Repetitive Cancer Training for Community Healthcare Workers: an Effective Method to Strengthen Knowledge and Impact on the Communities: Results from a Pilot Training at Kilimanjaro Region, Tanzania.

Cancer is a growing burden in Tanzania with high mortality rates. Low level of cancer awareness in the population and health workforce is one of the reasons. This study aimed to evaluate the effects of a cancer awareness training for community-level healthcare providers in Kilimanjaro Region. Main research interest was to assess the effects of the training on cancer knowledge of the healthcare workers and its application into practice. Community health workers (CHWs) (n = 25) and dispensary healthcare workers (DHCWs) (n = 16) attended cancer awareness trainings. Three training days over a 3-month period were provided for each group. Pre- and post-training assessments of the cancer knowledge were conducted on each training day. Application of the knowledge into practice was assessed at follow-up and complemented with qualitative data. Analysis of the questionnaires was provided by descriptive statistics. Qualitative data were analyzed by semantic thematic analysis. Both groups showed a statistically significant increase in knowledge after the three training days: CHWs + 10% (CI 95% = 2-18%, p = 0.015) and DHCWs 24.4% (CI 95% = 13-36%, p = 0.002). The community-level healthcare providers also started to apply the new cancer knowledge into practice and reported to feel more confident in cancer control. The pilot cancer awareness training was effective in increasing cancer knowledge and its application. It strengthened their confidence in care delivery and referral practices as well as education of the population. This concept of cancer awareness training might be also applicable to other countries in SSA.