By Michael Gwarisa
Amid critical gaps in key health and social indicators, findings from a four-month-long Data-to-Policy training program have underscored the urgent need for policy interventions, Health Times has learned.
The Data-to-Policy program, launched by Vital Strategies in collaboration with the United States Centers for Disease Control Foundation and the Zimbabwe National Statistics Agency (ZimStat), aims to promote evidence-based policymaking in Zimbabwe’s healthcare and social sectors.
Speaking on behalf of the ZimStat Director General at the Data-to-Policy Dissemination Forum in Harare, ZimStat’s Demography and Social Statistics Director, Mr. Aluwisio Mukavhi, emphasized the program’s focus on team-based training and mentoring of professionals.
The program aimed to equip policy professionals with essential analytical and communication skills. In partnership with Vital Strategies, we hosted Zimbabwe’s first-ever Data-to-Policy training in 2024,” said Mr. Mukavhi.
The training took place in three sessions from May to August, bringing together four dedicated teams from the Ministry of Health and Child Care (MoHCC), the Civil Registry Department, and the Ministry of Women Affairs, Community, Small and Medium Enterprise Development (MWACSMED).
Various representatives from organizations involved in the Data-to-Policy training presented their policy briefs at the dissemination meeting. Dr. Chipo Chimamise of the Ministry of Health and Child Care (MoHCC) highlighted Zimbabwe’s alarming maternal mortality ratio.
“Zimbabwe remains among the top three countries in Southern Africa with the highest Maternal Mortality Ratio (MMR). Maternal mortality in Zimbabwe is still unexpectedly high at 462 maternal deaths per 100,000 live births, significantly above the national target of 240 maternal deaths per 100,000 live births,” said Dr. Chimamise.
Although Zimbabwe’s MMR has declined from 614 deaths per 100,000 live births in 2014 to 462 deaths per 100,000 in 2019, the reduction remains insufficient to meet the 2025 national target.
“Despite the decline, MMR remains high, and Zimbabwe is unlikely to achieve the national target of 240 deaths per 100,000 live births by 2025. While progress has been made, our MMR is still above the Southern African regional average of 218 deaths per 100,000 live births.”
Leading causes of maternal mortality in Zimbabwe include pregnancy-related complications, primarily severe bleeding (32%), high blood pressure during pregnancy (19%), infections (11%), and complications from delivery and unsafe abortion (10%). These factors collectively account for 72% of all maternal deaths.
The findings also highlighted the urgent need to improve maternal care, which remains the leading contributor to maternal mortality in the country.
“Ninety-five percent of all maternal deaths are preventable, and 86% result from the ‘Third Delay,’the delay in receiving appropriate and adequate care and treatment at health facilities,” Dr. Chimamise added.
In predominantly rural provinces, the Third Delay accounts for 78% of all maternal deaths. Contributing factors include delays in patient assessment or management, clinical decision errors, insufficient knowledge and skills, poor health worker attitudes, and shortages of critical equipment, essential medicines, and consumables.
To address the maternal mortality crisis, Dr. Chimamise proposed comprehensive in-service training for healthcare workers in Emergency Obstetric Care (EmOC), measures to curb the exodus of skilled professionals through competitive remuneration, and improved working and living conditions for healthcare workers.
Beyond maternal mortality, another pressing health concern in Zimbabwe is the high cost of cervical cancer screening and treatment, which remains a major barrier to early diagnosis and care. The high cost of cervical cancer screening and diagnosis remains a major barrier to early detection and treatment.
Ms. Roseline Mafukudze, Principal Policy and Strategic Development Officer in the Ministry, stressed the need for stronger awareness campaigns while advocating for financial interventions.
“Strengthening cervical cancer awareness is crucial in improving access to information. However, introducing a 50% subsidy on all cervical cancer diagnoses and treatments would significantly cushion patients against the exorbitant costs they face when seeking services,” said Ms. Mafukudze.
Cervical cancer remains a major public health concern in Zimbabwe due to its high morbidity, mortality, and economic burden. The high death rate is attributed to the cost of diagnosis and treatment, as well as low public awareness of early symptoms.
“Subsidizing cervical cancer diagnosis and treatment would have the greatest impact on reducing cervical cancer mortality,” she emphasized.
An economic evaluation of the proposed policy options revealed that the 50% subsidy could prevent 1,648 cervical cancer deaths, nearly 50%, compared to an awareness campaign alone, which would prevent only 220 deaths. While the subsidy would have a slightly higher cost-effectiveness ratio than the awareness option, it would have a significantly greater impact in reducing mortality.
“To implement this proposal, the Ministry of Health and Child Care (MoHCC) must establish a ring-fenced cervical cancer budget, design a user-fee subsidy program, and conduct continuous monitoring and evaluation to ensure value for money.”
Adding to these challenges, many deaths go unregistered. This raises concerns about the accuracy of national health records and the effectiveness of policy planning
Letisia Zengeya, Assistant Registrar General for Births and Deaths, attributed low death registration rates to the inaccessibility of registration centers and a lack of public awareness regarding the importance of death registration.
“Seventy percent of deaths in Zimbabwe occur in rural communities, yet nearly half of these are not registered. Low death registration affects governance, health statistics, and policy decisions,” said Zengeya.
To improve registration rates, she proposed implementing an active notification system alongside targeted mobile registration exercises.
“In 2022, 43% of rural deaths were unregistered. However, in countries like Bangladesh, active notification programs have increased death registration from 24% to 94% within a year. If properly implemented, similar strategies could increase Zimbabwe’s death registration rate to 90%,” she added.
