Jumanne Kabula, Pasape Liliane, Moshi Irene R, Mrisho Mwifadhi
The Nelson Mandela African Institution of Science and Technology, P.O.BOX 447 Arusha, Tanzania.
Ifakara Health Institute, Health Systems and Policy Review & Environmental Health and Ecological Sciences (IHI), Kiko Avenue, Mikocheni, P. O. Box 78373, Dar es Salaam, Tanzania.
Ghana Med J. 2021 Jun;55(2):118-127. doi: 10.4314/gmj.v55i2.4.
Community health workers (CHWs) play significant roles in areas where professional health workforce succumb to serious human resource deficiencies. This study explored challenges the CHWs face in promoting maternal and neonatal health in two districts of Tanzania.
A cross-sectional study design was conducted in Bagamoyo and Mkuranga districts from March to May 2019.
Qualitative data were collected using in-depth interviews from 30 CHWs, thematic analysis was carried out by identifying major key themes emerging from the data.
The study found little community support resulted from jealousy of male household heads, mistrust, social-cultural believes and lack of community appreciation on the role of CHWs. Little support from local government resulted by political grievances among local leaders due to change in political administration. Other challenges were lack of basic knowledge in maternal and neonatal health, including breastfeeding. Irregular working schedules due to poor supervision, huge workload, old age and tiredness.
CHWs programs in Bagamoyo and Mkuranga districts were inactive and required innovative strategies to raise community and local government cooperation. Jealousy among male household's heads and CHWs need community members to participate in establishment of selection criteria. Socio-cultural beliefs call for community sensitization on how they affect maternal and neonatal health. Lack of community appreciation on the role of CHWs, irregular working schedule implied poor supervision and defined age limit would overcome challenges related to old age.
The study received financial support from the African Development Bank (AfDB) through a master scholarship program at the Nelson Mandela African Institution of Science and Technology (grant number. SA_Z1_21001550338).
在专业卫生人力严重短缺的地区，社区卫生工作者发挥着重要作用。本研究探讨了坦桑尼亚两个地区的社区卫生工作者在促进孕产妇和新生儿健康方面所面临的挑战。
2019年3月至5月在巴加莫约和姆库兰加地区进行了横断面研究设计。
通过对30名社区卫生工作者进行深入访谈收集定性数据，通过识别数据中出现的主要关键主题进行主题分析。
研究发现，由于男性户主的嫉妒、不信任、社会文化观念以及社区对社区卫生工作者作用缺乏认可，社区支持很少。地方政府的支持很少，原因是政治行政变革导致地方领导人之间存在政治不满。其他挑战包括缺乏孕产妇和新生儿健康方面的基本知识，包括母乳喂养。由于监督不力、工作量巨大、年龄较大和疲劳导致工作时间表不规律。
巴加莫约和姆库兰加地区的社区卫生工作者项目不活跃，需要创新策略来提高社区和地方政府的合作。男性户主和社区卫生工作者之间的嫉妒需要社区成员参与制定选择标准。社会文化观念要求对其如何影响孕产妇和新生儿健康进行社区宣传。社区对社区卫生工作者作用缺乏认可、工作时间表不规律意味着监督不力，设定年龄限制将克服与年龄相关的挑战。
该研究通过纳尔逊·曼德拉非洲科学技术研究所的硕士奖学金项目获得了非洲开发银行（AfDB）的财政支持（资助编号：SA_Z1_21001550338）。
