Online Reporter
Health Correspondent
For years, pregnant women in Zimbabwe’s districts faced a familiar fear: complications during childbirth often meant long delays in reaching central hospitals, putting both mothers and babies at risk. Today, that story is changing.
Through intensive mentorship and training programmes, district hospitals are now confidently managing complex obstetric and surgical cases, dramatically reducing referrals to central hospitals and saving lives.
“Before, most anaesthesia in district hospitals was handled by nurse anaesthetists. With their shortage, many emergency cases were delayed,” said Dr Fergus Tendai Mahumani, a lead mentor.
“Now, doctors — including general medical officers — are trained to work alongside nurses, providing safe spinal and general anaesthesia.”
Zimbabwe’s maternal mortality ratio (MMR) has significantly improved, dropping from 651 deaths per 100 000 live births in 2015 to 212 deaths according to the latest 2023–24 Zimbabwe Demographic and Health Survey (ZDHS). This represents a reduction of more than 60 percent over nearly a decade.
At one district hospital, a woman required an emergency Caesarean section but could not receive spinal anaesthesia due to low platelet levels. Thanks to the training, clinicians swiftly administered general anaesthesia locally, avoiding referral delays and saving both mother and child.
At St Luke’s Hospital, Dr Nesisa Ncube, a General Medical Officer, recalls the first time she applied her refreshed skills.
“A patient with severe antepartum haemorrhage needed general anaesthesia. I felt confident to act immediately. Previously, we would have waited for a specialist. This programme allows us to save lives right away.”
Dr Ncube was one of the doctors selected for intensive mentorship under Dr Mahumani at Mpilo Central Hospital, focusing on obstetrics and anaesthesia.
The week‑long training combined theory with hands‑on practice. On the first day, they practised spinal anaesthesia in maternity cases, reviewing dosages and equipment adjustments based on patient weight and height. In the following days, participants observed and performed more complex procedures — including gynaecology surgeries, general anaesthesia, rapid sequence induction, and managing emergencies such as failed intubation.
“This mentorship gave me the confidence to handle complicated cases back at St Luke’s,” Dr Ncube says.
“Patients with eclampsia, severe bleeding or conditions unsuitable for spinal anaesthesia can now receive safe, timely care locally.”
Since completing the training, the impact has been immediate: referrals to central hospitals have dropped dramatically, mothers and newborns are receiving life‑saving care close to home, and delays in critical procedures are minimised.
Mentorship programmes like this are transforming district hospitals into centres of excellence, proving that investing in skills and resources saves lives where it matters most.
Acting Medical Superintendent at St Luke’s Hospital, Dr Colleen Lihaka, highlights the results.
“Referrals have dropped from 82 in a single quarter to just 23. Last year we recorded one maternal death, but this year, thanks to mentorship programmes, follow‑up support and strengthened skills, we are proud to report zero maternal deaths.
Staff are more confident, better equipped, and able to manage complicated cases locally.”
Follow‑up mentorship visits have reinforced these skills, allowing staff to apply their knowledge confidently in real‑world scenarios, troubleshoot complex cases and strengthen teamwork across the hospital. Modern equipment provided through the Health Resilience Fund — including anaesthesia machines and neonatal resuscitation tools — has further enhanced the ability of district hospitals to respond to emergencies swiftly, saving both mothers and babies.
Hwange District has experienced similar progress. District Medical Officer Dr Fungai Musunami observes:
“Mentorship has empowered our GMOs to manage postpartum haemorrhage, ectopic pregnancies and other emergencies without referring patients. Delays are reduced, and more mothers survive.”
The programme’s success rests on hands‑on, context‑specific training. Mentorship is tailored to hospital resources: where general anaesthesia is limited, spinal anaesthesia is reinforced; in better‑equipped hospitals, general anaesthesia skills are strengthened.
Staff also learn to operate and troubleshoot anaesthetic machines, ensuring safety in every procedure.
Follow‑up visits reinforce skills in real‑world hospital settings, building long‑term capacity, teamwork and confidence.
“The vision is simple,” says Dr Mahumani.
“District clinicians should be competent and confident to provide life‑saving anaesthesia.
“No patient should be denied emergency surgery due to lack of anaesthesia services.”
Through mentorship, training, follow‑up and modern equipment, Zimbabwe’s district hospitals are no longer just first points of care — they are centres of excellence, where investing in skills and resources reduces referrals, lowers maternal mortality and restores health and dignity. This programme is being implemented by the Ministry of Health and Child Care and UNFPA, with support from Health Resilience Fund partners — Britain, Ireland and the European Union — proving that strong district‑level care saves lives where it matters most.
