Zimbabwe

The TB CAP program has now come to a close, it has been replaced by the TB CARE I program, to visit the TB CARE I Zimbabwe page please click here.

Zimbabwe is a land locked country situated in southern Africa covering 390,759 square km. Zimbabwe became independent in 1980, and the early years of independence were marked by impressive expansion of the social sectors, and (free of charge) 'health for all' was the motto of the day. The country was a net exporter of grain, tobacco and other agricultural products, had thriving mining and tourism industries and a relatively versatile industrial base. In the 1990's the national economic policy was strongly influenced by external pressures resulting in Economic Structural Adjustment Program which introduced, inter alia, health sector user fees at all health facilities but rural health centers. From 2000, the economy has declined substantially, resulting in serious inflation. In August 2008, the annual inflation rate was reported to be 11.3 million per cent. Infrastructure and food security have suffered significantly during the years of economical recession. In 2007/08 Zimbabwe's position in the Human Development Index ranking was 151 out of 177 countries.

Zimbabwe is ranked 20/22 among the high tuberculosis (TB) burden countries and a massive increase in the case load has been experienced since the 1990's, primarily due to the HIV epidemic. The reported incidence rates of all and sputum smear positive TB cases were 557/100,000 population and 227/100,000 population in 2006, respectively. Tuberculosis (TB) is the most common cause of death, particularly in age groups with high HIV prevalence (15-49 years).

TB CAP Project Period (2005-2010)

TB CAP has started working in Zimbabwe in 2008.
The long-term strategic approach of TB CAP is:

• To provide technical and financial support and assistance to the NTP central unit to strengthen its leadership and management capacity in critical areas of TB control in the country;
• To provide technical and financial support and assistance to TB control activities at the provincial, city, district, and health facility level, ensuring re-establishment of standard basic DOTS program management through capacity building and assurance of essential inputs;
• In the first year this will be done in one province and municipal health authority. Budget permitting and keeping lessons learned from the initial demonstration sites in mind, the intention is to roll out programmatic and operational support to other provinces and cities in the future years.
• To build NTP support on the existing structures, teams and systems of the HIV/AIDS/STI/TB unit and MoHCW, and with other national and international partners to avoid duplication and overlap, and ensure synergy and efficient collaboration with all stakeholders.

The main interventions proposed for this TB CAP project to Zimbabwe are:

B3.1 Strengthening leadership and management capacity for TB control and DOTS expansion at national, provincial, and city level (TB CAP IR 2)

• Facilitation of development of a TB control strategic plan and costed implementation plan
• Strengthening the national TB monitoring and evaluation system
• Introduction of Programmatic Management of Drug-resistant Tuberculosis (PMDT) concept
• Strengthening of TB laboratory services
• Supporting one province and municipal health authority in re-establishing and strengthening an effective DOTS program.

B3.2 Strengthening human resource capacity at service delivery levels (TB CAP IR 5)

• Development of national TB and TB/HIV course for health professionals in Zimbabwe
• Development of clinical TB/HIV course for medical and nursing staff
• Development of a national TB training plan.

B3.3 Strengthening TB/HIV scale-up (TB CAP IR 4)

• Support the functioning and outputs of the National TB/HIV Coordination Committee
• Ensure that collaborative TB/HIV activities are included into TB control strategic plan and the costed implementation plan.