An assessment of the Zimbabwe family planning programme: Results from the 1996 Situation Analysis Study

Within the past ten years, the Zimbabwe National Family Planning Council (ZNFPC) has conducted two major studies for assessing the availability and quality of reproductive health services. The two studies, generally referred to as Situation Analysis studies, were conducted in 1991 and 1996. The 1996 survey collected data from 192 health facilities spread throughout Zimbabwe. During this exercise, an inventory of physical facilities, equipment, and educational materials was taken. In addition, 758 provider–client interactions of new and revisit clients were observed. Exit interviews were conducted with service providers, and with family planning and maternal and child health clients. In this report, wherever possible findings from the 1996 study are compared to those of 1991 in which 181 health facilities were visited. However, the evolution of the Situation Analysis methodology since 1991 limits the degree to which comparisons can be made between the two studies

An assessment of the Zimbabwe National Family Planning Council\u27s community based distribution programme

Since its inception, the Zimbabwe National Family Planning Council’s (ZNFPC) community-based distribution (CBD) program has made significant and well-documented contributions to the demand for and use of family planning in Zimbabwe. Data from several studies have shown, however, a steady decline in this contribution and that the CBD agents spend more time resupplying existing clients than recruiting new acceptors. Moreover, the CBD program urgently needs to be able to address the AIDS crisis in the country. ZNFPC has undertaken this review to guide it in making appropriate decisions about the future direction of the program, allowing CBDs to have a broader range of responsibilities and modifying the structure to become more efficient. Some activities felt to be acceptable and feasible include: providing more detailed information on STIs/HIV/AIDS; identifying and referring individuals with STI symptoms for diagnosis and treatment at clinics; providing supportive counseling to people living with HIV/AIDS; educating communities about HIV voluntary counseling and testing (VCT) services and motivating their use; providing ongoing supportive counseling after HIV VCT testing; assisting parents to better communicate with their children on sexual and reproductive health issues; and advising adolescents like surrogate aunts and uncles

Strengthening the evaluation and research unit of the Zimbabwe Family Planning Council (1995–1998)

The Evaluation and Research Unit (ERU) plays a crucial role in supporting the research activities of the Zimbabwe National Family Planning Council (ZNFPC). Research activities are conducted in addition to analysis of service statistics and compilation of quarterly and annual reports. With a staff capacity of five and inadequate research skills existing in other units, the ERU finds it difficult to manage and monitor the diverse activities of the organization. To address these problems, a buy-in was signed between the Zimbabwe Government and USAID in May 1995. The objectives were to assist the ZNFPC in conducting operations research studies and strengthening the ERU’s research capacity. The ERU’s traditional role of implementing research had to be revised to research management. The ZNFPC requested that the Population Council’s Africa OR/TA II Project provide technical assistance to implement this new role. The ZNFPC convened a meeting of cooperating agencies, donors, government, and municipal departments to explore ways of improving the coordination and implementation of population activities in Zimbabwe. As noted in this document, recommendations from the meeting were developed and the Africa OR/TA Project used these as guidelines for designing future programs for strengthening the ERU’s research capacity

The feasibility of preventing mother-to-child transmission of HIV using peer counselors in Zimbabwe

<p>Abstract</p> <p>Background</p> <p>Prevention of mother-to-child transmission of HIV (PMTCT) is a major public health challenge in Zimbabwe.</p> <p>Methods</p> <p>Using trained peer counselors, a nevirapine (NVP)-based PMTCT program was implemented as part of routine care in urban antenatal clinics.</p> <p>Results</p> <p>Between October 2002 and December 2004, a total of 19,279 women presented for antenatal care. Of these, 18,817 (98%) underwent pre-test counseling; 10,513 (56%) accepted HIV testing, of whom 1986 (19%) were HIV-infected. Overall, 9696 (92%) of women collected results and received individual post-test counseling. Only 288 men opted for HIV testing. Of the 1807 HIV-infected women who received posttest counseling, 1387 (77%) collected NVP tablet and 727 (40%) delivered at the clinics. Of the 1986 HIV-infected women, 691 (35%) received NVPsd at onset of labor, and 615 (31%) infants received NVPsd. Of the 727 HIV-infected women who delivered in the clinics, only 396 women returned to the clinic with their infants for the 6-week follow-up visit; of these mothers, 258 (59%) joined support groups and 234 (53%) opted for contraception. By the end of the study period, 209 (53%) of mother-infant pairs (n = 396) came to the clinic for at least 3 follow-up visits.</p> <p>Conclusion</p> <p>Despite considerable challenges and limited resources, it was feasible to implement a PMTCT program using peer counselors in urban clinics in Zimbabwe.</p

The costs of integrating reproductive health services: An example using syndromic management of STIs in family planning clinics in Zimbabwe

Estimates from the United Nations Population Fund indicate that the costs of family planning (FP) and other reproductive health (RH) services are increasing and that it will be difficult for donors and countries to meet these costs. Many institutions delivering RH services operate significantly below their physical capacity to see clients, and much of the equipment required for expanding RH services may already be available for use. The marginal costs of adding infrastructure could be low. Many institutions have staff that are not fully occupied, and thus the staff necessary to expand RH services may also be in place. In this paper, we examine the cost implications for labor of expanding the provision of syndromic management services in FP clinics in Zimbabwe. Syndromic management of sexually transmitted infections allows health care workers to make a diagnosis without sophisticated laboratory tests because it is based on clinical syndromes and, in some cases, assessments of an individual patient’s risk for STI infection

Assessing the potential demand for and effectiveness of integrating STI/HIV management services with Zimbabwe National Family Planning Council\u27s clinic-based family planning services

HIV/AIDS is a threat to individual lives and the national economies of many sub-Saharan African countries, despite efforts to contain its spread. The region also suffers from high levels of other reproductive tract infections (RTIs), some of which increase the risk of sexual transmission of HIV. The control of RTIs is therefore seen not only as an important reproductive health care strategy, but as a key strategy in reducing the spread of HIV/AIDS. Most national health care programs in the region are actively seeking cost-effective ways of implementing an RTI management program that would reduce and prevent RTIs and HIV. To date, most emphasis has been placed on managing RTI/HIV within high-risk groups, but many programs are now trying to reach a bigger proportion of the at-risk population through integrating RTI/HIV management services into existing maternal and child health/family planning (MCH/FP) programs. As noted in this baseline survey report, a variety of methods were used to collect and synthesize information that could be used in developing an appropriate and cost-effective approach to the integration of RTI/HIV within FP services

Demand for and cost-effectiveness of integrating RTI/HIV services with clinic-based family planning services in Zimbabwe

The current spread of HIV/AIDS poses a major threat to individual lives and national economies in many sub-Saharan African countries. The region also has some of the highest levels of other reproductive tract infections (RTIs) in the world. Some of these RTIs increase the risk of sexual transmission of HIV infection. Thus, the control of RTIs is seen not only as an important reproductive health care strategy to alleviate symptoms of infection and long-term gynecological, obstetric, and neonatal complications, but also as a key strategy in reducing the spread of HIV/AIDS. As a result, all national health care programs in the region are actively seeking cost-effective ways of implementing an RTI management program that would reduce the spread of RTIs and ultimately HIV. Although there are many reasons to support an integrated approach to service delivery, many unanswered questions remain concerning its implementation, effectiveness, and cost-effectiveness. In 1998, the Africa OR/TA II Project and the Zimbabwe National Family Planning Council (ZNFPC) undertook a study to assist the ZNFPC in developing the most appropriate and cost-effective approach to managing RTIs in its clinics. Findings from the study are presented in this report