Primary Healthcare Workers' Perceptions about Barriers to Health Services in Zambia

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Abstract
In Zambia, health policy reforms have recently focused upon decentralization of care with an emphasis upon community-based services. The perspective of primary healthcare workers (PHCWs), who provide these services, may offer valuable insight into this changing health system. To explore the perspective of PHCWs in Zambia, we conducted a written survey of 80 PHCWs. Several barriers to care, many surrounding issues of access to care, were consistently and independently reported by the PHCWs surveyed. Shifting care into the community will only be beneficial if primary care clinics can offer a reasonable minimal standard of care. From the perspective of healthcare workers on the frontline of primary care delivery in Zambia, expanded training of providers and an increased number of providers is needed. Improving access to drugs and supplies is also necessary. User fees that might increase financial resources for the healthcare system may also deter needed care among vulnerable patient populations.