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abandoning home visits by nurses for lack of time between inoculation cycles; mothers were no longer advised by health care practitioners of any basis for bringing their children under five to clinics; thus primary care for mother and child declined. This reflection is also found in a paper on health worker motivation and RBF in Zimbabwe, which concludes that introducing RBF arrangements cannot alone overcome chronic systemic weaknesses, which require explicit organisational change management processes to be put in place across the system 49 A survey of health care purchasing in

 

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