MOROGORO

NEWSLETTER

Vol. No. 1 July 2003

MMMALARIA in PREGNANCY Malaria, which is transmitted by anopheles mosquito, causes high morbidity and mortality in pregnant mothers and children under five years. Over 30 percent of the total outpatients in health facilities are suffering from malaria. Malaria in pregnant mothers can cause the following problems: z Anaemia z Stillbirth z Low birth weight deliveries (less than 2.5 kg) z Premature delivery z Miscarriage z Maternal death Pregnant mothers receiving health education. Pregnant mothers are advised to attend antenatal clinics during the early stage of pregnancy, Insecticide Treated Nets (ITNs) are sold at a preferably before 20-weeks. At the clinics, they will discounted price to pregnant mothers at many be advised and provided with preventive drugs clinics. The aforementioned services are available including those against Malaria. During antenatal at all antenatal clinics in Region. clinics, pregnant mothers are examined and Ms. N. A. Ahmed Nursing Officer, investigated. Any illnesses detected are treated in Health Department, Morogoro Municipality order to protect the mother and the expected child. - In This Issue – One of the drugs recommended for the treatment z Malaria in Pregnancy ---- p.1 of malaria to a pregnant mother is a combination of

Sulphadoxine and Pymethamine (SP) in the z Greetings: Regional Administrative Secretariat ---- p.2 schedule prescribed below: -

z Congratulation: Regional Medical Officer ---- p.2 z 20 – 24 weeks pregnancy, 1st dose. z 28 – 32 weeks pregnancy, 2nd dose. z The Editorial Morogoro health Newsletter ---- p.3 NOTE: The SP should not be taken at the same z The Regional Health Meeting ---- p.4

time with folic acid because SP will not be z Community Participation ---- p.4

effective in that case. Health Activities-Kilombero

z HMIS – Health Information Management System ---- p.5

z Kilosa Councillors on Onchocerciasis Control

---- p.6

z Community Participation Strategy

Environmental sanitation -Ulanga ---- p.6

z Important Events ---- p.7 z Reader’s Forum ---- p.8 z Information and Announcements ---- p.8

A pregnant mother receiving anti malaria. MHP Morogoro Health Project

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The Morogoro Health Project pertaining to the management of in terms of traditions, level of (MHP) is being implemented in the health service delivery in understanding and other aspects under the various health facilities, namely, which must be considered during support of the Government of hospitals, dispensaries, health service delivery, with a view to Japan through her International centres and the like. improving quality. Cooperation Agency (JICA). Similarly, the Public on the The purpose of the project is other hand, is faced with the to improve management skills of challenge of adopting the the Council Health Management knowledge (especially using Teams and the Regional Health participatory approach) provided Management Team in order to by the experts, through the enable them design, plan, Newsletter, pertaining to better implement, monitor and evaluate methods of improving their activities related to quality health livelihood by observing health care delivery in the community. principles in accordance with the Achieving this objective is crucial The Regional Administrative new technological development Secretary MOROGORO in improving the health sector in in the growing economy. Mr. P. A. M. CHIKIRA the country. Lastly, I would like to urge all The health sector is at the top Additionally, the newsletter will stakeholders to contribute articles of the Government’s priority list in be a resourceful forum to experts in their areas of expertise and an attempt to improving delivery in exchanging experiences, and in experiences on management in of social services and in the fight learning from each other various delivery of health services or against poverty in the Tanzanian strategies of developing provide their constructive Development Vision by the year professional skills in managing suggestions on other people’s 2025. health delivery services in contributions with a view to It is my sincere hope that combating different health enhancing each other’s skills and service providers in the health problems in the community. professionalism in this ever sector and other stakeholders will Health personnel, on the one changing society. use the Newsletter to exchange hand, will gain insights of their knowledge and information clients from various backgrounds

Regional Medical Officer MOROGORO Dr. M.M.Z.MASSI

The Health Department in Morogoro Region for Since this is the first the first time is able to publish its own Newsletter. I Edition, there may be would like to congratulate all who made it possible for inadequacies. These should rather be used as a this newsletter to be published. catalyst for improvement. The Editorial Board spearheaded by Mr. Nicholas For the Newsletter to be sustainable and rich in Masaoe deserves special commendation for the its contents, all stakeholders are cordially invited to important task accomplished in ensuring that this subscribe articles and any other material support to Newsletter is produced. facilitate its publication. In this way, we will be able to Also, I would like to extend my commendation to exchange experiences, skills and even get new all those who contributed articles to the Newsletter. scientific information. I wish our Newsletter a success. PROMOTE YOUR BUSINESS THROUGH THIS NEWSLETTER!

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MOROGORO HEALTH NEWSLETTER

Chairman • The second is to have adequate sharing of Editorial Board experience and health information among RHMT, Mr. N. MASAOE CHMTs and other Regions. Regional Health Officer • The third is to improve the capacity of RHMT Morogoro and CHMTs in planning, implementation, The publication of this Newsletter is a result of monitoring and evaluation. one of the activities of Morogoro Health Project. During the situation analysis of RHMT and The object of the Newsletter is to facilitate CHMTs activities by the MHP, one of the problems exchange of ideas, views and experiences identified was inadequacy in sharing information between health service providers and the on experiences of the activities of the Teams. The community. fact that the RHMT and CHMTs have jointly Morogoro Health Project (MHP) which worked to publish this newsletter is one way of commenced on the 1st April 2001, is supported by addressing the problem. The publication of this the Government of Japan through Japan Newsletter in general was supported by Morogoro International Cooperation Agency - JICA. Health Project (MHP). The purpose of the Project is to strengthen the For sustainability of the Newsletter, RHMT, capacity of Council Health Management Teams CHMTs and the Editorial Board recommended (CHMTs) which are responsible for management that CHMTs incorporate a budget line in their of health services in the districts and the Regional annual Council Comprehensive Health Plans for Health Management Team which is responsible publication of the newsletter. for providing technical support to, advising The Editorial Board expects that this CHMTs and facilitating their activities. Newsletter will be a good avenue for the There are three Project Outputs exchange of ideas and experiences among • The first is to improve the Health Management RHMT, CHMTs, various health service providers, Information System (HMIS). stakeholders and the general public.

EDITORIAL BOARD Chairman Chief Advisor

Mr. N. MASAOE Regional Health Officer Dr. M. MASSI Regional Medical officer Secretary Associate Members

Mrs. C. MARO District Reproductive and Child Dr. A. TANAKA Advisor, MHP*

Health Coordinator, Morogoro Ms. M. CHITOSE Coordinator, MHP*

Deputy Secretary Dr. F. FUPI Advisor, MHP*

Mrs. N. AHMED Nursing Officer, Morogoro Municipality Members Advisory Committee Mr. J. MANKANBILA Regional Health Secretary Mr. H.Mohamed Dr. G. MTEY Municipal Medical Officer of Health, Lecturer, Morogoro Sokoine University of Agriculture Mr. J. BUNDU District Health Officer, Kilosa Hon. C. Binamungu Mr. K. KAKWAYA District Health Secretary, Kilombero Lecturer, Mzumbe University Mr. B. MBUMBUMBU District Health Officer, Ulanga Ms. Y. KITAYAMA Advisor, MHP* Ms. Sarah Dumba News Editor, Radio Dar-es-Salaam * MHP: Morogoro Health Project, JICA

PLEASE SEND YOUR ARTICLE TO THE EDITOR FOR PUBLICATION

3 Morogoro Health Newsletter RREEGGIIOONNAALL HHEEAALLTTHH MMEEEETTIINNGG Strengthening Health Services-MOROGORO

opened by the District Commissioner and closed by the Regional Medical Officer of Morogoro. Some of the key items covered include: - • Presentation and discussing district health annual reports for the year 2002. • Discussing the implementation progress reports of various programmes and projects in Morogoro for example MHP, TEHIP, HIV/AIDS, IDSR (Integrated Disease Surveillance and Response) and Reproductive and Child Health Services. • Receiving feedback of resolutions of National annual meeting of the Regional Medical Officers, Participants of the RHMT/CHMTs joint meeting. the Regional Nursing Officers, and Expanded Programme on Immunization (EPI). The Regional and Council Health Management • Discussing implementation of various alternative Teams (RHMT and CHMTs) Joint Meeting held on health financing options: Community Health Fund, 28th – 29th May 2003 at Kilosa to evaluate the health Basket Fund and National Health Insurance services activities in Morogoro Region called upon Scheme. the Health Sector and the related stakeholders to join • Presenting publication of Morogoro Health hands to strengthen health services at all levels in Newsletter. the region. • Discussing the collecting of accurate data and The participants included the RHMT and CHMTs utilising them at the collection point. members, District Planning Officers, representation The implementation of the meeting resolutions from Morogoro Health Project (MHP), Tanzania and recommendations will contribute to improvement Essential Health Intervention Project (TEHIP), and of health services in the region. other stakeholders. The Kilosa District Commissioner Dr. F. Fup; Advisor, Morogoro Health Project and the District Executive Director attended some of the sessions as invited hosts. The meeting was COMMUNITY PARTICIPATION in Health Activities-KILOMBERO Kilombero is among the forefront districts in the implementation of Health Sector Reform in the country. The experiences gained can be resourcefully utilized in other parts of the country, for not only has the capacity to plan and implement health activities increased, but also there has been a substantial incorporation of community participation to enhance Health Sector Reform (HSR) process. The community participation has stimulated Health Sector Reform in the district. For example, through realization of community based health care concept, the following have been achieved: all 19 government health facilities have introduced cost sharing in health services. Consequently, there is no Villagers participating in arranging bricks for burning. health facility which experiences shortages of drugs Utengule Dispensary– Kilombero. or medical supplies. Additionally, some of the health (Continued page 5)

4 (From page 4) Morogoro Health Newsletter facilities have savings of up to 4 Million shillings in interventions in solving the problems. their bank accounts. In order to keep the health Community participation has so far been extended facilities in good shape, every community member to some other sectors in the district. Indeed, contributes 200/= monthly. Out of this money, 9 Community participation has made the planning and dispensaries and 2 health centres have been implementation of various projects easier. rehabilitated. Most importantly, these funds are In a span of 6 years of the implementation of HSR managed by the communities themselves. All the 19 through community participation in facilities in the district have formed governing Council, there is already an indication that if committees, which are operational. communities get involved in the planning and Furthermore, communities contributed materials implementation of projects there can be impressive worth T.Shs 66.71 million, to the construction of impact to development. health facilities, which cost T.Shs 696.71 million. Mr. K. C. Kakwaya; There has been more emphasis on community District Health Secretary, Kilombero empowerment in identifying health related problems, setting priorities and coming up with some

HHMMIISS!!!!!! The Health Management Information System analysing, storing the information and utilising it for (HMIS) started in Morogoro Region in 1997. The improvement of the health services. Since some of purpose of the System is to have a National uniform the information collected through HMIS is information reporting mechanism through using inadequate, the Morogoro Health Project is also various books, forms and registers. The service aiming at improving the system. providers at all levels were trained on the collecting, LEADING CAUSES of DEATHs CHILDREN and ADULTS

Under 5 Years Above 5 Years

Prematurity ARI Preg. Disorder 3% PEM Diarrhoea 2% Birth Asphyxia 3% 2% TB 3% 3% Kidney Disease 2% 1% Diarrhoea Hypertension 4% 5%

Meningitis Pneumonia 4% 5% Anaemia 47% HIV 50% 6% 6% 11% Malaria 12% Malaria HIV Pneumonia 18% 13% Anaemia TB

[Source: Regional Health Annual Report 2001]

The data displayed here were collected from whereas AIDS and Tuberculosis are the second inpatients from the health facilities in Morogoro and third killers of those above five years. Region. The pie diagrams show that malaria is the Strategies should be initiated to control the top-most killer disease in both the children and causes of the deaths. adults. Anaemia and pneumonia are the second Mr. N. MASAOE / Dr. A. TANAKA and third killers of children under five years,

USE INSECTICIDE TREATED NETS TO PREVENT MALARIA

5 Morogoro Health Newsletter KKIILLOOSSAA CCOOUUNNCCIILLLLOORRSS on Onchocerciasis Control The Kilosa District Council held advocacy meeting for councillors on Onchocerciasis (river blindness) control. The meeting was also attended by the District Commissioner, District Management Team (DMT) and representative for the AIDS Control Programme and International Trachoma

Initiative (ITI) from the Headquarters Dar-es-Salaam. The District Commissioner outlined to the members the laid down Onchocerciasis control strategies. Some of the strategies include: -

• Conducting advocacy workshops for Councillors of Kilosa District Council the 33 Wards hit by the disease. • Allocation of funds for conducting training on The meeting recommended different ways for Onchocerciasis. As for this year the district has educating and sensitizing the community on already allocated funds for training and advocacy Onchocerciasis control, namely using: - to experts from different sectors. • Radio • Allowing putting up without charge, of posters and • Traditional dancers billboards which educate the community on • Posters and billboards Onchocerciasis control. Councillors vowed to be in the forefront in The problems which arose from the start of the educating and mobilizing the community on project were also reported at the meeting as follows: Onchocerciasis control. The meeting recommended • Shortage of time allocated for activities on to the Ward Development Committees to develop community sensitisation. strategies on Onchocerciasis control in their areas. • Rumour mongering on possible side effects of the The participants commended the whole programme drug used for the prevention and treatment of on Onchocerciasis control through community Onchocerciasis (Mectizan). participation at planning, implementation and • Overlapping of Onchocerciasis control activities monitoring stages. Mr. John Nganya Programme Coordinator - Kilosa with those of farming.

Authors Dr. A. TANAKA and Mr. J. BUNDU BBAALLAANNCCEE DDIIEETT !!!!!! Drawing by Ms. Y. KITAYAMA We eat plenty of fruits We drink blood and milk We eat rats (“samaki We eat raw fish. and vegetables. Healthy! from cows. Nice!! nchanga”-land fish) So good !! Delicious!!!.

COMBAT ONCHOCERCIASIS PROTECT YOUR HEALTH

6 Morogoro Health Newsletter CCOOMMMMUUNNIITTYY PPAARRTTIICCIIPPAATTIIOONN SSTTRRAATTEEGGYY Environmental Sanitation – ULANGA Community participation is one of the appropriate • Collecting, burning or incinerating refuse. ways of managing environmental sanitation. • Boiling drinking water. This strategy enables the community to take an • Destroying mosquito breeding places. active role in planning, implementation, monitoring • Identifying suitable sites for the construction of and evaluating activities on Environmental Sanitation houses. in their localities. • Using Insecticide Treated Mosquito Nets (ITNS). The community should be sensitized and • Safe disposal of waste water. educated on managing environmental sanitation. • Protect water sources by prohibiting human The community should also be made aware of activities that destroy the sources. the fact that poor environmental is a prime cause to In addition the following will be coordinated at epidemics, notably of Cholera, Typhoid fever and hamlet and ward level. Malaria. Accordingly Ulanga District is set to • Collection, analysis and utilization of environmental establish Environmental Sanitation sub-committees sanitation data for planning purposes. at hamlet level. The formation of sub-committee aims • Implementation of recommended strategies at at involving the community in managing these levels. Environmental Sanitation. • Cooperating with extension workers in setting The role of the Committees is managing and strategies for environmental sanitation. monitoring Environmental Sanitation at the hamlet. • Storage and dissemination of information on At household to village levels, the community will environmental sanitation data to the responsible be charged with the following responsibilities: - authorities. • Keeping the house surroundings clean. • Introducing environmental sanitation competitions • Constructing recommended pit latrines and using at all levels. them. Mr.B.Mbumbumbu; District Health Officer, Ulanga

IMPORTANT EVENTS: APRIL-JUNE 2003 INTERNATIONA z 7th APRIL: WORLD HEALTH DAY Theme: “Shape the future of life – Healthy environment for children”

z 25TH APRIL: AFRICA MALARIA DAY Theme: “Conquer Malaria by protecting women and children” The sensitisation rally of 20 cars set off in South Africa on 19th April 2003 and passed through Iringa and reached Morogoro Municipal on April the 24th, enroute to Dar-es-salaam. The convoy took on board 60 SADC (Southern African Development Cooperation) leaders. The strongly stressed message was on the reduction of malaria by the year 2005; using of Insecticide Treated Nets (ITNs).

z 31ST MAY: WORLD TOBACCO DAY – The event was commemorated at National level in Morogoro. Theme: “Stop promoting and encouraging use of Tobacco”. The Honourable Dr. Hussein Mwinyi, MP, Deputy Minister of Health was the Guest of Honour.

z 16TH JUNE: AFRICA CHILD DAY Theme: “Good upbringing of youths is fundamental to life” The day was commemorated in all districts with Vitamin A Supplementation for children aged between 6 months and 5 years.

REGIONAL/DISTRICT LEVEL ND z 2 MAY: KILOSA– Launching of the reduced price ITNs to pregnant mothers using discounted vouchers. z TH 28 MAY: ULANGA– The Launching of District Health Board. z th th 28 – 29 MAY: Regional Joint RHMT and CHMTs meeting at Kilosa. z TH 6 JUNE: KILOSA– The Launching of administration of drug for preventing and treating Onchocerciasis.

WASH YOUR HANDS WITH SOAP BEFORE MEALS AND WHENEVER YOU LEAVE THE TOILET

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IN THE NEXT ISSUE: JULY – SEPTEMBER 2003 z 7TH JULY: Dar-es-salaam International Trade Fair (DIT) – SABASABA z 8TH AUGUST: NATIONAL FARMERS FESTIVAL – NANENANE

RREEAADDEERRSS FFOORRUUMM INDENT SYSTEM SHOULD ALSO CATER FOR PRIVATE HEALTH FACILITIES A few years ago the Government conducted a Government and other relevant authorities to ensure series of seminars on HMIS, popularly known as that the Indent System services are also available to MTUHA, and Indent System in Morogoro Region. other privately owned health facilities without bias. The implementation of HMIS is regularly monitored Mr. C.P. Mihambo; in all health facilities. However, the Indent System Directors Office, MEIGS Dispensary, P.O.Box 9 has so far been catering for only Government and Mlimba, Kilombeoro Religious based health facilities. I request the

Discrimination against those living The HIV/AIDS status Voluntary Counseling with HIV/AIDS is a violation of Human Rights and Testing services (VCT) are now available at the following Health Facilities: z Mlimba Health Centre – Kilombero District z Morogoro Regional Hospital – Morogoro Municipality z St. Francis Hospital – Ifakara, Kilombero District z Turiani Hospital – Mvomero District z Ngerengere Health Centre – Morogoro District I care what about you?

Our esteemed readers, we invite views and suggestions on a name you deem suitable for this Newsletter.

Also we invite your contributions of articles to be included in the Newsletter

for the next issue due for September 2003: the articles should be related to health or opinions and suggestions on how health services are rendered in Morogoro Region and are not to exceed 400 words.

Articles or letters to the Editor should be sent to the following addresses: The Editor Morogoro Health Newsletter P.O.BOX 110, MOROGORO or, P.O.BOX 1193, MOROGORO, FAX 023 – 4148 or, Could be sent to the respective District Medical Officer or Municipal Medical Officer as follows: • P.O.BOX 166, Morogoro for Municipality. PUBLISHED BY THE EDITORIAL BOARD • P.O.BOX 1862, Morogoro. MOROGORO HEALTH NEWSLETTER • P.O.BOX 14, Kilosa. P.O.BOX 110, MOROGORO • P.O.BOX 47, Ifakara, Kilombero.

• P.O.BOX 4, Mahenge, Ulanga MHP Morogoro Health Project

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