Pfizer TOR extension Progress Narrative Report
(Oct- Nov 2015
A.3 Physical Address and Postal Box 58,Morogoro,Tanzania.
A.4 Telephone numbers
A.5 Email address Moretea2004@yahoo.co.nz or
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A.6 Project Coordinator
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| A. 7 Programmes Director | ||
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Section B: Project particulars.
B.1 Project Title: “Supporting the prevention and control of non-communicable disease among older people”
B.2 Overall Coordinator of the project: HelpAge International, Tz.
B.3 Project donor: HelpAge International and Pfizer.
B.4 Project Objective: To contribute to the reduction of the burden of ill health due to NCDs among older people in Tanzania.
B.5 Planned Project Objective and Activities for 2 months of October and November 2015:
Result 1: Promoting Health Ageing
Activities:
- Awareness meeting of older people, young children and adolescents living in multi-generational households on what constitutes “good health”
- Supporting Specialist Health Workers to provide health ageing knowledge to a mix of Children and OP Active Aging Groups with.
- Supporting a mix of Children and OP to spread learning to older people, young children and adolescents living in Multi-generational households (taking forward developed plan).
B. 6 Implemented project activities for 2 months of October and November 2015:
- Awareness meeting of older people, young children and adolescents living in multi-generational households on what constitutes “good health”
- Supporting Specialist Health Workers to provide health ageing knowledge to a mix of Children and OP Active Aging Groups with.
- Supporting a mix of Children and OP to spread learning to older people, young children and adolescents living in Multi-generational households (taking forward developed plan).
B.7 Postponed project activities:
All 3 activities were implemented in the two months of October - November 2015.
B.8. Reporting period: 25th November, 2015
1.0 Context:
1.1 The burden of diseases in Tanzania is high, with Communicable diseases still prevailing as the principal sources for morbidity and mortality. But increasingly, the country is confronted with the double burden of disease due to the rising tide of Non Communicable Diseases (NDCs). The ongoing Sensitization meetings with CHMTs Health and Nurse officers incharge , the Consultation meetings with MoHSW to review NCD management policy at lower and middle health facility levels as well as the Geriatric Training to health facilities within the project districts have shown a positive response by the government and OP themselves to take measures on NCDs.
MOREPEO implemented intergenerational activities which involved older people, young children and adolescents living in multi-generational households in Morogoro municipal to support healthy aging that cuts across the life stages of people. The activity intended to build on the work carried out through the project entitled: “Supporting the prevention and control of non-communicable diseases among older people” with funding from Pfizer Pharmaceuticals and learned from the implementation of a similar approach in Kibaha district from December 2014 to April 2015. Apart from Morogoro municipality we also involved older people, young children and adolescents from Dumila, Rudewa and Kasiki wards in Kilosa district council the aim was to extend the programme to other localities of Morogoro region focusing on healthier aging, by improving health and quality of life across all age cohorts moving beyond a focus on the management and treatment of illnesses.
The implementation of this programme promoted the increased understanding on how young people and those in their mid-life could adopt healthy life style to prevent the onset of age related chronic diseases. In practice this involved creating awareness among young people on the values and importance of good dietary practices, avoiding alcohol and smoking, engaging in physical exercise and practicing healthy sexual and reproductive health practices (i.e prevention sexually transmitted diseases including HIV and AIDS). Additionally it also involved creating common platforms that enabled older people and young people engage in intergenerational physical activities, exchanging ideas of what makes up good health both from the perspective of young people and older people. MOREPEO believes that the implemented activity will contribute to the improvement of the management of chronic conditions among older people already experiencing age related chronic conditions.
2.0 Implemented Project Activities by MOREPEO for 2 months of October and November 2015: .
2.1 Awareness meeting of older people, young children and adolescents living in multi-generational households on what constitutes “good health”
2.1.1 It was a 3 day awareness meeting combining one community in each of the six wards of Kihonda , Sabasaba and Kilakala (in Morogoro Municipality) as well as Dumila, Rudewa and Kasiki wards in Kilosa district council. The meeting was held from 17th to 19th Oct 2015 at Kilosa Roman Catholic meeting hall. Both participants from all 6 wards attended the meeting.
2.1.2 Participants for the meeting comprised the following group categories:
(1) Older men and women.
(2) Youths and children
(3) OPMGs.
(4) 6Kilosa district officials titled DSW, DMO, DACC, DVC(District VICOBA Coordinator):DCDO, and Physiotherapist .
(5) 6 WEOs , one from each 6 wards of Kihonda , Kilakala and Sabasaba in (Morogoro municipal); Dumila, Rudewa and Kasiki in Kilosa district council.
(6) 4 MOREPEO representatives.
Outputs
ü The meeting focused on the awareness raising to the participants regarding situation of Non- Communicable diseases, prevention and its management as well as the situation of health rights and entitlements to older people and their dependants for free medication in regards of achievements and challenges.
ü Concept on Communicable and Non – Communicable Diseases (NCDs) in respect to older people.
ü Prevention of the age related chronic diseases
ü The concept of age and ageing.
ü The stake holders of HBCs and Peer Educators.
ü The role of home based carers and Peer Educators in regards to beaded OPs affected by NCDs.
ü An overview of HIV &AIDS policy 2008
ü Awareness among young people on the values and importance of good dietary practices, avoiding alcohol and smoking, engaging in physical exercise and practicing healthy sexual and reproductive health practices (i.e prevention sexually transmitted diseases including HIV and AIDS).
ü Creating common platforms to enable older people and young people engage in intergenerational physical activities, exchanging ideas of what makes up good health both from the perspective of young people and older people.
Outcomes
- A total of 80 participants (F 49 and M 31) participated the meetings out of the given budget. 40 participants from each of the 2 districts of Morogoro MC and Kilosa DC attended the meeting under the same budget.
- 6 Ward officials participated the meeting to include: 6 Ward executive officers (1 from each) of the six Wards of Kihonda, Kilakala and Sabasaba in MMC; and Dumila, Rudewa and Kasiki from KDC.
- The Participants were knowledgeable with healthy life style, causes and prevention of non-communicable diseases.
- Awareness among young people on the values and importance of good dietary practices, avoiding alcohol and smoking, engaging in physical exercise and practicing healthy sexual and reproductive health practices.
- Apart from the eight former Active aging clubs from Kihonda, Kilakala and Sabasaba wards in Morogoro Municipal Council, Three Clubs of older people in Kilosa district involving young children and adolescents were formed basing on their residential area. The formed clubs were that of Rudewa, Kasiki (kilosa town), and Dumila. The formulated social clubs had a maximum of fifteen individuals each.
- Participants came up with an Action plan to champion the ongoing and newly established active ageing in their respective community in three months to come from December 2015 to February 2016.
ACTION PLAN
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S/N |
District |
Wards |
Activities |
verification |
Responsible |
Period Dec 2015 –Feb2016 |
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1 |
Morogoro MC |
Kihonda Kilakala Sabasaba |
* Provide self-Home Based Care to bed ridden clients/OPs.
*Doing physical exercises (jogging, lifting chairs, pushups, short and long distance walking, cycling, Aerobics, massaging, cleaning their surroundings, etc.) *Playing (cards, bao, dats, football
*Entrepreneurship – Making mats, making shampoo/soaps, making vigoda(traditional chairs) making ropes, buying and selling local chickens. Gardening ect. |
*Number of bed ridden clients received home based services in place. *Availability of registration book and number of OP, youth and young children participated in physical exercises
*Number of OP involving in IGAs in place and documented. *Monthly reports in place. *Quarterly reports in place. |
*DMO/Clinical /health officers.
*older people, young children and adolescents living in multi-generational households |
Every Saturday 4pm to 6 evening |
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2 |
Kilosa DC |
Dumila Rudewa Kasiki (Kilosa) |
* Provide self-Home Based Care to bed ridden clients/OPs.
*Doing physical exercises (jogging, lifting chairs, pushups, short and long distance walking, cycling, Aerobics, massaging, cleaning their surroundings, etc.) *Playing (cards, bao, dats, football *Entrepreneurship – IGAs . Making mats, making shampoo/soaps, making vigoda making ropes, buying and selling local chickens. Gardening ect.
* Forming Vicoba (Village Community Banks)
* Establishment of newly OP active clubs at their localities. |
*Number of bed ridden clients received home based services in place. *Availability of registration book and number of OP, youth and young children participated in physical exercises
*Number of OP involving in IGAs in place and documented.
*Number of established and registered VICOBA in place.
*Monthly reports in place.
*Quarterly reports in place.
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*DMO/Clinical /health officers.
*older people, young children and adolescents living in multi-generational households.
District Councils` VICOBA Coordinators (Morogoro and Kilosa) Secretary for Active Aging clubs.
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Secretary for Active Aging clubs.
Health workers (Morogoro and Kilosa) MOREPEO. |
Every Saturday 4pm to 6 evening
25th of each month.
30th Dec 30th March 30th June 30th August |
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2 |
6 |
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2.2 Supporting Specialist Health Workers to provide health ageing knowledge to a mix of Children and OP Active Aging Groups.
1) MOREPEO supported 2 specialist Health workers namely Dr. Bigawa a regional OP focal person and Dr. Dennis Ngalomba, the DMO for Kilosa District council to provide health knowledge to children and older people`s Active Aging clubs. 2 meetings from each of the two districts of Kilosa and Morogoro MC were held. Two meetings were held in each of the two months of November and December 2015.
Output:
ü To encourage them to meet at least once a week for discussing their issues , making physical exercises that will make them healthy and hence prevent them from getting diseases, especially NCD’s. Furthermore to enable them plan on what should be done in their unity to generate income, for example, forming Vicoba among them. It is easily to be supported when they are in groups rather than as individuals. When they are in groups, they will share ideals/ experiences because the group will for sure comprise people with different ideology.
ü To empower older people, young children and adolescents on how they can prevent themselves from getting NCD’s.
ü To train older people, young children and adolescents on how they can prevent themselves from getting Non communicable diseases (NCDs) and HIV & AIDs .
ü To orient older people, young children and adolescents on Home Based care.
ü Ways in which older people are regarded in society, both positive and negative;
ü To create a total of 80 young activists who will support the health campaign to reach young children and adolescents as per agreement that each OP to identify/to come up with at least one young chap.(each district to create 40 young activists)
ü Point out ways in which older people are disadvantaged;
ü Supervision and data Documentation on the number of people visiting government facilities for advice and treatment of NCDs
including information on diagnosis and referrals.
outcome
2.2.1 A total of 80 (F 49 and M 31) OP were reached by specialists health workers while sum of 80 (F 48,M32) young activists were created purposely to support health campaign so as to reach young children and adolescents. Each of the two districts of Kilosa and Morogoro MC created 40(F24,M16) young activists.
2.2.2 Participants for the 4 meetings(2 from each of the 2 districts of Kilosa and Morogoro MC) comprised a total of 160(F97,M63) older people, young children and adolescents.
2.2.3 Reviewing and improvement of HIV/AIDS, Health, HBC and income monitoring tools.
2.2.4 Experience exchange on success and challenges occurred on resource allocation, access to drugs and free friendly access to health services to OPs in two districts of Kilosa and Morogoro Municipality.
2.3 Supporting a mix of Children and OP to spread learning to older people, young children and adolescents living in Multi-generational households (taking forward developed plan).
MOREPEO in corabollation with health workers supported a mix of children and older people to establish intergenerational interactions linking with the active ageing groups currently working in Sabasaba, Kihonda and Kilakala in Morogoro MC and Dumila, Rudewa and Kasiki in Kilosa DC. The 4 meetings which was held in November and December 2015 were of five outputs as listed hereunder:
Outputs:
ü To exchange information on common health message and institute plans to spread them to more community members.
ü Presentation and discussing Key health issues that children and their older caregivers should be exchanging; particularly around the life course outcomes such as the prevention of NCDs, good nutrition, reproductive health and HIV and AIDS issues, and how both age groups should benefit from those sources to educate each other.
ü Health prevention and education activities and initiatives that both groups should engage in and collaboratively help each other.
ü To empower knowledge and behaviors that children and older people need, poor health habits like smoking and excessive drinking in their communities and the best way of transferring this knowledge. For example the use of cultural performance by children and storytelling by older people, children’s drawings, joint public awareness raising meetings, and healthy living testimonies.
Outcome:
Participants were knowledgeable on the prevention of NCDs, good nutrition, reproductive health and HIV and AIDS issues, and how both age groups should benefit from those sources to educate each other.
Increased knowledge and behaviors that children and older people need, poor health habits like smoking and excessive drinking in their communities and the best way of transferring this knowledge on the use of cultural performance by children and storytelling by older people, children’s drawings, joint public awareness raising meetings, and healthy living testimonies.
22 OPMG (11F and 11m) Rudewa, Dumila (Kilosa district), Mji Mpya, Boma, Mwembesongo, Sabasaba, Kihonda, Bigwa, Kingolwira (Morogoro Municipal Council), Gwata and Mkambarani (Morogoro Rural District) We succeeded to train 7 more participants with the same budget instead of the 15 originally planned participants.
The co-facilitation of this training resulted to the implementation of the plans to spread learning to older people, young children and adolescents living in Multi-generational households as well as to follow-up and support on this implementation plan
An ACTION PLAN to enable a mix of Children and OP to spread learning to older people, young children and adolescents living in Multi-generational households.
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S/N |
District |
Wards |
Activities |
verification |
Responsible |
Period Dec 2015 –Feb2016 |
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1 |
Morogoro MC |
Kihonda Kilakala Sabasaba |
*Cultural performance by children.
*Doing physical exercises (jogging, lifting chairs, pushups, short and long distance walking, cycling, Aerobics, massaging, cleaning their surroundings, etc.)
* children’s drawings
* Storytelling and healthy living testmonies by older people. |
*Number of children and young adolescents performed cultural dances. *Availability of registration book and number of OP, youth and young children participated in physical exercises
Number of children involved in drawings
List of older people involved in storytelling and healthy living testimonies. |
*older people, young children and adolescents living in multi-generational households |
Every Tuesday 2pm to 6 evening |
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joint public awareness raising meetings, |
Availability of registration book and number of OP, youth and young children participated in joint public awareness raising meetings. |
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Last Saturday of the fourth week of each month. |
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*Monthly reports in place. |
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25th of each month. |
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*Quarterly reports in place. |
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30th Dec 30th March 30th June 30th August |
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2 |
Kilosa DC |
Dumila Rudewa Kasiki (Kilosa) |
*Cultural performance by children.
*Doing physical exercises (jogging, lifting chairs, pushups, short and long distance walking, cycling, Aerobics, massaging, cleaning their surroundings, etc.)
* children’s drawings
* Storytelling and healthy living testmonies by older people. |
*Number of children and young adolescents performed cultural dances. *Availability of registration book and number of OP, youth and young children participated in physical exercises
Number of children involved in drawings List of older people involved in storytelling and healthy living testimonies. |
*older people, young children and adolescents living in multi-generational households |
Every Tuesday 2pm to 6 evening |
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joint public awareness raising meetings, |
Availability of registration book and number of OP, youth and young children participated in joint public awareness raising meetings. |
Older people, young children , adolescents and community members |
Last Saturday of the fourth week of each month. |
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*Monthly reports in place. |
Secretary for Active Aging clubs. |
25th of each month. |
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*Quarterly reports in place. |
Health workers (Morogoro and Kilosa) MOREPEO. |
30th Dec 30th March 30th June 30th August |
CHALLENGES.
ü Need to develop, monitoring and evaluation tools to assess their performance.
ü Lack of funds for supportive supervision.
ü Unfriendly health system.
ü Shortage of basic drugs for NCDs.
ü Shortage of test kits for NCDs eg. Blood glucose, BP. Machine weighing scale etc.
ü Shortage of skills personnel on geriatric cases.
ü Poverty among older people.
ü Our experience on screening of older people is inhibited with the inability for older people to access facilities in long distant places where they are subjected to cover long walking distances .As such, visits/outreach is very vital to conduct screening exercise in their respective villages.
Conclusion
Through Pfizer project Morogoro Municipal and Kilosa district councils have agreed to accommodate in their plans older people’s concerns especially the provision of free medication to all older people of 60 years and above. All 2 Councils of Morogoro Municipal and Kilosa have substantively strengthened their connection with MOREPEO which is working to help the government to improve service delivery for vulnerable groups especially those who are at risk of NCDs. The evidence generated from Pfizer extension programme has enabled MOREPEO to successfully proceed with its role of influencing police markers and department heads to improve well being of vulnerable groups not only in the pilot project area but also in all 7 districts of Morogoro region. The experience of the implementation of this programme indicates the benefit of focusing on healthier aging, by improving health and quality of life across all age cohorts moving beyond a focus on the management and treatment of illnesses.
Recommendation
MOREPEO recommends the inclusion of activities with younger people in Intergenerational Healthy Aging programme. The application of this approach promotes increasing understanding on how young people and those in their mid-life can adopt healthy life style to prevent the onset of age related chronic diseases.