Integrated Care for Hypertension, Diabetes and Depression in Zimbabwe


Image: Friendship Bench

The cities of Harare, Chitungwiza (30 kms south of Harare, the largest ‘high density’ township in Zimbabwe) and Gweru (capital of Midlands Province, 280 kms SW of Harare). The communities are served by 72 primary health care clinics (polyclinics, clinics and satellite clinics), from which nine have been selected for the initial diagnostic phase. 

Disease Prevalence

Hypertension is the commonest NCD, affecting around 30% of the adult population,1 and the prevalence of diabetes is rising rapidly.2 Both conditions are associated with obesity, also on the rise in urban settings. In PHC, treatment and control of hypertension is known to be sub-optimal.3,4,5 Friendship Bench, an innovative task-shifted psychological intervention provided by community health workers assigned to facilities has been scaled up across Harare, and is scheduled to be rolled out nationwide.6 NCD care (hypertension and diabetes) is provided in polyclinics in Harare by nurse practitioners running follow-up clinics with patient registries. There is currently no interaction between these services, with opportunities for integration around detection, case management, health promotion and disease prevention. 


  1. Mutowo MP, Mangwiro JC, Lorgelly P, et al. Hypertension in Zimbabwe: A meta-analysis to quantify its burden and policy implications. 2015; 3(1): 54-60. World J Meta-Anal 2015;3:54–60. doi:
  2. Mutowo M, Gowda U, Mangwiro JC, et al. Prevalence of diabetes in Zimbabwe: a systematic review with meta-analysis. Int J Public Health 2015;60:1–11. doi:
  3. Mungati M, Manangazira P, Takundwa L, et al. Factors affecting diagnosis and management of hypertension in Mazowe District of  Mashonaland Central Province in Zimbabwe: 2012. BMC Cardiovasc Disord 2014;14:102. doi:
  4. Goverwa TP, Masuka N, Tshimanga M, et al. Uncontrolled hypertension among hypertensive patients on treatment in Lupane District, Zimbabwe, 2012. BMC Res Notes 2014;7:703. doi:
  5. Basopo V, Mujasi PN. To what extent do prescribing practices for hypertension in the private sector in Zimbabwe follow the national treatment guidelines? An analysis of insurance medical claims. J Pharm Policy Pract 2017;10:37. doi:
  6. Chibanda D. Reducing the treatment gap for mental, neurological and substance use disorders in Africa: lessons from the Friendship Bench in Zimbabwe. Epidemiol Psychiatr Sci 2017;26:342–7. doi:10.1017/