Reaching out to remote communities in Zimbabwe on two wheels
China-funded UNICEF programme improves maternal and child health
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In the remote corners of Zimbabwe, where healthcare facilities are scarce and distances are vast, the humble bicycle and training programmes are making a world of difference. With support of the Government of China and UNICEF, village health workers are providing lifesaving care to women and children, bringing essential health services closer to those in need.
Sanele Mutsiwa, 25, smiles at her two-year-old daughter Faith at Kezi Clinic in Matobo district, Zimbabwe, where she has gone to get her child vaccinated. She holds a baby card, while Faith sits on her lap. Sanele says she owes this happy moment to her local village health worker, who supported her during pregnancy and after birth.
It was village health worker Duduzile Ndlovu who conducted Sanele’s pregnancy test, encouraged her to make the three-kilometre journey to the hospital to make a booking, and continued to monitor the mother and baby after birth.
“Duduzile has been with us all the way,” Sanele says. “She makes sure I know about the nutritional needs of my child, informs me about disease outbreaks and immunisation campaigns and pushes all of us in the community to adopt safe water, sanitation and hygiene practices.”
Sanele lives in Matabeleland South Province, a poor rural region of Western Zimbabwe, where it is difficult for young mothers to reach a health facility and have their babies vaccinated. But now they can rely on village health workers (VHW) who come and reach out to them, where they live.
In the arid landscapes of Mangwe and Matobo districts, the sight of a village health worker in her distinctive smock uniform and brown hat, pedaling down dusty paths on a blue bicycle with a China Aid logo, has become a beacon of hope.
For 60-year-old Ottilia Ncube, a village health worker in Mangwe with its scattered villages and homes, this simple mode of transport has revolutionized her ability to bridge the gap and deliver vital healthcare services to her community.
Ottilia’s bicycle is more than just a means of transport—it's a lifeline. "Home visits were a nightmare before I got this bicycle. I would walk, but there were areas I simply couldn’t reach," she says. "The bicycle is an answer to my prayers."
On a typical day, Otilla Ncube packs her maternal and neonatal care equipment and sets off on her bicycle to visit households in the community. Under a grass-thatched gazebo, she sets up her equipment.
Ncube’s role extends beyond health checkups. She is also a crucial link in promoting safe water, sanitation, and hygiene practices. During her home visits, she inspects homes and ensures that families are following proper hygiene practices, such as treating and storing drinking water safely. She also teaches mothers and their children how to properly wash their hands.
“At community level, the village health workers have been trained to identify danger signs in mothers and their newborns and make referrals to the health facility,” explains UNICEF Zimbabwe Health Specialist Meggie Gidiba.
Reducing child deaths
This crucial support is part of a broader initiative by the Ministry of Health and Child Care, in partnership with UNICEF and funded by the Government of China. Between 2018 and 2020, 600 bicycles were distributed to village health workers across Matabeleland South and Mashonaland Central Provinces. The goal was to improve access to maternal, newborn, and child health services in these hard-to-reach areas and to enhance the quality and use of these services.
Along with the bicycles, village health workers received kits equipped with essential tools such as respiratory timers, mid-upper arm circumference (MUAC) measuring tapes, weighing scales, thermometers, and medical supplies. These tools are vital for monitoring the health of pregnant women, newborns and children under five, and for ensuring timely interventions.
The programme is making a crucial contribution to Zimbabwe’s efforts to meet UN Sustainable Development Goal (SDG) 3, which aims to reduce neonatal mortality in all countries to at least 12 per 1,000 live births by 2030. Zimbabwe still has a significant way to go to reach the Goal. In 2019, neonatal mortality rate stood at 32 deaths per 1,000 live births. The numbers had not significantly changed since 2010.
Against this background, however, the UNICEF and China’s support to village health workers is paving the way for important progress. According to the District Nursing Officer for Mangwe, Ncebile Ngwenya, the programme has already gone a long way in improving access to health care in remote areas. “We now have good linkages with our communities. We are leaving no one behind,” she says.
Community outreach
Another village health worker to receive UNICEF training is Duduzile Ndlovu from Matobo district – the one who visited Sanelle when she was pregnant. Duduzile was among 3,500 VHWs who received a refresher training in 2021, as part of the China-funded initiative. This focused on community-based surveillance and home management for mothers, newborns, and children under five. Midwives and doctors also received on-the-job mentoring and capacity building in basic emergency obstetric and newborn care.
Duduzile says she is now better equipped to engage people in her community, including those previously resistant to modern medicine. "The training really upgraded my skills. I understood that it is important to avoid home deliveries at all costs," she emphasizes.
Before, the local clinic registered several home deliveries each month, a risky practice that often leads to complications. "We used to record about four home deliveries a month, but we have been recording none since the training," says Hazel Moyo, a primary care nurse at Kezi Clinic.
According to Hazel, diarrheal diseases are now also managed better. “Sometimes parents would bring children when it was too late to save the child’s life,” she continues. “The village health workers didn’t know much about diarrhoea, but they can now identify cases and administer oral rehydration salts.”
Support from China
Zimbabwe is one of 22 countries so far across Africa and Asia to receive funding from the Government of China, through CIDCA, for UNICEF programmes for children. Zhou Ding, China’s Ambassador to Zimbabwe, highlights the achievements of the programme.“ Cumulatively, 1.74 million people were reached, including pregnant women, children and families,” he says.
Over 57,000 pregnant women were referred to health facilities, and 447,138 children under five received growth monitoring services. Additionally, village health workers treated 5,216 children with diarrhea using oral rehydration salts and zinc in their communities, a significant achievement in preventing child mortality.
“I learned that immunization helps to ensure a child’s health, and if I don’t come my child could have health problems,” mother Masleen Mabikire explains while her daughter, 6-month-old Melina receives a vaccination drop. The girl looks happily at her mother, her mid-upper-arm circumference standing at healthy 13.5 centimeters, which indicates an appropriate nutritional status.
In Beijing, UNICEF China Chief of Public Partnerships Sae-Ryo Kim stresses that “China has made remarkable progress on children’s issues in the last four decades. It can now support other countries in their development. That’s why UNICEF and the Government of China are working together to support children in more than 20 countries around the world, including Zimbabwe.”
For children like Faith and Melina, this support from UNICEF and China means that they can now look forward to a brighter and healthier future.
