Rapid Assessment of Sexual and Reproductive Health and HIV Linkages in Zimbabwe

This 8-page summary highlights insights gained through an assessment process conducted in Zimbabwe to better understand the linkages between sexual and reproductive health (SRH) and HIV/AIDS. The assessment was part of a multi-country initiative, conducted using an assessment tool developed in 2009 by the International Planned Parenthood Foundation, United Nations Population Fund, World Health Organisation, the Joint United Nations Programme on HIV/AIDS, GNP+, the International Community of Women with HIV/AIDS, and Young Positives. The tool "supports national assessments of the bi-directional linkages between sexual and reproductive health (SRH) and HIV at the policy, systems and services level. The resulting report is meant to be used within countries to determine priorities and shape national plans and frameworks for scaling up and intensifying linkages.

The report outlines the process of assessment and then highlights the findings and challenges at policy, systems, and services level, including issues related to capacity building and community health care workers. It also looks at lessons learned based on the assessment process and the research results, and offers steps going forward. Recommendations based on the assessment are cited at the beginning of the report.

To give a few examples of the findings, the assessment found that there are no specific policies or guidelines at the national level to guide integration in Zimbabwe. Donors also tend to focus attention on either HIV or SRH, rather than integrated strategies, and because they channel much of their support through civil society organisations, the Ministry of Health and Child Welfare finds it increasingly difficult to coordinate SRH and HIV integration among development partners. The report notes that there is very little coordination among HIV and SRH organisations, and coordination forums that do exist tend to focus on either HIV or SRH without engaging with each other. In terms of capacity building, there have been some achievements in building the capacity of health care workers (HCW), but this is predominantly in rural, rather than urban areas.

At the service delivery level, while there is some degree of integration "this, however, is uncoordinated, uninformed by policies, and HCWs were found to be inadequately trained. Respondents described "integration by default", “just because there is only one service provider providing all t It was found that these services"."

The report also notes that although Zimbabwe has a large network of community based health care workers, distributors, and health promoters, these health workers have not been sufficiently trained in integration. Those interviewed reported that "there is weak SRH and HIV integration within programmes, mainly due to limited capacity and poor SRH and HIV coordination at community level."

The summary report offers the following communication related recommendations, among others:

• Sensitise policy-makers and planners on the bi-directional SRH and HIV integration and building national consensus on its operational definition.
• Establish a broad-based national taskforce on SRH and HIV integration. It is recommended that this should be a high-level committee headed by the Principal Director Preventive Services, Ministry of Health and Child Welfare (MoHCW), who reports to the Permanent Secretary.
• Strengthen national dialogue between SRH and HIV stakeholders
• Engage and advocate with donors on the need to support SRH and HIV integration through the existing donor coordination fora.
• Develop a community strategy for SRH and HIV integration.
• Reviewing health care workers’ (HCWs’) training curricula to incorporate SRH and HIV integration.

Click here to access the assessment tool.

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