Siphakeme .Mnindwa
Robin Muchetu, Senior Reporter
THE absorption of Village Health Workers (VHW’s) into the national health workforce will positively transform the sector and has been hailed as a milestone in the history of the Ministry of Health and Child Care.
The Government recently announced plans to add 22 000 VHWs into the civil service as it works on doubling the health sector complement by 2030. The move will not only see the employment of VHWs but is also expected to enable an increase in specialist doctors.
The country already has about 20 000 VHWs and will double this in a phased approach until the sector is functioning adequately, signifying the importance of these community heroes who are usually the first to identify various health needs or emergencies in communities.
Mr Itai Rusike, Executive Director of Community Working Group on Health (CWGH) and a public health expert said the commitment by the Government for the National Budget to address the critical issue of absorbing Village Health Workers onto the Government’s payroll system is welcome.
“A strong village health workforce is the cornerstone of every health system, and it is essential to ensuring universal health coverage and the attainment of Sustainable Development Goals (SDGs). The proposed plan to employ about 22 000 VHWs is a good measure to deal with the gap in the health sector in the face of the exodus of health workers from rural to urban areas and from developing to developed nations.
Even though VHWs do not replace the requirement for adequately trained staff at primary care levels, they are key cadres in the health system — fully aware of the health needs and aspirations of their communities. This makes them an invaluable asset in advancing community-oriented health delivery and they should be supported,” said Mr Rusike.
Deputy Minister of Health and Child Care Sleiman Kwidini in a recent interview, said village health workers are key because they live in the communities they serve and interact directly with the people at village level.
“The nature of the job has made us as the Government, see that they are key players that need to be motivated too in their line of work. That is why we have signed a compact where we are saying we have to double the health workforce by 2030. Through doubling the health workforce, the village health workers are the other people who are going to be included in this compact structure where for now we are assuming to adopt about 22 000 VHWs, funds permitting by 2024 to 2027,” said Deputy Minister Kwidini.
He said VHWs are the first to identify who is not well in communities and possibly what kind of disease those affected may have. By doing so, they are the ones who take statistics and information to the rural health workers.
Mr Rusike said VHWs were key to Zimbabwe’s successful expansion of primary health care in the early 1980s as they played a central role in closing the gap between public health services and communities at local levels by bringing health services outreach to communities and facilitating community roles in health delivery services.
“VHWs continue up to today to augment the work being done by the mainstream health sector, raising awareness, giving health advice, monitoring growth of children under five years, mobilising communities during outreach programmes and for immunisation and are trusted sources of information for community health literacy.
“The presence of VHWs in our communities is essential in our quest for equity in health and accessibility of health services, so we too will be part of this support, including documenting the roles and impacts of VHWs in our communities and we will continue to engage the Government and other stakeholders to value and resource these roles in the spirit of health for all,” added Mr Rusike.
He, however, highlighted that increasing health expenditure in tandem with the increased number of VHWs remains a challenge to the health sector saying there is urgent need to invest in VHWs by increasing domestic health financing and move away from the current over-reliance on external funding as it is not sustainable.
He also said in the event of the pull out of donors from funding certain projects, the country will be left with a huge gap to fill.
“It is therefore critically important to ensure that the health system is adequately resourced and that resources are efficiently and optimally utilised,” he said.
The ministry, however, said it will capacitate the village health workers further to ensure that they continue playing their roles with added knowledge. This is meant to increase their working capabilities.
The ministry has been affected by brain drain as several mainstream health workers have been leaving the country and are now practicing elsewhere while the country suffers a shortage.
In 2021, over 2 000 nurses were registered in the United Kingdom for employment. Government interventions led to a reduction in the number of health workers that could migrate to other countries.
The Ministry of Health and Child Care has, however, managed to start retaining the workforce that is available by calling for the improvement of the conditions of service and also some non-monetary benefits that can be availed to workers.
The country has 35 000 villages with the Government set to double the number of health workers. Each village will have at least one VHW while the remainder will be deployed to various peri-urban areas and large villages with room for some to be deployed in urban areas.
The ministry is also training more specialised health workers such as radiotherapists, nurses, doctors and other specialists to ensure that they meet the demand of workers needed.
VHWs played a critical role during the Covid-19 pandemic as they managed to provide vital information of where cases were suspected during a time when mobility was strictly monitored.
They provided much needed information to larger health institutions and also brought back information to the communities and this enabled key messages to be delivered to the rural communities. The workers are supervised by a sister in charge at a health centre within that specific ward.
Various partners have been supporting the Ministry of Health and Child Care in providing training periodically to the workers, capaciting them with skills, knowledge and other key resources they need to carry out their duties in the communities that they serve.
In carrying out their duties, VHWs say they face resistance from some members of religious sects, men and even women who do not believe in modern medicine or health interventions.
These groupings do not take part in mass immunisations, they do not believe in contraception and do not take pregnant women to hospitals to deliver their babies in a clean, safe environment, attended by a professional. — @NyembeziMu.
