Evaluating coverage of IMAM services in Zimbabwe to enable national programme
A national IMAM coverage survey that used a mixed-methods approach provided valuable insights into true service coverage and barriers to accessing IMAM services. The approach leveraged routine programme monitoring data and primary data collection in selected locations. The findings and the strong stakeholder engagement contributed to health system strengthening and enabled quality improvement of services.
29th October 2025
Sebinwa U., Blanarova L., Pajak P., Nkhungwa V.M., Katete P., Nyadzayo T.K
In Zimbabwe, Action Against Hunger supported a national IMAM coverage assessment between February and July 2024, using a novel approach, which allowed to draw national-level conclusions based on a reasoned selection of surveyed locations. The methodology was an adapted version of the Simplified Lot Quality Assurance Sampling Evaluation of Access and Coverage (SLEAC) approach, utilising mixed data collection methods over three iterative phases. The first stage consisted of an analysis of routine programme monitoring data at the level of provinces, which was integrated into a bottleneck analysis to identify high and low performing provinces and districts. These findings were organised into a bottleneck analysis framework model, which served to select three best-performing and three least-performing provinces. Within these, further analysis was conducted at district level, allowing the identification of high and low performing districts. In the second stage, a series of SLEAC surveys were conducted across the selected high and low performing districts to classify coverage and identify key barriers and facilitators of access and coverage from the community’s perspective. In the third stage, qualitative data was collected to better understand the identified barriers and facilitators and to formulate meaningful recommendations adapted to the context. Semi-structured interviews and focus group discussions were conducted with key informants who are directly or indirectly involved with the IMAM programme, including health facility staff and community health workers, key community figures, and caregivers of children under 5. Direct observations were also carried out at selected health facilities. Data from all components was triangulated and key strategic priorities at the national and sub-national level were identified, providing actionable insights to guide policy and programmatic improvements.
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