Motivation and Satisfaction Among Community Health Workers in Morogoro Region, Tanzania: Nuanced Needs and Varied Ambitions
Non-Financial Incentives
In 2012, the Ministry of Health and Social Welfare (MOHSW), Tanzania, approved national guidelines and training materials for community health workers (CHWs) in integrated maternal, newborn and child health (Integrated MNCH), with CHWs trained and deployed across five districts of Morogoro Region soon after. To inform future scale up, this study assessed motivation and satisfaction among these CHWs. [from abstract]
Enhancing the Quality of Clinical Clerkships in a Resource Limited Settings Medical School: Northern Tanzania
Pre-Service Education
To reduce healthcare worker shortages in sub-Saharan Africa, medical schools have increased enrolment. However, this
expansion has not been accompanied by adequate increases in faculty size or physical infrastructure.
Consequently, classes are overcrowded, and may lead to reduction in the quality of training, especially during clinical clerkships. Aiming to expose medical students to rural working environments and reduce overcrowding at the
main teaching hospital, in 2012 Kilimanjaro Christian Medical University College(KCMUCo) introduced a 12-week clerkship
rotation.
Supporting Close-to-Community Providers Through a Community Health System Approach: Case Examples from Ethiopia and Tanzania
Community Interventions
Staff Performance Assessment
Close-to-community (CTC) providers, including community health workers or volunteers or health extension workers, can be effective in promoting access to and utilization of health services. Tasks are often shifted to these providers with limited resources and support from CTC programmes or communities. Two cases are presented. [from abstract]
External evaluation of the Amref Health Africa Project on Sexual Reproductive Health Rights for the Young People (Tuitetee – Lets Fight For It), 2010- 2015
This end-of-project evaluation of the Swedish support to the Amref Health Africa Project on Sexual Reproductive Health Rights for the Young People (Tuitetee–LetsFight For It), 2010-2015 was commissioned by the Embassy of Sweden in Tanzania, through Sida's framework agreement for reviews and evaluations. [from preface]
Midterm Review of National Health Plans: An Example from the United Republic of Tanzania
HRH Strategic Plans
In the health sector, planning and resource allocation at country level are mainly guided by national plans. For each such plan, a midterm review of progress is important for policy-makers since the review can inform the second half of the plan's implementation and provide a situation analysis on which the subsequent plan can be based. [from abstract]
Can Smartphones and Tablets Improve the Management of Childhood Illness in Tanzania? A Qualitative Study from a Primary Health Care Worker's Perspective
eHealth and mHealth
The impact of the Integrated Management of Childhood Illness (IMCI) strategy has been less than anticipated because of poor uptake. Electronic algorithms have the potential to improve quality of health care in children. However, feasibility studies about the use of electronic protocols on mobile devices over time are limited. This study investigated constraining as well as facilitating factors that influence the uptake of a new electronic Algorithm for
Management of Childhood Illness (ALMANACH) among primary health workers in Dar es Salaam, Tanzania. [from abstract]
Financing Medical Education through the Private Sector
From 2010 through 2013, the SHOPS project implemented a series of pilot activities to explore the feasibility of introducing private sector health education financing mechanisms. SHOPS explored private sector solutions to help meet ambitious targets from the U.S. President's Emergency Plan for AIDS Relief for training new health care workers. This report shares the project's work with private pre-service education financing in Malawi, Rwanda, Tanzania, and Zambia.
Rewarding Safer Sex: Conditional Cash Transfers for HIV/STI Prevention
At the end of the one year of intervention, the results showed a significant reduction in sexually transmitted infections in the group that was eligible for the $20 payments every four months,but no such reduction was found for the group receiving the $10 payments. The effects were stronger among the lower socioeconomic and higher risks groups. The results of a post-intervention follow-up survey conducted one year after discontinuing the intervention indicate a sustained effect among males, but not among females. [from abstract]
The Leaking Pocket: The Implicit Struggle for Skilled Health Workers Between Private Not-For-Profit and Public Sector in Tanzania
Public health services in sub-Sahara Africa countries face severe health workforce shortages exacerbated by both outward migration and internal public-to-private sector migration—Tanzania is no exception. This review was conducted to characterize the extent of health workforce shortages in Tanzania, and the factors impacting on the shortage. [from abstract]
Pay for Performance: An Analysis of the Context of Implementation In A Pilot Project in Tanzania
Pay for performance schemes are increasingly being implemented in low income countries to improve health service coverage and quality. This paper describes the context within which a pay for performance programme was introduced in Tanzania and discusses the potential for pay for performance to address health system constraints to meeting targets. [from abstract]
Establishing Sustainable Performance-Based Incentive Schemes: Views of Rural Health Workers from Qualitative Research in Three Sub-Saharan African Countries
Performance-based incentives (PBIs) are currently receiving attention as a strategy for improving the quality of care that health providers deliver. Experiences from several African countries have shown that PBIs can trigger improvements, particularly in the area of maternal and neonatal health. The involvement of health workers in deciding how their performance should be measured is recommended. Only limited information is available about how such schemes can be made sustainable. [from introduction]
Knowledge and Health Information Communication in Tanzania
Training Effectiveness
The objective of this study is to explore and identify gaps in knowledge and information communication at all levels of health delivery system in Tanzania. [adapted from abstract]
Health Systems Governance in Tanzania: Impact on Service Delivery in the Public Sector
The aim of this research was to contribute to a better understanding of health system governance and apply this knowledge to the Tanzanian health system. The insights gained should aid policy makers and other stakeholders to design
interventions that are appropriate for the local context to ensure a stronger health system which is able to attain its goals of improving the level and distribution of health, while responding to the population's needs and protecting them from large, often catastrophic financial expenditures. [from introduction]
''It Is Like That, We Didn't Understand Each Other'': Exploring the Influence of Patient-Provider Interactions on Prevention of Mother-To-Child Transmission of HIV Service Use in Rural Tanzania
Mother to Child Transmission
Interactions between patients and service providers frequently influence uptake of prevention of mother-to-child
transmission (PMTCT) HIV services in sub-Saharan Africa, but this process has not been examined in depth. [from abstract]
What Elements of the Work Environment Are Most Responsible For Health Worker Dissatisfaction in Rural Primary Care Clinics in Tanzania?
In countries with high maternal and newborn morbidity and mortality, reliable access to quality healthcare in rural areas is essential to save lives. Health workers who are satisfied with their jobs are more likely to remain in rural posts. Understanding what factors influence health workers' satisfaction can help determine where resources should be focused. Although there is a growing body of research assessing health worker satisfaction in hospitals, less is known about health worker satisfaction in rural, primary health clinics.
An Analysis of Pre-Service Family Planning Teaching in Clinical and Nursing Education in Tanzania
In efforts to improve the quality of FP (Family Planning) services in Tanzania, including provider skills, this study sought to identify gaps in pre-service FP teaching and suggest opportunities for strengthening the training. [from abstract]
Factors that Act as Facilitators and Barriers to Nurse Leaders' Participation in Health Policy Development
Organizational Policy
Health policies impact on nursing profession and health care. Nurses' involvement in health policy development ensures that health care is safe, of a high quality, accessible and affordable. Numerous factors influence nurse leaders' ability to be politically active in influencing health policy development. These factors can be facilitators or barriers to their participation. There is scant research evidence from Eastern African region that draws
attention to this topic. This paper reports part of the larger study. [from abstract]
Applying Organizational Learning to Health Challenges in the Developing World
Health Sector Managers
In countries that have historically suffered from limited resources and entrenched medical systems – including Egypt, Afghanistan, and Tanzania – or ganizational learning approaches have enabled frontline health managers and their teams to achieve measurable improvements in critical areas such as family planning, HIV/AIDS treatment and prevention, children's health, and maternal mortality. [from introduction]
The Emergence of Hospital Accreditation Programs in East Africa: Lessons from Uganda, Kenya, and Tanzania
The objective of this manuscript was to examine existing hospital accreditation systems in three East African countries (Uganda, Kenya and Tanzania), assess attitudes and opinions of key stakeholders regarding hospital accreditation systems in the region, and identify lessons regarding sustainable and effective implementation of hospital accreditation systems in resource-limited countries. [from abstract]
Work Experience, Job-Fulfillment and Burnout among VMMC Providers in Kenya, South Africa, Tanzania and Zimbabwe
This analysis examines this issue of performance and attrition in [voluntary medical male circumcision] programs by looking descriptively at job-fulfillment and burnout. [from introduction]
Competency-Based Training "Helping Mothers Survive: Bleeding after Birth" for Providers from Central and Remote Facilities in Three Countries
To validate a new training module for skilled and semiskilled birth attendants authorized to provide care at birth—Helping Mothers Survive: Bleeding After Birth (HMS:BAB) [from abstract]
Addressing the human resource for health crisis in Tanzania: the lost in transition syndrome
Out-Migration/Brain Drain
The objective of this study was to improve knowledge on the HRH status in Tanzania by analyzing what happens to the number of medical doctors (MD) and doctor of dental surgery (DDS) degree graduates during the transition period from graduation, internship to appointment. [from abstract]
Task Shifting for Cataract Surgery in Eastern Africa: Productivity and Attrition of Non-Physician Cataract Surgeons in Kenya, Malawi and Tanzania
Task Shifting
This project examined the surgical productivity and attrition of non-physician cataract surgeons (NPCSs) in Tanzania, Malawi, and Kenya. [from abstract]
Using Incentives to Attract Nurses to Remote Areas of Tanzania: A Contingent Valuation Study
Rural/Urban Imbalance
This article analyses (1) how financial incentives (salary top-ups) and non-financial incentives (housing and education) affect nurses' willingness to work in remote areas of Tanzania and (2) how the magnitude of the incentives needed to attract health workers varies with the nurses' geographic origin and their intrinsic motivation. [from abstract]
Engaging People Living With HIV as Lay Counsellors in HIV Care and Treatment Services: Experiences in Kilimanjaro, Tanzania
This document summarises the key components of the lay counsellors programme that have contributed to its success, such as careful recruitment practices and recognition of lay counsellors as valued members of health-care teams. Also highlighted are specific steps that support the use of people living with HIV as lay counsellors and parameters regarding how to monitor the impact of this work. [from summary]
Beyond Antimalarial Stock-Outs: Implications of Health Provider Compliance on Out-of-Pocket
This article evaluated how stock-outs of the first line antimalarial, medication and non-compliant health worker behavior influence household expenditures during care-seeking for fever in the Ulanga District in Tanzania.
Involving Traditional Birth Attendants in Emergency Obstetric Care in Tanzania: Policy Implications of a Study of Their Knowledge and Practices in Kigoma Rural District
Skilled Attendance
This paper reports about knowledge and practices of traditional birth attendants on emergency obstetric care in a rural district of Tanzania and discusses policy implications on involving traditional birth attendants in maternal health services. [adapted from abstract]
Sources of Community Health Worker Motivation: A Qualitative Study in Morogoro Region, Tanzania
This study aimed to explore sources of community health worker motivation to inform programs in Tanzania and similar contexts. [from abstract]
Estimated Risk of HIV Acquisition and Practice for Preventing Occupational Exposure: A Study of Healthcare Workers at Tumbi and Dodoma Hospitals, Tanzania
The main objective of this study was to estimate the risk of HIV transmission and examine the practices for preventing occupational exposures among health care workers at Tumbi and Dodoma Hospitals in Tanzania. [from abstract]
Health Worker Factors Associated with Prescribing of Artemisinin Combination Therapy for Uncomplicated Malaria in Rural Tanzania
Improving malaria case management is partially dependent on health worker compliance with clinical guidelines. This study assessed health worker factors associated with correct anti-malarial prescribing practices at two sites in rural Tanzania. [from abstract]