1.11.2.10 28 1.11.2.11 28 1.11.2.12 28 1.11.2.13 29 1.11.2.14 29 1.11.2.15 30 1.11.2.16 / 30 1.11.2.17 30 1.12 44 1.12.1 45 1.12.2 46 1.12.3 46 1.12.4 53 1.12.4.1 57 1.13 59 CHAPTER TWO 61 2.0 PROBLEM IDENTIFICATION 61 2.1 61 2.2 61 2.2.1 61 2.2.2 63 2.2.3 63 2.3 63 PROJECT PROJECT CHAPTER PROBLEM DISCUSSION
2.3.1 64 2.3.2 65 2.3.3 65 2.4 66 2.5 68 2.5.1 SWOT 69 2.5.2 69 2.6 70 CHAPTER THREE 71 3.0 LITERATURE REVIEW 71 3.1 71 3.2 71 3.3 76 3.4 82 CHAPTER FOUR 86 4.0 IMPLEMENTATION 86 4.1 86 4.2 86 4.2.1 87 4.2.2 87 4.2.3 87 4.2.2 91 INTRODUCTION CONSTITUENCY LITERATURE PROJECT ACTIVITIES RESPONSIBLE DEVELOPMENT
Table 1.12: Micheweni District Child Immunization Status, 2006 BCG dose under 1yr DPT – Hb3 < 1 yr Measles < 1 yr TT 2+ Children fully immunized <1 yr Number 4,570 3,655 3,180 3,173 2,095 Source: RGOZ (2007): MOHSW, Routine Data Table 1.13: Micheweni District Child Immunization Status, 2007 District BCG dose under 1 yr BCG coverage 1yr Measles doses < 1yr Measles coverage TT2+ Children fully immunized < 1yr Proportion of children <yr fully immunized Micheweni 4,844 85.9 3,498 3,498 59.7 4214 3,282 39.4 Zanzibar 107.9 84.6 62.2 Source: RGOZ (2007): MOHSW, routine data. Immunization coverage in Micheweni district was national average for all antigens for children under 1 year of age. BCG coverage was 85.9 percent in 2007, below the national average of 107.9% and WHO standard of above 90 %. Measles coverage was 59.7 % in 2007 against national coverage of 84.6 %. Only about a third (39.4 percent) of children less than 1 year of age had been fully immunized compared to the national average of 62.2 percent. 1.8 Child Nutrition Provision of proper Nutrition to child is important to their Health. Monitoring of children’s weight throughout their childhood is a fundamental aspect of mother and child Health. The Nutrition of status of Under-five children in Micheweni district in 2007 (weight for age) showed slight improvement (10.3 percent) compared to the
Figure 1.2: Respondents on place of delivery The figure 1 above demonstrate that the most of respondents about 39 (78%) were delivered at home and only 11 (22 %) used hospital during their delivery and no one indicated to deliver in dispensary or to the TBA’s houses. Figure 1.3: Persons who Manage Deliveries At Home (n =39) The figure above indicate that high rate of respondents about 34 (87%) assisted by TBA’s during delivery while 5 (12%) assisted by skilled personal or health personal and no any respondents assisted by traditional healers. 1.20: Respondents on Why Delivered at Home? (n =39=category Frequency Relative frequency% Delaying in decision making 3 4.8 Transport problems 7 11 No any problem lead to hospital delivery 16 25.4 Sudden of labor 14 22.2 Distance from home to health facility 1 1.6 Needs family support 5 8 Behaviors of home delivery 9 14.2 Don’t afford cost of home delivery 4 6.3 Availability of TBA’s 2 3.2 Afraid hospital delivery 2 3.2 Total 63 100 The table above indicate that respondents have several reasons that hinder them to have hospital delivery as 16 (25.4 %) no problems which lead to deliver in hospital, 14 (22.2%) have sudden onset of labor which not able to reach hospital before
they are willing to participate in the project 2 awareness of the Community NGO- members Participate in Need assessment and define the Community problem. Participate in planning of the project High Positive impact, identify list of needs and prioritize major problem for action 1 Encourage to provide self help and support the project members Assist in the identification of needs and information and major problems. Also participating in contraction of the facilities Positive impact 2 To involve them at all level of project Central Collaborating partners in the Management of the Health Service Building Positive 2 To involve in the authorization and official approval participate Local Bureaucratic Coordinating agency to the Government Positive 2 To link with NGO and Central Gov’t provide support Conduct awareness training The Women Despite major beneficiaries, participate in training High Positive 1 Arrange a special training on maternal health Birth attendant Participate in training change agent to the Community Low Negative 3 Training on better health delivery Contractor Building to the proposed Health Service Building Positive 2 Enhance collaboration NGOs Assist in Mobilizing community in the Village Low Positive 3 Contract with them to take part in mobilizing Community Health Participate in service provision High Positive 1 Training for better service delivery 2.5 Organization Structure
Outputs Network of trained and traveling midwive Decrease ratio of number Micheweni women per midwife per year to X 1 Mobile Service Records Communication infrastructure remain reliable Reliable and efficient texting emergency services Increase by X% the number of maternal health- related texts exchanged per month Media reception surveys National strategy for achieving MDG 70 appropriately equipped midwives in project area Community surveys Social marketing and birth spacing campaign ( Health promotion) Increase by X% the number of certified midwives registered in the network monthly Number of media materials disseminated (radio ads, posters, billboards) % increase in the number of women seeking midwife services per month Midwife Survey Activities Recruit local trained midwives into traveling & text-messaging program, Provide midwifery medical kits; Establish a pregnancy – related Q-A text – message service; Launch social marketing campaign for text service and with info re , spacing ; Launch local leader outreach campaign; Partner with national Ministry of Health to recruit midwives, and distribute midwife kits Establish Monitoring and Evaluation System Budget Midwife spends: US 84,000(a year) Medical Kits US 100,000 Motorcycle 28,000 Vehicle maintenance Fuel: 60,000 Uniforms: 3000 Cell phones: 800 Mobile Minutes:6000 Radio ads: 3000 Outreach travel costs: 5000 Texting network setup: 10,000 (Program Monitor) 10,000 Receipts Invoice The local currency is not devalued 4.2.2 Inputs Table 4.3: Resource Plan Activities Resource Plan Input Cost (Tz.shs.) Budget (Tz.shs) Conducting CNA Research activities (30days) Research assistants 4 Local travel Stationeries 600,000 400,000 300,000
4.8: Project Action Plan for Houses, Incinerator and Capacity Buildings NO ACTIVITY PERIOD CONTRIBUTION Q1 Q2 Q3 04 CDF PARTNERS cost 1 Site clearing 10,000,000 10,000,000 0 20.000,000.00 2 Preliminary works 15,655,000,000 15,855,000.00 3 Blocks walls, concrete 46,487.671 46.487,671.00 4 Roofing and ceiling 16,544,000 16,544,000.00 5 Finishing, ,Plumbing and drainage 20,000,000 37,811,135.00 6 ELECTRICAL INSTALLA 17,811,135.00 17,811.135.00 7 Doors and windows 20,590,000 20,590,000.00 8 Erect hospital incinerator 14,790,000 14,790,000.00 TOTAL 186,867,806 186,867,806.00 ADD 10% CONTIGENCY GRAND TZ.SHS 18,686,780 205,554,586 18,686,780.00 205,554,586.00
project management, a Gantt chart provides a graphical illustration of a schedule that helps to plan, coordinate, and track specific tasks in a project. The main objective of a Gantt chart is to assess how long a project should take and to establish the order in which task need to be carried out by the ending of the project. Gantt charts are useful tools for planning and scheduling projects. They allow assessing how long a project should take, determine the resources needed, and lay out the order in which tasks need to be carried out. They useful in managing the dependencies between tasks. When a project is under way, Gantt chart is useful for monitoring its progress. You can immediately see what should have been achieved at a point in time, and can therefore take remedial action to bring the project back on course. This can be essential for the successful and profitable implementation of the project. CHAPTER FIVE 5.0 MONITORING, AND SUSTAINABILTY 5.1 Introduction Monitoring can be defined as a continuing function that uses systematic collection of data on specified indicators to provide management and the main stakeholders of an ongoing development intervention with indications of the extent of progress and achievement of objectives and progress in the use of allocated funds. Monitoring is the measurement through time that indicates the movement toward the objective or
away from it. Monitoring will provide information about the status and trends of resources or projects, but it should not be used to determine cause and effect. Monitoring is a type of evaluation performed a project is being implemented, with the aim of improving the project design and functioning while in action. Thus monitoring embodies the regular tracking of inputs, activities, outputs, outcomes and impacts of development activities at the project, program, sector and national levels. Monitoring and evaluation are synergistic. Monitoring information is a necessary but not sufficient input to the conduct of rigorous evaluations. While monitoring information can be collected and used for ongoing management purposes, reliance on such information on its own can introduce distortions because it typically covers only certain dimensions of a project or program activities, and careful use of this information is needed to avoid unintended behavioural incentives. In contrast, evaluation has the potential to provide a more balanced interpretation of performance. But evaluation is a more detailed and time-consuming activity, and because of its greater cost it needs to be conducted more sparingly. One approach is to rely on monitoring information to identify potential problem issues requiring more detailed investigation. M&E can be conducted using a wide array of tools, methods and approaches. These include, for example: performance monitoring indicators; the logical framework; theory-based evaluation; formal Researches such as service delivery Researches, citizen report cards, living standards measurement Researches (LSMS) and core welfare indicators questionnaires (CWIQ); rapid appraisal methods such as key
Work plan activities Timing of activities A availability of personnel, resources Monthly Quarterly Work plan Work schedules Project manager Supervisor Project Ensure staff and other resources are available Reschedule activities and deployment of resources as needed Cost and expenditure Budget amounts, funds on hand and expenditures, Balance in budget by approved cost categories Ledger of expenditure by budget category Receipts bank Financial officer/ accountant Project Auditor Ensure funds are available to executive activities Make budget and project revisions Determine need for other funding sources Staff and supervision Knowledge, attitudes and skills of staff Education level of staff salaries and benefits job performance reviews job description Resumes of staff Feedback from training attended Coordinator Project Manager Trainers Project Trainers Motivate Staff and Resolve problems Advise staff on career Placement Training needs Promotions Disciplinary action Materials Stork ordering and shipment status procurement regulations Stock registers Invoices Field worker report Logistics manager Project Ensure availability of in stock and g \ condition of material Quantity to order When to order Amount to keep in reserve for emergency Result No. And type of services dispensed characteristics of persons served/ educated worker reports team team Ensure objectives are Realistic Assess quality of services provided Revise objective Retrain staff Revise project strategy and approach Source: Micheweni Double House Project, 2015 5.2 Participatory Evaluation The OECD (2002) defined evaluation as the systemic and objective assessment of ongoing or completed project, or policy, including its design, implementation, and results. Evaluation is essentially a reality test to assess the significance of the project. Evaluation will be undertaken monthly to assess the effectiveness and impact of activities undertaken in the course of the project and to use the results to improve in effectiveness. Evaluation has two specific purpose accountability and learning. Accountability refers to the obligation of the project to demonstrate to the donor, manage
Health Committee Training on maternal mortality reduction 8 training workshops to be held Training report Structured direct observation Consultant MCED student September 2014 to December 200 participants to trained on TBA’s Training report attendance book Key Information interviews Consultant MCED student September to December 2014 Documentation And awareness1 Campaign Construction of double House building 1200 brochure to be distributed 200 One health house to be constructed Construction Complete a one years Field report Field report Survey Key information interviews Focus group interviews community interviews Project Manager Project manager Project Manager September to December 2014 January 2015 February to February 2015 Source: Micheweni Community Health Committee 2015 5.2.2 Appraisal Methodology used it is highly relevant to the timely production of management, focused evaluation information. Rapid appraisal is a multi method evaluation approach that uses a number of data collection methods in the context of the goal of applied research that is to provide timely, relevant information to decision makers on pressing issues they face in the project and program setting. The aim of applied research is to facilitate a more national decision – making process in real- life circumstances (Kumar, 1993). Rapid appraisals produce needed information on quick and timely basis and are relatively low cost, especially in imprisons with more format, structure d evaluation methods Such appraisals can provide a quick turnaround to see whether projects, programs, and policies are basically on track. Five major appraisal data collection methods were used: key informant interviews,
direct discussions with them for independent views on the project performances. The project evaluation questionnaire is shown in Appendix 7 were distributed for formative evaluation and administered to them all. 5.2 Project Monitoring The project for improvement of the maternal health in Micheweni district, since this is a community project, all major steps involved from the identification stage; implementation and also monitoring and evaluation were done in a 'participatory way'. Thus the project is planning to employ participatory monitoring and evaluation methodologies to track the project result or impact chain. The general project" intervention logic" or 'impact chain The general project" intervention logic" or 'impact chain" that the project planned to adopt is presented schematically as in figure 5.1 5.3 Financial Reporting and Auditing In order to ensure efficient monitoring of project expenditures, the Planning and Finance \committee on Micheweni Constituency Development Organization will maintain project accounting records corresponding to the appraised budget and List of Goods and Services. Detailed accounts on Bank and Government expenditures should facilitate the identification of expenditure by component, category of expenditure and source of finance. The accounts should clearly document Bank and Government disbursements by category of expenditure and the status of any revolving funds. The accounts and ledgers will be kept separately from any other project. External auditors will audit the project accounts annually, and at the end of the project. An Audit Report will be presented annually, to the Bank, within six (6)
Tanzania Demographic Health Survey (DHS), (2004). Tanzania National guide lines, (2007). Tanzania national (Prevention of Mother to Child Transmission of HIV) Guidelines, (2007). ‘Special labour and deliver Considerations’, Prevention of mother Transmission of HIV (PMTCT). National Guideline 24-43. The united Republic of Tanzania ministry of Health and Social Welfare. Tanzania. The National Road Map Strategic Plan (2008-2015) Rationale for the strategic plan to accelerate reduction of maternal, newborn and child death in Tanzania. United Republic of Tanzania, (2009). Current situation, existing plans and strategic next steps for newborn health. Situation analysis of newborn health in Tanzania.26-27. Waziri, H. (2009). ‘Tanzania’ Home deliveries contribute to mother/child deaths, Integrated Regional information Networks (IRIN). United Republic of Tanzania. Waznicki, K. (2010). Planned home births also associated with reduced medical intervention for moms. American Journal of obstetrics & Gynaecology. WHO. (2006). ‘Working to gather for health’. World health report, Genevar. Fact sheet, 11, Page No. 2. WHO.(2008).Proportion of births attended by a skilled health worker. Fact sheet, 11 Page No.1. Mwisongq and Njau J. (2008).Serikali ya Mapinduzi Zanzibar (SMZ), A study on factors inhibiting utilization of reproductive health services in Zanzibar: Final report, with a focus on cost. Ifakara Health Institute (ihi) Page 8.