Assessing mid-level health worker capacity to implement nutrition services in Tanzania and Uganda

Objective: The absence of a skilled human resource base is one of the greatest impediments to scaling-up nutrition interventions in East Africa, a region with a high burden of undernutrition. In the absence of nutritionists, health workers provide the bulk of nutrition services at the facility and community level. In addition to the limited capacity, the numbers of health workers needed to provide nutrition services outweigh the available supply. We undertook a capacity analysis of mid-level health workers in Uganda and Tanzania to better understand their perceptions on the knowledge and skills they should have to effectively implement nutrition interventions.

Methods: A qualitative research design using methods such as task and job analysis, semi-structured interviews, focus group discussions, and key informant interviews with district leaders was used to collect information on knowledge and perceptions of health workers.

Results: Shortages of health workers and their mal distribution in Uganda and Tanzania have implications on the way nutrition services are delivered in these countries. Most health workers had low levels of knowledge on nutrition issues and differing perceptions on what nutrition activities they implement. In both countries, workers mentioned that their training did not adequately prepare them to address nutrition needs at the community level.

Discussion: Countries can strengthen health worker knowledge and skills related to nutrition by making pre-service curricula competency-focused with specific nutrition components. In addition, using on the job training for health workers and introducing strategies such as task shifting may mitigate challenges of health worker shortages.