Strategies to enhance accessibility to health care in rural areas of Zimbabwe

Abstract

Background: Accessibility to health care in rural areas is globally impeded by physical, material, human, financial and managerial resources and societal barriers in the health care system. The Systems Model formed the backbone to developing a strategic action plan to address the challenges experienced by all stakeholders involved. Purpose: The purpose of this study was to describe accessibility to health care in rural areas to develop a strategic action plan to enhance accessibility to health care in these areas of Zimbabwe. Methods: A multiple methods approach combining qualitative and quantitative components during 4 phases. Phase 1 collected quantitative data with questionnaires from professional nurses and health care users who were conveniently sampled. Phase 2 collected qualitative data with a nominal group from national health directors who were conveniently sampled. Phase 3 was based on the findings from Phases 1 and 2 with a literature control to develop a draft strategic action plan. During phase 4 the strategic plan was amended and validated with a validation tool by members of the parliamentary portfolio committee on health in Zimbabwe with all-inclusive sampling. Framework: The Systems Model Framework was adopted for this study as outcomes and impact on people’s health is determined by inputs, processes and outputs. This model was relevant and applicable to accessibility to health care. Research findings: Accessibility to health care in rural areas of Zimbabwe is affected by inadequate distribution of physical resources, shortage of material and human resources, and a lack of financial resources. The strategies identified contributed to the strategic action plan which was amended and validated. The strategic action plan includes improving the health infrastructure, providing appropriate medical drugs, training and retention of health workers, providing medical equipment at the rural health facilities, reviewing the health worker workload and addressing staff shortages, providing free health care services in rural areas, and improving the capacity of the health care system. Conclusion: The strategic action plan was developed based on the inputs of the relevant stakeholders and the System Model. The inclusion of the parliamentary portfolio committee on health (members of parliament of Zimbabwe) might enhance the possibility for implementation which can enhance the accessibility to health care in rural areas of Zimbabwe.