The Government of United Republic of Tanzania is hosting a multi-country scale up workshop at the Tanzanian Training Centre for International Health (TTCIH) in Ifakara on the “One Million community health workers” campaign. The workshop participants include key national representatives from ministries of health of ten (10) African countries. The opening ceremony was officiated by the Deputy Minister for Health and Social Welfare, Dr Seif Rashid. Others present at the workshop include the Director of the Tanzania Training Centre for International Health, Professor Senga Pemba, the World Health Organization Representative for Tanzania, Dr. Rufaro Chatora, Secretariat staff from the Earth Institute at Columbia University, WHO staff from WHO Headquarters, Regional Office for Africa and Country Office, Representatives from TTCIH, Ifakara Health Institute (IHI), NGOs, bilateral organizations, UN agencies and members of the media.

In his welcome remarks, the Director of the Tanzania Training Centre for International Health (TTCIH), Prof Senga Pemba, commended the decision to hold the workshop in a remote location and said it “demonstrates in action the philosophy of serving the poor in rural remote areas”. 

In his address via Skype, Professor Jeffrey Sachs, Director of the Earth Institute at New York’s Columbia University, outlined the approach of the campaign as a strategy of accelerating progress towards reaching the millennium development goals. He added that CHWs are foundational to the strategy, for their recognized success in disease surveillance and prevention, vital events registration, timely provision of life-saving curative treatments, and patient referrals to health facilities. 

He stated that the 10 countries involved in the campaign are the “first movers” towards the campaign goal of having 1 CHW serving every 500 to 600 persons. Professor Sachs assured delegates that the campaign has the support of the African Union, the Secretary General of the UN, the MDG advocates (championed by His Excellency President Kagame of Rwanda and the Prime Minister of Australia) and the global initiatives such as the Global Fund, The World Bank, GAVI and PEPFAR. 

He further urged the campaign steering committee to support African governments in the development of strategies for scaling up their CHW workforce as well as their plans and efforts to mobilize the needed funding. Professor Sachs highlighted the elements that need to be addressed by the campaign to include:

• The number of CHWs needed for scaling-up
• Redefined roles
• Remuneration
• Training
• Medical supplies and materials needed such as back-packs and mobile phones
• Transport 
• Supervision

The WHO Representative, Dr. Rufaro Chatora, delivered introductory remarks on behalf of the UN family and development partners reiterating the need for the discussions to take into account among others, lessons learnt over the past four decades in CHW programs such as the health systems context, supervision at the district level and financial sustainability.

In his opening speech, the Deputy Minister for Health and Social Welfare, Dr Seif Rashid said that Tanzania has sufficient evidence that CHWs play a pivotal role in accelerating the attainment of Millenium Development Goals 4, 5 and 6; hence re-defining the role of CHWs will revitalise the primary health care system and contribute to reductions in morbidity and mortality. 

Dr. Rashid cautioned the workshop delegates to pay due attention to the health systems context in which CHWs are being scaled-up, propose sustainable financing mechanisms and means to provide supportive supervision at the district level. He urged participants to learn from the global lessons of the past in the use of the CHWs while working towards revitalizing and increasing the numbers of CHWs. The Deputy Minister concluded his remarks by assuring the commitment by the government in ensuring the CHW initiative brings healthcare services to where it is most needed, among the rural poor. 

Over the course of four days, the workshop delegates will have in-depth discussions on:

• The Maturity model approach to scale-up/upgrade planning for national CHW systems
• The Country driven examples of challenges and solutions for CHW system components
• The Vetting financial and operational CHW scale-up frameworks based upon maturity models
• High priority global institutional support to accelerate implementation plans