Zimbabwe has experienced harsh and escalating economic challenges which peaked in 2008. The economic decline resulted in a sharp decrease in funding for social services. Deterioration of health infrastructure, loss of experienced health professions, drug shortages, and a drastic decline in the quality of health services for the population was exacerbated by falling economic conditions.

Health at a Glance 2009
HIV prevalence (15-49 years olds) 13.7%
Number of people requiring ART 400,000
Number of people receiving ART 180,000
Maternal mortality (per 100,000 births) 725
Infant mortality (per 1000 live births) 60
Under 5 mortality (per 1000 live births) 86
Stunting among Under 5's 35%

Source: UNICEF

The National Health Strategy (NHS, 2009-2013) reported that HIV prevalence was at extreme levels of 13.7% (15-49 age group) with only 180,000 of an estimated 400,000 persons requiring treatment actually receiving antiretroviral therapy (ART) by mid-2009. Maternal mortality was reported at an unacceptably high level of 725 deaths per 100,000 births (Zimbabwe Maternal and Peri-natal Mortality Study, 2007). Child health status indicators were worsening, with infant mortality rising from 53 per 1000 live births in 1994 to 60 per 1000 live births in 2009 (MIMS). The nutritional status of children had declined: The percentage of malnourished children increased from 29.4% in 1999 to 35% among children under 5 years old (NHS, 2009-2013). NHS (2009-2013) also highlighted that cholera epidemics, aggravated by a country-wide breakdown of sewage and water supply and treatment systems, claimed 4,269 lives out of 97,469 total cases by end of April 2009.

What is Children First doing to help?

Children proudly show off their teddy bears during the launch ceremony for Mavambo Trust.
A child being screened for common childhood illnesses during a routine health check-up.

Children First's health strategy consists of three components that are delivered through partner organizations in Harare and Umzingwane district:

  • Pediatric aids care and treatment (IMPACT);
  • Primary health care (school health assessments, emergency health, and health education); and
  • Reproductive health.

Primary Health Care (School Health Assessments)

Children First screens school children for common childhood illnesses through school health assessments in supported schools. This screening is supported by emergency block grants provided to local clinics to absorb consultation and medical costs for major referral cases.

The school health assessments weighed children, measured the children's heights, and screened for minor childhood illness like ringworms, colds, rushes, and skin diseases. Some assessments also address dental and vision problems, and psychological problems such as trauma, depression and abuse. Children First works with local organizations to ensure children are referred for necessary medical or psychological support.

Additionally, Children First is working on plans to provide health kits in schools to enable schools to address minor ailments and injuries. First aid boxes will include oral rehydration mixtures, wound dressings, and bandages.

Pediatric ART

Children proudly show off their teddy bears during the launch ceremony for Mavambo Trust.
A child receiving home-based care.

Children First supports the work of NGO partners in initiates that seek to increase children's access to ART in their communities. Children have long been marginalized in accessing HIV/AIDS testing and treatment. Barriers to testing, treatment, and adherence include transport to service sites, lack of cash to pay for services and drugs, and lack of counselors or clinicians within the communities. Through the Integrated Model for Pediatric AIDS Care and Treatment (IMPACT), Children First, Clinton Foundation and Seke Rural Home-Based care are taking the laboratory into the community. The model enabled Children First to reduce the time from diagnosis to initiation of treatment from 4-6 months to approximately 2 weeks. The IMPACT Model has been adopted by other Children First ART partners Umizigwane AIDS Network (UAN) and Child Protection Society (CPS), who are continuously identifying more HIV positive children for commencement on ART. The identification process is complemented by strong referral and transport systems to improve access for HIV testing, CD4 counts, initiation on ART, and treatment for opportunistic infections.

Reproductive Health

Children First mainstreams sexual and reproductive health activities in partner interventions. The key strategy used in meeting adolescent and youth sexual and reproductive health needs is through youth friendly corners. These drop-in centers are normally attached to health clinics and offer sexual and reproductive health information and services. Children First is piloting this integrated model of the youth friendly corners in eight centers. The corners incorporate livelihoods and business skills training into to alleviate household vulnerabilities. Corners are linked with schools to involve in-school adolescents and youths, and are liked with national entrepreneurial youth programs and district/ward coordinating bodies to improve alignments with structured government initiatives.