13 July 2018
At the end of April 2018, Godwin Kabalika, THET Country Director for Tanzania, and Paul Ahura, THET Country Director for Uganda, led a visit for the Tanzanian Ministry of Health, Community Development, Gender the Elderly and Children (MOHCDGEC) to Uganda. The trip was designed to allow the respective Ministries of Health, the Makerere School of Public Health – Nottingham Trent Partnership leads and Community Health Workers (CHW) trained through the project to share experiences of CHW training and implementation across international borders.
Through Comic Relief funding, THET has been working with the Tanzanian Ministry to train the first formal cadre of CHWs in the Lake Zone since 2016. In Uganda, through the Health Partnership Scheme funded by DFID, we are supporting the Makerere School of Public Health – Nottingham Trent Partnership to train CHWs and their work in Wakiso District. The trip was organised to enable their Ministries to exchange lessons learnt on the implementation of CHW programmes in each country.
Uganda and Tanzania are both facing a transition from infomal community health volunteers to formally trained, appointed and compensated community health workers. It is apparent that this needs to be carefully managed considering the limited amount of resources in order to sustain impact and make sure that there are no gaps in care.
Despite these worries, Tanzania and Uganda directors for THET were pleased that both nations were able to take away key lessons from one another. From the CHW Uganda programme it was clear that their CHWs are encouraged to integrate entrepreneurship opportunities, helping them to subsidize what they earn. This approach could be applied in Tanzania as an interim solution while waiting for formal employment. The key lesson from Tanzania is that the MOH has put in place a scheme of service for its community health workers, this is the document that stipulates employment standards including salary that a CHW should be paid, entry qualifications, career progression and clear roles and responsibilities. In addition one of the key outcome of the trip was the fact that THET Tanzania managed to establish contacts with a range of international organization which are operating in Uganda including Pathfinders international Uganda and Living Goods, We were very excited with how the Living goods are leveraging technology to transform community health, something that surely THET and MOH Tanzania can replicate. The last added benefit is that Living goods are planning to set up a CHW programme in Tanzania and opportunity for collaboration. CHW can bridge the gap between the community and the facility and if well trained and employed will have a big impact in improving access to health care services and disease prevention. During the field visit the Tanzania delegation met with Bugembe Henry a CHW from Kijjansi town council. We were so impressed by the impact that he is making to his community by providing a range of health services such as health promotion, prevention and basic curative measures. Bugembe shared some impressive stats: the Makerere-Nottingham Partnership trained 127,011 people, made 40,213 household visits and treated 19,387 children.
Following from the health partnership symposium that was held in Tanzania last year, there has been growing technical cooperation between Uganda and Tanzania for both government and THET. While the Nottingham project had a presentation in Tanzania, the Tanzania team now had the opportunity to witness first-hand the operationalisation of CHWs through this visit. This was a build up to the online engagements that have been happening between the two countries since the symposium. Despite the diversity in the type of projects being implemented, the trip was hugely beneficial for the Ministries and it was also a great opportunity to share learning between Offices. We look forward to our next meeting at the THET Conference in London later this year!