It is almost nine years since pregnant women in Nyakayondwa, which is part of Nyakatuntu village in Chato district, Geita, were relieved of having to walk close to 10 kilometres to access antenatal care. At that time, Bwanga health centre was the only health facility where expectant women from this sub village could receive antenatal health care.
Things changed when Nyakayondwa leadership mobilized the community to raise about 300,000/- and used it to do something about the situation.
The money was enough to purchase a piece of land on which three ramshackle structures made of mud and thatch stood. Nowadays in Nyakayondwa, expectant women are to be found sitting in one of the three mud huts, waiting to be attended during the once a month antenatal clinic sessions. Sometimes, between 80 and 100 women attend these sessions, so the wait is quite long.
Anastazia Mizinzo(32) during antenatal clinic session at Nyakayondwa makeshift facility. Anastazia has five children of whom the last is one year and eleven months old and yet she expects a new baby in the next one month.
The second and smaller mud-hut is somewhat better looking because of its roof, which is made of corrugated iron sheets held down by stones and heavy wooden objects rather than nails. It is very poorly lit and ventilated and contains nothing but a wooden bed with an old striped mattress on which the nurse midwives attend expectant women. The third little hut serves as a shelter for a watchman hired to man the premises of the makeshift health facility. Together, the three ramshackle structures cater to the antenatal health care needs of the entire village population of about 5252 people, 2, 712 of whom are female.
Nurse midwives attending expectant women: Two nurse midwives Ainess Mavika and Mery Seleman from Bwanga Health Centre attend Grace Charles (24) during antenatal session at Nyakayondwa clinic makeshift facility.
Most inhabitants of the village earn a living through subsistence farming and live in grass thatched houses, not unlike those that comprise the makeshift antenatal and under five clinic. Despite its proximity to the world’s second largest fresh water lake and to large and small scale gold mining activities in Tulawaka, the village lacks basic social service infrastructure.
“This is a big leap forward as far as the provision of antenatal health services in Nyakatuntu village is concerned” says the village executive officer, Martin Faida.
Even so, the condition of the facility is appalling. Sanitation facilities are practically non-existent. There is a single pit latrine which provides limited privacy to its prospective users because one of its walls collapsed recently, during a heavy downpour. Nearby, a urinary exudes a nauseating stench which spreads all around the place.
Still, at least once a month, the pregnant women and children under five in Nyakayondwa get to see medical staff and are attended to with considerably less hassle than the long walk to Bwanga.
In search for Antenatal Services: A woman in Chato District, Geita Region carries her two babies as she walks to a health centre during antenatal clinic session. Because of poor service delivery, women are deprived of knowledge on contraceptive methods and as a result most of them bear children not only at tender ages but also at very close intervals
Bupina Dome (72) is Nyakayondwa subvillage chairperson. He says the predicament facing women who require maternal health services is a persistent cause of concern for the village. However, with the makeshift health facility already in place, something is better than nothing, he says.
Capital development grants (CDG) going to the area are regularly directed to activities other than health service delivery. Recently, a chunk of these funds in Bwanga ward was spent on construction of school buildings. Bwanga ward executive officer Ada Mtaki confirmed that about Sh13 million from the 2011-2012 financial year went into developing the infrastructure of the area’s ward secondary school which is named after the Minister for Works and area member of Parliament, John Magufuli.
“In 2011-2012, the Ward Development Council passed a resolution requiring CDG funds to be spent on construction of a ward secondary school” said Mtaki.
But in the minutes at one of the village meetings preceding the Sh13 million allocation to this issue, Nyakatuntu residents had identified construction of a health facility among their immediate development priorities. CDG funds are meant for development projects which reflect people’s development priorities at the village level.
For Anastazia Misinzo (32) who resides in Nyakatuntu village, construction of a health facility was a top priority. She recalls how things were when pregnant women had to walk all the way to Bwanga health centre and wait several hours for service so far from home. This was before the area’s leaders came up with the idea to fundraise for the makeshift health facility.
“During a particular clinic session, you could wait for as long as twelve hours to be attended.”
Ministry of Health policy guidelines stipulate that every pregnant woman or women seeking health care should be attended by a skilled healthcare provider within 30 minutes of arrival at a health facility. But a nurse-midwife at Bwanga Health Centre, Anna Nyakubiha, says nurses spend close to 30 minutes just drawing lines in exercise books which eventually serve as antenatal cards because these are in short supply. Expectant women must wait while this is being done.
“It is important because the information filled in these cards helps medical staff to anticipate or avert potential pregnancy complications that could lead to maternal morbidity and mortality,” she said.
The fourth Millennium Development Goal (MDG) target is to reduce to maternal mortality to at least 133 deaths out of 100,000 births by 2015. But according to various international reports, Tanzania will not be able to meet this target, having only managed to reduce maternal deaths from 578 to 454 over the past ten years. It is argued that if in ten years Tanzania has only been able to cut down its maternal mortality rate by 124 deaths, it won’t be able to cut down the remaining 321 deaths to meet the MDG target in less than two years.
But maybe things will change in Nyakayondwa, with the makeshift health facility bridging the gap in health service delivery. As the village chairperson put it, something is better than nothing.
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