A Process Evaluation of the National Development Strategy 1(NDS1) 2021 – 2025 on Health and Wellbeing Promotion in Matabeleland South Province, Zimbabwe

Matabeleland South Province is one of the 10 provinces in Zimbabwe. The province has suffered from a higher disease burden culminating in high incidence and prevalence rates. The country has adopted the National Development Strategy 1 (2021-2025) which considers public health as an important component in realising an upper middle income status by 2030. The main goal of the NDS1 health priority area is to improve the quality of life of the general population through programme financing, WASH promotion, prevention and control of diseases, and increasing competence in the health sector. Annual targets have been set that determine progress towards NDS1 goals. This document is a report of a process evaluation that was conducted to measure the NDS1implementation in Matabeleland South. The main objective of the process was to measure the programme implementation and determine factors influencing achievement so as to improve the programme and align it towards achieving its goal. The RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework was employed in the evaluation process. The evaluation design employed was an utilisation focused evaluation ensuring that evaluation findings are used to improve the development strategy. Convenient sampling was used to incorporate key informants into the evaluation. The programme framework was analysed using qualitative thematic reasoning. The evaluation established that the programme has universal coverage within the area and population. The effectiveness of NDS1 (health and wellbeing priority area) in Matabeleland South Province presented a constant progress with limited unintended outcomes. Implementation analysis indicated a higher programme quality, adherence to programme theory, a higher programme dose and average participant responsiveness. Programme maintenance was compromised by reliance on external funding and skilled worker attrition. On this note, it was recommended that the province should leverage staff capacity, increase social and behaviour change interventions, improve local programme financing, adopt a community based management system, and create an integrated disease management system for programme objectives to be realised.