Located about 120 kilometres north of the Tanzanian capital Dodoma enroute to Babati or Arusha, a hospital in Chemba District stands conspicuosly to serve people of the place and its neighborhood.

Despite a well-constructed tarmac road and cool breeze blowing along the way, it might take you close to two hours for safety considerations when you have a careful driver who doesn’t opt for a flat-out gas pedal.

Along the way to this remote yet vibrant destination, you are bound to be fascinated by the breathtaking picture-resque of the colourful landscape beauty sparkling on either side of the Dodoma-Babati road. As you go, time happens to run surprisingly fast and unnoticed.

Noticeably, as you come close to this growing but still a low-density population township, Chemba, sparkling white-painted buildings add a special outlook to the hilly landscape silently blessing your arrival all the way. Here you are at the Chemba District Hospital with its Medical Officer (DMO) “Dr. Deogratius Baltazari

Masim” extending a warm welcome to you and second to none brand of hospitality.

He is in charge of medical activities with a well organised team capable of planning and coordinating your visit with key briefings ahead of starting the field exploration.

Dr. Masim has been excited to host the Mkapa Foundation team while opening a wide smile. “Whenever I see the Mkapa Foundation I feel that they are one family with the people of Chemba”, he said.

Established in 2013, the Chemba District Council is one of the eight district councils of Dodoma City.

Before MFP III made an intervention three years ago, Dr Masim admits that medical services in this particular district left much to be desired . The district was Characterised by inadequate manpower that led to poor health services and facilities placed the people of Chemba at great health risks. They endured

torrid moments only for Mkapa Foundation to timely step in as top class saviour.

The Mkapa Foundation project got underway with deployment of 9 skilled health care providers in 9 health facilities and 114 Community Health Workers in all 114 villages of Chemba District.

“The skilled manpower has been keen in improving the quality of facilities in our facilities coupled with accessibility of services to the marginalized communities. The Community Health Workers deployed to our villages have been extremely helpful in creating a great link between our facilities and communities. They have been very instrumental in sending out the proper health education to the communities that address negative myths, beliefs and customs thus improving the utilization of health services especially for the pregnant women and children” Says Dr. Masim.

Dr. Masim’s testimony has been backed by District Health Secretary Aziza Hamisi.

Complimenting Dr. Masim’s words, M/s Aziza says that the district had a critical shortage of Skilled Healthcare Workers and some of the facilities in the District were still under control of the Medical Attendants.

She says 

“When the MFP III gave us 9 new skilled healthcare workers it sounded like we just picked up a piece of diamond from an open ground.. We were overjoyed… while assigning them stations to cover the likes of Mwailanje dispensary that were inoperative. It was no surprise that villagers endured a walk up to seven kilometres in search of health care services. HOWEVER, with the support from MFP III that works closely with the Government, these communities can finally get the services nearer or within their catchment area.”

Stressing more on the program contribution is Ms. Tatu Rashidi, a District Coordinator for Reproductive and child health. Ms Tatu expressed how the Maternal and Child Health indicators have significantly changed since the initiation of the project in Chemba.

 She says

“…before the project most pregnant women booked for their first Antenatal Visit 12 weeks AHEAD of pregnancy but now the numbers have changed from 13% of the women who started ANC before 12 weeks in 2018 to 19% in 2019 and it went up to 24% in 2020”.

 For the other indicators such four or more hospital visits for pregnant women and facility delivery

Ms. Tatu says “…in 2018 it was just 44% of pregnant women who had four or more visits to the health facility but in 2019 we had 66% and in 2020 we had 73%…we have also observed changes in terms of facility delivery, in 2018 there were only 34% of facility delivery it went up to 48% in 2019 and in 2020 we had 52%. All these have been largely contributed upon by the facility and community level initiatives that the MFP III have been implementing”

Ms. Tatu Rashidi believes that the MFP III has improved the medical services from where they were three years ago. She is positive that this year they will see a much higher rise in the indicators which they regard as a success to the District of Chemba and its people.

The Mkapa Foundation took the Mkapa Fellows Program Phase III to Chemba DC for the purpose of improving the healthcare services and the lives of people of Chemba, a mission that has made a significant improvement as contrasted to the past three years.

Just at the beginning of the second half 2019 he landed his one year contract with Mkapa Foundation under the Mkapa Fellows Program phase III. Dr. Joel Charles was then stationed at Babayu Dispensary by the Chemba Council’s Health Management Team led by the Councils Health Secretary, Ms. Aziza Hamisi.

Ms Aziza says that the deployment of Dr. Joel and eight other Skilled Healthcare Workers by the MFP III to them felt like an awaited miracle that finally came into being. 

“When the MFP III gave us nine new skilled healthcare workers, it felt like we just found a loose diamond in the sand” – recalled Ms. Aziza

But when Joel arrived at the Babayu Dispensary he found himself in a challenging situation. The dispensary was understaffed with just a medical attendant to help him and a working environment that was unfriendly. At this moment Joel imagined his future at this place was hanging by a loose thread. 

Lucky for him the people of Babayu were eager to get a Doctor for quite some time so they vowed to keep this one. The village health committee and other leaders together with the people of Babayu extended Joel all the support he needed to smoothen his work both at the Babayu dispensary as well as at their village. 

As if that was not enough Joel witnessed the renovation of Babayu dispensary, a facility that was built in 1973 and had since then never been renovated. It had only four small rooms, which weren’t enough to begin with let alone other challenges in the likes of reliable power and water supply. 

Dr. Joel was concluding a year in his contract with the Mkapa Foundation under the Mkapa Fellows Program phase III and settling in at the Babayu dispensary when the government announced vacancies.He applied and consequently was able to secure a place in the government payroll, then stationed at the same facility “Babayu Dispensary” that he previously worked under the MFP III project.

“When the MFP III gave us nine new skilled healthcare workers, it felt like we just found a loose diamond in the sand.” she recalled.

But when Joel arrived at the Babayu Dispensary he found himself in a challenging situation. The dispensary was understaffed with just a medical attendant to help him and a working environment that was unfriendly. At this moment Joel imagined his future at this place was hanging by a loose thread. 

Lucky for him the people of Babayu were eager to get a Doctor for quite some time so they vowed to keep this one. The village health committee and other leaders together with the people of Babayu extended Joel all the support he needed to smoothen his work both at the Babayu dispensary as well as at their village. 

As if that was not enough Joel witnessed the renovation of Babayu dispensary, a facility that was built in 1973 and had since then never been renovated. It had only four small rooms, which weren’t enough to begin with let alone other challenges in the likes of reliable power and water supply. 

Dr. Joel was concluding a year in his contract with the Mkapa Foundation under the Mkapa Fellows Program phase III and settling in at the Babayu dispensary when the government announced vacancies.He applied and consequently was able to secure a place in the government payroll, then stationed at the same facility “Babayu Dispensary” that he previously worked under the MFP III project.

“When the government announced vacancies I applied and out of a large number of those who were interested, I was lucky to secure this post. Now I work here as a government employee at the same station that I was previously working under contract with the Mkapa Foundation, I am used to this community and happy to serve them,” he said.

Joel is one among the 18 skilled healthcare workers who were mainstreamed and retained into the government system out of the 96 Health workers who were deployed in various stations under the MFP III . 

The presence of Dr. Joel at the Babayu dispensary, where he is now the health facility in-charge, has changed a lot as contrasted to the past when there was scarcity of skilled healthcare providers. Dr. Joel received an addition to his staff, a nurse from the government who now works with a stunning hand-in-glove cooperation in serving the Babayu Community through meeting their health needs.

Having a reliable team of healthcare providers and an improved facility has resulted in an increased facility deliveries as compared to the past. Now the facility delivers up to 15 pregnant women per month, a 4-fold increase from the previous 4 deliveries.

“After the addition of staff a lot has changed. For example now we can have up to 15 deliveries per month as compared to 4 or 5 when we were understaffed with a smaller unrenovated facility. Most of the women opted for the Bahi district because the facilities and services there were better than here but now we have both the staff and top quality facility”

The presence of Joel and other 8 skilled health care workers who are deployed in Chemba DC contributed to the availability of top notch health services and now the community relishes quality services from the skilled healthcare providers who have been placed in the hard to reach understaffed facilities. 

Musoma, Tanzania

When Otilia Mhagama and three other nurse midwives’ colleagues arrived at Nyasho Health Centre in Musoma for their first deployment in January 2021, they were reflecting on what would be their main task at the Health Centre. 

Little they could had known that their arrival was just a thrill for Dr. Hillary Mohamed, a Medical Officer in-charge, who managed the understaffed health center that have a total of 13 nurses and an average of 11 deliveries per day with less than four nurses in a daily roaster; caring for labor & delivery, and post-natal wards.

Otilia and her colleagues are among 93 midwives allocated through the USAID Afya Endelevu Activity implemented by Benjamin Mkapa Foundation to strengthen delivery of quality Reproductive Maternal and Child health services in Mara and Geita regions.

Located at the heart Centre of Musoma municipal, Nyasho facility attracts a high-volume of pregnant women and children who mostly are queued for about an average of 3 hours waiting for services due to shortage of nurses and it serves as Musoma municipal council facility. For the Medical Officer In-charge, Dr. Hillary Mohamed, the support of these four newly deployed nurses including nurse Otilia is a life-changing experience.

The support came at the right time. Due to shortage of nurse-midwives, we were working under tension especially when there was a Caesarean- Section emergency. But today, we thank God, these staff have improved daily roster and patient care which have also improved client flow and reduced unnecessary referrals. – Said Dr. Hillary

Today, with the present of nurses like Otilia and her midwives’ colleagues, they have improved service delivery including management of Cesarean Sections from 31 for the period of October to December 2020 to 56 clients for the past three months of January to March 2021. First ANC attendance has improved from 271 to 315 and facility delivery has also increased from 612 to 766 in the same quarter.

We used to refer clients to the regional referral hospital because we didn’t have adequate manpower to conduct thorough clinical assessment of pregnant women including care and support during labor and delivery – Added Dr. Hillary.

Clients’ confidence and trust on healthcare workers at Nyasho Health Centre have improved because they see changes in how they are receiving services. Waiting time has significantly reduced and all healthcare workers feel appreciated for the work they do from their clients. This is a very rewarding experience, and they hope they can continue to provide quality of care and reach more women and children for reproductive and Child health services. Afya Endelevu identified the needs at Nyasho Health Centre by looking into their unmet services delivery needs using service delivery data, client volume and workload which informed the allocation.

Through the support of the USAID, the Afya Endelevu Activity led by Benjamin Mkapa in close collaboration with the MOHCDGEC, PORALG and LGAs with a goal of Strengthening delivery of quality HIV, TB and reproductive, maternal, and child health (RMCH) services in high-disease burden areas with shortages of health workers through sustainable investments of HRH in Tanzania has managed to allocate 988 HCWs in 16 Region.