Abstract:

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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