Community Health Workers: At the Centre of Maternal Health Education Awareness

(Chemba District, Dodoma Region)

Chambalo Village located about three kilometres from Chemba District’s town center in Dodoma Region, is where you are bound to meet Theresia Nkhambi, a Community Health Worker (CHW) who has nothing more than excessive passion, dedication and an unwavering commitment in saving women’s lives.

She extraordinarily endures a daily walking distance of an average of 10 kilometres. Why? Her objective is visiting families for follow-ups and imparting them with awareness education on health related issues linked to Reproductive, Maternal, Newborn Child & Adolescent Health (RMNCAH).

Like in any other Tanzania rural settings, villagers are commonly associated with embracing several myths which sidelines them to access useful medical care at health facilities and Chambalo Villagers are no exception.

Highly vulnerable are women, particularly the pregnant ones who are more likely to consult traditional healers in resolving any health-related crisis. The common or rather widespread myth in Chambalo Village is that pregnant women attending clinics are more likely to be bewitched and consequently lose their young babies.

Ms Theresia is a native of this village. The name Chambalo is from the Burunge language meaning ‘hidden’. As a CHW, Theresia is gradually changing the narrative in her village by ensuring that it is no longer hidden from the access of healthcare services and the villagers are exposed to necessary health knowledge awareness.

Ms Theresia is among 114 Community Health Workers deployed by the Mkapa Foundation under the Mkapa Fellows Program Phase III advent. This provides linkages between communities and health facilities through provision of education and referral to patients who need urgent or further consultations.

Also they have been very instrumental in sensitizing women on the importance of attending clinics when they are pregnant to avoid maternal deaths that could otherwise be easily preventable.

The MFP III in collaboration with other stakeholders is complementing government initiatives by addressing the national challenges facing maternal health in Tanzania including high Maternal Mortality Ratio through deployment of these CHWs in rural settings.

Evidence shows that CHWs have been a way out to many communities who for decades have faced limited access to maternal health information camouflaged with traditions and customs that are affecting access to healthcare and services.

Theresia, concurrently rises up with the sun to attend her daily duties as a CHW. She is unfazed by daily walking of long distances, but rather obsessed to stage a fight against the reluctance of her own people through healthcare awareness education that she consistently spreads around the village.

“When I first started there was a bit of a hike because most people couldn’t grasp the importance of the knowledge that I was sharing with them. Therefore most of them never paid attention to me and to them it felt like a waste of time. But I am no quitter so I kept pushing day after day until they started showing a positive response towards me and my work” said Theresia.

Theresia does not take her work as a Community Health Worker lightly. She makes sure that everyone is safe and if someone needs further attention, she will go that extra mile to make sure that this person gets the needed attention. She remembers a woman that she had helped recently who had a persistent coughing and never wanted to go to the dispensary to seek medical attention.

“I told her that she needed to go to the dispensary to consult a doctor. She agreed and subsequently tested positive for HIV. She was unaware of her status afte earlier failing to attend dispensary whenever she was not feeling well. She was glad that my initiative to engage her on the importance of seeking medical care at the facility came at the right time and now she has started receiving her ARVs and her health is substantially much better than before,” added Theresia.

Describing the great impact that has been brought at the facility level due to the presence of the CHWs in the community, Dr. Admond Chiwanga, the facility incharge at Chambalo Dispensary, says the percentage of the ANC visits to the dispensary has increased from 20% when there was no CHW to about 70-90% after the CHW started the much needed Empowerment

“Thanks to the MFP III that brought these CHWs as they have been of significant

help in building strong links between us and the community. Theresia goes places where I can’t and brings in people with different issues especially those concerning maternal health,” Dr. Chiwanga added.

Chemba district has 114 villages which through the support of the MFP III each village is staffed by one CHW who are providing links between communities and the health facilities and breaking barriers include myth associated with lack of knowledge on health issues among villages.

“She is a good friend and cares about our wellbeing” says Zakia Iddi Ramadhan who just gave birth three weeks ago at the Chambalo Dispensary

“I was not sure if I was going to give birth at the dispensary had it not been for Theresias’ persuasion. She found me unwell with a pregnancy that was just over 12 weeks and she wouldn’t let me stay home without booking for Antenatal Clinic. Thanks to her, just three weeks ago I safely and soundly delivered my baby at the dispensary”.

For Theresia, she feels like her work has just started with confidence that she is going to empower her community on health awareness issues.

“…Now that I can witness the results I am even more motivated than before. It is clear that my work has planted a seed that grew into a fruit bearing tree. Even the men who were once reluctant to take their wives to the dispensary for Antenatal Clinic, are more eager to do that now,” concludes Theresia.

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Mkapa Foundation