HISTORY

In 2002, the National Institute of Mental Health (NIMH) in the United States awarded research support to Harvard Medical School (HMS) to conduct a five-year study on child health and development in Moshi, Tanzania. The major goal of this project is to find effective ways to strengthen community approaches to promoting the health and well-being of children during the era of HIV/AIDS epidemic. Investigators at Harvard, National Bureau of Statistics (NBS) and Kilimanjaro Christian Medical College (KCMC) are working to provide a foundation for the research in Moshi. This project, Child Health and Social Ecology (CHASE), has an office at Kahawa House in Moshi. The HMS, NBS and KCMC teams are preparing for two phases of the project as described below.

RESEARCH DESIGN

The project has three major components:

1. a comprehensive mapping of demographic and health attitudes in communities to be done by the NBS
2. health assessments of children, aged 10-14, and their caregivers at baseline and following the intervention
3. community-based health promotion interventions designed to address infectious diseases, especially HIV/AIDS.

The interventions implemented in years 2-4 will consist of household visits and community open houses, followed by group meetings of the 10-14 year old children with support and guidance by the CHASE faciliatation team. These young adolescents will be encouraged to organize activities that address the health of the community. The CHASE project will develop informational materials on health and education issues in the Moshi area. Through development of their skills in public discussion children will work within municipal structures to inform, monitor and promote health issues in the community.

OUR APPROACH

Our approach seeks to promote, protect and preserve the health and well being of children and communities. CHASE facilitators encourage and enable children and young people to play an active role in their health as well as the health of other children and their families. Through a coordinated program of community health promotion, we directly involve children in planning and decision-making around health activities. This approach has the potential to be more effective than when children are merely communicators of adult messages. We build our project on the Child-to-Child methodology that is well-founded and respected in other areas of Tanzania, Eastern and Southern Africa. We began our work by making an unbiased selection of 15 treatment and 15 delayed treatment (control) communities across Moshi Urban. Our overall goal is to develop training and support strategies that can be adopted and sustained across all Moshi Urban areas, and eventually into surrounding rural areas and other urban centers. Although the approach to health is comprehensive to include nutrition, malaria and education, special attention will be directed to the prevention of HIV/AIDS in youth and the reduction of stigma associated with this disease. We are especially concerned about the large numbers of girls and young women in Moshi as they are often reported to be the most vulnerable to HIV infection as seen in the many surveys conducted in different communities and different countries.