The Connect Project of Ifakara Health Institute of Tanzania and Columbia Mailman School of Public Health with the support of the Doris Duke Charitable Foundation has trained community health workers known as Community Health Agents (CHAs), or the ancronym WAJA in Swhili, in three districts in Tanzania. The project has encouraged the CHAs to start blogging their experiences and challenges in promoting community health. Below are two examples of their work as it involved malaria. More postings can be viewed on WordPress.
Boniface Madina Mwandishi, that CHA from Katindiuka Village, is particularly concerned about preventing malaria in pregnant women. When He talked to women in his service area he learned that the net voucher system that allows women to get insecticide treated nets at half the going price of TSH 2,500 (~$1.50) had problems.
First the vouchers were either late or not available in the nearby health facilities. Many cannot afford to pay the full price. Thus most women are not using nets to protect themselves and their unborn children from malaria.
A village elder complained to Boniface that his wife was not able to obtain a net even until a month after their child was born. The elder stressed that had the vouchers and nets been available more women and children would have been protected from malaria. Boniface will follow up to report on the lapses in the voucher system.
Castor Mwinamile, the CHA from Mchombe Village, reports on problems with Malaria Rapid Diagnostic Tests (RDTs). He had called mothers together for health education, but they also used the opportunity to complain about the current stock-out of malaria RDTs in the village.
Mothers noted that without RDTs the actual disease of their sick child could not be determined easily. Maybe the child with fever had a urinary tract infection or maybe it was malaria. The CHA promised the mothers to inform the project quickly about the stock-out.
While CHAs are given basic phones to communicate with supervisors and among themselves, some do have smart phones and are able to post on the blog and share with their fellow CHAs who may not have a phone.
The feedback to the program and shared learning among the CHAs, enabled by the blog, demonstrate a unique learning and problem solving experience in community health. These two postings also show that the CHAs have made their communities aware of the benefits of malaria services, hence their demand for better access.
There are other postings about malaria on the Sauti ya Waja, so if your Swahili is adequate, we encourage you to also learn from the Community Health Agents of Tanzania.