Evaluating the impact of community health worker integration into prevention of mother-to-child transmission of HIV services in Tanzania

Abstract

The International Initiative for Impact Evaluation (3ie) is an international grant-making NGO promoting evidence-informed development policies and programs. We are the global leader in funding, producing and synthesizing high-quality evidence of what works, for whom, why and at what cost. We believe that high-quality and policy-relevant evidence will help make development more effective and improve people's lives. 3ie impact evaluations3ie-supported impact evaluations assess the difference a development intervention has made to social and economic outcomes. 3ie is committed to funding rigorous evaluations that include a theory-based design, use the most appropriate mix of methods to capture outcomes and are useful in complex development contexts. About this report3ie accepted the final version of this report, Evaluating the impact of community health worker integration into prevention of mother-to-child transmission of HIV services in Tanzania, as partial fulfilment of the requirements of grant TW7.18 issued under Thematic Window 7. The content has been copy-edited and formatted for publication by 3ie. Some of the content does not conform to the series report norms or standards, but has been accepted as is. All of the content is the sole responsibility of the authors and does not represent the opinions of 3ie, its donors or its board of commissioners. Any errors and omissions are the sole responsibility of the authors. Any comments or queries should be directed to the corresponding author, Sandra I McCoy, smccoy@berkeley.edu. AcknowledgementsThe authors would first and foremost like to extend our gratitude toward 3ie for funding this evaluation. We would like to thank the Ministry of Health and Social Welfare of Tanzania, and in particular the Shinyanga Regional Medical Officer Dr Ntuli Kapologwe; without their support, this project would not have been possible.We would also like to thank administrative and research staff at Amref Health Africa and University of California, Berkeley, whose collaboration on the project has been essential. We thank Karen Webb and Barbara Engelsmann at the Organisation for Public Health Interventions and Development in Zimbabwe. Lastly, but most importantly, we are thankful to the health facility staff and other local stakeholders who supported this project, and to the research assistants and the impact evaluation field coordinator who collected the data showcased here.ii Summary Community health workers are key frontline health paraprofessionals who have the potential to enhance the World Health Organization's Option B+ strategy to eliminate mother-to-child transmission of HIV. By extending the reach of health services into communities facing a shortage of skilled health workers, community health workers may enhance retention in prevention of mother-to-child transmission (PMTCT) services, including HIV care and adherence to antiretroviral therapy.To test this hypothesis, we evaluated the Mama na Mtoto Pamoja (Mother and Child Together) intervention that integrated community healt...

Integration of Early Infant Diagnosis of HIV Services Into Village Health Clinics in Ntcheu, Malawi: An Exploratory Qualitative Study

“… 40 Our study reports that having services closer to the end-users accelerate a quick turn-around-time of results thereby improving uptake of EID services and this concurs with findings from a Tanzanian study where a timely collection of samples and provision of EID improved the community’s utilization of the services. 41 …”

Quality of care in a differentiated HIV service delivery intervention in Tanzania: A mixed-methods study

“…In Tanzania, CHW are involved in health promotional, educational, and rehabilitative interventions but their role beyond these activities, in particular in providing basic curative services, is yet to be formalized. Several studies show promise for expanding CHW roles, but more evidence is warranted [ 6 , 10 ]. Since DSD limits the frequency of clinical encounters for clients, it becomes pertinent to assure the QoC provided by these lay providers in order not to compromise client outcomes.…”

Integration of community health workers into the health system in Tanzania: Examining the process and contextual factors

“…Despite the efforts undertaken by the Ministry, there are limited studies which have been conducted on the process and contextual factors that influence the integration of CHWs into the health system in Tanzania. Previous studies on CHWs in Tanzania have focused on motivation and satisfaction among CHWS 21–23 and the impact of CHWs integration into prevention of mother to child transmission of HIV 24 . This study aimed at investigating the process of integrating CHWs into the health system and factors that facilitate or constrain the integration process in Rukwa and Katavi regions in Tanzania.…”

“…CHWs integration into prevention of mother to child transmission of HIV. 24 This study aimed at investigating the process of integrating CHWs into the health system and factors that facilitate or constrain the integration process in Rukwa and Katavi regions in Tanzania.…”