043: IMPLEMENTATION RESEARCH TO SUPPORT THE MINISTRY OF HEALTH AND SOCIAL WELFARE TANZANIA DEVELOP AN EFFECTIVE AND SUSTAINABLE COMMUNITY BASED HEALTH CARE PROGRAM

Background To ensure equitable access to health services, Tanzania has maintained a district level integrated facility-community basic health services. The facility component comprised of district hospitals, health centers and dispensaries. Although facility-based service delivery has human resource for Health (HRH) shortages, it is better organized. Since independence in 1961, Tanzania has developed many different types of Community-Based Health Initiatives (CBHI) using voluntary Community Health Workers (CHWs) however, to-date, none of the initiatives has a sustainable plan. The use of paid cadre of CHWs has the potential to be an effective, efficient, sustainable and equitable strategy to deal with the HRH shortage. An implementation research is paramount from the design to the implementation stages. Objectives To develop an Implementation research to support program design and implementation. Methods To work towards a harmonized and integrated Program, the Ministry of Health and Social Welfare (MOHSW) formed a CHW Task Force to advise the Ministry on matters related to development of a National Community Based Health Program (CBHP), Since its creation, a number of initiatives have taken place throughout 2012–2015. Result A National Policy guideline (2014), Strategic Plan (2014–2020), Training Curriculum (2015) and task sharing guideline were developed, approved and disseminated for use in development of a paid cadre of CHWs that will implement CBHP and deliver a comprehensive package of intervention that contribute to socio-economic development. A CHWs Learning Agenda Project (CHW-LAP) was initiated to establish a research platform for learning. Through the project, we have created a database that maps geographic and programmatic of CBHI and existing CHWs across the country, A Stakeholder Analysis to elicit stakeholder views on the development and implementation of CBHP and A descriptive costing activity to capture existing programmatic costs. Conclusion Embedding implementation research in CBHP has provided an opportunity to learn and adjust while implementing the Program activities.