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Integration of community health workers into the health system in Tanzania: Examining the process and contextual factors

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  • Peter Mgawe
  • Stephen O. Maluka

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 = 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.

Suggested Citation

  • Peter Mgawe & Stephen O. Maluka, 2021. "Integration of community health workers into the health system in Tanzania: Examining the process and contextual factors," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(3), pages 703-714, May.
  • Handle: RePEc:bla:ijhplm:v:36:y:2021:i:3:p:703-714
    DOI: 10.1002/hpm.3114
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    1. Mumtaz, Zubia & Salway, Sarah & Nykiforuk, Candace & Bhatti, Afshan & Ataullahjan, Anushka & Ayyalasomayajula, Bharati, 2013. "The role of social geography on Lady Health Workers' mobility and effectiveness in Pakistan," Social Science & Medicine, Elsevier, vol. 91(C), pages 48-57.
    2. Balcazar, H. & Lee Rosenthal, E. & Nell Brownstein, J. & Rush, C.H. & Matos, S. & Hernandez, L., 2011. "Community health workers can be a public health force for change in the United States: Three actions for a new paradigm," American Journal of Public Health, American Public Health Association, vol. 101(12), pages 2199-2203.
    3. Reich, Michael R., 1995. "The politics of health sector reform in developing countries: three cases of pharmaceutical policy," Health Policy, Elsevier, vol. 32(1-3), pages 47-77.
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