Healthcare access and systemic inequities affecting people living with epilepsy in Zimbabwe: a mixed-methods study

This study investigates the systemic, economic, geographic, and social factors that prevent people living with epilepsy in Zimbabwe from accessing timely, effective care. Despite epilepsy being a treatable neurological condition, a substantial proportion of people affected in low- and middle-income African settings remain undiagnosed, untreated, or inconsistently treated. The reasons are rarely a single failure but a layered set of barriers — specialist shortages, medication cost and supply, distance to facilities, stigma, and policy gaps. This study maps the scale and shape of the access gap in Zimbabwe through a combination of healthcare worker interviews, patient and caregiver accounts, and a review of available health system data. The aim is to produce an evidence base that can inform policy advocacy, NGO programme design, and future intervention research. The study is part of a wider three-project programme on epilepsy care and access in sub-Saharan Africa, led by Dr. Phyllis Kimani. Principal Investigator Dr. Phyllis Kimani, MPharm, UK and Kenya Qualified Pharmacist Collaborators To be confirmed — Zimbabwe-based academic research partners. Study design Mixed-methods, cross-sectional, observational. Study population Healthcare workers involved in epilepsy care in Zimbabwe; people living with epilepsy and their caregivers. Setting / location Zimbabwe — specific sites to be confirmed with the in-country research partner. Sample size To be confirmed with the Zimbabwe research partner. Inclusion criteria Healthcare workers actively involved in epilepsy care; adults (18+) living with diagnosed epilepsy; caregivers of people living with epilepsy. Exclusion criteria Participants unable to provide informed consent; conditions outside the epilepsy spectrum. Data collection methods • Semi-structured interviews with healthcare workers. • Semi-structured interviews with people living with epilepsy and caregivers. • Review of health system data on epilepsy diagnosis, treatment access, and medication supply. Analysis plan Thematic analysis of qualitative interview data. Descriptive summary of health system data. Triangulation of findings across data sources to produce an access-barriers framework. Ethics Ethics approval to be sought from the relevant Zimbabwean ethics body — to be confirmed. Funding Programme-level funding being sought; this registration does not commit any specific funder. Anticipated start date TBC — following ethics approval. Anticipated end date TBC — anticipated within 6–12 months of start. Status In planning. Planned outputs • Peer-reviewed journal manuscript. • Conference abstract and poster. • Policy brief for in-country health authorities and NGOs. Keywords epilepsy; healthcare access; Zimbabwe; sub-Saharan Africa; health systems; mixed methods; observational