267263 Assessing mid-level health worker capacity to implement nutrition services in Tanzania and Uganda

Wednesday, October 31, 2012 : 9:10 AM - 9:30 AM

Manisha Tharaney, MPH, MSW , SPRING Project, Helen Keller International, Arlington, VA
Anu Narayan, MA , John Snow Inc, Arlington, VA
Brenda Namugumya, Masters in Nutrition , Regional Centre for Quality of Health Care, Kampala, Uganda
Grace Muhoozi, Masters in Nutrition , Kyambogo University, Kampala, Uganda
Peter Rukundo, Masters in Nutrition , Kyambogo University, Kampala, Uganda
Onesmo Mella, MPH, MA , 22 Ocean Road, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
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.

Learning Areas:
Program planning
Public health or related public policy
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Describe how mid-level health workers perceive their roles and responsibilities in nutrition; 2. Assess whether their job descriptions and schemes of service support implementation of nutrition services at the facility and community level; and 3. Identify strategies to strengthen pro-nutrition environment at the facility level.

Keywords: Health Care Workers, Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a health systems and nutrition professional with ten years of experience working in global health and nutrition.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.