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Outline of the Project

Project Name

Project for Quality Improvement of Health Service Through 5S-Kaizen-TQM approach




Republic of Zimbabwe

Date R/D Signed

Febrary 4, 2022

Term of Cooperation

May 2, 2022 - May 1, 2026

Implementing Organization

Ministry of Health and Child Care, Zimbabwe


In Zimbabwe, the mortality rates from infectious diseases such as HIV, tuberculosis, and malaria remain high; and non-communicable diseases are becoming the leading causes of death regardless of social class. Furthermore, premature birth, perinatal asphyxia, and septicemia account for 44% of the mortality for children aged under five. Improving health indicators is an urgent issue in order to achieve the Sustainable Development Goals (SDGs) by 2030 to reduce infant mortality rate and infection prevention of HIV/AIDS, malaria, and other diseases.

In this situation, the Ministry of Health and Child Care of Zimbabwe (hereinafter referred to as MOHCC) set a goal in the "National Health Strategy (2016-2020)" to improve access to quality medical health services for the Zimbabwean people by strengthening the health care system. Moreover, in the "National Development Strategy (2021-2025)" to improve healthcare services by strengthening access to primary health care, reducing and rationalizing the burden on patients.

In Zimbabwe, all public hospitals are categorized as follows: the primary level (clinics and rural health centers), the secondary level (district and mission hospitals), the tertiary level (provincial hospitals), and the quaternary level (central hospitals) - and, patients receive more specialized treatment at the upper level hospital.

However, since the 2000s, the quality of services provided in public hospitals has become a serious issue due to the economic downturn. There are many issues in providing healthcare services: the outflow of medical staff to foreign countries has become serious while they are not paid enough due to inflation. There is also a shortage of basic medical supplies and maintenance engineers and difficulty in procuring consumables and spare parts for medical equipment.

To improve this situation, Japan International Cooperation Agency (hereinafter referred to as JICA) has sent the experts to promote the introduction of 5S-KAIZEN-TQM Approach in improving the quality of healthcare services in public hospitals. As a result, 5S activities have been voluntarily implemented in some hospitals, and the achievements such as reducing the waiting time of the patients to receive healthcare services, have been observed.

For further improvement of quality of healthcare services with existing resources by the 5S-Kaizen-TQM Appraoch, MOHCC requested the Government of Japan for a project, hence.

The Overall Goal

Quality of health service in target hospitals is improved under the supervision of Ministry of Health and Child Care, Quality Assurance and Patient Safety Directorate (hereinafter referred to as QAPS Directorate)

Project Purpose

Capacity on hospital management of target hospitals is strengthened under the supervision of Ministry of Health and Child Care, QAPS Directorate


[Output 1] The ability to guide and supervise hospital management using the 5S-Kaizen-TQM method for each hospital of the Ministry of Health QAPS Directorate and the Provincial Health Directorate will be strengthened.

[Output 2] The 5S-Kaizen-TQM method will be introduced at the target central and provincial hospitals based on the operational guide, and the implementation of supervision system to improve hospital management will be strengthened.

Project Activities

[Activities for the output 1]

1-1 Revise a guideline (roles and procedures of related organizations) to spread the 5S-Kaizen-TQM method nationwide
1-2 Revise M&E tool (report format) based on the contents of the guideline and promotion of implementation (Report submission as self-monitoring from each hospital, Data analysis and annual report preparation by the MOHCC, Development of site visit guidance tool by MOHCC)
1-3 Develop and revise training modules (including teaching materials) for hospital management, QAPS Directorates, and Quality Improvement Team (hereinafter referred to as QIT) and Working Improvmenet Team (hereinafter referred to as WIT) members (practitioners) of each hospital
1-4 Conduct trainings based on Activity 1-3
1-5 Formulate a basic plan for monitoring supervision (hereinafter referred to as ""M&S"") in which the QAPS Directorate of MOHCC guides target hospitals and the Provincial Health Directorate guides provincial hospitals.
1-6 Implement a patrol guidance to target hospitals by the QAPS Directorate and the Provincial Health Executive and Central Hospital Executives2 (Technical support by the QAPS Directorate to target hospitals where activities are not progressing, monitoring reports from target hospitals, reflection in resource allocation for improving hospital management based on the results of the patrol guidance)
1-7 Develop information sharing tools between hospitals, such as annual plans for each target hospital, training for creating annual reports, and support project newsletter (Kaizen Newsletter).
1-8 Organize 5S-Kaizen-TQM Award Contest
1-9 Conduct workshops to share good practices at target hospitals with non-target public hospitals

[Activities for the output 2]

2-1 Evaluate current status and challenges of providing medical services at target hospitals
2-2 Conduct a baseline and regular survey on customer satisfaction at each hospital (target department)
2-3 Nominate key person in charge of 5S-Kaizen-TQM implementation with his/her roles and responsibilities at each hospital
2-4 Implement leadership trainings for Management Directorates of target hospitals and QIT/ WIT members
2-5 Implement 5S-Kaizen-TQM method training for target hospitals by the staff of the QAPS Directorate
2-6 Implement 5S and Kaizen activities that contribute to hospital management and self-monitoring review at each hospital
2-7 Share improved cases as good practices at each hospital


[Japanese side]

[Assignment of experts]

  • Chief Advisor/ 5S-Kaizen-TQM Promotion 1
  • Deputy Chief Advisor/ Hospital Management
  • 5S-Kaizen-TQM Promotion 2
  • Monitoring and Evaluation
  • Training Coordination

[Project operational cost]

  • Expenses at trainings, forums, etc
  • Project-related activity costs at intervention sites (medical facilities, etc.)


[Zimbabwe side]

[Project Counterpart]

  • MOHCC (QAPS Directorate): Project Director, Project Manager, and other officials of the directorate
  • Central and Provincial Hospitals
  • Provincial Medical Directorate Office

[Space, Equipment, etc.]

Office space for JICA experts; equipment and others necessary for the implementation of the Project

[Local expenses]

Other local expenses necessary for the implementation of the Project


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