IT is about a 12-hour voyage from Muleba District Council to some Lake Victoria islands. Health service providers are required to go by boat for all those hours just to deliver services to islanders.
A few years ago, it was difficult for health service providers to reach such people. The introduction of Maternal and Child Survival Programme (MCSP), in the region brought about significant improvements in the provision of services. MCSP is funded by the US Agency for International Development (USAID), to increase coverage and utilisation of high-quality reproductive, maternal, newborn and child health interventions at all levels.
About 70bn/- has been spent during the MCSP implementation years in the country. The implementation of the five-year MCSP project in the region has taken immunisation to high heights by recording good performance. “We thank stakeholders for their support in the provision of vaccination in various parts of the region, but in particular in my district, which include a few islands in Lake Victoria,” said Muleba District Medical Officer Modest Lwakaimula.
He noted that to reach families in rural areas, including those in islands officials were required to spend some hours travelling by boat. He said the lake used to save as a barrier to the provision of health services, including vaccination. Muleba District has 32 islands. According to Dr Lwakaimula, people live on 28 islands only. He said at least 300,000 people resided on those islands, but there were only five dispensaries.
“We are required to put in place a strategy and budget that will enable us to reach all these islanders. We need to cover all these areas,” he noted. According to Dr Lwakaimula, the islands comprise five wards, but there is only one health centre. “We understand that it must be one ward, one health centre. But it is different here. Nevertheless, the government is working very hard to address this challenge,” he noted.
Dr Lwakaimula said vaccination was the most cost-effective public health intervention and his district had been successful in achieving high routine coverage, thanks to MCSP. “Muleba is one of the districts that have recorded good performance in immunisation in the region. MCSP has helped us dearly to attain this achievement,” he said.
He added: “We are excited and honoured to be part of this project. It is a critical step in the fight against child and maternal mortality.” Dr Lwakaimula explained that the project commenced in 2014 in Muleba District at a time the rate of immunisation was between 65 and 75 per cent, which was below standard. “The required standard is from 90 per cent. Therefore, we were not doing well before the establishment of this crucial project in our area,” he pointed out.
According to Dr Lwakaimula, as of today, the immunisation rate is at an average of 98.7 per cent, which is the best. Dr Lwakaimula said MCSP supported health service providers with training on how to use registers to ensure close a follow-up to all children in the area. Registers enable health providers to know, who does not go to health centre or who has missed on vaccination.
He added that the micro-plan was applied in Muleba and members of staff from 47 health centres were trained. A micro-plan is prepared to detail a schedule of vaccination services. He said immunisation mapping and a micro-planning approach was better in distribution of health staff. “MCSP has been helping us to plan on how to reach islanders for health services,” he noted.
Health workers save lives Successful interventions by community health workers (CHWs), have led to improvements in maternal and child health, including a reduction in mortality and morbidity from common childhood illnesses. Availability of health workers is key to vaccination coverage in many areas. The presence of health workers usually increases the availability of vaccination services, making it more likely that populations will be vaccinated. Dr Lwakaimula said his district had 166 villages and each village had two CHWs trained in using registers.
“We are very grateful to CHWs. They are doing a good job. They stand as a bridge between us and the community,” he said. The provision of quality training at various schools of nursing With a skills lab, tutors no longer deliver healthcare instructions using makeshift teaching aid and out-of-date materials. MCSP has helped to set up a preceptor corner, skills lab, training to tutors, a computer lab and many other equipment that help shape midwifery students.
For some years now the US Agency for International Development’s flagship, MCSP, in collaboration with the government of Tanzania and in-country partners, has supported the revitalisation of nursing and midwifery schools by providing new computers, equipment, supplies and learning materials.
These efforts are geared towards the improvement of the quality of nursing and midwifery services and expand access to high quality reproductive, maternal, newborn and child health services in communities.