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MOROGORO

NEWSLETTER

OOVVEERRVVIIEEWW OOFF JJOOIINNTT FFIINNAALL EEVVAALLUUAATTIIOONN

OOFF MMOORROOGGOORROO HHEEAALLTTHH PPRROOJJEECCTT

ear Readers,

Congratulations!!

After the report on the Joint Final Project

Evaluation in October 2005 the Morogoro Health

Project (MHP) has succeeded to get Japan

International Cooperation Agency (JICA) approval

for extension for one year; until March 2007.

MHP, supported by JICA, welcomed Tanzania -

Japan Joint Final Evaluation Team (headed by Ms.

Harumi Kitabayashi, JICA Headquarters, Tokyo,

Japan) to review the project progress and

achievements since the project commencement in

April 2001. Because the Project was originally

designed to end after five-year implementation in

March 2006, this is a prime time to consider the

Project future orientation.

The Evaluation Team, consisting of JICA

Headquarter independent External Consultant, Ms.

Minako Nakatani and two representatives from the

Ministry of Health, Tanzania, reviewed the project

achievements through in-depth interview and

questionnaire to the counterparts, conducting

independent on-site visits to all the districts and

through attending several important meetings, such

as “Project Final Internal Evaluation Workshop”,

“Morogoro Health Stakeholders Conference” and

“Tanzania – JICA Project Review Workshop”,

during the evaluation period from 1st to 23rd October

2005.

Finally, the Evaluation Team discussed the

Evaluation Report with high authorities from the

President’s Office Regional Administration and

Local Government, Ministry of Health, Morogoro

Regional Secretariat and District Councils in

Morogoro Region. They agreed upon optimal project

outcomes in health management development,

certain impacts on health service delivery and

utilization in Morogoro Region.

D

ISSN 0856-9525 ISSUE No.5 December 2005

Group picture of Joint Final Project Evaluation

for Morogoro Health Project

Morogoro Health Newsletter - No.5

2

The Evaluation Report concluded, “During the

Evaluation Mission, various behavioral changes

towards evidence-based management among

Regional Health Management Team (RHMT) and

Council Health Management Team (CHMT)

members were recognized. Such changes are

valuable in supporting the decentralization process

under Local Government Reform and Health Sector

Reform, and essential for ensuring the improvement

of district health services. Future efforts are

necessary by all stakeholders to consolidate such

changes in the managerial capacities of RHMT and

CHMT members, for the benefit of the Frontline

Health Workers and ultimately the health service

users of the Morogoro Region”.

In order to consolidate project outcomes in

RHMT and CHMTs and disseminate project lessons

and experiences to other regions, the Evaluation

Team recommended the Project to be extended one

more year from April 2006 to March 2007 under full

scale assistance by JICA. The project can be a model

of future managerial capacity development in health

systems in Tanzania. Tanzania and Japan should

work together harder for quality and equitable health

services in Tanzania.

MHP would like to appreciate the enduring efforts

from all our stakeholders and to admit more and

more commitment to the Project.

If you need more information on the Final

Evaluation Report, it is available in the MHP office

and Regional Medical Officer (RMO) / District

Medical Officer (DMO) s’ offices.

Thank you very much for your kind cooperation

and consideration for the Project. We have to serve

for the better future of the people in Tanzania.

Dr. T. Sugishita

Chief Advisor

Morogoro Health Project

-- IInn TThhiiss IIssssuuee --

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EDITORIAL BOARD

Chairperson:

Mr. N. Masaoe Regional Health Officer

Secretary:

Ms. C. Maro District Reproductive and Child

Health Coordinator, Morogoro

Deputy Secretary:

Ms. N. Ahmed Nursing Officer, Morogoro Municipality

Members:

Mr. J. Mankambila Regional Health Secretary

Dr. G. Mtey Municipal Medical Officer of Health, Moro.

Dr. O. Mbena District Dental Officer, Mvomero

Mr. J. Bundu District Health Officer, Kilosa

Mr. D. Dia District Health Secretary, Kilombero

Mr. W. Mkessey Ag. District Health Officer, Ulanga

Ms. M. Tsuda Advisor, MHP*

Chief Advisor:

Dr. M. Massi Regional Medical Officer

Associate Member:

Dr. F. Fupi Advisor, MHP*

Advisory Committee:

Mr. H. Mohamed Lecturer, Sokoine University of

Agriculture, Morogoro

*MHP: Morogoro Health Project, JICA


3

MOROGORO HEALTH NEWSLETTER Dear esteemed readers,

On behalf of the Editorial Board of this

Newsletter, I welcome you to the 5th issue of this

Newsletter.

Today I would like to high-light various issues.

The general public should be aware that Malaria, the

leading public health problem, no longer responds

adequately to Sulfadoxine - Pyrimethamine (SP). A

new combination therapy is expected to be initiated

from 2006. The public is advised to wage collective

combined strategy to fight the mosquitoes which

transmit Malaria by for example: extensive use of

ITNs, destroying all mosquito breeding sites,

screening houses, seeking early treatment.

The Board commends the leadership of Central

Government and Councils in Morogoro Region for

their recognition of the Newsletter and hence putting

up budget line in their annual plans for its

publication. This spirit has impressed JICA, the

donor of the Morogoro Health Project (MHP). This

has assured firm sustainability of the Newsletter

when the donor support ends.

Nine members of the Editorial Board attended a

four-day-training on Newsletter type setting and

related computer skills, which was conducted at

Mzumbe University. The training was important in

enhancing the skills of the Board members. The

Board thanks MHP for financing the training.

A team of four external final evaluators of MHP,

Ms. Harumi Kitabayashi, Prof. Ichiro Okubo, Mr.

Ikuo Takizawa and Ms. Minako Nakatani conducted

the MHP Final Evaluation from 1st to 23rd October

2005. The Team visited all six Councils of

Morogoro Region. In the 14 health facilities visited

the team observed some health workers using the

Newsletter to disseminate health education issues to

their clients. Most of health workers interviewed

were aware of the existence of the Newsletter. This

highly impressed the Evaluation Team. The Board

commends those who read the Newsletter and share

the text with community. Others are advised to

emulate. The Evaluation Team was satisfied with

implementation of MHP. The Team’s opinion was

that the MHP objective of managerial capacity

building of the Health Management Teams in

Morogoro region has been optimally realized. The

MHP project which was to end in March 2006 has

been extended to March 2007.

The Board is further requesting all readers of this

Newsletter to send articles and suggestions for

publication. This will facilitate achieving the

objective of the Newsletter, i.e. to exchange

experience and skills among health service providers

and the community.

I take this opportunity to inform our readers that,

mid-January 2006, I shall retire from Public Service;

hence my position as Chairperson of the Editorial

Board seizes mid-December 2005. My best wishes

to the incoming Chairperson Dr. G. Mtey and assure

him of my un-swayed support and commitment to

the development of the Newsletter.

I thank the Editorial Board members and readers

for their cooperation, support and commitment

which lead to the success of the Newsletter. I wish

you all Merry X-mass and Prosperous New Year. We

shall meet if God wishes.

Mr. N. Masaoe

Chairperson

Editorial Board

Mr. N. MasaoeChairperson

Editorial Board


4

CCUUSSTTOOMMSS AANNDD TTAABBOOOOSS HHAARRMMFFUULL TTOO TTEEEETTHH

A human tooth is among the organs of the body

that plays a role of beautify the face, protection

essentially as a weapon and also chewing food and

fruits.

Therefore maximum care has to be taken to

safeguard them from harm or damage, by seeking

treatment whenever necessary and frequent

check-up.

However in some countries, people are used to do

some traditional sculpture works on their teeth,

based on some cultural beliefs. Teeth sculpturing

became famous in most countries. Some decades

ago it conveyed various messages and meanings; e.g.

during wartimes and as a gesture of prestige,

especially among women.

Tooth extraction was also considered as a

“Medical’’ intervention to relieve outstanding pain

of some teeth. This move was however, more

psychological, and rarely as an appropriate. Teeth

decoration, in any form is doing harm to the mouth

and the teeth itself.

In the modern times, teeth decoration is no longer

useful to the Tanzanian. We have to discourage

decoration practice and even its extraction without

reasonable cause.

Some of the traditional belief and practices which

need to be discouraged are:

Tooth sculpturing and polishing. This

practice destroys the upper layer that

protects the teeth.

Extraction of front lower teeth.

Extraction of front upper teeth and piercing

of the upper lip to insert cylindrical object

(“Ndonya”), a decorative gesture by woman,

mostly older women.

Extraction of infancy teeth. This hurts the

child, and delays the growth of permanent

teeth. The rumors of ‘plastic teeth’ is mere

myths, all teeth are genuine ones.

Use of teeth to uncap bottles mostly of

beverages and soft drinks, cutting ropes,

crushing bones and lifting heavy objects.

To polish brown teeth due to e.g. fluorine.

Disadvantages of the practices are:

Difficulty and pain when the tooth gets into

contact with cold or even hot food or drinks.

Tooth decay can be easily accelerated.

A tooth becomes loose easily and can

ultimately be exfoliated.

Hence let us take all necessary measures to

observe the guidance to safeguard our teeth for

better health.

Dr. O. Mbena

DDO Mvomero

NNEEWW AANNTTII--MMAALLAARRIIAA DDRRUUGGSS

Malaria is still the most common dangerous disease

in the third world and it ranks number one in terms of

high morbidity and mortality, especially in under five

children and pregnant mothers. The Government

produced new National Guidelines for Diagnosis and

Treatment of Malaria for the aim of attaining uniform

malaria cases management in the country .The guiding

principle of Malarial drug policy is to promote safe,

effective, good quality, affordable, accessible and

acceptable Malaria treatment also encourage rational

Morogoro Health Newsletter – No.5

5

drug use in order to minimize development of drugs

resistance.

Our country changed its Malaria Treatment Policy

Guideline from Chloroquine to Sulfadoxine -

Pyrimethamine (SP) combination therapy as the first

line for drug for the treatment of acute Malaria

episodes in August 2001. However over the last 4

years resistance to SP has already been reported to be

on the increase. Recent studies (2004) in Tanzania

indicate that the mean SP treatment failure is now

25.5% and molecular markers of SP resistance have

recorded high levels of mutation. The mean treatment

failure of Amodiaquine, the 2nd line anti-Malaria is

12%. The findings indicate that a change in the

treatment guideline is necessary.

According to the risk of increasing parasites

resistance to existing mono-therapies, there is now a

global move towards use of combination therapy.

Another reason is that these drugs are more

efficacious and they may delay the spread of drug

resistance.

Recommended therapy:

• Combination therapy recommended is

ARTEMETHER / LUMEFANTRINE (ALU), it

is recommended as first line therapy.

(See Table-1)

• The second line drug where ALU has failed or is

contraindicated is Quinine.

• The drug of choice for treatment of severe

Malaria is Quinine.

• The first line drug for pregnant women and

children less than 5 kg (under two months) is

Quinine.

• SP will continue only for pregnant women as

Intermittent Presumptive Treatment (IPT). The

dose is administered between 20-24 weeks of

gestational age and second dose of IPT will be

administered at 28-32 weeks.

Administration of SP to all pregnant women will

prevent them from high risk of peripheral parasitaemia

and placental Malaria because during pregnancy

Malaria is often asymptomatic.

IPT should be administered as Direct Observed (DOT)

during an ant-natal visit.

Drug compliance is very important to prevent

incorrect administration of ALU, since ALU is not a

single dose therapy. Early diagnosis and effective case

management of Malaria is very important. Clear

instruction to the patient is necessary. All pregnant

mothers should be encouraged to use Insecticide

Treated Nets (ITNs) besides using IPT.

Reference: Malaria Control Series 10

Ms. C. Maro

DRCHCo Morogoro

Table-1 ALU dosage regimen - Dosage of Artemether 20 mg & Lumefatrine 120 mg (ALU) tablets

Weight (Kg)

Age Day 1 Day 2 Day 3 Colour code

Dose 1st 2nd 3rd 4th 5th 6th Hours 0(“) 8 24 36 48 60 tablets tablets tablets tablets tablets tablets 5-14 3 months up to

3 years 1 1 1 1 1 1 Yellow

15-24 3 years up to 7 years

2 2 2 2 2 2 Blue

25-34 7 years up to 12 years

3 3 3 3 3 3 Red

35 and above

12 years and above

4 4 4 4 4 4 Green


6

FFOOOODD VVEENNDDOORRSS:: KKAAPP-- RREESSEEAARRCCHH PPAAPPEERR

Food vending is a fast growing business in both

urban and per urban setting. The business, nick name

in Swahili “mama/baba lishe”, despite selling food at

reasonable prices, provides employment to several

women and men of middle age and others. Organized

groups of food vendors have been instrumental in

providing services in functions such as weddings,

funerals etc. where many clients are served.

Canning fruits, pickles, jam and even wine

preparations and bottling for ultimate sale for human

consumption are undertaken by some food vendors.

The hygiene compliance of most of the food

vendors leaves much to be desired. The consumers of

street food do it at untold risk of contracting serous

food born infections. On this consideration research

on the Knowledge, Attitude and Practice (KAP) of

food vendors was conducted in Kinondoni Municipal

of Dar es Salaam. The findings, conclusions and

recommendations are applicable in many food

vending business, and serves as a module for

improving the practice in the country.

In the study area 175 registered food vendors were

interviewed using a structured questionnaire.

The interviewees were in the following categories.

• Aged between 18 to 48 years.

• Sex females 154 [88%] and 21 [12%] males.

• Education 150 [86%] had primary, 13 [7%]

secondary/vocational and 12 [7%] had no formal

education.

• On food safety knowledge 172 [98%] had scanty

information while 3 [2%] had vague knowledge.

The environment in which food was prepared and sold

was of the following features:

• Surroundings were littered with left over food,

used plastic bags etc.

• Utensils were dirty and stored in used plastic

bags.

• No disinfectants or soap for cleaning utensils and

hand washing.

• Poor liquid and solid wastes management.

• Some of the structures used were ruinous and

dilapidated, lacking essential provisions such as:

running water, sanitary facilities, disposal of

solid and liquid wastes.

Good practices observed:

• Food was served hot to early customers.

• Prices of food were affordable.

• Some food vendors had hot water for utensils

and hand washing.

Bad practices generally practiced by food vendors

include:

• Talking while preparing or serving food.

• Picking nose or teeth.

• Scratching body.

• Sneezing without protection.

• Coughing without protection.

• Smoking while serving or preparing food.


7

• Irregular or no medical examinations etc.

• Absence of uniforms and or protective gear.

Conclusion and Recommendations:

Food vending is a fast growing industry. The

conducts of operations require regular monitoring and

continuous orientations on good preparation practices.

The following is recommended to the responsible

authorities.

• Identification, registration and certification of all

food vendors.

• Prepare and institute, in consultation with food

vendors, minimum standards and regulations.

• Ensure and institute regular medical examination

of every food vendor.

• Organize regular and frequent health education

sessions on food safety. Such trainings can be

financed trough the Comprehensive Council

Health Plans.

• Assist them to acquire loans to facilitate

improving their business.

• Recognize their leadership and plan with them

regular meetings and dialogue.

• Ensure that all food vendors have clean uniforms

and protective gear all the time.

• Keep young children/infants away from business

premises.

Ms. L. F. Temu

HO [Internship]

Morogoro Regional Hospital

MMAANNAAGGIINNGG TTHHEE EENNVVIIRROONNMMEENNTT TTHHRROOUUGGHH TTHHEE CCOOMMMMUUNNIITTYY

IINN MMOORROOGGOORROO MMUUNNIICCIIPPAALLIITTYY

Morogoro Municipal is one of the Municipalities

with an attractive environment and scenery of the

Uluguru Mountains, many rivers and numerous

streams. However, this is systematically deteriorating

due to reasons hereunder.

• The majority of residents do not value

cleanliness. They rarely participate in activities

geared to keep the Municipal clean.

• Liquid and solid wastes flow and accumulate in

the residential areas unabated.

• Some residential buildings do not have;

o Acceptable sanitary facilities (latrines)

o Proper soakage pits for waste water disposal

o Proper washing slabs

o Receptacles for storage of domestic wastes

• Used plastics containers and bags litter the entire

Municipal.

• Some occupiers keep livestock in high density

areas, causing unwanted irritation and nuisance

to neighbors.

Morogoro Municipal has three times ranked the 12th

out of the 13 Municipalities in Tanzania mainland in

the Environmental Sanitation Competitions organized

by the Ministry of Health due to the aforementioned

reasons and other factors such as dilapidated public

abattoirs, an unfenced public cemetery, the presence

of an old and poorly rehabilitated main market, poorly

rehabilitated unpaved roads with poor storm water

drains and the presence of many “squatter areas”.

Always insist to be served hot, hygienically prepared food


8

The residents of Morogoro Municipal should take

full responsibility of their health and the cleanliness of

their Municipality by forming partnership with the

Municipal authority to reverse the current trend.

In 2003, the Municipality, with the assistance from

the Danish Embassy through DANIDA, has come up

with a new approach which is the Sustainable

Morogoro Program (SUMO). If the program is

supported, it will be part of the solution of the

problem.

One of SUMO’s main objectives is to address the

Solid Waste (SW) problem in the Municipality

through a more participative, effective and efficient

management to be known as the Morogoro

Sustainable Solid Waste Program already in place

since July 2005. The program is mainly Community

Based Organizations (CBOs) engaging women and

youths in managing SW in partnership with the

Municipality.

This is expected to offer, apart from ownership,

economic empowerment to the CBOs thus

contributing towards “MKUKUTA” (Poverty

Reduction Programme).

The CBOs are expected to get their earnings

through fees which they will collect from households

and in turn clean streets, drains and open spaces as

well as serve as an eye for Health Officers in matters

pertaining to the observance of health regulations

within their areas of jurisdiction. They will also

collect from the households selected Skip Bucket

areas and in turn pay Skip Bucket empting fees to the

Municipality. These fees are to be collected and

operated in a special account and be used by the

Municipality to sustain recurrent, dumpsite

management and replacement costs.

The CBOs will be selected through competitive and

transparent local tendering at the ward level by the

Ward Development Committee (WDC). Selected

CBOs will in turn be endorsed by the Municipal

Council Tender Board to formalize the tendering

process. They will also be assisted with initial grant

for basic equipment and working gear required.

Monitoring and Evaluation (M&E) will be done at

the local level by the respective WDCs. M&E by the

Centre will be done through the Wards and the Skip

Bucket emptying fund.

This article aims at raising awareness of the new

process to all stakeholders in order to solicit

cooperation in its implementation and at the same

time offer room for views and suggestions for

improvement.

Our conviction is that “we can make a change if we

do it together“.

CHMT

Morogoro Municipality

HHOOMMEE BBAASSEEDD CCAARREE IINN KKIILLOOSSAA DDIISSTTRRIICCTT

Kilosa District has started to implement Home

Based Care (HBC) for People Living with HIV/AIDS

(PLWHA) and chronic illnesses.

The chronic illnesses are:

HIV/AIDS, Diabetes mellitus, Epilepsy, Carcinoma,

Tuberculosis, Mental illness and Heart diseases


9

The program was initiated due to the following:

The number of patients with HIV/AIDS and

chronic illness has increased. The hospital bed

occupancy due to HIV/AIDS and related diseases

is 50 – 60%.

Enable health workers to assist to build capacity

at all levels of community and family on how to

help patients through HBC.

Specific objectives of the program are:

To reduce pains for PLWHA and chronic illness.

To facilitate family members who provide care

for PLWHA to attend to other responsibilities.

To provide counseling to PLWHA and other

chronic illness and their families.

Distribute HBC supplies, equipments and drugs

to trained community HBC provider.

Sensitize and motivate community to establish

and maintain HBC services focusing on felt

needs and sense of ownership.

Promote awareness on infection prevention, care

and support of chronic illnesses in the

community.

14 Clinical Officers and 28 Public Health Nurses

received 21-day-training on HBC. They started to

implement the program in their health facilities.

The Ministry of Health through the National AIDS

Control Program provided 14 bicycles for HBC

providers; Drugs were purchased for 14 health

facilities, including one hospital, 5 health centers and

8 dispensaries. Funds were also received for

procurement of sugar and floor for the heath facilities

in the program.

Benefits to be realized from HBC are:

The community is sensitized to desist from

discriminating PLWHA.

Reduced hospital bed occupancy through HBC.

HIV/AIDS infection is reduced.

Community members looking after patients by

HBC saves time for other productive ventures.

Through HBC and Antiretroviral (ARV) therapy,

many patients recover and return to normal life.

Other supportive services for HBC patients are:

Prevention of opportunistic infection by using

supplied drugs.

Provision for enriched meals and ensuring good

ventilation of their houses.

Promotion of personal hygiene practices and

clean environment.

Encouraging frequent physical exercises.

Building capacity of HBC providers.

Providing recreational facilities, such as indoor

games, film / video shows etc.

Spiritual support.

Legal support.

Economic / financial support.

Community education in ARV therapy

fundamentals.

Through HBC, HIV/AIDS patients receive ARV

according to World Health Organization (WHO) guide

lines. The district intends to role over this program to

the remaining 49 health facilities in three years.

Dr. W. Munuo

Home based care coordinator

Kilosa

Support mental disordered people in the community by Home Based Care


10

OOVVEERRVVIIEEWW OOFF HHEEAALLTTHH OOPPEERRAATTIIOONNAALL RREESSEEAARRCCHH MMAANNAAGGEEMMEENNTT BBYY

TTAANNZZAANNIIAA--JJAAPPAANN MMOORROOGGOORROO HHEEAALLTTHH PPRROOJJEECCTT

Recently a “Collection (Corpus) of the 1st

Operational Research Reports” was produced as an

outcome of practical management trainings for the

Regional and Council Health Management Teams

(RHMT and CHMTs) in Morogoro Region, through

Morogoro Health Project (MHP) whose main

objective is to strengthen managerial capabilities in

district health services in the region.

The introduction of the Health Sector Reform

(HSR), in Tanzania, requires district health managers

to pursue “Evidence-based Plans”, which involve

processes of capturing and analyzing local health

problems and reflecting them in their Comprehensive

Council Health Plans (CCHPs). Consequently,

Operational Research (OPR) implementation for the

purpose of getting evidence became a unique but an

essential challenging activity by Morogoro Region

RHMT and CHMTs. Analytical attitude and thinking,

which could be acquired through OPR management,

are necessary for health managers to respond to newly

demanded expectations from the Public Sector

Reforms agenda by the government.

With strong demands from the Health Management

Teams the MHP has been, since September 2004,

facilitating the process of conducting actual OPR by

RHMT and CHMTs in respective districts. This is in

addition to providing them with essential technical

skills and involving also Frontline Health Workers

(FLHWs) and the community. After the operational

research, interventions were planned and, where

applicable, included in CCHPs.

The researched topics (involved team in bracket)

and the respective planned interventions in the year

2005/6 were:

1) High perinatal deaths in Morogoro Municipality

(RHMT) - Intervention: Strengthen model perinatal

ward

2) Factors influencing utilization of ITNs among

Under-Fives in Morogoro Urban (Municipal

CHMT) - Intervention: Sensitization meetings to

hamlet leaders on ITNs use

3) Exploration of utilization pattern of health

services by pregnant mothers during delivery in

Morogoro District (Morogoro CHMT)

- Intervention: Orient FLHWs on focused antenatal

care

4) Factors influencing low coverage of ITNs in

Malaria control in Mvomero District (Mvomero

CHMT) - Intervention: Sensitization of private sector

on ITNs sale

5) Determining factors that influence diarrhoea

disease epidemic among households in three

divisions in Kilosa District (Kilosa CHMT)

- Intervention: Community sensitization on cholera

control

6) Determining performance of health

interventions in addressing cholera outbreaks in

Ifakara Division in Kilombero District (Kilombero

CHMT) - Intervention: Participatory Hygiene and

Sanitation Transformation (PHAST) training for

community and health assistants

7) Determining factors influencing high morbidity

and mortality to Under-Five Children in Mwaya

Division in Ulanga District (Ulanga CHMT)

- Intervention: Training on Community IMCI

In November 2004, the MHP established OPR

Working Group (WG), composed of one OPR Contact

Person from each RHMT and CHMT. Through


11

intensive discussions in regular WG meetings, the

members developed rapport among themselves, and

accommodated suggestions and constructive

criticisms to improve the quality of their researched

topics. Consequently they are strengthening their

communication and team building skills, which are

directly applied by the health management team of

each WG member. The WG members are the

important instrumental agents in the OPR

management.

In summary, OPR management created

‘confidence’ among the health managers, which is

essential to accomplish their challenging managerial

tasks by means of required technical skills. Thus, it

can be concluded that OPR management is among the

most effective strategies to strengthen managerial

capacity of the regional and district health managers

under the decentralization process of Public Sector

Reforms in Tanzania.

In view of the significance of sharing research

results with the community and various authorities of

relevant levels in order to maximize the benefit from

the research, the CHMTs and RHMT decided to

organize information dissemination activities with

stakeholders by using most cost-effective means in the

respective districts. The OPR WG acknowledges that

“Morogoro Health Newsletter” is one among such

means and appreciates for the space allocated for OPR

activities in the Newsletter.

Appreciation is expressed to the RHMT and

CHMTs for their dedication, to the Regional and

District administrative authorities for their support and

cooperation throughout the research exercise, to the

FLHWs and the communities for their cooperation

during data collection.

It is believed that the health managers in Morogoro

Region would further develop their managerial

capacity by perpetually continuing the OPR

implementation which would have positive impacts

toward many optimal directions to actualize better

health services and hence better health status of the

people of Morogoro Region and Tanzania generally.

Ms. E. Fukushi

Technical Advisor & OPR-WG Organizer

Morogroro Health Project

IMPORTANT EVENTS : August – December 2005 AUGUST 1st – 5th, 2005 Regional Medical Officers’ Conference

Theme: “Non-communicable diseases: a challenge to Tanzania people” Venue: Mtwara

AUGUST 8th, 2005 Nane Nane (Farmers’ Day)

Theme: “Quality farming is an important tool for reduction of all types of poverty”

Venue: Mbeya (national) and Morogoro (zonal)

OCTOBER 2nd – 23rd, 2005 Final Evaluation of Morogoro Health Project (MHP) Good achievements were reported, and the Project has been extended for one year up to March 2007.

OCTOBER 14th, 2005 Nyerere Day NOVEMBER 18th, 2005 Opening of Kilosa Health Information Resource Centre DECEMBER 1st, 2005 World AIDS Day Theme: “Stop AIDS: keep promise” Venue: Songea, Ruvuma

DECEMBER 9th, 2005 Independence Day DECEMBER 14th, 2005 General Election Day of the United Republic of Tanzania


12

CARTOON The significance of Food Safety to the Community Author/Drawing: Mr. N. Masaoe & Mr. J. Bundu

Articles or letters to the Editor should be addressed to:- The Editor Morogoro Health Newsletter P.O.BOX 110, MOROGORO or, P.O.BOX 1193, MOROGORO FAX 023 - 2614148

Or

Could be sent to the respective District Medical Officer or Municipal Medical Officer as follows:-

P.O.BOX 166, Morogoro Municipality P.O.BOX 1862, Morogoro P.O.BOX 14, Kilosa P.O.BOX 47, Ifakara, Kilombero P.O.BOX 4, Mahenge, Ulanga

PUBLISHED BY THE EDITORIAL BOARDMOROGORO HEALTH NEWSLETTER

P.O.BOX 110, MOROGORO

M H P

Morogoro Health Project

• Our esteemed readers, we invite views and suggestions on a name you deem suitable for this Newsletter.

• Also we invite your contribution of articles to be included in the Newsletter for the next issue due for July 2006: the articles should be related to health or opinions andsuggestions on how health services are rendered in Morogoro Region and are not to exceed 400 words.

The food is fresh and served hot.

Why do you eat street vendor’s food? Don’t you have enough money? That’s the problem …

you eat everything.

What about its hygiene?

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