HEALTH SYSTEM THINKING
MEDICINE MANGEMENT
MEDICINE MANGEMENT
HEALTH PROMOTION
HPSS APPROACH FOR HEALTH PROMOTION
Based on an initial analysis of the situation of health promotion in Tanzania, in the first phase of the project, HPSS designed and piloted evidence-based, innovative, and empowering community participatory techniques and mechanisms to address existing gaps and unmet needs.
In Tanzania, like many countries, health promotion in had not been participatory in the past, but had been interpreted and implemented as a top-down approach that relied heavily on health education, with communities being passive receivers of information.
The framework for HPSS’s health promotion strengthening was the WHO Ottawa Charter that defines health promotion as a comprehensive approach within and beyond the health sector that enables people to increase control over their health. This goes beyond the common interpretation of distributing posters and leaflets, to strengthening five core pillars within national and local systems:
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Building healthy public policy
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Creating supportive environments
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Strengthening community actions
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Developing personal skills
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Re-orienting health services
The empowerment of individuals and strengthening the actions of families, groups and communities for health therefore became a main focus of strengthening health promotion approaches within national, regional, district and communities, the government duty-bearers and supervisors as well as civil society organisations.
In response to the need for national skills development and reorienting services towards participatory approaches, HPSS developed and piloted practical training modules and resources for Master Trainers from among the Health Officers, Community Officers and School Health Coordinators from each of Dodoma Region’s seven districts from the health, community development and schools sectors.
The regional Master Trainers trained their peers using the HPSS Community Participatory Health Promotion training pack, thereby ensuring that all government duty-bearers and community-based organsiations concerned with community health were capacity built to better serve community needs. This was achieved at low cost by a cascade of trainings and interventions to learning villages, who supported surrounding villages to take up community participatory health promotion activities. In this way, the project was able to demonstrate that skills can be rapidly built over whole regions, with minimal investment and outside expertise
A supportive environment for capacity–built officers was created by training regional and district health managers and developing the job descriptions for health, community development and school health staff to include specific health promotion duties. These were further supported by guidance documentation and the introduction of supportive supervision.
As there was no policy framework to support community action for health, HPSS supported the government to develop a pilot health promotion strategy for Dodoma Region. Working closely with government partners at the national, regional and district levels, as well as with community organisations, NGOs and educational institutions, the project formed a Health Promotion Technical Working Group (TWG) and the successful strategy document formed the basis for the national Policy Guidelines for Health Promotion.
To ensure that strengthened national expertise was sustained and developed in the future, HPSS developed a number of courses and trained lecturers at the University of Dodoma (UDOM), which now maintains health promotion teaching and will take the lead in rolling out expertise to other training centres throughout Tanzania.
MASTER TRAINERS AND POLICY GUIDELINES
In the current phase 3, project support and resources are dedicated towards consolidating the tools approaches and experienced gained from the Dodoma pilot to support the government of Tanzania in adapting them for national scaling up through its institutions and bodies, as shown in the Phase 3 theory of change.
Through the establishment of a Technical Assistance Facility (TAF), coordinated through the government Health System Strengthening Resource Centre, HPSS will complete its intervention cycle to ensure sustainable results after the life of the project:
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Provide supportive guidance based on the lessons learned from piloting innovative participatory health promotion approaches within the health, community and school sectors with the development of national planning and implementation guidelines.
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Support further strengthening of health promotion structures within PORALG and MoHCDGEC for directing, supporting, and supervising health promotion in all 26 regions and their 184 districts in Tanzania. Health promotion innovations, training packages, materials, tools and guidance documents, etc. will be scaled-up nationally.
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Support completion, internalization and institutionalization of health promotion supportive supervision via the digital format of the tools and the development of a mobile application for the National Information Sanitation System (NSMIS).
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Empower UDOM Health Promotion Resource Centre to capacity build Health Promotion Officers from the government at national, regional and council levels to ensure the adaptation and national scale-up of training packages and tools for effective and efficient evidence-based health promotion interventions.
Expected results:
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Consistent and high quality support provided by government duty-bearers to school and community health promotion initiatives are supported by approved policy and implementation guidelines.
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Policy guidelines and implementation manual are well disseminated to all actors and are able to implement them.
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Health Promotion system led by MoHCDGEC and PORALG, is well coordinated with the Regional Secretariats and Local government to up-scale community participatory andinter-sectoral approaches.
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Centralised national health promotion structure is capacity-built and functioning to sustain future planning, training and innovations and tracking implementation results, and emerging policy issues.
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A national deployed to all 26 regions
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A mobile solution for NSMIS is developed and deployed in all regions.
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Evidence base on health promotion in Tanzania is generated through research and best practices to inform policy and future adaptations of HP approaches.
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Communities are empowered by strengthened health promotion structures, expertise and modern approaches to take action to prevent disease and optimize their well-being.
