By Kuda Pembere recently in Mat South
Accessing basic health services is always a nightmare for people living in remote areas where they are faced with transport fare headaches due to the long treks to a nearest health facility. As a result, many end up shunning health care services, and resorting to risky health practices such home delivery of babies, not taking children for immunisation among others.
During a Matabeleland South media tour assessing the impact of the Health Resilience Fund (HRF) in improving the attainment of universal health coverage, the Ministry of Health and Child Care (MoHCC) through the HRF has an integrated health outreach component bringing central hospital services to remote areas.
The HRF is funded by the UK Government, the Embassy of Ireland, the European Union (EU) and GAVI with the United Nations Children’s Fund (UNICEF) while the World Health Organization (WHO) and United Nations Population (UNFPA) are the implementing partners.
The programs aligns with Zimbabwe’s National Development Strategy alongside the National Health Strategy. Flanked by her two young children, the younger one, an under 5, Sengeziwe Moyo who appears to be in her 20s waits for her turn to be served. She does not mind waiting to get her children immunised.
My name is Sengeziwe Moyo, l stay in Mahlokohloko, the clinic is too far from us. It is about 12km. I came here for vaccinations for my two children.
“This one haven’t been vaccinated for a long time because the clinic is far and my child can’t manage to walk for such a long distance,” Sengeziwe says. “That is why l finally came here so that her eyes can also be treated.”
Transport operators taking advantage of the road networks charge an arm and a leg for the fares, becoming a factor demotivating health seeking for the likes of Sengeziwe.
“The coming of the doctors here helped us a lot especially for those with young children. We also have village health workers who brings the vaccines closer sometimes. For us to go to the clinic we use combis but the challenge is we cannot afford money for transport, they are expensive. It is 60rand (US$3) going there and another 60rand (US$3) coming back,” she says.
Hundreds throng the health outreach assembly point for a chance to consult opthalmologists or eye doctors, mental health services nurses, and getting screened for non-communicable diseases such as hypertension and diabetes, child growth monitoring to mention but a few.
“What you have witnessed today is what we call the integrated outreach service. It’s also another component of self-delivery that we’re benefiting from HRF. So with the integrated outreach concept is we want to try and reach out to people closer in their homes and probably identify where we’ve got gaps.
“Maybe it might be nutrition, it might be reproductive health, TB, HIV. Our village health workers can actually go into communities, look for patients or cases that need assistance in those areas, and then they are referred to some outreach points where the health teams, a multidisciplinary health team, will then go out and provide services.
“So, for example, what you’ve witnessed today with teams that were offering things that clinic level with diagnostic tracks for x-rays and laboratory, V-ACC services, dental services. These are services that people usually do not get routinely. So there’s also that component to then to strengthen our service delivery at the community level,” explained the Acting Provincial Medical Director for Mateleland South Dr Felix Muza.
Highlighting the challenges faced by the people who came to be served by health workers, Mat South Provincial Nursing Officer Joyce Sibanda noted there are districts where the nearest clinic is 57 KM.
“This outreach point is about 15KM from the nearest clinic village which is Stanmore. So you find that in situations like this, there may not even be transport that is plying the route.
“Even if the transport should be there, we may also have challenges that the people have no money. But in other districts, you find that the outage point is about 57 kilometers from the nearest clinic.
“So you can’t expect people to be walking that distance, especially the elderly, those who are sick, and the young ones.
“And also in our population, we also do have the child-headed families that are there. With situations like that, it becomes very difficult to be walking to the facility for its services,” she said.
In Bulilima district, there is another outreach program bringing together hundreds of people.
Community health nurse for the district Mr Chrispen Mabhasa explained that they had hoped to these outreaches on a monthly basis instead of the quarterly routine.
“The outreaches, in a normal way, they are actually done monthly, but at times we don’t go out. Like I am saying availability of resources determine whether we go out or we dont. But otherwise we’ve planned for them month until January. I mean January to December,” he said.
He said they had a rehab technician as well as eye nurses.
“As they are screening, they are also considering the rehab. I was saying, to cater for that service, we brought our own rehabilitation technician.
“She’s there, she’s in the screening room with the doctor. So all our clients who need that service, they have been served from there,” Mr Mabhaza said.
Banking on Plumtree District Hospital, serving about 75 percent of Bulilima, Mr Mabhaza said the community relies on such outreaches.
“Yeah, it is a big hindrance. Why? Bulilima is vast. So for us to have resources to transport our clients from the furthest area to Plumtree it is about 110 kilometers.
“It so happens at times we dont have fuel. But if Bulilima is going to district hospital maybe in the same even the resources will be fewer. But now traveling from Plumtree to it becomes a really big challenge.
