In Tanzania, a cascade of NCD knowledge begins

On a bright day in March, 54 doctors from eight regions settled into a conference room in Dodoma, Tanzania to become Trainer of Trainers in non-communicable diseases (NCDs).

They were not alone. Similar three-day trainings of 36 healthcare professionals representing two regions had already taken place. Training for an additional 68 healthcare professionals representing the country’s remaining 10 regions is planned later in 2022.  

The Trainer of Trainers will cascade their knowledge to 2,400 health care professionals representing 600 primary health care units across communities in all corners of the vast Tanzanian territory.

The training is a main component of Tanzania National NCD Programme - Phase II – one of WDF’s largest partnership projects to date as measured by its targets and grant size. 

“After successfully building NCD capacity at the zonal, regional and district levels, we are now taking the next step - strengthening access to care for people with diabetes and other NCDs closer to their homes and within their communities,” says Dr Kaushik Ramaiya, CEO at Shree Hindu Mandal Hospital and head of the Tanzania Diabetes Association (TDA). 

Training first

WDF has supported projects in Tanzania since 2003, over the past seven years in direct partnership with TDA, the Ministry of Health and the President’s Office for Regional Administration and Local Government. Tanzania National NCD Programme - Phase II is a new phase of collaboration launched in 2019 with additional funding from the Novo Nordisk Foundation. 

Healthcare professionals trained through the programme will receive the resources needed to screen, diagnose and treat NCDs in their local clinics. The programme will also raise NCD awareness in the general public and teach school children about NCDs as part of Tanzania’s national school health programme. 

But the training had to come first – and before the workshops could commence, much preparation was needed. A programme team had to be hired, NCD training material prepared, and collaboration with key stakeholders established, to name just a few tasks. COVID complicated everything, delaying project rollout by more than a year.

Emil Morell, WDF’s regional advisor for East Africa, and based in Nairobi, helped develop the training methodology and participated in training and evaluation sessions. 

“It’s exciting to see everything on track,” he says. “TDA is doing a great job of moving this complex and ambitious programme forward, and my WDF colleagues and I are working hard to provide support where relevant."

NCD clinics across the country

During training evaluation sessions earlier in 2022, the programme team interviewed participants to understand its effects. 

“They told us that the training has improved their teaching skills. A majority say they now set specific days for presentations on NCDs to patients and colleagues at their facilities,” says Dr Rachel Nungu, Programme Manager of the National NCD programme at TDA. 

Participants also reported keeping in touch with fellow trainees, supporting and advising each other. Back at home, many have established WhatsApp groups where local healthcare providers whom they have trained can share experiences, challenges, and achievements related to NCD prevention and management.

The evaluation also found that all the participants surveyed have implemented monthly to weekly NCD clinics in the healthcare facilities where they work. 

“The aim of this programme is to help communities fight NCDs through screening and quality basic management for the NCD patients, so this finding is really meaningful,” Dr Nungu says. “A triage desk at these facilities gives us hope that we can offer early detection and prevent the community from succumbing to premature deaths from NCDs.” 

With the training well under way, the team can turn its focus to other programme objectives, such as raising NCD awareness and supporting the roll-out of implementation research on NCDs based on the recently launched national NCD research strategy. The project is set to conclude in 2024.