Abstract:
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.
