Integration of community health workers into the health system in Tanzania: Examining the process and contextual factors
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Date
2021
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
International Journal of Health Planning and Management
Abstract
Education (DUCE) & Institute of Development Studies (IDS), University of Dar s Salaam, Dar es Salaam, Tanzania
Correspondence
Stephen O. Maluka, Dar es Salaam University College of Education (DUCE) & Institute
of Development Studies (IDS), University of Dar es Salaam, 2329 Dar es Salaam, Tanzania.
Email: stephenmaluka@yahoo.co.uk Funding information
Institute of Social Work
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 in‐ depth interviews (n à 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.