Bulawayo

Sick leave is time spent away from work due to illness or injury. A preliminary review of sick leave records for 2012 for the 6 clinics in Nkulumane showed 3 clinics experienced higher sick leave incidents than the other 3 clinics. The study sought to establish the prevalence and associated factors for sick leave in the City of Bulawayo, Zimbabwe. An analytic cross-sectional study was carried out among Bulawayo City Health employees working in 20 health facilities. A total of 144 respondents and 3 key informants were interviewed. An interviewer-administered questionnaire, key informant interview guide, and a checklist were used to collect data, which was analysed using Epi Info. The prevalence of sick leave was 34%. Employees who took sick leave less than six months ago were 4.3 times more likely to go on frequent sick leave than those who did not (POR 4.3, P-Value 0.002). Employees who reported good team climate were less likely to go on frequent sick leave (POR 0.29, P-Value 0.002). Feeling unappreciated at work was a risk factor for frequent sick leave (POR 2.61, P-Value 0.01). The cost of sick leave for the City of Bulawayo in 2012 was $US20 840. Periodic refresher meetings on conditions of service, training of managers and other employees on good teamwork, and production of a standard template for recording sick leave by clinics may assist in curbing frequent sick leave incidents.

Through an in-depth analysis of select programs in Bulawayo, this case study identifies varying actors operating within different levels of governmental involvement. This is exemplified through macroscale national government projects, local government coping strategies, public-private partnerships and non-governmental intervention. We will separately evaluate the efficacy of their solutions to the water crisis. Subsequently, using previous and ongoing projects as examples, we will detail how the efficacy of transformative change relates to their levels of government involvement. While the conclusions reached in this paper are specific to Bulawayo, it is our hope that the results offer insight to solving the problem of insufficient water sanitation worldwide. International efforts have been working towards this goal for decades and we hope to learn from these examples and offer insights of our own.