TY - JOUR
T1 - Human resource for health reform in peri-urban areas
T2 - A cross-sectional study of the impact of policy interventions on healthcare workers in Epworth, Zimbabwe
AU - Taderera, Bernard Hope
AU - Hendricks, Stephen James Heinrich
AU - Pillay, Yogan
N1 - Funding Information:
The authors acknowledge the contributions of the School of Health System and Public Health, Faculty of Health Sciences, University of Pretoria, towards this study. We are most grateful to the African Doctoral Dissertation Research Fellowship Award (ADDRF 2015-2017 ADF 002) offered by the African Population and Health Research Centre in partnership with the International Development Research Centre which made this research possible. We are also grateful to the University of Pretoria Postgraduate Research Bursary (10443925) which also made this study possible. Our gratitude is also extended to the Ministry of Health and Child Care, Health Services Board of Zimbabwe, Provincial Medical Directorate of Mashonaland East and the Seke District Medical Office, Epworth Local Board, and Epworth community for their contribution to this study.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/12/16
Y1 - 2017/12/16
N2 - Background: The need to understand how healthcare worker reform policy interventions impact health personnel in peri-urban areas is important as it also contributes towards setting of priorities in pursuing the universal health coverage goal of health sector reform. This study explored the impact of post 2008 human resource for health reform policy interventions on healthcare workers in Epworth, a peri-urban community in Harare, Zimbabwe, and the implications towards health sector reform policy in peri-urban areas. Methods: The study design was exploratory and cross-sectional and involved the use of qualitative and quantitative methods in data collection, presentation, and analysis. A qualitative study in which data were collected through a documentary search, five key informant interviews, seven in-depth interviews, and five focus group discussions was carried out first. This was followed by a quantitative study in which data were collected through a documentary search and 87 semi-structured sample interviews with healthcare workers. Qualitative data were analyzed thematically whilst descriptive statistics were used to examine quantitative data. All data were integrated during analysis to ensure comprehensive, reliable, and valid analysis of the dataset. Results: Three main factors were identified to help interpret findings. The first main factor consisted policy result areas that impacted most successfully on healthcare workers. These included the deployment of community health workers with the highest correlation of 0.83. Policy result areas in the second main factor included financial incentives with a correlation of 0.79, training and development (0.77), deployment (0.77), and non-financial incentives (0.75). The third factor consisted policy result areas that had the lowest satisfaction amongst healthcare workers in Epworth. These included safety (0.72), equipment and tools of trade (0.72), health welfare (0.65), and salaries (0.55). Conclusions: The deployment of community health volunteers impacted healthcare workers most successfully. This was followed by salary top-up allowances, training, deployment, and non-financial incentives. However, health personnel were least satisfied with their salaries. This had negative implications towards health sector reform interventions in Epworth peri-urban community between 2009 and 2014.
AB - Background: The need to understand how healthcare worker reform policy interventions impact health personnel in peri-urban areas is important as it also contributes towards setting of priorities in pursuing the universal health coverage goal of health sector reform. This study explored the impact of post 2008 human resource for health reform policy interventions on healthcare workers in Epworth, a peri-urban community in Harare, Zimbabwe, and the implications towards health sector reform policy in peri-urban areas. Methods: The study design was exploratory and cross-sectional and involved the use of qualitative and quantitative methods in data collection, presentation, and analysis. A qualitative study in which data were collected through a documentary search, five key informant interviews, seven in-depth interviews, and five focus group discussions was carried out first. This was followed by a quantitative study in which data were collected through a documentary search and 87 semi-structured sample interviews with healthcare workers. Qualitative data were analyzed thematically whilst descriptive statistics were used to examine quantitative data. All data were integrated during analysis to ensure comprehensive, reliable, and valid analysis of the dataset. Results: Three main factors were identified to help interpret findings. The first main factor consisted policy result areas that impacted most successfully on healthcare workers. These included the deployment of community health workers with the highest correlation of 0.83. Policy result areas in the second main factor included financial incentives with a correlation of 0.79, training and development (0.77), deployment (0.77), and non-financial incentives (0.75). The third factor consisted policy result areas that had the lowest satisfaction amongst healthcare workers in Epworth. These included safety (0.72), equipment and tools of trade (0.72), health welfare (0.65), and salaries (0.55). Conclusions: The deployment of community health volunteers impacted healthcare workers most successfully. This was followed by salary top-up allowances, training, deployment, and non-financial incentives. However, health personnel were least satisfied with their salaries. This had negative implications towards health sector reform interventions in Epworth peri-urban community between 2009 and 2014.
KW - Epworth
KW - Health reform
KW - Human resources
KW - Peri-urban
KW - Policy
KW - Zimbabwe
UR - http://www.scopus.com/inward/record.url?scp=85038100770&partnerID=8YFLogxK
U2 - 10.1186/s12960-017-0260-x
DO - 10.1186/s12960-017-0260-x
M3 - Article
C2 - 29246149
AN - SCOPUS:85038100770
SN - 1478-4491
VL - 15
JO - Human Resources for Health
JF - Human Resources for Health
IS - 1
M1 - 83
ER -