On why the rural vote matters for Zimbabwe

On 30 July 2018, Zimbabwe will be getting to the polls to decide the leadership it entrusts to move its nation forward. In this short article, we re-iterate the significance of this election from a public health policy perspective, focusing on the health and well-being of the next generation. We briefly highlight the key and current statistics regarding child health outcomes (i.e. in terms of neonatal, infant, and under-five mortality). These child health outcomes, are globally considered essential markers of the overall health of a society (especially the infant mortality rate) as highlighted in the Sustainable Development Goal – # 3.

Neonatal mortality is the probability that an infant dies before reaching the age of one month while infant mortality is the probability that a child dies before reaching the age of one year (12 months). Under-five mortality on the other hand represents the likelihood of a child dying before celebrating their fifth birthday of life (i.e. dying before reaching the age of five years). Below, we provide a brief summary of the current state of our child mortality outcomes as extracted from the nationally representative Zimbabwe Demographic and Health Survey (ZDHS) 2015 report.

First, we show how child mortality has evolved over time since the 1980s for the country as a whole. The graph below is extracted from the ZDHS, 2015 report, and is shown as Figure 8.1 on page 132 of the report.

As the above figure shows, child mortality is still a big problem in Zimbabwe. Looking at neonatal and infant mortality, we can see that the current levels are actually worse than they were in the 1980s, which clearly signifies that we have not really progressed at all. For example, while 27 children for every 1,000 live births died within their first month of life in 1988, about 29 children per every 1,000 live births did not make it to their first month birthday in 2015. These statistics are still unacceptably high by any standards. Of course, looking at the data at the province level will reveal a completely different picture especially if we just focus on under-five mortality. Zooming into the data at the province level unmasks an even worrying and sad reality facing our very own children, the future of Zimbabwe.

Second, we show the distribution of under-five deaths across Zimbabwe’s ten provinces as reported in the 2015 ZDHS (i.e. figure 8.2 on page 133 of the ZDHS 2015 report).

The graph shows that, in terms of under-five mortality, the situation in the provinces is much dire. It is imperative to note that five of the ten provinces are well above the national under-five mortality average. For example, under-five mortality in Manicaland province stands at a staggering 112 deaths per 1,000 live births in 2015, a figure that is 62% above the national average. The question is why do we still have this many children dying before they even reach the age of five? If in some industrialized nations such as the United States for example, an under-five mortality rate of just 2.49 deaths per every 1,000 live births is considered totally unacceptable (Centres for Disease Control and Prevention), why should we (Zimbabwe) tolerate a child mortality rate that is about 30 times higher?

A careful review of the data also shows that child mortality is highly concentrated among Zimbabwe’s rural population (92 vs 60 deaths per every 1,000 live births in rural and urban, respectively) (see Table 8.2 on page 136 of the ZDHS 2015 report)  and among the very poor segments of the population. Given that about 60% or higher of Zimbabwe’s population resides in the rural areas, it is important that Zimbabwe vote wisely as we get to the polls. As can be seen from the figures above, the data suggests that, as a nation (in terms of child health), we are actually worse-off than we were more than 30 years ago. More specifically, the fact that our children are actually dying at a much faster rate before they even reach the age of 12 months than they did more than 30 years ago, before Zimbabwe’s Independence, speaks volumes and should not be acceptable.

From a public health policy perspective, we need the rural vote more than ever before, since we just cannot afford to continue on the above trajectories for child health outcomes. Children are the leaders of the future and any public policies that are not sensitive to the needs of this vulnerable and yet essential group is just not acceptable. This clearly highlights why the rural vote is so much pertinent, given that more than 60 percent of Zimbabwe's population resides here, the future of these children will be dictated by what the rural vote will decide. Now, is the time, Zimbabwe should awaken from its slumber, decide and be in control of its own destiny. If the premature (and otherwise preventable) deaths of many young and innocent children in  our beloved Zimbabwe does not move your heart and mind to at least vote wisely as a Zimbabwean citizen, then nothing will ever move you. Children are the future, and as such, deserve nothing but the very best of our care! A new and prosperous Zimbabwe is possible and must be judged on how best it will respond and address the delicate health needs of these children (what we call the voiceless). That is what we will call, in own humble opinions, a truly successful and progressive Zimbabwe, which is possible in our lifetime.

Website link for Marshall Makate: https://econmakfaraim.wordpress.com/ 
Website link for Tutsirai Sakutukwa: https://sites.google.com/site/tutsisakutukwa/home