ANNUAL REPORT

OF THE WHO
COUNTRY OFFICE
IN ZIMBABWE
2022

WHO Zimbabwe Annual Report 2022

Contents

Abbreviations and Acronyms ii

MESSAGE FROM WHO REPRESENTATIVE iv

EXECUTIVE SUMMARY v

COUNTRY OVERVIEW & WHO OPERATIONAL PRESENCE vi

Country Overview vi

WHO Operational Presence vii

PROGRESS PER PILLAR 1

Universal Health Coverage 1

Health and Well-being 7

Health Emergencies 12

Better Support 18

CELEBRATING GLOBAL HEALTH DAYS 20

ACKNOWLEDGMENTS 21

WHO Zimbabwe Annual Report 2022 i

Abbreviations and Acronyms

COVID-19 Corona Virus Disease of 2019

CSOs Civil Society Organizations

CVDPV Circulating Vaccine-Driven Polio Virus

EDC Epidemiology and Disease Control

FAO Food and Agricultural Organization of the United Nations

FP Family Planning

GoZ Government of Zimbabwe

HIV Human Immunodeficiency Virus

HPOS Health Professional Online Service

HRH Human Resources for Health

HR Human Resource

HSCF Health Sector Coordination Framework

HWSSL Health Workforce Safeguard and Support List

IEC Information, Education and Communication

M&E Monitoring and Evaluation

MCAZ Medicines Control Authority of Zimbabwe

MHPSS Mental Health and Psychosocial Support

MoHCC Ministry of Health and Child Care

MPDSR Maternal and Perinatal Death Surveillance and Response

NCDs Non-communicable diseases

NGOs Non-Governmental Organizations

NHS National Health Strategy

NMRL National Microbiology Reference Laboratory

NPO National Professional Officer

PCR Polymerase Chain Reaction

PHEIC Public Health Emergency of International Concern

PPM&E Policy Planning Monitoring and Evaluation

WHO Zimbabwe Annual Report 2022 ii

i
Abbreviations and Acronyms

PRSEAH Preventing and Responding to Sexual Exploitation, Abuse and

Harassment

RCCE Risk Communication and Community Engagement

RDT Rapid Diagnostic Tests

SSA Special Services Agreement

TB Tuberculosis

ToRs Terms of Reference

TWG Technical Working Group

UHC Universal Health Coverage

UNAIDS United Nations Programme on HIV/AIDS

UNCT United Nations Country Team

UNFPA United Nations Population Fund

UZ University of Zimbabwe

WCO WHO Country Office

WFP World Food Programme

WHO World Health Organization

WPVI World Polio Virus type 1

ZIMVAC Zimbabwe Vulnerability Assessment Committee

ZINATHA Zimbabwe National Traditional Healers Association

ZNFPC Zimbabwe National Family Planning Council

WHO Zimbabwe Annual Report 2022 iii

ii
 MESSAGE FROM

WHO
REPRESENTATIVE

It is my great pleasure to introduce the WHO Country Office (WCO) in Zimbabwe

Annual Report for the year 2022. This report provides a comprehensive overview
of the health situation in Zimbabwe, highlighting the key achievements and
challenges WHO faced in supporting the Government of Zimbabwe to realize
its health priorities.

The year 2022 saw the country recording a measles outbreak, 15 years after the
last case was reported. Polio cases were also reported in the Region, exposing the
cracks in routine immunization due to the COVID-19 response. The WHO Country
Office supported the Ministry of Health and Child Care (MoHCC) to respond to
the measles outbreak, carry out polio vaccination campaigns while integrating
COVID-19 vaccination in routine immunization for efficient use of resources as
well as catch up on those who had been missed, particularly children. In line
with the Universal Health Coverage goal and the National Health Strategy (2021-
2025), efforts were focused on health system strengthening.

I commend my predecessor, Dr. Alex Gasasira, for his strong leadership,

commitment and the guidance provided to the team during the year 2022.
I would like to appreciate all the WHO staff; the Ministry of Health and Child
Care as well as all stakeholders for the great achievements highlighted into this
Report.
I wish you all happy reading.

Professor Jean-Marie Dangou

WHO Country Representative for Zimbabwe

WHO Zimbabwe Annual Report 2022 iii

iv
EXECUTIVE
SUMMARY

This report highlights the work of the World Health Organization (WHO) in
Zimbabwe towards contributing to the triple billion targets in the context of
the Sustainable Development Goals (SDGs).

The report outlines an overview of the health situation in Zimbabwe

and gives an overview of WHO presence in the country as guided by the
Programme Budget (PB) 2022-23. The report also highlights progress made in
contributing to the Universal Health Coverage through the Cluster Approach
i.e. Life Course, Communicable and Non-Communicable Diseases, Healthier
Populations, Emergency Preparedness and Response, and Operations.

Highlighted also in the report are the collective efforts made to support the
Ministry of Health and Child Care (MoHCC), in collaboration with other UN
agencies, Civil Society, Donors and other valued partners.

WHO Zimbabwe will continue to focus on championing the health agenda

in the country through supporting the country to implement priority areas
under the National Health Strategy 2022-2025 and other national health
outcomes.

WHO Zimbabwe Annual Report 2022 iv

v
 COUNTRY OVERVIEW &
WHO PRESENCE

Country Overview

Zimbabwe is a landlocked country in Southern Africa, between the Zambezi and Limpopo Rivers,
bordered by South Africa to the south, Botswana to the south-west, Zambia to the north, and
Mozambique to the east. The capital and largest city is Harare. The second largest city is Bulawayo.
The estimated population is 15 million people. Zimbabwe has 16 official languages; with English,
Shona, and Ndebele being the most common.

The health response is governed by the overarching National Development Strategy 2021- 25 (NDS
1) and the National Health Strategy (NHS 2021-25). The national Health Strategy identifies eleven
(11) health priorities to which the WCO contributed during 2022.

Zimbabwe’s health system has been affected by the country’s recent socio-economic difficulties.
Maintaining human resources has therefore been a critical area in the health system. The public
sector provides 65 percent of health care services in the country (MOHCW 2005), and so a shortage
of public sector workers affects the majority of the population.

Having noted the high health worker exodus, the government has been exploring and implementing
measures to slow down this trend. A sustainable remuneration and retention package for health
workforce has been identified as high priority to address further exodus of staff. Government has
therefore endeavored to address high staff turnover by continuously reviewing monetary and
non-monetary incentives to attract and retain health staff. Government has in addition set aside
resources towards the construction of institutional accommodation at various health centres,
including procurement of staff buses and operational vehicles. A scheme has been put in place to
allow duty free importation of personal vehicles using free funds.

WHO Zimbabwe Annual Report 2022 vi

v
WHO Operational Presence
WHO presence is guided by the Programme Budget (PB) 2022-23. The WHO Zimbabwe Country
Office Team in 2022 consisted of a total of 87 staff members. Of these, 41 had fixed-term contracts, 2
had short-term contracts, and 44 were on short-term service agreements or consultancy contracts.
All staff members fell under one of five clusters: UHC, UCN, WHE, UHP, and Operations. The team’s
focus was to provide technical support to the Ministry of Health and Child Care (MoHCC). In 2022,
the country office partnered with other UN agencies and civil society organizations to support
MoHCC’s National Health Strategy (NHS) 2022-2025. These partnerships included FAO, UNICEF,
UNOPS, UNFPA, FriendshipBench, Pamvuri, CDC Africa, and BRTI.

The Programme Budget is based on a new model that espouses a paradigm shift that seeks to
deliver results by providing capacities to country offices while addressing funding challenges.

WHO 2022 – 2023 work plan was developed based on a new model that espouses a paradigm shift
that seeks to deliver results by providing capacities to country offices while addressing funding
challenges
The paradigm shift is premised on a triple approach, namely:

Multi-Country
Assignment Teams
Pillar approach: Use of Technology:
(MCAT):
where functions are which will allow countries whereby technology
categorized into 6 pillars to pool funding and share is used as a vehicle for
that can be incrementally human resource expertise remote support, thus
implemented (starting (i.e. pillar 2) and enabling countries
with the minimum to deliver service at
presence i.e., pillars 1 and reduced costs (less travel)
3), depending on available as evidenced during
resources; COVID-19 restrictions

The WCO Zimbabwe roles have mainly been the following;

• providing leadership on matters critical to health and engaging in partnerships where joint
action is needed;
• setting norms and standards and promoting their implementation;
• providing technical support, catalysing change, and building sustainable institutional capacity;
• monitoring the health situation and assessing health trends.

WHO Zimbabwe Annual Report 2022 vii

vi
PROGRESS PER
PILLAR

Universal Health Coverage

Main achievements

• Zimbabwe implemented the 2gether 4 Sexual and Reproductive Health and Rights (SRHR)
programme, a partnership between four UN Agencies (UNAIDS, UNFPA, UNICEF and WHO)
and Sweden that provided US$10 million to Zimbabwe between 2018 and 2022. Through the
2gether4SRHR programme, access to quality and client centered services improved through
integration of critical SRHR, HIV and sexual and gender-based violence (SGBV) related services.
Percentage of health facilities providing integrated SRHR/HIV/SGBV services in 2gether4SRH
supported districts increased from 0% (in 2018) to 99% in 2022. About two million people from
the 13 supported districts are estimated to have benefited from the 2gether4SRH initiative.

• The Human Resources for Health Policy which guides the establishment of a sound basis for
formulating HRH strategies and plans to improve coverage and the quality of health services
for the people of Zimbabwe, was reviewed and updated. WHO ensured that attention was
given to include the global, regional, and national pronouncement highlighting HRH issues
and their bearing on the achievement of SDGs and the refocus on Primary Health Care.

• A comprehensive Health Labour Market Analysis was undertaken to guide HRH Strategy (2023-
2030) development that will be costed to produce an HRH Investment Compact aimed at the
progressive development of a sustainable Health Workforce. In addition, the HRH Strategy will
maximize on private sector contribution by engaging them to optimize expanded contribution
to HRH training and employment. The HRH Strategy promotes integration of Community
Health Workers by securing government commitment to support them through grant aiding.

WHO Zimbabwe Annual Report 2022 1

• HRH coordination improved through
resuscitating HRH Task Force and
Subcommittees that now provide guidance on
coordinated implementation of HRH strategies
in line with new HRH Policy.

• Capacity building of data management and

M&E was strengthened. The trainings have led
to improved data quality and analysis. M&E skills
will help government to identify success and
gaps in implementation of NDS1 and the NHS,
and plan for adjustments to programming and
resource allocation as needed to achieve set
targets.

• MoHCC updated the Digital Health Atlas

with the support of WHO. The DHA is a global
repository to register digital health products,
including those related to COVID-19 vaccination
management. The DHA supports countries to
strengthen governance of Digital Health Tools.

• The National CRVS Comprehensive Assessment

was implemented in collaboration with MoHCC.
The results guided the prioritization of activities
to improve the country’s CRVS systems.
Implementation of the CRVS Strategic Plan will
improve births and deaths registrations in the
country, which will improve availability of data
for planning essential services.

• WHO regularly contributed to the weekly Routine

Monitoring of the Health System (RMHS). The
RMHS serves as an early warning system that
shows the state of the health system and helps
decision-makers to rapidly identify potential
problems in the Health System.

• The National Health Sector M&E Policy, the M&E

Plan for the National Health Strategy (2021-
2025) were finalised. The National Strategic
Information Technical Working Group, Robust
Health Information and M&E systems are
essential for the success of the NHS and NDS1.

WHO Zimbabwe Annual Report 2022 2

 through reviewing of all RMNCAH collection
and reporting tools. To date SRH data is
disaggregated by age, making it possible
for policymakers to target investments to
address inequities within adolescent and
youth populations.

• WHO in collaboration with UNFPA, UNAIDS

and UNICEF enhanced data for decision
making through domesticating the SADC
SRHR scorecard as a review tool for tracking
country progress in meeting SDG 3 and 5.

• WHO created an enabling legal and policy

environment for adolescents and women
in Zimbabwe through supporting the
country to revise the Post Abortion Care and
Comprehensive Abortion Care guidelines
and training materials in line with the latest
WHO recommendations.

• Improved HRH coordination through

resuscitating HRH Task Force and
• COVID-19 vaccination in collaboration Subcommittees that now provide guidance
with MoHCC resulted in 6 585 846 people on coordinated implementation of HRH
cumulatively receiving dose and 4 952 887 strategies in line with new HRH Policy.
people cumulatively receiving dose 2
• Developed and launched the first National
• WHO implemented the one stop model of Surgical, Obstetric and Anaesthesia Strategy
integration at four (4) ZNFPC sites in Harare (NSOAS) 2022-2025 on 30 September 2022.
and Bulawayo (Spilhaus, Fife Avenue Clinic, The strategy will promote access to surgical
Lister House, and Mpilo Central Hospital). services from district level, a positive move
Capacity of 40 health workers on provision towards strengthening primary health care
of integrated FP/HIV care services was built. as 83% of key tracer surgical operations were
In 2022 alone, 40 085 clients received being performed at central and provincial
integrated HIV/FP services from the four hospitals. The strategy also becomes a strong
facilities . The leadership at ZNFPC also advocacy and resource mobilization tool to
embraced the one stop-shop model and increase investments towards surgery which
is currently being expanded to cover the is in integral part of UHC. When people in
remaining sites run by ZNFPC. need if surgery receive quality surgery in a
timely and affordable fashion, they have a
• The use of health facility data was improved chance to improve their quality of life.
to strengthen RMNCAH programming

WHO Zimbabwe Annual Report 2022 3

• Built MOHCC capacity to undertaking Health
Financing Progress Matrix assessment
to enable Zimbabwe to systematic track
of progress in implementation of health
financing policies towards UHC.

• WHO contributed to establishing the first

Innovation Hub with a capacity for 20
students/developers under the MoHCC. The
Hub is expected to lead multi-stakeholder
groups to support the appropriate use and
scaling up of digital health and innovation
to accelerate progress towards the health-
related SDGs. WHO provided equipment
for the Innovation Hub, including laptops
and workstations, and renovated the space
allocated to the Hub to make it suitable for
use.

• The measles vaccination campaign that

played a crucial role in bringing the
outbreak under control was implemented in
collaboration with MoHCC. By 30 September
2022, nearly 7,701 cases and 747 deaths had
been recorded across Zimbabwe. New cases
dropped significantly towards the end of 2022
and by January 2023, the cumulative measles
cases for the period 1-28 January 2023 were 6
cases and 0 deaths.

• Built MOHCC capacity to undertaking Health

Financing Progress Matrix assessment
to enable Zimbabwe to systematic track
of progress in implementation of health
financing policies towards UHC.

WHO Zimbabwe Annual Report 2022 4

Main challenges, and possible solutions

Accelerated HRH attrition throughout the country. Generated

1 evidence to support lobbying for Zimbabwe’s inclusion into the
Health Workforce Support and Safeguard List 2023.

Vacancies in some key leadership posts at MoHCC affecting prompt decision-

2 making: e.g., Country Director PPM&E, Director EDC, Director Family Health
(this is also limiting coordination for effective programme implementation)

3
Limited GoZ financial resources and late disbursements making
MOHCC increasingly reliant on development partner funding for
most programs.

4 High attrition of health workers trained in data management.

5 Sub-regional WPV1, cVDPV1 and cVDPV outbreaks increased risk

of Poliovirus importation and need for robust response actions

6 In country outbreaks of Measles and Pertusis required response actions

Solutions:

• Keep forging partnerships, including with “non-traditional” partners for successful

implementation of programs (e.g CSOs, NGOs, Professional associations, academia)
• Synergies between programs and inter-cluster linkages are essential to gain mileage on
program implementation.
• Hold periodic TWG meetings and more frequent MoHCC -partner meetings
• Further strengthen community involvement and participation in health services provision
• Strengthen coordination mechanisms at all levels of the health systems
• Increase regular capacity building through on the job training and making use of virtual
platforms

WHO Zimbabwe Annual Report 2022 5

 Successful
innovations/technologies
WHO contributed to establishing the first Innovation Hub with a capacity for
20 students/developers under the MoHCC. The Hub is expected to lead multi-
stakeholder groups to support the appropriate use and scaling up of digital
health and innovation in order to accelerate progress towards the health-related
SDGs. WHO provided equipment for the Innovation Hub, including laptops and
workstations, and renovated the space allocated to the Hub to make it suitable
for use.

6
 HEALTH and WELL-BEING
Programme: TB, HIV & Malaria

• Development of Malaria Strategic • Development of guidelines on HIV

Documents treatment and care
In collaboration with MoHCC, WHO provided WHO in collaboration with other stakeholders
technical and financial support in developing and the MoHCC developed updated guidelines
the National Malaria Strategic plans (MSP, SBC for HIV Treatment and Care; an Operational
Communication Strategy) and the National Service Delivery Manual (OSDM) for improved
Integrated Vector Management Strategy quality of service delivery was finalized.
(IVM).

WHO, in partnership with UNICEF, other

• Implementation of the AFRO 11 project stakeholders and the MoHCC established
a Zimbabwe Country Team for the Global
WHO implemented the AFRO 11 project that
Alliance to End AIDS in Children. The country
contributed to the development of research
team developed an action plan to End AIDS in
for alternative vector control interventions.
Children in Zimbabwe, by the year 2030.

• Surveillance • Integration of HIV Services in Family

WHO rendered technical support for Planning Clinics
surveillance for early detection of malaria WHO supported the country to implement
outbreaks. This involved collection, collation a demonstration project on the integration
and analysis of weekly malaria data, resulting of HIV services in Family Planning Clinics.
in early detection of malaria outbreaks. Findings from this project will guide scale
up of the intervention and were showcased
in international conferences such as the
• Review of the National TB Strategic
23rd International Union Against Sexually
Plan
Transmitted Infections Conference
WHO provided guidance to the MoHCC, to
conduct an External Mid-Term Review of the
Zimbabwe National TB Strategic plan 2021-
2025.

• Piloting of a “Prevent TB” Application

WHO in partnership with the MoHCC to pilot
ed the implementation of a Prevent TB App
for data management. This is a great stride Team of External and Local Reviewers who participated
towards leveraging data and technology in in the Programmatic Management TB Preventive
Therapy led by Dr Avinash Kanchar from the WHO
the fight against TB. Global TB Programme; Holiday Inn Zimbabwe; 8 July
2022

WHO Zimbabwe Annual Report 2022 7

 Programme: Non-Communicable Diseases (NCDs)

• Built Capacity of Primary Health Care

As a result of PEN implementation in
Workers to Identify and manage
Rushinga district:
Common NCDs through PEN
• People screened in 2022: 31540 vs
To understand PEN implementation for scale up 1340 in 2020
to other districts, an assessment of the progress • Patients on treatment in 2022: 2100
of PEN implementation was conducted. WHO vs 450 in 2020
provided guidance in developing the assessment • Admissions with complications in
tool. WHO, MoHCC and Clinton Health Access 2022: 28 vs 34 in 2020
Initiative participated in the collection and • Deaths from complications in 2022:
analysis of data. 20% vs 50% in 2020

NCD Regional Focal point, Dr Prebo Barango facilitating Director NCDs, CHAI officer, Masvingo provincial
the PEN training workshop hospital matron and Sister in charge OPD during the
PEN assessment

Main challenges and possible solutions

Main challenges Possible solutions
1. Competing priorities and limited number of expedite recruitment of NPO HIV/Hep/STIs
officers to support implementation of activities

2. Limited resources to support MoHCC priorities continue with resource mobilization

especially where WHO has a comparative
advantage to support

Successful innovations/technologies
1. Implementation of the WHO Prevent TB APP. The mobile app allows registration,
screening, and referral of people targeted for TB screening or TB preventive
treatment. Alerts help the providers to follow up people through the preventive
care pathway.
2. Integration of HIV services in Family Planning Clinic. The integration will help to
increase the access to and uptake of both HIV and Family Planning services

WHO Zimbabwe Annual Report 2022 8

 HEALTH PROMOTION
Main achievements

• Development of the adolescent milk substitutes. The new regulations are

nutrition strategy guided by the World Health Assembly,
WHA 34.22 resolution of 1981 which calls for
WCO in partnership with the MoHCC, Ministry
provision of safe and adequate nutrition for
of Women, Ministry of Education, Ministry
infants through protection and promotion of
of Agriculture, FAO, WFP, UNICEF, and
breastfeeding.
UNDP. reviewed and finalized the adolescent
nutrition strategy to guide implementation
of evidence-based nutrition interventions
• Development of the National
for this age group. The adolescent period
Cancer Control Plan (NCCP)
presents a window of opportunity to build
behaviors and practices that will support Zimbabwe was selected as one of the priority
good nutrition, health, and family wellbeing countries to implement the Global childhood
well into adulthood. cancer initiative (GICC). Through the technical
expertise from WHO AFRO, WHO Country
Office and IAEA consultants, the development
• Review of Statutory Instrument 46
of the National Cancer Control Plan (NCCP)
of 1998 on breast milk substitutes
commenced in 2022.
Under the 2gether4SRHR Initiative, WCO in
collaboration with UNICEF and WFP supported
the review of the Statutory Instrument 46 of
1998 which regulates marketing of breast

WHO Zimbabwe Annual Report 2022 9

• Capacity building of health workers “Boosting care and prevention of noncommunicable
to identify and manage mental diseases at the primary level in Zimbabwe”, featured
health conditions during the 72nd WHO Regional Committee for

WHO rendered technical expertise and Africa. 21 articles were published on the website,

financial support to build capacity of national with most republished on national print, online

level trainer of trainees, to identify and manage and broadcast media.

mental health conditions through mhGAP.

All 10 provinces in the country were reached.
Zimbabwe then piloted the roll out of the
EQUIP supported mhGAP and Friendship
Bench Problem Solving Therapy interventions
Feedback received from
in the selected province of Mashonaland West.
participant after the
completion of the WHO-
Quality Rights training:
• Development and costing of Quality
Rights 3-year work plan

WHO in collaboration with MoHCC built “After learning about QR l felt so

capacity of medical personnel on Quality ashamed about the way l had been
Rights. A 3-year Quality Rights work plan, handling clients before, l wish l could
go back to all clients l mistreated
was developed in 2022 and is now being and apologize to them. Before I
implemented. trained in QR l used to admit clients
and immediately order them to be
mechanically restrained without even
• Development of the National talking to them. I just assumed that
since they had come to the hospital it
Sanitation and Hygiene Policy
was automatic that the only way to treat
The policy seeks to address safely managed them was when they were restrained.
sanitation and hygiene in alignment with If a client complained about the
medication, they were taking l would
the national and Sustainable Development not listen to their concerns because l
Goals (SDGs). The final draft is being collated thought that l knew what was best for
for presentation to the Permanent Secretaries the client. After QR training l now ask
the clients if they are experiencing any
for Environment and Health ministries. Once side effects and if the medication is
approved, this policy will act as Government
of Zimbabwe commitment to provide reliable,
working for them
”
………Sister Annette Mashonaland
safe, affordable, secure and sustainable water.
Central Provincial Mental Health
Officer, MH nurse

• Increased visibility of MCO work She went on to recruit 135 others who
and donor support have completed the e-training -police
officers, PWLE, police officers, rehab
In 2022, 926 messages were posted technicians, psychologists, social
workers, prosecutors, social workers,
across all social media platforms. At least court interpreters.
six documentaries were produced and
disseminated; one of the documentaries,

WHO Zimbabwe Annual Report 2022 10

 Human-interest
story
• Zimbabwe embarked on a mass drug administration campaign for bilharzia and parents who
were engaged narrated how the outreaches were helpful https://bit.ly/42DQPJn
• This story reveals the journey of people with drug-resistant to long tuberculosis treatment
regimens. The shorter regimen is a welcome development that eases their struggle. https://
bit.ly/42ncN3y
• Following the cyclone Idai, more than 45,000 people benefitted from the services provided by
WHO and some detailed how the outreaches provided relief for them https://bit.ly/3HUIKbr

11
 Health Emergencies

Main achievements

• Improved epidemic preparedness

and response
Zimbabwe participated in the State Party to the World Health Assembly (WHA) on the
Annual Reporting (SPAR) for 2022 as required implementation of capacity requirements. The
by the International Health Regulations (IHR second edition of SPAR (2021) has 15 capacities
2005). SPAR allows countries under the IHR and 35 indicators. Zimbabwe overall scored
to fulfill their obligation to report annually 67% in 2022 up from 59% in 2021.

IHR Capacity 2022

WHO Zimbabwe Annual Report 2022 12

• Adaptation of the 3rd edition of the • Updated cholera (4th edition) and
IDSR Technical Guidelines typhoid (2nd edition) guidelines

At the 69th session of WHO Regional The Government of Zimbabwe has undertaken
Committee for Africa held in Brazzaville, several activities to strengthen the countries
Republic of Congo in September 2019, African prevention, control and management of
ministers of health adopted a regional strategy cholera and typhoid. For example, following
for responding to health emergencies. the cholera outbreak in 2018, a National Task-
This Integreted Diseases Surveillance force for Cholera Elimination was created
and Response (IDSR) strategy for 2020- to support in ending cholera in Zimbabwe,
2030 is focused on strengthening disease through a multi-stakeholder approach which
surveillance and response systems, with the involves government, the private sector and
aim of lessening the impacts of public health development partners. This task-force, which
outbreaks. In line with the new IDSR strategy, includes WHO, spearheaded the development
AFRO extensively updated the IDSR Technical and launch of a Zimbabwe Multi-Sectoral
Guidelines (IDSR TGs) into a 3rd edition that Cholera Elimination Plan 2018 -– 2028 guided
takes into account modern developments in by the Global Task Force on Cholera Control
disease surveillance and response including (GTFCC).
the one health approach and strengthening
implementation of IHR (2005) core capacities. The last cholera guidelines were developed
MOHCC with support from WHO conducted in 2009 and the typhoid guidelines in 2011.
a workshop to adapt the 3rd Edition IDSR These documents had essentially fallen out
TGs. The Zimbabwe WHO country office and of synchronization with current Global and
MOHCC further trained 80 Trainer of Trainers regional guidance as well as the recently
(TOT), to build a core of provincial and district developed Zimbabwe Multi-Sectoral Cholera
trainers who will cascade the training in their Elimination Plan 2018-2028. Therefore, the
provinces and districts. MoHCC with support from World Health
Organization and partners conducted a five-
day workshop in December 2022 to update
the third edition of the Zimbabwe cholera
control guidelines and the first edition of
the guidelines for Managing Typhoid Fever.
The workshop, sought to align the cholera
guidelines to support implementation of the
Zimbabwe Cholera Elimination Roadmap
2019-2028, as well as update the guidelines for
the management of typhoid fever in Zimbabwe
in line with Global guidelines.

Participants for the Adaptation of IDSR TG

WHO Zimbabwe Annual Report 2022 13

 response, it was critical to ensure that the
• Strengthening Community based
guidance of the NHS 2021-2025 was adhered
Surveillance and contact tracing
to. An assessment of clinical equipment was
WHO contributed five vehicles to the Province undertaken to guide procurement, distribution,
of Bulawayo to strengthen contact tracing use and maintenance of hospital equipment.
during the response to multi-etiological
outbreak of measles, diarrheal and shigellosis.
Procurements made by WCO Zimbabwe.
This assistance impacted positively towards
contact tracing as the number of contacts Patient Monitors USD 230,210
increased threefold. PPE USD 1,834,722

Genome USD 300,000

Sequencing
Equipment
Genome USD 27,000
sequencing
reagents
Digital mobile USD 450,000
X-ray machines
Ceiling mounted USD 500,000
digital X-ray
machine

PHEOC, WHO and Bulawayo City assessing

a point where sewer pumping is done which • Strengthened Laboratory capacity
was reported to be malfunctional
WHO took the lead in developing and evaluating
Zimbabwe’s National COVID-19 Laboratory
• Improved health infrastructure and Testing Strategy and reviewing the National
access to medical equipment in Health Laboratory Strategy. These efforts
response to COVID-19 greatly strengthened Zimbabwe’s laboratory
systems. WHO championed the adoption of
The MOHCC received significant amounts of
the WHO COVID-19 self-testing guidelines,
clinical equipment as part of the COVID-19
reviewed standard operating procedures, and
response. This was done with resources from
adoption of the updated WHO guidelines for
various sources including Ministry of Finance
SAR-CoV-2 infection detection. The MoHCC has
and Economic Development, development
obtained molecular PCR machines to make
partners, UN agencies, the private sector, and
COVID-19 testing more accessible at provincial
others. The equipment package was aligned to
and district levels, and WHO provided technical
the basic package of services offered at each
and financial assistance to train laboratory
level of care. With the large quantities of clinical
scientists.
equipment received as part of the COVID-19

WHO Zimbabwe Annual Report 2022 14

WCO provided technical support for the WCO built capacity of 400 Interfaith leaders
genomic sequencing of COVID-19 at the on COVID-19, Mental Health and Psychosocial
National reference laboratory in partnership Support, Routine immunization and Monkeypox.
with Africa CDC. WHO supported MoHCC to COVID-19 vaccination campaigns reached
carry out genomic sequencing processing an over five million people through Interpersonal
average of 48 samples per month. Communication initiatives. Advocacy and
engagement of traditional, religious and political
leaders was done in collaboration with MoHCC
and various partners that include UNICEF,
CSOs and other CBOs. Evidence was generated
• Reviewed key Risk Communication
through COVID-19 Knowledge Attitudes Practice
Community Engagement (RCCE)
and Social norms study and Qualitative study
strategic documents
on social-behavioral determinants of population
compliance with PHMS and COVID-19 vaccine
The COVID-19 RCCE Strategy and the
uptake.
COVID-19 Vaccine Demand Creation Strategy
were reviewwd. These strategic documents
provide a framework for the development of
well-coordinated national action plans for
infodemic management, build demand for
vaccination and uptake of essential health
services to promote and protect health of the
communities.

We reached over 249 202 people with

information and 23 652 people were provided
with psychosocial support. 8244 people were
referred for further management at health
facilities.
WHO and partners contributed to the
production and distribution of over 50 000
IEC Materials on COVID-19, Measles, polio,
cancer, mental health and other NCD’s,
Gender Based Violence, World Health Day and
climate change. There was successful Inclusion
of People with Disabilities and vulnerable
communities and training of Ecumenical
mental health champions in all the provinces.

WHO Zimbabwe Annual Report 2022 15

 • Publications produced for disaster
risk reduction

On 13 October 2022, WCO participated in the

commemoration of the National Preparedness
Planning: Emergencies Related to the 2022/23
Rainfall Season workshop in October 2022, this
workshop coincided with the International Day
of Disaster Risk Reduction commemorations.
The Department of Civil Protection Zimbabwe
coordinated the workshop,. Photo of UN agencies representatives who participated
in National Commemoration (WHO, UNWOMEN,
UNHCR, UNICEF, UNDP, and UNOCHA)
The main discussion point was the characteristics
of meteorological hazards and the extent of
Feature publications
the problem of floods and land slide risks in
1. WHO as an enabler in the Results Report 2022
Zimbabwe. A review of the experiences of
https://www.who.int/about/accountability/
the 2021/ 2022 season was done with specific results/who-results-report-2020-2021/how-
highlights of the current early warning systems. who-is-an-enabler-of-better-health-for-all
The hydrological forecast for the 2022/23 season 2. Muchaneta Gudza-Mugabe, Mathias Dzobo,
was discussed with special emphasis on their Agnes Juru, Lucia Sisya, Anderson Chimusoro,
implication on different sectors including health. Raiva Simbi, Alex Gasasira (2022) Laboratory
The MOHCC also shared on the implications capacity strengthening in Zimbabwe as
part of the COVID-19 response: what has
of the forecast’s implications on health. Key
worked? What still needs to be done? Pan
discussions around this emphasized on the
African Medical Journal. 2022;43:85. [doi:
preparedness that did not leave out psychosocial 10.11604/pamj.2022.43.85.35595] https://
support services. The workshop culminated in www.panafrican-med-journal.com/content/
the contingency planning process led by UNDP. article/43/85/full/ Posted October 2022
3. Muchaneta Gudza-Mugabe, Sithole K, Sisya
L, Zimuto S, Charimari LS, Chimusoro A,
Simbi R and Gasasira A (2022) Zimbabwe’s
emergency response to COVID-19: Enhancing
access and accelerating COVID-19 testing as
the first line of defense against the COVID-19
pandemic. Front. Public Health 10:871567.
doi: 10.3389/fpubh.2022.871567 posted
March 2022

Banner with the theme as well as the Sendai Seven campaign

that is running from 2016 to 2022

WHO Zimbabwe Annual Report 2022 16

 Main challenges, and any solutions

Challenges
• Gaps in reporting and documenting of RCCE activities at national and
subnational levels is affecting monitoring and evaluation of RCCE
interventions.
• Testing of COVID-19 remains low. Most trained nurses on antigen RDT
have since left the country or changed duty stations leaving a large gap at
testing sites.
• Genomic surveillance samples not being referred to NMRL.
• Shortage of dedicated HR for genomic sequencing surveillance testing.
• Delayed reporting of data of PHEIC (Covid-19 and Cholera)
• Use of outdated tools for data visualization

Solutions
• Engage more human resource for RCCE and Health Promotion
or engage interns.
• Build Capacity for HPOs/RCCE at national and subnational level
in M and E, Community Feedback and Accountability.
• Train/provide refresher trainings to nurses for testing and
reporting on COVID-19.
• Sensitize provinces and districts to refer samples for genomic
surveillance.
• Procure licenses for MoHCC to use latest data visualization tools

Human-interest story
• https://www.afro.who.int/countries/zimbabwe/news/beating-resistance-tuberculosis-
treatment-switch-zimbabwe.
• https://www.afro.who.int/about-us/making-difference-health-africa/tendai-westerhof-hiv-
advocate
• A traditional healer in Masvingo who was trained in health issues and encouraged to visit her
nearest health facility discovered that she had hypertension which is now being managed. She
went ahead and bought a blood pressure machine which she is now also using to check blood
pressure for clients who visit her shrine. She has referred a number of people to the health
facility who had high blood pressure reading.
• WHO is an enabler of better health for all: https://www.who.int/about/accountability/results/
who-results-report-2020-2021/how-who-is-an-enabler-of-better-health-for-all

WHO Zimbabwe Annual Report 2022 17

 Better Support
Main achievements
• Strengthened country capacity in
data and innovation
WCO with the support of USG funding level. The workshop focused on QGIS mapping,
conducted a Data Management strengthening Microsoft Excel, ODK data collection tool
workshop. The workshop targeted MoHCC and data visualization in Tableau. In total 65
colleagues at National, Provincial and District people were trained.

WHO Zimbabwe Annual Report 2022 18

21
• Leave no one behind approach
focused on equity, gender and
human rights progressively
incorporated and monitored

• Contributed to the finalization of the

statutory documents of UN standards of
conduct for protection from PRSEAH.
• Developed and distributed PRSEAH IEC
package to use when out on mission
(posters, fliers and do’s and don’ts); as well
as visibility materials to all staff.
• Contributed to the establishment of the
UN Business Operation Strategy (BOS).
• WCO Zimbabwe was one of the countries
that piloted PRSEAH Risk Assessment and
shared experiences with other countries.
• Addressed the issue of gender parity of
staff members during recruitment; hired
the first female driver in 2022.

Main challenges, and possible solutions

Challenges Solutions
• Lack of funds for PRSEAH activities for • Consider including a budget line to sup-
2023. port PRSEAH activities when developing
• Insufficient flexible funds to satisfy proposals across all thematic areas/ clus-
operational needs. ters.
• Staff demotivation due to functional
review.
• Unable to issue longer contracts to SSAs
due to lack of funding which negatively
impacts on retention of institutional
memory.

WHO Zimbabwe Annual Report 2022 19

CELEBRATING GLOBAL HEALTH DAYS
- 7 April 2022
African Vaccination
Week, commemoration
- 27 April 2022

World Mental Health Day

WHO Zimbabwe Annual Report 2022 20

ABIG THANK YOU
TO OUR PARTNERS AND DONORS

WHO Zimbabwe Annual Report 2022