TITLE:
The Impact of Political Reforms in Improving Quality Health Services: The Case Study of Shamva District
AUTHORS:
Olivia Gumbo
KEYWORDS:
Political Reforms, Health Services, Community Participation, Empowerment, Accountability
JOURNAL NAME:
Open Journal of Political Science,
Vol.9 No.2,
April
29,
2019
ABSTRACT: Zimbabweans continue to experience challenges in combating
communicable diseases such as tuberculosis, diarrheal diseases, and HIV/AIDS.
The country’s health sector decentralisation implementation is moving at a
snail’s speed, triggering complaints of unsatisfactory service delivery at
rural health centres. The study examined the impact of political reforms in
improving quality health services in Shamva District. The identified political
reforms were decentralisation and the second republic that emerged in November
2018 that embraced the 100-day plans approach, civil service reform agenda,
development of transitional stabilisation plan and vision 2030 agenda. The
study was guided by interpretive and critical post-modernist paradigms.
Qualitative methodology was utilised; key informant interviews, focus group discussion
and desk reviews were data generation tools that were utilised. The data
generated were analysed using grounded theory. The key findings are that
decentralisation enabled district health officials to interact with communities
through social accountability strategies such as community scorecard,
results-based financing and village health worker model that is implemented in Shamva District by Civil Society
Organisations. The second republic political reforms enforced the user fee
policy in the health sector and focused on improving primary health care. The
political reforms led to improved health rights knowledge of communities and
quality health services in Shamva District. The study concluded that lack of
continuous funding and sustainable plans led to the reversal of positive
results that were brought in by the political reforms. The major recommendation
is that government should understand that service delivery is not poor by
accident; rather it is a symptom of the underlying
institutional environment and political economy analysis should be done to
address the real blockages in health sector.