Abstract
This research study sought to identify the health service delivery challenges in urban areas using Mutare as a point of reference. Interviews, focus group discussions and observations were used to collect data from selected residents of Mutare city. Mutare city is experiencing poor service provisions and serious health service delivery challenges. This is witnessed by high doctor to patient ratio, high infant and maternal mortality rates as well as high incidences of malaria and other infectious diseases. The challenges are not limited to drugs and medical facilities, medical staff, transport, distance and referral mechanism, costs and financing of services culture and attitudes, corruption and bribery. Recommendations were made regarding the possible adjustment to existing health strategies and policies used in Zimbabwe, for the improvement of the health service delivery system of the city of Mutare. New strategies were also recommended for the improvement of the health system of the city. Lastly, some proposals were made for further research on the health service delivery challenges in rural areas so that comparisons are made to see whether the challenges are the same.
Highlights
According to the OECD (2010), all over the world cities face the most acute challenges of health service delivery because of fast increasing populations
The nurses-in-charge were all females while the ward councillors and the city health authorities were male dominated
Another female married in the age range [26-35] interviewed on health service conditions had this to say: “we are facing challenges in meeting nutritional needs for ourselves and the children because of the current economic situation.”. This shows that some residents are going without proper nutrition and is in line with Nembhard et al (2009) who reasoned that health service provision in many urban areas has been undermined by HIV/AIDS, poverty, economic decline, social inequalities as well as political discord and as a result, communities have experienced outbreaks of epidemics and declining service quality. Another male respondent of age range 65+ among the focus group discussions when asked about the health service conditions in the city had this to say: “We have to commute to our nearest clinics which are more than 5km from our usual places of residence”
Summary
According to the OECD (2010), all over the world cities face the most acute challenges of health service delivery because of fast increasing populations. City health authorities should in conjunction with the national and provincial governments address this problem and it is a crucial responsibility of the government and government institutions to deliver better public health services to the society. This will enable the society’s welfare to improve in line with the Millennium Development Goals (MDGs) number four (to reduce child mortality), number five (to promote maternal health), and number six (to combat HIV/AIDS, malaria and other diseases), (Zhou and Chilunjika, 2013). This study sought to empirically identify the health service delivery challenges in urban areas using Mutare city as point of reference
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