THE number of pregnant women turning up to utilize formal system before and during delivery in Tarime has significantly increased, thanks to the Africa Medical Research Foundation (AMREF) for initiating a health project that has widely benefited thousands of rural women in the area. Implementation of the three years project tapped Tuimarishe (strengthening health service system) kicked off April 2011 targeting 17 interior remote villages of Ingwe Division in the Northern Tarime District of Mara Region.
It aims to link informal health and formal health systems with improvement of maternal health services as well as addressing the problems of Malaria, HIV/AIDS and gender based violence in the villages, according to AMREF officials.
In a bid to achieve the intended objective, AMREF had trained 210 community health workers who have greatly helped to sensitize the target villagers to realize the importance of utilizing available health facilities. "We have 12 trained health community workers in every village and aim was to improve health service in the 17 villages by using informal and formal health systems.
People are now aware of the role of the two systems," Mr Michael Kimaryo, In charge of AMREF's Tuimarishe Project in Tarime office said. The project has so far benefited nearly 18,000 people majority of them being women and children. Hundreds of women have been sensitized to utilize available health facilities when giving birth instead of continue to rely on traditional birth attendants.
Samson Marwa, one of the community health workers residing at Mangucha village in Nyanungu ward said the AMREF's campaign to make people utilize health facilities has registered a lot of success in the area. "Many women are now delivering at health centres and they also test HIV/AIDS status. People are also boiling drinking as well as using latrines," Marwa told the 'Daily News' at a visit to the Tarime interior remote village which is bordering the Kenyan Rift Valley province recently.
Mangucha is one of the AMREF's Tuimarishe project areas reached with difficulties especially during rain seasons in the area. "We also use traditional dance groups to sensitize and help in delivering messages on maternal health services, malaria and HIV/ AIDS as well as gender based violence issues during village health day conducted after every three months," Ms Mwajuma Omar, the project officer said.
Government clinical officers stationed in the targeted villages have hailed project, saying that it significantly helped to maternal health services as well as boosting health service delivery in the area. "In the past pregnant women used to regard health centres as referral hospitals and come at late stages but now they came soon after becoming pregnant and during delivery," Deus Nyauke, a clinical officer in charge at Nyamwaga dispensary said.
The number of pregnant women delivering at the rural health public facility has increased from 20- 42 between 20011 and now, according to Mr Nyauke. Similarly the number of outpatient attending at the dispensary has rose from an average of 12- 20 during the same period, he said. "In the past it was also not easy for a man to accompany her wife to attend clinic but they now come but much efforts are still need to make men realize they need to accompany their wives to attend clinic when they become pregnant," he said, thanking AMREF for initiating Tuimarishe project in the area.
Unlike other several rural public heath facilitates situated in the project area, Nyamwaga dispensary has been equipped with a number of facilities such as microscopes, CD4 machines and furniture ( eg tables and chairs). The health facilities have also undergone major rehabilitation with the support of the project that is schedule to expire March next year.
"Generally this Tuimarishe project has improved efficiency on health service delivery and the number of patient using our health facilities have also increased significantly at this time as compared to the past," Mr Andrew Chacha, a senior clinical and a counsel at the Tarime District Government Hospital said. AMREF has further educated about 50 traditional birth attendants in the villages on the importance of referring pregnant women to deliver at the nearby health centres instead of keeping them at their homes.
"AMREF are telling us not to keep pregnant women at our homes and we are now refereeing them to the health centres. I am even referring some serious cases to Tarime District Hospital," Ms Maria Pius, 73, a prominent and highly experienced traditional birth attendant in Nyamwaga ward said. She however cited poverty as the major factor that still force some pregnant women to deliver at the homes of traditional birth attendants. "It is sometimes disturbing to see some pregnant women coming late hours without being accompanied without even a single relative or having a single cent.
It becomes impossible to give such women a referral and the environments of our beds are not good for delivery," Ms Maria complained. She requested relevant authorities to consider the possibility of giving rural villages ambulances that would be rushing pregnant women to the health centres or hospitals when need arises. Traditional elders have also been involved to help fight gender based violence issues under the project with female genital mutilation (FGM) getting special attention. Tarime is one Mara regions districts where FGM is widely conducted very often.
"We thank AMREF for coming to create awareness on gender based violence. Apart from female circumcision which has now become voluntarily thing we are also educating people that men that they have no right to beat their wives and women have also not right to mistreat their husbands", said Samson Mwita Sinda, 50, who is the secretary of traditional leaders in Muriba village.
FGM has is one of the challenges hampering the project's efforts meant to improve health of women and children in the area. "FGM is the biggest challenge and the communities are not ready to change, young girls are being circumcised", the Project Manager Mr Kimaryo said. Meanwhile Mr Kimaryo has appealed for other stakeholders to help the 210 community health workers perform their work without so much difficulty.
"We are doing everything possible to motivate them (community health workers) by giving them T shirts and we are now on the process providing them with bicycles but we need more help", he said.