Moving forward in Zimbabwe - Brooks World Poverty Institute - The ...

Moving forward in Zimbabwe
Reducing poverty and promoting growth
These indicators of the state of health do not tell the whole
story, as some of the hidden and long-term impacts of a prolonged
socio-economic crisis will not be known until much later. For
example, long-term nutrition-induced deficiencies that affect a
whole generation of children will not be known for some time.
Data from the Zimbabwe National Nutrition and Food Security
Assessment of October 2007 shows significant increases in the
prevalence of underweight children (17.4 per cent), wasting at
4.1 per cent and stunting at 28.9 per cent. The long-term impacts
on life chances and the true costs of current poor nutrition and
immunisation coverage on a generation of children that has grown
up under such difficult situations will need to be taken into account
in planning for health recovery.
Health facilities, equipment and transport
Health infrastructure capital investment has not kept pace with
population expansion. Notably, a big gap continues to exist in
secondary care facilities in urban areas. This situation has resulted in
Provincial and Central Hospitals being used as first referral centres,
leading to congestion and a fall in the quality of services offered.
Since the Family Health project financed by the World Bank in early
1990, there has been limited capital injection in the building of new
facilities in urban areas, while lack of repair and maintenance has
led to considerable deterioration in most of the rural infrastructure.
Although the deterioration in infrastructure can also be explained
by the staff cutbacks of the mid-1990s, it is also clear that once the
state became cash-strapped during the crisis, regular maintenance
and timely repair of buildings and equipment also suffered.
Similarly the Anti-Retroviral Therapy (ART) review of 2008
showed that one of the major problems facing communities in
Zimbabwe and leading to their failure to access health services
is transport to get to the hospitals. Where this is available it has
become expensive and beyond the reach of many. The review
showed that some ambulances are in a state of disrepair and most
have outlived their economic life span. The few vehicles that are
being procured under different Programmes did not last long due
to overuse, as they were the only reliable vehicles available for use
in the districts.
Medical equipment and laboratory and supplies
Zimbabwe used to have such good medical equipment and
laboratory services in the decentralised health delivery service
that it was unknown for patients from the rural areas to come to
the central hospitals, unless it was for major surgical operations.
District hospitals had all the services that would meet the priority
diseases in the country. In the current crisis the medical equipment
has slowly ground to a halt. Most of the contract holders for
servicing the machines have left the country and there is no budget
to pay them. Similarly, the radio and telecommunications system
in most of the districts, especially rural areas, virtually collapsed.
This meant that patients were moved from one point to another
without prior knowledge of whether the service they require is
available where they are being referred to. In addition, a breakdown
in communication made it difficult for health centres to share
working equipment and medicines..
Health infrastructure capital investment has not kept pace with population expansion, notably, a big gap continues to
exist in secondary care facilities in urban areas (Photo © Tsvangirayi Mukwazhi).
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