Exploring Access to Care in Zimbabwe Using the 3-Delay Model.

Area of Science:

• Otolaryngology-Head and Neck Surgery
• Public Health
• Healthcare Access

Background:

• Access to specialized surgical care, including otolaryngology-head and neck surgery, is crucial for patient outcomes.
• Identifying barriers to care is essential for improving healthcare delivery in resource-limited settings.

Purpose of the Study:

• To identify the diverse barriers to care experienced by otolaryngology-head and neck surgery patients in Harare, Zimbabwe.
• To categorize these barriers using a 3-delay model.

Main Methods:

• Interviews were conducted with 46 adult and child patients at four otolaryngology clinics in Harare.
• A standardized six-question survey, administered via interpreter, assessed delays in seeking care, reaching facilities, and receiving adequate care.

Main Results:

• The average delay from problem presentation to treatment was 16.3 months.
• The most common delay was Type 3 (67%), with patients unable to receive timely treatment at appropriate facilities.
• Type 1 delays (35%) were linked to fear, traditional healing preferences, or unawareness of treatable conditions. Type 2 delays (37%) were associated with travel distance, time, and finances.

Conclusions:

• Otolaryngology patients in Zimbabwe encounter numerous delays in accessing care.
• Systemic issues such as surgical backlogs, complex referral pathways, and inadequate transportation infrastructure significantly impede patient access.
• The 3-delay model effectively identifies barriers, informing strategies to enhance access to safe and affordable surgical care.