Ward medical officers key to reducing child mortality rates

Friday November 29 2013

Mothers nurse their new born infants at a

Mothers nurse their new born infants at a district hospital. Although many maternity wards lack proper medication and medical instruments, the survival and health of these infants and their mothers depends on more basic facilities and services such as clean toilets and good sanitation  and a healthy diet.  PHOTOIFILE 

By The Citizen Correspondent

Mwanza. Maternal health stakeholders have been urged to effectively engage ward and district health officers as another approach to reduce death among expectant mothers and under five children by 75 per cent as stipulated by the 2015 millennium development goals (MDGs) .

In addition, involvement of ward health officers in strengthening maternal health will improve availability of services rendered to pregnant women and children.

This can influence citizens to contribute their resources to implementing different projects geared toward improving health services.

The resolution was reached during a one day meeting organised by a Mwanza-based NGO, Tandabui Health Access Tanzania, THAT/ AFYA Radio.

The goal of the event  was to discuss the role of ward health officers in improving maternal health provision.

Participants of the meeting were ward health officers, district coordinators of reproductive health and district health officers from Nyamagana, Ilemela and Geita districts.

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Ilemela District health officer, Daniel Batare, said strategies to reduce maternal and child mortality rate, will succeed if ward health officers are involved since they are the only civil servants working directly with the people.

“ I have been thinking  that many health projects have been implemented with the involvement of other stakeholders while ward health officers are excluded…this is the cadre with great influence in society, they attend every meeting from village to ward level, which gives them the opportunity to motivate citizens on attaining desired goals,” said the district health officer.     

“There must be cooperation with ward health officers on health facilities budgeting that will  include preparing strategies on educating the society. It’s the education that will prevent the spread of diseases as goes the saying that prevention is better than cure.

We should avoid budgeting for medicines and forget educating society on health issues,” he added.

He said it is not sufficient to dwell on the availability of medicines and health providers for the improvement of maternal health, while expectant mothers are living in unhygienic environments, including areas without toilets, and are prone to diseases which will affect their health and that of their unborn babies.

He urged that  outreach should focus on the provision of health education with the involvement of health officers. 

He encouraged health care workers to change their perspectives  that the essentials for health services are drugs and medical supplies like BP machines while not realising the  importance of having  basic sanitary facilities  as many health complications are the results of improper usage of toilets.

“Ward health officers who have ten villagers health attendants in every village monitoring health issues including registering pregnant women, have capacity to sensitise and take actions on individuals and families that go against health regulations,” said Batare.

Health officer in Kalangalala Ward Geita District, Philipo Ngika, said cooperation between parties will  improve health in the community, warning that if it fails, public health will be at risk.

 A heated debate emerged in the meeting on wether ward health officer are capable of closing health  facilities which, according to the officer, has been found running contrary to health regulations, like lack of toilets, bathrooms and incinerators.

A nurse at Shaddy Dispensary in Mwanza City, Lucy Magesa said, although there has been some success in the provision of health services at her facility, lack of an incinerator is a hindrance to them and urged for authorities to solve the issue

For her part a nurse at Sahwa Dispensary in Mwanza City, Mary Mdeme said, most dispensaries have hygiene challenges, asking ward health officers if they have the mandate to close health facilities like they do to café, hotels and restaurants.

Igogo Ward health officer, Novatus Rutahoile said they have the mandate, but it can lead to confrontations with their employer who is the District Executive Director (DED) and politicians who like to have a building without other important services for a health project to be complete

Ilemela District health officer, Daniel Batare said, the ward health officer has the mandate to order closure of health facilities if he/she is satisfied that it will endanger public health .

“Health officers have legal power which cannot be revoked even by (DED)…. It’s shameful to have health services which lack essential aspects like an incinerator. Think of what will happen if a dog is seen coming from a health facility with a placenta,” he said.

“If you talk to the community and it fails to find solutions to the said issue, a health officer is required to inform the DED of the respective area and suggest an action that should be taken; if the DED fails to respond accordingly, then he/she has to issue a notice of closure and copied to DED and District Medical Officer (DMO), said Batare.

He said politicians are sometimes to blame since they prioritise certain projects forgetting that without toilets or incinerators health services cannot be complete.

The statement was echoed by Geita District hospital health officer David Ngoi, who said there was a need to have a wide perspective on health issues by looking at other areas rather than medical supplies and medical professionals.

“Visit a toilet located at a health facility you will find anomalies….Geita District Hospital has problems with toilets. A toilet for expectant mothers at the facility is inadequate. It needs not more than Sh, 200,000 for renovations. The same is also true for the clinic, its floor requires renovations,” he said

Other issues were raised during the meeting, participants expressed their concern after it was learnt that the generator which was provided more than a year ago by the ministry of health for Geita District Hospital has yet to start generating electricity as technicians are attempting  to connect it to the national grid

One participant, Paulina David, said she sent her sister to Geita District Hospital for delivery, where electricity was cut for more than 18 minutes before it returned, although it was reported that the generator was working

Acting Geita DMO, Sungu Nesphory, said the problem with the generator would be solved soon after technicians from the state power utility, TANESCO, and Tanzania Electrical, Mechanical and Services Agency (TEMESA), connect the generator to the national power grid so that it will start to run once TANESCO’s power is off.

Closing the meeting, Afya radio manager, Dotto Biteko, urged health personnel to implement their duties professionally while taking care of politicians who most of the times are always looking for elections.

He said sometimes politicians will prefer to skip some laid down regulations like the launching of a health facility which has not met the required standards as set by the ministry of health.

“Once you decide to issue a closure notice for school or health facility after you’re satisfied that services rendered can cause health hazards you should be prepared for what might happen as some people may get angry with your decision. You should continue with your duties so long as  you’re following the rules and regulations,” he said.