Paediatric Surgery in Zimbabwe headed for better days

We were so pleased to learn of a paediatric surgical camp held in Mutate, Zimbabwe, earlier this month - which saw a total of 101 children receiving surgery. 

The five day camp, which was free, took place in Victoria Chitepo Provincial Hospital in Mutare; Zimbabwe's third most populous city.

The project directly follows the launch of Zimbabwe's first ever National Surgical Obstetric and Anaesthesia Strategy (NSOAS). Launched last month, Kids Operating Room, led by our Director for Africa Rosemary, were proud to be involved in the development of the strategy. 

Like many other parts of the country, Mutare faces various challenges surrounding access to healthcare. This camp, which focused on hernia surgeries, offered huge relief for many families who had been waiting years to receive this care.

Leading the camp was paediatric surgeon Dr Precious Mutambanengwe. She told us, “We have a huge surgical backlog - especially for children with hernias. We have over 1000, and more keep getting added monthly. We are desperate to cut down this waiting list. This is the first one camp focussed on paediatric hernia cases.”

Paediatric surgery in Zimbabwe shares similar challenges with many other African countries. Among them, a shortage of specialised paediatric surgeons, limited resources, and inadequate infrastructure. These issues contribute to a high burden of paediatric surgical conditions, a high rate of disease, and a high rate of deaths among children who require surgical intervention.

To provide timely, affordable, safe and quality surgical services, the Government of Zimbabwe in September 2022 launched its first five year plan of the National Surgical, Obstetric and Anaesthesia Strategy (NSOAS). The strategy aims to promote access to surgical services to district level, a positive move towards strengthening primary health care where 83% of surgical operations in the country happening at national and provincial hospitals. Additionally, the strategy purposes to address both infrastructure and equipment related gaps.

Dr Mutambanengwe acknowledged that the NSOAS is set to bring to paediatric surgery in the country - with this surgical camp being just the beginning. 

“There has been acknowledgement of the huge need in children for conditions like hernias and tonsillectomies. Most facilities lack infrastructure to cater for children and the specialists to carry out the operations. NSOAS was key in recruiting donors and partners and is the main reason it was possible to host this camp,” says the paediatric surgeon.

The five-year strategy has several key components intended to guide the development and implementation of policies and programs related to surgical, obstetric, and anaesthesia care.

The outcome with regards to Children’s Surgery will be monitored in its implementation by: 

i) Infrastructure: Number of Central hospitals with functional paediatric theatres with targets for 2023( 3),2024( 4),2025( 5) 

ii) Supplies: Number of Central Hospitals with adequate Surgical, Obstetric and Anaesthesia supplies for paediatric age 

iii)Workforce- Anaesthesia and surgical specialists per 100,000 population and/ one paediatric surgeon per 100k population 

iv) Service delivery for Paediatric age( 0-17yrs): Target is surgical volume per 100k operations per year; surgical cases cancelled versus total of scheduled cases; waiting time from diagnosis to treatment, theatre waiting time for electives, number of paediatric patients on theatre waiting list and surgical infection rate. All these targets and measurements will then inform interventions required for paediatric surgery healthcare in the country.

Zimbabwe was the fifth country in the Southern African Development Community (SADC) Region and ninth in Africa to develop and launch its NSOAS. However, it was the first country in Southern Africa to specifically single out paediatric surgery interventions in a national health strategy document. This follows the World Health Assembly 68.15 resolution which recognized the central role of surgery and anaesthesia care in achieving Universal Health Coverage. The strategy is aligned with Zimbabwe's national health policies and plans, and with global initiatives to improve surgical, obstetric, and anaesthesia care in low- and middle-income countries.

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