By Eugenie Muchetu

Harare ,(New Ziana)– As Zimbabwe grapples with rising non-communicable diseases (NCDs) alongside persistent infectious threats, health experts are calling for a strategic shift in the way the sector communicates with the public, arguing the current messaging, largely focused on signs and symptoms, is reactive and not sufficient for promoting long-term wellness.

Historically, health communication has centred on infection response, triggered by outbreaks, an approach which, while vital during emergencies, has left gaps in proactive education around lifestyle changes, early detection, and wellness.

Experts argue that prevention-focused messaging could empower communities, reduce disease burden, and ease pressure on the healthcare system. Lovemore Makurirofa, Information, Research and Evaluation Officer at the Cancer Association of Zimbabwe (CAZ) confirmed that programming has long been biased toward treatment rather than prevention.

“People are taught to seek care only when signs and symptoms appear—high fever and weak joints for malaria, rice watery diarrhoea for cholera. That is how we have conditioned the population: wait for a sign, then go to the clinic,” he said.

Such mindset, he noted, is reinforced from childhood and as such, there is need to reframe public health messaging around NCDs. “Even when encouraged to get screened for NCDs like cancer, hypertension or diabetes, many respond, “I’m fine—I feel healthy,” because they have been taught to seek care only when symptoms appear,” he said.

A Ministry of Health and Child Care (MOHCC) official who spoke on condition of anonymity for professional reasons concurred, noting that while symptom-based messaging has assisted communities recognize illness early, it has left gaps in prevention, lifestyle education, and awareness of environmental factors like sanitation and hygiene.

“The National Health Strategy (2021–2025) and National Development Strategy 1 (NDS1) provide a strong framework to address these gaps by ensuring that media campaigns balance symptom awareness with prevention-focused education. This will empower communities not only to know when to seek treatment but also how to protect and maintain their health,” he said.

The World Health Organization (WHO) underscores the importance of effective media communication, outlining six key standards, namely accessible, actionable, credible, relevant, timely, and understandable, for promoting healthier behaviours and driving policy change.

Itai Rusike, Executive Director of the Community Working Group on Health (CWGH), added that while campaigns mention prevention, communities often engage, “only when illness strikes and seek immediate relief before returning to risky behaviours like smoking, poor hygiene, and unsafe water use.”

Even after COVID-19, handwashing is neglected at home, work, and public spaces—many of which lack water, and the 2008–09 cholera outbreak in Chitungwiza, driven by failures in water and sanitation, exposed deeper systemic gaps. A 2022 policy brief co-authored by the CWGH calls for a “health for all, all for health” transformation, one that restores community decision-making and redesigns environments to support prevention.

The MOHCC official emphasized that preventive messages must use simple, clear language and local examples. “Practical steps like handwashing routines, balanced diets, or regular check-ups help turn information into habits that reduce disease risk,” he said, adding however, poverty, limited access to health services, cultural beliefs, and stigma often hinder adoption,” he said.

Rusike noted that screening is often seen as costly and inconvenient, especially when follow-up systems are weak yet, he argued, prevention saves money and lives, to which the MOHCC official agreed, noting that preventive measures reduce hospital admissions and medical expenses, easing pressure on an overstretched system.

Common misconceptions, fear of bad news, stigma, or the belief that check-ups are unnecessary, also discourage preventive care, while even free services face hidden costs like transport, child care or time off work when healthy, and addressing these barriers is key to improving uptake.

Makurirofa noted that early-stage NCDs often do not show symptoms, making proactive education essential and he advocated for increased resources toward outreach teams that can engage communities directly, encouraging clinic visits even in the absence of illness.

He stressed that changing public perception around non-communicable diseases requires more than just new messaging, it demands resources to undo years of conditioning. “This idea was taught and re-taught. When I present on cervical cancer and urge women to get screened, the first question is always, ‘What signs should I look for?’ They believe if they feel fine, screening isn’t necessary.”

Makurirofa said the mindset affects both women and men, noting that tests for blood pressure at workplaces would find people who need urgent care, but they would not go to hospital because they feel ‘fit.’ “They were taught to seek help only when something seems abnormal. That’s the message we must correct,” he said.

The MOHCC official added that regular check-ups help identify risks early, making treatment simpler and less costly, adding early detection prevents catastrophic health expenditure at individual and family level. He advocated for a “settings approach” to health promotion, delivering information and services through schools, workplaces, and community outreaches.

Zimbabwe is seeing a surge in NCDs like cancer, hypertension, and diabetes, many of which do not show early symptoms and by these appear, the disease would have already progressed.

Access to screenings remains a challenge, especially for low-income and rural communities, with free breast cancer screenings being rare and mostly urban, offered by the CAZ and other organisations during October, the Breast Cancer Month. Outside this period, the CAZ provides year-round exams at its Harare and Bulawayo centres for a nominal fee of US$5 with Mammograms costing between US$60 (for one breast) and US$120 (for two), depending on the facility, and these costs deter early detection.

Most people who undergo exams are covered by medical aid and for those paying out of pocket, the costs are prohibitive. While the examinations are vital, what Zimbabwe urgently needs is accessible screening services at the population level where people know exactly where to go for prostate, cervical, or breast cancer screening, and the centres should be available nationwide.

“We need designated screening centres, just like we have for HIV testing. That way, anyone who wants to be screened knows where to go,” said Makurirofa. Currently, prostate cancer screening is not available nationwide and cervical cancer remains the only NCD with a structured national screening program, and experts recommend that facilities offering cervical screening also provide breast exams.

“I think we’ll get there soon, but right now, cervical cancer is killing many women,” Makurirofa said. Despite gaps, Zimbabwe has made progress as Free Visual Inspection with Acetic Acid (VIAC) cervical screening is available at many rural, district and mission hospitals, supported by the government and partners.

In Harare, VIAC screening is offered free at council clinics, Wilkins Hospital and the Zimbabwe Family Planning Council at Spill House, while Pap smears, requiring lab processing, are not free, and expanding both methods across districts remains a priority.

Rusike noted that the health sector in Zimbabwe operates within a narrow legal remit where key social determinants namely water, sanitation and nutrition, fall under other agencies, and when these systems fail, the Health Ministry is left managing the fallout. He also critiqued the health training, which he said follows a Western biomedical model, and often sidelining holistic, community-based methods rooted in Traditional African Medicine.

With major funders like the Global Fund and USAID transitioning out by 2030, Rusike called for urgent reform to meet population growth and shifting disease patterns. The WHO recommends co-creating health content with community leaders, segmenting audiences by language and literacy, and integrating traditional and digital channels.

It also urges specialized training for journalists, rapid feedback loops, robust monitoring and above all, it emphasizes equity, translating materials into all national languages, including sign language.

The MOHCC official said campaigns should promote healthy living, not just illness response, with nutrition, physical activity, vaccination, hygiene, and early detection being central.

Yet media messaging in Zimbabwe often defaults to dramatic case counts, obscuring systemic issues like unsafe water and food insecurity while most information is in English, Shona, and Ndebele, excluding the other national languages.

The media can help normalize health monitoring, said the MOHCC official, adding that sharing relatable success stories, highlighting role models, and using interactive formats like radio call-ins or social media Questions & Answers can shift public perception. “Over time, consistent messaging helps communities see health monitoring as a normal positive habit rather than something only done when illness occurs,” he said.

Research shows that prevention-focused communication improves outcomes and that vaccination campaigns as well as community education have saved lives, especially from incurable viral diseases.

A paradigm shift is therefore needed, one that prioritizes health promotion from the grassroots where village health workers, schools, churches, and local leaders all play a role.

As Zimbabwe navigates shifting disease patterns and donor transitions, centering prevention in media messaging is essential as the difference between perpetual crisis response and resilient, community-driven wellness lies in the way health is communicated.

New Ziana