A word from WVT National Director
C
hild Health Now Campaign (CHN) supports the Tanzania government’s broader plan of significantly reducing maternal, under-five and infant mortalities by 2035. In the past three years, CHN has made a significant contribution to the targeted communities in Kilindi,
Handeni, Same and Arusha rural districts. To date, through working with government and community, the campaign has impacted 885,771 beneficiaries, allowing them to access improved health services, increasing enrolment to Community Health Fund (CHF) and improving the nutrition of their children, pregnant mothers and community at large. Going forward, WVT will integrate this campaign to its ongoing programs to ensure sustainability and replication to other Area Development Programmes (ADPs) implementing health related projects.
Tim Andrews National Director
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World Vision Tanzania World Vision Tanzania (WVT) is a Christian, relief, development and advocacy Non-Governmental Organization (NGO) which started in 1981. WVT reaches 4.5 million people including 1 million children, in 13 of 30 regions with an annual budget of about USD 26, 596, 359 (37 percent of which is from grants & private non sponsorship and the remaining being sponsorship funding). WVT works with all people regardless of tribe, religion and ethnicity to help improve and sustain the well-being of children within families and communities, especially the most vulnerable. By 2020 WVT will be contributing to the measurable improvement in the sustained well-being of 22 million boys and girls – especially the most vulnerable. World Vision Tanzania strategy 2016-2020 has the following priority areas: Livelihood, the primary sector; Health, Nutrition and Water Sanitation & Hygiene; Education and Advocacy & Justice for Children. Spiritual Development and protection of children are cross-cutting functions. Education is prioritized as a secondary objective and will be implemented depending on availability of funds.
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The estimated Maternal Deaths in Tanzania is 410 per 100,000 live births
Under-fives Deaths is 52 per
1000 live births
of under five suffer wasting
Infant mortality 36 per
1000 live births
of under five are anemic
Percentage of women who delivered in health facilities in Tanga and Arusha regions, within the localities where the CHN campaign operates is 44.5% and 47.3% respectively; well below the
Neonatal Mortality rate
21/1000 live births
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national average of 51%.
of under five are stunted
of under five are underweight UN 2013
Stunting for children under-five in Tanga, Arusha, Kilimanjaro regions, within the areas where the CHN campaign operates is 49.4%, 43.9% and 27.6% respectively, which is above WHO classification of 20%
The Government of Tanzania aims to end all preventable maternal, newborn and child deaths by 2035
The estimated Newborn mortality rates in Tanzania is
46
deaths per
1000 births.
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About the CHN Campaign
C
hild Health Now Campaign (CHN) is a World Vision (WV) five year global campaign. It was launched in Tanzania in October, 2012 to contribute to Government’s efforts to reduce maternal, newborn and child mortalities in line with Millennium Development Goal 4; To reduce child mortality
and Goal 5: To improve maternal health. The campaign advocates for adequate long term financial allocation to the health sector by the government; increased community enrolment in the CHF scheme; improved Maternal, New Born and Child Health (MNCH) services; and improved nutritional status for children under five and mothers. The campaign ends in September 2016 and targets 885,771 beneficiaries (259,900 females, 242,274 males, 190,516 girls and 193,081 boys) in four districts of Kilindi and Handeni, Tanga region; Same, Kilimanjaro region; and Arusha District Council, Arusha region. These districts were identified based on their high rate of maternal, newborn and child health related complications. In addition, these areas were selected based on existing programming coverage. Government and community are key partners in this campaign. Different approaches such as establishing nutrition groups, using Community Voice and Action (CVA) advocacy approach, direct engagement with Government, working through Community Health Workers (CHWs) and working with coalitions like White Ribbon Alliance Tanzania and other likeminded organizations have contributed to positive campaign outcomes some of them illustrated in this story photo book. 8
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Teaching
parents
value
of
nutritious foods heals children
F
or two years, Mwamvua and Bakari a married couple residing in Kilindi District, struggled to make sense of
their sickly twins. Desperately in search of a cure for Fadhila and Fadhili, the distraught parents sought the help of a witchdoctor, but despite the mediation the children remained ill. Not until, a CHN-trained nutrition group visited the couples’, home and revealed that their children were malnourished would a dramatic healing process begin. This involved the parents learning the basics of good nutritional practices like how to identify and prepare nourishing foods. One year later the twins are healthy, strong and growing normally. “I have no words to thank World Vision Tanzania because I would surely have lost my children�, says Bakari, the father.
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Precious pits saving lives
A
waste disposal system is essential for any health facility. In Tanzania, all health facilities are required
by Government to have a placenta pit for the safe disposal of medical residue. Placentas are difficult to burn, placenta pits are the preferred disposal practice. In many areas including Mgera, east of Tanzania, the availability of placenta pits within health treatment centers is a key deciding factor
COMMUNITY ENGAGEMENT BOOSTS VACCINATION ACCEPTANCE
M
saje dispensary, in Handeni district and CHN worked together to create community awareness of the importance of vaccination for pregnant women and
children under-five. Previously, parents resisted immunization on grounds that it transmitted infection and reduced their fertility. Breaking the barriers to this myth by garnering parental agreement was a significant factor towards acceptance and ultimately increasing the number of children vaccinated.
of whether a pregnant mother will give birth at a health facility or opt out. In the absence of one, mothers often risk their lives and their unborn baby through unsupervised home births.
So when a
nutrition group noticed that their local dispensary did not have a pit, they quickly intervened, raised money and constructed one. “Since the pit’s construction, many
Through the initiative, we have exceeded our monthly target. We now vaccinate about 100 to 150 children a month
women are delivering at the facility with an average of 10 to 15 births per month”, said the health care provider. 12
says leader in charge of the dispensary. 13
CHF an all-inclusive public health package
T
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Health care at your door step
rich. But all that changed in 2012 when
T
she joined the CHF, a national health
ups, treatment of minor ailments and the
coverage in which members make small
immunization of children from child-hood
payments at regular intervals. Membership
diseases. But it is the use of the ‘hospital-
is voluntary and lasts for only one year,
on-wheels approach’, popularly known as
but can be renewed. The system targets
‘mobile clinics’, which makes this support
the vulnerable such as those over the
exclusive. Every month, the mobile clinics
age of 60, the very poor, the disabled,
avenue attends to children under five
the chronically ill and orphans. Since the
years in far reaching areas in the Maasai
inception of CHF, the CHN campaign
heartland. They are weighed; vaccinated
has made it one its key goals to sensitize
and pregnant mothers access ante-natal
women like Tatu to understand the
services. The initiative is run by the local
scheme and to enroll. Now with access to
hospital and CHN. Presently, seven areas
affordable health insurance Tatu does not
namely Losikitiko, Imbibia, Engurtoto,
suffer any financial set-backs or anxiety
Likamba, Losinoni juu, Losinoni chini and
whenever her children fall ill. For only Tsh
Olkokola have been reached, dramatically
10,000 (U$D 5) annually, Tatu is able to
improving maternal, newborn and child
care for the entire family’s health needs.
health and nutrition rates.
atu, a widow and a mother of five assumed that quality health services were the reserve of the
he Olturimet District Hospital in Arusha, north of Tanzania provides a range of services such
as health education, ante-natal check-
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Close collaborations promote wellfunctioning health fund
S
ince the launch of CHN Campaign in Mukulat area, WVT worked closely with the Arusha District Council to create
awareness to the targeted communities on the benefit of a CHF. Additionally, the organisation is promoting ways to the district council on
Close collaborations promote well-functioning health fund
how CHF can be sustainably managed. As a result, awareness has been created and the District has institutionalized a proper way in which funds generated from CHF are well managed by the governing boards of local health facilities. This has contributed to increased enrolment as people are assured of getting health services including medication, a serious challenge in other areas. According to the District CHN Coordinator, in 2012 only 16 per cent of Mukulat’s population joined CHF. To date more than 45 percent are enrolled and 67 percent of the total clients’ contribution in each local health facility is spent on medication. 16
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ACTION IN HAND, CHANGE IS POSSIBLE
“
Kikundi cha Kumi Bora” or “Top
group to savings and lending arrangements.
Ten Group” dreamt of making their
Through the association they have been
community healthier and happier,
able to get money to subsidize the food
especially vulnerable groups like pregnant women and children under-five. They have now turned their vision into a reality.
they are providing for free. “Before CHN campaign people were hardly aware about nutrition related issues.
With training support from Nakombo ADP,
Many thought that nutrition is expensive.
the group provides health education to
They did not know that wholesome food
expecting and lactating mothers and their
is available in our localities. The other
male partners; provides food for free to
challenge was how to prepare it. But as
malnourished children; demonstrates how
we speak because of the education we
to cook nutritious food to the targeted
are providing the community is aware and
communities; provides nutritious food
people are healthier”, informed the group
for free to vulnerable children including
chairperson.
orphans and people living with HIV and AIDS. All supported children have access to CHF, a reliable government-driven, nationwide health care system.And they have gone a step further by channeling back some of their own earnings from farming back into the group. For sustainability purposes Nakombo ADP has also introduced the 18
“Being empowered by WVT has meant that we have been able to make an impact in our community. Being healthy you are able to engage in economic activities, live a happier life and support those in need. This is what we want our community to understand and put into practice”, she added.
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