Communities play critical role in advancement of good health and wellbeing

By Byron Mutingwende


I had travelled a distance of about 50km from Harare to Mwanza Secondary School in the Chikwaka area under Goromonzi District on a fine Friday where the Ministry of Health and Child Care was holding a Community Health Symposium. The meeting afforded an interactive engagement between high level health officials and the community on health matters.


It was a culmination of a post-doctoral research by Dr. Fortunate Machingura of the University of Manchester in collaboration with the Department of community medicine of the University of Zimbabwe (UZ). The meeting was held under the topic, “Taking the Agenda of the 2030 Sustainable Development Goals to rural communities in Zimbabwe: Leaving No One Behind.”


Guest Speaker, Dr. Gibson Mhlanga, the Acting Permanent Secretary in the Ministry of Health and Child Care said the government aims to attain the highest level of health for all Zimbabweans through engaging communities on their health needs.


“No single person should die from preventable diseases in the communities and the development of any country is hinged on the good health and wellbeing of its people,” Mhlanga said.


The government is strengthening community health programmes for the treatment of both communicable and non-communicable diseases including malaria, tuberculosis, HIV and AIDS, diabetes and hypertension, among others. In its quest to make health services affordable for all, Mhlanga said the government was working to ensure user fees are totally scrapped in the rural areas. He hailed the Ministry of Finance for giving the Ministry of Health the greenlight to employ 2 000 more nurses countrywide.


Dr. Gerald Shambira, a Lecturer at UZ said they train health practitioners in community medicine as it relates to the Sustainable Development Goal (SDG) on health and wellbeing.


Shambira said that health is closely associated with wellbeing, which comprises wellness in terms of the physical, mental, emotional and spiritual wellbeing. Machingura weighed in by saying that good health was not just the absence of a wound.


“Community medicine emphasises on person-centred healthcare in that we are moving from an era where the doctor would prescribe medicine to a patient. There is a deliberate move towards empowering communities to be in charge of their health. Healthcare doesn’t start at the hospital but in the home. It is necessary for communities to change certain lifestyles that are detrimental to the people’s health. That is why there are village health workers who encourage good health practices in the local communities.


On linking Sustainable Development Goals to health and other development initiatives, Muchinguri said: “Sustainable Development Goals include 17 goals with 169 targets covering a broad range of sustainable development issues, from ending poverty and hunger to improving health and education, reducing inequality, and combating climate change. They aim to resolve the social, economic and environmental problems which affect the world’s poorest people and to complete the unfinished business of the Millenium Development Goals (MDGs). They point key areas which should inform our development interventions; and are benchmarks for measuring integral human development, promotion of human dignity and social justice.”


Mwanza Rural Health Centre serves a population of 15 547 people who come from 35 villages. It is a part of the 29 health centres in Goromonzi, a district of 298 000 residents.


“Despite the high population, we are short-staffed since there are only five nursing staff mebers, one data entry clerk, one environmental health technician and one general hand. We are therefore appealing for more nursing staff members. We are facing challenges on referrals, especially obstetric emerges, which may lead to loss of life although we have not recorded any maternal mortality case so far,” said the Nurse-In-Charge of Mwanza Rural Health Centre.


Vivien Mateta, Goromonzi District Administrator hailed the positive participation of the community of Mwanza when the villagers helped in moulding bricks and pooled funds for the construction of mothers’ waiting shelter at the rural health centre in line with the Zimbabwe Agenda for Sustainable Socio-Economic Transformation (ZIMASSET) social services and infrastructure clusters.


Dr. Tapiwa Gwinji, Goromonzi District Medical Officer said that there were now four clinics with mothers’ waiting homes resulting in the number of people delivering at home coming down to 13%.


Concilia Mukarati outlined some expectations on what the community looks forward to in terms of health delivery.


“There is a need to upscale training workshops on sexual reproductive health and rights (SRHR) issues. Through sex and sexuality education, we as women, are now able to make decisions on how we want to have sex with our partners. SRHR workshops involving men and women have resulted in a decline in the number of women who in the past were forced to engage in sex even with thir spouses with STIs. Our ward is very big and we appeal to the government to give us a resident doctor who will attend to emergencies. Through the Perekedza Mimba Yako Programme, men now accompany their pregnant wives to clinics for HIV testing and delivery of babies,” Mukarati said.


She appealed for an ambulance at Mwanza Rural Health Centre because patients in critical conditions may risk losing their lives since Makumbe Hospital is some 120km away.


Augustine Munyongani bemoaned the increase in cases of prostate cancer among elderly men and said that the absence of treatment for snake bites and rabies vaccines at the local clinic was leading to serious health complications in the community. Tazvitya Tondoro called for the localisation of TB screening and appealed for more personnel at the HIV testing centre at the clinic.


George Munetsi said that people with disabilities (PWDs), especially those who suffer secondary disability due to conditions like stroke, were finding it difficult to travel to Makumbe and Ruwa Rehabilitation Centres for physiotherapy sessions.


“We call for the revival of rehab visits to homesteads to help those people who may be grounded at home due to a lack of transport money. Those who are mentally challenged should also be given tablets at home,” Munetsi said.


Dickson Mwanza called for the setting up of youth centres where the youths would converge to discuss matters on SRHR and strategies on employment creation and combatting an upsurge in the substance and drug abuse among young people.


Moses Man’anzo, the Environmental Health Technician for Mwanza area said water provision stood at 78,4% since only 36 out of the 40 boreholes were fucntional. He said open defecation was rampant at a measly 38, 7% of the population who had functional toilets while the rest were substandard, a situation leading to an upsurge in diarrheal diseases.


Cheikh Tidianne Cisse, United Nations Population Fund (UNFPA) Zimbabwe Reprepresentative, in a speech read on his behalf by Abbigail Musemburi, said his organisation was working on three of the SDGs.


“As UNFPA, we support the implementation of SDGs because it is central to our mandate. We work to support SDG3 “ensuring healthy lives and promoting well-being at all ages” as well as SDG4 on inclusive equitable quality education and SDG5 which seeks to foster gender equality and empower all women and girls.,” Cisse said.


The UN agency supports the government’s commitment to ensuring every woman and young person has access to sexual reproductive health services and rights. UNFPA bemoaned the fact that young people fail to reach their full potential through unwanted pregnancies, early child marriages and lack of knowledge about their sexual reproductive health services thereby predisposing themselves to diseases such as HIV and AIDS. It added that many women and girls development is stifled as a result of gender-based violence.


“We work with the government of Zimbabwe to ensure the provision of quality maternal health services, empowering young people with lifesaving information on SRHR and through access to SRH services such as family planning, cervical cancer screening, fistula repair.”


A one Mrs. Takaendesa revealed how she suffered obstetric fistula after she was exposed to heavy work during pregnancy and raptured her bladder during childbearing up to a point when she can no longer control her urine. Dr. Edwin Mpeta, a Reproductive Health Specialist with UNFPA said that a woman with obstetric fistula suffers emotionally and pyschologically but his organisation is currently providing free treatment at Chinhoyi Provincial Hospital.