*6.2.2 Qualitative study*

*Healthcare Access - Regional Overviews*

areas in the country.

District.

14–41% households), the use of protected water sources for drinking water increased

It is noteworthy that changes which required purchasing were on the lower end of the scale with BVIP latrine construction, buying mosquito nets and fuel efficient stoves being the least amount of change. As this was during a time when Zimbabwe was completely dysfunctional economically and while there was over 75% unemployment in the country, with over 3 million Zimbabweans living abroad as economic migrants, it is not surprising there was little affordability. Indeed given this context it is impressive that 2108 high quality BVIP latrines which cost at least US\$100 at the time (when cement was in short supply nationally) were built by self-supply by households in some of the most challenging

After only 8 months, the post intervention survey showed that compliance level was over 80% of the registered CHC members in 15 indicators (**Figure 4**), of which 12 were over 90%, which leaves little doubt as to the effectiveness of the CHC training to stimulate exceptional levels of community response in Mberengwa

*Percentage hygiene behaviour change of 7477 CHC members in Mberengwa District, Zimbabwe. 2012 [46].*

by 23% (61–84%), ventilation of housing increased by 21% (65–86%). Use of mosquito nets whilst still low (8.9–19.8%) increased by 11% and fuel-efficient stoves increased by 14% (4.2–18.2%) (**Figure 4**) [46]. The effect of the improved hygiene could be quantified by the condition of the children. Over 90% of CHC households could demonstrate children with no skin diseases, no worms, and a complete immunization card for all children. Mothers in over 90% of CHC homes could demonstra-

tion how to treat dehydration with a Sugar salt rehydration solution.

**46**

**Figure 4.**

In one ward of Mberengwa a qualitative study was conducted in three villages [10] which established that CHC members were considerably more knowledgeable than non CHC members. Understanding the cause of diseases was claimed by CHC members to be the reason for their increased use of safe borehole water and the construction of latrines raising coverage in a village from 36.6–53%, and hand washing facilities by 22.1% (from 5 to 27.1%).

The study states in the conclusion,

*'As community members reflected on the impact of CHCs on their lives, the increases in their health knowledge was evident and participatory practices were prevalent across the CHCs. CHCs are currently bringing about a multitude of positive change, as the activities initiated by their members are practiced at the community level. Not only have health indicators changed, but more importantly, village member's perceptions of their capacity have increased; they feel more able to control disease and improve their lives. More importantly, they are taking action to prevent disease and sharing what they have learned with other communities' [10]*
