Abstract
BackgroundAccessibility of healthcare in rural areas is globally impeded by physical, material, human, financial and managerial resources and societal barriers in the healthcare system. Developing countries like Zimbabwe are significantly affected.AimThe aim of this article was to share the perspectives of nurses and healthcare users (HCUs) in the rural areas of Zimbabwe with regard to the accessibility of healthcare.SettingThe study was conducted at 45 rural health facilities in Chegutu district, Mashonaland West province and Masvingo district in Masvingo province, Zimbabwe.MethodsA self-administered questionnaire (for professional nurses) and a structured interview questionnaire (for HCUs) were utilised to gather data in a cross-sectional survey. Two districts were randomly sampled from 59 districts. All nurses working in 45 public health facilities in the selected two districts, who were willing and available to participate, were included. Ninety nurses participated in the study. The HCUs were selected through a multistage sampling technique. The sample size for HCUs was calculated by using Dobson’s formula, and 445 HCUs were included via convenience sampling.ResultsNurses reported challenges such as work overload because of staffing shortages (55%) and the supply of necessary medical drugs that lacked consistency in both the quantity and type ordered(46.7%). The challenges faced by HCUs included long distances from villages to health facilities (86%), unaffordability of transport costs and lack of access to medical drugs (59.95%), causing them to seek assistance from traditional healers (43%).ConclusionBoth the nurses and HCUs perceived grave challenges regarding access to health facilities, health workers and medical drugs, all of which are bound to have an impact on the health of communities in rural Zimbabwe.
Highlights
Accessibility of healthcare in rural areas is globally impeded by physical, material, human, financial and managerial resources and societal barriers in the healthcare system
The accessibility of healthcare services depends on the availability of physical materials, and human as well as financial resources, and the processes followed to ensure access to healthcare.[24]
Health workers are an essential part of the healthcare inputs (Systems Model) required to enhance access to healthcare.[36]. Both the nurses and healthcare users (HCUs) in this study reported access to health workers as the greatest challenge they face
Summary
Accessibility of healthcare in rural areas is globally impeded by physical, material, human, financial and managerial resources and societal barriers in the healthcare system. In developing countries like Zimbabwe, access to healthcare services is often influenced by long distances and travel times to health facilities, the availability of financial resources to travel or pay for care and the availability of medical drugs as well as competent healthcare workers.[3] For example, in Zimbabwe, people in rural areas often have to walk between 10 km and 50 km to access the nearest health facility.[3]. Access can be further impeded by a lack of infrastructure, such as dirty roads that are not maintained, resulting in poor road conditions and potholes that create barriers to transport.[4] In Zimbabwe, because of economic challenges, bridges that have collapsed because of rain are not repaired, hindering travelling of patients during critical times[5] and negatively affecting the timely delivery of medical drugs and medical supplies to rural health centres
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