Improving facility-based MCH services for women in the Rushinga District, Zimbabwe

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In the 1980s and early 1990s Zimbabwe had one of the best primary health care systems in sub-saharan Africa. Political and economic challenges since then have led to a chronic under investment in the health sector and a significant, if not alarming, deterioration in health indicators.

Maternal mortality in Zimbabwe is unacceptably high at 725 per 100,000 live births and reducing maternal mortality is a priority of the Zimbabwean Ministry of Health and Child Welfare (MOHCW).

Currently less than 30 percent of women and their babies receive immediate postnatal care, with the majority of mothers sent home immediately after delivery or delivering at home.

There has been an increasing trend of home deliveries in Zimbabwe since 1999, in the context of a weakened health delivery system and economic hardships. Recent statistics indicate a 13-26 percent rise from 2005/2006 to 2009/2010 with the national rate of home deliveries reported as 39 percent by the Multiple Indicator Monitoring Survey (MIMS) and 35 percent by the Preliminary Report of the ZDHS 2010-2011.

Project activities were undertaken in Rushinga district, Mashonaland Central in Zimbabwe with three strategic objectives:

  • Refurbishment of Maternal Waiting Homes services to support uptake of facility-based delivery for women in remote communities
  • Improved community demand for maternal health services through the development of an “action birth card’ which was designed as a planning tool for rural prenatal women
  • Improved capacity of rural health sites to provide quality maternal, newborn and child health services to clients and/or effective referrals through health care worker training.


  • July 2012 – June 2015


  • Construction and/or refurbishment of 11 new Maternity Waiting Homes for District-wide coverage from July 2013 – July 2015
  • More than 11,000 direct and 34,779 indirect beneficiaries were reached with community health education interventions including the action birth card
  • 902 rural women used the new waiting homes in a 12-month timeframe
  • 139 men were able to visit their wives to bring food and stay overnight in the homes
  • 11 health care workers trained in basic emergency obstetric and newborn care
  • 25 nurses completed mentorship attachments at the District Hospital.


  • The project contributed to a significant increase in demand and uptake of facility-based maternal and child health services. Nine-two percent of recorded births in Rushinga occurred in a health facility, an increase from 51 per cent at the project’s inception (2010/11).

  • Through the action birth card, the project engaged rural women to identify barriers to service uptake and to problem solve barriers using existing resources.

  • The card acted as an important tool for empowering women to set and achieve goals around safe motherhood, and it increased male involvement in family health issues.

A survey of 174 women who used the Action Birth Card (ABC) demonstrated significant increase in service uptake compared to previous pregnancy without the ABC in Zimbabwe.

  • Increased referrals were made to higher level facilities for complications

  • The project raised the profile of Australian interests in Zimbabwe: “We are proud as Australia to have supported such a worthwhile initiative,” Australian Ambassador to Zimbabwe, H.E. Ms. Suzanne McCourt said. - Herald, May 2, 2015.

  • The project also raised awareness of maternal and child health issues nationally in Zimbabwe and demonstrated the Australian contributions through other media articles: “Maternity shelters saving lives.” - The Standard, 24 August 2015 and “Rushinga gets 11 maternity waiting homes.” - Newsday, 29 April 2015.


The project was implemented in collaboration with local partners, The Organisation for Public Health Interventions and Development Trust (OPHID) which develops and implements innovative approaches and strategies to strengthen HIV Care and Treatment, as well as Maternal, Newborn and Child Health (MNCH).

OPHID has been supporting the Ministry of Health and Child Care in the implementation of the National Prevention of Mother to Child Transmission (PMTCT) of HIV Programme since 2001 and has direct, site level support to more than 600 health facilities in three Provinces of Zimbabwe.


  • DFAT Australian NGO Cooperation Program (ANCP)
  • The Drakensburg Trust

Contact Details

For any general enquiries relating to this project, please contact:

Mary-Ann Nicholas

Head, Project Management Office