Zimbabwe

For a summary of MCHIP work that has ended in Zimbabwe, click here.

MCHIP Zimbabwe Associate Award

Start and end dates: January 2014 to December 2016

MCHIP Partners Involved

JSI, Jhpiego and Save the Children

Key Partners in Country

Zimbabwe Ministry of Health and Child Care (MoHCC), University of Zimbabwe, UNICEF, UNFPA, WHO, World Bank, DFID, Absolute Return for Kids, Plan International, EGPAF, OPHID, PSI, PSZ, IRC, Cordaid, DOMCCP

Description of work

Under the Associate Award in Zimbabwe, MCHIP is strengthening and increasing access to high-quality maternal, newborn and child health (MNCH) services. Through support to the MOHCC, we are scaling up and rolling out evidence-based, high-impact interventions to reduce maternal, newborn, and child morbidity and mortality.

Specifically, MCHIP aims to strengthen capacity of the MoHCC at national level to formulate evidence-based national health policies, strategies and programs to enhance scale-up of high impact MNCH interventions. We are also strengthening MoHCC capacity at provincial and district levels to improve the quality of integrated MNCH services at health facilities. Our efforts extend to the community through support of provincial and district level scale-up plans, and by strengthening the capacity of community health workers and civil society organizations (CSOs) to effectively implement MNCH activities.

Technical Scope

  • Maternal health
  • Newborn health
  • Child health
  • Immunization
  • Nutrition
  • Quality of care
  • Other cross-cutting: health system strengthening; social and behavior change communication; community mobilization; mHealth

Scale

  • National level
  • Various programming in all seven districts – and all 283 health facilities – in Manicaland Province; Standards-Based Management and Recognition (quality improvement) in 36 health facilities

Major Results to Date

  • Supported the national adoption and roll out of the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) Assessment, Classification and Treatment Register. Developed and successfully piloted an Assessment, Classification and Treatment register for sick children under age five, which provides guidelines for how to systematically attend to a sick child presenting at a primary level health facility. MoHCC adopted register for national roll out.
  • Participate in the quality improvement of MNCH service delivery dialogue at the national level, including: support of multiple quality assurance/quality improvement Technical Working Group meetings; contributing to the national revision of the integrated supportive supervision (SS) checklists; and ensuring careful selection of quality standards were included in the SS checklists to be used by all health partners. (These supportive supervision tools were field tested in Manicaland and Mashonaland Central and will now be used nationally.)
  • Supported the MOHCC to apply for two new vaccines – the Measles Rubella (MR) vaccine and the Inactivated Poliovirus Vaccine (IPV) – and implemented a national MR vaccine and Vitamin A supplementation campaign. Provided technical support to the post-MR campaign coverage survey.
  • Assisted the MOHCC to review and revise the MCCM training manuals for community-based health workers and included checklists to make the training competency based. Supported the revision and update of village health worker (VHW) job aids, and designed and pre-tested a VHW SS manual.
  • Supported Baby-Friendly Hospital Initiative (BFHI) activities in Mutare and Chimanimani districts. Sponsored BFHI certification celebrations held at Mutambara Hospital for Mutambara and Biriiri hospitals in Chimanimani district. Played a significant role in supporting several institutions to achieve BFHI certification by providing trainings and SS visits. Continuing support to the MOHCC to explore and document the association, if any, between BFHI certification and observed newborn and child health outcomes will be provided.
  • Completed CSO mapping exercise and selection process, and awarded a sub-award to the Diocese of Mutare Community Care program (DOMCCP). Worked with DOMCCP to strengthen their technical and organizational capacity, and supported them to implement a variety of community mobilization and training activities, included strengthening the capacity of lead mothers and lead fathers to promote and sustain improved health seeking behaviors.
Select Health and Demographic Data for Zimbabwe
GDP per capita (USD) 449.18
Total Population 12,522,784
Maternal Health
Maternal Mortality Ratio (deaths/100,000 live births) 790
Percent of maternal deaths due to HIV 52.7
Skilled birth attendant coverage 68.5
Antenatal care, 4+ visits 71.1
Newborn Health
Neonatal mortality rate (deaths/1,000 live births) 23.8
Infant mortality rate (deaths/1,000 live births) 59.9
Child Health
Under-five mortality (deaths/1,000 live births) 82.5
Treatment for acute respiratory infection 26.3
Oral rehydration therapy for treatment of diarrhea 70
Immunizations
Diphtheria-pertussis-tetanus vaccine coverage (3 doses) 73
Percent of districts with >80% DPT3 coverage 58
DPT3 coverage equity ratio (wealthiest:poorest quintile) 1.23
Family Planning
Modern contraceptive prevalence rate 58.4
Total fertility rate 3.8
Malaria
Vulnerable populations who slept under an insecticide-treated net (ITN) the previous night** 3.1
Pregnant women receiving 2 doses intermittent preventive treatment for malaria 6.3
Children with fever treated with antimalarials within 24 hours 3.4
HIV
HIV Prevalence, adult 14.3
ART coverage, adult 34
Health Systems
Density of physicians (per 1,000 population) 0.16
Density of nurses & midwives (per 1,000 population) 0.72
Total Health Expenditure per capita (USD) 66.42
Sources: Demographic information and health systems, World Bank; Newborn health, child health, DPT3 equity ratio, family planning, SBA, and ANC4, COUNTRY YEAR Demographic and Health Survey; DPT3 coverage and percent districts >80%, MMR, ART coverage and maternal deaths due to HIV, WHO; HIV prevalence, UNAIDS 2010 Global Report
*Calculated from DHS data as number of pregnant women and number of children under five who slept under an ITN the previous night divided by the total number of pregnant women and children under five.