The Sunday Mail
The health sector has remained one of Zimbabwe’ strongest pillar over the past 35 years
Despite the numerous challenges that the country has faced over the years, the health sector has remained one of the hallmarks of success in the post-Independence era.
It has remained one of the strongest pillars in sustaining the country’s development over the past 35 years.
Prior to Independence, the health system was divided into two systems.
The white minority enjoyed the first world, insurance-funded health care system while the black majority only enjoyed the basic medical services.
Back then, the country only had four referral hospitals – two were meant for the white minority population while the other two served the entire black population.
While there were approximately 280 doctors to serve less than 300 000 whites, there were only 850 doctors for the seven million Africans in 1978.
The situation was worsened by the fact that the white colonial system enrolled a minimum number of black students to train as doctors. Thus from 1968 to 1976, while 376 doctors graduated from the then University of Rhodesia’s School of Medicine, only 82 were black.
The black people in the rural areas could only access medical services through Mission health facilities or make-shift clinics provided by whites to their employees.
In 1980 at the attainment of Independence, Government’s first port of call in addressing these imbalances was to increase the enrolment for medical students, especially black students.
By 1995, the number of students who graduated at the University of Zimbabwe’s School of Medicine had risen to 958 with more than 667 being black students, an increase of 200 percent.
The number of doctors and State-registered nurses also rose significantly between 1981 and 1995 with the Health Professions’ Council stating that 15 000 nurses and 1 200 to 1 300 doctors registering with the council annually.
Government also abolished the dual health system used by the Smith regime and introduced a four-tier health system which comprise of Primary, Secondary, Tertiary and Quaternary tiers.
The Primary health system comprises of rural clinics. These health centres cater for the rural population. If need be, they are then transferred to referral medical centres.
According to the Zimbabwe National Health Profile 2013, rural clinics and health centres have ballooned to 1 464 over the past 35 years.
District, mission and rural hospitals fall under the Secondary health system tier. These referral hospitals amount to 179 with an average of nine hospitals per province.
The country also boasts of seven provincial or central hospitals which are under the Tertiary health system tier. There are also 14 special hospitals which are referred to as third referral hospitals and are under the Quaternary health system tier.
These are also national level teaching hospitals.
The Ministry of Health and Child Care National Health Profile (2013) also reports that by 1997, 85 percent of the country’s population lived within 8 km of a primary care facility.
The Access to Health Care Services Study (2008), revealed that most communities live within 5 km radius from their nearest health facilities, whilst 23 percent lives between 5 to 10 km and 17 percent are over 10 km from their nearest health centre.
Due to the accessibility and availability of trained health personnel, the 2005 to 2006 Zimbabwe Demographic and Health Survey noted a marked increase in women visiting health institutions.
According to the survey, 81 percent of mothers received at least one tetanus toxoid injection during pregnancy while 80 percent were assisted by a trained health professional at their last birth.
According to a Zimbabwe Multiple Indicator Cluster Survey (MICS) for 2014 carried out by Zimbabwe National Statistics Agency (ZimStat), breastfeeding is nearly universal in Zimbabwe; with 98,1 percent of women with a live birth in 2012 breastfeeding their babies.
Childhood supplementary feeding, improvements in water supply and sanitation have also been promoted.
Zimbabwe has also been implementing an immunisation programme under the Zimbabwe Expanded Programme on Immunisation (Zepi) since 1982.
By August 2014, 69,2 percent of children aged 12 to 23 months were fully vaccinated by their first birthday and about 92 percent had received BCG vaccination; 84,9 percent had received polio 3 vaccinations; 85,4 percent had DPT 3 and 82,6 percent received measles vaccination.
The proportion of fully vaccinated children has increased between the age groups of 24 to 35 months (54 percent) and 12 to 23 months (69 percent), the MICS stated.
In addition, as a result of the child-feeding scheme introduced by the Government through the Ministry of Health and Child Care’s Supplementary Feeding Programme, infant malnutrition declined from 29 percent to 10 percent between 1980 and 2013.
Concerned about the high birth rate in the country, the Health Ministry set up the Zimbabwe Child Spacing and Family Planning Council in 1981 to promote the use of family planning methods.
The contraceptive prevalence rate in the country has increased in the last 22 years from 38 percent in 1984 to over 80 percent in 2014.
So effective was this unit in disseminating family planning information and promoting child spacing methods that Zimbabwe is reputed to have the highest rate of contraceptive use in all of Sub-Saharan Africa.
The MICS 2014 report also revealed that the number of children dying from preventable causes is now much lower than 20 years ago. Four out of five children are now being immunised from preventable diseases.
The number of Zimbabwean women dying while giving birth has also decreased to 614 per 100 000 in 2014.
According to health officials, this is due to increased midwife training.
However, like all other sectors in the country, health fraternity also faced challenges during the period 2007 and 2008.
According to the Draft Health Human Resources country profile published in 2010, there was a decline in the numbers of public health workers from 25 251 in 2007 to 24 083 in 2008.
The draft report also states that infrastructure also deteriorated due to socio-economic challenges that were being faced by the country.
The same draft report, however, says in 2009 the total number of health personnel such as state-registered nurses increased to 27 840 with doctors increasing from 667 to 827.
Nursing staff increased to 16 668.
The Zimbabwe National Health Profile 2013 further states that there is a notable improvement in the staffing levels in all departments and across all disciplines from 2009 to 2011 with 21 percent vacant posts in the health sector.
Last year, United Nations country director, Michael Bartos, said the country had made significant progress towards achieving the Millenium Development Goal in combating HIV and Aids.
He said Zimbabwe was ranked fourth in terms of anti-retroviral use globally and according to Bartos, use of anti-retrovirals was contributing towards the decline in the number of deaths due to Aids.
Zimbabwe’ health sector also broke new ground last year when it performed a successful operation on con-joined twins at Harare Children’s Hospital.
The operation, which was the first success of its kind in Zimbabwe’s medical history, was hailed by medical experts across the country.
It signified the recovery of the medical sector.
After the successful operation,numerous Indian hospitals signed various Memorandum of Understandings with major referral hospitals such Mpilo Central Hospital.
The MoUs will enable the institution to conduct specialist diagnostic operations and perform sophisticated operations including transplants.
The Artemris, Fortis and Mendanta Indian hospitals signed another MoU with the National University of Science and Technology (Nust) under which senior Indian doctors will lecture at Nust medical school.
And to add icing to the cake, Zimbabwe remains a powerhouse in the region as far as training health personnel is concerned.
