I wanted to share some thoughts on an inspiring initiative undertaken by the Tanzanian government to create a new social worker cadre to care for and support the country’s most neglected and vulnerable children. This new cadre is a group of volunteer para-social workers that are part of a conscious strategy to start small in order to have a big impact on the country’s greatest resource: its future generation. It is an innovation that needs organizational, financial, and political support.  

With the 2006 World Health Report, it became exceedingly that clear many developing countries did not have the health workforce needed to meet their needs. For example, around 15% of the global population lives in Africa, but the continent has only 3% of the world’s health workforce and accounts for less than 1% of the world’s health expenditures. The HIV/AIDS crisis necessitated many years of focus on HIV prevention, treatment, and care, but in many cases health systems remain fragile and the health workforce still insufficient. These systems have been further compromised with the global economic downturn.

Although the Tanzanian government and the Ministry of Health and Social Welfare recognize the critical importance of an adequate workforce to respond to HIV/AIDS as well as other health priorities, it is particularly challenging to create a practical solution.  In rural areas, Tanzania’s health and social welfare shortages are particularly problematic with deficits of 70% or more for some cadres. This puts vulnerable children, particularly those living with HIV or orphaned by the disease, at risk especially since so few of them have resources to cope and too often live in poverty and neglect in remote villages. But great challenges can also bring about some of the most inspirational innovations, as has been the case in Tanzania to provide quality services and support to vulnerable children.

The Tanzanian government responded by developing two new health worker cadres—the voluntary para-social worker and the para-social worker supervisor—to provide services to Tanzania’s most vulnerable children. This initiative by the government of Tanzania was launched in collaboration with the IntraHealth International-led Tanzania Human Resource Capacity Project and other partners such as the Institute of Social Welfare. Together, this partnership successfully trained over 3,000 para-social workers to provide critical services in villages for the most vulnerable children as well as over 500 para-social-worker supervisors to oversee this work.

Para-social workers offer much needed psycho-social and family support services as well as referrals for children to protective services if the social worker suspects neglect or abuse. These workers are filling a critical gap in the health workforce and offering uncompromising focus and support on the most vulnerable children. The government’s commitment and local and international partnerships have been key to the success of the cadre.  

According to Jennifer Macias, country director of the Tanzania Human Resource Capacity Project, the next steps are to:

• Continue to roll out and offer training to develop the essential competencies of the para-social workers
• Strengthen the professional social welfare service systems in Tanzania
• Formalize the recruitment, hiring, and performance management of all social  workers
• Develop career pathways for those dedicated to the social services field.

For more information on this exciting initiative, please contact Jennifer Macias, jmacias@intrahealth.org.