HEALTH-EDUCATION SERVICES IN DEVELOPING-COUNTRIES - THE CASE OF ZIMBABWE

Little research has been done on the organization of health services in, developing countries. This study uses a checklist approach to assess Zimbabwe's health service and combines it with an historical analysis. The data include interviews with key staff members of the Department of Community Medicine and observations by one of the authors during work as a district doctor. Policy formulation, organization and management, and resources have developed to a medium level. However, support of peripheral health workers has been weak. Services on the ground, almost exclusively carried out by non-specialists, are unsatisfactory. Improvements in health status have mainly been due to the success of service delivery programmes such as immunization. Diseases which require behaviour changes have not improved or, as in the case of AIDS, even worsened. Health education services have evolved from a 'village educator' to a 'diploma educator' stage. In order to facilitate the use of more effective and participatory methods, a speedy upgrading of the service to a 'specialist stage' is needed together with a further training and reorientation of health workers at district level.