(Zimvac) 2020 Rural Livelihoods Assessment Matabeleland South Provincial Report

Zimbabwe Vulnerability Assessment Committee (ZimVAC) 2020 Rural Livelihoods Assessment Matabeleland South Provincial Report

ZimVAC is coordinated by the Food and Nutrition Council Housed at SIRDC: 1574 Alpes Road, Road Hatcliffe , Harare Tel: +263-242-862586/ +263-242-862025. Website: www.fnc.org.zw. Email: [email protected]. Twitter: @FNCZimbabwe. Instagram: fnc_zim. Facebook:@FNCZimbabwe

1 Foreword

The Zimbabwe Vulnerability Assessment Committee (ZimVAC) under the coordination of the Food and Nutrition Council, successfully undertook the 2020 Rural Livelihoods Assessment (RLA), the 20th since its inception. ZimVAC is a technical advisory committee comprised of representatives from Government, Development Partners, UN, NGOs, Technical Agencies and the Academia. In its endeavour to ‘promote and ensure adequate food and nutrition security for all people at all times’, the Government of Zimbabwe has continued to exhibit its commitment for reducing food and nutrition insecurity, poverty and improving livelihoods amongst the vulnerable populations in Zimbabwe through operationalization of Commitment 6 of the Food and Nutrition Security Policy (FNSP).

As the country is grappling with the COVID-19 pandemic, this assessment was undertaken at an opportune time as there was an increasing need to urgently collect up to date food and nutrition security data to effectively support the planning and implementation of actions in a timely and responsive manner. The findings from the RLA will also go a long way in providing local insights into the full impact of the Corona virus on food and nutrition security in this country as the spread of the virus continues to evolve differently by continent and by country. In addition, the data will be of great use to Government, development partners, programme planners and communities in the recovery from the pandemic, providing timely information and helping monitor, prepare for, and respond to COVID-19 and any similar future pandemics. Thematic areas covered in this report include the following: education, food and income sources, income levels, expenditure patterns and food security, COVID-19 and gender based violence, among other issues.

We want to applaud the ZimVAC as well as the food and nutrition security structures at both provincial and district levels for successfully carrying out the survey during this unprecedented time. In spite of the apparent risks, they exhibited great commitment towards ensuring that every Zimbabwean remains free from hunger and malnutrition. We also extend our appreciation to Government and Development Partners for the financial support and technical leadership which made the assessment a resounding success. The collaboration of the rural communities of Zimbabwe as well as the rural local authorities is sincerely appreciated. The leadership, coordination and management of the whole assessment displayed by the staff at the Food and Nutrition Council (FNC) is also greatly appreciated.

We submit this report to you for your use and reference in your invaluable work. We hope it will light your way as you search for lasting measures in addressing priority issues keeping many of our rural households vulnerable to food and nutrition insecurity. George D. Kembo (DR.) FNC Director/ ZimVAC Chairperson 2 Table of Contents Foreword ……………………………………………………………………………………………………………………………………………………………………………………………….…………..…………..……………………………………………….…..2 Acknowledgements ………………………………………………………………………………………………………………………………………………………...…………………………..…….…..……………………………………………….…….….…4 Acronyms ………………………………………………………………………………………………………………………………………………………………………………………………..…………..………………………………………………..…………..…..6 Background and Introduction ………………………………………………………………………………………………………………………………………………………………..…………..………………….……………………..………………………7 Assessment Purpose ……………………………………………………………………………………………………………………………………………………………………………..…………..………………………………………………..……………..11 Assessment Methodology ……………………………………………………………………………………………………………………………………………………………………..…………..……………………………………………..………………..18 Demographic Description of the Sample ……………………………………………………………………………………………………………………………………………..…………..…………………………………………..………………………28 Education ……………………………………………………………………………………………………………………………………...... …………………………………..…………..……………………………………………..…………………….…34 Chronic Illness…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………40 Social Protection …………………………………………………………………………………………………………………………………………………………………………………..…………..…………………………………………..…………………..…47 Agricultural Production ……………………………………………………………………………………………………………………..……………………………………..…………..………………………………………………..………………………….50 Incomes and Expenditure ……………………………………………………..……………………………………………….………………………………………..…………..……………………………………………..…………………..……………….83 ISALS and Loans……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..………………90 Water, Sanitation and Hygiene ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….95 Access to Services and Infrastructure…………………………………………………………………………………………………………………………………………………………………………………………………………………………………...112 Food Consumption Patterns…………………………………………………………………….……………..……..………………………………………………………..…………..……………………………..……….………………………………………119 Livelihoods Based Coping Strategies ………………………………………………………………………………………………………………………………………………………..…………..…………………………………………..……………….…136 Non-Timber Forest Products………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….139 Complementary Feeding ………………………………………………………………………………………………………………………………………………………..…………..…………………………………………..…………………..……………….146 Child Nutrition Status………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….…159 Gender Based Violence…………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………..165 COVID-19 and Livelihoods………………………………………………………………………………………………………………….…………………………….………………………. ………………………………………………………………………….171 Shocks and Stressors……………………………………………………………………………………………….……………..……..…………………………………………………………..…………..………………………..…..………………………………188 Food Security…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………194 Conclusions and Recommendations …..…………………………………………………………………………………………………..……………………………………………..…………..……………………………………………………....………206

3 Acknowledgements The technical and financial support received from the following is greatly appreciated: • Office of the President and Cabinet • Food and Nutrition Council • SIRDC • Ministry of Lands, Agriculture, Water, Climate and Rural Resettlement • Ministry Public Service, Labour and Social Welfare • Ministry of Health and Child Care • Ministry of Local Government and Public Works • Ministry of Women Affairs, Community, Small and Medium Enterprise Development • District Development Fund • Rural District Councils • Sizimele • World Vision

4 Acknowledgement of Support

ZIMBABWE

5 Acronyms

EA Enumeration Area

FNC Food and Nutrition Council

FNSP Food and Nutrition Security Policy

FNSIS Food and Nutrition Security Information System

HDDS Household Dietary Diversity Score

HHS Household Hunger Score

NNS National Nutrition Survey

RLA Rural Livelihoods Assessment

SAM Severe Acute Malnutrition

TSP Transitional Stabilisation Programme

ZimVAC Zimbabwe Vulnerability Assessment Committee

6 Background and Introduction

7 Introduction

• ZimVAC livelihood assessments’ results continue to be an important tool for informing and guiding policies and programmes that respond to the prevailing food and nutrition security situation. To date, 20 rural and 6 urban livelihoods updates have been produced.

• ZimVAC plays a significant role in fulfilling Commitment Six, of the Food and Nutrition Security Policy (FNSP) (GoZ, 2012), in which the “Government of Zimbabwe is committed to ensuring a national integrated food and nutrition security information system that provides timely and reliable information on the food and nutrition security situation and the effectiveness of programmes and informs decision-making”.

• It has become mandatory for FNC to coordinate annual livelihood updates with the technical support of ZimVAC.

8 Zimbabwe Vulnerability Assessment Committee (ZimVAC)

ZimVAC is a consortium of Government, Development Partners, UN, NGOs, Technical Agencies and the Academia. It was established in 2002 and is led and regulated by Government. It is chaired by FNC, a department in the Office of the President and Cabinet whose mandate is to promote a multi-sectoral response to food insecurity and nutrition problems in a manner that ensures that every Zimbabwean is free from hunger and malnutrition.

ZimVAC supports Government, particularly FNC in:

• Convening and coordinating national food and nutrition security issues in Zimbabwe

• Charting a practical way forward for fulfilling legal and existing policy commitments in food and nutrition security

• Advising Government on the strategic direction in food and nutrition security

• Undertaking a “watchdog role” and supporting and facilitating action to ensure sector commitments in food and nutrition are kept on track through a number of core functions such as:

▪ Undertaking food and nutrition assessments, analysis and research;

▪ Promoting multi-sectoral and innovative approaches for addressing food and nutrition insecurity, and:

▪ Supporting and building national capacity for food and nutrition security including at sub-national levels. 9 Assessment Rationale

The 2020 RLA was undertaken to guide the following:

• Evidence based planning and programming.

• Early warning for early action.

• Evaluation of the socio-economic impact of the COVID-19 pandemic.

• Monitoring and reporting towards commitments made within the guiding frameworks of existing national food and nutrition policies and strategies (TSP, FNSP, Zero Hunger strategy and the SDGs.

• Development of the National Development strategy and the Food and Nutrition Security Strategy, for the next five years.

• The rapidly evolving food and nutrition security situation which was feared to be further deteriorating since the beginning of the COVID-19 crisis in Zimbabwe in April 2020 called for collection of additional and up to date FNS data.

• The current seasonal analysis could not rely on data collected in February 2020 prior to the COVID-19 crisis.

• The survey was envisioned to support the setting-up of the food and nutrition security near real time monitoring and capacitation of sub-national Food and Nutrition Security Committees.

10 Purpose

The overall purpose of the assessment was to provide an annual update on livelihoods in Zimbabwe’s rural areas, for the purposes of informing policy formulation and programming appropriate interventions.

11 Objectives The specific objectives of the assessment were:

1. To assess impact and severity of both Drought and COVID 19 on rural livelihoods. 2. To estimate the population that is likely to be food insecure in the 2020/21 consumption year, their geographic distribution and the severity of their food insecurity 3. To assess the nutrition status of children of 6 – 59 months. 4. To describe the socio-economic profiles of rural households in terms of such characteristics as their demographics, access to basic services (education, health services, protection services and water and sanitation facilities), assets, income sources, incomes and expenditure patterns, food consumption patterns and consumption coping strategies. 5. To determine the coverage (accessibility, availability and quality) of humanitarian and developmental interventions in the country. 6. To determine the effects of shocks experienced by communities on food and nutrition security. 7. To measure resilience at all levels and identify constraints to improving their resilience. 8. To identify early recovery needs in order to determine short to long term recovery strategies. 9. To assess the medium and long term (future) sources of vulnerability and risks to food and nutrition security.

12 Background

• The 2020 RLA was undertaken against a continuously evolving food and nutrition security situation. The performance of the agricultural season negated by the consecutive drought, coupled with the COVID -19 pandemic have affected the livelihoods of the rural and urban population.

• COVID-19, declared a pandemic on 11 March 2020, has literally turned the world ‘upside down’ since it started in Wuhan, China with global reported cases of more than 21 million and more than 760, 000 deaths (14 August 2020).

• The Government of Zimbabwe, responded to the pandemic by gazetting Statutory Instrument 83 of 2020 Public Health (COVID-19 Prevention, Containment and Treatment) Order 2020, on March 27, 2020 declaring the COVID-19 crisis a “national disaster” and introduced a nationwide lockdown with the aim of slowing down the spread of COVID-19.

• The lockdown indicated that essential industries and services needed to remain open to support the health sector and ensure minimal disruption in critical goods and services. During the lockdown the public was strongly encouraged to stay in their homes and to practice social distancing, among other critical preventative measures outlined.

• Prior to the COVID-19 pandemic, food insecurity in the Southern African region was already alarmingly high, with a record 45 million food insecure people across the SADC countries. Key drivers of this food insecurity include climatic shocks (drought, flooding) and structural macro-economic and social factors.

• The risks which threaten to exacerbate the precarious food security situation through the following:

- impacts on exports, imports (supply chain of essential goods such as food, medicine and other essential supplies such as seeds and fertilizers),

- livelihoods (employment and income reduction) and fiscal pressure on the health sector.

- the downstream impact of policy interventions and regulations being implemented to control the spread of COVID-19 which will be felt at individual, household, community and national levels.

• The COVID-19 outbreak and its debilitating impacts on livelihoods will further exacerbate the situation, eroding community coping capacities and deepening food and nutrition insecurity of vulnerable households and individuals.

• Furthermore, we are likely to see an increase in the number of vulnerable people as those who typically are able to cope may find themselves struggling to meet needs given the unprecedented challenging environment.

13 Background

• Impact on Trade

- immediate impact of COVID-19 being realized through its impact on trade.

- Zimbabwe being hit by a drop in export revenues due to slow-down in demand and weakening of its currency.

- On the import side, Zimbabwe with high food import burden will be affected.

- The decision for lockdown is needed for reducing infection and “flattening the curve” but has far reaching effects on people and their livelihoods, especially of daily wage earners, small businesses, the informal sector and the large population already at risk because of pre-existing vulnerability conditions.

14 Background

• Impact on Programme and Supply Chain

- Requirements to maintain social/physical distancing and travel restrictions are negatively impacting programme delivery and humanitarian and developmental activities, which threatens food and nutrition security.

- Travel restrictions and border closures are likely to delay the movement of the essential supplies such as seed and fertilizers (for the winter season) which are crucial for the preparation for the 2020/2021 planting season. This could have longer-term implications on the food security of households.

• Programmes will inherently have to depend on reduced information and evidence.

15 Background

• COVID-19 Effect on Populations

- There is a high likelihood that urban areas are at the highest risk because of high density settlements as they are also the main entry points for international travel. The population group most affected would include the urban poor and the daily wage employees whose livelihoods are curtailed by the lockdown measures.

- The disruption of supplies of agricultural inputs is likely to affect the preparations for the next agricultural season which is very much needed to start the recovery from the back-to-back droughts that have been experienced so far and affect farmers’ livelihoods.

- Markets play a major role in enhancing food and nutrition security. However, market dynamics, failures and shortcomings often weaken the desired impacts and long term effects. Furthermore, households with livelihood options such as petty trade, vending, casual labour, skilled trade and own businesses were likely to experience the most impact of no trade during the lockdown period.

16 Background • Poverty continues to be one of the major underlying causes of vulnerability to food and nutrition insecurity as well as precarious livelihoods in Zimbabwe. According to the ZIMSTAT Poverty, Income, Consumption and Expenditure Survey 2017 Report, 70.5% of the population were poor whilst 29.3% were deemed extremely poor.

• The projected GDP growth rate for 2019 was -6.5% and 3% for 2020.

• Year on year inflation for May 2020 was at 785.55%.

• The Total Consumption Poverty Line (TCPL) for April 2020 was ZWL 7,425.81 which is 703.4% higher compared to the same time last year.

• The impact of poor rainfall distribution was compounded by the unaffordability of key agricultural inputs such as seed, fertilisers and herbicides. Consequently, the area planted to major crops in the 2019/20 season was lower in most areas compared to the same time in the previous season.

17 Assessment Methodology

18 Methodology – Assessment Design

• The assessment was a cross-sectional study whose design was guided and informed by the Food and Nutrition Security Conceptual framework (Figure 1), which Zimbabwe adopted in the FNSP (GoZ, 2012), and the conceptual framework on food security dimensions propounded by Jones et al. (2013) . • The assessment was also guided and informed by the resilience framework (figure 2) so as to influence the early recovery of households affected by various shocks. • The assessment looked at food availability and access as pillars that have confounding effects on food security as defined in the FNSP (GoZ, 2012). • Accordingly, the assessment measured the amount of energy available to a household from all its potential sources hence the primary sampling unit for the Figure 1: Food and Nutrition Conceptual Framework assessment was the household.

19 Figure 2: Zimbabwe resilience framework (UNDP Zimbabwe, 2015)

20 Methodology – Assessment Process

• ZimVAC, through multi-stakeholder consultations, developed an appropriate assessment design concept note and data collection tools informed by the assessment objectives.

• The primary data collection tools used in the assessment were the android–based structured household tool and the District key informant tool.

• ZimVAC national supervisors (including Provincial Agritex Extension Officers and Provincial Nutritionists) and enumerators were recruited from Government, United Nations, Technical partners and Non-Governmental Organisations. These underwent training in all aspects of the assessment. In order to minimise risk of spreading COVID-19, training for both supervisors and enumerators was done virtually.

• The Ministry of Health and Child Care was the lead ministry in the development of the Infection, Prevention and Control (IPC) guidelines for the assessment. These were used to train all enumerators and supervisors on how to practice IPC measures during the whole assessment process.

• The Ministry of Local Government, through the Provincial Development Coordinators’ offices coordinated the recruitment of district level enumerators and mobilisation of provincial and district enumeration vehicles. Enumerators for the current assessment were drawn from an already existing database of those who participated in one or two previous ZimVAC 21 assessments. Four enumerators were selected from each district for data collection. Methodology – Assessment Process

• Primary data collection took place from 11 to 25 July, 2020. In recognising the risk of spreading COVID-19 during data collection, innovative approaches were used to collect vital information without causing any harm. The RLA was guided by global and country specific recommendations and all necessary precautions were taken to avoid potential transmission of COVID-19 between enumerators and community members. In order to reduce exposure to COVID-19 through person to person physical contact, primary caregivers were capacitated to measure their children using Mid-Upper Arm Circumference (MUAC) tapes and assessment of oedema.

• Data analysis and report writing ran from 27 July to 21 August 2020. Various secondary data sources and field observations were used to contextualise the analysis and reporting.

22 Methodology - Sampling and Sample Size

• Household food insecurity prevalence was used as the key indicator to determine the sample to ensure 95% confidence level of statistical representativeness at district, provincial and national level. Number of Sampled • The survey collected data from 20 randomly selected EAs that were enumerated in Households the 2019 RLA. • A two staged cluster sampling was used and comprised of; Beitbridge 199 • Sampling of 20 clusters per each of the 60 rural districts, denoted as EAs in Bulilima 200 this assessment, from the Zimbabwe Statistics Agency (ZIMSTAT) 2012 master sampling frame using the PPS methodology Mangwe 200 • The second stage involved the systematic random sampling of 10 households per EA (village). Gwanda 200

Selection of Households for the “Panel” survey: From a selected village, a list of the Insiza 200 households that were interviewed during the 2019 survey was created and 5 households selected using systematic random sampling. Household data interviews Matobo 188 were conducted in the sampled households. Umzingwane 199 Selection of Non-Panel Households: From the same randomly selected village a household list of non-panel households from the village head was generated and the Total 1386 remaining number of households (5) from the sample was identified using systematic random sampling.

• A total of 200 households were interviewed per district, bringing the total sampled households to 1386. 23 Methodology – Sampled Wards

24 Data Preparation and Analysis

• Primary data was transcribed using CSEntry on android gadgets and using CSPro, it was consolidated and converted into SPSS, STATA and DBF datasets for: • Household structured interviews • District key informant Focus Group Discussion (transcribed in excel)

• Data cleaning and analysis were done using SPSS, STATA, ENA, Microsoft Excel and GIS packages.

• Analyses of the different thematic areas covered by the assessment were informed and guided by relevant local and international frameworks, where they exist.

• Gender, as a cross cutting issue, was recognised throughout the analysis.

25 Technical Scope

The 2020 RLA collected and analysed information on the following thematic areas:

• Education • Social Protection

• Health • Markets

• WASH • Gender Based Violence

• Nutrition • COVID-19

• Agriculture and other rural livelihoods activities • Linkages amongst the key sectoral and thematic areas • Food Security • Cross-cutting issues such as gender • Shocks and stressors

26 Assessment Findings

27 Demographic Description of the Sample

28 Population Distribution by Age

100 90 80 70 60

50 43 41 40 41 39 39 40 40 39 41 37 38 36 37 38 38 37 40 33 30 20 Proportion of Population (%) Population of Proportion 13 14 12 10 11 11 11 12 11 11 10 11 12 10 11 12 12 10 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

0-4 years 5-17 years 18-59 years 60+ years

• Children aged between 0-4 years constituted 11% of the sample in 2020 which is a decrease from 15% recorded in 2019. • The dependant age groups (<17 years and 60+ years) constituting 61% of the population might be indicative of high economic dependency.

29 Characteristics of Household Head: Sex 100 90 80 68 70 64 66 60 61 60 60 56 54 53 48 50 46 44 40 40 40 40 36 34 32 30

Proportion of Household (%) Household of Proportion 20 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

Male Female

• There were more male headed households than female headed across the districts except in Bulilima and Mangwe.

• Bulilima (60%) and Mangwe (53%) had the highest proportion of female headed households.

• A lot of males from the area migrate to neighbouring South Africa and Botswana in search of work. 30 Characteristics of Household Head: Marital Status

100 5 5 1 4 4 5 2 11 7 90 27 22 22 27 80 30 29 36 29 6 70 34 8 7 7 9 8 7 6 7 60 15 5 8 6 50 12 6 13 25 40 24 30 60 63 47 52 51 51 20 45 Proportion of Households (%) Households of Proportion 33 27 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

Never married Widow/widower Divorced/seperated Married living apart Married living together

• The majority (45%) of household heads in Matabeleland South were married and living together.

• Bulilima (27%) and Mangwe (33%) had the lowest proportion of couples married and living together. 31 Characteristics of Household Head: Education Level Attained

100 3 1 4 3 1 1 2 2 3 90 15 12 20 23 22 22 26 29 80 6 38 14 9 9 70 18 11 13 60 14 7 50 51 52 56 40 49 49 42 50 41 40 30

Proportion of Household Heads (%) Heads Householdof Proportion 20 26 10 19 18 15 16 17 14 9 12 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National None Primary level ZJC level O level A level +

• Umzingwane (40%) has the highest proportion of households with household heads who had attained O’ Level and above, this may be attributed to having a relatively large peri-urban population.

• Mangwe (16%) and Beitbridge (18%) have the lowest proportion of household heads who had attained education levels O’ level and above. 32 Household Vulnerability Attributes by District

100

30 22 24 19 18 20 16 16 17 16 17 15 13 14 12 10 12 10 10 11 10 10 10 12 8 7 10 4 6 5

Proportion of Households with at least one member one(%) member least at withHouseholdsof Proportion 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Axis Title

Orphan Mental or physically challenged Chronically ill

• About 18% of households in Matabeleland South had at least one member who was an orphan, compared to 15% at national level.

33 Education

34 Children in School by District

100 88 88 90 86 87 85 87 82 85 83 80 70 60

50 (%) 40 30 18 17 20 15 15 14 13 12 12 13

10 Proportion of Children of School Going Age Age Going School of Children of Proportion 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial Nationally Not attending school Attending school

• Mangwe (18%) district has the highest number of children of school going age who were not in school (before the Covid-19 induced lockdown and closure of schools). • Umzingwane (12%) and Matobo (12%) had the least proportion of children who were not in school (before lockdown). 35 Top 10 Reasons for Not attending School

Non- payment Expensive Child Not of last or no considered interested Pregnancy Distance to Completed No birth term money too young in school /marriage school to O/A level Disability certificate school fees (%) (%) (%) (%) far (%) (%) Other (%) (%) (%) (%) Beitbridge 24 36 9 7 9 4 1 0 1 1 Bulilima 61 16 7 4 2 2 2 2 0 2 Mangwe 57 29 1 6 0 1 0 4 0 0 Gwanda 52 21 6 0 5 2 6 5 0 0 Insiza 42 19 10 8 3 5 1 2 2 2 Matobo 36 24 7 2 5 10 7 2 2 0 Umzingwane 39 31 3 14 3 3 3 0 3 0 Provincial 45 25 7 6 4 4 3 2 1 1

• About 61% of children who were not attending school in Bulilima were not attending school because it was expensive or there was no money to take them to school. • Close to 14% of children not attending school in Umzingwane were reported to be unable to attend because of pregnancy or marriage. 36 Children Sent Away for Non Payment of Fees

100 93 90 78 78 80 72 69 70 67 62 60 55 57

50 45 43 38 40 (%) 31 33 30 28 22 22 20 10 7 0

Proportion of Children of School Going Age Age Going School of Children of Proportion Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Mat South Nationally No Yes

• Insiza (45%) and Matobo (43%) had the highest proportion of children sent away from school for non payment of fees in the first term.

• This is cause for concern as it goes against Government policy. 37 Children Receiving any Form of Home Schooling

100 98 98 99 95 93 93 90 87 90 84 80 70 60 50 40 30

20 16 13 10 10 5 7 7 2 2

Proportion of children attending school (%) school attending children of Proportion 1 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Mat South Nationally

No Yes

• Beitbridge (16%) and Insiza (13%) had the highest proportion of children receiving some form of home schooling. • This means the majority were not receiving home schooling.

38 Health Services

39 Chronic Illness

40 Households with at least one Person Living with a Chronic Condition

100 90 80 70 60 50 40 36 33 28 30 21 23 22 18 20 Proportion of Households (%) Households of Proportion 13 14 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

• Approximately 23% of households had at least one person living with a chronic condition in the province. • Insiza had the highest proportion of households with people living with chronic conditions (36%) in Matabeleland South (23%). 41 Households with at Least One Member Living with a Chronic Condition by Type by District

Type of Chronic Condition

Heart Other HIV/AIDS disease Diabetes Asthma Hypertension Arthritis Epilepsy Stroke Cancer Tuberculosis Kidney Ulcers disease (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) Beitbridge 37.5 0.0 5.0 0.0 45.0 0.0 5.0 0.0 0.0 7.5 0.0 0.0 2.5

Bulilima 56.7 0.0 16.7 3.3 16.7 0.0 0.0 0.0 0.0 10.0 0.0 3.3 0.0 Mangwe 32.3 0.0 16.9 12.3 30.8 0.0 3.1 3.1 0.0 3.1 1.5 0.0 3.1 Gwanda 45.6 3.8 13.9 6.3 26.6 3.8 0.0 0.0 0.0 2.5 1.3 1.3 2.5 Insiza 66.0 1.1 8.5 3.2 12.8 1.1 3.2 1.1 1.1 0.0 1.1 1.1 4.3 Matobo 60.6 0.0 12.1 3.0 15.2 0.0 0.0 0.0 0.0 6.1 0.0 0.0 6.1 Umzingwane 49.0 3.9 2.0 3.9 29.4 2.0 0.0 2.0 2.0 0.0 0.0 2.0 9.8 Provincial 50.0 1.5 10.7 5.1 24.5 1.3 1.8 1.0 0.5 3.1 0.8 1.0 4.1 National 41.7 2.8 11.2 6.0 29.5 4.5 1.9 1.8 1.2 2.4 0.4 2.0 5.0 • The most common chronic conditions in the province were HIV/AIDS (50%) and hypertension (24.5%). • Beitbridge (45%) had the highest proportion of households with at least one member with hypertension while Insiza (12.8%) had the least. • Insiza (66%) had the highest HIV burden while Mangwe (32.3%) had the least. 42 Reasons for Missing ART Dose

Failed to access the health facility for more medication 0.5

Forgot to take medication 1.0

Lack of transport to go and collect the drugs 0.5

Do not have required currency to purchase 0.5

Medication too expensive - cannot afford 0.5

0.0 0.2 0.4 0.6 0.8 1.0 1.2 1.4 1.6 1.8 2.0 Proportion of People Living with HIV who Missed an ART Dose (%)

Provincial

• The most reported reasons for missing an ART dose amongst people living with HIV/AIDS in the province was forgetting (1%) followed by failure to access the health facility (0.5%), lack of transport (0.5%) and prohibitive cost of chronic medicines (0.5%), respectively. 43 Reasons for Missing Dose (Other Chronic Conditions)

Other 1.0 Failed to access the health facility for more medication 1.5

To avoid side effects 0.3 Not interested 0.5 No money to pay for transport 3.1 Lack of transport to go and collect the drugs 2.0 Failed to follow instructions for taking the medicines 0.3 Forgot to take medication 0.8 Do not have required currency to purchase 3.8 Medication too expensive - cannot afford 10.7 0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 16.0 18.0 20.0 Proportion of People Living with Other Chronic Conditions who Missed a Dose (%)

Provincial

• A significant proportion of those who reported to have missed a dose for other chronic conditions were largely affected by a lack of financial resources to acquire the necessary medication (10.7%). • The other most reported reasons for missing a dose for other chronic conditions in Matabeleland South included not having the required currency to purchase the medication (3.8%), as well as lack of money to pay for transport (3.1%). 44 HIV-Related Services Accessed from the Health Facilities

100 90

80 71.9 70 60 56.1 50 40 30 19.9 21.3

20 Proportion of Households (%) Households of Proportion 10 1.0 0.9 0.5 0.6 1.0 2.7 0 Food aid Cash transfer Counselling sessions School support Vocational training Provincial National

• Counselling sessions was the most accessed service by 71.9% of household members living with HIV. • Reduced access to basic HIV treatment and care services such as condoms, psychosocial support, information and counselling often leads to defaulting of medication and treatment failure. 45 Social Protection

46 Households which Received Support by District

Households which Received Support by Households which Received Support in the District Province from 2017 - 2020 100 96 100 94 94 88 91 87 87 90 86 87 90 86 78 79 80 80 70 70 61 60 60 50 50 40 40 30 30

Proportion of Households (%) Householdsof Proportion 20 Proportion of Households (%) Householdsof Proportion 20 10

10 0 Provincial Provincial Provincial Provincial National 2020 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial 2017 2018 2019 2020

• The proportion of households that received any form of support in Matabeleland South increased marginally from 86% in 2019 to 87% in 2020. • Umzingwane district had the highest proportion of households that received any form of support at 96% whilst Matobo had the least at 61%.

47 Households which Received Support from Government

100 89 90 81 80 78 70 70 67 69 70 64 60 55 50 40 40 30

Proportion of Households (%) Households of Proportion 20 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial Provincial National 2019 2020 2020

• Matobo district (40%) had the least support from Government. • Government support in Matabeleland South increased from 69% in 2019 and 70% in 2020.

48 Households which Received Support from Different Sources

Support Govern UN/NGO Church Rural Rural non- Urban Urban Diaspora Mutual Civic Charity Women/m from any ment support support relatives relatives relatives non- relatives groups groups groups en groups source support (%) (%) (%) (%) (%) relatives (%) (%) (%) (%) (%) (%) (%) (%) Beitbridge 88 64 31 3 20 10 12 2 26 2 0 0 1 Bulilima 91 78 24 0 13 16 8 3 56 1 0 0 1 Mangwe 94 70 40 6 20 10 13 1 63 12 0 1 5 Gwanda 94 81 39 2 28 11 26 8 43 8 2 1 5 Insiza 86 67 30 3 12 11 20 3 20 5 2 2 3 Matobo 61 40 14 1 3 3 9 3 15 3 1 1 0 Umzingwane 96 89 31 2 9 2 16 3 12 0 0 0 1 Provincial 87 70 30 2 15 9 15 3 33 4 1 1 2 National 76 55 33 3 13 7 16 2 11 2 0 0 1 • Government support (70%) and NGO support (30%) dominated support received by households.

• Remittances from diaspora relatives play an integral part of support received in Bulilima (56%), Mangwe (63%), and Gwanda (43%). 49 Agricultural Production

50 Effects of the Fall Army Worm (FAW)

51 Households Affected by FAW

100

70 65

60 57

40 37

30 27 26

Proportion of Households (%) Householdsof Proportion 22 20

8 10

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane

• The proportion of households affected by Fall army worm was highest in Insiza (65%) and lowest in Mangwe (8%).

52 Measures Taken to Control Fall Army Worm

100 90 80 70 60

50 43 40 30 23 21

Proportion of Households (%) Householdsof Proportion 20 8 10 4 4 1 0 Nothing Traditional control Applied commercial Applied commercial Applied commercial Applied other Other methods (physically picking the pesticides (more than pesticides pesticides (less than substances specify pest) recommended dosage) (recommended dosage) recommended dosage) 2019/20

• Most households (43%) did not use anything to control FAW, 23% used traditional control method and 21% applied commercial pesticides at recommended rates. 53 Crop Production

54 Households which Planted Cereals

Crops Planted District Maize (%) Sorghum (%) Pearl millet (%) Finger millet (%) Wheat (%) Beitbridge 56.3 39.2 14.6 21.6 12.6 Bulilima 53.0 27.0 54.5 3.5 1.0 Mangwe 58.0 64.0 59.5 26.0 0.0 Gwanda 87.0 53.0 10.0 9.5 0.5 Insiza 83.0 33.0 4.0 6.0 1.0 Matobo 53.7 30.9 19.1 9.6 0.0 Umzingwane 80.9 13.1 0.5 1.0 0.5 Provincial 67.4 37.2 23.2 11.0 2.2 National 80.3 25.6 10.4 6.7 0.7

• Maize remained the most popular cereal planted by households throughout the province (67.4%) with Gwanda (87%) reporting the highest proportion of households who planted the staple cereal. • Less than half of the households in the province planted small grains namely; sorghum (37.2%), pearl millet (23.2%) and finger millet (11%). 55 Households which Planted Pulses

District Cowpeas (%) Groundnuts Round nuts (%) Sugar beans Soya beans (%) Cotton (%) Sunflower (%) (%) (%) Beitbridge 14.1 19.6 18.6 4.0 1.0 0.5 1.0

Bulilima 30.0 30.0 20.5 2.5 0.0 0.0 0.0

Mangwe 40.0 35.5 35.5 14.0 0.0 0.0 0.0

Gwanda 53.5 54.0 38.5 5.0 0.0 0.0 2.0

Insiza 39.0 27.0 17.5 7.5 2.5 2.5 3.0

Matobo 17.6 17.6 12.8 2.7 1.1 0.0 0.5

Umzingwane 11.6 7.5 5.0 5.5 0.0 0.0 0.0

Provincial 35.8 27.3 21.2 5.9 0.7 0.4 0.9

National 26.1 31.4 16.8 7.4 1.0 5.7 2.9

• Cowpeas (35.8%) and groundnuts (27.3%) were the most common pulses grown in the province. • More than half (53.5%) of the households in Gwanda reported to have planted cowpeas. • Sunflower (0.9%) was the main oil crop grown compared to cotton (0.4%).

56 Sources of Inputs for Crops

Maize Sorghum Finger Pearl Tubers Cowpeas Groundnut Roundnut Sugar Soya Tobacco Cotton (%) (%) millet millet (%) input s input input bean bean (%) (%) (%) (%) source source (%) source (%) input input (%) source source Input sources (%) (%) Government 52 33 7 17 0 4 1 1 3 5 1 59 Purchases 31 6 6 5 10 10 14 17 40 45 29 4 Retained 17 32 52 51 53 46 54 48 33 30 1 1 Carryover 9 15 23 20 31 24 25 27 18 10 1 2 Remittances 4 7 8 5 6 8 6 6 6 8 2 1 Non-Governmental 2 6 3 4 0 5 1 0 3 0 0 1 organisation (NGO) Gifts 2 8 7 8 7 7 5 7 3 2 1 1 Private contractors 0 1 0 0 0 0 0 0 1 0 68 36

• Government was the main input source on maize (52%), sorghum (33%) and cotton (59%). • Pearl millet(51%), finger millet(52%), tubers(53%), cow peas(46%), groundnuts (54%) and round nuts (48%) were grown using retained seed. • Purchases were the main input source for sugar beans (40%) and soya beans (45%).

57 Average Household Cereal Production by District

350 319

300

250 203 200

150

100 70 74

Average Household Production (Kg) Production Household Average 50 39 38 28 30 24 23 17 9 10 10 7 2 1 1 2 2 6 3 4 4 1 1 2 4 3 6 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Maize Surghum Finger Millet Pearl Millet Tubers

• Average household production for maize in Matabeleland South was relatively low in most parts of the province, although Insiza reported an average of (319kg) per household for the staple cereal. • Bulilima district reported the highest average household production for pearl millet at 30kg. 58 Average Household Cereal Stocks as at 1 April

100 90 80 70 66 60 54 50 43 40 36 36 30 32 30 24 19 20 15 9 10 4 7 4 5 Average Household Cereal Stocks (Kg) (Kg) Stocks Cereal Household Average 2 1 2 1 1 1 2 2 1 1 1 1 1 2 1 1 2 1 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Axis Title

Maize Sorghum Finger Millet Perl Millet Wheat Rice

• The average household maize stocks as at 1 April stood at 36kg for Matabeleland South, below a national average of 54kg. • Households in Bulilima district reported the highest average sorghum stocks at 15kg during the same period.

59 Average Household Cereal Production Maize produced (Kg) Small grains produced (Kg) District 2017/18 2018/19 2019/20 2017/18 2018/19 2019/20 Beitbridge 161.4 27.7 6.8 121.1 19.4 2.8 Bulilima 102.1 39 38.6 154 39.4 31.8 Mangwe 59.5 8.7 24.1 120.7 9.7 25.7 Gwanda 229.8 18.8 16.6 103.6 14.9 8.1 Insiza 647.7 164.3 319.2 28.2 27.5 3.8 Matobo 396.4 51.5 37.7 103.8 22.7 13.2 Umzingwane 506 11 70.5 10.5 1.1 0.0 Provincial 2103.9 321 513.5 641.9 134.7 85.4

• There was a slight increase in provincial maize production in 2019/20 season compared (513.5Kgs) to the previous season(321kgs) but it was still 4 times less than the 2017/18 season (2103.9Kgs) • The highest maize production was noted in Insiza (319.2kg) which has a Northern part (former commercial farms) that produces a substantial amount of maize. • The relatively high household maize output in Umzingwane (70.5kg) was attributable to maize under irrigation in the area.

• Small grains production remained depressed in the 2019/20 season and lower than the 2017/18 and 2018/19 seasons. 60 Average Cereal Prices 2020

Maize Grain Price (USD) Maize Meal Price (USD) Sorghum Price (USD) Pearl Millet Price (USD) Finger Millet Price (USD)

District Beitbridge 5 4 7 7 0 Bulilima 0 6 0 0 0 Mangwe 0 5 0 0 0 Gwanda 0 5 0 0 0 Insiza 5 4 3 3 3 Matobo 0 5 0 0 0 Umzingwane 6 5 8 0 0 Provincial 5 5 4 4 3

• Umzingwane reported the highest maize grain prices at USD 6 per bucket. • The prices of sorghum and pearl millet were highest in Beitbridge at USD 7 per bucket, respectively.

61 District Average Maize Grain Prices - 2020

• Maize grain was not available in Bulilima, Mangwe, Matobo and Gwanda

• The prices were highest in Umzingwane (USD 6 per bucket) and lowest in Insiza (USD 5) and Beitbridge (USD 5)

62 District Average Maize Meal Prices - 2020

• The prices for maize meal were highest in Bulilima (USD 6 per 10kg) and lowest in Insiza and Beitbridge (USD 4 per 10 kg packet), respectively.

63 Livestock Production

64 Households which Owned Cattle

100 13 13 90 15 16 18 20 25 23 27 5 3 2 4 80 8 8 6 5 10 6 10 70 8 4 13 11 10 10 8 7 11 13 60 17 12 9 9 50 11 8 40 30 65 65 65 62 52 55 56

20 43 46 Proportion of Households (%) Householdsof Proportion 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Zero One to Two Three to Four Five >Five

• About 56% of rural households in the province did not own cattle. • Bulilima had the highest proportion of households who owned cattle (57%), whilst Beitbridge, Mangwe and Matobo had the lowest proportion of households with cattle 35%, respectively.

65 Households which Owned Draft Cattle

100 1 1 3 5 3 2 6 5 12 4 1 11 1 9 90 2 5 4 8 9 14 11 80 4 7 11 5 70 60 50 99 96 90 94 40 85 76 75 74 70 30

Proportion of Households (%) Householdsof Proportion 20 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Zero One Two >Two

• About 14% of rural households in the province owned draft cattle. • Insiza had the highest proportion of households with draft cattle (30%), whilst Beitbridge had the lowest proportion of households with draft cattle (1%). 66 Goat Ownership by District

100 10 90 17 30 32 80 16 42 51 50 52 70 12 69 7 60 11 17 9 50 5 12 40 10 11 14 11 8 30 63 10 7 54 Proportion of Households (%) Householdsof Proportion 8 7 46 20 37 7 32 10 22 19 22 14 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Zero One to Two Three to Four Five >Five

• Approximately 68% of rural households in the province owned goats. • Gwanda recorded the highest proportion of households with goats (86%), whilst Umzingwane had the lowest proportion of households with goats at about 37%. 67 Average Livestock Numbers per Household

20 18 16 15 14 13 12 12 11 11 10 10 10 10 9 9 9 8 8 7 8 8 8 7 6 7 7 6 6 6 6 5 5 5 5 4 4 4 4 4 4 4 3 3 3

Average Head Size per Household per Size Head Average 2 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Cattle Donkeys Sheep Goats

• Mangwe district recorded the highest average number of cattle per household (15), followed by Matobo and Insiza (10), respectively. • The provincial average goat head size per household stood at 10 compared to national average head size of 6 animals. • Umzingwane reported an average number of 9 sheep per household, whilst Bulilima and Insiza both reported an average of 5 animals,

respectively. 68 Cattle Deaths

100 2 5 1 10 6 9 6 1 15 12 2 2 90 19 6 6 3 11 5 19 9 5 80 4 14 17 16 70 19 19 20 23 60 23 28 50 32 28 20 89 40 76 30 63 62

Proportion of Households (%) Householdsof Proportion 51 20 40 35 33 35 10

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National zero one to two three to four five > five

• Households in Matobo recorded the lowest cattle deaths (11%), whilst Gwanda households recorded the highest cases of cattle deaths (67%). 69 Main Cause of Cattle Deaths

100 2 3 4 7 4 5 8 1 9 11 12 1 90 7 2 1 13 4 80 21 42 37 70 33 44 60 61 50 94 87 40 80 71 30 56 54 56

Proportion of Households (%) Householdsof Proportion 20 40 28 10

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Axis Title

Drought/Lack of water Diseases Predators Slaughter for own consumption Floods/cyclone Other

• Drought is the highest cause of deaths recorded in Beitbridge (94%) and Gwanda (87%). • Diseases are also a cause of concern, with Umzingwane and Mangwe being the most affected districts at 44% and 42% respectively. 70 Goats Deaths

100 5 2 3 3 8 10 9 5 8 2 14 3 10 90 2 2 3 8 2 8 4 14 14 11 12 11 80 15 10 22 15 70 8 14 18 17 23 60

50 86 40 72 65 30 64 62 61 61 64

54 Proportion of Households (%) Householdsof Proportion 20

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National zero one to two three to four five > five

• Matobo had the lowest goat mortality with 86% of households reporting not having recorded any goat deaths. • Insiza had the highest proportion of households which had recorded goat deaths (47%). 71 Main Cause of Goats Deaths

100 5 4 3 5 3 7 4 7 2 1 3 13 1 90 1 2 15 25 21 7 26 23 14 80 24 33 70

60 28 50 52 65 49 36 47 73 40 68 67

30 Proportion of Households (%) Householdsof Proportion 20 43 25 10 21 20 22 13 7 8 0 4 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Drought/Lack of water Diseases Predators Slaughter for own consumption Floods/cyclone Other

• Disease was the most common cause of goat deaths in Matobo (73%), Umzingwane (67%) and Insiza (65%). • Predators were the second major cause of goat deaths in Bulilima (33%), Gwanda (24%), Umzingwane (26%), and Insiza (15%). • Drought was the biggest cause of goat deaths in Beitbridge, as reported by 43% of households in the district. 72 District Average Cattle Prices

• The prices for cattle were highest in Umzingwane (USD 495) per beast and lowest in Beitbridge (USD 218).

73 District Average Goat Prices

• The prices for goats were highest in Insiza (USD 47) and lowest in Gwanda (USD 22).

74 Average livestock prices

District Cattle Price (ZWL$) Goat Price (ZWL$) Chicken Price (ZWL$) Cattle Price (USD) Goat Price (USD) Chicken Price (USD) Beitbridge 17563 1859 351 218 23 4 Bulilima 17763 3652 433 221 45 5 Mangwe 21954 3513 351 273 44 4 Gwanda 24140 1756 439 300 22 5 Insiza 21516 3761 402 267 47 5 Matobo 24140 2248 492 300 28 6 Umzingwane 39831 2257 527 495 28 7 Provincial 23985 2726 434 298 34 5

• Cattle were more expensive in Umzingwane (USD 495) as compared to other districts and were more than double the price of those in Beitbridge (USD218). • Goats were more expensive in Insiza (USD47), Bulilima (USD45) and Mangwe (USD44) which was more than the provincial average price of USD 34. 75 Access to Agricultural Extension Services

76 Access to Agricultural Extension Services by year

100

70 59 60 60 59 60 58 57 57 56 49 47 50 45 44 46 41 43 40 38 40 35 35 31 28 30 25 25 26 24 22

Proportion of Households (%) Householdsof Proportion 19 20

0 Manicaland Mash Central Mash East Mash West Mat North Mat South Midlands Masvingo National 2018 2019 2020

• There was a general increase in access to extension services across all provinces as compared to the last two years, with Matabeleland North and Matabeleland South recording the highest proportion of households with access to extension services at 60% each.

77 Access to Agricultural Training, Cropping and Livestock Advice

100 94 96 95 97 97 94 94 94 91 92 88 89 90 85 86 86 87 81 80 81 80 68 71 70 65 65 61 60 58 51 50 47 40 30

20 Proportion of Households (%) Householdsof Proportion 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Agricultural Training Cropping Advice Livestock Advice

• Umzingwane district (86%), recorded the highest proportion of households that had access to livestock advice services. • Access to agricultural training was generally high throughout the province with the exception of Beitbridge at 68%.

78 Livestock Advice from Government Extension Officers or Other Extension Officers

100

60 53 49 50 43 40 35 35 29 30

Proportion of Households (%) Householdsof Proportion 19 20 14 10

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial

• Households in Beitbridge (53%) reported to have received the highest livestock extension advice followed by Bulilima (49%). • Umzingwane reported to have the least lowest livestock extension advice 14% from Government Extension Officers or other Extension Officers. 79 Access to Animal Health Centres

100

70 66 66

60 49 50 48 47 40 41 40 29

30 Proportion of Households (%) Householdsof Proportion 20

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial

• Close to 66% of households in Insiza and Umzingwane reported that they had access to an Animal Health Centre. • Bulilima had the least proportion of households with access to an Animal Health Centre.

80 Satisfaction with Livestock Advice

100 90 80 70 60 82.4 81.7 84.8 89.8 86.4 88.2 86.6 50 94.4 40 30

20 Proportion of Households (%) Households of Proportion 10 14.7 10.6 18.3 15.2 10.2 11.8 12.5 0 2.9 5.6 3 0.9 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial Not satisfied at all Somewhat satisfied Satisfied

• From the households who had received livestock advice, households in Bulilima recorded the highest satisfaction index at 94.4% followed by Gwanda at 86.8%. • About 3% of households who had received livestock advice in Insiza reported that they were not satisfied at all by the service. 81 Quality of Service Received From the Animal Health Centre Accessed in the Last 3 Months

100 90 80 70 68.8 73.5 60 81 84.9 81.7 81.4 89.4 91.1 50 40 30

Proportion of Households (%) Households of Proportion 20 23.4 26.5 10 19 12.9 16.7 16.6 7.8 10.6 6.3 0 2.2 1.7 2.5 2 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Province Not satisfied at all Somewhat satisfied Satisfied

• Umzingwane (91.1%) reported the highest satisfaction with service from Animal Health Centres followed by Bulilima and Insiza at 89.4% and 84.9%, respectively. 82 Income and Expenditure

83 Current Most Important Source of Income

Other 1 Non-state social transfers 1.7 Own business 2 Gathering natural products for sale e.g. firewood 2 Pension 3 Skilled trade/artisan 4 Food crop production/sales 4 Government social transfers 4 Remittance within 5 Petty trade 6 Formal salary/wages 7 Livestock production/sales 7 Small scale mining/mineral sales 7 Vegetables production/sales 9 Casual labour 15 Remittances outside 20 0 5 10 15 20 25 Proportion of Households (%)

• Most households continue to rely on remittances (22%) as the most important source of income, followed by casual labour (15%), vegetable

production/sales (9%), small scale mining (7%), livestock production/sales (7%) and formal salary (7%). 84 Current Most Important Source of Income by District

Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane (%) (%) (%) (%) (%) (%) (%) Remittances outside 12.6 44.4 35.0 15.5 6.1 19.5 10.1 Remittance within 2.5 3.6 3.6 7.5 4.0 6.5 10.6 Food crop production/sales 2.0 1.0 7.0 7.1 9.2 1.0 Cash crop production 0.5 1.0 1.6 1.0 Casual labour 18.2 14.3 10.7 13.5 11.6 18.4 15.7 Livestock production/sales 14.6 5.6 8.1 8.0 5.6 5.9 1.0 Skilled trade/artisan 1.5 5.1 7.1 1.0 1.5 5.9 3.0 Own business 0.5 0.5 2.0 4.0 1.1 5.6 Petty trade 13.6 1.0 2.0 3.5 6.6 3.2 9.1 Pension 4.0 1.0 3.6 3.0 2.5 4.9 2.5 Formal salary/wages 6.6 2.0 9.6 6.5 6.1 9.2 8.6 Fishing 0.5 1.5 Gifts 2.5 0.5 1.0 0.5 0.5 Vegetables production/sales 4.5 8.7 7.6 9.5 14.6 3.2 15.2 Small scale mining/mineral sales 0.5 9.5 22.7 8.1 10.6 Government social transfers 9.6 7.1 2.0 7.0 1.0 0.5 0.5 Non-state social transfers 1.0 3.1 2.0 4.0 0.5 1.0 Cross border 2.0 0.5 Gathering natural products for sale e.g. firewood 1.0 1.0 4.6 0.5 2.5 1.1 3.5 Rentals 1.0 Other 3.0 1.5 0.5 1.5 0.5 85 Average Household Monthly Income (USD) for April 2020

120

100 97 87 80

59 60 55 57

USD 51 44 45 44 45 39 41 40 37 36

20 20 20

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial 2019 2020

• Provincially, the household average monthly income decreased from USD 51 in 2019 to USD 45 in 2020. • The lowest household average monthly income was reported in Umzingwane (USD 36) and the highest was in Beitbridge (USD 59). 86 Average Household Monthly Expenditure (USD) for April 2020 70 60 60

40 31 USD 30 27 24 22 22 21 19 20 20 20 15 17 13 10 10 6 6

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial 2019 2020

• Average expenditure for the month of April was USD 21.

• Bulilima (USD 15) reported the lowest expenditure. 87 Food Expenditure Ratio 100 90 80 72 69 69 67 68 68 67 68 70 65 64 63 64 64 66 65 65 64 65 60 50

40 Proportion (%) Proportion 30 20 10 0 Manicaland Mash Central Mash East Mash West Mat North Mat South Midlands Masvingo National 2019 2020

• The proportion of food expenditure decreased from 68% in 2019 to 65% in 2020. • This means that households have less to spend on other essential services such as health and education.

88 Average Household 6 Month Expenditure

30 27 25

20 15 15 13 14 USD 12 12

10 8 5 5

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial

• Average household expenditure was highest in Insiza (USD 27) and lowest in Umzingwane (USD 5).

89 ISALS and Loans

• Internal Savings and Lending Schemes (ISALS) is one of the ways through which the poor have financial access.

• ISALS assist communities excluded from participating in the mainstream financial services sector.

• In Zimbabwe, ISALS have also been used by those in the middle class (even in formal employment) to fund various initiatives.

• Access to affordable loans remains a challenge for rural communities in Zimbabwe.

90 Sources of Loans

NGOs 0.3 International Development Organisation 0.3 Zimbabwe Woman Microfinance Bank 0.9 Government/Rural credit fund 1.8 Money lender 1.8 Local trader/shopkeeper 2.7 Other financial institutions 2.7 Micro finance institution 2.7 Other banks 9.5 Farmers organisation 19.0 ISAL/SACCO 25.2 Friend/relative 34.7

0 10 20 30 40 50 60 70 80 90 100

Proportion of Households (%)

• Of the 2.8% of households which received loans, the major sources were friends and relatives (34.7%) and ISAL/SACCO (25.2%).

91 Types of Loans and Primary Use

Types of Loans Loan primary use 100 100 90 90 80 80 72.8 70 70 60 50 60 42.9 40 50 30 18.3 40 20 13.4 11.5 11.5

Proportion of Households (%) Householdsof Proportion 10 4.3 4.3 30 20.4 0

Proportion of Households (%) Householdsof Proportion 20 17.2 11.5 10 7.1 0.6 0

• The most common type of loan remains cash as reported by 72.8% of the households.

• The primary use of loans was for consumption purposes. 92 Households with a Member in an ISAL Group

100 90 80 70 60 50 40 30 16 Proportion of Households (%) Households of Proportion 20 15 15 15 11 12 13 12 9 9 8 7 9 7 8 8 10 6 4 0 Manicaland Mash Central Mash East Mash West Mat North Mat South Midlands Masvingo National 2019 2020

• There was a decline in the proportion of households with a member belonging to an ISAL/Mukando group from 15% in 2019 to 12% in 2020. • Households continue to engage in ISALS/Mukando as they offer an alternative source of informal lending and saving compared to the 93 formal financial services sector which remains inaccessible to many rural households. Use of Share-out from ISAL Group

100 90 80 70 60 50 44 40 30 25 26 19 20 13 10 Proportion of Proportion Households (%) 8 9 10 7 7 6 6 4 4 2 1 0 Food Household Livestock Education Agricultural Financing Buying Health costs utensils purchase inputs and Income construction equipment generating materials projects 2019 2020

• A larger portion of the share-out from ISALS was used for purchasing of food (44%) compared to 25% in 2019. • Other consumption related uses of ISAL share-out included households utensils (26%) and education (7%). • However, investment of ISAL share-out to ﬁnance income generating activities (6%), purchase of livestock (9%) and purchase of

construction materials (4%) were also reported. 94 Water, Sanitation and Hygiene (WASH)

95 Ladder for Drinking Water Services

Service level Definition Safely Managed Drinking water from an improved water source that is located on premises, available when needed and free from faecal and priority chemical contamination. Basic drinking water Basic drinking water services are defined as drinking water from an improved source, provided collection time is not more than 30 minutes for a roundtrip including queuing.

Limited drinking water services Limited water services are defined as drinking water from an improved source, where collection time exceeds 30 minutes for a roundtrip including queuing.

Unimproved water sources Drinking water from an unprotected dug well or unprotected spring.

Surface Water sources Drinking water directly from a river, dam, lake, pond, stream, canal or irrigation channel.

Note : “Improved” drinking water sources are further deﬁned by the quality of the water they produce, and are protected from faecal contamination by the nature of their construction or through an intervention to protect from outside contamination. Such sources include: piped water into dwelling, plot, or yard; public tap/standpipe; tube well/borehole; protected dug well; protected spring; or rainwater collection. This category now include packaged and delivered water, considering that both can potentially deliver safe water.

96 Access to Improved Water by District 100 88.3 90 84.7 87.1 81.8 83 80.3 78.3 80 76.6 71.572.4 73 72.7 70.873.2 70 65.8 65.5 61.0 60.9 59.7 60.7 58.3 60 55.9 55.3 50 40.2 40

Proportion of Households (%) Households of Proportion 20

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial 2018 2019 2020

• Improved water incorporates water sources from safety managed, basic, limited water services . • Provincially access to improved drinking water has marginally improved from, 2018 (65.5%), 2019 (70.8%) and 2020 (73.2%) 97 Main Drinking Water Services

100 3.1 10.1 10.6 8.7 90 25.5 21.1 9.6 25.6 26.9 6.4 80 44.7 5.7 2 1.5 30.1 70 18.2 25 8 12.2 20.2 60 29.5 0 50 18.8 12.1 40 64.3 30 62.1 58.2 58 53 Proportion of households % households of Proportion 20 45.3 42.1 43.2 10 0 Beitbridge Bulilima Gwanda Insiza Mangwe Matobo Umzingwane Provincial Basic water services Limited water services Unimproved water services Surface water services

• Bulilima had the highest proportion of households (64.3%) using basic water services. • Mangwe (44.7%) had the highest proportion of households using surface water services.

98 Households Drinking Surface Water by District

• Mangwe (45%) had the highest proportion of households drinking water from surface sources such as dams, rivers, lakes and ponds. • Umzingwane had the lowest proportion of households at 3% while Beitbridge (10%) and Matobo (10%) are the other districts with a proportion below the provincial average of 21%. • These districts were at risk because surface water sources are easily polluted or contaminated with chemicals, faecal matter and microorganisms that cause waterborne diseases, and eventually malnutrition.

99 Drinking Water Treatment by Districts

100 96.2 97.5 96.2 96.5 97 94 95.4 97.5 97.5 94.2 94.2 93.8 92.5 91.9 91.3 90 84 80 70 60 50 40

Drinking Water (%) Water Drinking 30 20

Proportion of Households not Treating not Households of Proportion 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial 2018 2020

• Matobo (84%) had the lowest proportion of households not treating their water before use whilst Gwanda had the highest (97%). • Untreated water increases the chances of diarrheal diseases hence the population accessing unimproved and surface water sources remains at risk.

100 Methods of Drinking Water Treatment

Boil

Add bleach/chlorine [jik or water guard] 24.5% Strain it through cloth

Use a water filter (ceramic,sand,composite,etc)

5.1% 52.0% Solar disinfection

4.1% Let it stand and settle 1.0% 3.1% 7.1% Add water treatment tablet 3.1% Other

• Of the small proportion of households treating drinking water in the Province (5.8%), boiling water to make it safer before drinking was the most popular water treatment method and was practised by 52% of households.

101 Distance Travelled to Main Water Source

100

90 22.7 23.5 33.3 33.3 80 34.7 34 33.7 51.5 70 60 37.9 38.8 50 34.4 34.1 33.2 36 40.1 40 18.5 30

20 39.4 37.8 Proportion of households (%) households of Proportion 32.2 29.9 30 32.3 32.5 10 26.2 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial Less than 500m More than 500m but less than 1 km 1km and above

• According to the Sphere Standards, the maximum distance that any household should travel to the nearest water point is 500m. • Provincially, 32.5% of households travelled less than 500m to the nearest water source, with 33.3% travelling more than 1 km.

102 Time Spent Queuing at Water Point

100 2.8 5.6 8.8 5.6 11.2 12.1 7.3 8.8 90 13.6 6.2 16.1 19.4 14.3 80 25 15.4 13.8 12.1 26.1 70 13.8 27.4 60 33.2 35.7 27.2 50 40 41.7 72.8 66.7 30 61.2 46.1 49.5

20 42 40.1 Proportion of households (%) households of Proportion 10 18.6 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Province Less than 15 min (or within premises) 15 to 30 min 30 min to 1 hr More than 1 hr

• According to sphere standards queuing time should be less than 30 minutes. • Provincially 76.9% of the households spent less than 30 minutes queuing at a water point. • Gwanda (72%) had the highest proportion of households spending less than 15 minutes queuing at a water point while Bulilima (18%)had the least. • Excessive round-trip and queuing times can lead to reduced individual water consumption and increased consumption from unprotected surface sources, and result in less time for other tasks such as care practices. Queuing time also affects the risk of violence at the water point. 103 Ladder for Sanitation

Service level Definition

Safely Managed Use of improved facilities that are not shared with other households and where excreta are safely disposed of in situ or transported and treated offsite. Basic sanitation facilities Use of improved facilities which are not shared with other households.

Limited sanitation Use of improved facilities shared between two or more households. facilities

Unimproved Sanitation Facilities that do not ensure hygienic separation of human excreta from human contact. Facilities Unimproved facilities include pit latrines without a slab or platform, hanging latrines and bucket latrines.

Open Defecation Disposal of human faeces in fields, forest, bushes, open bodies of water, beaches or other open spaces or with solid waste.

Note: Improved sanitation facilities: Facilities that ensure hygienic separation of human excreta from human contact. They include ﬂush or pour ﬂush toilet/latrine, Blair ventilated improved pit (BVIP), pit latrine with slab and upgradeable Blair latrine.

104 Household Sanitation Facilities

100 90 80 34.2 47.5 45.2 70 56.5 64 64 67.6 6.5 73.5 60 0 3 50 9.5 20.6 4 40 10 30 3 5.3 30 59.3 3 3.20 0.52.5

Proportion of households (%) households of Proportion 20 33 30 33 29.3 31.2 34.2 10 23.5 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial Open defecation Unimproved Limited Basic

• The proportion of households which accessed improved sanitation facilities was 60.5%, leaving more than 30% the population vulnerable to diarrheal diseases. • Beitbridge (40.7%) had the lowest proportion of households with access to improved sanitation, while open defecation was more prevalent in same district at 59.3%. 105 Open Defecation by District

• Investment in sanitation facilities has remained low in the rural areas. • Open defecation was most prevalent in Beitbridge district (59%).

106 Ladder for Hygiene

Service level Definition

Basic Availability of a handwashing facility on premises with soap and water.

Limited Availability of a handwashing facility on premises without soap and water.

No Facility No hand washing facility on premises.

Note: handwashing facilities may be fixed or mobile and include a sink with tap water, buckets with taps, tippy taps, and jugs or basins designated for hand washing. Soap includes bar soap, liquid soap, powdered detergents and soapy water but does not include sand, soil, ash and other handwashing agents.

107 Hand Washing Practices at Critical Times

Other 0.5 Whenever i feel like my hands are dirty 17.8 Regularly 35.9 After assisting the sick 14.4 Before and after eating 61.1 After changing childrens nappies/diappers 22.7 Before handling food 74.2 After using the toilet 77 Never 4.5

0 10 20 30 40 50 60 70 80 90 Proportion of Households (%)

• Most households reported washing their hands after using the toilet (77%), Before handling food (74.2%) and before eating (61.1%).

108 Availability of Handwashing Facilities

100 14.6 10.5 11 90 19.1 19.6 19.6 26 80 36

50 89.5 89 40 84.9 80.9 80.4 80.3 73.5 30 64

Proportion of households (%) households of Proportion 20

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial No service Limited Basic

• Provincially 80.3% of households had no handwashing facilities. • Bulilima (26%) and Mangwe (36%) had a higher proportion of households with basic hand washing facilities compared to the provincial average (19.6%). • Handwashing has a direct impact on infectious disease, especially diarrhoea. 109 Handwashing Facilities by District

• There are 5 districts which had 80% or more of the population without hand washing facilities namely Gwanda (90%), Insiza (89%), Beitbridge (85), Matobo (81%) and Umzingwane (80%).

• The issue of handwashing facilities needs to be prioritised in order to meet the SDG6 target of universal access to handwashing facilities.

110 Access to Services and Infrastructure

111 Access to Police Services

100 90 80 70

60 54 56 51 50 43 44 43 40 37 35 35 30

20 Proportion of Households (%) Households of Proportion 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

• Nationally, about 43% of households reported that police services were reachable within one hour. • Only 35% of households in Insiza and Mangwe districts could reach the nearest police services within one hour.

112 Access to Victim Friendly Unit

100 90 80 70 60 50 41 37 40 32 30 27 26 22 23 19 18 20 Proportion of Households (%) Households of Proportion 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

• Only 18% of households reported to have a Victim Friendly Unit in their area, compared to 26% throughout the province and 32% nationally.

113 Access to Services for Physical and Sexual Violence

100 90 80 70 60 50 43 39 40 33 30 28 29 30 23 21 19 20 Proportion of Households (%) Households of Proportion 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

• Matobo had the highest proportion of households that had access to services for physical ad sexual violence with Umzingwane recording the lowest at 19%.

114 Distance to Nearest Health Facility

100 6 90 20 18 21 16 29 27 27 23 80 32 70 32 33 60 44 31 34 33 33 50 36 40 30 62 51 48 46 44 20 36 40 38 40 Proportion of Households (%) Householdsof Proportion 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Less than 5km 5 to 10km More than 10km

• Umzingwane (62%) had the highest proportion of households who reported that they travelled less than five kilometres to their nearest health facility. • About 29% of households in Beitbridge were reported to be travelling more than 10 kilometres to their nearest health facility.

115 Availability of Food and Nutrition Security Infrastructure Food and Nutrition Security Infrastructure

Farming Solar powered Storage Nutrition Agro- Irrigation equipment Fowl runs water source Borehole facility Savings Beehives gardening forestry Other (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) Beitbridge 3.5 17.2 15.7 0.5 15.7 1.5 1.5 1.0 70.7 1.5 3.5 Bulilima 20.6 9.3 32.5 10.3 23.7 6.7 1.0 2.1 44.3 0.0 2.6 Mangwe 1.5 29.0 11.0 0.0 0.5 7.0 11.0 0.5 49.5 0.0 15.0 Gwanda 21.1 19.1 36.2 9.5 17.1 2.0 3.5 0.5 59.8 0.0 16.1 Insiza 8.2 24.0 26.2 2.2 12.6 16.9 0.5 0.5 44.3 0.0 20.8 Matobo 3.2 14.5 38.2 0.0 3.2 4.3 3.2 1.1 15.1 1.1 26.3 Umzingwane 8.6 11.6 18.7 0.5 12.6 1.5 1.5 0.5 26.8 2.0 32.3 Provincial 9.6 17.8 25.3 3.3 12.2 5.6 3.2 0.9 44.6 0.7 16.6 National 5.6 19.6 27.4 1.2 5.4 11.0 4.5 1.1 44.4 0.6 19.5

• Gwanda had the highest proportion of households who reported to have irrigation infrastructure (21.1%), whilst Mangwe recorded the highest proportion of households with farming equipment (29%). • Food and Nutrition Security infrastructure is important in ensuring farming households enhance their ability to produce, store

and utilise food. 116 Access to Animal Health Centres

100 90 80 70 66 66 60 48 49 50 47 40 41 39 40 29 30

20 Proportion of Households (%) Households of Proportion 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

• Nationally, 39% of households had access to animal health centres. • The highest proportion of households that used animal health centres was in Insiza and Umzingwane districts recording 66% each.

117 Access to Early Warning Information on Weather and Seasonal Performance Access to Early Warning Information Use of Information Received in Planning 100 100 90 90 79 80 74 78 80 71 74 69 66 70 70 63 60 54 60 52 50 50 45 44 50 40 33 33 40 30 19 20 30

20 12 20 proportion of Households (%) Householdsof proportion 10 (%) Householdsof Proportion 10 0 0

• About 33% of rural households in the province reported that they had received early warning information on climate, weather and seasonal performance. • Of the households who had received early warning information in Matabeleland South, 71% of those reported to have used the 118 information in planning their response mechanisms. Food Consumption Patterns

119 Food Consumption Score

Food Consumption Score Groups Score

Poor 0-21

Borderline 21.5-35

Acceptable >35

120 Matabeleland South Food Consumption Patterns

100 90 80 70 65 60 50 42 39.5 40 31 29.2 30 30 28 21

Proportion of Households (%) Households of Proportion 20 14 10 0 2018 2019 2020 Poor Borderline Acceptable

• The 2020 assessment had the least proportion of households with an consuming acceptable diet. 121 Food Consumption Patterns

100 14.3 11.6 90 16.7 32.7 29.2 30.7 80 36.5 38.5 45.5 24.9 70 36.7 60 48.4 50 39.5 38.7 28.7 51.3 40 50.5 30 48 63.3 49

Proportion of Households (%) Households of Proportion 20 34.8 31.8 30 30.6 10 13 16.1 6.5 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Poor Borderline Acceptable

• Matobo (63.3%) had the highest proportion of households with a poor food consumption score while Mangwe (6.5%) had the least proportion. 122 Households with Poor Food Consumption Patterns

• Matobo (64%), Beitbridge (49%), Bulilima (35%), and Insiza (32%) had a high proportion of households with poor food consumption patterns.

123 Average Number of Days Households Consumed Food from the Various Food Groups

Vegetables 5

Fruits 0

Oils 6

Milk 1

Meat 1

Legumes 1

Cereals 5

0 1 2 3 4 5 6 7 Average Number of Days

• Oils (6 days), Vegetables (5 days) and Cereals (5 days) were the top consumed food groups in the province. • Fruits at (0 days) were the least consumed food group. 124 Average Number of Days Households Consumed Food from the Various Food Groups

Cereals Legumes Meat Milk Oils Fruits Vegetables (Average Days (Average Days (Average Days (Average Days (Average Days (Average Days (Average Days District consumed) consumed) consumed) consumed) consumed) consumed) consumed)

Beitbridge 3 0 1 0 5 0 5

Builima 5 1 0 0 6 0 5

Mangwe 7 1 1 1 7 0 6

Gwanda 7 1 1 1 6 0 5

Insiza 6 1 1 1 5 0 4

Matobo 2 1 0 1 5 0 3

Umzingwane 6 0 1 1 6 0 6

• Cereals were consumed on average 5 days or more in all districts except Beitbridge (3 days) and Matobo (2 days). • Oils were consumed on average 5 or more days in all provinces while vegetables were also consumed in a similar fashion with the exception of Matobo which had an average of 3 days.

• Fruits were the least consumed food group (0 days). 125 Household Dietary Diversity Score (HDDS)

HDDS Classification

<3 Low

4-5 Medium

>5 Acceptable

126 Household Dietary Diversity Score by District

100 11 13 8.5 90 17.6 18 21 21.1 15.8 80 70 40.4 60 54.8 61.6 50 75 62 74.5 61.5 63.3 40 30 51.1

20 Proportion of Households (%) Households of Proportion 27.6 10 20 22.6 14 12.5 17.5 15.6 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial Low Medium Acceptable

• Matobo had the highest proportion of households with a low HDDS (51%) 127 Average Household Dietary Diversity Score by District

5 4.7 4.7 4.6 4.5 4.6 4.5 4.3 4.4 4.4 4 3.6 3.5 3

2.5 HDDS 2 1.5 1 0.5 0 Beitbridge Bulilima Gwanda Insiza Mangwe Matobo Umzingwane Provincial National

• Only Matobo (3.6%) and Beitbridge (4.3%) had a Household Dietary Diversity Score (HDDS) lower than the Provincial and National average (4.4%) 128 Households Consuming Vitamin A Rich Foods

100 90 21.8 80 33.5 37.5 44.5 49.8 70 63 68.8 71.2 60 77.9 50 63.3 40 50.5 45 42 30 39.8 20 31 19.5

Proportion of Households (%) Households of Proportion 28.1 20.1 10 16 17.5 13.5 14.9 10.4 9.3 0 3 6 2 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Never Consumed Consumed 1 to 6 days Consumed for 7 days

• Almost all districts except Matobo (21.8%) had more than 30% of the population consuming Vitamin A rich foods for 7 days in a week prior to the survey. • None of the districts had a proportion of households consuming vitamin A rich foods above the national average (71.2%). 129 • Less than 20% of the households had never consumed vegetables in the past 7 days prior to the assessment. Households Consuming Iron Rich Foods

100 3.5 2 2 4.5 3 0 3 2.6 3 15.1 90 17.5 27.3 29.2 29.1 80 36.5 31.7 38.5 37 70 60 50 40 80.5 84.9 69.2 65.3 68.2 67.9 30 61.5 57 60

Proportion of Households (%) Households of Proportion 20 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Never Consumed Consumed 1 to 6 days Consumed for 7 days

• Consumption of iron rich foods is low all districts with over 50% of the province reporting never consuming iron rich foods 7 days prior to the survey. 130 Households Consuming Protein-rich Foods

100 5.1 8 12 11 7.5 10.6 11.7 11.5 90 15 80 35.9 70 45 46.2 43.2 50 47.2 48 60 58 53.5 50 40 30 59.1 47 46.2 46.2 20 39 42.7 40.5 Proportion of Households (%) (%) Households of Proportion 30 31.5 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Never Consumed Consumed 1 to 6 days Consumed for 7 days

• The proportion of households that never consumed any protein rich foods seven days prior to the survey was 42.7 % provincially with Beitbridge (59.1%) having the highest proportion 131 Minimum Dietary Diversity for Women of Child Bearing Age

100 90 80 70 60 50 40 30 18.8 19 20 16.8 15.5 Proportion of Women (%) Women of Proportion 12.1 13.6 12.6 10 6.4 6.8 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

• The minimum dietary diversity for women of child bearing age was very low with the province experiencing a drop from 41% in 2019 to 12.6% this year

132 Women Consumption of Protein, Iron and Vitamin A Rich Foods 100 88.5 90 82.3 81.1 83 80 73.1 73.2 76 70 66.4 63.9 60 53.4 49.6 50 40.2 40 37.1 37.1 36.1 37 30 26.1 26.9 24.7 21.7 23.4 24.1 20 18.5 18.9 Proportion of Women (%) Women of Proportion 20 11.4 10 3.5 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Consumed Vitamin A rich foods Consumed Protein Rich Foods Consumed Iron Rich Foods

• Consumption of vitamin A rich foods by women of child bearing age was very high but only one district, Beitbridge (88.5%) was higher than the national average (83%). • Consumption of iron rich foods was low throughout the province with Matobo (26.9%) having the highest proportion of women 133 consuming such foods. Household Hunger Scale

• In the province, the majority of households (83%) faced little to no hunger while 16% faced some moderate hunger and 1% severe hunger. • Matobo district had the highest proportion of households reporting moderate hunger (21%) and severe hunger(11.3%)

134 Reduced Coping Strategy Index (rCSI)

• In the province 56% of households had high reCSI indicative of food access challenges. • Beitbridge (83% and Umzingwane (79%) had the highest proportion of households with a high rCSI.

135 Livelihood Based Coping Strategies

Category Coping Strategy

Stress • Borrowing money, spending savings, selling assets and more • livestock than usual.

Crisis • Selling productive assets, directly reduce future productivity, • including human capital formation. • Withdrawing children from school • Reducing non food expenditure.

Emergency • Selling one's land, affect future productivity, but are more • difficult to reverse or more dramatic in nature. • Begging for food. • Selling the last breeding stock to buy food.

136 Households employing at Least one Livelihoods Based Coping Strategy

Approximately 24.5% of households in the province employed at least one coping strategy. Umzingwane (43.7%) had the highest proportion while Bulilima (7%) and Mangwe (9%) had the least. 137 Households Engaging in Different Categories of Livelihood Coping Strategies

• Umzingwane (25%), Gwanda (16%) and Beitbridge (14%) had the highest proportion of households engaging in emergency coping strategies 138 Non Timber Forest Products

139 Availability of Indigenous Fruits Beitbridge Bulilima Gwanda Insiza Mangwe Matobo Umzingwane Provincial (%) (%) (%) (%) (%) (%) (%) (%) Uxakuxaku/Snot apple (Azanza garckeana) 1 92 73 84 95 66 89 72 Umnyi (Bird plum- Berchemia discolor ) 47 1 54 16 0 27 5 22 Umkhomo ( Baobab- Adansonia digitata ) 66 0 33 4 0 10 0 17 Umkhemeswane/African monkey orange (Strychnos spp) 2 26 5 17 1 10 10 10 Umganu/Amarula (Sclerocarya birrea) 23 1 8 13 2 20 4 10 Umtshwankela/Tsubvu /Smelly berry (Vitez mombassae) 0 2 9 6 0 2 12 4 Umthunduluka /Granite mangosteen (Garcinia buchananii) 1 1 1 14 1 2 11 4 Nhengeni/Sour plum (Ximenia caffra) 1 1 10 10 0 1 1 4 Umthunduluka/matudza/governors plum (Flacourtia indica) 0 0 2 10 0 1 11 3

• Snort apple was widely available in the Province (72%), only Beitbridge (1%) reported a proportion less than 65%. • Governors Plum was the least available indigenous fruit in the Province (3%). 140 Consumption of Indigenous Fruits

Beitbridge Bulilima Gwanda Insiza Mangwe Matobo Umzingwane Provincial (%) (%) (%) (%) (%) (%) (%) (%) Uxakuxaku/Snot apple (Azanza garckeana) 1 92 74 84 95 67 88 72 Umnyi (Bird plum- Berchemia discolor ) 50 1 54 16 0 29 6 23 Umkhomo (Baobab- Adansonia digitata ) 66 0 33 2 0 7 1 16 Umkhemeswane/African monkey orange (Strychnos spp) 2 24 4 12 1 8 9 8 Umaganu/Amarula (Sclerocarya birrea) 20 1 6 9 1 17 1 8 Amadorofiya (Prickly-pear/Opuntia) 1 1 4 15 16 13 0 7 Umtshwankela/Smelly berry (Vitez mombassae) 1 2 9 4 0 4 14 5 /sour plum (Ximenia caffra) 1 2 10 7 0 1 3 3 Umthunduluka/Granite mangosteen (Garcinia buchananii) 2 0 1 9 0 1 10 3

• Snort apple was the most widely consumed indigenous fruit in the Province (72%), only Beitbridge (1%) reported less than 65% . • Sour plum (3%) and granite mangosteen (3%) were the least consumed indigenous fruit in the Province . • Consumption rates mirrored availability of the indigenous fruits in the Province 141 Availability of Edible Insects

Beitbridge Gwanda Insiza Mangwe Matobo Umzingwane Bulilima Provincial (%) (%) (%) (%) (%) (%) (%) (%)

Hwiza/Mhashu/Inthethe/ Locusta migratoria 2 12 29 0 11 17 0 10 Ishwa/inhlwa/Macrotermes 0 2 40 1 8 70 2 17 Madora/Amacimbi/Gonimbrasia belina/ mopani wrms 99 99 67 100 84 22 99 82

Nyenze/Inyeza/Ioba leopardine 0 6 7 1 3 4 7 4

Tsambarafuta/Ihlabusi/Carebara vidua 1 8 28 1 2 27 1 10

Tsumwarumwa/Inswabanda/Ruspolia differens 0 2 6 0 2 5 0 2

• Mopani worms or amacimbi (82%) were the most widely available edible insect in the Province, all interviewed households in Mangwe reported their availability. • This is expected as the mopani worm harversting season has just been concluded in the Province. • Inswabanda (2%) was the least available edible insect in the Province. 142 Consumption of Edible Insects

Beitbridge Bulilima Gwanda Insiza Mangwe Matobo Umzingwane Provincial

Hwiza/Mhashu/Inthethe/ Locusta migratoria 2 0 3 14 0 6 9 5

Ishwa/inhlwa/Macrotermes 1 1 1 26 0 3 70 13

Madora/Amacimbi/Gonimbrasia belina 97 100 97 64 97 89 27 83

Nyenze/Inyeza/Ioba leopardine 0 6 1 1 1 2 2 2

Tsambarafuta/Ihlabusi/Carebara vidua 1 1 1 11 1 1 13 4

Tsumwarumwa/Inswabanda/Ruspolia differens 1 1 0 1 0 1 3 1

• Amacimbi (83%) were the most widely consumed edible insect in the Province, all interviewed households in Bulilima reported their consumption. • Inswabanda (1%) was the least consumed edible insect in the Province. • Consumption patterns mirrored availability of the edible insects 143 Availability of Indigenous Vegetables

Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial mowa/bonongwe/imbuya 50 63 75 78 61 66 70 67 nhungunira/ucucuza 1 4 1 20 18 17 23 12 nyevhe/runi/ulude 49 93 91 94 97 71 92 85 nyenje/gusha/idelele 70 96 98 98 74 86 91 88 munyemba/ imibhida yendumba 76 75 84 98 72 72 59 77 mundawarara/isihlabe 0 0 0 0 0 10 10 3 mutsine/muuwu/ucucuza 1 0 0 7 7 7 4 4

• Idelele (88%) and ulude (85%) were the most widely available indigenous vegetables in the Province. • Mangwe (98%) ,Gwanda (98%) and Bulilima (96%) reported the highest proportions in the Province. • Isihlabe (3%) and ucucuza (4%) were the least available indigenous vegetables in the Province.

144 Consumption of Indigenous Vegetables

Beitbridge Bulilima Gwanda Insiza Mangwe Matobo Umzingwane Provincial mowa/bonongwe/imbuya 46 62 76 46 73 65 65 62

nyevhe/runi/ulude 43 88 93 94 89 69 92 10

nyenje/gusha/idelele 67 95 97 65 98 84 89 82 munyemba/imibhida yendumba 74 69 91 52 80 63 49 86

nhungunira/ucucuza 4 4 19 18 0 11 15 68 mutsine/muuwu/ucucuza 1 0 0 3 0 2 1 1

• Imibhida yendumba (86%) and idelele (85%) were the most widely consumed indigenous vegetables in the Province. • Mangwe (98%) ,Gwanda (97%) and Bulilima (95%) reported the highest proportions in the Province who consumed idelele while Mangwe (80%) had the highest proportion of households who consumed imibhida yendumba. • Ucucuza (1%) was the least consumed indigenous vegetables in the Province. 145 Infant and Young Child Feeding Practices

146 Complementary Feeding

147 Definition of indicators

Indicator Definition

Minimum Acceptable Diet (MAD) Minimum acceptable diet (MAD), defined as the proportion of children 6-23 months who were achieving both MDD and MMF. Minimum Meal Frequency (MMF) Minimum meal frequency (MMF) was defined as receiving solid, semi-solid, or solid foods 2 or more times daily for children 6-8 months, and 3 or more times daily for children 9-23 months in addition to breastfeeding. For non-breastfeeding children aged 6-23 months it is defined as receiving solid, semi-solid or solid foods, or milk feeds, at least 4 times.

Minimum Dietary Diversity (MDD) Minimum dietary diversity (MDD) is defined as receiving at least 5 or more types of food from following groups (1) grains, roots, tubers, (2) legumes, nuts (3) dairy products, (4) flesh foods (meat, fish, poultry and liver/organ meats), (5) eggs, (6) Vitamin A rich fruits and vegetables, (7) other fruits and vegetables, (8) breastmilk.

148 Complementary Feeding Practices by Province

100 90 80 70 60 50 40 30 27.3 22.4 21.4 20.1 22.6 20.6 16.1 18.3 18.2 20 13.0 14.6 10.7 10.2 9.8 12.2 10.3 11.2 Proportion of Children (%) Children of Proportion 7.2 10 3.1 0.7 0.9 2.1 1.5 1.7 3.3 3.8 2.1 0 Manicaland Mash Central Mash East Mash West Mat North Mat South Midlands Masvingo National

Minimum Meal Frequency Minimum Dietary Diversity Minimum Acceptable Diet

• Only 1.7% of children in Matabeleland South received a Minimum Acceptable Diet (MAD), a decrease from 6.4% in 2018. • Matabeleland South recorded the second highest Minimum Meal Frequency (MMF) at 22.6% but it was a major decrease from the 64.7% in 2018. • The Minimum dietary diversity for Matabeleland South (9.8%) was less than the National average (11.2%) and the second lowest after Matabeleland North (7.2%). 149 Provincial Complementary Feeding Practices Trends 100 90 80 70 64.7 60 50 40

30 22.6 19.0 Proportion of Children (%) Children of Proportion 20 16.0 13.5 9.8 10 6.4 4.0 1.7 0 2018 2019 2020 Minimum Meal Frequency Minimum Dietary Diversity Minimum Acceptable Diet

• The Minimum Acceptable Diet was lower in 2020 (1.7%) than in 2019 (6.4%) and 2018 (4%). • Most complementary feeding practices with the exception of Minimum Meal Frequency (MMF) in 2020 preformed poorly, less than a quarter of the children 6 to 59 met the criteria. 150 Complementary Feeding Practices by District

100 90 80 70 60 50 39.1 40.7 40 28.2 30 25 23.3 22.6 20 13.3 11.8 9.812.2 10.3 11.1 9.8

Proportion of Households (%) Households of Proportion 10 5 4.3 5.1 3.7 2.9 0 0 0 0 3.3 1.7 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial Minimum Meal Frequency Minimum Dietary Diversity Minimum Accepatble Diet

• The proportion of children 6 to 59 months consuming a Minimum Acceptable Diet (MAD) in the province is very low (1.7%), with 4 districts namely Beitbridge, Bulilima, Mangwe and Gwanda recording 0%. • Umzingwane (40.7%), Mangwe (39.1%), Bulilima (25%) and Matobo (23.3%) recorded higher proportions of children 6 to 59 months consuming a Minimum Meal Frequency (MMF) above the Provincial average.

151 Vitamin A Supplementation

152 Provincial Vitamin A Supplementation for Children 6-59 in the Past 6 Months

100 90 National Target 80 70 60 55.8 50 45.7 45.6 42.8 44.4 42.8 38.7 40 37.4 30.8 30

Proportion of Children (%) Children of Proportion 20 10 0 Manicaland Mash Central Mash East Mash West Mat North Mat South Midlands Masvingo National

• Mat South (42.8%) had a vitamin A supplementation rate similar to the National average (42.8%).,it was however lower than the 90% National target. 153 District Vitamin A Supplementation for Children 6-59 in the Past 12 Months 100 National Target 90 80 70 60 60 56.8 50.4 47.1 46 50 42.8 42.8 40 30.7 30 17.1 Proportion of Children (%) Children of Proportion 20 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

• Beitbridge (17%) has the lowest proportion of children receiving vitamin A in the past 12 months , while Gwanda (30.7%) is the only other district that had proportions below the Provincial and National average (42.5%). 154 District Vitamin A Supplementation for Children 6 - 11 in the Past 12 Months

100 100 National Target 90 85.7 82.4 81.8 80 75 75 73.3 71 70 60 50

40 33.3 30

Proportion of Children (%) Children of Proportion 20 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

• All districts with the exception of Beitbridge (33.3%) performed above the National average (71%). • Only Mangwe district at 100% performed above the national target of 90 %.

155 District Vitamin A Supplementation for Children 12- 59 in the Past 12 Months

100 National Target 90 80 70 62.4 61.7 60 54.8 54 52 50 46.8 45.9

40 34 30

Proportion of Children (%) Children of Proportion 18.5 20 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

• All districts with the exception of Beitbridge (18.5%) and Gwanda (34%) performed above the Provincial (46.8%) and National average (45.9 %). • None of the districts in the province performed above the national target of 90 % , this may be due to COVID-19 induced restrictions. 156 Prevalence of Child illness for Children 0-59 Months 100 90 80 70 60 50 40 27 30 22 21 21 20 19

Proportion of Children (%) Children of Proportion 20 14 15 14 11 11 13 13 13 12 13 11 11 11 8 8 10 10 10 7 8 7 5 0 Manicaland Mash Central Mash East Mash West Mat North Mat South Midlands Masvingo National Diarrhoea Cough Fever

• Childhood illness has a negative impact on dietary intake, nutrient utilisation among children. • Prevalence of child illness was assessed as presence of illness during the two weeks preceding the survey. • The prevalence of diarrhoea (7%), cough (10%) and fever (5%) for Matabeleland South province were less than the national averages at 10%, 157 19% and 11% respectively. Provincial Prevalence of Child illness for Children 0- 59 Months

16 Fever 5

25 Cough 10

9 Diarrhoea 7

0 10 20 30 40 50 60 70 80 90 100 Proportion of Children (%)

2019 2020 • Generally, there was a decrease in prevalence of child illness for children 0-59 months in the province in 2020 compared to 2019. 158 Child Nutrition

159 Acute Malnutrition by Province Based on MUAC for Age Standards

160 • Height and weight are the most widely used anthropometric measurements to assess nutritional status.

• Mid Upper Arm Circumference (MUAC) is sometimes used and has been an integral part of most assessments in Zimbabwe.

• Many guidelines recommend the collection of MUAC data along with Weight for Height (WFH) data during surveys or for rapid assessments.

• The advent of the COVID-19 pandemic worldwide has necessitated a different approach during the 2020 Rural Livelihoods assessment to minimise exposure of household members and enumerators.

• The concept of family led MUAC was adopted with enumerators guiding mothers on how to take MUAC measurements and the tapes were left for mothers to use routinely to check nutritional status.

• Only MUAC data was collected hence there was no analysis done for stunting and underweight which need weight and height measurements to compute.

161 Child Nutrition Status based on MUAC

Indicator Definition Prevalence cut-off values for public health significance

Global Acute Malnutrition MUAC for age <-2SD of the WHO Child Growth <5% :Acceptable Standards median and/oedema 5–9.9%: Poor MUAC of 15%: Critcal (WHO, 2000)

Severe Acute Malnutrition MUAC for age <-3SD of the WHO Child Growth 0-2 % :Acceptable Standards median and/oedema >2%: Unacceptable MUAC of +2 SD of the WHO Child <2.5%: Very Low Growth Standards median 2.5-<5%: Low MUAC of >200mm 5-<10%: Medium 10-<15%: High ≥15%: Very High (De Onis et al., 2019)

162 Acute Malnutrition by Province Based on MUAC for Age Standards

6.0 5.5 5.0 4.9 5.0 5.0 4.4 4.5 4.5 4.1 4.0 3.4 3.1 2.8 3.0 2.6 2.7 2.6 2.6 2.4 2.3 2.4 2.4 2.1 2.1 2.0 1.9 2.1 2.0 1.6 1.4 1.4

1.0 Proportion of Households (%) Households of Proportion

0.0 Manicaland Mash Central Mash East Mash West Mat North Mat South Midlands Masvingo National Global Acute Malnutrition Moderate Acute Malnutrition Severe Acute Malnutrition

• The Matabeleland South acute malnutrition rates based on MUAC for age were similar to the national average with the Global Acute Malnutrition (GAM) rate at 4.5% for both. • The province had the 5th highest GAM rate after Matabeleland North, Manicaland, Masvingo and Midlands provinces. • MUAC for age is considered a more useful indicator of nutritional status of populations than absolute MUAC and maybe an alternative when 163 weight and height measurements are difficult to obtain as was the case in this assessment. Acute Malnutrition by Province Based on MUAC Measurements

7.0 5.9 6.0 5.2 5.0 4.1 3.8 4.0 3.8 3.6 3.1 2.92.9 3.0 3.0 3.0 2.7 2.7 2.8 2.12.1 2.1 2.0 1.9 1.82.0 2.0 1.5 1.2 1.2 1.1 0.9 Proportion of Households (%) Households of Proportion 1.0 0.7

0.0 Manicaland Mash Central Mash East Mash West Mat North Mat South Midlands Masvingo National Global Acute Malnutrition Moderate Acute Malnutrition Severe Acute Malnutrition

• Acute malnutrition rates based on absolute MUAC measurements only had Matabeleland south at 3% which was less than the National

average of 3.8%. 164 Gender Based Violence (GBV)

165 Gender Based Violence (GBV)

• In Zimbabwe, gender based violence undermines opportunities for both men and women, denying them the ability to fully utilise their basic human rights.

• Violence against women is any act of gender based violence that results in physical, sexual or psychological harm or suffering to women (UN General Assembly Resolution 48/104 Declaration on the Elimination of Violence against Women, 1993).

• Spousal abuse has been the most common form of gender based violence.

• The Inter Agency Standing Committee (IASC) 2015 notes that many forms of GBV are significantly heightened during humanitarian emergencies including natural disasters like drought.

• Food insecurity, in itself, and factors contributing to it can be key drivers of GBV.

166 Households which Reported Spousal Violence and Other Forms of Gender Based Violence

100 90 80 70 60 50 40 30 19.2 20 13.0 Proportion of Households (%) Households of Proportion 10.4 7.4 10 4.4 7.3 6.9 2.1 0.6 1.5 0.1 0.4 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

• Insiza district reported the highest prevalence of spousal violence (19.2%) and other forms of Gender Based Violence (0.6%). • Umzingwane district had the lowest incidences of spousal violence in the province at 1.5%.

167 Sexual Violence and Verbal Abuse by District

Forms of Sexual Violence and Verbal Abuse Physically force you Physically force you Force you with Verbally abuse you, Deprive you of to have sexual to perform any threats or in any deprive you from money to buy basic intercourse with him other sexual acts other way to physical needs in commodities for when you did not you did not want to perform sexual acts order to punish you you or your want to you did not want to children

Beitbridge 7 7 0 79 29 Bulilima 0 0 0 0 0 Mangwe 0 0 0 38 63 Gwanda 0 0 7 43 14 Insiza 6 3 9 70 39 Matobo 25 8 8 50 25 Umzingwane 0 0 0 50 50 Provincial 7 3 6 57 32 National 15 7 7 71 33

• Matobo district (25%) had the highest proportion of households who reported having been forced by the spouses to engage in sexual intercourse when they did not want.

168 Victims who Sought Medical Attention after Spousal Violence

100 90 80 70 60 50 40 30 18.2 20 14.3 8.3 10.3 Proportion of Households (%) Households of Proportion 10 5.4 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

• Insiza district (18.2%) had the highest proportion of households who reported that they had sought medical attention after being abused by their spouses.

169 Households where Incidents of Physical/Sexual Violence had been Reported

Reported incident of physical/sexual violence

Police (%) Church (%) Relatives/friends (%) NGO(%) No one (%) Other (%) Manicaland 45.5 0.0 40.9 4.5 0.0 9.1 Mash Central 33.3 8.3 50.0 0.0 0.0 8.3

Mash East 71.4 0.0 28.6 0.0 0.0 0.0 Mash West 25.0 0.0 50.0 0.0 25.0 0.0

Mat North 33.3 0.0 33.3 0.0 16.7 16.7 Mat South 30.0 0.0 60.0 0.0 0.0 10.0 Midlands 37.5 0.0 25.0 0.0 37.5 0.0 Masvingo 66.7 0.0 0.0 16.7 16.7 0.0 National 45.1 1.2 37.8 2.4 7.3 6.1

• Matabeleland South had the highest proportion of households which reported incidents of physical/sexual violence to relatives/friends. • Nationally, about (45.1%) of households reported cases of physical/sexual violence to the police. 170 Coronavirus Disease (COVID-19)

171 Coronavirus Disease (COVID-19)

• Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus (WHO,2020).

• Most people who fall sick with COVID-19 will experience mild to moderate symptoms and recover without special treatment (WHO,2020).

• The virus that causes COVID-19 is mainly transmitted through droplets generated when an infected person coughs, sneezes, or exhales. These droplets are too heavy to hang in the air, and quickly fall on floors or surfaces (WHO,2020).

• You can be infected by breathing in the virus if you are within close proximity of someone who has COVID-19, or by touching a contaminated surface and then your eyes, nose or mouth (WHO,2020).

172 COVID-19 Risk Perception

100 5 6.6 7 10.6 11.6 10.6 11.2 7.3 90 15.5 9.5 27.1 80 20.4 34 26.6 25.1 40.4 13 70 18.1 36.7 13.1 16.7 60 12.6 21.5 3.5 15.7 50 16.5 19.7 26.5 40 26.3 42.2 36.2 18.5 27.4 30 41.7 20 9.1 45 22.3 Proportion of Households (%) Households of Proportion 24 29.1 10 17.7 18.6 20.1 20.6 8.5 10.6 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National No risk at all Low Medium High Don't know

• This is a novel virus and those districts with a high risk perception tend to be those who have had a some burden of cases as compared to those with a low risk perception. • Beitbridge district (40.4%), Matobo (36.7%), Bulilima (34%) and Mangwe (26.6%) recorded the highest proportion of households which had a high risk perception compared to the provincial average.

• Insiza recorded the highest proportion of households with a no risk at all perception at 45%. 173 Knowledge on How the COVID-19 Spread

Other 2.1 1.5

Touching a contaminated surface and then touching your face 27.9 24.8

Not washing hand with clean water and soap 51.6 47.9

Not covering your mouth and nose with a mask when in public 63 65.9

Coughing and sneezing without covering your mouth and nose 68.9 63.2

Being in close contact with someone COVID-19 including hand shaking and hugging 77.1 77.9

0 10 20 30 40 50 60 70 80 90 Proportion of Households (%)

National Provincial

• The proportion from Matabeleland South are similar lo the national averages , meaning there is similar knowledge in most households nationally.

174 Knowledge on How the COVID-19 is Spread

Being in close contact Coughing and Not covering your Not washing hand Touching a Other with someone COVID- sneezing without mouth and nose with with clean water and contaminated surface (%) 19 including hand covering your a mask when in soap (%) and then touching your shaking and hugging mouth and nose public (%) face (%) (%) (%) Beitbridge 81.1 65.7 56.8 47.3 10.7 0.0 Bulilima 85.3 66.7 77.4 56.5 17.5 0.0 Gwanda 64.9 49.1 60.2 31.0 19.9 1.8 Insiza 87.3 68.5 52.5 39.8 25.4 5.5 Mangwe 66.9 69.7 77.9 71.0 44.8 2.8 Matobo 82.8 51.7 76.2 59.6 49.0 0.0 Umzingwane 74.7 70.9 63.3 34.2 11.4 0.0 Provincial 77.9 63.2 65.9 47.9 24.8 1.5 National 77.1 68.9 63.0 51.6 27.9 2.1

• In all districts the most cited response on how COVID-19 is spread was, being in close contact with someone COVID-19 including hand shaking and hugging. • The least cited avenue of spreading COVID-19 in all districts was touching a contaminated surface and then touching one’s face, (24.8% Provincially). 175 Knowledge on COVID-19 Symptoms

Fever (%) Cough (%) Shortness of Sore throat Runny or Muscle or Headaches Fatigue (%) Sudden loss breath (%) (%) stuffy nose body aches (%) of taste and (%) (%) smell (%)

Beitbridge 36.9 78.0 51.2 62.5 64.9 14.9 44.6 14.9 1.8

Bulilima 86.5 79.4 52.3 36.8 21.3 26.5 45.2 14.2 0.0

Gwanda 69.1 63.0 25.3 17.9 37.0 8.6 57.4 10.5 0.6

Insiza 71.3 74.1 50.6 50.0 38.5 16.1 37.9 20.7 2.9

Mangwe 81.8 81.8 53.0 25.0 20.5 12.1 55.3 4.5 3.0

Matobo 79.5 67.5 55.6 63.6 37.1 35.1 41.7 24.5 4.6

Umzingwane 73.5 80.9 43.2 30.2 35.2 11.1 19.1 10.5 0.0

Provincial 70.6 74.8 47.1 41.3 37.0 17.7 42.7 14.5 1.8

National 74.0 84.7 44.1 44.9 33.1 17.8 52.4 26.4 3.6

• Provincial and National responses mirrored each other with most figures close to each other. • Cough was the top cited symptom in most districts except in Gwanda and Bulilima which had fever as the top mentioned symptom. 176 Knowledge on How to Stop the Spread of COVID-19

Wash your Cough or sneeze Avoid touching Limit social Avoid close Clean and Always cover your Other (%) hands with in your bent your eyes, nose gatherings and contact with disinfect nose and mouth clean water elbow (%) and mouth (%) time spent in someone with frequently with a mask when and soap often crowded COVID-19 touched objects in public (%) (%) places(%) symptoms (%) and surfaces (%)

Beitbridge 90.5 64.6 50.0 37.3 24.7 10.8 21.5 0.6 Bulilima 88.8 19.7 42.1 53.9 34.3 20.2 57.3 0.6 Gwanda 63.3 14.1 13.0 60.5 15.8 9.6 72.3 2.3 Insiza 80.6 40.0 28.9 58.9 38.3 17.8 57.8 13.3 Mangwe 80.7 56.0 47.0 59.0 50.0 29.5 78.3 1.2 Matobo 80.1 48.1 51.3 59.6 59.6 45.5 46.2 0.0 Umzingwane 64.0 41.5 35.4 50.0 40.2 12.8 31.1 0.6 Provincial 78.2 39.9 37.7 54.4 37.2 20.6 52.7 2.8 National 77.9 42.6 35.4 60.9 42.2 24.0 57.1 1.7 • Frequently washing your hands with clean water and soap often, was the top mentioned response in all districts as it was cited over 60% of households. • Limit social gatherings and time spent in crowded places, was the next top mentioned response across all districts with the exception of Beitbridge which had cough etiquette coming in second. 177 Knowledge on How to Protect Oneself Against COVID-19

Frequently Use alcohol Avoid Use a face Cover mouth Avoid Practice social Staying at Traditional/ wash hands based hand touching mask in public with flexed crowded distancing (%) home (%) religious with soap sanitizers mouth, eyes places (%) elbow when places (%) practices (%) under running (%) and nose (%) sneezing and water for 20 coughing (%) seconds (%)

Beitbridge 79.8 8.1 40.9 48.5 26.3 26.8 49.0 49.0 0.5 Bulilima 76.5 6.5 20.5 58.0 23.0 27.5 44.5 52.5 0.0 Gwanda 44.5 6.5 7.5 70.5 6.5 41.5 30.0 26.0 1.0 Insiza 72.5 13.0 21.0 54.0 18.5 26.5 46.5 52.5 2.5 Mangwe 64.5 9.0 27.5 56.5 20.0 48.5 51.5 63.5 1.0 Matobo 64.9 18.1 45.7 50.5 41.5 50.0 44.7 48.4 7.4 Umzingwane 54.3 9.5 32.2 57.8 17.6 36.2 38.7 22.6 1.0 Provincial 65.3 10.0 27.7 56.6 21.7 36.6 43.5 44.9 1.9 National 66.5 11.0 27.0 50.4 23.5 43.5 49.2 54.5 1.6

• A high proportion of households in all districts, believed frequently wash hands with soap under running water for 20 seconds was a way to protect oneself from COVID-19, with the exception of Gwanda where the top mentioned option was, use a face mask in public places 178 Knowledge on What to do When One Suspects They Have COVID-19 Go to the clinic right Stay at home and notify Consult local Call the toll free Home-based Don't know (%) away (%) the nearest health traditional number (%) remedies (%) service provider (%) healer/prophet (%)

Beitbridge 76.8 39.4 4.0 2.0 2.5 5.6

Bulilima 45.0 62.0 21.5 3.5 7.5 13.5

Gwanda 74.4 25.6 0.5 2.5 1.5 4.0

Insiza 59.0 29.5 1.5 7.0 7.0 8.5

Mangwe 68.0 45.5 0.0 0.0 0.0 6.0

Matobo 83.0 32.4 8.0 5.9 9.6 9.6

Umzingwane 71.9 30.7 3.5 6.0 1.5 5.5

Provincial 68.1 37.9 5.6 3.8 4.2 7.5

National 68.9 34.6 2.7 13.0 4.7 4.9

• The highest ranking most mentioned response in all districts, was visiting the clinic right away, followed by, stay at home and notify the nearest health service provider. 179 • Provincial and national figures mirrored each other in terms of response ranking Effects of COVID-19 Induced Restrictions

Loss of Loss of Failed to Failed to access Reduced Reduced Reduced Gender Based Restricted business employment access basic sources of salaries (%) food sources Violence access to income (%) (%) health commodities income (%) (%) (GBV) (%) agricultural facility (%) (%) markets (%)

Beitbridge 5.1 15.9 3.1 7.7 55.9 9.7 76.4 0 6.2

Bulilima 3.0 8.0 2.0 11.6 32.7 7.0 62.3 0 1.0

Gwanda 6.3 2.6 2.6 43.2 33.9 2.6 73.4 0 3.1

Insiza 7.5 5.9 0.0 7.0 62.9 4.8 54.3 1.6 2.7

Mangwe 6.5 8.0 0.0 15.5 58.0 4.5 72.0 0 0.0

Matobo 11.3 9.1 8.1 25.3 52.2 3.8 43.5 0 2.7

Umzingwane 29.4 5.6 2.0 15.7 44.2 6.1 43.1 0 6.1

Provincial 9.9 7.9 2.5 17.9 48.4 5.5 60.9 0.2 3.1

National 18.3 8.5 4.7 21.2 51.5 4.6 50.1 0.3 13.4 • The most mentioned effect of COVID-19 was, reduced food sources, with the exception of Umzingwane and Insiza which had, reduced sources of income and Gwanda with, failed to access basic commodities • Only Insiza (1.6%) mentioned gender based violence (GBV) as an effect of COVID-19 induced restrictions 180 Knowledge on How to Slow down COVID-19 Spread

100 89 88.5 89.5 89.4 90 83.4 83.5 82.8 85.2 79.8 80

Proportion of Households (%) Households of Proportion 20

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincal National

• Over 70% of respondents across all districts were knowledgeable about how to stop the spread of COVID- 19

181 Households Which Failed to Purchase Personal Protective Equipment (PPE)

100 99.5 89.7 88.5 88.8 90.9 90 86.6 86.9 85.5 82.7 80 70 60 50 40 30

Proportion of Households (%) Households of Proportion 20 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National

• More than 80% of respondents cannot afford PPE across all districts, with Mangwe district being the peak of the lot with 99.5% of the respondents failing to afford purchase 182 Sources of Personal Protective Equipment (PPE)

100 90 80 70.3 68.8 70 66.7 67.7 60.1 60.7 60 56 55.5 56.656.9 54.5 52.354.9 46.6 47.3 47.5 50 43.7 40.6 40 30 20 Proportion of Households (%) Households of Proportion 13.3 9.6 7.1 9.3 8.1 9.2 10 3.2 3.4 4 0 Beitbridge Bulilima Gwanda Insiza Mangwe Matobo Umzingwane Provincial National Purchases Homemade Donations

• Provincially purchases (52.3%) and homemade PPE (54.9%) were sources of PPE with donations (8.1%) falling way behind. • The highest proportion of homemade PPE was in Bulilima (70.3%) and Gwanda (66.7%)

183 Preferred Future Sources of Information

Health VHW/CHW Posters (%) Radio (%) Television (%) Social media Workshop (%) Print media Opinion facility (%) (%) (%) (%) leaders (%)

Beitbridge 57.1 62.6 8.1 35.4 2.0 5.6 7.6 1.0 9.1

Bulilima 56.5 75.5 11.5 24.5 5.0 33.5 6.5 1.5 15.5

Gwanda 50.8 45.2 14.6 26.6 1.5 8.0 37.7 9.5 10.6

Insiza 41.0 40.0 11.0 22.0 4.5 7.5 21.0 17.5 3.0

Mangwe 65.0 81.0 33.0 34.0 2.5 28.0 12.0 3.0 1.0

Matobo 70.7 73.4 17.0 16.5 3.2 8.0 5.9 1.6 6.4

Umzingwane 76.4 58.8 8.5 16.1 5.0 7.0 20.1 2.0 1.0

Provincial 59.5 62.3 14.8 25.1 3.4 14.0 15.9 5.2 6.6

National 61.8 56.2 10.2 39.7 3.5 10.3 9.2 3.1 7.2

• The preferred future sources of information in the province were Community Health Workers (62.3%) and health facilities (59.5%), while television (3.4%) print media (5.2) were least preferred. 184 Access to Products and Services During COVID-19 Induced Restrictions

185 Households With Difficulties Accessing Essential Services 100 89 90 82.9 80 73.7 70 67.5

60 54.4 46.3 50 43.8 41.442.2 38.9 40 38.5 36.9 35.935.7 35.537.1 40 35 33 30.5 31.329.7 31.9 30 27.3 28.2 30 25.126.624.7 22.8 21.1 22.4 19.8 18.6 20 17.716.7

Proportion of Households (%) Households of Proportion 14.1 12.3 11.2 8 10 7.1 6.1 5 2.6 4.5 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Public Transport Health Services Social Services Extension Services Security Services

• Public transport was the most difficult service to access in the province (54%), with Gwanda (89%) and Umzingwane (82.9%) above the national average of 73.7% • Umzingwane and Matobo reported over 30% of their populations failing to access each essential service. 186 Households With Difficulties Accessing Essential Products and Necessities

100 90 79.4 78.7 80 71.4 6767.9 69.2 70 65.5 64.2 61.5 60 52.6 54.8 47.8 48.9 50 44.8 45.4 42 39.739.2 40 41.7 40 35.736.2 37.9 31.3 30 23.4 18.8

20 17.5 17.8 Proportion of Households (%) Households of Proportion 10 10.6 8.2 10.6 10 3.5 5.4 4.5 0.5 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial National Food Medical Supplies Sanitary Products Water

• Food was the most difficult product to access during the COVID-19 induced restrictions with Mangwe (79.4%), Gwanda (78.7%) and Umzingwane (71.4%) reporting figures above the national and provincial average. • Gwanda and Matobo had over 60% and 40% of respondents respectively reporting failure to access food, medical supplies and sanitary products. 187 Shocks and Hazards

188 Shock Exposure Indices Trend by Province 16 14 14 13 13 13 1313 12 1212 1212 12 1111 11 11 1111 1111 1111 11 10 10 10 10 9 9 9 8 8 7 7 6 6 6

5 5 Shock Exposure Index Exposure Shock 4 4

0 Manicaland Mash Central Mash East Mash West Mat North Mat South Midlands Masvingo National 2017 2018 2019 2020

• Generally there was increased exposure to shocks in the country, although Matabeleland South’s shock exposure index at 11 was below the

national average of 12 189 Average Shock Exposure Index

16 14 14 13

12 11 10 10 10 10 8 8

6 Shock Exposure Index Index Exposure Shock 4

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane

• Gwanda and Beitbridge had the highest average shock exposure indices at 14 and 13 respectively whereas Bulilima has the lowest at 8

190 Mat South Shock Prevalence Perception

0.2 Veld fires 0.3 0.4 Conflict/social unrest 0.4 0.4 Floods 0.6 0.6 GBV ( physical or sexual violence within the home) 0.8 0.9 Death of main income earner in the household 2.5 5.1 HIV and AIDS illness 6.1 8.3 Other health related (eg TB, BP) 8.6 12.3 Crop pests 12.6 14.1 COVID-19 Pandemic 25.1 25.9 Livestock price changes i.e sharp drop or increase 26.1 55.1 Cash shortages 57.2 71.6 Drought 84.3 0 10 20 30 40 50 60 70 80 90 100 Proportion of Households %

• Droughts and mid season dry spells were shocks perceived as hazardous in the province at a proportion of 84% and 72% respectively 191 Severity of Shocks on Households

100 90 29 36 36 80 43 44 44 50 51 70 55 69 68 66 70 72 71 77 60 85 90 87 92 86 86 50 44 40 46 40 43 42 38 30 30 39 28 18 Proportion of Households % Householdsof Proportion 20 27 27 28 23 23 13 27 10 12 17 18 18 19 23 9 12 6 13 12 10 11 12 14 14 0 1 1 1 1 1 2 5 5 5 6 7

Minor/Mild Moderate Severe

• Drought and most economic shocks were the most severe shocks experienced by households 192 Household perception of their Ability to Cope with Future Shocks 100 1 2 2 2 3 3 4 2 5 4 4 7 7 4 6 9 9 90 17 15 17 19 19 23 27 27 27 25 28 28 31 37 80 28 29 32 30 30 35 33 35 70 47 41 60 52 52 42 50 45 40 40 78 78 75 72 71 71 70 70 67 66 64 64 30 63 61 61 56 20 44 42 33 32 31 10 24 24 Proportion of Households (%) Households of Proportion 0

Unable to cope Able to cope with difficulty Able to cope without difficulty

• Most households perceived that they were not equipped to deal with most livelihood and economic based shocks such as loss of income and weather related events 193 Food Security

194 Food Security Analytical Framework

• Food security exists when all people at all times, have physical, social and economic access to food which is safe and consumed in sufficient quantity and quality to meet their dietary needs and food preferences and it is supported by an environment of adequate sanitation, health services and care allowing for a healthy and active life (Food and Nutrition Security Policy, 2012).

• The four dimensions of food security as give in Figure 3 are: • Availability of food • Access to food • The safe and healthy utilization of food • The stability of food availability, access and utilization

195 Food Security Analytical Framework

• Each of the surveyed households’ potential to acquire minimum expenditure food basket (Figure 3) was

computed by estimating the household's likely disposable income (both cash and non cash) in the 2020/21

consumption year from the following possible income sources;

• Cereal stocks from the previous season;

• Own food crop production from the 2020/21 agricultural season;

• Potential income from own cash crop production;

• Potential income from livestock ;

• Potential income from casual labour and remittances; and

• Income from other sources such as gifts, pensions, gardening, formal and informal employment.

196 Food Security Analytical Framework

• Household Food Security Status

• The total minimum expenditure food basket that could be acquired by the household from the

cheapest available sources using its potential disposable income was then computed and compared to

the household’s minimum expenditure food basket.

• When the total minimum expenditure food basket that a household could acquire was greater than its

minimum expenditure food basket requirements, the household was deemed to be food secure. When

the converse was true, the household was defined as food insecure.

• The severity of household food insecurity was computed by the margin with which its potential energy

access was below its total minimum expenditure food basket requirements.

197 Food Security Analytical Framework

• Household Cereal Security Status

• From the total minimum expenditure food basket, the total energy that could be acquired by the

household from the cheapest available sources using its potential disposable income was also

extracted and compared to the household’s minimum energy requirements.

• When the potential energy a household could acquire was greater than its minimum energy

requirements, the household was deemed to be food secure. When the converse was true, the

household was defined as food insecure.

• The severity of household food insecurity was computed by the margin with which its potential energy

access was below its minimum energy requirements.

198 Summary of Food Security Status Findings

• During the peak hunger period (January to March 2021) it is estimated that approximately 51.2% of the rural households will be cereal insecure.

• The 51.2% of rural households will translate into approximately 341,221 individuals requiring 50,501 MT of cereal (Maize Grain).

199 Cereal Insecurity Progression by Income Source

100 100.0 98.7 98.7 98.4 90 81.6 80 70 60 51.2 50 40 30 20

Proportion of Households (%) Households of Proportion 10 0 Food insecurity from Food insecurity from Food insecurity from Food insecurity from Food insecurity from Food insecurity from cereals stocks cereals stocks plus cereals stocks plus cereals stocks plus cereals stocks plus cereals stocks plus food crops food crops plus cash food crops plus cash food crops plus cash food crops plus cash crops crops plus crops plus livestocks crops plus livestocks remittances plus casual labour plus casual labour and remittances and remittances plus income

• The cereal insecurity prevalence is projected to be 51.2% during the peak hunger period of 2020/21.

200 Cereal Insecurity by District 100

70 61 60 58 55 53 49 51 50 48

40 35 30

Proportion of households (%) households of Proportion 20

0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial

• Umzingwane (61%) and Bulilima (58%) are projected to have the highest proportion of households facing cereal insecurity during the peak hunger season of 2020/21. • Beitbridge is projected to have the least prevalence of cereal insecurity at peak. 201 Cereal Insecurity Progression by Quarter

100 90 80 70 61 60 58 52 55 53 51 49 51 47 49 48 50 44 43 40 41 40 40 35 37 32 32 33 27 27 30 24 24 26 21 22 22 20

Proportion of households (%) (%) households of Proportion 20 12 14 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial Apr - Jun Jul - Sept Oct - Dec Jan - Mar

• The second quarter of the 2020/21 is projected to have 33% of the households to be cereal insecure. • Bulilima (52%) and Mangwe (51%) are projected to have over half of their households cereal insecure during the third

quarter. 202 Cereal Insecure Population by Province by Quarter

Food Insecure Population District Apr - Jun Jul - Sept Oct - Dec Jan - Mar Beitbridge 21,415 42,830 48,184 62,461 Bulilima 79,922 128,177 156,829 174,924 Mangwe 42,677 72,642 91,711 98,975 Gwanda 46,643 71,075 103,281 116,607 Insiza 32,340 58,906 93,556 113,191 Matobo 40,802 59,260 73,832 87,433 Umzingwane 43,842 73,735 97,648 120,566 Mat South 134,756 222,829 292,132 341,221

• Gwanda (103,281) and Bulilima (156,829) are projected to have over a half of their population cereal insecure by the third quarter (October to December 2020).

203 Cereal Requirements (MT) by Province by Quarter

Cereal Requirements

District Apr - Jun Jul - Sept Oct - Dec Jan - Mar Beitbridge 3,169 6,339 7,131 9,244 Bulilima 11,828 18,970 23,211 25,889 Mangwe 6,316 10,751 13,573 14,648 Gwanda 6,903 10,519 15,286 17,258 Insiza 4,786 8,718 13,846 16,752 Matobo 6,039 8,770 10,927 12,940 Umzingwane 6,489 10,913 14,452 17,844 Mat South 19,944 32,979 43,235 50,501

204 Cereal Insecurity and Poverty Lines

100 90 80 39.2 42.0 45.5 47.5 51.0 52.1 48.8 70 64.8 60 50 40 30 60.8 58.0 54.5 52.5 49.0 47.9 51.2 20 Proportion of households (%) households of Proportion 35.2 10 0 Beitbridge Bulilima Mangwe Gwanda Insiza Matobo Umzingwane Provincial Cereal Insecure Below FPL

• A total of 48.8% of the households are projected to be below the food poverty line. Indicating that most of the rural households will not be able to meet all their food needs to support a healthy life. 205 Recommendations and Conclusions

206 Recommendations and Conclusions

• Gender Based Violence remains a challenge as 7.4% of households reported to have had incidents of spousal violence. To mitigate against forms of domestic violence, there is need for extensive social marketing to raise awareness of the phenomenon and promote behaviour change amongst both males and females.

• Given the level of food insecurity already obtaining in the rural areas, the Government and its Development Partners should consider continuing with food assistance programmes with plans to scale up these earlier in the consumption year than usual.

• To help farmers recover from two consecutive seasons of poor production, the Government should consider tying food assistance programmes to preparedness for the upcoming farming season.

• Households’ access to Food and Nutrition Security Infrastructure is critical in promoting food production, preservation and utilisation in rural households. There is need for Government and it development partners to invest in water infrastructure to improve access to water irrigation and unlock the potential of dry productive farming communities.

• Proportions of households accessing loans remain low and these were predominantly given by family and friends to family members and friends; they remain largely informal. Financial inclusion in the formal institutions such as Banks, SACCOs and microfinance remains largely constrained. This may be stemming from the fact that most of these households are borrowing for consumption hence presenting a credit risk to the formal financial institutions.

207 Recommendations and Conclusions

• Efforts should be directed at stimulating investments in rural areas and towards supporting ISALs to improve financial inclusion. Humanitarian programmes that improve access to food may also assist in redirecting the decision of farmers in borrowing for investment rather than consumption to improve their credit rating with formalised financial institutions.

• There is a high proportion of households using surface water. A paradigm shift from primarily relying on unimproved drinking water sources to improved communal water points and improved piped water into households using renewable energy sources (solar) is recommended.

• There is a high proportion of households practising open defaecation. Elimination of open defecation through availing of resources (both soft and hardware) for the construction of latrines using locally available resources is recommended. Customized service standards should reconcile with technology choice and service levels with the economic capacity of user groups.

• Water, Sanitation and Hygiene (WASH) education programmes need to be integrated to achieve improved public health by scaling up sanitation- focused participatory hygiene and health education, schools health clubs, sanitation action groups and community health clubs. Mainstream WASH activities into other sectors such as Education, Youth, Women affairs, Agriculture.

• There is need to carry out Knowledge, Attitude, Practices and Behaviour (KAPB) study on why communities are reluctant to take up basic hand washing facilities

208 Recommendations and Conclusions

• There is need to apply the marketing mix often presented as the 4Ps-Product, Price, Place and Promotion which provides framework on how to design a comprehensive hand washing program.

• There is need to invest in increasing the proportion of households accessing improved water sources less than 500m from their homestead by protecting close by unprotected sources and drilling of more boreholes in newly resettled areas.

• There is need for increased investment in the livestock sector by Government and its partners especially targeting areas with high mortality rates for restocking, irrigation infrastructure for fodder production and capacity building for extension personnel e.g. in terms of mobility, communication etc.

• Fall armyworm infestation is slightly high and needs to strengthened by timely provision of pesticides at affordable prices

• Government is the main input source for maize and sorghum whist purchases are observed for other inputs. (Climate smart agriculture looks at promotion of traditional grains)

• Livestock extension advice revealed improvement as compared to last season.

• Active screening and Family Led MUAC for screening and management of Acute Malnutrition at district level in the face of high provincial Global Acute Malnutrition (GAM) rate (4.5%).

• Most households were not consuming quality diets that are adequate to meet their micronutrient requirements. A multisectoral approach to address and strengthen interventions to enhance the nutritional content of family diets is required.

209 Recommendations and Conclusions

• Strategies to employ include products on of diverse plant and animal food sources, promotion of consumption of diverse diets and value addition on of locally available foods.

• Production indices are too low for cattle, goats and sheep.

• The proportion of children being turned away for non payment of school fees in Mat South(33%) is almost 5 times higher than the national average (7%) and therefore there is need to enforce implementation and monitoring and evaluation of national policies related to the promotion of universal access to education.

• Mangwe and Insiza need to assess the reasons behind the high proportions of children of school going age not attending school

• Considering that most shocks were weather and economy related , appropriate Agri based interventions and possible increase in cash transfer support would mitigate adverse impacts

• The number of orphans recorded by Mat South requires an in-depth inquest to establish causal factors

• There has been disruption of essential services such as public transport, health services, social services, and extension services due to COVID-19 and line ministries and have to step up efforts to improve access.

• COVID-19 induced restrictions have seen households face difficulties accessing essential products such as food, sanitary ware and medical supplies.

210 Recommendations and Conclusions

• The proportion of people living with chronic illness missing a dose of their medication is need a cause for concern. For the most par, patients of chronic conditions are limited by limited financial resources to access critical medication. There is need for a comprehensive approach to ensure accessibility of these critical medicines to satellite health facilities based on an area-based database system.

• There is need to capacitate the Department of Livestock and Veterinary Services’ disease surveillance and disease control. This should include increased mobility, refresher training of front line staff and provision of relevant work tools and equipment.

• Production indices are too low for cattle, goats and sheep.

• Fall armyworm infestation is slightly high and needs to strengthened by timely provision of pesticides at affordable prices

• Government is the main input source for maize and sorghum whist purchases are observed for other inputs. (Climate smart agriculture looks at promotion of traditional grains)

• Livestock extension advice revealed improvement as compared to last season

211