Understanding Barriers to Utilization of Maternal and Childhood Services through Community Dialogue in the Context of Result Based Financing
Zimbabwe is implementing a Result Based Financing program
since 2011, which was designed to improve utilization of maternal and child health
services offered by public health facilities. Four years after the program inception,
reports of low vitamin A coverage and, high home deliveries are common. The study
sought to understand why there is still low uptake of maternal and child health
services. Using cases of Mazowe district health facility catchments, community dialogues
were employed to explore underlying causalities to low maternal and childhood health
services uptake. Qualitative data analysis methods of transcribing, organizing,
categorizing, and coding were used to sift themes and emerging issues. Out of 135
community leaders who participated in this study, we found poor accessibility of
health facilities (high transport cost, poor road network, long walking distance
and unavailability of outreach services), limited health service promotion, and
socio-cultural beliefs (clients linked early attendance for antenatal care with
abortion from bewitchment) as major barriers to health service utilization in the
study community. We also found dialoguing a good method to inform, educate and stimulate
collective responsibility towards improving health services uptake in our study
communities. We suggest that health programs in Zimbabwe should consider improving
accessibility of health facilities, promotion of health services and increase dialoguing
with communities on cultural barriers in order to increase the impact of Results
Based Health Financing Programs.
Keywords: Barriers, Utilization, Maternal and Childhood Services,
Community dialogue, Results Based Financing.
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