Village health workers: Frontline of Zim’s well-being

“GROWING up I always wanted to become a health worker. But unfortunately, I was not privileged enough to get someone who would pay for me to do a nursing course. I never gave up, and in 2002 that is when l got the opportunity to receive training so that I could become a village health worker. I am driven by passion and this kind of work of assisting others in the community gives me joy.”

This is the story of Ms Virginia Chuchu of Ward 30, Muzvidziwa village under headman Madyangove in Chivi.

Her courage, determination is one of the reasons why she is among the most efficient village health workers in Chivi where she is assisting people in her community.

“I work in three areas in my ward,” said Ms Chuchu. “I make sure that I supervise how children are being taken care of, check on pregnant mothers, those taking contraceptives, monitor those on ART to avoid defaulting on medication, among other key things.”

Ms Chuchu said all this during a media tour that was organised by the Ministry of Health and Child Care (MoHCC) in partnership with development partner, UNICEF.

Ms Chuchu is one of many village workers who are positively impacting their communities in Zimbabwe.

The role of village health workers cannot be underestimated in Zimbabwe’s health sector.

These workers focus on disease prevention and provide community care at the primary level in rural and peri-urban wards, where they serve as a key link from the community to the formal health system.

The village health workers are trained by the Ministry of Health and Child Care which conducts an initial eight week training of both practical and oral lessons.

Regularly, the ministry offers refresher trainings in partnership with donors.

The village health workers are directly supervised by the nurse-in-charge at the health centre within their ward.

In addition, they are broadly supported by the ward health team at the community level.

Village health workers are people who are driven by love, compassion, dedication and determination to help others in the community.

They do their work on a voluntary basis and receive quarterly allowances from Government and donor partners once in a while.

UNICEF, in partnership with Government, is capacitating village health workers with knowledge, skills, uniforms and training.

Another village worker from Mwenezi, Mr Mayefu Sibanda (60), told The Herald that he was driven by his love for children to join the profession.

“I discovered that l love children so much and that is why I decided to become a village health worker so that l can assist them,” he said. “I started in 2002 when I was 36 years then and the bulk of my work involves working with children, ensuring that they are being taken care of well and that they get treatment on time if they are not feeling well.”

For Sibongile Mlilo from Chithlathla village in Mwenezi, among her key roles is to educate women who have children living with disabilities to allow them to socialise with others so that they live normal lives.

“We teach women who have disabled children not to keep them indoors,” she said. “That child should be regularly taken to the hospital for check-ups because some disabilities can be dealt with.

“I always advise them to take those children to school so that they are equally empowered.”

Mrs Mlilo said they always advise people that whenever they get sick they should visit the nearest clinic.

Like any other profession, village health workers encounter challenges while undertaking their duties.

Simbai Mboweni from Joseph Village under Chief Negare, who has been a health worker since 2010, said in the past, he used to face a lot of resistance from fellow men.

“I recall that in the past I used to face resistance from fellow men in the community whenever I would talk about health issues, especially on the importance of visiting the nearest clinic when they feel sick and more importantly testing for HIV,” he said.

Mboweni said men used to be shy to visit medical facilities and disclose their health conditions to health workers.

Healthcare workers used to face a lot of resistance from some apostolic sect members who do not subscribe to modern medical treatment and visiting clinics and hospitals.

For Dorica Mavindidze from Hucheche, Chivi, an area largely dominated by apostolic members, her courage to confront religion has made it possible to win the hearts of apostolic women who now vaccinate their children, and receive contraceptives at hospitals.

She recalled how she almost got assaulted by an angry family who wanted her out their homestead and not to inspect their sick children.

“At one particular moment, I was chased away by someone holding a hammer and I came back home running for my dear life,” she said. “Fortunately the village head was informed and he intervened and told them I am a Government official whose duty should be respected.

“So, I went back at that household where there are 15 wives and 42 children and I managed to speak to the senior wife about the importance of vaccinating children and she understood.”

Ms Mavindidze said she was happy that eventually the women in that family secretly agreed to vaccinate their children and they recovered from polio and measles.

In their line of duty, the village health workers encounter a number of challenges that sometimes affect their work.

These include lack of uniforms, stationery, bicycles for easy movement, resistance and inconsistent payment of allowances.

Mr Sibanda said they need uniforms, branded t-shirts and stationery. Most of the times they buy stationery on their own.

He said they were short of scales to weigh children.

Ms Muchuchu said people looked down upon them and they received allowances inconsistently.

“We never received Covid-19 allowances, as village health workers we feel that we also deserved it,” she said. “We also see inconsistencies in terms of getting our allowances. We are supposed get them after every three months, but some among us go up to more than two years without receiving anything.”

The village health workers bemoaned the long distances they travel to visit all households.

The bicycles they got from the Government a decade ago were no longer functional.

Speaking to The Herald, Mwenezi district nursing officer Mr Auguste Chikoti said in their area they were in need of more village health workers so that all areas were covered adequately.

“In the 18 wards, on average each village health worker covers at least 100 households,” he said. “We have about 269 village health workers, a number far less to cater for the whole district. Certain wards such as Chingwizi are bigger than the others so we would need more in such areas.”

Over the past years, UNICEF, working in partnership with the Ministry of Health and Child Care, has vowed to continue to work and empower the frontline health workers, including the village health workers and the professional nurses at the local primary health facilities.

This way, it helps to ensure that they deliver basic health services to the people.

For these health programmes, UNICEF partners include the donors of the Health Resilience Fund — the European Union, Ireland, the United Kingdom and Gavi, the Vaccine Alliance — as well as Australia, Canada, China, France, Japan, the Netherlands, Norway, Sweden, United States Bureau for Humanitarian Assistance, Eli Lilly Foundation and Rotary.