February 2015 KC Teams; Stakeholders in the health sector are concerned over the limited number of health workers in Zimbabwe which is threatening the health delivery system and in particular HIV-related issues.
Itai Rusike, executive director for non-governmental organisation Community Working Group on Health, said the number of village health workers has diminished over the last two decades in Zimbabwe to less than 10,000 when there is a national need of about 20,000.
“The situation is even worse in resettlement areas as some of the village health workers are made to travel very long distances to see clients instead of just covering their village,” said Rusike.
Lack of incentives for health workers
Rusike added: “Whilst communities cite low morale due to lack of incentives as the major setback, the village health workers point to lack of incentives and supporting resources and protective equipment as a major barrier to their performance.”
According to UNICEF in Zimbabwe, village health workers play an essential role in the primary health care system and the fight against HIV and AIDS.
“Zimbabwe is at the epicentre of the HIV/AIDS epidemic. Nearly 1 in every 6 children has lost one or both parents to AIDS. Village health workers, who know and have held every child in their community, come face to face with the reality of the situation on a daily basis.
“Making sure that pregnant women are tested early and receive antiretroviral drugs helps ensure that fewer mothers pass the virus along to their babies,” says UNICEF.
Village health workers essential to HIV care
Ms Moyo, 38, a village health worker, said she attends to more than 200 households in her village.
“I conduct door to door services in my village, but because of shortages of village health workers I have to attend to many people of which at times I fail to fullfill everything that needs to be done.
“We do home visits to different patients, some with chronic diseases such as asthma and tuberculosis, as well as HIV/AIDS patients to make sure they are taking their medication on time and consistently,” added Moyo.
Asked on whether health workers are well remunerated, she was sceptical, but explained: “Our goal is the betterment of our community, so we don’t expect to be paid much. We desire to see people out of their sick beds.”
Overburdened health workers
Hattie (name changed), a woman living with HIV from Seke rural community, said village health workers are vital to improving the health of the community but bemoaned their shortage.
She said: “To be honest village health workers are few, the one in our village is in charge of two villages, and you can see the burden that she has. We fear that if this continues new HIV infections and other diseases might increase since health workers are the bridge between us and the government.
“We also urge responsible authorities to build shelters that can be used by village health workers when carrying out their duties.”
Government must invest in village health workers
Village health workers were key to Zimbabwe’s successful expansion of Primary Health Care in the early 1980s.
“They played a central role in closing the gap between public health services and communities at local levels as well as bringing health services to communities, and facilitating community roles in the health delivery system,” said Rusike.
The result of the low ratio of village health workers to tackle HIV and limited primary health care in rural areas is high morbidity and mortality, although there has been a slight decrease in maternal mortality (United Nations Zimbabwe newsletter).
Rusike added that reduced access to health care services within rural areas adds to cost burden or barrier to service uptake for women, indicating the need to improve the quality of maternity services in the rural areas.