Contextual Factors Undermining Community Health Worker Data Systems During Health Emergencies in Zimbabwe: A Cross-Cadre Survey Analysis
Abstract:
Community health workers (CHWs) are central to community surveillance and primary health care in Zimbabwe, yet the data systems supporting their work are especially vulnerable during epidemics, cyclones and other health emergencies. This study examined the contextual factors undermining the collection, transmission, verification and use of CHW data during health emergencies in Zimbabwe between 2018 and 2025 and identified priorities for strengthening system resilience. A cross-sectional, multi-cadre structured survey was administered through Kobo Toolbox to 142 respondents across eleven cadres spanning the community, facility, district and provincial levels of the health system. Respondents reported near-universal involvement in emergency-related data work (95.0%) and described data roles as clearly defined (89.3%), but only 67.1% could still transmit data when electricity or internet connectivity failed. Data collection was the most disrupted stage of the CHW data pathway (30.7%), and tools and devices (67.6%) together with power and connectivity (58.5%) were the factors most often blamed for undermining continuity. Only 33.6% rated emergency-specific training as adequate, and overall data timeliness and quality was rated good or very good by 48.6% of respondents, falling to 40% among community-level respondents. Respondents' priorities for the Ministry of Health and Child Care centred on infrastructure investment (32.9%) and workforce training (30.0%). The findings indicate that Zimbabwe's community health information system is broadly functional at its technical core but remains constrained at the point of community-level data capture, pointing to sequenced, practical investment priorities for strengthening emergency-responsive CHW data systems.References:
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