Nationalization of Community Health Volunteers into A Single Cadre System in Zanzibar

Introduction: The Zanzibar Ministry of Health (MOH) has worked with many organizations to improve health outcomes. These organizations introduced distinct community health volunteer (CHV) programs to the communities and pursued government goals in health and social welfare. These volunteers conducted health promotion activities and substantially contributed to reaching MOH target indicators. The MOH recognized the impactful role of these volunteers and decided to formalize CHVs within the government. The government reached out to D-tree International to support the formalization of CHVs from recruitment to training to deployment.

Methodology: The revised Zanzibar Community Health Strategy formally recognizes and sets the stage for a national, single cadre of CHVs. All community members are invited to apply to become CHVs, and recruitment is done using a digital platform to reduce favoring in recruitment. All recruited CHVs are given a 10-day training comprising of household registration, nutrition, immunization, early childhood development (ECD), and integrated reproductive and child health services. Trained CHVs are awarded a special certificate and are given work aids, including phones.

Results: Since the national CHV program launched in 2019, it has already expanded to 6 districts and trained 1,038 CHV. CHVs have registered 89,810 households and 462,685 people, conducted 6,648 pregnancy visits and referred 15,563 clients to health facilities.

Conclusion: Government ownership of CHVs increases the specialty of the program, as prior CHV programs were run by NGOs. It also removes the confusion among communities, as only one CHV deals with primary health care in the households than previously when many volunteers would come to introduce themselves as a CHV. This program also enables CHVs nationwide to discuss important topics with pregnant women and close relatives while encouraging male involvement. Increased awareness of mothers and community members on the importance of essential maternity services and recognition of danger signs for both mother and newborn has enabled them to make life-saving decisions in time.