Baseline report: Mhuri/Imuli Project

The project, which began in 2018 and will conclude in 2023, is a collaborative effort between FHI 360, the Ministry of Health and Child Care (MOHCC), and the Zimbabwe National Family Planning Council (ZNFPC) for countrywide FP service provision. Zimbabwe's maternal mortality ratio of 651 maternal deaths per 100,000 live births is significantly higher than global averages and is not on track to meet the Government of Zimbabwe's target of 300 maternal deaths per 100,000 live births by 2020. Despite progress made in improving Zimbabwe's MNCH and FP status, challenges persist, including limited access to facility-based services, cultural and religious beliefs that inhibit women from seeking services, and the apostolic sects' influence on women's health-seeking behaviors. A desk review of existing MNCH interventions in Manicaland province and FP activities nationally was conducted as part of the Mhuri/Imuli project's baseline assessment. The review involved data extraction from various sources, including national surveys, the national District Health Information System (DHIS2), national strategies, annual MOHCC reports, and reports from the Maternal, Newborn and Child Health Integrated Project (MCHIP), which was the predecessor project to Mhuri/Imuli. Data for Manicaland MNCH-FP indicators were disaggregated by district wherever possible, while FP, impact, and outcome level indicators were disaggregated by province where data was available. Data were summarized using frequencies, proportions, and presented in graphs and tables generated in Microsoft Excel. The results of the desk review indicate that Manicaland province's performance is lower than national averages for most MNCH-FP indicators. Manicaland province has the lowest modern contraceptive prevalence rate (mCPR) at 57%, with only 24% of women in Mutare District registering for antenatal care before 16 weeks, the lowest in the province. Additionally, only 60% of women in Manicaland attended all four ANC visits, and only 53% received the recommended three doses of IPTp, significantly lower than the national average of 81%. Manicaland province also has the third highest under-five mortality rate, the second-highest neonatal mortality, and the highest peri-natal mortality in Zimbabwe. BEmONC coverage in the province ranges from 0-6%, with no data available on facilities that provide five signal BEmONC functions. The results of the desk review highlight the need for targeted interventions to improve MNCH-FP outcomes in Manicaland province, including increasing access to facility-based services, addressing cultural and religious barriers, and improving the quality of care provided at health facilities.