Original Research

Factors associated with retention of community health workers in maternal, newborn and child health programme in Simiyu Region, Tanzania

David P. Ngilangwa, George S. Mgomella
African Journal of Primary Health Care & Family Medicine | Vol 10, No 1 | a1506 | DOI: https://doi.org/10.4102/phcfm.v10i1.1506 | © 2018 David P. Ngilangwa, George S. Mgomella | This work is licensed under CC Attribution 4.0
Submitted: 14 May 2017 | Published: 02 August 2018

About the author(s)

David P. Ngilangwa, Amref Health Africa, Dar es Salaam, Tanzania, United Republic of
George S. Mgomella, Department of Public Health and Primary Care, University of Cambridge, United Kingdom


Background: Attrition of community health workers (CHWs) continues to threaten the full realisation and sustainability of community-based health programmes globally.


Aim: This study aimed to understand factors associated with CHWs’ recruitment and their retention.


Setting: This study was conducted in five districts of the Simiyu Region, namely, Bariadi, Busega, Itilima, Maswa and Meatu in north-western Tanzania.


Methods: In this cross-sectional study design, 341 CHWs who were working with the maternal health programme were randomly selected. Semi-structured questionnaires were administered to all participants. Data were descriptively and inferentially analysed using SPSS version 20.


Results: Majority (58.0%) of CHWs were below 35 years. Over half (53.1%) had completed primary education only. Motivation factors for being CHW were aspiration to serve the community and desire for further training to become a qualified medical practitioner. Community recognition and financial incentives were among the key retention reasons for the CHWs. Being married (odds ratio [OR] 5.9, 95% confidence interval [CI] 1.7–20.1) having prior volunteer experience (OR 10.5 95% CI 12.7–40.5) and prior employment OR 21.8 (CI 12.2–38.9) were positively associated with retention of CHWs, while being a female was negatively associated with retention OR 0.4 (CI 0.2–0.8).


Conclusions: Both financial and non-financial incentives were critical in contributing to the retention of CHWs. Thus, health programmes should carefully select CHWs by understanding their motives beforehand, and provide them with incentives.


Community health workers; retention; recruitment; attrition; maternal;Tanzania


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