Abstract
Migration and poor performance of healthcare workers in Zimbabwe hinder primary healthcare delivery. This has compelled the country to exploit the potential of village health workers in primary healthcare. The Village Health Worker Strengthening Plan was never operationalised owing to unclear roles and limited coordination. The study aimed to explore the roles, challenges, and strategies as informed by setting and context to improve the effectiveness and efficiency of Village Health Workers in service delivery. The study was conducted in the Beitbridge district, Matabeleland South Province, Zimbabwe. A qualitative exploratory survey with semi-structured interview guides was administered to 36 participants, comprising Village Health Workers, nurses, environmental health practitioners, and medical doctors. Three main themes were analysed, and 15 subthemes were found. The role of Village Health Workers was to promote health, prevent and control disease, diagnose and treat minor ailments, and conduct community-based disease surveillance and referrals for complicated cases to primary healthcare facilities. Challenges were inadequate logistical supplies, allowances, knowledge and skills, mobility, and personal protective equipment. Optimal stocking of the medical and equipment supplies, improving allowances, community health integration into the healthcare system, embracing mobile health technology, capacity building, and supportive supervision were sub-themes on suggested strategies to improve service delivery. The study helped clarify the roles and challenges and suggested strategies by health service providers, as informed by empirical findings, to improve the effectiveness and efficiency of Village Health Workers in service delivery. It is recommended that needs assessments be conducted on village health work to enhance their capacity and support.