Enhancing community health workers support for maternal, adolescent and newborn health project plus contraception in rural Tanzania (IMCHA)

Access to the means of preventing unwanted pregnancies and unsafe abortions is critical for averting maternal and newborn deaths and disease. One out of every five Tanzanians is an adolescent, and by the age of 19, half of all girls are pregnant or have already given birth to a child. While contraceptive use by adolescents has increased, less than one in every six adolescents uses contraceptive methods. There are severe limitations in access to family planning services in rural Tanzania, particularly in the districts surrounding Lake Victoria.

This project, a collaboration between the Bruyère Research Institute and Shirati KMT Council Designated Hospital, will complement a current project to build an enhanced cadre of community health workers in rural Tanzania by integrating a focus on the reproductive health needs of women. The project will train community health workers (CHWs) to educate adolescents and women about family planning options, including safe sexual behaviors, and help improve access to family planning services using mobile health applications. Nurses will be trained to work with these CHWs to provide enhanced family planning methods and prevent stock shortages by using m-health stock monitoring of family planning items.

A mixed methods approach will be used to measure the effectiveness and impact of the interventions under this project. Quantitative measurements of contraceptive use (from baseline and post-intervention) will be undertaken using m-health measures of stock levels and work flows of CHWs. Qualitative data from focus group discussions with women, CHWs, and nurses, as well as participatory research activities with policymakers, will ensure a better understanding of the cultural aspects of reproductive health and needs from women and adolescents. Involvement of regional and district medical officers in planning and regular engagement of policymakers at local, regional, and national levels will increase awareness and integration of knowledge in policy and programming.

This project is funded by the Innovating for Maternal and Child Health in Africa program. It is a seven-year $36 million initiative funded by Global Affairs Canada, IDRC, and the Canadian Institutes of Health Research.