“Because even the person living with HIV/AIDS might need to make babies” – Perspectives on the drivers of feasibility and acceptability of an integrated community health worker model in Iringa, Tanzania

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dc.contributor.authorShelley, Katharine D.
dc.contributor.authorFrumence, Gasto
dc.contributor.authorMpembeni, Rose
dc.contributor.authorMwinnyaa, George
dc.contributor.authorJoachim, Juliana
dc.contributor.authorKisusi, Hawa Kadria
dc.contributor.authorKillewo, Japhet
dc.contributor.authorBaqui, Abdullah H.
dc.contributor.authorPeters, David H.
dc.contributor.authorGeorge, Asha S.
dc.date.accessioned2020-02-20T10:56:39Z
dc.date.available2020-02-20T10:56:39Z
dc.date.issued2019
dc.description.abstractBackground: Countries with health workforce shortages are increasingly turning to multipurpose community health workers (CHWs) to extend integrated services to the community-level. However, there may be tradeoffs with the number of tasks a CHW can effectively perform before quality and/or productivity decline. This qualitative study was conducted within an existing program in Iringa, Tanzania where HIV-focused CHWs working as volunteers received additional training on maternal, newborn, and child health (MNCH) promotion, thereby establishing a dual role CHW model. Methods: To evaluate the feasibility and acceptability of the combined HIV/MNCH CHW model, qualitative in-depth interviews (IDIs) with 36 CHWs, 21 supervisors, and 10 program managers were conducted following integration of HIV and MNCH responsibilities (n = 67). Thematic analysis explored perspectives on task planning, prioritization and integration, workload, and the feasibility and acceptability of the dual role model. Interview data and field observations were also used to describe implementation differences between HIV and MNCH roles as a basis for further contextualizing the qualitative findings. Results: Perspectives from a diverse set of stakeholders suggested provision of both HIV and MNCH health promotion by CHWs was feasible. Most CHWs attempted to balance HIV/MNCH responsibilities, although some prioritized MNCH tasks. An increased workload from MNCH did not appear to interfere with HIV responsibilities but drew time away from other income-generating activities on which volunteer CHWs rely. Satisfaction with the dual role model hinged on increased community respect, gaining new knowledge/skills, and improving community health, while the remuneration-level caused dissatisfaction, a complaint that could challenge sustainability.en_US
dc.identifier.citationShelley, K. D., Frumence, G., Mpembeni, R., Mwinnyaa, G., Joachim, J., Kisusi, H. K., . . . George, A. S. (2019). “Because even the person living with HIV/AIDS might need to make babies” – perspectives on the drivers of feasibility and acceptability of an integrated community health worker model in iringa, tanzania. International Journal of Health Policy and Management, 8(9), 538-549. doi:10.15171/ijhpm.2019.38en_US
dc.identifier.issnDOI: 10.15171/ijhpm.2019.38
dc.identifier.urihttp://hdl.handle.net/10566/5186
dc.language.isoenen_US
dc.publisherInternational Journal of Health Policy and Managementen_US
dc.subjectCommunityen_US
dc.subjectHealth Workersen_US
dc.subjectImplementation Researchen_US
dc.subjectIntegrationen_US
dc.subjectTanzaniaen_US
dc.title“Because even the person living with HIV/AIDS might need to make babies” – Perspectives on the drivers of feasibility and acceptability of an integrated community health worker model in Iringa, Tanzaniaen_US
dc.typeArticleen_US

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