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'''OVERVIEW''' | '''OVERVIEW''' | ||
In Zimbabwe, you will find a complex picture regarding sexual and reproductive health care. On the one hand, Zimbabwe has one of the highest rates of contraceptive usage in all of Africa. There are numerous HIV testing sites across the country, and many NGOs are actively working on issues related to HIV/AIDS prevention, condom access and women's health care. On the other hand, Zimbabwe is still recovering from a massive economic crisis that hit the country in the early 2000s. Most recently, the country has now found itself managing major political changes with the 2017 coup. In total, this has left the country in a difficult position, where it finds itself stretched thin and unable to fully manage the many different facets of sexual and reproductive health care in the country. While the government has partnered with NGOs to help deal with HIV/AIDS and cholera, it has not invested as much money and energy into developing resources for maternal health. There are also not enough physicians and gynecologists in the country.<ref>[https://www.fistulafoundation.org/countries-we-help/zimbabwe/ Fistula Foundation - Zimbabwe]</ref> As of 2017, Zimbabwe is a country that is in a state of deep transition. | |||
==Contraception (Birth Control)== | ==Contraception (Birth Control)== | ||
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Contraception is widely used in Zimbabwe and, in fact, Zimbabwean women have higher rates of contraceptive usage than nearly all other African countries, with the exception of [[Morocco]] and the island nations of [[Mauritius]] and [[Réunion]]. In Eastern Africa, Zimbabwe has the highest rate of contraceptive usage overall. However, it should be understood that not all Zimbabwean women have adequate access to contraceptives, and 11.4% of Zimbabwean women still have unmet family planning needs.<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use 2015]</ref> | Contraception is widely used in Zimbabwe and, in fact, Zimbabwean women have higher rates of contraceptive usage than nearly all other African countries, with the exception of [[Morocco]] and the island nations of [[Mauritius]] and [[Réunion]]. In Eastern Africa, Zimbabwe has the highest rate of contraceptive usage overall. However, it should be understood that not all Zimbabwean women have adequate access to contraceptives, and 11.4% of Zimbabwean women still have unmet family planning needs.<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use 2015]</ref> | ||
Women in Zimbabwe may not always have autonomy regarding health decisions. A United Nations report, released in 2019, found that only 57% of women in Zimbabwe were able to make their own choices regarding their reproductive health and rights (which include sexual intercourse with their partner, contraception use and health care).<ref>[https://www.chronicle.co.zw/only-60percent-of-zimbabwe-women-have-say-in-safer-sex-negotiations/ ‘Only 60percent of Zimbabwe women have say in safer sex negotiations’]</ref> | |||
For Zimbabwean women, the vast majority who use contraceptives tend to use birth control pills. According to a 2015 report, the most common forms of contraception for Zimbabwean women (who are married and of reproductive age) are birth control pills (42.8%), contraceptive injectables (8.8%) and contraceptive implants (8.2%). There are generally low rates of usage of condoms (3.2%), female sterilization (0.9%), IUDs (0.4%) and vaginal barrier methods (0.2%). The traditional family planning methods, such as withdrawal (0.6%) and rhythm method (0.2%), are extremely uncommon.<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use 2015]</ref> | For Zimbabwean women, the vast majority who use contraceptives tend to use birth control pills. According to a 2015 report, the most common forms of contraception for Zimbabwean women (who are married and of reproductive age) are birth control pills (42.8%), contraceptive injectables (8.8%) and contraceptive implants (8.2%). There are generally low rates of usage of condoms (3.2%), female sterilization (0.9%), IUDs (0.4%) and vaginal barrier methods (0.2%). The traditional family planning methods, such as withdrawal (0.6%) and rhythm method (0.2%), are extremely uncommon.<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use 2015]</ref> | ||
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* In Zimbabwe, '''condoms''' are sold by local shops and street vendors, government initiatives and social networking programs (such as Marie Stopes International, Population Services International and DKT International). They are also sold in front of clubs and beer halls in cities, such as Harare. The vendors who sell condoms at night report that many people feel more comfortable buying condoms from them than from the local shops, which can feel more public and exposed.<ref>[http://www.thezimbabwean.co/2015/05/people-shun-free-condoms/ The Zimbabwean: People shun free condoms]</ref> Some night club bathrooms also have free condoms, which come in blue colors. Finally, while it's a more expensive option, condoms can also be purchased online and delivered to a Zimbabwe address. For example, you can [https://www.caretobeauty.com/zw/condoms/ buy Durex condoms from the Care to Beauty website]. | * In Zimbabwe, '''condoms''' are sold by local shops and street vendors, government initiatives and social networking programs (such as Marie Stopes International, Population Services International and DKT International). They are also sold in front of clubs and beer halls in cities, such as Harare. The vendors who sell condoms at night report that many people feel more comfortable buying condoms from them than from the local shops, which can feel more public and exposed.<ref>[http://www.thezimbabwean.co/2015/05/people-shun-free-condoms/ The Zimbabwean: People shun free condoms]</ref> Some night club bathrooms also have free condoms, which come in blue colors. Finally, while it's a more expensive option, condoms can also be purchased online and delivered to a Zimbabwe address. For example, you can [https://www.caretobeauty.com/zw/condoms/ buy Durex condoms from the Care to Beauty website]. | ||
* In Zimbabwe, you can find '''birth control pills''' at pharmacies, clinics and social networking programs (such as Marie Stopes International, Population Services International and DKT International). You need a prescription to access birth control pills. Some of the birth control brands you may find in Zimbabwe are brands called Safe or Control, which are distributed by local NGOs and sold at pharmacies and health centers. You may also find Microgynon (which is not sold in most pharmacies, but is certainly sold in some, such as Booties Pharmacy), Ovidon, Ovral, Lo-Femenal, Nordette and Rigevidon. One Harare pharmacy reported carrying pills called 'Control' and 'Secure,' which sold for about $1 per packs of two. | * In Zimbabwe, you can find '''birth control pills''' at pharmacies, clinics and social networking programs (such as Marie Stopes International, Population Services International and DKT International). You need a prescription to access birth control pills. Some of the birth control brands you may find in Zimbabwe are brands called Safe or Control, which are distributed by local NGOs and sold at pharmacies and health centers. You may also find Microgynon (which is not sold in most pharmacies, but is certainly sold in some, such as Booties Pharmacy), Ovidon, Ovral, Lo-Femenal, Nordette and Rigevidon. One Harare pharmacy reported carrying pills called 'Control' and 'Secure,' which sold for about $1 per packs of two. | ||
* At Chisipite Medical & Dental Centre, contraceptive injectables (Depo-Provera) are $10 and implants (Norplant, Implanon, etc) are $50 for insertion and $30 for removal, as of December 2017. These price quotes came directly from the medical centre. | |||
===Costs=== | ===Costs=== | ||
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Generally speaking, Zimbabwe is considered to have a "high prevalence" of HIV. In 2016, it was estimated that 13.5% of the population was living with HIV/AIDS and that 74% of infected adults were on antiretroviral treatment. The most common form of transmission was unprotected heterosexual sex.<ref>[https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/zimbabwe Avert: HIV/AIDS in Zimbabwe]</ref> However, certain populations experienced higher rates of infections, including sex workers (57.1% infection rate), men who have sex with men (also known as "MSM") and prisoners (28% infection rate).<ref>[http://www.unaids.org/en/regionscountries/countries/zimbabwe UNAIDS - Zimbabwe]</ref> When sex workers or MSM have sought out treatment or care for HIV in Zimbabwe, especially when they have developed efforts specifically to serve their communities, they have often encountered barriers, including intimidation, arrests and condom confiscation from police. Sex work and homosexuality are illegal in Zimbabwe, and police often respond with intimidation and arrests.<ref>[https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/zimbabwe Avert: HIV/AIDS in Zimbabwe]</ref> | Generally speaking, Zimbabwe is considered to have a "high prevalence" of HIV. In 2016, it was estimated that 13.5% of the population was living with HIV/AIDS and that 74% of infected adults were on antiretroviral treatment. The most common form of transmission was unprotected heterosexual sex.<ref>[https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/zimbabwe Avert: HIV/AIDS in Zimbabwe]</ref> However, certain populations experienced higher rates of infections, including sex workers (57.1% infection rate), men who have sex with men (also known as "MSM") and prisoners (28% infection rate).<ref>[http://www.unaids.org/en/regionscountries/countries/zimbabwe UNAIDS - Zimbabwe]</ref> When sex workers or MSM have sought out treatment or care for HIV in Zimbabwe, especially when they have developed efforts specifically to serve their communities, they have often encountered barriers, including intimidation, arrests and condom confiscation from police. Sex work and homosexuality are illegal in Zimbabwe, and police often respond with intimidation and arrests.<ref>[https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/zimbabwe Avert: HIV/AIDS in Zimbabwe]</ref> | ||
For women in Zimbabwe, STI prevention can be difficult, who often encounter gender inequality in marriages in relationships. For example, only 68% of Zimbabwean men believe that women have the right to refuse intercourse if they know the man is having sex with other women. Furthermore, only 8 out of 10 Zimbabwean women believe that they have the right to ask their partner to use a condom if the partner has a sexually-transmitted disease.<ref>[https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/zimbabwe Avert: HIV/AIDS in Zimbabwe]</ref> | For women in Zimbabwe, STI prevention can be difficult, who often encounter gender inequality in marriages and in relationships. For example, only 68% of Zimbabwean men believe that women have the right to refuse intercourse if they know the man is having sex with other women. Furthermore, only 8 out of 10 Zimbabwean women believe that they have the right to ask their partner to use a condom if the partner has a sexually-transmitted disease.<ref>[https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/zimbabwe Avert: HIV/AIDS in Zimbabwe]</ref> | ||
In Zimbabwe, HIV transmission rates have been dropping -- for example, 79,000 people contracted HIV in 2010 compared to 40,000 in 2016. Furthermore, the number of people who have died due to AIDS-related illness has also declined in recent years. However, HIV/AIDS remains a serious issue for the country. Currently, the majority of HIV expenditures in the country (an estimated 75%) | In Zimbabwe, HIV transmission rates have been dropping -- for example, 79,000 people contracted HIV in 2010 compared to 40,000 in 2016. Furthermore, the number of people who have died due to AIDS-related illness has also declined in recent years. However, HIV/AIDS remains a serious issue for the country. Currently, the majority of HIV expenditures in the country (an estimated 75%) come from international donors.<ref>[https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/zimbabwe Avert: HIV/AIDS in Zimbabwe]</ref> | ||
===Testing Facilities=== | ===Testing Facilities=== | ||
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* The Zimbabwean government is also supposed to be distributing free self-test kits to people. This work is in coordination with UNITAID, a global health initiative based out of Switzerland, and other African countries, such as Malawi, South Africa and Zimbabwe, are also taking part in the initiative. To learn more about the free self-test kits, click [https://www.voanews.com/a/zimbabwe-hiv-aids-self-testing/3214465.html here]. | * The Zimbabwean government is also supposed to be distributing free self-test kits to people. This work is in coordination with UNITAID, a global health initiative based out of Switzerland, and other African countries, such as Malawi, South Africa and Zimbabwe, are also taking part in the initiative. To learn more about the free self-test kits, click [https://www.voanews.com/a/zimbabwe-hiv-aids-self-testing/3214465.html here]. | ||
====Mobile Testing Facilities=== | ====Mobile Testing Facilities==== | ||
* The Ministry of Health has set up mobile testing facilities. They visit schools and testing centers in clinics. However, there has been past criticism of these mobile testing facilities not being youth friendly in the past.<ref>[https://reliefweb.int/report/zimbabwe/fear-hiv-testing-among-zimbabwe-s-teens Fear of HIV Testing Among Zimbabwe’s Teens]</ref> | * The Ministry of Health has set up mobile testing facilities. They visit schools and testing centers in clinics. However, there has been past criticism of these mobile testing facilities not being youth friendly in the past.<ref>[https://reliefweb.int/report/zimbabwe/fear-hiv-testing-among-zimbabwe-s-teens Fear of HIV Testing Among Zimbabwe’s Teens]</ref> | ||
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====Public Councils & NGOs==== | ====Public Councils & NGOs==== | ||
''' | '''Note:''' It is estimated that about over 1600 facilities provide free integrated HIV testing and counseling in Zimbabwe.<ref>[http://www.sundaymail.co.zw/story-3/ | ||
HIV self-testing kits get green light]</ref> Below, we have listed some NGOs, clinics and centers that provide free or low-cost testing. However, this is just a small glimpse into the options available, which are wide-ranging and extensive. | HIV self-testing kits get green light]</ref> Below, we have listed some NGOs, clinics and centers that provide free or low-cost testing. However, this is just a small glimpse into the options available, which are wide-ranging and extensive. | ||
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* '''Pre-Exposure Prophylaxis (PrEP)''' is available in Zimbabwe, and there are an estimated 1,500 - 2,000 users. One of the distributors is [http://www.psi.org/country/zimbabwe-2/#about Population Services Zimbabwe]. To learn more information about PrEP access in Zimbabwe, click [https://www.prepwatch.org/zimbabwe/ here] and [http://www.herald.co.zw/zim-to-roll-out-pre-exposure-hiv-pill/ here]. | |||
* '''Post-Exposure Prophylaxis (PEP)''' is available by prescription in Zimbabwe,<ref>[http://www.b-metro.co.zw/understanding-post-exposure-prophylaxis/ Understanding Post Exposure Prophylaxis]</ref>, so one should visit a clinic or physician if that person is interested in obtaining PEP. To learn more information about PEP options in Zimbabwe, you can contact [http://nac.org.zw/ National AIDS Council] or [http://www.psi.org/country/zimbabwe-2/#about Population Services Zimbabwe]. | |||
===Costs=== | ===Costs=== | ||
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===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
Pads, tampons and menstrual cups are available in Zimbabwe. However, there are social stigmas against tampons, which are incorrectly believed to break the hymen or damage the "purity" or virginity of young women. For this reason, tampon use is opposed to by many mothers of young girls and unmarried women. | |||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* You can find '''pads/pantyliners''' in Zimbabwean cities, such as Harare. | |||
* You can find '''tampons''', especially tampons without applicators, in Zimbabwean cities, such as Harare. The tampons sold in general stores are not very affordable for many Zimbabwean women, as they typically run at about $4.10 per pack.<ref>[https://www.expatistan.com/price/tampax/harare Expatistan - Tampons, Harare]</ref> However, some clinics and NGOs may provide menstrual products for free or a reduced price to locals in need of more affordable options. | |||
* If you want a '''menstrual cup''', there are some local sellers and producers in Zimbabwe. For example, the [http://www.thebutterflycup.co.zw/ Butterfly Cup] is a menstrual cup company, based out of Harare. They can be reached by phone (Call +263 77 329 2606), email (hello@thebutterflycup.co.zw) or [https://www.facebook.com/thebutterflycupco/ Facebook]. | |||
===Costs=== | ===Costs=== | ||
* The Butterfly Menstrual Cup is $15 USD (as of November 2017). | |||
==Gynecological Exams== | ==Gynecological Exams== | ||
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* [http://wellwomanclinic.co.zw/ Well Woman Clinic]: Recommended by a Harare local. The practitioners have been trained in a variety of countries, including Zimbabwe, South Africa, Germany and | * [http://wellwomanclinic.co.zw/ Well Woman Clinic]: Recommended by a Harare local. The practitioners have been trained in a variety of countries, including Zimbabwe, South Africa, Germany and the USA. "General practitioners, with a specific interest in woman’s health, will see patients for the whole range of women’s health problems including Pap Smears, HRT, Osteoporosis etc." 18 East Road, Avondale, Harare, Zimbabwe. Tel: (+263) 4 796 492/3/4/6. Fax: (+263) 4 704 200. Email: wellwoman@zol.co.zw | ||
* Dr Djordjevic: Address: 11 Dunkirk Drive, Alexandra Park, Harare. +263 77 701 9485 | * Dr Djordjevic: Address: 11 Dunkirk Drive, Alexandra Park, Harare. +263 77 701 9485 | ||
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===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
In Zimbabwe, employees are legally entitled to 98 days of paid maternity leave after a year of employment.<ref>[https://mywage.org/zimbabwe/main/decent-work-check/maternity-and-work/maternity-leave Zimbabwe - Maternity Leave]</ref> <ref>[https://mywage.org/zimbabwe/main/decent-work-check/maternity-and-work Zimbabwe - Maternity & Work]</ref> <ref>[http://www.ilo.org/wcmsp5/groups/public/---dgreports/---dcomm/---publ/documents/publication/wcms_242615.pdf Maternity and paternity at work – Law and practice across the world]</ref> However, many women may work for businesses that do not comply with the laws, or they may run their own small businesses and have difficulty taking this time off work. | |||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
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===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
In Zimbabwe, abortion is only permitted in certain cases, which are the following: if the pregnancy endangers the life or physical health of the woman, if the pregnancy is the result of rape or incest, or if the fetus has a serious risk of impairment.<ref>[https://www.womenonwaves.org/en/page/2797/zimbabwe Women on Waves: Zimbabwe]</ref> In all other cases, abortion is illegal. In order for an abortion to be legal, it must be performed in specific institutions that are designated for abortions. Furthermore, the superintendent of the institution must approve of the abortion. | In Zimbabwe, abortion is only permitted in certain cases, which are the following: if the pregnancy endangers the life or physical health of the woman, if the pregnancy is the result of rape or incest, or if the fetus has a serious risk of impairment.<ref>[https://www.womenonwaves.org/en/page/2797/zimbabwe Women on Waves: Zimbabwe]</ref> In all other cases, abortion is illegal. In order for an abortion to be legal, it must be performed in specific institutions that are designated for abortions. Furthermore, the superintendent of the institution must approve of the abortion. | ||
For more information, you can read a report from the Guttmacher Institute: [https://www.guttmacher.org/article/2018/10/abortion-zimbabwe-national-study-incidence-induced-abortion-unintended-pregnancy-and Abortion in Zimbabwe: A National Study of the Incidence of Induced Abortion, Unintended Pregnancy and Post-Abortion Care in 2016] | |||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* Emergency Phone: 999 | |||
* Ambulance Phone: 994 | |||
* Police Phone: 995 | |||
* Fire Department Phone: 993 | |||
====Police Contacts==== | |||
* Harare Police Emergency|(+ 263 4) 995** | |||
* Police Central|(+263 4) 748836/77651** | |||
* Police Avondale|(+263 4) 336632** | |||
* Police Borrowdale|(+263 4) 860067/61** | |||
* Police Highlands|(+263 4) 495304/495504** | |||
* Police Mabelreign|(+263 4) 336000** | |||
* Police Milton Park|(+263 4) 799298/708113** | |||
====Children in Need of Help==== | |||
* Childline 23 hours toll free helpline to children and families|(+263 4) 796741/793715** | |||
* Emergencies only|(+263 772) 221921** | |||
====24-Hour Emergency Rooms==== | |||
* Belvedere Medical Centre, 740196/236, 189 Samora Machel Avenue , Harare | |||
* Emergency Medical Centre, Corporate 24, (04) 700401 , 6 Bath Road Belgravia, Harare | |||
* RMC - Rockfoundation Medical Centre, (04) 338879 | Mobile: 0774812484, 92 Norfolk Road, Mount Pleasant, Harare | |||
* Traffic Police, 0772 859 253 or 0772763066, Harare | |||
* Trauma Centre & Hospital, (04) 700667, 778470084, 15 Lanark Road, Belgravia, Harare | |||
For more information on emergency phone numbers and contacts, click [http://www.finditfast.co.zw/listing/emergency-numbers.html here]. | |||
===Costs=== | ===Costs=== | ||
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==List of Additional Resources== | ==List of Additional Resources== | ||
* PSI Zimbabwe: "Since 1996, PSI/Zimbabwe has collaborated with the Ministry of Health and Child Care (MoHCC) to develop, market and scale health innovations which empower families to lead healthier lives." Program Office - PSI/Zimbabwe, Block E, Emerald Office Park, 30 The Chase West, Emerald Hill, Harare, Zimbabwe. Phone: + 263-4-334-631. Fax: + 263-4-339-632. Email: info@psi.org.zw-zim.co.zw | * To learn about LGBT laws and rights in Zimbabwe, click [http://www.equaldex.com/region/zimbabwe here]. | ||
* Association Of Women's Clubs (AWC) Of Zimbabwe: Sekai Holland, 11 Kent Avenue, Avondale, Harare. Tel: (263-4) 304471/2. E-mail: sekaiholland@mango.zw | * [http://www.psi.org/country/zimbabwe-2/#about PSI Zimbabwe]: "Since 1996, PSI/Zimbabwe has collaborated with the Ministry of Health and Child Care (MoHCC) to develop, market and scale health innovations which empower families to lead healthier lives." Program Office - PSI/Zimbabwe, Block E, Emerald Office Park, 30 The Chase West, Emerald Hill, Harare, Zimbabwe. Phone: + 263-4-334-631. Fax: + 263-4-339-632. Email: info@psi.org.zw-zim.co.zw | ||
* [https://www.oxfamamerica.org/explore/stories/feeding-zimbabwe-association-of-womens-clubs/ Association Of Women's Clubs (AWC) Of Zimbabwe]: This group is partnered with Oxfam and primarily works in rural parts of the country. Address: Sekai Holland, 11 Kent Avenue, Avondale, Harare. Tel: (263-4) 304471/2. E-mail: sekaiholland@mango.zw | |||
* Department Of Women's Affairs: Ministry of National Affairs, Employment Creation and Co-operatives, Physical: ZANU(PF) Headquarters off Rotten Row/Samora Machel Ave, Harare, Postal: Private Bag 7762, Causeway, Harare, Zimbabwe, Tel 263-4-753284/753289/774172, Fax (263-4) 774194. | * Department Of Women's Affairs: Ministry of National Affairs, Employment Creation and Co-operatives, Physical: ZANU(PF) Headquarters off Rotten Row/Samora Machel Ave, Harare, Postal: Private Bag 7762, Causeway, Harare, Zimbabwe, Tel 263-4-753284/753289/774172, Fax (263-4) 774194. | ||
* Federation Of African Media Women (FAMWZ): 1st Floor Katenga House, 19 Selous Avenue, Harare, Zimbabwe, Tel (263-4) 738893/4 | * Federation Of African Media Women (FAMWZ): 1st Floor Katenga House, 19 Selous Avenue, Harare, Zimbabwe, Tel (263-4) 738893/4 | ||
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