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Health workers at the heart of the community

29 May 2019


With 75% of Tanzania’s almost 58 million people living in rural areas the need for decentralised care that reaches the community is crucial. Diarrhoeal diseases, sepsis, malaria, TB and HIV/AIDS contribute to the country having the fourth highest number of maternal deaths in Sub-Saharan Africa.  

Tanzania has a hierarchical health system, dispensaries at the village level managed by the village leaders are the closest level of care to the community. Since 2016, THET in partnership with the Ministry of Health and the Benjamin Mkapa Foundation have been training community health workers to bridge the gap between health facilities and the communities they serve.

In 2016, Samwel, selected by his village, began his training as a Community Health Worker. Driven by a desire to serve his community, he had always taken part in community sessions, helping to raise awareness of village issues and supporting the  committee in its work.

‘I have lived in my village since I was born and my community are so pleased that I am here as a Community Health Worker. They trust and support me and that makes me feel so confident in my role.

Before I graduated, a volunteer health worker used to visit the village every two or three weeks to spread awareness in the community on different topics but in between these visits there would be no one. I think my interest in health was sparked by this and at first I wanted to be a nurse but then I heard about the Community Health Worker certificate and knew that is what I wanted to do.

Compared to other villages I know, it is quite small with 3000 people and seven hamlets within it. It is a lot of people to see, as I am just one person with no car, motorcycle or bike. Often that means I walk for almost an hour to visit people in their homes, although sometimes I use my salary to rent a motorcycle to help get me around and this costs 3,000 (TZSH). Every week I try to visit at least 80 patients, roughly 400 a month.

Malaria is the biggest burden in my community and with the my training, the support of the Community Health Management Team for the district (population of over 400,000), and other initiatives I have been helping to conduct research into the incident rates and the effectiveness of awareness raising in terms of prevention. I am happy to say that lots of families are now using nets I recommended.

I think the training definitely covered the issues I face in the community, all of the modules I did on the year course I use in my work now, from my favourite module on reproductive and child health to social welfare and gender based violence. I really enjoy using my skills and knowledge to visit the elderly and knowing how to care for them and advise them is great.

I often run campaigns which I also really enjoy, from sanitation and the need for latrines, to the benefits of breastfeeding and sanitation measures.

There are many patients and families that stay in my mind that I have helped, recently I discovered a patient with TB when we did a screening session so that was a success. Probably the happiest example I have is of Mama Musa, her home is about half an hour walk from here and I visited her when she was very pregnant. I could see some of the danger signs developing for her and her baby and I advised her to go to the health facility, but she was very reluctant to go before she had to. So I worked with the community and we were able to mobilise transport for her and continued to speak with her on the  benefits of going now and in the end she went, she received treatment and she has a successful delivery. I could not have wanted more.

I would encourage anyone who is thinking of becoming a CHW to do it! Study hard, do not be put off by the employment issues and you will enjoy your work. Stay optimistic about employment and even if you are not receiving a salary use the skills you have learnt to volunteer and help your community.”


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