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Lake Zone (Kagera Region, Mwanza Region, Mara Region and Shinyanga Region) D3CB Proposals Region/District Title of Proposal Budget Estimate(Tsh) Approved budget Status Remarks Contract/parties and expected outputs and modes of 1 Kagera Region RHMT Kagera Improving 20,435,000 20,435,000 Approved with The objectives should link Accessibility of the preconditions to be with problem. poor to basic health fulfilled before the Methodology to be services in Kagera funds are released applied, justification of the Region budget, not clear on what RHMT is contracting to EDI. The title of the study should read as follows: Study on the factors contributing to poor utilisation of health services in Kagera Region. RHMT Kagera Improving the quality 20,198,000 0 Not approved The issues are routine and coverage of roles of the RHMT in Antenatal and support of districts and Obstetric Care at can be funded through health facilities in other funding mechanisms Kagera region as they do not fit in with demand concept Page 1 Sheet1 EDI in Building capacity of 23,527,500 23,527,500 Approved with EDI should have a collaboration District Health preconditions to be separate contract so the with RHMT Organizationsl fulfilled before the budget catering for EDI Kagera funds are released should be cut from this budget Tanzania Youth Promotion of 19,564,655 0 Not approved for Proposal is not linked with Elderly Partnership in Health funding district health services. Employment and Services Delivery in The proposal aims at Development Lake Zone creating a forum to Organization promote partnership.Peer reviews forums already exist there is no need for new forum. The proposed budget includes capital investment (laptop and printer). Not clear how the result will be used to improve health services delivery Kagera Regional Training health 6,405,000 0 Idea is good although The proposal did not Hosp personnel on it does not fit in follow the format, the neonatal, resustation demand driven as the objectives, methodology skills at the hospital idea is by the hospital should be well formulated not a demand from the Districts Page 2 Sheet1 Kagera Regional Determine Current 19,987,000 0 Not approved As a reference ask for Still not approved Hosp efficacy of Proposal is good but NIMR tool being used in 8 because this type of Sulphadoxine/ allowances are sites testing malaria drug research is already Pyremethamine in excessive ( 3 doctors treament efficacy. Most of ongoing in Ifakara and treatment of to receive 200,000 per the funds are being used to NIMR uncomplcated month for 6 month and cater for allowances. Good Malaria etc support staff 100,000 proposal but motive per month for 6 behind is monetary gain. months and in addition We need to have a policy the doctors to get or use the Basket ceillings 200,000 per month on total allowances for 6 month to payable. complile data) The motive is supplementation of salary Bukoba Improving monitoring 20,314,300 0 The demand by the An institution with The proposal to be Township Council and evaluation of Council for assistance expertise in the area of rewritten with help of health services in to improve knowledge data management should Dr Mbuya Bukoba Township and skills in data be recruited to assist the Council collection, analysis district in this area and use at all health facilities is good. The strategy of holding workshops facilitated by DMO and his team is not the right way to go about it Page 3 Sheet1 Tanzania Advocacy for 19,878,400 0 Not approved Methodology and analysis Not funded because the integrated rehabilitative needs of technique should be clear issues raised have not Development disabled children in links with district and the been addressed Rally Bukoba District region not there. The Foundation(TIDE Council account section of HSPS RAF) Bukoba to scrutinise budget further district Council to ascertain what we are funding since budget is not broken according to items KaragweDistrict Establishment of user 21,679,000 17,679,000 Approved less Approved to sign Council fees and Community 3,000,000 for contract with HSPS Health Fund in procurement of Karagwe computer and accessories Bukoba District Capacity building in 20,000,000 20,000,000 Approved but to Training department to To contact the Zonal Council planning skills ascertain actual cost identify Zonal training training Centre in with Dr Mwakilasa of centre to conduct training Mwanza to see how to DHR and actual cost involved do it especially the rate for paying facilitator 60,000 Mugana Hospital Reducing morbidity 20,000,000 0 CHMT and the DDH Although the procurement To revise the budget Kiziba Division and mortality of top hospital to re work out issues have been Bukoba D.C. five common diseases the budget and addressed they have added in Kiziba division activities other unnecessary activities. The budget on needs assessment is EDI in The effect of Health 15,750,000 0 Approved but release The objectives, outputs collaboration Policities in Kagera of funds will be after and likages with the with RHMT region on health address of suggested Council should be clear. Kagera seeking behaviour improvements to the The contract will be with proposal as follows EDI Page 4 Sheet1 2. Shinyanga Region Bukombe DC Sensitisation of 19,999,900 16,340,000 Approved but not the The conducting of Community health budget amounting to quarterly Council board fund as an additional 3,659,9000 meetings supervision is or alternative source catered for in CCHP of fund Meatu To sensitise 20,000,000 20,000,000 Approved The proposal had no communities, Council appropriate title we have Health Board suggested a title The members and health output will be CHF facilities committees introduced in Meatu on CHF as option to District Council by July introduce for health 2005. The proposal should financing include page numbers Kahama Burden of Malaria in 20,000,000 0 There is need to ask Provider to be identified Kahama District National Malaria to assist the district especially among the Control to review the Pregnant mothers and propsal and see how under five children. they can help the district Kahama Community 20,000,000 13,496,000 The budget request for The hire of transport will Sensitisation on computer training in need to be justified also participatory Hygiene Mwanza for 2 officers and Sanitation for 40 days at Tsh transformation 60,000 per day and study materials not approved Kahama Address the high 20,000,000 20,000,000 Approved but a Pages to be numbered in maternal mortality in provider skilled in this the proposal.Need to Kahama district area should be identify institution to indentified to facilitate facilitate the district to the district ensure that the end Page 5 Sheet1 Bukombe Sensitisation of 19,999,900 19,999,900 Approved There is need to include Community on expected outputs in the Community Health proposal Fund as an additional/ alternative source of Bariadi Sensitisation of 22,346,000 22,346,000 Approved but the Budget is realistic. There Community on district to update the is need to include in the Community Health proposal based on proposal specific Fund as an additional/ comments objectives and expected alternative source of Outputs health financing in the district Kolandoto To train assistant 20,346,000 20,346,000 Approved The bonding of staff to be Hospital African medical officers, trained for five years may Inland Church of clinical officers, assist to come up with Tanzania nurses and lab techs strategy for retention of to fill gaps left by trained staff workers who left the organization Shinyanga To be facilitated by 3,925,400 3,925,400 Approved but funds Objectives and out puts Municipal central level to be released after the need further refinement Council facilitators on disaster proposal is updated as the RHMT should assist preparedness stipulated with this. The title is not disaster preparedness but should be more specific to "Cholera preparedness" Then the targets propsed are realistic Shinyanga Train CHMT 9,786,600 9,786,600 Approved but to Training department to Municipal members on ascertain actual cost identify Zonal training Council Comprehensive with Dr Mwakilasa of centre to conduct training planning DHR and actual cost involved Page 6 Sheet1 Shinyanga HIV/AIDS control Not approved budget Format not followed, Municipal initiative not clear, strategy not objectives, methodoloy Council clear not followed. The district needs health on how to formulate good proposals. Shinyanga Improve Quality data 20,525,500 20,525,500 Approved but a Health provider to be District Council collection, proper use provider should be identified to assist the and reporting at indentified to facilitate district health facilities the district Shinyanga Adherence to set 470,726,000 0 Not approved RHMT/RMO should assist District Council standards of health proposal has to many the Council to priorities care in Shinyanga issues they want to isues district Council tackle in one year. The ceiling for each proposal should be around 20 million only. Maswa District To ensure that all 104 20,000,000 0 Approved for funding Council village health will only be committees and 104 considered after village health satisfactory committees are clarification is given oriented on on why the funds from HIV/AIDS and STI HSPS are being used control measures solely to cater for workshops allowances. When you have so many other players in the district undertaking AIDS control( AMREF, IMC, CARE-VSHP, CRS) Page 7 Sheet1 Shinyanga To train Hospital 21,373,900 0 Not approved Orientation on waste Regional Hospital Management Team on management in the waste management hospital should be conducted in the hospital. Why the trips for to weeks to where and what are the allowances for and who is going to provide the training if an outside provider institution we need to know so that HSPS contracts the provider directly 3 Mwanza Region RHMT Mwanza Streamlining Referral 18,918,000 0 Not approved The whole concept of To be re submitted System Obstetric demands for service Cases in Mwanza improvement should be Region from the Councils/institution e.g district not top up. The payment of 1 TA at 80,000 per day who is the person and from where. The improvement of obstetric referral will not be achieved through holding workshops Page 8 Sheet1 RHMT/FBO Support to improve 21,600,000 0 Not approved The whole concept of To be re submitted Mwanza health services demands for service through establishing improvement should be public-private from the partnership in Councils/intitutions e.g Mwanza region district not top up. In this case Missungwi and Bukumbi etc should demand not RHMT. The payment of TA at 80,000 per day who is the person and from where. RHMT Mwanza Integrated Mental 19,760,000 0 Not approved Demand Driven requires To be re submitted Health care in the that the needs should Primary Health care come from the districts facilities in Mwanza and the districts should Region express their commitment to improve. Ideas should not be pushed top down. RHMT Mwanza Imrproving 24,787,000 0 Not approved Demand Driven requires To be resubmitted HIV/AIDS that the needs should prevention, care and come from the districts support for and the districts should psychiatrict patients express their commitment in Mwanza region to improve. Ideas should not be pushed top down. RHMT Mwanza Improvement of 20,626,000 0 Not approved Demand Driven requires To be resubmitted quality health services that the needs should delivery for Mwanza come from the districts region through and the districts should reliable data express their commitment collection and use to improve. Ideas should not be pushed top down. Page 9 Sheet1 RHMT Mwanza Improving Malaria 7,145,000 0 Demand Driven requires To be resubmitted management by that the needs should adhering to set come from the districts standards in Mwanza and the districts should express their commitment to improve. Ideas should not be pushed top down. RHMT Mwanza Improving 22,844,000 Pending There is need for the To be resubmitted Management of demands to come from the Diabetes mellitus care hospitals and CHMTs. by adhering to set Had discussions with reps standards Mwanza of IDFand WDF they will Region assist with refinement of the proposal Kwimba D.C. Use of accurate data 20,468,000 Approved but activity Discussion with Dr for Planning and to be under taken by Mbuya on support decision making to institution or Provider modalities improve quality of with expertise in data health care in Kwimba management to assist with capacity development together with other districts that have indicated demand in this area Kwimba D.C. Mobilising additional 20,000,000 20,000,000 Approved Previous concerns have Joern working on health financing been addressed contract through initiation of CHF in all 37 health facilities Page 10 Sheet1 Kwimba D.C. Providing Quality of 20,522,800 0 The plan needs further Need to include outputs To be resubmitted health care services improvements before and out comes 1.1 activity according to set being approved for to assess availability of standards in funding STD quidelines 1.3 train management of Self orientation on common diseases Quidelines HMT &CHMT Some body from zone to come from Kwimba. Diabetes one to be done by the TDA and Region training to be on the job during supervision Tanzania Youth Promotion of 19,564,655 0 Not Approved (The The linkage not clear how Elderly Partnership in Health proposal needs further this proposal links up with employment and Services delivery in refinement) district health services . In Development Lake Zone the proposal it is proposed to organise forum for exchange of views but a peer review forum already exists under RMO. The proposal also contains capital investment issues. Not clear how the results will be usedto improve health services delivery Page 11 Sheet1 Mwanza City Establish Public 20,000,000 0 Not approved 75% of the funds in the Council Private forum on proposal are to be used for health care delivery in payment of allowances Mwanza city and the other funds (5,500,000) are to be used for pucharse of Lap top and power point machine this is not acceptable. Provider institution with Sumve Use of accurate data 20,006,000 0 Not approved You do not need to Designated for Planning and improve data management District hospital decision making to in the hospital by spending improve quality of amounts of funds mainly health care at Sumve on DSA, and procurement of 4 computers. There is need to identify out side facilitator with expertise in this area to assist the Sumve Improving and 20,021,000 0 Not approved Intention is good but Designated supporting better ways of addressing District hospital community based the issue necesssary. The health initiatives of main focus in the proposal good quality at Sumve are workshops/DSA for PHC/CBHC service hospital staff area 4. Mara Region Page 12 Sheet1 RHMT Mara Improvement of 20,000,000 20,000,000 Approved but with Lay out of the proposal Region supervisory skills of following should be improved, Mara Region RHMT preconditions to be met objectives and methodology needs to be improved ( suuggested areas of improvement reflected in proposal document. The purchase of Lap top for RHMT approved because it is necessary here. Since CEDHA will be contracted to do the training we need to know out of the total budget will go to CEDHA so that they are paid directly by HSPS once a contract is signed with them RHMT Mara Project proposal on 19,958,900 663,900 Approved but the Region training of RHMT on instituttion to provide Financial the two weeks training management for non to be given to HSPS financial managers so that the money for providing training after getting a quatation is paid directly to institution. The RHMT will get 663,900 to cater for the other activities in the budget Page 13 Sheet1 Bunda D,C. Improving Health 38,000,000 21,422,000 Approved but not the Funds for purchase of Status through Better budget of 16,578,000 cows, goats and their Nutrition at villages in to be used for sheds should be sourced Bunda District purchase of 20 cows, else where Council 15 goats and sheds Serengeti District Improvement of data 20,046,000 Approved but activity The proposal not signed . management skills of to be under taken by The procurement CHMT members and Provider with of laptop or computers not health service expertise in data approved HMIS provided providers in serengeti management should be computers to all districts district contracted to assist in the country with capacity development together with other districts that have indicated demand in this area Total 310,492,800 Page 14 Sheet1 Page 15 Sheet1 Page 16 Sheet1 Page 17 Sheet1 Page 18 Sheet1 Page 19 Sheet1 Page 20 Sheet1 Page 21 Sheet1 Page 22 Sheet1 Page 23 Sheet1 Page 24 Sheet1 Page 25 Sheet1 Page 26 Sheet1 Page 27 Sheet1 Page 28 Sheet1 Lake Zone (Kagera Region, Mwanza Region, Mara Region and Shinyanga Region) D3CB Proposals Region/District Title of Proposal Approved Status Remarks Contract/parties budget and modes of disbursement of funds 1 Kagera Region KaragweDistrict Establishment of 17,000,000 Approved Improved supply Contract signed Council user fees and of drugs & funds through DED Community Health medical supplies Fund in Karagwe Improved infrastructure and environment Bukoba District Capacity building Approved 10 CHMT trained Contract signed Council in planning skills etc funds with zonal training catered for centre Mwanza under budget for Zonal centre Murngwaza Health Human 12,053,000 Approved Signed contract Contract still to be designated resource not yet received signed funds hospital Ngara development project through hospital district Diocess Ngara DC capacity building in 19,308,000 Approved 10 CHMT Contract signed health management trained on funds through DED information system computerised in Ngaras data management 86 HC & Dispensary staff trained in data management 2. Shinyanga Region Bukombe DC Sensitisation of 19,999,900 Approved Signed contract Contract still to be Community health not yet received signed funds fund as an through DED additional or alternative source Meatu To sensitise 20,000,000 Approved Improved Contract signed communities, collection of fees funds to be Council Health channeled through Board members DED and health facilities committees on CHF as option to introduce for health financing Kahama Community 14,943,000 Approved Signed contract Contract still to be Sensitisation on not yet received signed funds participatory through DED Hygiene and Sanitation transformation Kahama Address the high 20,000,000 Approved Signed contract Contract still to be maternal mortality not yet received signed funds in Kahama district through DED Bukombe Sensitisation of 19,999,900 Approved Improved Contract signed Community on collection of fees funds through DED Community Health Fund as an additional/ alternative source of health financing in the district Bariadi Sensitisation of 20,000,000 Approved Signed contract Contract still to be Community on not yet received signed funds Community Health through DED Fund as an additional/ alternative source of health financing in the district Kolandoto To train assistant 20,180,000 Approved All positions Contract signed Hospital African medical officers, filled with funds through Inland Church of clinical officers, trained staff & Health Director Tanzania nurses and lab techs increased care at AICT to fill gaps left by hospital workers who left the organization Shinyanga To be facilitated by 3,925,400 Approved Signed contract Contract still to be Municipal central level not yet received signed funds Council facilitators on through DED disaster preparedness Shinyanga Train CHMT Approved 10 CHMT trained Contract Signed Municipal members on budget with Mwanza Council Comprehensive included in Zonal Centre planning Zonal centre budget Shinyanga Improve Quality 20,595,000 Approved 90 health Contract signed District Council data collection, workers trained funds through DED proper use and on data reporting at health management, facilities follow-up and monitoring Shinyanga To train Hospital 10,753,000 Approved undertaken Train 2-3 on Train 2-3 on return Regional Hospital Management Team return prepare prepare the training on waste the training for for users on the job management users on the job when they come when they come back and get the back and get the requirements for requirements for management of management of waste. Contract waste signed with RHMT RHMT Shinyanga Training of RHMT 10,160,000 Approved Signed contract Contract still to be members on not yet received signed funds Financial through RS Management Maswa DC Improve Quality 19,206,100 Approved Improved skills Contract signed data collection, and knowledge funds through DED proper use and of health workers reporting at health in data facilities management; improved skills on data collection, storage and use by health providers 3 Mwanza Region Mwanza Zonal RHMT training 46,558,500 Approved 24 RHMTS Contract signed Training Centre covering three trained in with Mwanza Regions (Mwanza, planning and Zonal training Kagera and Mara management & centre final report on training and follow-up provided to HSPS Mwanza Zonal Trainingprogramme 86,206,000 Approved 48 CHMT Contract signed Training Centre for CHMT on members trained with Mwanza planning, in planning and Zonal training management, Management, centre ( to train partnership and final report on Bunda, DC, Magu resources use training and DC,Shinyanga DC, followup visits and Bukoba DC) submitted to HSPS RHMT Mwanza Close follow-up of 12,497,000 Approved 7 districts in Contract signed supervision to Mwanza closely with RHMT funds monitor monitored+F25 through RS implementation of approved D3CB proposals in 7 districts in Mwanza region RHMT Mwanza Improving 13,424,000 Approved 10 RHMT Contract signed collection and use of trained in at funds through RS alternative health Mzumbe in Financing schemes financial in Mwanza management and supervision strengthened RHMT Mwanza Improvement of 15,250,000 Approved 14 RHMT Contract signed quality health trsined in data funds through RS services delivery for collection 14 Mwanza region members of through reliable RHMT trsined data collection and on Basic use computer skills, better reporting RHMT Mwanza Improving Pending To harmonize Pending Management of with Document Diabetes mellitus to be submitted care by adhering to by TDA to WDA set standards Mwanza Region Bunda D,C. CHMT Human 21,551,500 Approved 10 CHMT trained Contract signed Resources for with Mwanza health capacity Zonal training building centre Geita DC Providing Quality 14,920,000 Approved All health Contract signed of health care facilities funds through DED services according provided with std to set standards in treatment obstetric care guidelines & all services, diabetes health workers mellitus and oriented on std guidelines Kwimba D.C. Use of accurate 18,835,000 Approved Knowledge on Contract signed data for Planning planning and funds through DED and decision data management making to improve imparted to 16 quality of health HMTs & care in Kwimba improved skils in use of data for supervision and M&E Kwimba D.C. Mobilising 20,000,000 Approved Fees collection Contract signed additional health raised from Tsh funds through DED financing through 34,684,501 to initiation of CHF in Tsh 250,000,000 all 37 health facilities Kwimba D.C. Providing Quality 20,106,000 Approved All health Contract signed of health care facilities funds through DED services according provided with std to set standards in treatment management of guidelines & 122 common diseases health facilities trained through on job support Magu DC To strengthen Approved Budget is Contract signed CHMT included in with Zonal training management Mwanza Zonal centre Mwanza capacity training budget Magu DC Strengtheninghealth 18,530,000 Approved Improved skills Contract signed management and knowledge funds through DED information system of health workers in Magu district - in data management; improved skills on data collection, storage and use by health providers Magu DC Providing quality 21,067,500 Approved All health Contract signed health care serviceS facilities funds through DED according to set provided with std standards in treatment Malaria, Obstetrict, guidelines & all Diabetes mellitus health workers and Mental health oriented on std guidelines Missungwi DC Strengthen Health 19,272,000 Approved District health Contract signed Financing in governance funds through DED Missunwi District structures are established & improve collection of user fees from Tsh 364,420.50 to Tsh 12,000,000 Missungwi DC Improving quality 19,692,000 Approved All health Contract signed of health care by facilities funds through DED providing health provided with std services according treatment to set standards in guidelines & all Malaria, Obstetric health workers care, Diabetes and oriented on std mental health in guidelines Missungwi district Sengerema DC Improving quality 14,920,000 Approved All health Contract signed of health care by facilities funds through DED providing health provided with std services according treatment to set standards in guidelines & all Malaria, Obstetric health workers care, Malaria oriented on std Diabetes mellitusetc guidelines Ukerewe DC Use of accurate 19,688,000 Approved Improved skills Contract signed data for planning and knowledge funds through DED and decision of health workers making to improve in data quality of health management; care improved skills on data collection, storage and use Ukerewe DC Mobilising 19,713,200 Approved Improve Contract signed additional health collection of user funds through DED financing in fees ( cost Ukerewe sharing, NHIF, DRF) Mwanza City Strengthening 9,393,500 Approved Situation analysis Contract signed Council referral system in report used to funds through City Mwanza in develop strategy Director Obstetric care for strengthening referral and delivery services in HCs & dispensaries Mwanza City Improving 28,635,000 Approved Improved Contract signed Council Financial Financial funds through City Management Management Director 4. Mara Region Bunda ICDP Improving Health 21,493,000 Approved Written baseline Contract signed Status through but not the survey translated funds through DED Better Nutrition at budget of into action, Diocess develop villages in Bunda 16,578,000 increased food officer District Council to be used prod & improved for health status purchase of 20 cows, 15 goats Bunda D,C. CHMT Human Approved 10 CHMT trained Contract signed Resources for budget with Mwanza health capacity included in Zonal training building zonal centre centre budget Serengeti District Improvement of 14,920,000 Approved Improved skills Contract signed data management and knowledge funds through DED skills of CHMT of health workers members and in data health service management; providers in improved skills serengeti district on data Total 683,244,300 Total budget 600,000,000 allocated POA