In commemorating 10 years anniversary of the Mkapa Foundation and in recognizing partners and donors support towards our noble cause, the Foundation organized and conducted a joint field visit upcountry as a showcase to exhibit what has been achieved by the Mkapa Foundation through the financial, technical and in-kind support from various stakeholders.
The Joint field visit was held from 3rd till 6th April 2016 and was comprised of representatives from the BMF Board of Trustees, management and staff together with officials from the Government, Donors and corporate partners. The visited sites were sampled areas that BMF interventions has been carried and these were 3 Regions of Morogoro, Coast and Kagera.
The main purpose of the visit was to review progress, observe the contextual challenges, and ascertain programme effectiveness, relevance, sustainability and scale up of our projects.
The team divided into two groups whereas one visited the Eastern zone and the other one Lake zone and each group was led with BMF official. Courtesy calls were made to the respective Regions and Districts. Among the conversations made during courtesy call with the Morogoro Regional Administrative Secretary, he aired appreciation to BMF. He further said “We are thankful for the support from BMF and their partners. We further encourage and welcome other supporters to Morogoro Region to assist in other critical health sector challenges, particularly revamping the Mortuary of the Morogoro Regional Hospital. He said they are intending to buy a new, modernized and accepted standard fridges for the mortuary where support is much appreciated.
During the field visit, the mission visited and met 37 students that have been granted scholarship and are studying nursing courses at the Morogoro Public Health Nursing School. The student grants are provided by the BMF in collaboration with the Ministry of Health through the Health Systems Strengthening Project financed by the Global Fund. The intervention is associated with contractual agreement with students, which is geared towards reducing vacancy rate of Health workforce in the country. Upon their graduation they are expected to be deployed in underserved Local Government Authorities as per agreed bonds.
Students at PHN – Morogoro listening to the team visited them
Another area that BMF interventions has shown impact is on reducing health workforce attrition rate and increasing staff work morale, whereas the construction of staff houses in underserved facilities is among the interventions, The mission team managed to visit four (4) staff houses located in Morogoro District Council, and Bagamoyo District Councils, whereby the former are in final stages of construction and the latter houses were already handed over to the district authorities and were being utilized by the health workers.
The Team speaking at one of the health worker living in the staff house constructed by BMF in Chato
It is well known that BMF’s goals is to complement the government efforts on strengthening health systems thus health training institutions have further benefitted from our interventions through increasing availability of tutors as one of the strategy to improve production of qualified health professionals from training institutions. The Mission Team visited Kilosa Clinical Officers Training College and had optimistic conversation with tutors who were highly dedicated and committed to teach and undertake of all measure to ensure quality education to the students.
One among the 6 tutors said, “Our employment contracts with the BMF and Ministry of Health under this Project ended in February 2016, but we are still at the Institute supporting the students while awaiting for the mainstreaming exercise into the public employment system to take place”. It was further noted that the delay in mainstreaming into public employment system was attributed by the delay in release of Government employment permit for health workers. Nevertheless it was observed that there is good cooperation and relationship between the tutors and the entire Management of the College. .
The Mission Team having conversation with tutors at Kilosa COTC in Morogoro Region
During the same visit the team were able to witness a number of staff who were recruited and deployed by BMF since year 2007. Innovative recruitment being one of the core business of the Foundation followed by mainstreaming of project staff into government employment system is one of the key strategies for increasing health workforce into the country. Such staff were found in Bagamoyo, who are currently working under government employment system with different capacities whereas one of them is the District Hospital matron.
Some of the health workers recruited by BMF led projects and deployed at Bagamoyo DC and thereafter mainstreamed into Government employment and permanent system.
During the parallel joint field visit which was taking place in Lake Zone, the team visited Bugando Medical centre – School of anesthesia, RAS Geita, RMO Geita, Geita School of Nursing, Chato District Council, RMO Kagera, Hospital Management Team Kagera Regional Hospital, CHMT Bukoba District Council, DED Biharamulo and CHMT Biharamulo District Council.
Among other districts benefited from a number of BMF interventions is Biharamulo District Council. Several interventions implemented by BMF include; recruitment of 22 health workers under the different projects such as the Mkapa Fellows Programme Phase I and Phase II and the Health Systems Strengthening Project. The team visited Nyakanazi Health centre where they theatre, maternity ward and staff houses constructed by BMF.
BMF interventions further contributed in improving maternal health services in Biharamulo districts by construction of theatre and equipping them within the health centres of Nyakanazi and Nyakahura as well as construction of maternity ward at Nyakanazi. According to the acting District Executive Director Biharamulo District Council, he said” I commend BMF in their support to Biharamulo DC whereby it has used cost effectively and efficiently the minimum financial resources available to construct the theatre and maternity ward at the Nyakanazi health centre. We have lots of lessons to learn from them”.
In our discussion with regional or district level officials at the regions of Mwanza, Geita and Kagera but also districts of Chato, Bukoba DC and Biharamulo the team commended our good work done toward addressing health sector challenges. This including capacity building to CHMTs on Human Resource Management, Human Resource supportive supervision, effective planning skills for their Annual Council health plans, and assessing health workers performance through the Open Performance Rapid Appraisal System of the Government (OPRAS).
One of interesting finding was revealed by the Council Health Management Team “Through interventions made by BMF it has contributed to high star rating scores of Biharamulo district amongst the 8 Local Government authorities within the Kagera region. This exercise of star rating was conducted by Ministry of Health in March 2016. Thus we are happy with the support from BMF on the construction of theatre, maternity ward, staff houses and support of Human Resource component and theatres equipment.”
Joint Field visit team meeting with Biharamulo Council Health Management Team (CHMT)
Other institutions visited by the team were Bugando Medical Centre and Geita school of nursing where students are supported by BMF through student grants scholarships program. They thank BMF for the sponsorship and declared that some of them they could not afford the training costs.
For the regions and districts visited, shortage of human resource at all levels was the main issue reported that affect quality of services delivery. For example in Geita Regional hospital there are only two specialists and 3 medical officers and at district level there are only 23 medical officers. In Kagera regional hospital there are two specialists and at LGA level there is critical shortage of clinical officers by 70%. Also shortage of staff houses was one of the challenges in all LGAs visited that affect retention of health workers.
The field visit team with some of students benefited from student grants scholarships at Geita School of Nursing
We thank all parties participated in this joint field visit. Special thanks goes to BMF Board of Trustees Members, Irish Aid, Abbott Fund, PPF Pensions Fund, Geita Gold Mine, Ministry of Health, Community Development, Gender, Elderly and Children, President Office Regional Administration and Local Government (PORALG). Also we thank Regional Secretariat, health training institution principals and District officials for their participation and sustainable partnership and we envisage further partnership in years to come.