Improving Nurse Participation in Project ECHO: An Institutional Analysis of Primary Health Facilities in Dar es Salaam Region, Tanzania.

Abstract

Background: Project Extension for Community Health Care Outcomes (Project ECHO) is recognized as an effective and affordable way to improve healthcare professionals' knowledge. Project ECHO rapidly expanded in Tanzania from 1 hub to 4 hubs and 12 to nearly 200 spokes in just 3 years. Despite its success, participation among healthcare workers remains low. The study aimed to determine the institutional factors influencing nurses' participation in Project ECHO sessions.

Methods: This cross-sectional study was conducted among 450 nurses from 42 selected primary health facilities in Dar es Salaam, Tanzania. A standardized questionnaire was used to collect data from the study participants. We evaluated the association between sociodemographic variables and institutional factors with Project ECHO participation through descriptive analyses and multivariable logistic regression.

Results: Overall, 64% of the study participants had not attended a single ECHO clinic in the past year. The availability of information and communications technology experts to provide technical backstopping to staff (AOR: 0.45, 95% CI: 0.27-0.76, p value = 0.003) and the availability of designated rooms equipped with appropriate equipment (AOR: 20.95, 95% CI: 4.44-98.82, p value < 0.001) were associated with participation.

Conclusion: The study identifies several factors influencing nurse participation in Project ECHO. These include internet access, incentives, and well-equipped computer labs, all highly valued. Additionally, the availability of information, communication, and technologies (ICT) experts and effective training significantly contribute to positive experiences. To improve participation, addressing the challenges posed by inflexible scheduling and resource limitations is essential.