Gwaza Gamuchirai P, Zhou Danai T, Plüddemann Annette, Heneghan Carl
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
Afr J Prim Health Care Fam Med. 2025 May 30;17(1):e1-e13. doi: 10.4102/phcfm.v17i1.4847.
The integration of diagnostic services presents a critical opportunity to improve health outcomes in low- and middle-income countries (LMICs), potentially averting up to 1 million premature deaths annually. Antenatal care provides a critical platform for diagnosing multiple diseases in an integrated manner.
This study explored the experiences of healthcare providers and pregnant women using integrated diagnostic services at a primary care facility in Zimbabwe.
A qualitative case study was conducted at Mabvuku Polyclinic in Harare, Zimbabwe.
Using purposive sampling, 14 healthcare workers and 22 pregnant women participated in interviews. Observations and semi-structured interviews were recorded, transcribed and analysed using NVivo software. Thematic analysis was applied to identify key themes related to access, patient-provider interactions and systemic barriers.
According to the interviewees' reports, challenges such as limited resources, medical equipment and staff hinder efforts to integrate diagnostic services. The women strongly preferred integrated diagnosis, even if it meant enduring long waiting times, and valued the convenience of receiving all necessary services in a single visit. The study highlighted the hidden socio-economic barriers to 'free' healthcare and underscored the importance of addressing systemic inefficiencies.
The insights gained from this study are transferable and contribute to the understanding of integrated diagnostic services in maternal healthcare contexts.Contribution: They offer practical recommendations for improving service delivery and health outcomes in similar settings.
诊断服务的整合为改善低收入和中等收入国家（LMICs）的健康结果提供了一个关键机遇，每年有可能避免多达100万人过早死亡。产前保健提供了一个以综合方式诊断多种疾病的关键平台。
本研究探讨了津巴布韦一家初级保健机构中医疗服务提供者和孕妇使用综合诊断服务的经历。
在津巴布韦哈拉雷的马布武库综合诊所进行了一项定性案例研究。
采用目的抽样法，14名医护人员和22名孕妇参与了访谈。观察和半结构化访谈被记录、转录并使用NVivo软件进行分析。采用主题分析法来确定与获取服务、医患互动和系统性障碍相关的关键主题。
根据受访者的报告，资源有限、医疗设备和人员等挑战阻碍了综合诊断服务的开展。这些女性强烈倾向于综合诊断，即使这意味着要忍受长时间等待，并且重视在一次就诊中就能获得所有必要服务的便利性。该研究突出了“免费”医疗保健背后隐藏的社会经济障碍，并强调了解决系统性低效率问题的重要性。
本研究获得的见解具有可转移性，有助于理解孕产妇保健背景下的综合诊断服务。贡献：它们为在类似环境中改善服务提供和健康结果提供了实用建议。
