Integration of community health workers into the health system in Tanzania: Examining the process and contextual factors
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Date
2021-01-15
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Abstract
Integration of community health workers (CHWs) into the
health systems has become a global concern. Recently, the
Government of Tanzania through the then Ministry of
Health and Social Welfare initiated different strategies that
aimed at integrating CHWs into the health system. This
paper discusses the process and factors that influence the
integration of CHWs into the health system in Tanzania.
The study employed qualitative case study design using indepth
interviews (n . 37). In addition, various documents
including health policies, Community‐based Health Policy,
community health workers guideline and Community
health workers training curriculum were reviewed. Data
were analysed by using thematic analysis. The findings
indicated that potential CHWs were selected based on the
National Council for Technical Education standards that
required an applicant to have four (4) passes in the
ordinary level examination. None of the CHWs who had
undergone training had been employed by the government.
This differed from what was prescribed in the CHWs
guidelines. Integration of CHWs into health system in
Tanzania has not been optimal because of inadequate
preparations in terms of stakeholders engagement,
infrastructure, legal and policy frameworks, technical
expertise and financial resources. Effective integration of
CHWs into the health system requires working with
different actors to communicate objectives, achieveIntegration of community health workers (CHWs) into the
health systems has become a global concern. Recently, the
Government of Tanzania through the then Ministry of
Health and Social Welfare initiated different strategies that
aimed at integrating CHWs into the health system. This
paper discusses the process and factors that influence the
integration of CHWs into the health system in Tanzania.
The study employed qualitative case study design using indepth
interviews (n . 37). In addition, various documents
including health policies, Community‐based Health Policy,
community health workers guideline and Community
health workers training curriculum were reviewed. Data
were analysed by using thematic analysis. The findings
indicated that potential CHWs were selected based on the
National Council for Technical Education standards that
required an applicant to have four (4) passes in the
ordinary level examination. None of the CHWs who had
undergone training had been employed by the government.
This differed from what was prescribed in the CHWs
guidelines. Integration of CHWs into health system in
Tanzania has not been optimal because of inadequate
preparations in terms of stakeholders engagement,
infrastructure, legal and policy frameworks, technical
expertise and financial resources. Effective integration of
CHWs into the health system requires working with
different actors to communicate objectives, achieve ownership of the stakeholders, manage conflict and
cooperation, and sustain changes.
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Keywords
Community Health Workers, Integration in Health System, Tanzania