The document discusses a community health worker program in rural Tanzania that aims to improve access to healthcare and HIV services for people living with HIV. It describes how the program, run by an NGO called SIC, uses volunteers from local communities who provide home visits, supplies, counseling, and help forming support groups. The community health workers receive initial and refresher training and supplies like bicycles. The results shown demonstrate that the program has steadily increased both the number of patients registered and people taught about HIV/AIDS over its first year. Lessons learned include the importance of community health workers who are HIV-positive themselves and having clear rules about eligibility. Recommendations focus on ongoing training, support for people living with HIV,

1. Community Health Workers in
Meru and Arusha Districts in
Northern Tanzania
Presentation to National Organization of Peer
Educators
June 20, 2008
Presented by Joan Amanya

2. Overview
• Issues
• Description
• Lessons Learned
• Recommendations

3. Issues
• In rural areas of northern Tanzania, communities are
at risk for HIV but have limited access to services.
• There are few sources of accurate prevention information
in the villages, limited opportunities to be tested, and
people living with HIV are often far from the nearest
source of medical care.
• Therefore the SIC Community Health Worker
Program has three goals:
1. To improve access to health care for people living with HIV
2. To improve community knowledge about HIV and reduce
stigma towards people living with HIV
3. To empower people with HIV to care for themselves and each
other

4. Description—SIC
• NGO registered in the US,
UK, and Tanzania.
•
• SIC works in three districts
of Tanzania—Meru and
Arusha Rural in Arusha
Region, and Babati in
Manyara Region

5. Description—The Community
Health Workers Program
Uses volunteers from the local
community, who provide:
– Home visits
– Monthly supply of soap and multivitamins
– Mosquito net
– Help forming support groups
– Counseling and education for family members

6. Description—Selection

7. Description—The Program
• 5 days initial training, annual refresher
• Monthly meetings and motivation payment
• Bicycles, scales, and other supplies

8. Results
Number of Registered Patients (Cumulative, May 2007-
April 2008)
0
50
100
150
200
250
300
May-
07
Jun-
07
Jul-
07
Aug-
07
Sep-
07
Oct-
07
Nov-
07
Dec-
07
Jan-
08
Feb-
08
Mar-
08
Apr-
08
NumberofPatients

9. Results
Number of People Taught by Community Health
Workers (May 2007-April 2008)
0
2000
4000
6000
8000
10000
12000
14000
16000
May-
07
Jun-
07
Jul-
07
Aug-
07
Sep-
07
Oct-
07
Nov-
07
Dec-
07
Jan-
08
Feb-
08
Mar-
08
Apr-
08
NumberofPeopleTaught

10. Results
Wards with HIV Postive Support Groups Versus Wards without
HIV Positive Support Groups
0
10
20
30
40
50
60
M
buguni
M
uriet
K
ing'oriIlkiding'a
O
ldonyo
S
am
bu
B
angata
M
akibaM
langariniLeguruki
K
iranyiM
aroroniN
durum
a
K
isongo
K
ikw
e
O
ljoroM
atevesM
oshono
NumberofRegisteredPatients
Wards with Groups Wards without Groups

11. Lessons Learned
• Community members can be strong educators and care
for PLHA
• CHWs who are HIV positive themselves are more
effective at recruiting other PLHA and forming support
groups
• It is important to have specific rules about who is
included in the program and what services exactly we
provide to them
• By providing high quality services, CHWs enroll more
people for care

12. Recommendations
• Strong initial training
• Refresher training
• Continue supporting PLHA
• Work with HIV-positive CHWs
• Quality selection of CHWs
• Registration and follow-up

13. Tuko pamoja
kuushinda ukimwi!

14. Thank you. Questions?