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By Caiphas Chimhete
There is a need to retrain and capacitate rural community structures on their roles and responsibilities to ensure knowledgeable dissemination of health information for the attainment of universal health coverage in the country, a recent assessment has indicated.
It was found out that members of health centre committees (HCCs), Village Development Committees (VIDCOs) and Ward Development Committees (WADCOs) were not properly constituted and not knowledgeable about their roles and responsibilities as no proper capacity building was conducted before they assumed office.
Such community structures are responsible for spearheading the development of their areas in consultation with the general members of the communities.
Community structures normally focus on developmental projects such as the construction of health posts, construction of waiting homes’ homes at health facilities, road maintenance and rehabilitation of water points such as boreholes.
The assessment carried under the project “Intelligent Community Health Systems Initiative – Strengthening Community Platforms for Health” by the Community Working Group on Health (CWGH) with support from UNICEF, noted that community structures needed to be revamped and be capacitated to ensure they can adequately execute their functions including promoting health services for the benefit of ordinary citizens.
Among the community structures that were assessed are health centre committees (HCCs), Village Assemblies (VAs), Village Development Committees (VIDCOs), Ward Development Committees (WADCOs) and women’s learning and action groups. The assessment was done in Manicaland province’s districts of Mutasa, Makoni and Nyanga.
In the health sector, community structures such as HCCs and Village Health Workers (VHWs) are also channels of information dissemination to the communities. They are key in disseminating information on issues such Covid-19 vaccination, immunization, malaria programmes and government policies and positions on critical matters.
“Most community level structures do not have approved work plans like HCCs which falls under the Ministry of Health and Child Care,” noted the assessment report. “Therefore there is great need to train committees on how they should come up with an annual work plan with input from the community for approval by district authorities.”
Different community structures appealed for the government to speed up the establishment of health posts to reduce the distances people cover to seek treatment in rural areas. Some people walk for distances of up to 20 kilometres to the nearest health centre.
The report calls for the development of a curriculum/training manual for community structures to enhance the performance of their duties in line with the Rural District Council (RDC) Act and Traditional Leaders’ Act.
It also highlighted the “need to depoliticize community governance structures” to ensure they execute their duties professionally without interference.
“Some HCCs are still being chaired by councillors opposed to the HCC guidelines and Public Health Act,” noted the report. “There is too much political polarization crippling development,” in rural communities.
The Intelligent Community Health Systems Initiative – Strengthening Community Platforms for Health” programme, which is being implemented in the country’s two provinces of Manicaland and Mashonaland West, aims to strengthen community voice and empowerment through functional community feedback mechanisms.
It is also meant to empower marginalized and vulnerable groups for increased participation in health governance, improve access to health services through establishment of health posts and to improve the quality of Maternal, Neonatal and Child Health (MNCH) services and services utilization.
In the long run, the programme is expected to raise awareness of the government’s National Community Health Strategy (NCHS) and Essential Health Package (EHP), establish a community complaints handling mechanism as well as improve governance interface, dialogue and provider responsiveness.
CWGH has been a key partner in the development of the NCHS and EHP from its inception making it easy for spearheading the revitalization of community structures and strengthening social accountability through the improved interface between communities and authorities.