Community Health Workers in Meru and Arusha Districts in

Northern Tanzania

Presentation to National Organization of Peer Educators

June 20, 2008Presented by Joan Amanya

Overview

• Issues

• Description

• Lessons Learned

• Recommendations

Issues• In rural areas of northern Tanzania, communities are

at risk for HIV but have limited access to services.

• There are few sources of accurate prevention information in the villages, limited opportunities to be tested, and people living with HIV are often far from the nearest source of medical care.

• Therefore the SIC Community Health Worker Program has three goals:

1. To improve access to health care for people living with HIV2. To improve community knowledge about HIV and reduce

stigma towards people living with HIV3. To empower people with HIV to care for themselves and each

other

Description—SIC

• NGO registered in the US, UK, and Tanzania.

•

• SIC works in three districts of Tanzania—Meru and Arusha Rural in Arusha Region, and Babati in Manyara Region

Description—The Community Health Workers Program

Uses volunteers from the local community, who provide:– Home visits– Monthly supply of soap and multivitamins– Mosquito net– Help forming support groups– Counseling and education for family members

Description—Selection

Description—The Program

• 5 days initial training, annual refresher

• Monthly meetings and motivation payment

• Bicycles, scales, and other supplies

ResultsNumber of Registered Patients (Cumulative, May 2007-

April 2008)

0

50

100

150

200

250

300

May-07

Jun-07

Jul-07

Aug-07

Sep-07

Oct-07

Nov-07

Dec-07

Jan-08

Feb-08

Mar-08

Apr-08

Nu

mber

of

Pati

en

ts

ResultsNumber of People Taught by Community Health

Workers (May 2007-April 2008)

0

2000

4000

6000

8000

10000

12000

14000

16000

May-07

Jun-07

Jul-07

Aug-07

Sep-07

Oct-07

Nov-07

Dec-07

Jan-08

Feb-08

Mar-08

Apr-08

Nu

mber

of

People

Tau

gh

t

ResultsWards with HI V Postive Support Groups Versus Wards without

HI V Positive Support Groups

0

10

20

30

40

50

60

Mbugu

ni

Muriet

King'o

ri

I lkid

ing'

a

Oldon

yo S

ambu

Banga

ta

Makib

a

Mlang

arin

i

Legu

ruki

Kirany

i

Maror

oni

Nduru

ma

Kisong

o

Kikwe

Oljoro

Matev

es

Mosho

no

Nu

mb

er

of

Reg

iste

red

Pati

en

ts

Wards with Groups Wards without Groups

Lessons Learned

• Community members can be strong educators and care for PLHA

• CHWs who are HIV positive themselves are more effective at recruiting other PLHA and forming support groups

• It is important to have specific rules about who is included in the program and what services exactly we provide to them

• By providing high quality services, CHWs enroll more people for care

Recommendations

• Strong initial training

• Refresher training

• Continue supporting PLHA

• Work with HIV-positive CHWs

• Quality selection of CHWs

• Registration and follow-up

Tuko pamoja kuushinda ukimwi!

Thank you. Questions?