[{"bbox": [85, 147, 1140, 636], "category": "Table", "text": "<table><tr><td></td><td></td><td></td><td></td><td>Policy dialogue with the government and UN partners for a proper retention scheme for medical and nursing staff. Policies to enhance recruitment and deployment with a gender lens</td></tr><tr><td>1</td><td>MSs initially committed to funding the HRF or TEI withdraw</td><td>Low</td><td>Low</td><td>Technical and financial monitoring of the implementation of the action will be a continuous process and transparency will be ensured. Donors will work closely with the MoHCC and ensure a sustainable exit strategy including increasing financial support for the HRF from the government.</td></tr><tr><td>2</td><td>More COVID-19 waves and limited vaccination</td><td>High</td><td>Medium</td><td>Government aims to vaccinate 60% of population by December 2021. Vaccine stocks are adequate but more measures are needed to be to address vaccine hesitancy. The government and partners have plans to address this and the EU is involved in policy dialogue.</td></tr></table>"}, {"bbox": [93, 698, 252, 721], "category": "Section-header", "text": "## Lessons Learnt:"}, {"bbox": [93, 723, 1132, 802], "category": "Text", "text": "In spring 2021, a UNICEF-initiated evaluation of the HDF concluded that the HDF's objectives and strategies were consistent with and relevant for Government of Zimbabwe's health sector policies and plans in terms of prioritizing and addressing community healthcare and nutrition needs."}, {"bbox": [93, 803, 1132, 935], "category": "Text", "text": "Over the past decade, health sector support through the HDF (and the predecessors Health Transition Fund/Extended Support Programme (ESP)) made significant gains in the financing, management and delivery of basic health services, including progress towards reducing user fees especially at primary health care (PHC) level; increasing availability of essential medicines and commodities; and increasing coverage (above 80%) of the community-based health care services through the establishment of community health workers nationwide."}, {"bbox": [93, 961, 1132, 1147], "category": "Text", "text": "The HDF succeeded, to some extent, to slow down the breakdown of the health system that had been underway since the early 2000s and that was significantly accelerated during the economic and financial crisis of 2007-2008. Notable progress on several key health indicators was achieved over the past decade. For example, between 2014 and 2019, maternal mortality decreased by 25% and under 5 mortality decreased by 3% (Multiple Indicator Cluster Survey - MICS 2019). Stunting declined from 32% in 2011 to 24% in 2019 (MICS, 2019). Between 2016 and 2021 over one million adolescents and youth were reached with sexual and reproductive health rights (SRHR) and HIV services in 20 targeted districts, which contributed to a reduction in adolescent pregnancies."}, {"bbox": [93, 1173, 1132, 1306], "category": "Text", "text": "The HDF accelerated innovative technology use for healthcare services, which did help improve results. For instance, the Village Health Worker (VHW) use of mobile application/devices for registration and reminders for mothers for antenatal and post-natal care did work in improved rates for antenatal care visits. Similarly, the online/remote specialist consultations (via phone - under mentorship interventions) proved useful, and merits replication wherever possible."}, {"bbox": [93, 1332, 1132, 1465], "category": "Text", "text": "In addition, the HDF provided DPs with a strong platform for engagement and influence in the sector. Benefits of the pooled fund have included avoidance of duplication of effort; the ability to strengthen the health system in coordination with other donors and the government; and the opportunity to use resources flexibly for emergency response while protecting essential services. For example funds were allocated for response interventions to health emergencies such as Cyclone Idai in 2019 and the COVID-19 pandemic."}, {"bbox": [93, 1491, 1132, 1598], "category": "Text", "text": "However, despite the success of the HDF and general improvements in health service delivery, a deeper investigation of health indicators shows a less satisfactory picture. The programme faced the challenge of a continuous outflow of trained healthcare workers (especially doctors & nurses) due to low salaries/compensation. This is causing serious disruption, impacting the quality of care, and is disproportionally affecting women."}, {"bbox": [603, 1637, 627, 1659], "category": "Page-footer", "text": "14"}]