From: Improving motivation among primary health care workers in Tanzania: a health worker perspective
Problem | Proposed solutions by health workers | Recognized by DMO | Major constraints expressed by DMO |
---|---|---|---|
Training | 1. Give untrained health workers formal training to acquire skills needed | Yes | 1. Not enough funds allocated |
 | 2. In-service training | Yes | 2. Understaffing |
Understaffing | Nurses currently working as administrators should be replaced by non-medical staff | Yes | Not enough funds to employ new staff. |
Acting upwards | None | Yes | None |
Acting downwards | None | No | Â |
Gambling with health | Equip all health facilities with microscopes | Yes | Guidelines for personnel in dispensaries doesn't include laboratory staff. |
 |  |  | Not enough laboratory technician/assistants trained |
Referral and feedback | 1. Specialist should visit health facilities regularly to conduct site training on cases the health workers normally refer to them | Yes | None |
 | 2. Completed referral letter should be returned to referring clinic | Yes | None |
Supervision | 1. Feedback to be given on previous supervision visits | Yes | 1. Time constraints due to intense workload of DMOs. Also, DMO activities (and resources) still partially controlled by central government. |
 | 2. Recognition from DMO of hard work they are doing | Yes | 2. None |
Promotion | Timely promotions as outlined by Ministry guidelines | Yes | Have no final decisions; can only recommend to higher authorities |