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Table 2 Summary of results

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  
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