Satisfaction of community health worker- students with the training program at Kahama and Shirati Health Institutes in Tanzania

Abstract

Background There is the global dearth of evidence on the satisfaction of Community Health Worker (CHWs) students trained in the formal training programmes. In Tanzania, the gaps on satisfaction of CHW students with training program have existed since the inception of the Community Based Health Program (CBHP) policy guideline. Objective This study aimed at assessing the level of satisfaction of CHW students with the training programme from Kahama and Shirati Health Institutes. The study envisaged specifically to assess the satisfaction of trainees with the content of the courses, relevance of the training to the job, instructors competency, teaching methodology, learning environment and the use of technology. Methodology The study used Kirkpatrick’s Model - focusing on Level 1 to measure the satisfaction of the CHWs students with the training programme. The study employed across-sectional design with a total of 153 students pursuing the Community Health(CH) program and alumni of the CH programme who were sampled by simple random sampling, and a total of 14 tutors from Kahama and Shirati Health Institutes who were also purposively sampled. Data were collected using i) CHW survey using questionnaire-Kirkpatrick tool ii) Focus Group Discussion (FGD) with the tutors. Quantitative data were processed, edited and descriptively analysed using SPSS version 20. The likert scale (1-5) was used and computation of weighted score was done which was used to get the score and decision rule. Focus Group Discussion (FGD) data were transcribed and analysed using content analysis. Results The majority (66%; weighted score =4.5) were strongly satisfied with the course content and the curriculum despite the fact that the curriculum did not reflect the core need of the community health. In addition, 70% (weighted score=4.6) of the students were strongly satisfied with the available learning environment for the course. However, in some cases, there were concerns about the use of old teaching facilities, inadequate quantity and quality of the teaching and learning materials as well as lagging behind in use of innovation in teaching and learning. In the area of the tutors’ competence, most students (69%, weighted score=4.6) were strongly satisfied with their capacity to teach. However, tutors themselves had concerns about being not oriented on the new cadre and students had concerns that the objectives of the course were not thoroughly articulated by tutors. The majority (70%; weighted score=4.7) of students were strongly satisfied with the relevance of the programme. However, they were not sure about their employability. Conclusion It is concluded that there is strong satisfaction and motivation among the CHW students with the community health programme, in particular, the way the training is run, the competence and motivation of the tutors to teach them and the way the practical attachments are structured to give them opportunity to practise what they have learnt in the class. Despite these positive findings of the Programme, it yet is constrained by having a curriculum that does not capture all required contents, some tutors not well oriented on teaching the new programme, and inadequate use of innovative platforms such as m-learning and e-learning in teaching and learning. Recommendation Success of CBHP in Tanzania needs strong Public and Private Partnership. The need for curriculum review should go hand in hand with putting in place CHW recruitment and deployment systems to assure CHW employability. On-the-job training programmes for the tutors are a key to enhance their teaching skills.