title: Placing learning needs in context: distance learning for clinical officers in Tanzania.
abstract: BACKGROUND
  Poor public health indicators in Tanzania have led to the upgrading of nursing and clinical personnel who currently have just core training. Clinical officers (COs) have 3 years training in basic and applied medicine and are responsible for healthcare of large and dispersed rural populations.
  
  
  OBJECTIVE
  UNESCO-Wales has funded colleagues in Wales (UK) to assist the upgrade of COs. An inquiry into their learning needs and the Tanzanian context has produced a framework for design of a module for COs on sexually transmissible infections and HIV & AIDS by distance learning.
  
  
  METHODS
  Face-to-face discussions were held with the Ministry of Health, healthcare workers, educators and administrators in Tanzania; a review of training documents was carried out; and a follow-up questionnaire issued to COs.
  
  
  RESULTS
  The discussions and review highlighted teacher-centred approaches, and management, infrastructure and resources obstacles to curriculum change. Principal learning needs of COs around STIs were: counselling, syndromic management, drugs management, laboratory diagnosis, health education, resources, staffing and service morale.
  
  
  CONCLUSIONS
  Placing learning needs in context in dialogue with Tanzanian colleagues was an advance on simple transfer of educational technologies and expertise. The inquiry resulted in a draft study guide and resources pack that were positively reviewed by Tanzanian tutors. Management and resources issues raised problems of sustainability in the module implementation.
authors.affiliation: Cardiff University, School of Postgraduate Medical and Dental Education, Cardiff, UK. sbrigley@gmail.com
authors.forename: Stephen
authors.initials: S
authors.lastname: Brigley
authors.forename: Ian
authors.initials: I
authors.lastname: Hosein
authors.forename: Irnei
authors.initials: I
authors.lastname: Myemba
mesh_terms: D000293:Adolescent; D000328:Adult; D020375:Education, Distance / Q000458:organization & administration*; D004502:Education, Medical, Continuing / Q000458:organization & administration; D015658:HIV Infections / Q000517:prevention & control; D006282:Health Personnel / Q000193:education*; D006801:Humans; D020407:Internet; D007407:Interviews as Topic; D008875:Middle Aged; D011634:Public Health; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013636:Tanzania; D014480:United Nations; D055815:Young Adult