COLLEGE OF HEALTH SCIENCE

SCHOOL OF MEDICINE

BSc IN MEDICINE: COMMUNITY HEALTH MEDICINE

INDIVIDUAL ASSIGNMENT

REG. No . T/UDOM/2015/17096

NAME: MILTON M.MAKANGE

 1. What are the current challenges that face community health nursing and midwifery in
Tanzania, discus the solution of each challenges
Community health nursing or midwifery
Is a synthesis of nursing and public health practice applied to promoting and preserving
the health of populations (ANA,2000).
Treat “Population as a Whole”– Focus on individual, family, groups, community,
Utilizing Health promotion, health maintenance, health education, and management,
coordination, and continuity of care for meeting population needs.

The following are the challenges facing the community health nursing and midwifery

i. Shortage of resources
The participants described a shortage of personnel, equipment and facilities that leads to
problems with overwork and causes poor delivery of community health to the targeted
population
Solution:
 Shortage of resources
Emphasize on importance of providing resources such as weather survival kits, cards and
other technologies, however fund is limited but the organization or institution shall
provide all required resources, to the community health nurses.

ii. Fund
Most community nurses experience difficulties in economy during proving the
community health services this make difficult to reach people in different areas in the
community and fail to deliver what was intended to the given community

Solution
 Enough fund should be provided to the community health nurses that make them
easy to obtain equipment for different services

iii. Ignorance among individual in community

Most people in a community are not aware with due to lack of educations and their
cultural ties in which bring the difficulties among the community health nurses to
perform their duties.
Solution
 Before conducting any community program , the government should provide the
society with the education on the importance of health in order to make them
ready to accept the community health

iv. Poor implementation of health policies in Tanzania

The government had tried in better way to formulate policies that aims mainly on health
protection, prevention and curing the Non communicable disease but fail to manage as
 the result the community health nurse fail to provide the service to the community . They
do not providing a conducive environment for nurses to perform different community
teaching.
Solution
 Government should make sure that they implement the policy and provide all
requirements that will give comfortable environment for nurses and other health
workers Improvement in security which could give community workers a great
confidence to perform their work in a community

v. Beliefs
Different areas in different community in Tanzania they have different perception about
health services. This make some community refusing the kind of care that are given by
community nurses this lead challenge to the nurses and the whole program will be
affected.
Solution
 Program implementers should be aware with health behaviors by focusing on the
attitudes and belief of individuals in order to have community health nurses with
aware with a real situation on the given areas

vi. Language barrier

Most societies in Tanzania especially in rural areas do not know to speak national
language this make a barrier for them to provide good participation to community nurses

Solution
 To have the organization’s interpreter resources, typically include in-person
interpreters employed by an organization or to have local translator for tribes

vii. Inadequate equipments for services

Most community nurses lack health equipments such as gloves, wheel chair, protective
clothes, this make difficult to perform their work especially in the community with
communicable diseases like cholera

Solution
Implementers of program on community health should ensure that all equipments needed
are present before the program start to run

viii. Most areas are remotes

 A large number of people in Tanzania are living in villages and most villagers in our
countries are isolated in health services due poor infrastructures causing difficult for
community healthy nurses to reach those areas an

Solution
 The ministry of shall establish taskforce to investigate ways of addressing the
shortage of community nurses in remote areas to ensure that these areas get
community health services

ix. Cultural factors

Community nurses fail in changing people health attitudes because most people in
community have already their cultural ties, for instance community nurse can teach
about importance of eating cooked eggs in pregnant women but culture had already
beliefs that have effect to the new born
Solution
 Cultural barriers: Program implementers may need to adapt materials such as
information packets, to ensure all program materials are culturally appropriate,
for instance, if patients are not comfortable with computer the community health
nurse may use paper charts to collect information during a home visit.

x. Poor transports and infrastructures

Most areas in Tanzania have poor infrastructures this make difficult for community
nurses to reach these areas. Also the areas where community health services have to be
delivered have limited access to transportation.

Solution
 Improvement of infrastructures which can make easy for nurses and other health
workers that working in community to reach these areas easily and those
indigenous people to be able to reach to the health settings when referral is
provided

xi. Safety
 Programs must ensure the safety of community health nurses but this is a challenge to the
health providers where by they are travelling to remote areas where roads are unsafe or
impassable due to increment weather
Solution
 Safety in order to ensure safety the program shall provide safety training to
community health workers or nurses , other strategies to promote safety including
daily reporting to the supervisors , sharing travel routes and anticipated times for
home visits , storing sensitive client information in a locked file and not
transporting medications

xii. Patient referrals

Programs may encounter difficulties referring patients to the medical providers, and
coordinating services with outside providers and agencies, hence lead a challenge to the
community health in Tanzania.
Solution
 To allow the community health nurse to monitor and analyse areas in need of
referrals, and nurse to prepare the referral for the client
xiii. Partnerships
There is challenge in agreements with partners in the community and in identifying
opportunities to work with.
Solution
 Partnership: The implementers of the program shall have an agreement with
partners in the community and identifying opportunities to work with new
organization will help extend the reach of community health nurses or workers
program
2. What are the current health focus in Tanzania based on Ministry of health, Community
Development Gender, Elderly and Children.
The following are the current focus in Tanzania based on Ministry of health , Community
Development Gender , Elderly and Children
I. Strengthened intersectoral capacities for the management of environmental
threats to health in order to reduce the morbidity and mortality caused by
communicable diseases

II. Increased access to prevention , diagnostics , care, treatment, and interventions for
tuberculosis ,HIV , and malaria by strengthening the health systems and
addressing environmental issues

III. Increased and sustained access to safe and quality essential medicines for
Neglected Tropical Diseases (NTDs),

IV. Increased evidence to use for advocacy , leadership and multisectoral response on
injuries, with a focus on risk factors , road safety, child injuries and violence
against children women and youth .

V. Increased access to interventions to prevent and manage Non Communicable

Diseases (NCDs) and monitoring their factors by reducing the burden of NCDs
through health promotion , and reduction, prevention, treatment and monitoring
their risk factors

VI. Improved capacity for surveillance and interventions for reduction of nutritional
risks factors

VII. Increased access to highly quality, reproductive , maternal, newborn , child , and
adolescent health interventions through addressing the social determinants of
health

VIII. Increased vaccination coverage for hard to reach populations and communities.

IX. Enhanced capacity for intersectoral collaboration to address the social

determinants of the health.
X. Strengthened capacity to develop and implement appropriate policies and
legislation for Human Resources for Health(HRH) planning, management,
 production and retention, and to adopt innovative health financing that ensures
increased quality ,access and equity of the health services

XI. Increased access to , and rational use , safe efficacious and quality medicines and
health technologies

XII. Built capacity of civil registration and vital statistics systems, including to support
the strengthening of Health Management Information System( HMIS) reviews ,
assessments, research and evaluation, to generate evidence for the policy

XIII. Built core capacities required for Implementation of International Health

Regulation ( IHR) (2005) in MOHSW and the local government authorities for
all-hazard alert and response by providing support for the developing the
minimum IHR(2005) core capacities and strengthened the capacity to implement
disaster risk management

XIV. Increased capacity to manage health risks of emergencies and build resilience,
including and preparedness for rapid and effective response to heslth –related
disasters and emergencies and major epidemics using the One Health approach

XV. Strengthened surveillance systems to identify paralysis due to wild poliovirus or

type -2 vaccine-related poliovirus.