Evaluating the Impact of Community Health Worker-Led Programmes on Glycaemic Control in Dar es Salaam, Tanzania: A Systematic Review

The increasing prevalence of diabetes mellitus in Tanzania strains formal healthcare systems. Community health worker (CHW)-led programmes are increasingly deployed to support diabetes management in resource-limited settings such as Dar es Salaam, but their effect on glycaemic control requires systematic assessment. This systematic review aimed to synthesise evidence on the impact of CHW-led programmes on glycaemic control among people with diabetes in the Dar es Salaam region. A systematic review was conducted. Multiple electronic databases were searched for relevant studies. Inclusion criteria encompassed studies reporting on CHW-led diabetes management interventions in Dar es Salaam, with glycaemic control as an outcome. Study screening, selection, and data extraction were performed independently by two reviewers. The quality of included studies was appraised using appropriate tools. A limited number of studies met the inclusion criteria. The available evidence, while not extensive, suggests a positive trend. Programmes incorporating regular home visits and personalised CHW-led education were associated with improved glycaemic control. One study reported a significant proportion of participants achieving a reduction in HbA1c levels exceeding 1%. CHW-led programmes show potential for improving diabetes management in Dar es Salaam. However, the current evidence base is limited, underscoring the need for more rigorous research to confirm these findings and determine optimal intervention structures. Future research should employ robust study designs with longer follow-up. Programme planners should integrate CHW-led support with formal health services and ensure adequate CHW training and supervision. National health policy should explore sustainable funding models to scale effective CHW diabetes programmes. community health workers, diabetes mellitus, glycaemic control, Tanzania, systematic review, Dar es Salaam This review consolidates the existing evidence on CHW-led diabetes management in Dar es Salaam, highlighting a promising but under-researched area. It identifies specific intervention components associated with positive outcomes and provides clear directions for future research and policy.