Abstract:

Background: The escalating number of children living and working in streets (CLWS) in Tanzania has become one of the neglected Public Health issues associated with modernization, poverty, family disintegration, urbanization, HIV/AIDS epidemic and industrialization. It is of more concern that, most of the CLWS hardly do have access to health care and socio-protection services as a result increase their vulnerability to infections and engagement in risk behaviors such as early unprotected sex. Over recent, more promising efforts by CSOs to work with and assist CLWS in Tanzania has been reported. However, little is known regarding the CSOs involvement in enhancing access to health care and social protection to CLWS in Tanzania.

Objective: To explore the role of civil society organizations, prevailing barriers and existing opportunities in enhancing access to health care and socio-protection services among to CLWS in Mwanza city, northwestern Tanzania.

Methods: A phenomenological approach was used to enable a full understanding of the individual, organizational, and social context factors regarding the role, prevailing barriers and opportunities of organizational (i.e., Civil Society Organizations – CSO, Nyamagana District, Social Welfare department), in enhancing access of health care services and socio-protection among children living and working in different streets in Mwanza city.

Results: Gender inequality emerged among CLWS where majority of the present children are male. Incidence of rape among CLWS are said to be common. Individual CSOs, are involved in resources mobilization, provision of basic life skills and education on self-protection, and mobilization of health care services with donor dependency. Incomplete dosage for given medication was likely to be common as older children tend to take medication from their counterpart young ones. Negative attitude towards CLWS among health care workers to CLWS was reported to be common. There is also an emerging community-based opportunity for enhancing access to health services and creating social protection to the children at home and those working and living in the street from some of the CSOs.

Conclusion: Individual Children living and working on the street face life-threatening limited access to health services and lack adequate social protection that calls for immediate intervention. Self-medication and incomplete dosage are a norm among this marginalized, most excluded and unprotected group. Individual Civil society organization attempts to address their need with a lot of barriers from the community and health care system.