Tanzania

Experiences, Opportunities and Challenges of Implementing Task Shifting in Underserved Remote Settings: The Case of Kongwa District, Central Tanzania

The aim of this was to describe the current situation of implementing task shifting in the context of acute shortages of health workers and, secondly, and to provide a descriptive account of the potential opportunities or benefits and the likely challenges which might ensue as a result of implementing task shifting. [adapted from abstract]

Challenges of Developing an Instrument to Assess Health Provider Motivation at Primary Care Level in Rural Burkina Faso, Ghana and Tanzania

The objective of this study was to develop a common instrument to monitor any changes in maternal and neonatal health care provider motivation resulting from the introduction of pilot interventions in rural, primary level facilities in Ghana, Burkina Faso, and Tanzania. [from abstract]

Assessing Performance Enhancing Tools: Experiences with the Open Performance Review and Appraisal System (OPRAS) and Expectations Towards Payment for Performance (P4P) in the Public Health Sector in Tanzania

This article addresses health workers’ experiences with the open performance review and appraisal system (OPRAS) in Tanzania, expectations towards pay for performance, and how lessons learned from OPRAS can assist in the implementation of pay for performance. The broader aim is to generate knowledge on health workers’ motivation in low-income contexts. [adapted from abstract]

Maternal and Newborn Healthcare Providers in Rural Tanzania: In-Depth Interviews on Motivation, Performance and Job Satisfaction

This article describes an exploratory study that asked: what is understood by the term motivation; what encourages and discourages providers of maternal and newborn care in rural areas; and which factors influence their performance and job satisfaction. [adapted from author]

Task-Shifting: Experiences and Opinions of Health Workers in Mozambique and Zambia

This paper describes task-shifting taking place in health centers and district hospitals in Mozambique and Zambia to identify the perceived causes and factors facilitating or impeding task-shifting, and to determine both the positive and negative consequences of task-shifting for the service users, for the services and for health workers. [adapted from abstract]

Improving Quality and Use of Data through Data-Use Workshops: Zanzibar, United Republic of Tanzania

This research attempted to test the hypothesis that health information systems data quality and data use are interrelated: poor quality data will not be used, and because they are not used, the data will remain of poor quality; conversely, greater use of data will help to improve their quality, which will in turn lead to more data use. [from introduction]

Measuring Workload for Tuberculosis Service Provision at Primary Care Level: A Methodology

This article describes a methodology developed to establish tuberculosis (TB) related work load in a given context and for a given patient load for use by TB program managers and health planners. The authors piloted this methodology in Tanzania in three districts; one rural, one urban and one semi-urban district as the countrycurrently faces a health workforce shortage of 65% in the public sector and 86% in the private sector, with unequal distribution between urban and rural areas. [adapted from author]

Who is Doing What? Performance of the Emergency Obstetric Signal Functions by Non-Physician Clinicians and Nurse-Midwives in Malawi, Mozambique, and Tanzania

This policy brief explores actual performance of emergency obstetric care (EmOC) and other related maternal and newborn health services by Nurses, nurse-midwives, and non-physician clinicians who provided at least one of the EmOC signal functions in the previous three months preceding data collection in hospitals and health centres throughout Malawi, Mozambique, and Tanzania. [adapted from author]

Workhood: A Useful Concept for the Analysis of Health Workers' Resources? An Evaluation from Tanzania

Drawing on livelihood studies in health and sociological theory of capitals, this study develops and evaluates the new concept of workhood. As an analytical device the concept aims at understanding health workers’ capacities to access resources (human, financial, physical, social, cultural and symbolic capital) and transfer them to the community from an individual perspective. [from abstract]

How to Know What You Need to Do: A Cross-Country Comparison of Maternal Health Guidelines in Burkina Faso, Ghana and Tanzania

This study explored clinical practice guidelines (CPGs) for maternal health in Burkina Faso, Ghana, and Tanzania to compare factors related to CPG use including their content compared with World Health Organization guidelines, their format, and their development processes; and to explore perceptions of their availability and use in practice. The overall purpose was to further the understanding of how to increase CPGs’ potential to improve quality of care for mothers. [adapted from abstract]

Baseline Assessment of HIV Service Provider Productivity and Efficiency in Tanzania

This baseline assessment of HIV/AIDS service providers gathered information on productivity and engagement to develop a set of improved human resource practices that will be integrated into ongoing HIV service delivery. [adapted from summary]

Why Do Health Workers in Rural Tanzania Prefer Public Sector Employment

This article discusses health workers’ preferences for workplace and their perceptions and experiences of the differences in working conditions in the public health sector versus the church-run health facilities in Tanzania. The broader aim is to generate knowledge that can add to debates on health sector management in low-income contexts. [from abstract]

Human Resources for Health Care Delivery in Tanzania: A Multifaceted Problem

This study documented staffing levels and productivity in peripheral health facilities in southern Tanzania. [from abstract]

Pay for Performance in Tanzania

This case study explores the process between donors and the government of moving pay for performance (P4P) from concept to design to implementation. It describes key areas of disagreement, and highlights the political tensions inherent in translating high-level interest in P4P into on-the-ground action. [from author]

Use Pattern of Maternal Health Services and Determinants of Skilled Care During Delivery in Southern Tanzania: Implications for Achievement of MDG-5 Targets

The objective of this study was to assess the use determinants of skilled attendants at delivery in Mtwara rural district. The information obtained will help the district health management team to develop interventions to improve use of delivery care services and ultimately achieve the millennium goal to reduce the high rates of maternal mortality. [from author]

Community Health Workers: An Important Resource Towards Achieving the MDGs

Based on lessons learned from Tanzania, this resource advocates for the integration of community health workers (CHWs) into the revised HRH strategic framework, including the development of new strategies to enable CHWs to contribute more effectively to improved maternal and newborn health outcomes. [adapted from author]

Evaluation of Knowledge Levels Amongst Village AIDS Committees After Undergoing HIV Educational Sessions: Results from a Pilot Study in Rural Tanzania

This paper describes the evaluation of a tailored HIV curriculum for village AIDS committees (VACs) within a rural area to determine if the curriculum increased levels of HIV knowledge among the VAC members through conducting baseline and post-training surveys. [adapted from author]

Antenatal Care in Practice: An Exploratory Study in Antenatal Care Clinics in the Kilombero Valley, South-Eastern Tanzania

This paper uses ethnographic methods to document health workers’ antenatal care practices with reference to the national Focused Antenatal Care guidelines and identifies factors influencing health workers’ performance. Potential implications for improving antenatal care provision in Tanzania are discussed. [from abstract]

Missing the Essentials? Children Can Be Saved if They Are More Carefully Examined

A study from rural Tanzania shows that health workers usually don’t do the investigations that are required to identify some of the deadly illnesses that could be diagnosed and treat. [adapted from author]

Huge Potential for Improved Health Service Quality

This brief outlines a study from rural Tanzania that shows that there is a huge potential for improving service quality with the existing workforce, by reducing the large gap between knowledge and practice. [adapted from author]

Is Worker Effort Higher in Church-Based than in Government Health Facilities?

This brief reports the main results from a study aiming to compare worker effort levels in church-based and government health clinics in Tanzania. [from author]

Convincing Health Workers to Work in Rural Areas

The focus of this brief is on nurses’, clinical officers’ and assistant medical officers’ job preferences and their willingness to work in rural and remote areas in Tanzania. [from author]

Tanzanian Lessons in Using Non-Physician Clinicians to Scale up Comprehensive Emergency Obstetric Care in Remote and Rural Areas

This article evaluates an intensive three-month course developed to train non-physician clinicians for remote health centres to address the unmet need for emergency obstetrical care in rural areas.

Screening of Women for Intimate Partner Violence: A Pilot Intervention at an Outpatient Department in Tanzania

This study evaluated the feasibility of health worker training on and use of an abuse screening tool for women attending an outpatient department as a health care intervention to address gender-based violence. [adapted from author]

Health Worker Motivation in the Context of HIV Care and Treatment Challenges in Mbeya Region, Tanzania: A Qualitative Study

The aim of this paper is to explore the challenges generated by HIV care and treatment and their impact on health worker motivation in Mbeya Region, Tanzania. [from abstract]

Community-Owned Resource Persons for Malaria Vector Control: Enabling Factors and Challenges in an Operational Programme in Dar es Salaam, United Republic of Tanzania

By investigating the community-owned resource persons - their demographic characteristics, their reasons for participating in the an urban malaria control program (UMCP), and their work performance - this study outlines how communities can become responsible for malaria control. [adapted from author]

Effectiveness of a Community Intervention on Malaria in Rural Tanzania: a Randomised Controlled Trial

This article describes a community intervention conducted aimed at improving early malaria case management in under five children. Health workers were trained to train community-based women groups in recognizing malaria symptoms, providing first-line treatment for uncomplicated malaria and referring severe cases. [adapted from abstract]

Measuring Client Satisfaction and the Quality of Family Planning Services: A Comparative Analysis of Public and Private Health Facilities in Tanzania, Kenya and Ghana

This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients’ satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates.

Practicing Provider-Initiated HIV Testing in High Prevalence Settings: Consent Concerns and Missed Preventive Opportunities

The aim of this study was to determine the use of different types of HIV testing services and to investigate perceptions and experiences of these services with a particular emphasis on the provider initiated testing in three selected districts in Kenya, Tanzania, and, Zambia.

Perceived Unfairness in Working Conditions: the Case of Public Health Services in Tanzania

The main objective of this article is to explore health workers’ experience of working conditions, linked to motivation to work. [from abstract]