**6. Conclusion**

We also note the importance of multisectoral engagement in emergency response and in particular, these reported recent cholera outbreaks. Multisectoral engagement is observed in the name of the cluster system during the cholera outbreak of 2008/2009, the civil protection committees at various levels led by the ministry of local government and the IACCH, all for the purposes of streamlining and coordinating the response. The success of controlling the cholera outbreaks is built upon functional multisectoral engagement. The Global Task Force on Cholera Control's Ending Cholera—A Global roadmap to 2030, recognizes multisectoral engagement as one of the three key axis for cholera control [30]. The key cholera drivers are largely known and most of them are outside the health sector. The tools for prevention and control of cholera outbreaks are also known to work and anchor on improving access to clean water and improving sanitation, improving community awareness and hygiene practices including the hand washing [10–13]. The health sector is mainly responsible for responding to outbreaks in terms of case management and surveillance. The requirement of multisectoral engagement becomes more important realizing the limitations of the health sector in cholera prevention efforts.

Over the years Zimbabwe has witnessed rapid response to, and reducing case fatality rates from, cholera. The investments made over the years to strengthen the health system partly explain this phenomenon given the fact that the cholera case fatality rate reflects the access to basic health care [31]. Availability of HRH, strengthened surveillance and improved availability of basic commodities have been realized over the years. The per capita expenditure on health increased from \$9 in 2009 to \$24 in 2015. Regarding retention of health workers, average in-post rate stands at 81% [32]. Indeed the Ebola viral diseases outbreak in West Africa brought to the fore the central role of strengthened health systems in responding to diseases

The presence of skilled rapid response teams, especially following the scale up of training following the 2008/2009 cholera outbreaks, as well as the recent training sessions in response to the typhoid outbreaks in Harare, has improved the capacity of health workers to manage epidemics. Health worker capacity for rapid detection and swift control of outbreaks is essential in emergency preparedness and response [34]. RRTs which are multidisciplinary teams ensure this takes place and where they are functional this has led to reduced mortality and shortened period for control [35]. The timing of activation of RRTs is also important for good

Correct information is necessary for the communities to take appropriate action to prevent infection or to get immediate assistance when they get infected [36, 37]. The sustained information dissemination through the district structures made the people**'s** perception of risk remain high and to quickly adopt responsible behaviors as advised. Majority of the population anywhere in Zimbabwe still remember and reminisce the events of 2008/2009 which left them devastated and hence are very responsive to behavior change communication messages. Lessons from the field show us that when inadequate information is given it may lead to information gaps allowing unorthodox sources to lead with misinformation resulting in panic or inappropriate actions [3]. On the other hand clear information dissemination on a regular basis from trusted sources has led to communities taking part in the response measures leading to rapid containment of epidemics as reported in Uganda during an EVD outbreak the

outcome for delayed activation may also lead to increased mortality.

outbreaks [3, 4, 33].

58 Current Issues in Global Health

Emergencies and in particular outbreaks of infectious hazards remain a global concern. The IHR (2005) together with other guiding documents on specific themes on emergency preparedness and response remain available to guide countries in building capacities for emergency preparedness and response. The capacity of countries to mount adequate response to control emergencies depend on the resilience of their health systems build upon organizational, community and individual resilience and to a large extent dependent health systems institutional capacities as defined by the WHO health systems building blocks.

Zimbabwe having gone through a period of economic difficulties, faced one of its worst ever cholera outbreaks, which resulted in high rates of infection and deaths. This being said the country managed to use this event as a stepping stone which has resulted in the country building resilience to mount adequate response to outbreaks in the recent years. Understandably, resilience is not an all or none event but a process with levels of attributes, and Zimbabwe continues to work towards achieving all resilience attributes. Other countries can learn from Zimbabwe's experience to build resilience.
