2024: A year of milestones in health

Rumbidzayi Zinyuke

Health Buzz

Today, the year 2024 comes to an end! And what a year it has been, particularly for the health sector?

The country has achieved significant milestones this year, reflecting the Government’s commitment to enhancing healthcare services nationwide.

In this edition we look at some of the developments in the sector to evaluate how the country has fared in ensuring universal health coverage for all.

HIV/AIDS: A continued fight

Advancements in HIV/AIDS interventions

Zimbabwe was among the first few African countries to achieve the UNAIDS 95 95 95 global target in the fight against HIV and Aids to ensure that 95 percent of people infected know their status, are on treatment and have suppressed viral load.

While more still needs to be done, particularly in attaining these targets among children, these achievements have to be commended.

And the work continues.

The country introduced the administration of the Cabotegravir long-acting (CAB-LA) injectable pre-exposure prophylaxis as one of the HIV prevention products available under a research study.

The CAB-LA became the third PrEP product to be introduced this year in demonstration sites under the Catalysing Access to New Prevention Products to Stop HIV (CATALYST) study.

Health Financing

Statistics show that only 10 percent of Zimbabweans have medical aid, meaning that the majority of the people are paying for health services out of their own pockets.

Not only has this made healthcare a burden for the poor, it has also increased the burden on the already strained public health system as the only available option for many.

In November, the Government held a National Health Financing Dialogue, which was key in trying to map out a local resource mobilisation strategy.

“We are aware that the donor community support all over the world is going down. So Zimbabwe has to find innovative ways of financing itself and making sure that we move in this area. On a whole of Government approach, through Treasury, we have pushed for more budget allocation to the Ministry of Health.

“And this has resulted in a jump from 9,86 percent to 13,01 percent. The Treasury also has availed the sin tax, one of which is the sugar tax, which is a local intervention earmarked to reduce the incidence of NCDs, particularly cancer, in the country,” said Health and Child Care Secretary, Dr Aspect Maunganidze.

Cancer has been one of the most difficult disease to manage which needs increased investment.

The fact that this was identified as a priority area for the sugar tax, is a step towards the right direction.

 The Ministry of Health and Child Care is now in the process of procuring cancer machines for Parirenyatwa and Mpilo hospitals using the money from the tax.

This will be further expanded to other hospitals across the country as more cancer treatment centres are established.

 “We have the National AIDS Trust Fund and we are looking now beyond just HIV, but being able to integrate the services with regards to HIV treatment and other comorbidities that our population is faced with, including diabetes, hypertension and cancer.

“We are implementing availability of a basic diagnostic tool for our village health workers so that they will be able to screen and diagnose basic conditions, especially diabetes and high blood pressure. So these manoeuvres are part of our local health financing interventions as we move towards having a national health insurance, through which we expect to unlock more value for the whole nation,” added Dr Maunganidze.

Emerging health threats: A resilient response

 2024 has been a year where Africa, and indeed Zimbabwe, was faced with many public health threats.

The country began the year with a cholera outbreak that brought back memories of one of the worst which happened in 2008. By the end of July, Zimbabwe had been declared cholera free following various interventions by Government and its partners.

Although a few more isolated cases of cholera were reported at the onset of the rainy season, they were managed.

This was made possible through a robust incident management system which was not disbanded after the initial outbreak.

Permanent Secretary Maunganidze contends that the country still needs to increase capacity in Water, Sanitation and Hygiene (WASH).

 This includes improved WASH infrastructure and provision of safe water for all.

Just as the country was emerging from the cholera outbreak, a new threat emerged. The African region was hit by a new outbreak of Mpox.

Mpox was declared a global public health emergency by the World Health Organisation in August after a new clade 1b strain of the viral infection spread from Democratic Republic of Congo to neighbouring African countries.

Zimbabwe recorded only two cases and the containment of these was credited to a resilient surveillance system, especially at the ports of entry, as well targeted health promotion in communities.

Human resources for health

Zimbabwe is red listed by the World Health Organisation due to the high levels of attrition and the country has been on a drive to come up with ways of making sure that the skilled personnel stays.

To address the critical shortage of healthcare professionals, the Ministry of Health developed the Human Resources for Health Strategy (2023-2030) and the Health Workforce Investment Case (2024-2026). These strategic frameworks aimed to ensure a sustainable health workforce by focusing on training, retention, and equitable distribution of health workers across the country.

How to achieve this?

“Obviously, there is need for increasing establishment, through treasury, for our posts in the health sector. We need to make sure that the local incentives that are already in place are strengthened.

“One of the most notable interventions that we’ve had in 2024 is that now our Health Service Commission is fully in place and is seized with making sure that conditions of service are improved for our workers,” Dr Maunganidze said.

Maternal and child health outcomes

Targeted interventions have led to notable improvements in maternal and child health, particularly in rural regions.

These efforts have contributed to reduced maternal and child mortality rates, reflecting the effectiveness of the implemented health strategies.

According to Dr Maunganidze, maternal and child mortality have been a red flag for the country’s health sector performance.

While maternal mortality still remains high at 362 per 100 000 live births, there has been progress as this figure reflects a significant decline from past years.

 “But we are saying no woman should die giving birth. So we have now embarked on an accelerated maternal mortality reduction, which has involved identifying the key factors that lead to maternal mortality, one of which has been bleeding around the time of delivery and delayed transfer to the appropriate institution.

“We are making sure that our National Blood Services Zimbabwe is capacitated, so that there are enough blood stocks for our mothers when they deliver,” he said.

Besides this, the Ministry has also embarked on further training and capacitation for health workers, some very key aspects in safe delivery.

This has been done through the e-learning platform for midwifery training aimed at ensuring that midwives are equipped with up to date skills to be able to offer safe deliveries for all women across the country.

“In addition we have also made sure that the appropriate equipment is delivered to our institutions. In particular, we have incubators for our neonatal units, delivery beds to our maternity units, especially in the central hospitals where we have seen that there have been much higher numbers of our mothers going to the central hospitals for delivery,” he added.

However, the Government is aiming to reduce the burden at the central hospitals and focus on strengthening the referral system for pregnant women.

This is being done through the building of district level hospitals in the main cities to ensure women are attended to there before being referred to the central hospitals.

Prospects for 2025

In December, the Ministry of Health and Child Care held its performance review for 2024 and strategic planning for 2025 with partners and the key government departments.

The goal was to make sure that the Ministry delivers on its mandate of ensuring the health and well-being of all Zimbabweans.

And the prospects look brighter for 2025.

“We expect to continue reducing the maternal mortality and perinatal mortality. We also want to make sure that access to health is improved. So through our investment compact, we are going to see more schools of nursing refurbished to almost double the intake.

“For training programs like nursing, environmental health, pharmaco-technicians, we want to make sure that we have the right cadre who is well skilled on the ground and delivering service,” noted PS Maunganidze.

The target, he said, was to increase health posts to 6 600 by 2030.

By addressing the challenges and building on the successes of 2024, Zimbabwe can create a healthier and more prosperous future for its people.

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