ehealth digital library

Digital library of
the Tanzania
health
community

Equally Able, But Unequally Accepted: Gender Differentials and Experiences of Community Health Volunteers Promoting Maternal, Newborn, and Child Health in Morogoro Region, Tanzania.

Feldhaus, I., Silverman, M., LeFevre, A. E., Mpembeni, R., Mosha, I., Chitama, D., Mohan, D., Chebet, J. J., Urassa, D., Kilewo, C., Plotkin, M., Besana, G., Semu, H., Baqui, A. H., Winch, P. J., Killewo, J. and George, A. S. (2015) Equally Able, But Unequally Accepted: Gender Differentials and Experiences of Community Health Volunteers Promoting Maternal, Newborn, and Child Health in Morogoro Region, Tanzania. International journal for equity in health, 14 (1). p. 70. ISSN 1475-9276

[img]
Preview
PDF
Isabelle_Feldhaus.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial.

Download (607kB)

Abstract

Despite emerging qualitative evidence of gendered community health worker (CHW) experience, few quantitative studies examine CHW gender differentials. The launch of a maternal, newborn, and child health (MNCH) CHW cadre in Morogoro Region, Tanzania enlisting both males and females as CHWs, provides an opportunity to examine potential gender differences in CHW knowledge, health promotion activities and client acceptability. All CHWs who received training from the Integrated MNCH Program between December 2012 and July 2013 in five districts were surveyed and information on health promotion activities undertaken drawn from their registers. CHW socio-demographic characteristics, knowledge, and health promotion activities were analyzed through bi- and multivariate analyses. Composite scores generated across ten knowledge domains were used in ordered logistic regression models to estimate relationships between knowledge scores and predictor variables. Thematic analysis was also undertaken on 60 purposively sampled semi-structured interviews with CHWs, their supervisors, community leaders, and health committee members in 12 villages from three districts. Of all CHWs trained, 97 % were interviewed (n = 228): 55 % male and 45 % female. No significant differences were observed in knowledge by gender after controlling for age, education, date of training, marital status, and assets. Differences in number of home visits and community health education meetings were also not significant by gender. With regards to acceptability, women were more likely to disclose pregnancies earlier to female CHWs, than male CHWs. Men were more comfortable discussing sexual and reproductive concerns with male, than female CHWs. In some cases, CHW home visits were viewed as potentially being for ulterior or adulterous motives, so trust by families had to be built. Respondents reported that working as female-male pairs helped to address some of these dynamics. Male and female CHWs in this study have largely similar knowledge and health promotion outputs, but challenges in acceptance of CHW counseling for reproductive health and home visits by unaccompanied CHWs varied by gender. Programs that pair male and female CHWs may potentially overcome gender issues in CHW acceptance, especially if they change gender norms rather than solely accommodate gender preferences.

Item Type: Article
Keywords: Maternal, Newborn, Child health, Community Health Worker (CHW), Gender
Subjects: Health Systems > Human Resources
Divisions: Other
Depositing User: Mr Joseph Madata
Date Deposited: 02 Sep 2015 08:18
Last Modified: 02 Sep 2015 08:18
URI: http://ihi.eprints.org/id/eprint/3330

Actions (login required)

Edit Item Edit Item

Downloads

Downloads per month over past year

View more statistics