Challenges facing community health workers in promoting maternal and neonatal health in Bagamoyo and Mkuranga districts, Tanzania.

Objectives: Community health workers (CHWs) play significant roles in areas where professional health workforce succumb to serious human resource deficiencies. This study explored challenges the CHWs face in promoting maternal and neonatal health in two districts of Tanzania. Design: A cross-sectional study design was conducted in Bagamoyo and Mkuranga districts from March to May 2019. Methods: Qualitative data were collected using in-depth interviews from 30 CHWs, thematic analysis was carried out by identifying major key themes emerging from the data. Results: The study found little community support resulted from jealousy of male household heads, mistrust, social-cultural believes and lack of community appreciation on the role of CHWs. Little support from local government resulted by political grievances among local leaders due to change in political administration. Other challenges were lack of basic knowledge in maternal and neonatal health, including breastfeeding. Irregular working schedules due to poor supervision, huge workload, old age and tiredness. Conclusion: CHWs programs in Bagamoyo and Mkuranga districts were inactive and required innovative strategies to raise community and local government cooperation. Jealousy among male household's heads and CHWs need community members to participate in establishment of selection criteria. Socio-cultural beliefs call for community sensitization on how they affect maternal and neonatal health. Lack of community appreciation on the role of CHWs, irregular working schedule implied poor supervision and defined age limit would overcome challenges related to old age. Funding: The study received financial support from the African Development Bank (AfDB) through a master scholarship program at the Nelson Mandela African Institution of Science and Technology (grant number. SA_Z1_21001550338).