Vil­lage health work­ers in pri­mary health­care

It is mid­morn­ing in Gu­rure Vil­lage, Nyazura in Man­i­ca­land.

The Sunday Mail (Zimbabwe) - - SOCIETY - Em­manuel Kafe

THERE is a slight breeze on this oth­er­wise hot sum­mer day.

Ms Munetsi Hungwe (31), a com­mu­nity health worker in the vil­lage, sits with a young mother un­der a tree.

Gen­tly, she asks her some ques­tions: “How are your chil­dren to­day?” “Is your daugh­ter breast­feed­ing?” “Are you get­ting enough to eat?”

Hungwe play­fully coaxes the 10-month-old baby to put out her arm to have it mea­sured.

The re­sults are ex­cel­lent — in the “green” on the tape mea­sure. No signs of acute mal­nu­tri­tion.

This house­hold is for­tu­nate on this day.

The chil­dren are healthy, the baby is feed­ing well, and the young mother is on time with her an­te­na­tal vis­its.

Ms Hungwe of­ten faces an ur­gent con­di­tion — an un­der-nour­ished child or a preg­nant woman who has not yet gone for an an­te­na­tal visit. The health worker is al­ways ready.

On her bi­cy­cle, she car­ries a back­pack laden with oral re­hy­dra­tion so­lu­tion, flip charts and a hand­book.

Her mo­bile phone has be­come the new “vir­tual stetho­scope”, it is al­ways at hand to call the am­bu­lance or clinic, or to text the nurse-in-charge at Ruk­weza Clinic, a lo­cal treat­ment cen­tre just a few kilo­me­tres from her vil­lage.

The phone pro­vides a link be­tween Ms Hungwe and the en­tire health sys­tem, in­clud­ing an ex­pert au­to­mated sys­tem that in­forms her about vac­ci­na­tions, test re­sults, and dates for re­peat an­te­na­tal vis­its, among oth­ers.

Ms Hungwe is a proud and ca­pa­ble mem­ber of the new gen­er­a­tion of com­mu­nity health work­ers who are in­creas­ingly on the front­lines of dis­ease con­trol in ru­ral ar­eas.

“I re­ceived my train­ing at a lo­cal clinic in 2004. We were taught a lot of things. These in­cluded the need to ed­u­cate the com­mu­nity about hy­gienic habits, such as build­ing toi­lets, clean­ing houses and yards and weigh­ing chil­dren, among other lessons,” she said.

With HIV/Aids still the lead­ing cause of death among women of re­pro­duc­tive age glob­ally and the main cause of child mor­tal­ity in coun­tries with high HIV preva­lence, like Zim­babwe, her strength and re­silience is help­ing to fight stigma and elim­i­nat­ing mother-to-child trans­mis­sion of HIV.

She is in charge of a vil­lage with al­most 400 peo­ple. More have been re­ly­ing on her for health in­for­ma­tion.

Ms Hungwe hopes her ef­forts will lessen the spread of com­mu­ni­ca­ble dis­eases.

The health sec­tor con­tin­ues to suf­fer from brain drain. A huge chunk of Zim­bab­wean nurses and doc­tors con­tinue to trek to coun­tries where the con­di­tions of ser­vice are bet­ter. There­fore, de­spite in­vest­ing in train­ing med­i­cal per­son­nel, Zim­babwe is left with a chronic short­age of doc­tors and nurses.

To cush­ion the coun­try against this, com­mu­nity health work­ers are step­ping up to the task.

They come from within their ru­ral com­mu­ni­ties and are typ­i­cally young peo­ple with around eight to twelve years of school­ing.

When prop­erly trained and sup­ported as part of an or­gan­ised lo­cal pri­mary health sys­tem, com­mu­nity health work­ers are sav­ing lives.

They are warmly em­braced by their com­mu­ni­ties and bring trust, cul­tural knowl­edge and sen­si­tiv­ity to top­ics such as child­birth, con­tra­cep­tives, and fam­ily plan­ning.

They reach out to the vul­ner­a­ble in­di­vid­u­als — the poor, el­derly and the dis­abled.

Vil­lage health work­ers play an es­sen­tial role in the pri­mary health­care sys­tem. They are con­tribut­ing to­wards the fight against HIV/Aids and other dis­eases.

Since the first cases of cholera were recorded early this month, Ms Hungwe has been ed­u­cat­ing ev­ery­one in her vil­lage about the dis­ease.

For­tu­nately, no cases of cholera have been recorded in her area.

Ms Hungwe said every now and then, they re­ceive train­ing as well as uni­forms and health kits from non-gov­ern­men­tal or­gan­i­sa­tions and the Gov­ern­ment.

“The bi­cy­cle I was given pro­vides a low-cost and sus­tain­able mode of trans­port that al­lows me to travel up to 20 kilo­me­tres a day to reach the re­mote ru­ral fam­i­lies,” she said.

Ms Hungwe said there is need for more train­ing to en­able vil­lage health work­ers to at­tend to more com­plex sit­u­a­tions.

A UNAids doc­u­ment pub­lished in 2017, which is ti­tled “Two mil­lion African Com­mu­nity health work­ers”, re­ports that a sub­stan­tial body of ev­i­dence demon­strates that com­mu­nity health work­ers in­crease up­take of health ser­vices, re­duce health in­equal­i­ties, pro­vide a high qual­ity of ser­vices and im­prove over­all health out­comes.

Part of the doc­u­ment reads: “Com­mu­nity health worker pro­grammes also rep­re­sent good jobs, bol­ster na­tional and lo­cal economies and in­crease pro­duc­tiv­ity by im­prov­ing health and well-be­ing.

“In­vest­ments in com­mu­nity health work­ers will also en­able Africa to turn the pro­jected near-dou­bling in the youth pop­u­la­tion through 2050 from a po­ten­tially per­ilous ‘youth bulge’ into a dy­namic ‘de­mo­graphic div­i­dend’ that drives eco­nomic growth and im­proves liv­ing stan­dards.”

In­deed, in­vest­ments in com­mu­nity health work­ers present an ideal op­por­tu­nity to tackle the most vex­ing prob­lems in Africa — health and the per­ilously high lev­els of un­em­ploy­ment among young peo­ple.

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