregnancy and childbirth in Zimbabwe are largely severe bleeding (after childbirth), infections, and high blood pressure during pregnancy (pre-eclampsia and e c l a m p s i a ) .

T h e G ove r n m e n t h a s p a r t n e r e d stakeholders to curb these causes.
For instance, United Bulawayo Hospitals, which records about 4 756 deliveries yearly with a 40 percent C-Section rate, has beneﬁted from a partnership between the Ministry of Health and Child Care and UNFPA.

The Government of Zimbabwe, however, has taken over the funding of blood coupons.
Before Independence, training in Medicine, and other health sciences was a preserve for whites, who enjoyed free and easy access to university education, with blacks having to pass through a bottlenecked system that squeezed them out.

22 Nurses graduation Village health workers Thousands of doctors and nurses have been trained since 1980, to close the rural-urban healthcare provision gap.
Between 1980 and 1989, the number of doctors graduating from the University of Zimbabwe increased by about 40 percent (Sanders, 1992).

However, the distribution of health personnel was still a challenge, especially so as the numbers fell short of requirements.

Another challenge in the early 1980s and 1990s was that health personnel, especially doctors, shunned rural mission and district hospitals.
According to Sanders (1992), in 1983, 67 percent of doctors were at central level, with 1 596 at provincial level, and a further 15 percent at district mission hospitals.

The proportion of doctors at central level had increased to 72 percent, 12 percent of whom were in the provinces and 16 percent in district and mission hospitals, by 1988.
To address the issue, the Government recruited expatriate doctors to man provincial and district hospitals, while putting in place mechanisms to attract and retain personnel.

Following Zimbabwe's independence from Britain in 1980, Zimbabwe's health sector adopted a strong focus on PHC.
Zimbabwe moved from a “curative, urban-based and minority-focused health care system to one which emphasized health promotion and prevention and provided some acceptable level of health care to the majority rural population.” As part of the shift toward PHC, the National Village Health Worker Program was formally launched in 1981 with a goal of training 15,000 village-based basic health workers and extending health care coverage to people who would otherwise have no access.
From 1982 to 1987, the government trained 900–1,000 VHWs annually, so that by 1987 there were 7,000 VHWs.

Another milestone achieved in taking primary healthcare to Zimbabweans' doorsteps was the Village Health Worker Programme which began in 1982.

The programme focuses on disease prevention and provision of community care at primary level in rural and peri- urban areas, thus, serving as a key link from the community to the formal health system.
By 1987, the Ministry of Health (now Ministry of Health and Child Care) had trained about 7 000 community- based village health workers to enhance promotive and preventive care in rural areas.

23 Where economic stratiﬁcation exists, as is usually the case in rural areas, villagers are divided among themselves to ensure that the neediest are the ﬁrst to be served.
The 1990s and early 2000s saw demand for healthcare services surging due to HIV/AIDS prevalence, hence encumbering authorities in their eﬀorts to contain the condition, leading to loss of many lives.

However, through Government's partnerships with donors and other stakeholders, inroads have since been made in the provision of antiretroviral therapy, containment of prevalence rate and curbing of stigmatisation.

Zimbabwe is making progress towards the UNAIDS 90-90-90 goals.
The UNAIDS targeted that in 2020, 90 percent of people living with HIV would know their status, 90 percent of people who know their HIV-positive status would be on treatment, and 90 percent of people on treatment would have a suppressed viral load.

According to the Zimbabwe Population-based HIV Impact Assessment (Zimphia) 2020 study, more than 95 percent of targeted people were tested for HIV in the ﬁrst phase launched in 2019.
The Zimphia 2020 study is a population household survey led by the Ministry of Health and Child Care working in collaboration with the Zimbabwe National Statistics Agency (Zimstat), National Aids Council (NAC) and ICAP at Columbia University.The study, which is supported by the United States President's Emergency Plan for Aids Relief (Pepfar) through the Centre for Disease Control and Prevention, is aimed at determining Zimbabwe's progress towards UNAIDS' 90-90-90 goals, as well as guiding policy and funding priorities.
Milestones in surgery Zimbabwe has held her forte in medical annals by successfully performing a major operation on Siamese twins born on April 22, 2014 to a Murehwa couple.

A team of 50 Zimbabwean medical personnel, led by academics from the University of Zimbabwe's College of Health Sciences, worked on the eight-hour delicate procedure at the Harare Children's Hospital in July 2014.
The twin boys; Kupakwashe and Tapuwanashe Chitiyo, were joined from the lower chest to the upper abdomen and shared a liver.

In September 2019, Zimbabwean surgeons broke yet another world record by successfully conducting an operation to remove a 12,3kg 11-year-old kidney cyst from a patient at Parirenyatwa Group of Hospitals.

The cyst became the largest to be removed in the world, with the previous record set in Japan where a similar one weighing 11,5kg was removed.
Dr Shingirai Meki, a consultant urologist and lecturer at the University of Zimbabwe's College of Health Sciences, led the team of Zimbabwean doctors that conducted the complicated surgical procedure.

24 Kidney removed Like any other sector in Zimbabwe, the health sector has not been spared by economic challenges which are hindering the Government's eﬀorts to fund public health delivery, thus, restricting citizens' access to healthcare.
In the past two decades or so, the Government's capacity to provide adequate, eﬃcient and reliable healthcare services and facilities has mainly been hamstrung by the illegal economic sanctions imposed on Zimbabwe by Western countries in response to the country's post-2000 Fast Track Land Reform Programme aimed at correcting imbalances in land ownership.

Due to ﬁ n a n c i a l c o n s t r a i n t s , i n f r a s t r u c t u r a l development projects have been hindered.
The health sector has also been burdened by brain drain, inadequate equipment and drugs, which impede ordinary citizens' access to quality healthcare.

The novel coronavirus (Covid-19) pandemic, which has plunged the world into a health crisis Development Programme (UNDP) as “the greatest challenge we have faced since World War Two”, brought along trials of its own.
Nevertheless, the light beckons at the end of the tunnel as the Independence Flame kindled by the coming on board of the Second Republic, led by President Mnangagwa, ﬂickers on.

Hospital and medical infrastructure since 2018 Zimbabwe healthcare is provided through primary, secondary, tertiary care and quinary hospital, to cover all disciplines.
Since 2018, the Ministry of Health and Child Care made signiﬁcant achievements in the development of health infrastructure ranging from the construction of new health facilities to rehabilitation/ refurbishment of existing infrastructure.
In view of the above, a total of 47 health facilities were constructed and completed, 94 projects were under renovation/ rehabilitation to completion, a total of 1 074 health facilities were solarised, and 201 health facilities beneﬁtted from the borehole water project.. Zimbabwe Solar For Health Project Solarised The construction of Lupane Provincial Hospital has progressed signiﬁcantly on the central stores, pharmacy, casualty, outpatient department, administration block, junior staﬀ house, maternity block, surgical ward, paediatric ward, dental clinic, eye clinic, kitchen substation, and antenatal and post-natal section.
Stoneridge The Ministry has invested an estimated US$210 million on bringing quality healthcare to all Zimbabweans, with the project set to provide four by 20-bed and 26 by 20-bed health centres as well as ﬁve by 60-bed district hospitals.

A hi- tech equipped Stoneridge health centre was opened with outpatient, maternity, ART and inpatient facilities and staﬀ accommodation.

Medical equipment The Government of Zimbabwe has procured medical equipment at national level as well as through its institutions.
The equipment is part of the initiative by the Ministry of Health and Child Care to retool its hospitals The equipment is to the tune of US$23m, and deliveries and installations of the same have started.
Some of the equipment include the following: § Magnetic resonance imaging equipment § Mammogram § Image intensiﬁers (C-Arm) § Fixed Digital Xray machines § Mobile digital x-ray machines § Anesthec machines § Ophthalmic microscope § Dental sets, which include dental chairs, dental x- ray and dental autoclave § Vital signs monitors § Covid virtual hospital equipment § Venlators § Theatre lights § Mulparameter monitors § Ultrasound scan machine The Ministry of Health and Child Care is also at an advanced stage to procure CathLab equipment to resuscitate the open-heart surgery.
Site visits by prospective suppliers have been done as part of the eﬀorts to avail a full complement of medical services to the citizens.Human capital -specialised medical training programmes.

The Ministry expanded medical training programmes in diﬀerent specialties, to deliver the bespoke workforce required by the Government, including accident and emergency nursing, midwifery, mental health, Mmed, intensive care unit, renal nursing, and operating theatre.
Others include oncology, and palliative, B-tech environmental health, nursing anaesthesia, advanced orthopaedic nurse training, ontology surgery, advanced clinical nursing (clinical oﬃcer).The medical rehabilitation technicians' course has now been upgraded from certiﬁcate to diploma level.
Radiography training in therapy and diagnostic, which was being oﬀered at Parirenyatwa Group of Hospitals, is now under the Harare Institute of Technology on an aﬃliation framework.The Ministry will soon be resuscitating the biomedical equipment technician training in conjunction with Harare and Bulawayo polytechnics.

This is a critical course, which will increase the stock of technicians responsible for the repair and serving of the biomedical equipment.
Medical transport Ambulances One of the most important aspects of medical transport is safety and quick response time to mitigate casualty numbers.

To this end, the Ministry is in the process of procuring the upgraded model of ambulances for the 63- district hospitals, eight provincial hospitals and six central hospitals.

These ambulances, which are a lifeline during emergencies, are equipped with the latest medical equipment and designed with the latest technology and software.
Already 32 vehicles procured by the Government, and eight from supporting partners, have been received.
A c c e s s t o m e d i c i n e s : L o c a l p r o d u c t i o n o f pharmaceuticals For the Government, the pharmaceutical sector has implemented measures that will see increased production, enhancement of competitiveness, market expansion, production diversiﬁcation, export development, improved ease of doing business and mobilisation of the required ﬁnancial resources.The pharmaceutical manufacturing strategy for Zimbabwe 2021-2025 was launched to enhance productivity and competitiveness of the manufacturing industry in the country.The objective of the strategy is to increase market share of the local pharmaceutical products from the current 12 percent to 35 percent by 2025; to increase local product of local medicines from US$31,5 million to US$150 million by 2025; to increase local production of essential medicines from 30 percent to 60 percent by 2025, and to improve export of pharmaceutical products from 10 percent to 25 percent by 2025.
25 NATPHARM ONE OF THE SIX STATE OF THE ART WAREHOUSES IN THE COUNTRY.

Warehouse National Pharmaceutical Company (Natpharm) has increased its capacity to manufacture pharmaceutical products, while the Medicines Control Authority of Zimbabwe has been capacitated to ensure registration of pharmaceutical products and upgrading in quality management systems.
For ease of distribution, the Government, through the Ministry of Health and Child Care, has secured US$6 million funding from the Global Fund and US$25 million grant from the Chinese government to construct state-of-the-art Natpharm warehouses across all provinces.

While the Harare warehouse is awaiting commissioning, the Masvingo and Mutare warehouses are nearing completion, with the remainder at varying construction stages.
Investment Zimbabwe is set to become a hub of pharmaceutical manufacturing for international and regional consumption following the joint venture agreement between global medical consumables manufacturing giant Intrapharma (UAE) and the Government.

Intrapharm will start by investing US$100 million, and gradually grow its investment in response to market demand.
The National Institute of Health Research (NIHR) Infections remain a major public health problem, and warrant research in order to reduce morbidity and mortality.

NIHR plays a critical role in providing information on risk factors and disease trends, functional abilities, patterns of care, healthcare costs and use, as well as outcomes of treatment or public health interventions.

NIHR is also a leading research institute for the WHO speciﬁed Preventive Chemotherapy Neglected Tropical Diseases (PC-NTD).
To date, the department has conducted the following researches: § A baseline population-based age-stratiﬁed sero-epidemiological prevalence survey for covid-19 in Zimbabwe § A national Lymphatic ﬁlariasis conﬁrmatory survey triggering annual mass drug administration for the control and elimination § The national entomological survey: status of malaria vector bionomics in Zimbabwe; baseline assessment to determine the distribution of mosquito vectors responsible for the transmission of malaria in Zimbabwe.
26 WHAT IS AN EPIDEMIC The Centers for Disease Control and Prevention (CDC) describes an epidemic as an unexpected increase in the number of disease cases in a specific geographical area.

Yellow fever, smallpox, measles, polio are prime examples of epidemics.

An epidemic disease doesn’t necessarily have to be contagious.

West Nile fever and the rapid increase in obesity rates are also considered epidemics.
Epidemics can refer to a disease or other specific health-related behavior (e.g., smoking) with rates that are clearly above the expected occurrence in a community or region.

particular region.

This makes the disease spread and rates predictable.

Malaria, for example, is considered endemic in certain countries and regions.

WHAT IS PANDEMIC?

The World Health Organisation (WHO) declares a pandemic when a disease’s growth is exponential.
This means the growth rate skyrockets, and each day cases grow more than the day prior.

In being declared a pandemic, the disease has nothing to do with causative microbiological agent virology, population immunity, or disease severity.

It means a virus covers a wide area, affecting several countries and populations.

WHAT DOES ENDEMIC MEAN?

A disease outbreak is endemic when it is consistently present but limited to a particular region.

This makes the disease spread and rates predictable.
Malaria, for example, is considered endemic in certain countries and regions.

Jokes HEALTH COMMEMORATION DAYS 31 Jan - Leprosy Day 04 Feb - World Cancer Day 13 Mar - Kidney Day 24 Mar - World TB Day 07 Apr - World Health Day 25 Apr - World Malaria Day Zimbabwe Special Initiative for Mental Health