By Michael Gwarisa
HARARE – Zimbabwe’s ongoing efforts to improve public health outcomes could receive a major boost through strengthened collaboration with expert institutions such as the Zimbabwe College of Public Health Physicians (ZCPHP), government officials and experts have said.
Speaking in an interview on the sidelines of the Zimbabwe College of Public Health Physicians Winter Symposium in Harare, Dr. Agnes Mahomva, the Public Health Advisor to the President and Cabinet, said the ZCPHP’s renewed commitment to supporting the national health agenda comes at a critical time when the country is grappling with persistent gaps in maternal, neonatal, and child health outcomes.
I think I’m so happy and proud that the Zimbabwe College of Public Health Physicians is stepping up,” said Dr. Mahomva. “You are aware we do have some challenges in our health sector, and the Ministry is working very hard, but it’s very important to remember that government can’t do it alone.”
She stressed that leveraging science and data to guide interventions was no longer optional but essential, particularly in identifying and addressing the root causes of poor health indicators.
“Using data, the science, is exactly what government is looking for,” she added. “Otherwise, we continue seeing ourselves complaining with all the evidence, putting in strategies and approaches to respond to some of the gaps and challenges, but perhaps answering or addressing the wrong issues because we haven’t used data.”
Dr. Mahomva said government welcomed the College’s efforts to serve as an authoritative voice in public health, committed to supporting national efforts through evidence-based analysis, policy input, and strategic partnerships.
Her call comes on the back of the recently released Zimbabwe Demographic and Health Survey (ZDHS 2023), which confirmed troubling trends in national health outcomes. While there have been some gains, including a reduction in maternal mortality, the figures remain far too high.
“The ZDHS clearly demonstrated, or rather confirmed, that the national health status is not in the right place,” she said. “Infant mortality, neonatal mortality, and while maternal mortality has gone down, it is still unacceptably high.”
Adding depth to the discussion, Dr. Patron Mafaune, a public health physician and health systems specialist, highlighted the need to look beyond clinical care to the broader social and structural factors shaping health outcomes.
“When you look at the relative contribution of medical care and the social determinants of health, you realise that medical care contributes basically around 10 to 20 percent,” said Dr. Mafaune. “The emphasis is to understand how our health is also influenced by factors like living conditions, sanitation, nutrition, and education.”
He noted that historically, significant improvements in public health were driven not by medical breakthroughs but by advances in social infrastructure and environmental health.
“The decline in tuberculosis actually happened before the BCG vaccination was even discovered. That underscores the importance of improvements in social conditions,” he said.
Dr. Mafaune also raised concerns about the misconception that high healthcare spending guarantees better outcomes.
“Even the best medical care cannot fully compensate for social disadvantages. If you look at countries like the US, they have the highest health spending per capita globally, yet their life expectancy doesn’t always reflect that,” he said. “Spending more doesn’t necessarily result in better outcomes. What we need is balanced investment, including in the social sectors.”
According to the ZDHS 2020 to 2025, only 67 percent of the population has access to electricity, and the disparities between urban and rural areas remain wide.
Taking the conversation further into the domain of maternal health, Dr. Jaensch Masanga Mutede from the Ministry of Health and Child Care’s Family Health Department underscored the urgent need to confront rising fertility rates and teenage pregnancies, which continue to fuel maternal mortality.
“So these are our current concerns, the intersection between these three groups of people, looking mainly at our maternal mortality as our unit of mortality, and especially our teenage pregnancies,” said Dr. Masanga. “We have noted in our analysis and in some of the presentations that all the three need to move together for us to achieve a considerable reduction in our maternal mortality rates.”
She pointed out that while the highest fertility rates occur among women aged 20 to 24, the 15 to 19 age group remains a major concern due to their disproportionate contribution to maternal deaths.
“We’ve got high fertility rates, the highest between the 20 to 24 age group, but we see that the 15 to 19 age group is the fourth age group with high fertility. Unfortunately, they are going to account for between 25 percent of maternal deaths, and if you’re looking at those below 25 years, they are going to be between 33 percent of our maternal deaths,” she said.
Education and location also play a critical role.
“There are higher fertility rates in the rural areas, which is twice what is being experienced in the urban population for both the 15 to 19 years and the 20 to 24 years. And then we also have education coming in. Women with more than secondary education will give birth seven years later. So the teenagers who are out of school, by 18 years they have started their families.”
As Zimbabwe navigates an evolving health landscape, experts say it is now more crucial than ever to harness the expertise of public health professionals and institutions, integrate research into practice, and act on data to drive systemic reform.
Dr. Mahomva concluded by reaffirming government’s willingness to engage and collaborate with ZCPHP and similar bodies to build a responsive, resilient, and equity-driven health system.
“We’re there to work with them to make sure that the challenges we’re seeing in our health sector are addressed in the right way, using data and strengthening the collaborations and partnerships that are so very much required.”
