Citizen Engagement crucial for improved government responsiveness on maternal, newborn and child health.

By Kenneth Simbaya just back from Tanga.

 Citizen Hearing or simply call it citizen engagement is a promising game changer for women’s,  children’s and newborn’s health in the country if the country is to  reduce maternal, children and new-borns  deaths. I can  authoritatively say following a one week Citizen Hearing exercise in Tanga region and Dar es Salaam, which was organized as part of White Ribbon day observations.

Citizen Hearing organized by  White Ribbon Alliance Tanzania (WRATZ) an alliance of individuals, governmental and non governmental institutions advocating for safe motherhood in the country and
globally took place in Handeni, Kilindi, Korogwe and Tanga Municipal  between March 7 through 14th and climaxing with the national Citizen Hearing on March26th broadcasted live through ITV’s Malumbano ya Hoja  programme.

Picture:Suleiman Abdalla (center) from Korogwe district, asking the Korogwe district Community Development Officer (right) a question at the Citizen Hearing exercise, left is Kenneth Simbaya facilitating the session.   


 According to WRATZ the exercise aimed at bringing together citizens and government officials to listen to each other and act on women’s,  children’s and newborn’s health priorities, with the intent of
increasing accountability for maternal, newborn and child health  (MNCH).

“The government need to work closer with citizens so as to enable citizen engagement and government responsiveness, hence bring the  accountability needed to end needless deaths to innocent mothers and  new-borns,”said Rose Mlay, WRATZ  National Coordinator.

Currently according to World Health Organization and Ministry of  Health and Social Welfare statistics 7,900 mothers die annually from  pregnancy related complications, 40,000 babies do not survive the  first month of their life, 47,000 are born dead (stillbirth).

 According to Rose 80% of these deaths could be served if both wananchi  and government played their role accordingly, especially ensuring the  availability of Comprehensive Emergency Obstetric Newborn and Child Care (CEmONC) as pledged by the government in One Plan, a government
document detailing government pathways to reduction of maternal,  newborn and child deaths in the country.

White Ribbon Alliance for Safe Motherhood Tanzania, National Coordinator Rose Mlay, elaborating a point at the Citizen Hearing exercise in Kilindi district, Tanga region.

Speaking at the climax of the White Ribbon Day (March15 2015) the  WRATZ Board of Director Chairman Craig John Ferla said that White  Ribbon Day is not a celebration but a day to reflect on the  preventable deaths of thousands of our mothers and babies.

White Ribbon Alliance for Safe Motherhood Tanzania, Board of Directors Chairperson Craig John Ferla addressing the audience at the climax of White Ribbon Day on March 15, 2015, at Tangamano grounds in Tanga city, Tanga region.

Craig said, since the last White Ribbon Day was marked in Rukwa region  in 2014, it is estimated approximately 8,000 women in Tanzania will have died in pregnancy or childbirth, which put in context is almost equivalent to the total number of people who lost their lives to Ebola in Sierra Leone, Liberia and Guinea during the same time, and yet look at the global attention and panic to contain the epidemic compared to the relative silence surrounding the loss of our mothers.
“This tragic loss is taken to another scale when counting the deaths  of our newborns and stillbirths during the same period,  it is estimated that 40,000 newborn babies will have died, and a further
47,000 babies born dead, with half of them dying during delivery,”

Craig told the audience adding that This is like the whole of Tanga  City population being wiped away after every three years – and  considering that most of these deaths are preventable by interventions  that are within our means, it is clear to all that this prevailing
situation is unacceptable.

“We all must do more to reverse this tragic loss of our mothers and  babies – accountability needs to be practiced by all and not simply  preached,” Craig stressed.

He demanded that much more resources be spent on interventions to save  the lives of our mothers and babies.

Khalid Mohamed Mngulu, presenting children's views on how to reduce maternal and newborn deaths during the Citizen Hearing exercise in Handeni district Tanga region.

According to the WRATZ Board of Directors Chairman, as much as there  is excellent political will in maternal, newborn and child health, and  strong evidence-based national strategies, we will never be able to  achieve our goals without backing this up with the necessary  investment to deliver quality and equitable health services.

White Ribbon Day was observed at National level in Tanga region and  officiated by the Tanga regional commissioner on behalf of the  Minister of Health and Social Welfare Dr Seif Selemani Rashid.

Officiating the event the Tanga RC said that reduction of maternal  death is one of the Millennium Development Goals which our country has  committed to. Maternal reduction is MDG number five, which calls for  countries around the world to cut maternal deaths by 75% by December
31st 2015.

Kwediboma Ward Councilor Mwajuma Hatibu Sempule, responding to questions from citizens at the Ctizen Hearing exercise in Kilindi district Tanga region.

Maternal death in Tanzania at the time of the commitment stood at 526  per 100,000 live births, MDG commitment calls Tanzania to cut the  deaths to 193 per 100,000 live births.

The RC called for increased accountability if we are to end needless  deaths of maternal, newborn and child deaths in the country. He  appealed to mothers to ensure that they deliver in health facilities,  strengthen family planning for safer planned pregnancies.

Tanga Regional Medical Officer (RMO) Dr Asha Mahita, responding to questions from citizens at the Citizen Hearing in Tanga city, Tanga region.


 Ends

End needless maternal, newborn and child deaths

By Kenneth Simbaya – Recently in Dodoma

May25: Seven days after the President of the United Republic of Tanzania Jakaya Mrisho Kikwete implored regional leadership across the country and other stakeholders to end needless maternal, newborn and child deaths in the country, 81 members of parliament (MPs) have echoed the president’s appeal by appending their signature on the petition which calls the government to ensure that health centers in the country provide CEmONC services as promised in the National Road Map Strategic Plan To Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania 2008-2015.

Evidence for Action Tanzania (E4A) Country Director Craig Ferla who is also the WRA Tanzania Board of Directors chairman delivering a message to MPs on Wednesday May 21, 2014 at the MP petition signing event. Photo by Kenny Simbaya

MPs appended their signatures in Dodoma on Wednesday last week, at a function organized jointly between The White Ribbon Alliance For Safe Motherhood Tanzania (WRA Tanzania) and Tanzania Parliamentary Group For Safe Motherhood. The function took place at Pius Msekwa Parliamentary Hall.   

Speaking to the MPs at the MPs petition signing function, the national WRA Tanzania coordinator Rose Mlay told MPs that, she has been heartened to see MPs adding their voice to say NO to avoidable pregnant mothers, newborn and child deaths, by ensuring that health centers have Comprehensive Emergency Obstetric Care (CEmONC).

“We have had enough deaths of mothers and babies, we can’t continue loosing innocent lives like this,” remarked Rose Mlay, demanding MPs to tell her what overrides life?

 

WRA Tanzania National Coordinator Rose Mlay Delivering a message to MPs on Wednesday 21/2014 when WRA Tanzania met with MPs to sign a petition demanding CEmONC services at health centers. Photo by Kenny Simbaya

 

According to Mlay whatever we do, be it agriculture, infrastructure, business, water etcetera is for life, how comes we ignore maternal and newborn deaths and prioritize other things.

Speaking at the launch of Sharpened One Plan on The National Road Map Strategic Plan To Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania 2008-2015, a plan aimed at contributing to achieving Millennium Development Goals number 4&5, President Kikwete called for increased accountability and good stewardship at both national and local government in implementing and managing the national plan for Reproductive Maternal, Newborn and Child Health.

“I want this to be a permanent political agenda at all levels of our government. We must use this opportunity to ensuring that every level takes this matter seriously.  The undertaking made by the Regional Commissioner today is very reassuring indeed”, Kikwete told regional commissioners, regional medical officers, regional administrative secretaries and other stakeholders at the launch of the Sharpened One Plan on May 15^th at Julius Nyerere International Conference Center.

 

President of the United Republic of Tanzania Jakaya Mrisho Kikwete (fourth seating from left) after launching The National Road Map Strategic Plan To Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania 2008-2015 at Julius Nyerere International Conference Center  on May 15, 2014. Photo by Kenny Simbaya

On her part  Hovieyh Afnan Holmes, speaking at the launch of the Sharpened One Plan on behalf of a mulitidisplinary, multiinstitutional collaboration that advocates to ending preventable maternal, newbron and child deaths globally known as Countdown to 2015, a team which helped  the ministry of health and social welfare (MoHSW) come up with the Sharpened Plan, said Global Countdown to 2015 is looking for accountability at the national and local government and partners to ensure accountability for the actions highlighted in the Sharpened One Plan, specifically around family planning, care at birth, so that by 2030 progress will be made and no one will be left behind.

Ellaborating further when reached by this paper Hoviyeh said that accountability is crucial at all levels of the government, but more important at the local government, the point of implementation in Tanzania and civil society is required to facilitate the implementation of the Sharpened One Plan during the next 600 days before the end of 2015 (a time when MDGs ends) and beyond.

She said This Plan aims to address the unmet need for family planning, address the gaps for coverage and quality of care at birth, and continue the progress already achieved in child health.

According to Hoviyeh, based on the data a particular emphasis needs to be placed on women from the Western and Lake Zones who are being left behind for family planning services, and on rural women and babies who are being left behind for care at birth. As global Countdown they helped with the analysis that shows that 18,400 lives could be saved by the end of 2015 if rapid action leads to the implementation of the plan across Tanzania.

“Having a good plan or policy is only the first step. To save lives this Plan must be implemented and especially to reach the poorest. Accountability requires that the government plays their role to implement but also requires that civil society - and the media - keep track and hold the government accountable. Countdown to 2015 supports and endorses the use of the Tanzanian regional and district scorecards, launched at the event, a tool by which to facilitate this accountability and track what progress is being made,” Hovieh told the Guardian.

Countdown to 2015 tracks tracks coverage levels for health interventions proven to reduce maternal, newborn and child mortality, it calls for governments and development partners to be accountable, identifies knowledge gaps, and propsoes new actions to reach MDGs 4 & 5. The policy brief for the Sharpened One Plan can be found on htt://www.countdown2015mnch.org

Available data show that Tanzania has achieved MDG4, which is about reducing child motarlity by two thirds, but MDG5 which about reducing maternal motarity by tow thirds is still a mount Kilimanjaro task to the country.

According to the Presdient, the target for Tanzania is to have 193 deaths for every 100,000 live births by 2015, but at currently Tanzania records 454 per 100, 000 births and hence making it very difficult for the country to achieve the target.

 

Ends

As we celebrate The World Rural Women’s Day it’s time to bridge the gap

 

If you doubt that women in rural areas play a crucial role for the family and community development, you should have seen my late grandmother Violet Mkisi.  May God rest her soul in peace. I real admired and I still admire her hardworking spirit. And if there is something I will take from her it is this, she was spirited towards  hardworking. And I can openly say she left an indelible mark to her family and neighbors.  

This is a woman who new that the difference between successful people and unsuccessful people is how you spend your time both during the day and at night. No wonder she committed herself to work hard no matter what. She never missed village community work, unless she was ill. Unlike my grandfather who would say “hatuwezi kwenda wote, ukienda wewe nimeenda mimi” literally meaning that we can’t all go if you go it means I have gone also” .

Taking absolutely total responsibility of family matters from paying school fees, to health care. Pushing the wheel forward as she new that life has to be lived like a clock. A clock ticks clockwise and not otherwise. This wasn’t an easy choice for her but I learnt soon that she was faced with these choices. And if she never chose to take the total responsibility, we would have suffered a lot. Thanks my grandma. And sorry that you had to shoulder all that load alone. I wish I was old enough to help.

It is from her where I learnt to wake up at 0500am. She was always the last person to go to bed, but the first person to wake up. She would wakeup at 0500am, at this time everybody else is fast asleep, lit the fire at the fire place, prepare for us whatever was available for breakfast. By 0600am wake up us ready to go to school as she readies to go to the farm. Going to the farm with my grandfather was a rare phenomenon.

 At a time when my late grandfather Thomas Msyete.  May God rest his soul in peace. Would go at a local brew joint and spend some hours there, my grandmother just like many other rural women would be busy doing this and that for her grandchildren, her own children and her husband. At that age I couldn’t tell. But now I know that the workload between my grandfather and my grandmother wasn’t evenly distributed amongst them. From outside people would think my grandfather is the one who was contributing most to the family, but in actual fact it wasn’t Thomas but Violet.

Violet my grandmother isn’t the only unsung heroine, there many of such in rural areas, just like my grandmother, they are denied most of their rights, including education, to own land. They produce much, but they have no say on what they produce. They can’t even decide the number of children they want. Leave alone other conjugal rights.

Rural women just like my grandmother work in dangerous environment, to some farms aren’t close to their communities, they go to fetch firewood and water far from communities hence risking to be raped or harmed in any other way. This is a rural woman. Men, CSOs, the government need to support these creatures who give and give and give and keep giving their love to their families and communities. They endure a lot.  

Time to bridge the gap between rural women and urban women. If the majority of the population live in the rural area. And statistics tell us that the majority are women. We need to harness their potentials and channel their potentials to bring about development for this country. There are so many benefits if the gap between the rural woman and urban women will be bridged. Such benefits range from health families to increased family income and community development.

Future development of Tanzania and any other developing country depends on how we empower women especially rural women who are the majority. Efforts should be put to educating more goes who are women to be, as the more educated women/girls a nation have the better health and fewer children each mother conceives.

  

October15 is  The World Rural Women’s Day, it was celebrated internationally for the first time in 2008, as a way to honor rural women who make up a quarter of the world’s population, who in Tanzania contribute to 80% of food production.

According to United Nations website rural women play a critical role in the rural economies of both developed and developing countries. “In most parts of the developing world they participate crop production and livestock care, provide food, water and fuel for their families, and engage in off farm activities to diversify their families livelihoods. In additional they carry out vital functions in caring for children, older persons and the sick.” Reads part of the UN website. 

This day is also important as it is used to raise the profile of rural women, sensitize both the government and the public to their crucial, yet unrecognized role and promote actions in their support.

As we celebrate The World Rural Women’s Day it’s time to bridge the gap

Author

Kenny Simbaya

Teacher, Journalist, Activist for youth participation, and a consultant in management and community engagement

My mission is: To live people and organization better than I found them.