Essential Health Services Support Additional Financing VI The purpose of this proposed AF is to provide financing to support the Government of Zimbabwe to
sustain essential health services (EHS) following the COVID-19 pandemic and in light of the acute economic
crisis which threatens to reverse gains made for reproductive, maternal, child, newborn, and adolescent
health (RMNCAH). Prior to the COVID-19 pandemic, Zimbabwe had made commendable progress in the
provision of RMNCAH services at all levels of care. Findings from the Multiple Indicator Cluster Survey (MICS
2019) reflect successes of the decade-long investments into the RMNCAH program by the Government and its
partners. Zimbabwe recorded its first case of COVID-19 on March 20, 2020, and the measures introduced to
contain the spread of the virus resulted in disruptions in healthcare provision, particularly of essential health
services in relation to maternal and child health, sexual and reproductive health, and chronic conditions. The
pandemic 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 Sexual and Gender Based Violence (SGBV)
cases during lockdown; and reduced funding for RMNCAH programming as funds were reprogrammed to fight
the pandemic. The COVID-19 pandemic further affected service delivery due to the national lockdowns and related social distancing restrictions to minimize the risk ofCOVID-19 transmission. While results-based financing in the health sector helped cushion inflation’s impact, the decrease in real value of salaries and reported personal protective equipment shortages have led to doctors' and nurses' strikes and/or absences. 
The mini-Poverty, Income, Consumption and Expenditure Surveys (PICES) conducted in 2019 and 2020 showed a decrease in rural dwellers who sought treatment from 81 percent to 71 percent although more urban dwellers sought treatment (77 percent to 83 percent). Data from a sample of health facilities show reductions in several
reproductive, maternal, and child health and nutrition services (e.g., antenatal care, postnatal care, institutional
deliveries, family planning and growth monitoring) and indicators (e.g., institutional maternal deaths and home
deliveries) that worsened since 2018To mitigate the impact of COVID-19 and ensure access to essential health services for all, the Ministry of Health and Child Care (MOHCC) adopted alternative ways of delivering health services to people, including the use of digital platforms, and conducting integrated outreaches to bring services closer to people.
The Government of Zimbabwe (GoZ) formally expressed interest in the EHS grant in a letter to the GFF
Secretariat dated August 6, 2021. As requested by the Government, the proposed AF will support the country
in strengthening the health system’s capacity to increase access, quality, and equity of RMNCAH services. To support the Government of Zimbabwe to deploy and manage COVID-19 vaccines and strengthen related health system capacity for pandemic preparedness and deliver essential health services, particularly RMNCAH The provision of a comprehensive package of essential health services including immunization, antenatal and postnatal care to communities without access to health facilities.