Promoting Sexual and Reproductive Health Rights in Zimbabwe's Local Government
"Explore how Zimbabwean local authorities are working towards enhancing sexual and reproductive health rights through services like STI treatment, HIV prevention, and advocacy. Challenges include gender inequity, poverty among women, and weak economic capacity, emphasizing the need for effective policies and strategies. Issues in health departments include inadequate information, limited resources, stigmatization, and poor service quality hindering equitable access to SRH services."
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Presentation Transcript
From the Ground Up From the Ground Up- - Sexual and Reproductive Sexual and Reproductive Health Rights and Local Government in Zimbabwe Health Rights and Local Government in Zimbabwe Daniel Chirundu on behalf of Zimbabwean Local Authorities
Organisation of Local Authorities and Reproductive and Organisation of Local Authorities and Reproductive and Sexual Health Rights Sexual Health Rights Local Authorities in Zimbabwe- Urban 32 and Rural Councils 60 (92) Mandated by Urban Council Act and Rural Districts Council Acts to provide services Sexual and Reproductive Health Services Maternity Services STI Treatment and Prevention HIV Services Advocacy Community Services Sections of Council Scope of service vary depending on size of Council Harare and Bulawayo- National Centres of Excellence STI treatment Kadoma Chinhoi- Kwekwe Mutare- Integrated HIV/TB Treatment Other Council- Basic SRH Services and advocacy Ministry of Health and Child Care Ministry of Women Affairs and Gender Partners Genderlinks, Ceshar
As local authorities we strive to.. As local authorities we strive to .. .develop, implement and evaluate effective policies and strategies related to SRHR leading to the improvement of sexual and reproductive health outcomes for our residents UCAZ Health Officers Forum 2015
Problems that need address Problems that need address Gender inequity- Cross Cutting all LA Depts Poverty among women-Cross Cutting all LA Depts Weak economic capacity- Economic Development Sections Sexual and Gender based Violence- Health and Community Services
Issues and Challenges in Health Departments Inadequate Information Syndromic Approaches Inadequate implementation of intervention Counselling Behavioural Intervention Sex Education Condom Distribution Inadequate access to services Structural factors contribute to increased vulnerability and prevent equitable access to SRH Services Limited Resources Stigmatisation Poor quality of Services Little or no follow up of sexual partners
Limitation in Case management Heavy reliance on syndromic management to guide treatment No use of laboratory Antibiotic resistances to gonorrhoea reducing treatment option Inadequate resources Materials (medicines) Human Resources Heavy reliance on partners Limited Research on SRH Centres of excellences among LA (Harare; Bulawayo and Kadoma) Hampers understanding of epidemiology of SRH problem
Health Target in SRH. Screening for HIV/ STI- 100% of all women Women Receiving effective treatment- 95% Syphilis sero-positive women receiving at least effective regime-100% Key population having full range of services- at least 50% LAs to provide SRH services and facilitate linkage to services not available at primary health care HIV Services ( Post Exposure Prophalaxis) Reproductive Health- VMMC and VIAC Family Planning Post Natal Care Services Provision of HPV vaccines through immunisation programs
Guiding Principles in Provision of SRHS in LAs Guiding Principles in Provision of SRHS in LAs Universal Health Coverage Residents obtain services without suffering financial hardships Evidences Based Intervention Services based on latest available scientific Evidences Protection and Promotion of Human Rights Gender equity Health Equity So that no one is left behind Partnerships and Integration with other relevant sectors Community Engagement To provide sustainable and locally appropriate solutions
Best Practises in SRHR In LAs Best Practises in SRHR In LAs Specific Health Program for Special Groups Commercial Sex Workers Adolescents Integration of HIV and TB Services Integration of VMMC and VIAC Services Evidence based interventions
Best Practises Shared at International Forum Best Practise Policy Implication Primary health Care facility ca deliver 1st Pregnancies with good outcomes Evaluation of Emergency Obstetric and Neonatal Care in Kadoma City-2012 Delayed Initiation of ART in TB?HIV Co Infected Patients Sanyati-2012 Decentralisation if ART Initiation to Primary care level Trends in Maternity Delivery Outcomes at Kadoma General Hospital 2007-2011 Unbooked deliveries increase need to remove barriers Cost Analysis of Setting Medical laboratory Services at Primary Care facility 2013 Feasible to provide lab services at Primary Care facilities Evaluation of Infection Control Program at Primary Health care facilities-2013 Provision of Post Exposure Prophylaxis at Primary Health Care Facilities Determinants of Late Presentation for Paediatric ART Services-2014 Decentralisation of Paediatric ART Services to reduce costs Pre-cancerous Lesions of the Cervix Among Women Secondary Data Analysis -2015 Integration of HIV Services and VIAC Services
Best Practises Policy Implications Determinants of Uncontrolled Hypertension among Clients on ART seeking Care in LA Health Centres Integration of NCD care with HIV Services Evaluation of PMTCT of HIV program focusing on option B+- 2016 Improvements of tracking systems to reduce lose to follow up Evaluation of Clinical care given to Sexual Assault Victims-2017 Need for guidelines on dealing with victims Willingness to Pay for HIV Services-2017 Free Services to continue Viral Load Suppression among Adolescents on ART in Harare-2017 Determinants of First Line ART failure among Clients attending LA Health Centres -2016 Cross boarder collaboration in Provision of ART. Evaluation of the Sexual and Reproductive Health Program for Female Sex Workers, Kadoma City, 2017 Relook at sustainability of the Program and introduce VIAC and Wart Treatment
Best Practise Policy Implication Evaluation of the Maternal Death Surveillance and Response System, Sanyati, Zimbabwe 2017 Surveillance System need to include communities Adherence to Antiretroviral therapy among Clients Utilising a Primary Health Care Facility Kadoma Zimbabwe (2016) Need to reinforce adherence as it was below 95%. Do Short Message Reminders Improve ART Adherence? Randomized Control Trial among HIV Clients - Kadoma (Zimbabwe) - KAMP Study Protocol. Methodology to test efficacy of SMS on Adherence Use of Technology to Improve Healthcare Outcomes is the Need of the Hour! Clients on ART Willing to be reminded to adhere through SMS A Parallel Group Randomised Control Study to Investigate the Efficacy of Weekly Motivational Text Messages on Adherence Among Clients on Anti-Retro viral Therapy- Kadoma Mobile Phone Study (KAMPS) 2016-17 Good viral suppression and immunological outcomes due to receiving weekly motivational SMS Condom Use among HIV infected clients seeking care at Rimuka Integrated HIV and Tuberculosis Site, Kadoma, Zimbabwe 2015. Need for continued condom promotion
