A dissertation submitted in Partial Fulfillment of the Requirements for the Degree of
Master of Science in Public Health Research of the Nelson Mandela African Institution of
Science and Technology
Maternal and neonatal mortalities are global public health of concern and are estimated to cause
about 830 women deaths every day, of which 99% are from sub-Saharan African countries. In
Tanzania maternal and neonatal mortality rate is still alarming. The National health strategic plan
for 2008-2015 of Tanzania directed the deployment and trainings of community health workers
(CHWs) in provision of maternal, neonatal and child health services. Despite such trainings, yet
there is limited evidence of the applicability of the knowledge acquired during trainings when
performing their duties. Therefore, this study aimed at determining whether trained CHWs apply
learned knowledge when performing their duties so as to improve maternal and neonatal health
status. This study, further explored challenges facing community health workers in applying
learned knowledge. Under this study both quantitative and qualitative methods were used.
Qualitative method used primary data from 30 in-depth interviews with CHWs. Quantitative data
were secondary obtained from a cross-sectional survey done to evaluate UNICEF/GoT
interventions conducted in thirteen districts of Tanzania in 2007-2010. This study found
significant association between age and applicability of learned knowledge among trained
CHWs. Community health workers aged above 40 years were more likely to apply the learned
knowledge in maternal and child health than those aged below 40 years. Furthermore, this study
found several challenges reported to hinder knowledge applicability among CHWs. These
include; little participation from community members and local government, shortage of
refresher training in maternal and neonatal care, irregular working schedules, unclear roles and
responsibilities on neonatal health, heavy workload as well as becoming older and less effective
in visiting households, little community member’s participation resulted by jealousy among
CHWs and male household heads, mistrust between CHWs and community members as well as
social cultural beliefs.