Date of Award

Spring 2021

Document Type

Open Access Thesis


Epidemiology and Biostatistics

First Advisor

Mufaro Kanyangarara


The impact of the coronavirus disease 2019 (COVID-19) pandemic has been felt worldwide, especially in Sub-Saharan Africa (SSA). With fractured health systems, disrupted supply chains, limited resources, and continued fighting of endemic diseases such as malaria, SSA is at risk for greater impact. Manicaland Province has the highest incidence rate of malaria in Zimbabwe, and a higher malaria mortality rate than the national average. Manicaland also has the third highest number of COVID-19 cases and deaths in Zimbabwe. In this study, health care facilities and households throughout Makoni, Mutare, and Buhera districts in Manicaland Province were administered cross-sectional surveys. We determined the current state of health care facilities’ preparedness to diagnose and treat malaria and assessed the factors associated with preparedness. We also investigated the factors associated with health care utilization in the last 3 months and COVID-19 knowledge among of symptoms, infection, and prevention among households and heads of households. While health care facilities had many tracer items necessary to diagnose and treat malaria, there were gaps in availability of malaria treatment services and drugs. Rural location of facility was associated with greater health care facility preparedness. Household size, education, and medical aid status were significant factors included in the final model for health care utilization. However, the only significant association observed was among households larger than 4 members, which had greater odds of utilizing health care in the last 3 months. Also, ages 31-55, attending primary school or higher, and hearing about the COVID-19 pandemic and emergency number were associated with increased COVID-19 knowledge, while age of greater than 55 was associated with decreased knowledge of COVID-19. The findings here help to assess the current state of malaria preparedness in health care facilities in Manicaland Province in the midst of the pandemic, and factors for intervention concerning health care utilization and COVID-19 knowledge in rural and malaria-endemic areas.

Included in

Epidemiology Commons