DEPARTMENTS

ADMINISTRATION

BLAIR RESEARCH INSTITUTE

ENVIRONMENTAL HEALTH

EPIDEMIOLOGY AND DISEASE CONTROL

FAMILY AND CHILD HEALTH

FINANCE

CENTRAL HOSPITALS

HOSPITAL EQUIPMENT AND MAINTANANCE

HOSPITAL PLANNING AND PROJECTS COORDINATION

GOVERNMENT ANALYST LABORATORY

HEALTH PROFFESSIONS AUTHORITY

FAMILY AND CHILD HEALTH DEPARTMENT

Mission
The mission of the department of Family and Child Welfare is to ensure the highest possible level of health and quality of life through promoting, developing and implementing interventions for the improvement of Reproductive Health of individuals, families and communities.

To achieve this mission or vision, the department's efforts are directed towards:

• Focusing on Reproductive Health as an essential component in overall national development towards improving the quality of life for all citizens of Zimbabwe.
• Achieving equity in reproductive health by targeting resources and programmes to the most vulnerable and needy sectors of the population.
• Developing innovative, and new approaches in managing the delivery of reproductive health services in ways that enhance access, community satisfaction and local accountability.
• Reducing Reproductive Health related morbidity and mortality.
• Enhancing community participation and involvement in Reproductive health service development.
• Promoting appropriate Reproductive health lifestyles and behaviour.

Table of Contents

1. Implementation Strategy for the NRHCP
2. Zimbabwe National Reproductive Health Care Program
3. Health Education Unit
4. Rehabilitation Unit
5. Nutrition Unit
6. Maternal Health and Safe Motherhood Unit
7. National Plan of Action for Children Unit
8. Zimbabwe Expanded Programme on Immunisation
9. Further Information

1. Implementation Strategy for the National Reproductive Health Care Programme
The national strategy for the National Reproductive Health Care Programme (NRHCP) will focus on three major components which aim to facilitate and streamline the implementation of the programme throughout the country:

• Advocacy;
• Implementation of programmes and activities;
• Evaluation of programmes and specific activities.

ADVOCACY:
The new challenges presented by the approach to reproductive health care require a great deal of ADVOCACY in order to ensure general understanding of the concept of Reproductive Health, an enabling political, socio-cultural environment including increased allocation of resources for RH programmes and activities.

IMPLEMENTATION OF PROGRAMMES AND ACTIVITIES:
The technical and strategic co-ordination f the NRHCP implies the clear definition and direction of the Programme Components and contents as well as the methods and implementation strategies.  Effective links between programmes and actvities will globally result in:

• Promotion of reproductive health;
• Prevention of reproductive ill-health and related problems;
• Provision of "Effective and Integrated Care and Rehabilitation";
• Extension and Provision of reproductive health care services to the neglected population groups, i.e., adolescents, men, families.

The implementation strategies recommended aim to maintain the quality of care effectively provided and improved on the gaps and new requirements of reproductive health care.  The development and implementation of the programme necessitate an incremental and participatory approach.  There is therefore need to evaluate what is in place in the system and to what extend the system is responsive to the reproductive health needs of the population.  The identification of gaps and inadequacies as well as commonalities within and between programmes will be eventually followed by the creation and further strengthening of necessary linkages between programmes.

2. Zimbabwe National Reproductive Health Care Programme

2.1 The components of this programme are:

• Safe motherhood, prenatal care, safe delivery, essential obstetric care, perinatal and neonatal care, postnatal care.
• Family planning information and services.
• Prevention and management of infertility and sexual dysfunction in both men and women.
• Prevention and management of complications of abortion.
• Provision of safe abortion services, where the law so permits.
• Prevention and management of reproductive tract infections, especially sexually transmitted infections (STIs) including HIV/AIDS.
• Promotion of health sexual maturation as from pre adolescence, responsible and safe sex throughout the life time and gender equality.
• Elimination of harmful practises such as female genital mutilation (FGM) premature marriage and domestic and sexual violence against women.
• Management of non-infectious conditions of the reproductive system such as genital fistula, cervical cancer, and reproductive health problems associated with menopause.

2.2 Reproductive Health Activities

• Introduction of the reproductive health concept in the country through a multisectoral approach.
• Carrying out a programme baseline survey to facilitate planning and programme implementation.
• Development of comprehensive services that are of good quality, equitably accessible, affordable and appropriate to the needs of individuals, families and communities, especially the under-served group.
• Reorientation of planning process for a more pragmatic and participatory approach to the identification of problems, needs and interventions.
• Development of programme guidelines and protocols.
• Establishing an enabling environment for service providers.
• Recognising and supporting the roles of professional bodies.
• Enhancing the institutional capacity of the national health system to adequately address reproductive health needs.

3. Health Education Unit
The Health Education Unit (HEU) in the Department of Family and Child Health is responsible for health education/promotion activities in Zimbabwe. Its main functions are:

• To assess, plan, implement monitor and evaluate the delivery of health education programme in the country.
• To provide professional support and policy guidelines in health education to different organisation at national , provincial and district levels.
• To co-ordinate health education activities among the private, public and non-governmental organisations.

3.1 The Mission for Health Education is:

• The improvement of the general well-being of individuals, families and communities.
• The encouragement of people to be responsible for their own health through their own actions and efforts.
• The promotion of the adoption of positive health behaviour.

3.2 Health Education Objectives

• In pursuance of its mission, Health Education Unit works within the framework of the following objectives.
• Unifying fragmented health education/promotion services into a comprehensive and integrated system.
• Reducing disparities and inequities in health education service delivery.
• Assessing health education needs and instituting appropriate interventions.
• Designing, producing and distributing/disseminating health education media/messages to the community.
• Formulating health education guidelines and policy.

3.3 Methodology/Strategy

In 1994 - 1995 a Health Education Strategy and Health Education Policy were developed. These two documents are providing guidance and policy direction in the planning implementation and valuation of health education programme.

The five year IEC/HE strategy is five tiered and it focuses on designing and developing health education interventions for:

3.3.1 Priority Health Problems

Those health problems, with the most serious consequences for mortality and morbidity in Zimbabwe. These are HIV/AIDS, tuberculosis, ARI/CDD, infant nutrition and reproductive health.

3.3.2 Seasonal Health Problems

Those health problems which are predominantly seasonal in nature, such as malaria and diarrhoea which commonly increase in frequency during the rainy season.

3.3.3 Epidemic Prone Problems

Those health problems such as cholera, rabies, meningitis which strike irregularly (both in terms of time and place) and with an intensity to merit emergency mobilisation of the health sector.

3.3.4 Quality of Care

The programme that works to improve health status by focusing not on technologies but on improving the effectiveness of health services by attending to standards for effective treatment. In patient education, quality of care focuses on interpersonal communication which addresses health worker-client counselling and education.

3.3.5 Other Health Problems

Those health problems such as mental illness, smoking, heart disease, leprosy oral health, diabetes mellitus, hypertension and injuries which may be serious contributors to mortality and morbidity, but take lower priority because of their relative public health importance.

4. Rehabilitation Unit
The mandate for the Rehabilitation Unit is to prevent, minimise and cure physical mental, visual and hearing disabilities through a process of timely interventions from the onset of injury or disease to resettlement in the community through a network of experts in rehabilitation who are physiotherapists, occupational; therapists, speech therapists, orthopaedic technologists, rehabilitation technicians as well as nurses, doctors and other health workers.

Rehabilitation has over the years developed a comprehensive programme which includes referral services, outreach and community based activities.

4.1 Rehabilitation activities include:

• Early identification of children with disabilities and referrals.
• Provision of direct treatment/training of people with disabilities, their families and communities.
• Provision of appropriate aids, applications and equipment for all disabilities.
• Training and education of community workers on disability issues.
• Integration of children with disability into mainstream of schools.
• Provision of opportunities for vocational training and employment.
• Involvement and participation of disabled people, their families and community at large in rehabilitation programme thereby empowering people with disabilities.

5. Nutrition Unit
The mandate for Nutrition Unit is the promotion of healthy diets, and lifestyles and reducing the prevalence of nutrition related diseases.

5.1 The components of the Nutrition Programme are as follows:

• Food and nutrition policy development and implementation.
• Food and nutrition surveillance and programme monitoring and evaluation.
• Community based nutrition programmes.
• Maternal, infant and young child nutrition.
• Control of micronutrient disorders.
• Control of diet related chronic diseases.
• Nutrition advocacy, information, education and communication.
• Nutritional institutional support, capacity building and human resource development
• Institutional feeding and dietetics services.

5.2 Strategies for the Nutrition Programme

• Establishment of a national food and nutrition policy and secretariat to co-ordinate its development and implementation.
• Strengthen advocacy activities targeted at policy-makers and communities affected to give support to food and nutrition activities.
• Strengthen capacity building initiatives to meet the challenges of decentralisation, food and nutrition policy development, subcontracting of catering services and management of emerging nutrition and diet related problems.

5.3 Nutritional Status

The following table indicates the changes which have taken place in the nutrition status of young children in Zimbabwe between 1982 - 1998. Due to various factors nutrition indicators have worsened over the years.

Percentage of children moderate to severely malnourished.

6. Maternal Health and Safe Motherhood Unit

The mandate for this unit includes:

• Dissemination of the Departmental strategy of the Reproductive Health Care progremme at all levels of the health system in the country.
• Facilitating and monitoring the implementation of activities of the Reproductive Health programme.
• Developing and supporting mechanisms for bridging identified gaps in the Reproductive Health field activities.
• Improving the general knowledge and skills of all people involved in the provision of Maternal Health Service and Safe Motherhood including a better quality health care service.
• Reorganising the health care delivery system to the underserved community for a more cost effective and cost efficient service, ensuring that services are equitably accessible and affordable to all communities in the country.
• Compiling national activity reports on projects or programmes, including not only quantitative but also qualitative information.
• Monitoring Health for All and Global Afro Indicators relating to Safe Motherhood and Child Survival and Development.
• Contributing to and focussing attention on the implementation of CDD/ARI, Safe Motherhood and the Integrated Management of Childhood Illness approach (IMCI) according to the African Health Development Framework.
• Networking with other related technical (such as nutrition, EPI, malaria, HIV/AIDS, CDD, ARI and others) and provincial MCH/FP Managers with the aim of improving maternal and child health indicators.

7. National Plan of Action for Children Unit
The NPA for children is mandated with the responsibility of insuring that the UN convention on the rights of the child 'CRC' is implemented in the country through ensuring that the needs of children are considered paramount throughout the government's programmes, services and development strategies.

Within the national government an inter-ministerial core group has been appointed to oversee the process of the national programme of action. Ministry of Health and Child Welfare (NPA Unit) provides the secretariat for the programme.

7.1    The components to guide implementation of the NPA by areas of policy include:

• Goals as stipulated by world summit goals for the year 2000.
• Relevant articles of the UN convention of the rights of the child.
• Responsible lead and supporting sectors.
• National strategies.
• Measurable targets for achievement.
• Indicators.
• Monitoring plan.

7.2    The national priorities adopted for the programme of action include:

• Nutrition
• Child health
• Water and education
• Early childhood development and basic education
• Social welfare development
• Child protection measures.

7.3 Activities undertaken so far include:

• Determining the situation of children
• Advocacy Activities
• Interministerial co-ordination activities.
• Development of child protection measures.

8. Zimbabwe Expanded Programme on Immunisation (ZEPI)
ZEPI is a unit within the department of Family and Child Health Department. Its mandate is to reduce mortality and morbidity due immunisable diseases i.e tuberculosis, diphtheria, whooping cough, tetanus, poliomyelitis measles, hepatitis B.

The ZEPI programme aims to vaccinate all children in Zimbabwe against the target diseases by their first birthday.

8.1 Programme Objectives

• To provide adequate high quality vaccines, cold chain equipment and other EPI supplies.
• To maintain vaccination coverage above 80% in all EPI antigens among all children under the age of one year.
• To maintain active surveillance on polio/AFP, measles and neonatal tetanus as an integral strategy towards the ultimate eradication and elimination of the three target diseases.
• To ensure continued high profile political advocacy for vaccines and immunisations.
• Strengthen community based strategies for addressing food and nutrition programmes in a manner which empowers communities to assess analyse and act on their problems with minimal external support.
• Drought preparedness strategies to minimise impact of recurrent droughts on vulnerable groups.

Contact Persons

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