Document Type
Article
Publication Date
2-1-2025
Abstract
OBJECTIVES: We aim to identify the diversity of barriers to care for otolaryngology-head and neck surgery patients in Harare, Zimbabwe.
METHODS: Interviews were conducted at four general otolaryngology clinics in Harare in October 2022.The patient population included children and adults presenting to either government or private clinics. Via interpreter, six standardized questions were discussed with each patient. Survey responses were used to categorize patients into one or more of three types of delays: (1) deciding to seek care, (2) reaching the appropriate healthcare facility, and (3) receiving adequate care after reaching that facility.
RESULTS: Forty-six patients participated in this survey. The average time from problem presentation to treatment in this population was 16.3 months. Twenty-six percent of patients experienced more than one type of delay. The most common type of delay was Type 3 (67%). Many of these patients reached appropriate facilities but could not receive timely treatment due to lengthy wait times. Type 1 delays affected 35% of patients. Notable causes were fear of doctors, preference for traditional healing, or ignorance to a treatable problem. Type 2 delays were also reported in 37%, commonly due to long distance and time to travel and insufficient finances for these journeys.
CONCLUSIONS: ENT patients in Zimbabwe experience a myriad of delays to receiving appropriate care. Systemic issues, including backlogged surgical lists, convoluted referral patterns, and poor transportation infrastructure, are significant contributors to patient delays. The 3-delay model is useful for identifying barriers to care for future efforts to improve patient access to safe and affordable surgical care.
LEVEL OF EVIDENCE: Level VI.
Recommended Citation
Green, Katerina; Matinhira, Naboth; Jain, Amiti; Vallecillo, Tissiana; Arya, Priya; Candelo, Estephania; Katiro, Munyaradzi; Nyamurowa, Tafadzwa; Douse, Dontre'; and Wiedermann, Joshua, "Exploring Access to Care in Zimbabwe Using the 3-Delay Model" (2025). SKMC Student Presentations and Publications. Paper 44.
https://jdc.jefferson.edu/skmcstudentworks/44
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Language
English
Comments
This article is the author's final published version in Laryngoscope Investigative Otolaryngology, Volume 10, Issue 1, February 2025, Article number e70091.
The published version is available at https://doi.org/10.1002/lio2.70091.
Copyright © 2025 The Author(s).