Abstract

A low level of community participation was identified as one of the weaknesses of the health sector in the United Republic of Tanzania. In order to remedy this situation, a systematic process of training trainers and students was established with full involvement of village people. Twenty-five themes were put forward as starting points for discussions between students and villagers. The students were encouraged to learn from the villagers by listening to them and asking them questions. They also participated in community activities and lived with villagers so as to obtain a good understanding of rural living conditions. In this way, problems were identified and solutions were jointly formulated. A workbook was developed during a series of workshops with students, trainers, village communities, and planners. At least two teachers were trained from each health training school; all schools were supplied with workbooks. The approach has been adopted by most health training schools in Tanzania, and the Ministry of Health is now committed to it. Both students and trainers find this to be a valuable learning experience.

PIP:

A 1978 evaluation of the United Republic of Tanzania's health sector revealed a low level of community participation. To remedy this weakness, the community-based training program for medical assistants was reorganized to enable participants to develop analytical skills, understand the complex nature of rural development problems, and view health issues from an individual and community perspective. Through home visits, role plays, and community discussions, the students became familiar with local views on problems such as nutrition, childcare, and traditional medicine. Other student activities included a community analysis and needs assessment, immunization outreach, participation in tasks such as harvesting, and village meetings to evaluate previous work. A series of workshops with students, trainers, villagers, and health planners resulted in preparation of a workbook for use in health training programs. The emphasis of this approach to training is its view of the community itself as the principal training resource. Although early evaluation reports suggest that communities are now more willing to participate in health-related projects, agriculture and party-building are given higher priority than work on health issues. Thus, continued dialogue is needed to avert a conflict of priorities between health workers and their constituents.