Abstract
A study was conducted in Buhera district, Zimbabwe, to estimate coverage of health services by relating routinely collected health statistics to census data. Buhera is a relatively underdeveloped district, with health services provided by a district hospital, 2 rural hospitals, 12 health centers and 50 mobile clinics. Data were collected concerning the number of individuals making outpatient visits, antenatal visits and vaccinations per month for each catchment area. Overall, there were 69 new outpatient visits/100 people in the catchment area per year. Several areas were found to have much lower rates, and this was linked to areas with high membership in the Apostolic Church, a group that forbids medical treatment. There were 43 new antenatal visits/100 pregnancies. Low rates were linked to areas with no female medical assistants. 32% of children under 1 year of age were vaccinated against measles. Low vaccination rates were linked to Apostolic Church membership. In a cluster survey, 36% of respondents cited religious beliefs as the reason for incomplete immunization. Routine health statistics were found to underestimate vaccination rates by 25%. This was attributed to incomplete recording and forms being lost. Analysis of routine data is believed to provide useful information that may allow identification of underserved areas and of barriers to health care utilization.
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