An assessment of the potential of health attendants for family planning and reproductive health expansion in Tanzania.

Prior to 1994 the Tanzania Family Planning Policy Guidelines and Service Standards and the Tanzania Family Planning Training Strategy which were developed to guide family planning service delivery and training identified Nurse Midwives Public Health Nurses MCH Aides and Medical Assistants as the primary MCH/FP service providers. At a 1994 meeting of Regional Medical Officers to obtain their input to develop a five-year (1994-1999) strategy for family planning training it was learned that the expansion of family planning services particularly in peripheral rural health units was severely restricted because of the limited numbers of these staff in each district available for training. Therefore to increase the number of health workers eligible for FP training Health Attendants were proposed as a new and suitable cadre to fill this service need. As a result the 1994 revised Tanzania National Policy Guidelines and Standards for training and service delivery now identifies Health Attendants as among the priority cadres for FP training alongside MCH Aides Nurse Midwives Public Health Nurses and Medical Assistants to provide service at dispensaries health centers and within communities. The FP functions of Health Attendants that are stipulated in the guidelines are similar to those of MCH Aides. They range from providing information education and counseling to FP clients to providing a variety of FP methods including IUCDs. MCH Aides and Health Attendants are also expected to screen clients for STDs and to refer clients with STDs for treatment. However very little is documented about this cadre of Health Attendants in terms of who they really are what they do and what they are capable of doing. Thus it would be difficult to formulate a strategy for their effective participation in the expansion of FP/RH services. In response to this lack of information and the demand and expressed need for their training a three-phase pilot project was designed to address these questions. The first phase consists of three parts. Part One was this Needs Assessment Study whose findings and recommendations will form the basis of Part Two (the developing and refining of the training materials and approaches) and Part Three (the field testing of the training strategy). In the two later phases Health Attendants in Tanzania will be trained using the developed training materials (Phase 2) and the effectiveness of the training will then be evaluated (Phase 3). The primary purposes of this needs assessment study were to: Explore the potential of Health Attendants to provide FP/RH services; Obtain data to guide development of a strategy to enable Health Attendants to participate in the expansion of FP/RH services in Tanzania. (excerpt)