SikikaBlog: SIKIKA’S SAM EXERCISE: A FRUITFUL ACCOUNTABILITY BUILDING APPROACH IN LINDI

Lindi Social Accountability Monitoring (SAM) team has successfully conducted a health stakeholders meeting in Lindi Municipal by presenting findings after analyzing and verifying district plans, implementation and financial reports.

SAM is an accountability building approach that relies on civic engagement through which ordinary citizens and/or Civil Society Organizations (CSOs) participate directly in exacting accountability. In 2016, SAM exercise has been successfully facilitated by SIKIKA particularly in the health sector in Kilolo district, Kondoa district and Lindi Municipal with the ultimate purpose of ensuring Quality Health Services (Human right) for all.

The stakeholders meeting was officiated by The Lindi District Commissioner Mr. Shaibu Issa Ndemanga and chaired by the SAM team chairperson Mr. Frank Magari.

When officiating the meeting held at COETC hall, Lindi District Commissioner and also a mentor of SAM team Mr. Ndemanga commended Sikika’s SAM exercise “This is very important to the government especially officials that have been entrusted with responsibilities by our stakeholders to implement what has been planned. I assure the SAM team, Sikika and all participants in this meeting that the government is with you in this, in order to ensure issues of integrity, accountability and transparency prevails to bring development to our citizens”.

Moreover, in his opening speech Mr. Ndemange acknowledged on how Sikika’s SAM experience of the past five years 2011-2015 has influenced the current health sector strategic plan, saying, “for the first time SAM exercise has been recognized in the Health Sector Strategic Plan IV, the main aim of the government to incorporate SAM in its strategic plan is to strengthen health service provision systems through civic engagement in planning and evaluation of implementation”.

A SAM team chairperson Mr. Frank Magari commented that “the report that we have launched today gives a very clear picture of health services provision in our district, we have received good cooperation from the district management and we are glad to hear that they will use our report to come up with a plan on how to improve the provision of health services in Lindi”.

According to Mr. Magari, SAM team received a two weeks training which included the analysis of the documents then went to field (visited health facilities) to verify information analyzed and held meeting with the Council Health Management Team (CHMT) and Council Health Management Team (CMT) to discuss the findings. The documents analyzed included Municipal strategic plan 2012/2013- 2016/2017, Comprehensive Health Plan 2014/2015, quarterly implementation reports 2014/2015, and Full Council meeting minutes 2014/2015 and Internal Audit and Controller Audit General reports of 2014/2015.

The SAM team report presentation congratulated health stakeholders for six main issues:

Two out of twelve (Mnali and Chikonji) health facilities were found to have friendly environment for the physically challenged people
All twelve visited health facilities have electricity supply
One facility had demonstrated that it is possible to improve health service by use of its own resources. Mingoyo dispensary was found to have used its own resources to construct its medical store and to modify CTC service provision area
Most of the facilities were reasonably clean with a few notably clean Mingoyo, Nachingwea and Kingeng’ene health facilities. CHMT conducts its supportive supervision effectively
In an effort to improve health workers living environment and therefore be able to retain and attract more HRH the Municipal council has built good HRH residential houses at some Mnali, Chikonji, Kingeng’ene, Mbaja, Nachingwea and Mingoyo

On the other hand, twelve challenges were found to be common in most health facilities visited in Lindi Municipal:

All dispensaries are not fenced
All dispensaries except Kitumbikwela, Nachingwea, Kineng’ene and Chikonji have no improved toilets; most have one toilets used by both health service workers and patients regardless of gender.
Some health facilities have very old buildings with cracks
All dispensaries except Mingoyo and Kitumbikwela have no laboratory rooms
All health centers except Mnali and Chikonji have no friendly environment for physically challenged people
Shortage of Human Resources for Health in all health facilities eg. When SAM team visited Mitwedo health facility for the first time they did not find any one including a facility in charge, and on the following day the team found a volunteer and therefore did not manage to conduct an interview.
Though the munivipal has managed to build good residential houses for HRH at some facilities, yet All health facilities have insufficient residential houses for health workers while most of the available ones can not accommodate a family (Bedroom and Sitting room)
All health facilities have very few households enrolled in the CHF
Ineffective use of suggestion boxes. As Health Facility Governing Committees (HFGC) do not have authority over the suggestion boxes.
Most health facilities are overwhelmed by a huge number of people that are exempted from paying for health service.
Delays in salary increment and promotion of health works regardless of the annual OPRAS evaluation.

Commenting on the findings, The Lindi District Commissioner Mr. Ndemange called upon stakeholders to take into serious consideration issues that have been raised by the SAM team and plan a way forward in line with government policies and strategic plans on how to improve the provision of health services in Lindi. “Here at Lindi we can come up with something special from this SAM report, something that will make us unique from others in the provision of quality health services to our people” he advised.

The Sikika’s Executive Director representative, Ms. Atuswage Mwangomale elaborated to the stakeholders that SAM exercise has been extended to ten more districts including Lindi and Kilolo in the organizations strategic plan 2016/2020 after been proven in the previous strategic plan to be the best approach for building accountability and ensuring quality health services for all. She commended the SAM team in Lindi for effectively owning the exercise and coming up with a reliable report. Moreover, she appreciated the support from the Municipal management without which the SAM exercise would have hardly succeeded.