Diagnóstico rural participativo (Tanzania)

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Experiencia relativa al proyecto de Mdm en Singida, evaluaciones, Tanzania

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Diagnóstico rural participativo (Tanzania)

  1. 1. PRA Introduction Briefly history of MdM in TZ  Estimated population (Census 2002): 38,329,000  PHC (1995-2000) Extension: 3 times Spain  Ethnic diversity: more than 120 ethnic groups  Arusha Region (Karatu District)  Official language: Swahili and english  IDH 2007: 159 (177)  HIV/AIDS (2000-2008)  IDG 2007 (Renta, Alfab, Esp.Vida): 138 (157)  Pwani, Arusha and Zanzibar  Poverty. 57.8% de la población vive por debajo del umbral de la pobreza (1$ día)  SRH&R, since March 2009  Economy. Crecimiento anual PIB entre 6 y 7%  Pre-identification process (10/2007-03/2008)  Agriculture.  Criteria of MdM, extension, sub-sector (50% PIB; 85% X; 90% trab.)  48 regions. 13 indicators (poverty, access to health and SSR)  Cultivable. 4% de superficie  Cultivos  13 district preselected (communication, logistic, knowledge)  Consumo interno. Maíz, arroz, trigo,  Questionnaires (neccessity, capacity, resources) to DMO mijo, alubias  Exportación: café, té, flores, sisal, caña  Selection of Same and Singida (March 2008) de azúcar, cebollas  Otras exportaciones: tanzanita, oro, pesca,  Rapid rural appraisal on Same and Singida. April/May 2008 turismo  Interviews with community members, focal groups, secondary data  Participatory Rural Appraisal (PRA). 3 months Program cycle (Same Program) Characteristics of Singida Rural District Year 2009: Opening of program and office PRA =  MdM works in 2 Divisions (Comarcas) among 7 IDENTIFICATION process May-July 09 divisions in the District (Provincia) (whole district cover in 9 years by phases) Revision of results and reformulation in August 09  Population: around 80.000 inhabitants (census 2002) collaboration with SDC  Different ethnic groups. From Sept 09  Nyaturu majority Implementation of Program Activities  High extension and low density Continuous Evaluation From Sept 09  Singida Region is the poorest region in TZ PRA LIMITATIONS Some PRA Techniques and Results In the Community meetings Secondary data sources  Poor participation of women  Population for every village range between 3500 – 4000 (1570 male & 1960 Female)  They have big expectation from Medicos del Mundo  VEOs doesn’t have data relating with health  Majority of participants ask what is next after PRA problems in the village.  Data from Health facility shows that the top five disease  Poor coordination between Village Executive Officers and are, Malaria, Diarrhea, ARI, Pneumonia and Anemia community  In the village that doesn’t have health facility we fail to  In some village the participants were not the initial ones have statistical data of health problem from VEOs  Language barrier (kinyaturu vs kisuahili)  Cholera
  2. 2. Some PRA Techniques and Results Some PRA Techniques and Results Interview to youth (FGD) Interview to PW: age range (19 – 48 yrs)  Age range (18 – 34)  Delay to attend clinic during pregnant period, one with nine month attend only two time  Lack of Knowledge on SRH & R (77% of youth interview lacked SRH&R knowledge)  Most of them deliver their previous pregnant at home and still they are planning to do so. (65% under TBAs and 35% under  Sexual harassment done to the student by their teachers HCP)  Early pregnancy (85% responded on presence of early pregnancy)  Workload of PW was very high, minimum they are working almost 14 to 17 hours per day  Lack of knowledge about Sexuality and HIV  Lack of support from their partners (only 46% receive support)  They know about condoms but never use it (96% knows, but only 27% use it)  Distance to the nearest health facility rise between Half to 15 km  Parents are not transparent to them on issues related to SRH & R  Transport fees range between 20000/= to 30000/=(11.4 to 17.14 Euro)  Behaviour, like using drugs, robbery, cigarette and alcoholism  Poor balanced diet Some PRA Techniques and Results Some PRA Techniques and Results Interview to TBAs: age range (45 – 75 yrs) Gender Resources Mapping and pictorial  Lack of support from government Gender Based Violence  Associated with unequal power relation & decision making  Women beaten with theirs sexual partner  Most of them are not using protective and delivery equipment  Sexual abuse and harassment  Patriarchal system  Most of them attend 3 to 10 deliveries and even more women  Sexual suppression within a month (example Ghata Village) FGM: (information were provided in a very secretly way)  Some refer the complicated case to nearest health facility  Still practiced very secretly to new born babies except Merya village  Most of them are aged  In FGD they mention a lot of advantage and few disadvantages  Some wish to stop  Lack of knowledge on SRH & R (96% lack the knowledge) Raping cases  They don’t have a skills on detecting complicated cases  Marital raping were noted (happen when one spouse forces the other to have sexual intercourse)  There are reported raped cases by more than one man  Some reported that even children are raped (example in Ilongero were 2 children were raped to death). Pair wise ranking General impressions of facilitators  lack of HF in many villages, long distance from households to HF in Need Num villages on Position st Comments/result 62 villages we have only 17 health facilities 1 position  Shortage of skilled staff and equipment: discourages patients to attend the HF Education on SRH&R to the community 17 1 Early and unwanted  Difficult access in some villages for emergencies due to bad situation pregnancies of roads Lack of safe and clean water 10 2  TBAs have an active role in their community but most feel not recognized by authorities Absence of Health facility 9 3 Most PW not attend clinic and  Lack of motivation to VHC Home delivery  Lack of Income generating activities Diseases 8 4 Malaria, Pneumonia,  Alcoholism, Drug abuse Diarrhoea,  Food insecurity Out dated traditional and customs 7 5 FGM  Illiteracy especially to women  As a result of illiteracy and lack of income generating activities Poor infrastructure 6 6 Weather roads opportunities : Poor health services 4 7 Human resources and  Imbalanced decision making and resource ownership between equipment men and women Domestic violence 4 8 Patriarchal, Women beating,  Gender based violence: raping , FGM, biting women & children Raping  Lack of family planning: economic burden for families, lack of opportunities Poor Nutrition 4 9 PW and children are more affected
  3. 3. Asanteni kwa kunisikiliza Thanks for listening!!! Muchas gracias

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