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

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