Catalogue of Practices

Zimbabwe Community-based Distribution Programme

Zimbabwe National Family Planning Council

Objective

The Zimbabwe National Family Planning Council (ZNFPC), a parastatal body in the Ministry of Health and Child Welfare (MOH), has the mandate of coordinating and providing FP services in the country. 

Scope
The strategy is to encourage the private sector and urban health services system to continue providing FP services in the urban areas while the ZNFPC concentrates on the rural population. Community mobilization and participation have been identified as the cornerstone for the success of this strategy. 

Background
Since 1980 after independence from Britain, the GOZ's emphasised  development to the neglected rural communities. The strategy was to organize the communities so that they could mobilize local resources, plan and implement their own programmes,  in designing and supervising, motivating and maintain their own programme sustainability.

The communities, through the Ministry of Community Development (MOCD), women's organizations and the local political structures, are responsible for selecting CBD workers for their areas and the supervision of these workers once they have been deployed. As a result, the community-based distributors are accountable and answerable to the community which selected them. Through community development committees the FP programme keeps in constant touch with the communities as well as inform them on recent developments in the FP programme.

The biggest challenge was to reach the dispersed and sparsely populated rural areas with appropriate services. The terrain differs over most of the country and makes the static clinic system not so readily accessible to the majority of the rural population. Thus, outreach services offer the most viable alternative.






Main Activities
Mobile Clinic Services
The ZNFPC operates mobile clinics in underserved rural areas providing mainly FP and some primary health care services. Using a one-tonne van equipped with a tent, an examination couch and pelvic examination equipment, a nurse visits a number of venues each month delivering these services. These mobile clinics provide clinic methods, treatment of minor ailments and providing back-up services to the community-based distributors operating within the catchment areas. 

Community-Based Distribution Programme
The CBD workers bring FP information and services to the  rural population. The bulk of the CBDs are employed by ZNFPC but some private companies and a non-governmental organization (NGO) named Population Services Zimbabwe, have started their own CBD projects serving also rural communities. The ZNFPC has a total of 760 CBDs covering the rural communities with an estimated population of two million women of reproductive age.
Management Features
Strategy: A number of community leadership workshops and seminars have already been conducted throughout the country to get support at the grassroots level.Community mobilization and participation have been identified as the cornerstone for the success of this strategy. 

Human Resource Management: The backbone of the Zimbabwean FP programme's service delivery is the community-based distribution (CBD) programme. The CBD workers bring FP information and services to the doorsteps of the rural population of Zimbabwe. The features of Zimbabwe CBD programme are:

  • selection and recruitment of CBD workers
  • CBD training
  • supervision
  • medical back-up to the CBD programme
  • record keeping
  • funding of the CBD programme
  • monitoring & evaluation