Empowered in the dark: How the Shasha Project is changing lives in Nyazura

By Edina Chido Chisadza

Loud music emanating from the numerous bars at the dusty Nyazura Business Centre, in Rusape District, Manicaland, fills the air as merry-makers enjoy themselves as if there is no tomorrow.

Among the revelers are many unemployed youths, finding solace in the so-called wise waters. They dance the night away with unbridled freedom. The joy spills onto the dusty streets of the small growth point, which are extremely dark.

Like most growth points and small towns in Zimbabwe, Nyazura has no street lights.

This doesn’t bother the revelers though.  

The growth point is a hive of activity despite the darkness, which is unsettling to visitors – this reporter included.

For some, the darkness is very handy, as it gives them good cover to do all sorts of heinous activities.

Among them is Monalisa Mutuma, a sex worker, whose livelihood is based on how many men she can bed in a night.

Monalisa, an average-built light-skinned woman, resides in the Old Location suburb of Nyazura.

A beautiful and confident woman, Monalisa has many stories to tell.

As a sex worker, she has faced a fair number of challenges, stigma included.

This is moreso in a generally conservative community like Nyazura. She talks about people twisting their faces in disgust on seeing her and their whispers – sharp as knives.

But it was not just the social isolation that threatened her well-being – it was also the lack of access to basic healthcare.

Contraceptives, a fundamental right for any woman, were a luxury she could ill afford. The local clinic, supposed to be a beacon of hope, offered little solace. The pills she so desperately needed were not provided for free, and yet she needed them as a sex worker.

“For my profession, condoms are like a safety shoe or a helmet for a construction worker, and yet I did not have ready access to them. I am however happy that this is a problem of the past,” she says with a broad smile.

Monalisa is one of the beneficiaries of the USAID funded Shasha project which is under implementation in her community until 2028. The project started in 2018 and was extended for five years in 2023.

The Shasha project is aimed at improving the health and well-being of women in Zimbabwe. It focuses on expanding health services and enhancing access to family planning education.

As part of this endeavor, the Shasha project, along with the Mhuri/Imuli II project, received a substantial funding boost of $25 million from USAID . This investment is expected to make a significant impact, reaching over 1.5 million women with essential services over a period of five years .

The Shasha project’s emphasis on family planning education and health services so as to address unique challenges faced by women in Zimbabwe. The project is helping to empower women and improve their overall quality of life.

The project has seen Monalisa and her fellow sex workers in Nyazura, access health education, and free contraceptives including condoms, which are vital for her trade.

“I no longer have to choose between my health and her livelihood. With the free condoms, I can breathe a sigh of relief, knowing that I am safe and my clients are safe,” she says.

Nyazura Clinic – Photo Credit: Edina Chido Chisadza

The contraceptives are available through Village Health Workers who have been trained under the Shasha and Mhuri Projects.

“As sex workers, we are thrilled about USAID’s initiatives,” Monalisa says. “We are now receiving free essential services at the local level, courtesy of our village health workers.

“Through our village health workers, we receive comprehensive training on female condom usage and access these essential services free of charge. Additionally, they instruct us on the proper use of short-term contraceptives and condoms to safeguard against sexually transmitted infections.

“Given our profession’s risks, they also offer emergency contraceptives and Pre-Exposure Prophylaxis (PrEP) as an extra precautionary measure,” she explained.

Monalisa Mutuma

Other Nyazura community members are equally excited about the coming in of the Shasha and Mhuri projects which have significantly changed the health status and awareness of the community.

“Before the USAID funded programs came to our community, accessing quality prenatal care and safe delivery services was nearly impossible for many of us,” said Natasha Chikono, a Nyazura rural resident.

Chikono said mothers and infants are benefitting immensely from the programme.

 “Now, my neighbours and I can visit our local health clinic and our village health workers, receive the care we need, and know that our children have a much stronger chance of surviving and thriving,” she noted.

Natasha Chikono

Nyazura villagers say the Mhuri project is wholesome.

In its effort to make a grassroots impact, USAID has ensured that its grantees train Village Health Workers who have become vital cogs of implementation.

Five Village Health Workers have been trained in Nyazura making, access to prenatal care easier for the community.

Violet Chiripinda, a dedicated Village Health Worker at Nyazura Clinic’s Ward 33, shared her enthusiasm about the training she received from the Mhuri project in 2018.

“Through this training, I gained valuable skills on community outreach, service delivery and confidentiality. Specifically, I learnt how to provide condoms, family planning pills, and other essential services while respecting community members’ privacy,” she explained.

“Young people, aged between18 and 25, have benefited greatly from this project. They now recognise the importance of knowing their health status, leading to a significant reduction in unplanned pregnancies in our community. Previously, unplanned pregnancies were rampant, but thanks to USAID and its partners, we have seen a remarkable improvement.”

Violet Chiripinda

Village Health Workers cover specific constituencies where people can come to their homes for assistance. The workers also do community outreach programs and door-to-door campaigns for awareness raising.

A nurse at Nyazura Rural Clinic, said the Mhuri and Shasha projects have been a game-changer for the local community.

“Prior to the project, Village Health Workers lacked the resources to provide essential services to their community. However, thanks to the initiative, Village Health Workers are now empowered to offer family planning services to community members,” said the nurse.

“This advancement not only increases access to healthcare but also eliminates costs for travel to and from the clinic, making quality care more convenient and affordable.

“Given the high unemployment rates in our area, these free services are desperately needed. The community is extremely appreciative of these initiatives, which are made possible through generous funding from USAID.”

The nurse emphasised that the initiatives had high demand from the community.

Health Service Delivery improvement statistics for Manicaland Province from 2019 – 2023

Dr Tendai Nyafesa, the District Medical Officer for Makoni District said maternal deaths had decreased in the district.

“We have a reduction of 30 to 40 percent in the maternal deaths in the previous years,” he said, attributing this to the effective training that health workers underwent through the technical assistance of FHI360 (A USAID partner).

The technical partner helped in capacity-building of health workers in management of obstetric which resulted in improvement of quality of health services from the primary and secondary level institutions of health.

Dr Nyafesa gave his insights on the training opportunities that arose from the implementation of the program.

“A lot of health workers including nurses and doctors were trained in the removal of long-term contraceptives,” he said.

“This project managed to involve everyone, targeting hard to reach facilities with all interventions. Everyone got assistance in terms of quality health provision and it was not concentrated in urban areas. It was in line with Vision 2030, there was equity and quality in health, leaving no one behind.”

However, Dr Knowledge Chipango, Shasha Project’s Chief of Party says brain drain was a challenge in the health sector. He said many health professionals trained under Shasha Project had left for greener pastures.

“A significant number of healthcare professionals are departing the public sector to join private institutions or emigrating in search of better opportunities,” he said.

“This exodus results in a shortage of essential skills required to deliver quality services. In the public sector, we often find that healthcare workers we train today are gone within three months, forcing us to start anew.”

Dr Chipango said the positive side was that the drain was a demonstration of the quality of health professionals that the project is producing.

Chiripinda said although the programme was a huge success, the shortage of some tools were hindering her effectiveness.

“I lack essential equipment, such as glucometers for blood sugar testing. Insufficient resources often lead to stock-outs, forcing clients to travel to clinics for services I could provide locally”, she said.

Dr Chipango said the project would reach 1.5 million clients by 2028 when it comes to an end.

The Shasha project is being implemented in Harare, Manicaland and Midlands provinces.

“In Harare we are only running outreach services, hoping to avert close to half a million unintended pregnancies. We are also looking at averting close to 2 000 maternal deaths.

“In this year alone, we already reached almost 40 000 people who have received family planning methods in their various forms,” said Dr Chipango.

At the end of Quarter 3 this year, Shasha Project, had trained 195 providers in various health sectors, among them community health workers.

The project carries on from the Mhuri/Imuli project, which was a five-year, (2018 – 2023) USAID funded project implemented by FHI 360.

It improved family planning services nationally and maternal, newborn, and child health (MNCH), malaria and Covid-19 outcomes in Manicaland province of Zimbabwe, including Nyazura.