Health service utilization in Manicaland Province, Zimbabwe during the COVID-19 pandemic: results from a cross-sectional household survey

Abstract

Background The coronavirus disease 2019 (COVID-19) pandemic has impacted utilization of health care, especially in low-resource settings in Sub-Saharan Africa. Here, the current state of health care utilization in Manicaland Province, Zimbabwe during the COVID-19 pandemic was assessed. Methods Cross-sectional surveys were administered to randomly selected households in three districts in Manicaland Province, Zimbabwe from August to September 2020. Data on socio-demographic characteristics, utilization and perceptions of health facilities, and COVID-19 risk perceptions and impact were collected using a structured questionnaire administered to heads of households. Factors associated with health care utilization in the 4 weeks prior to the survey were identified using logistic regression. Findings Among the 542 respondents enrolled in the study, most were married or co-habiting, were employed, had attended secondary school or higher, and headed households with more than 4 members. About half (53.3%) of households reported visiting a health facility in the previous 4 weeks. The most cited barriers of service at health facilities were the unavailability of medicines, cost of services and waiting time see a provider. The multivariate logistic regression analysis indicated that the likelihood of health care utilization in the previous 4 weeks was higher among households with a respondent who was 55 years or older, had attended secondary school or higher, and was unemployed; and among households with a child under 5 years or a pregnant woman and located in Makoni or Mutare rural districts. Conclusions These findings indicate the need to improve quality of care by increasing the availability of essential medicines, removing financial barriers to health services, and reducing waiting times. Key factors such as age and education level of the head of household and the presence of vulnerable populations such as children and pregnant women in households should be considered when targeting health awareness and education to improve health service utilization during the pandemic.