IN 2019, Zimbabwe joined the world in Nairobi, Kenya for the 25th International Conference on Population and Development (ICPD) Programme of Action (ICPD25). The week-long event aimed to strengthen partnerships and harness re-commitments in the continued empowerment of women, and young people and ensuring access to sexual reproductive health (SRH) services.
By Michael Gwarisa
Next year, 2024, the ICPD will mark 30 years since the ICPD Programme of Action was adopted in 1994 by 179 Member States in Cairo Egypt. The ICPD, according to the United Nations Population Fund (UNFPA), emphasizes the value of investing in women and girls, both as an end in itself and as a key to improving the quality of life for everyone. It also affirms the importance of sexual and reproductive health, including family planning, as a precondition for women’s empowerment. It calls for an end to gender-based violence and harmful traditional practices, including female genital mutilation.
Represented by the Ministry of Health Child Care (MoHCC) at ICPD25, Zimbabwe made close to 30 commitments to scale up and advance quality access to SRH services and improve the quality of life for its young population.
The government first committed to Increasing by 50 percent, the maternal mortality reduction from 651 / 100000 live births by 2030; as well as developing a comprehensive national SRHR package and integrating it into the national UHC strategies, policies, and programs; and deploying two trained midwives to provide integrated sexual and reproductive health services at all eligible primary health care facilities by 2030. Proactively invest in post-secondary school skills building to reduce youth unemployment by half, by 2030.
According to the latest data from the 2022 Population and Housing Census, Zimbabwe reduced maternal mortality from 960 per 100,000 live births in 2010, to 363 in 2022.
Speaking to Journalists during a Media Briefing ahead of the launch of the State of the World Population Report, UNFPA Reproductive Health Specialist, Dr. Edwin Mpeta said Zimbabwe was on track to meeting its ICPD promise to reduce maternal mortality by the year 2030.
I know some of the commitments Zimbabwe made at the ICPD were around maternal mortality and some were around Family Planning. In terms of progress, for issues around maternal mortality, we are more or less on track although we need to do more. I think we are doing okay but there is more that needs to be done around maternal mortality,” said Dr. Mpeta.
In terms of improving the human resources aspect around Maternal Health through increasing the number of skilled birth attendance, data shows that high skilled attendance at birth currently stands at 86%. Dr. Mpeta however said COVID-19 wreaked havoc and reversed some of the gains that had been recorded around Maternal Mortality in Zimbabwe. However, an independent study that was conducted shows that at some point before COVID-19, Zimbabwe’s Maternal Mortality had been reduced to around 200,000.
Zimbabwe also pledged to curb teenage pregnancies from 21.6 percent to 12 percent by 2030; and avail comprehensive short and long-term, and permanent Family Planning methods at all Family Planning service provision points by 2030.
Dr Mpeta said Zimbabwe was also doing relatively okay In terms of Family Planning but coverage in adolescent girls and young women was still a major cause for concern.
“In terms of the proportion of women using Family Planning, this has not dropped. We are still doing well. Even in terms of stockouts, we have maintained it at less than 5 percent. Our unmet need in terms of Family Planning right now overall for all women it’s around 10 percent. However, for adolescents, the unmet need is still high and is around 12 percent.”
According to Census data, the modern contraceptive prevalence rate for married women increased from 60.7 percent in 2012, to 67.86 percent in 2022. However, teen pregnancies remain high as there has been a 42 percent increase in first Antenatal Clinic (ANC) visits by under 16 girls. The age group is stalked by high maternal deaths. Maternal Mortality Ratio (MMR) of 25-30% of all MMR is among adolescent girls.
Some of the commitments made by Zimbabwe were around strengthening Comprehensive Sexuality Education (CSE). A pledge was made to support all SRHR service provision points provide youth-friendly services and support all schools, public and private, delivering a quality-assured Comprehensive Sexuality Education (CSE) package appropriate for age, including HIV information, by 2030; and ensure hard-to-reach populations such as Persons With Disabilities (PWD), PLRA, emergency areas, prisons, sex workers, young people in conflict with the law have immediate access to comprehensive Sexual Reproductive Health and Rights (SRHR) services.
Mr. Blessing Nyagumbo, the UNFPA Zimbabwe Programme Specialist for Adolescents and Youths said Zimbabwe has made significant strides in rolling out CSE.
“In our local content, CSE has been re-profiled or given another term and it is known as the Life Skills Sexuality HIV/AIDS education. In terms of the approaches, to make it sustainable, we have focused on strengthening the capacity of the Ministry of Primary and Secondary Education Staff. That is from the teachers, administrators, district staff, inspectors, directors, and provincial level among others.
“One of the best approaches we have taken is Curricularising that CSE and if you go to our schools you find that it is now part of the curriculum. It’s part of the timetables and their sessions that talk of CSE. In some schools, it is also part of the morning address during assemblies. One of the approaches that are starting and guided by the ministry is that of school and community integration for it to be complemented within the community. We are roping in the Parent or guardian-child communication so as to sustain the CSE,” said Mr. Nyagumbo.
He added that the exclusion of those with disability was a cause for concern and there was need to move with speed in making CSE disability inclusive. He said they working on efforts to ensure CSE becomes disability inclusive through developing Information Education Communication (IEC) material that is sensitive to disability issues. This includes havening IEC material in braille and audio form etc.
Zimbabwe also committed to finalizing and fully implementing the Disability Amendment Act to support service access by women and girls with disabilities by 2030. In 2021, Zimbabwe’s President, Emmerson Mnangagwa launched the National Disability Policy.
In terms of data capturing and dissemination, Zimbabwe promised to continue strengthening the production of quality, relevant, timely, and, where possible, fully disaggregated vital country statistics through the decennial population census program to inform policy planning, including SDG monitoring and reporting, by 2030; and Invest in the statistical lead agency, ZIMSTAT, to offer timely and accurate statistics.
Mr Sunday Manyenya, the UNFPA Monitoring and Evaluation Specialist said, “We have strengthened capacity of the national statistical system to produce, analyse and use disaggregated population data to inform policy, decision-making and development programming, including in humanitarian situations.
“In terms of key interventions, we continue to coordinate support to ZIMSTAT to strengthen the national statistical system, we supported the 2022 Census, we are supporting the 2023 Zimbabwe Demographic Health Survey, we support the Household budget survey, other surveys such as Vital Medicine Availability Survey as well as a support to strengthen sector information management systems (Health, education, Gender). We also support strengthening the use of data for policy analysis and decision making.”
Meanwhile, a number of gaps and areas still need attention for Zimbabwe to fully fulfill its numerous pledges made at the ICPD. For instance, Zimbabwe pledged to ensure emergency preparedness across all relevant sectors, by 2030; build or strengthen coordination structures for preparedness and response to emergencies; and support the strengthening of the Civil Protection Unit to coordinate humanitarian actors to prioritize Prevention of Sexual Exploitation and Abuse and Sexual Gender Based Violence in humanitarian situations.
While progress has been made, Mr Manyengwa said there still remain data gaps in geographical coverage, timeliness, accessibility and the level of disaggregation, particularly by appropriate age, disability status and socioeconomic status, across the various sectors. He also said there is weak coordination of statistical production and research as well as limited sharing, dissemination, and use of data.
While Zimbabwe committed to finalise and implement the National Health Insurance Scheme as well as allocate at least 15 percent of the national budget to the health sector with specific allocation for SRHR and Family Planning, by 2030; the country is yet to create a National Health Insurance policy to cater for the poor and vulnerable population. The country also needs to increase domestic financing for health care as well as increase domestic funding for Family Planning. The government has invested US$3 million in 2022 and 2023 against a demand for Family Planning funding of US$8 million. The bulk is taken up by donor and development partners.