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Gender at the Core: Results-Based Financing For GENDER AT THE CORE Women and the RBF Programme in Zimbabwe MARCH 2019 RBF Approximately FOREWORD / women die daily ‘due to complications800 of pregnancy and child birth. Our mission as the Ministry of by the Sustainable Development Goals stunting prevalence Health and Child Care (MoHCC), is to (SDGs) and the African Union’s Agenda at national level has ‘administer, coordinate, promote and 2063. Among other goals, the TSP seeks to dropped from 33% in advocate for the provision of equitable, address the following critical challenges in 2010 to 26% in 2018. appropriate, accessible, affordable and the heath sector: However, acceptable quality health services and females3.7 in the billion world today, yet women it remains above the care to Zimbabweans.’ Every citizen in • Sub-standard quality of maternal acceptable global remain underrepresented in the Zimbabwe should enjoy their inalienable health services, such as ante-natal threshold of Global Developmental Discourses 20%. right to health, as to deny it, is to deny the care, delivery, and post-natal care, right to life itself. Our mission is therefore including the prevention of mother-to- critical, but not easy; infrastructure must child transmission of HIV and sexually be developed, staff trained and deployed, transmitted infections medicines supplied and communities • Medicine shortages and the provision mobilised. To achieve this we need family planning products partners. This is why we are grateful for • Inadequacy of emergency transport 70%of constitute the world’s poor, make up Women 70% the support we receive through Crown and communication systems, which of the world’s working hours and earn only of 10% Agents under the Results-Based Financing have a bearing on mortality rates the world’s income, half of what men earn. Programme (RBF). • Strengthening the Health and Management Information System at Through RBF a number of health facilities facility level in several districts have already made good 2012 Muonwe Clinic and community has strides. We have seen buildings repaired, We continue to cherish and nurture the the first female chairperson, undergone significant improvement new maternity wings built and more invaluable partnerships which help us to Irene Silikombola, was since the appointment of its first medicines procured. In addition to this, the reach these goals. appointed. female Health Centre Committee (HCC) chairperson. support we receive though RBF which goes towards paying staff allowances has kept This publication presents real life stories 2012-2014 facilitated the drilling of a morale high and improved service levels. describing the impact of our partners’ borehole thus improving access interventions on real people and their to potable water. These developments are in line with the communities. The Ministry is proud to be government’s Transitional Stabilisation partnering with them in helping to create the second female chairperson Programme (TSP), which is informed these success stories. Maud Adam 2014-18 purchased $300.00 worth of bricks and half a ton of cement in her own capacity. Major General (Dr) G. Gwinji (Rtd) Secretary for Health and Child Care 3 RBF RBF WHAt’S IN THIS IssUE? LIST OF ACRONYMS / Foreword 3 ANC Ante-Natal Care List of Acronyms 5 CBO Community Based Organizer From the Editor 6 CEDAW Convention on the Elimination of all Forms of About The Publication 7 Discrimination Against Women News: New Minister of Health Appointed, Pledges Support for RBF 8 CSS Client Satisfaction Survey DHE District Health Executive Chapter One DSC District Steering Committee 1.1 Introduction: Women and the RBF Programme 10 EU European Union 1.2 Women’s empowerment goals in the strategies of RBF’s partner organisations 12 FP Family Planning 1.2.1 UNICEF: Saving Children through Empowering Women 12 GAP Gender Action Plan 1.2.2 Women’s health and the European Union 15 HCC Health Centre Committee 1.3 Women at the Core of Primary Health Care 16 HDF Health Development Fund 1.3.1 Women as primary healthcare service providers 16 HFO Health Field Officer 1.3.2 Community Based Organisation (CBOs): New roles for women in the provision HIV Human Immuno-Deficiency Virus of health services at community level 17 GEWE Gender Equality and Women’s Empowerment (A 1.3.3 HCCs: Opportunities for Effective Female Leadership at Grassroots Level 19 Programme of the EU) MoHCC Ministry of Health and Child Care Chapter Two MP Member of Parliament 2.1 Introduction: Gender Equality in Decision Making: Women in Health Policy Making 27 NCDs Non-Communicable Diseases 2.1.1 Dr. Labode: Using a Rich History of Leadership to Shape the Future of RBF 28 OPD Out Patient Department 2.2 What the doctor ordered: A female PMD tackles women’s health and defies PMD Provincial Medical Director gender norms 31 PMTCT Prevention of Mother to Child Transmission (for HIV) PNC Post-Natal Care Chapter Three PPH Post-Partum Haemorrhage 3.1 Introduction: RBF and Women: The Human Face Stories 37 RBF Results-Based Financing 3.2 There is Life in Darkness: Apostolic Faith Mothers Seek Maternity Services at Night 37 RHC Rural Health Clinic 3.3 No more lives lost unnecessarily 39 RMNCH Reproductive, Maternal, Newborn and Child Health SADC Southern Africa Development Community Chapter Four SDGs Sustainable Development Goals 4.1 Introduction: Crown Agents Eager to Deliver 40 TB Tuberculosis 4.2 Genesis: RBF and Women in Crown Agents Zimbabwe 41 TBA Traditional Birth Attendants 4.3 Women and the RBF Programme today and in the future 43 UNICEF United Nations International Children’s Emergency Fund WASH Water, Sanitation and Hygiene WHO World Health Organization 4 5 RBF RBF FROM THE EDITOR / This issue is a ‘shout out’ to women! As Crown Agents together with all of our stakeholders in the RBF programme we want to celebrate women and raise greater awareness of women’s issues, which are not getting the recognition they deserve. Dedicated commemorative days such as Women’s Month, International Women’s Day, the number of days it will take you International Day of the Girl Child and the 16 to finish reading this booklet. By Days of Activism Against Gender are wonderful that time, globally, approximately women’s initiatives, but they are few and far between. This edition seeks to shine a light on 830 WOMEN would have died what women are doing every day in the health owing to pregnancy and sector all over Zimbabwe. We want to talk about childbirth related these women now and to keep talking. causes. / This publication aims to highlight how women 1 have influenced and impacted, not only their personal spheres, but the health sector and Together with the Ministry of Health and Child human development discourses at large. We Care, UNICEF and the Health Development FROM LEFT: will present success stories and case studies Fund, the RBF programme is striving to achieve Caroline Mubaira, HDF-RBF Deputy team leader; Sister Matimba, Matron at Bikita Rural Hospital; and we hope to provoke serious reflection both measures; it is financing interventions Marie-Jeannne Offosse, HDF RBF Team leader and Muchaneta Mwonzora, Crown Agents Country Director. on the crucial role these women are playing to reduce maternal and neonatal deaths towards the betterment of our country. and making strides to empower women to participate in sustainable solutions for The situation for women today, not only in Zimbabwe. Zimbabwe but globally, is poor. The average reader will probably need a full day to read this It is not our intention for this issue to leave ABOUT THE PUBLICATION / edition cover-to-cover. As horrific as it sounds, you in despair, but rather to raise awareness of in that very same space of time an average the challenges women face, and to celebrate Millions in public funds are being conceived this publication – to simplify of 830 women would have died across the the champions and the heroines of women’s channeled towards development aid every development discourse by telling the real world from causes related to pregnancy and health. year. The need to demonstrate that these life stories behind our work. childbirth. Several more hundred would have resources are achieving their targets has lost their new born children, particularly those We hope that this edition will inspire you to see living in developing countries. women not as victims, but as heroes of their given rise to results frameworks which This is the third edition by Crown Agents. own and our collective struggles. can prove that they are being put to good The first edition was titled, Results-Based Yet the causes of this tolerated ‘femicide’ are use. Very often however, these frameworks Financing: The Story of Hope and Caring preventable. Only minimal investments are On behalf of Crown Agents and the editorial make our work too technical and scientific in Zimbabwe, followed by a second needed to make a difference as well as the team, I would like to wish you a very prosperous for an ordinary person to follow. Reports edition named Results-Based Financing: 2019! recruitment of more women in finding the based on log frames, for example, will fall Strengthening the Health Delivery System solutions to this inequity. Women are capable of taking on and delivering inordinate amounts Marie-Jeanne Offosse short of telling the full human story. The in Zimbabwe. In this edition we describe of work and responsibility, yet few women HDF/RBF Team Leader at Crown Agents tangible grass-roots impact of our work how the RBF programme impacts women’s in Zimbabwe play a role in decision-making Zimbabwe is sometimes lost as real people become health and we celebrate a diversity of and even fewer are acknowledged for their data and statistics. Somebody has to tell women who are driving the programme.
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