By Michael Gwarisa
The World Bank has officially handed over the Health Sector Development Support Project (HSDSP), to Zimbabwe’s Ministry of Health and Child Care (MoHCC), as part of efforts to institutionalise and create continuity of projects beyond donor funding.
Initiated in 2011, the Health Sector Development Support Project was characterised by different funding cycles including the latest additional financing. Through the project, Zimbabwe has recorded positive gains on the maternal and child health side of services through innovative health systems strengthening approaches, supported by an investment of US$78 million with co-financing from the Government of Zimbabwe through support from the Global Financing Facility (GFF) and Health Results Innovation Trust Fund (HRITF).
Speaking at the Grant Closeout event in Harare, Minister of Health and Child Care, Dr Douglas Mombeshora said the government was ready to take over from where the World Bank has left.
As we celebrate these achievements, we must also recognise that our work is far from over. The Close-out of the Health Sector Development Support Project does not mark the end of our efforts but rather the beginning of a new chapter,” said Dr Mombeshora.
He added that whilst gains made thus far were commendable, there was a need to keep the momentum to ensure Zimbabwe remains on course to meet the Sustainable Development Goals targets by 2030.
“As we move on to consolidate the gains made and advance the institutionalisation of the Results Based Financing (RBF), I would like to kindly request donors to continue providing additional technical and financial assistance to realise and sustain the benefits of these efforts,” he said.
He also said the RBF has been adopted as one of the healthcare financing mechanisms in Zimbabwe.
“This project has been made possible through support from our long-time friends the World Bank and the Global Financing Facility with Cordaid as the implementing entity. You committed millions of dollars towards increasing coverage and quality of an integrated package of Reproductive, Maternal, New-born, Child, and Adolescent health and nutrition (RMNCH-N) using an RBF approach,” said Dr Mombeshora.
Through support from the HSDSP, Zimbabwe managed to pilot the RBF project in two districts in 2011 before scaling it up to 16 additional districts in 2012. Through evidence generated from the 18 districts, the project was further scaled up to 42 rural districts through Health Development Fund support and the two cities, Harare and Bulawayo.
“The Health Sector Development Support Project, with its focus on RBF has transformed the way we deliver healthcare services in this country. Through this program, we have prioritised performance and results, ensuring that our healthcare facilities are motivated and incentivised to deliver high-quality care to our citizens. This is in line with the government’s Integrated Results Based Management approach.”
Dr Mombeshora added that notable gains have been realised over the years through the RBF program, and these include increased coverage, utilisation, and quality of maternal and newborn health services. He said the RBF has also fostered community engagement, ownership, governance and accountability and also strengthened health information management systems at all levels of care.
Meanwhile, the Close-out of the grant in Zimbabwe also marks the commencement of a new World Bank funding of a US$15 Million Essential Health Services Grant. The grant seeks to strengthen Zimbabwe’s health system by capacitating about 25 Secondary care facilities, and support outreach Activities as well as Community Health Systems.
World Bank Country Manager, Ms Eneida Fernandes applauded the government of Zimbabwe for successfully adopting the projects under the HSDSP.
“As we celebrate these achievements, it is imperative to acknowledge the Government of Zimbabwe’s commendable efforts in institutionalizing the project’s design, implementation processes, and financing approaches,” said Ms Fernandes.
She added that government’s unwavering commitment, exemplified by the direct financial support to rural districts and the scaling up of initiatives, underscores their dedication to ensuring the sustainability of the initiatives.
“Today is not about closing a project but recognizing Government-led efforts towards sustainable health system reforms. While we celebrate our successes, we must also acknowledge the challenges that remain and those that lie ahead”
Through this project, over one million women received prenatal care services in RBF-supported facilities (1.39 women received 4 or more prenatal care visits) and more than 1.1 million women delivered at the supported facilities. Approximately 2,267,228 children received Vitamin A supplementation and over 958,845 children completed the primary course of immunization, reflecting our collective commitment to safeguarding the health of future generations.
Heleen van den Berg, Cordaid Chief Executive Officer said, “The RBF has brought positive change most notably in relation to the services provision of the contracted health facilities. The quality of services increased and remained relatively stable even during challenging times such as COVID-19, and reliability of health data improved.”
Success under the Health Sector Development Support project is highlighted by the improvements in service quality, with facilities in RBF supported districts achieving average quality scores between 80% and 85% from the previous scores of below 70%. The Impact Evaluation of the results-based financing approach in the 18 also improved coverage and quality of key maternal and child health indicators, with districts implementing RBF having been observed to have increased the percentage of women delivering in clinics and hospitals, where it is safer, by 13% more than non-implementing districts.
