The H4+ is a partnership of UN agencies concerned with maternal and child health –including the World Health organization (WHO). The H4+ advocates for stronger focus on maternal, newborn and child health and works with countries to strengthen health systems and provide better services for mothers and children.
PROJECT TITLE: ENGAGING WITH COMMUNITIES AND TRADITIONAL LEADERS IN ZIMBABWE TO IMPROVE WOMEN’S AND CHILDREN’S ACCESS TO CARE AND SERVICES INCLUDING HIV.
Women’s Action Group has been implementing the H4+ initiative in four districts namely Mbire, Chipinge, Gokwe North, Hurungwe with support from UNAIDS. Based on work done in these districts there has been evidence that with the required support, traditional and church leaders can mobilise communities to seek health services. From the experiences of WAG it is evident that traditional and religious leaders are critical in Reproductive Maternal Neonatal and Child Health (RMNCH) issues as they can influence negative traditional and cultural practices such as early marriages and gender based violence. Traditional and church leaders play a pivotal role in influencing health seeking behavior amongst their communities at household and community level. Anecdotal evidence in the districts where WAG implemented the H4+ confirmed; reduction in home deliveries, high uptake of couple HIV counselling, realisation of the importance of establishing mothers’ shelters at health centers. In Mbire District, the programme recorded some key achievements in health seeking behaviours where communities including men were able to access RMNCH services through the support of traditional leaders on the Health Day. Through working with traditional leaders in the programme in the previous phase of this programme, traditional leaders have been able to mobilise the community to pay a dollar per family to support health service delivery in Mbire District. WAG is happy that UNAIDS continued supporting the project and this year WAG will scale up the initiatives based on the lessons learnt and achievements from the four districts. Implementation of the project will be in the six H4+ districts.
Results of the Intervention
a. Traditional and Religious leaders are succeeding in mobilizing their communities to access and utilize health services. This can be evidenced by an increase in the number of people accessing health services at the local clinics and also the large numbers of people who came for the Community Health Day to access the services for free.
Traditional Leader getting tested for HIV at a Community Health Day in Mbire
b. Through the H4+ programme, the communities has realized the importance of community initiatives in health and GBV related issues. With the support from UNAIDS, WAG has facilitated the construction of a Waiting mothers shelter at Chirunya Clinic in Mbire district. The community chipped in and make a contribution of bricks, water, labor, river and pit sand. In Chiredzi district, though the contributions of the community, a clinic was constructed at GwasecheWaiting Mother’s Shelter under construction at Chirunya Clinic in Mbire
c. Traditional leaders are taking a lead in addressing religious and cultural practices which have negative implications on people’s health. In Chitsungo ward in Mbire, traditional leaders have come up with a law which forbids home deliveries and if one deliver at home, they pay a fine of 2 goats (one for the chief and the other one for the village head). Meanwhile, in Chiredzi district, it is believed that a cultural practice, called Ukomba has been contributing to early child marriage. Under the Ukomba practice, young girls would go for an initiation into womanhood where there are taught on how to handle a man in marriage. It is believed that after the ceremony, young girls are dropping out from school and getting married earlier. The traditional leaders have however resolved that they are now compiling the list of the girls going for ukomba with the signatures of the parents. This list will assist them in making a follow up with the children on whether they are going to school or not.Traditional leaders in Gokwe North holding their tool kits after the training
d. After noting the gaps in Health and GBV, WAG has managed to bring the issues to the attention of Policy makers at the National Advocacy Meeting that was held in Harare. As a way forward Parliamentarians committed to taking some of the advocacy issues for debate in ParliamentHonourable Sibanda making a contribution at the National Advocacy Meeting