By Kuda Pembere and Rebeccah Zindati
The creation of a dedicated Primary Health Care and Community Health Directorate has been described as a significant step toward improving accountability, coordination, and service delivery for community health worker (CHW) programming in Zimbabwe.
Currently, the Department of Community Health is housed under the Nursing Services Directorate in the Ministry of Health and Child Care, a structure that stakeholders say limits oversight of CHWs despite their central role in delivering healthcare at the grassroots level.
The proposal to establish the directorate was discussed at the Multi-Stakeholder Community Health Forum in Mazowe last week, hosted by the Ministry of Health and Child Care in partnership with the Africa Centres for Disease Control and Prevention (Africa CDC). The directorate will coordinate community-based services, paving the way for the development of the National Community Health Strategy 2026–2030.
Hwange Central legislator and acting Parliamentary Portfolio Committee member Hon. Daniel Molekele speaking with HealthTimes during the forum said establishing a separate directorate was long overdue.
“I agree that it is actually a very important administrative gap that should not be allowed to continue. We need community healthcare or primary healthcare to have a separate directorate or department so that they coordinate the response at the basic entry level of healthcare,” he said.
“Where we are today, where there is no clarity, we are really in charge in coordinating, getting mixed up and not really being accountable. That situation is not tenable. So I think as a committee, we are more persuaded on the argument that we should have a national directorate that coordinates across the country at a community level, at a primary healthcare level.”
Secretary in the Ministry of Health and Child Care, Dr. Aspect Maunganidze, said government was committed to expanding and strengthening the CHW workforce.
“Since 2020, we have developed and ratified the first ever National Community Health Workforce Strategy 2020–2025,” he noted. “This foundational strategy has been pivotal in unifying service delivery at the community level through instruments like the Community Health Essential Package, the Community Health Investment Case, and the Health Case Toolkit.”
Dr. Maunganidze added, “You are aware that we launched the Health Workforce Strategy 2023–2030 and signed the Health Workforce Investment Format in October 2024.”
He said Zimbabwe plans to increase its CHW network from 22,000 to 40,000 by 2028.
“The Government is already committing resources to community health from 2025 formats, which is really a strong signal of ownership and sustainability,” he said.
Richard Kintu, Director of Policy & Advocacy at Africa Frontline First, said a dedicated directorate would improve coordination of community health strategy development and implementation.
“It also offers policy guidance and leadership to stakeholders and IPs, coordinates with other departments such as Monitoring and Evaluation, Nursing, Planning and other units, and engages at sub-national level,” he said.
“Community health is a huge task that requires resources and personnel. Recruiting and deploying 40,000 VHWs is huge, and it requires a department and budget to drive this program to ensure effective implementation. It also aligns with the continental direction to create a designated unit for community health to draw technical assistance and best practices to country level.”
Dr. Barnabas Kwame Yeboah, Africa CDC Senior Technical Officer for Community Health Advocacy and Sustainability, said a dedicated directorate would strengthen health systems and improve responses to disease outbreaks.
“In the context of global and continental agenda for health, one of the critical areas of health care is primary health care. So most member state countries, their health system is revolving on primary health care systems. And one thing we want to promote, advocate for our countries in Africa is to adopt best practices across the continent.
“And one of the things we want to advocate for is the establishment of primary health care departments in every ministry of health. That will have the responsibility, oversight, and leadership to ensure that our health systems revolve around primary health care. And what this also means is that it will support community health systems so that we can detect, prevent, and respond to disease outbreaks appropriately.”
Meggie Gabida, Senior Technical Officer for Integrated Community Health Service Delivery at Africa CDC, said CHWs would be placed on a geo-referenced national registry integrated with Zimbabwe’s digital health system to streamline payment and monitoring.
“Through tabling a Bill to the Cabinet by the Health Minister, this would ensure sustainable funding and full integration of VHWs into the health sector,” she said.
She also stressed the importance of coordination and partnerships. “The evidence is clear. The Ministry noted with foresighted leadership and meaningful partnerships, Zimbabwe can deliver integrated health services to all communities.”
Concerns were also raised over CHWs who, after training, abandon community service to seek caregiver jobs elsewhere. Nkayi District Hospital staff CHW, Noliwe Ndlovu, said training fees could help improve accountability.
“This free training is good, but however there’s need to charge because at the end people are only concerned about a certificate which will give them an opportunity to seek caregiver jobs elsewhere,” said Ndlovu.
