Behavioural Drivers and Barriers to Public Health and Social Issues in Mbire District, Zimbabwe

In Mbire District, Zimbabwe, foundational behaviours in child health, education, sanitation, and energy lag: only 60 % of births are registered, fewer than 50 % of infants are exclusively breastfed, Early Childhood Development Education (ECDE) enrolment is below 50 %, open defecation is practiced by 23 % of households and under 32 % of households have reliable electricity. Structured surveys via Kobo Toolbox namely, focus group discussions (FGDs) and key-informant interviews (KIIs) were conducted to elicit information regarding district-level Social and Behavioural Change (SBC) strategy development. The data source had a sample size of 200 participants. A total of 180 participants made up 15 FGDs comprising of 12 participants in each group, and a total of 20 participated in KIIs. Transcripts were coded in QDA Miner 6 (κ = 0.82), and drivers and barriers were quantified by code frequency and case coverage. Results show that community leadership advocacy and targeted communication (radio, village meetings, school clubs) consistently enabled all five behaviours. In contrast, financial and logistical constraints (fees, distance, technology costs), documentation requirements, and entrenched cultural norms (home births without registration, early complementary feeding, latrine taboos, traditional cooking methods) inhibited uptake. While mobile registration units, NGO-subsidized school fees, and subsidized cookstoves improved outcomes in isolated areas, lack of sectoral integration limited broader impact. A multi-pronged approach that (1) aligns mobile and clinic-based services with community events, (2) pairs subsidies with technical training (e.g., latrine building, stove maintenance), and (3) co-designs culturally sensitive messaging with local leaders to amplify health, education, WASH, and energy programs was recommended.