Health and well-being are the central concerns for most African people. If health and well-being (utano) is the top priority for most Africans, the general and almost complete breakdown of the Zimbabwean public health care system in the past decade (2000-2010) has had far-reaching repercussions on the whole populace. Whereas African theology and religious studies have expended considerable energy in addressing the theme of health and well-being, there have been limited attempts at developing indigenous theologies. This study plugs the gap in the available scholarly literature by proposing a Karanga theology of health and well-being paying particular attention to a specific community‘s responses to the health delivery systems in Zimbabwe. Through an examination of indigenous responses to health and well-being and critiquing the collapse of the health delivery systems in the period 2000-2010, the study argues that understanding health agency in contemporary Zimbabwe enables appreciating the centrality of utano (health and well-being). This study also seeks to establish the agency of the community in responding to the national health care crisis, focusing specially on the Karanga community in Murinye district. It explores the Karanga healthworlds and documents the agency of the Karanga health-seekers and health-care providers in responding to the health-care crisis. The major focus of the study is to establish how the Karanga navigate the existing religious and medical facilities (Modern scientific bio-medicine; Traditional healing and Faith-healing) in their search for healing by conducting fieldwork research which entailed the use of interviews and participant observation. The study was also influenced by oral theology based on the community‘s underlying faith experiences. It also relied upon the life history approach and narrative theology to establish trends and patterns in the Karanga medical system. The study concludes by exploring some useful and life-giving Karanga indigenous resources that can be utilized in constructing a Karanga theology of health and well-being in contemporary Zimbabwe. A Karanga theology of utano places emphasis on a liberative motif which is life-giving and life-enhancing. This includes acknowledging the agency of health-seekers who are actively involved in their own welfare. It argues that utano is achieved when, on the basis of indigenous beliefs and Christian beliefs regarding health, individuals and families invest in refusing to accept ill-health. Information drawn from study participants demonstrated how they sought the opinions of traditional healers, prophet healers and modern health practitioners whenever they felt that their condition was compromised. The study foregrounds the fact that for the Karanga people, issues of health and well-being cannot be separated from their religious perspectives. There are diverse religious traditions among the Karanga people and these inform their understanding of utano. As such, the three health delivery systems should not be viewed as competitors for clients but more importantly, they should be viewed as complementing each other. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.

Submitted in fulfilment of the requirements of the degree of Doctor of Technology: Public Management, Durban University of Technology, 2017. / The world over, countries are burdened with existing and emerging diseases and while that affected all nations, sub-Saharan Africa carried the heaviest portion. This filtered to Zimbabwe where a myriad of health challenges are faced. Unavailability of medicines coupled with poor inventory management of these medicines has been prevalent. Insufficient financial resources and increasing cost of healthcare costs is one of the pressing matters. It is also important to note that these challenges are occurring at a time when government is realising the crucial role of procurement in addressing health challenges. Due to the extent, depth, breadth and nature of the health challenges and their criticality in establishing sustainable and affordable health system in Zimbabwe, a case study approach has been adopted where data from questionnaires, interviews, documents and observations were corroborated and triangulated in an effort to bring to the surface deep-seated procurement matters and how they are related to the challenges provided. Thus, in terms of the research findings, it was first revealed that the procurement legislative frameworks and processes are fragmented and not in one place resulting in multiple accountabilities. It was further shown that the framework is inappropriate in a healthcare set-up where issues of speed and flexibility in addressing requirements are paramount. It was also shown that procurement planning being a critical aspect is regrettably and detrimentally missing in procurements. In addition, the selection criteria as set out in the regulations and practiced by individual state health facilities indicated over-reliance on price and that being the case, key aspects such as quality and supply-lead time are missed and yet are very necessary in terms of evaluation among other factors. In the findings, the peripheral role of procurement staff with clinicians being also at the epicentre of purchasing decisions was presented. Perhaps related to that was the inadequacy of procurement skills and competences from the procurement personnel. Last on the findings, financing and the frequency of disbursement was unmatched with hospital requirements and thus resulting in unavailability of adequate medicines and equipment. / D