Fikia Haraka Project

The world faces a global health crisis unlike any in the history of the United Nations. The COVID-19 pandemic is causing enormous human suffering while debilitating the global economy and upending people’s lives. When the United Republic of Tanzania recorded its first case of COVID-19 on 16 March 2020, its Government acted immediately and resolutely through a series of measures to alleviate suffering and prevent further spread. Among other things, it closed schools and learning institutions, enforced quarantine and restrictions on travels, and put in place bans on large public gatherings. According to WHO Situation Report March 2022, Tanzania has recorded a total of 33,773 confirmed cases and 800 deaths. An estimated 15 million people in Tanzania live under the national poverty line. The socio-economic impact of the virus is likely to hit these people the hardest. The COVID-19 pandemic will also put pressure on an already stretched healthcare system, which faces a shortage of qualified health workers and high neonatal and maternal mortality.

The accessibility of Tanzania’s health service has been challenged with inadequate fund, shortage of fully trained health staff in the hospitals, poor communication and transport infrastructure. Also, it was recorded that, about 45% of the population were living within 1 km of a health facility, 93% within 10 km and 72% within 5km.   Furthermore, health service has been offered at different kind of level within the country. These include referral hospitals, specialized hospitals, region hospitals, district hospitals, health centers and dispensaries (COWI, 2007). All of these challenges have been associated with the fact that, Tanzania is still a developing country with a small budget to financing all of the development plans.

TYEGD intends to Introduce a digital application that will be installed to the phone of health community workers to enable them to track and report clients with emergency health conditions (Illness) in hard to reach areas for quick medical services. Furthermore, TYEGD intends to procure a mobile van that will be installed medical equipment and supplies to support outreach services so as to reach remote areas in a quickest way. The installed application  will act as the bridge between clients in hard to reach areas  and facility in charges for quick and reliable health services. 

TYEGD intends to reach the entire population of Mara region with the total population of 1,743,830 people (Tanzania Census, 2012 ) 

• Decreased maternal and child mortality caused by a lack of infrastructures including the lack of technology that will accelerate early receipt of information.
• Using a mobile van will reduce the cost of underserved population using fares coming to health facilities.

The administrative capacity of TYEGD has significantly grown over 5 years from being an organization with strong management team in place. It has board of directors that oversee all the program activities, and the management is accountable to it. In the past 5 years, TYEGD has distinguished herself as an active and recognized player in the raising the livelihood of the people, it serves in the regions and country. Guided by its strategic plan, her animation philosophy and approach, the organization has been able to make substantial contribution towards stimulating public debates and activism on social issues affecting marginalized groups. It has thus worked with others in designing and implementing different programs including lobbying and advocacy campaigns, economic empowering programs in Mara, and reproductive health programs to adolescent girls in primary and secondary schools. 

 Around 15 million people in Tanzania live under the national poverty line in which socio-economic impact of the virus is likely to affect them. The COVID-19 pandemic is also put pressure in healthcare systems, which faces a shortage of qualified health workers and high neonatal and maternal mortality. TYEGD in collaboration with  facility in charges, village health committees and community health volunteers as well as Health care providers will work to enable equal access to health services among underserved community through the use of technology and online platforms to promote the expansion of platforms to provide health services to the most vulnerable communities and those underlying emergence health illness  such as pregnancy mothers, people living with HIV, Malaria and other serious illness. TYEGD intends to facilitate fast health service and access to clients through the introduction of a digital application that will be installed to the phone of facility in charges, health care providers and community health volunteers to enable them to track and report clients with emergency health conditions (Illness) in hard to reach areas for quick medical services. TYEGD is well positioned to bring the following solutions to address the challenges in our communities 

• The commitment is to ensure that a total of approximately 1.744 million people are directly reached and benefiting from the program. The Installed application for quick report of emergency health illness that will be used among community volunteers and facility in charges is aiming to provide stimulus for self-reliance and it will act as a model for a comprehensive approach in community health and preservation program in the whole Districts of Mara region.
• On the other hand, TYEGD will engage IT professionals so as to train health care providers on how to use the application which will help them to track and report clients with emergency condition. Furthermore, the organization will also train community village health committees to follow up with community health workers and provide education to families with clients in emergency conditions in order to provide regular information to the project team. There will be regular monitoring using the Council Health Management Team (CHMT) to determine project progress and results.
• To smooth the implementation and quick report of clients, TYEGD will engage facility in charges, village health committees, community health volunteers as well as health care providers to support risk communication and community engagement (RCCE) and dissemination of messages using the phone app in hard to reach areas
• TYEGD is expecting to procure a mobile van that will be installed medical equipment and supplies to support outreach services. The high-risk clients will be attended to by the mobile unit and referral service will be rendered to relevant clients at the nearby facility. Health providers will receive clients’ details through the installed application about the location of client ready for quick action to reduce mortality rate and other serious health issues among underserved communities.
• Lastly TYEGD expects to protect clients with emergency health illness, marginalized and disadvantaged groups including people living with disabilities from COVID-19 related discrimination, whilst fostering provision of health services through outreach services, mobile clinic to meet their health needs and participation in the COVID-19 response.

One of the approaches that TYEGD uses is partnerships. We believe we can do great by uniting skills and expertise to solve various challenges. TYEGD believes that through this intervention we will be able to reach more partners in implementing the project, including technology stakeholders, Government and society at large. Thus, the existence of community engagement with various stakeholders will enable us to use a variety of resources to carry out all activities and to the highest degree.

Through Fkia Haraka Project Application, near medical experts will get clear information regarding location and health status of the client before visiting him/her. This approach will enable people in remote areas to seek medical assistance from reliable health providers easier hence it will help to reduce mortality rate among Tanzanians who are living far away from health service centers. This approach is critical in rural and other remote areas that lack sufficient health care services, including specialty care. As patient ownership of mobile devices increases, new opportunities for direct communication with health care providers.

The proposed project have three main impact goals; (1) To improve the health condition of the people, (2) To serve the lives of the people and (3) To improve government health system by ensuring centred services and with high level of transparency among different authorities.

To improve health conditions of the people

• One among the impact goals of the proposed Project is to improve the health condition of the people around Mara region. With this project, people will have centrally be able to handle different stresses that exist and live longer life. Through prehospital services on medical health conditions, people will have assurance of good health and eventually reduce the rates of morbidity and the severity of diseases particularly that occurs suddenly, and improve the quality of life of huge number of people including people who have contacted COVID’19, children and women.
• Through strengthening emergency care and other services, FIKIA HARAKA project will be able to serve more than 1.7 million people in Mara region who face different challenges when it comes to access of health services. The established units with a procured community mobile van will be dedicated to treat all acute health conditions in the communities including suspect of COVID’19 cases. The established mobile application will serve as hub for connecting clients and health care service providers for quick services and feedback.

To serve the lives of the people

To improve government health system by ensure centered services and with high level of transparency among different authorities

Effective emergency care systems will be designed in such a way that it removes most of the barriers that hinder access to health care services from primary to tertiary level to enhance the capacity of health care providers to deliver medical treatments for clients, resulting in increased efficiency of service delivery as well as and client satisfaction. The role of the mobile application is to connect clients and health service providers, it responds quickly to who should be responsible in responding to the emergency cases based on factors such as distance and equipment. Everyone connected to it can see responses and actions that are required to be taken. Taken into consideration of transparency to the call, the system will help health workers to increase accountability for their works

In one Year All health facilities within program scope will be advocated on significant of this technology and prepare emergency unit to be registered in this Fikia Haraka App Within 5 years TYEGD will  Ensure Working with government to ensure that each emergency unit is using App  and Technology can be successfully applied in community-based patient care to enhance the capacity of health service providers to deliver medications management for clients, resulting in increased efficiency of service delivery as well as staff and patient satisfaction. Strategies in managing both the large distances and sparse population densities is to turn to technologies that will allow patients and practitioners to access each other, exchange information, and to develop appropriate care plans. Information systems which support these efforts have been shown to improve not only the health outcomes for patients, but the financial and time commitments made by individuals, their families, and the wider communities

The project will be evaluated by

• Number of emergency cases attended by health providers
• Number of health providers who attended patients through app
• Reduced mortality rate in a specified program scope.
• Number of people using Fikia Haraka App.

TYEGD’s programs are designed to benefit its beneficiaries with the highest possible impacts. FIKIA Haraka project has a set of well-connected elements from activities to outcomes, set of indicators, means of verification and ways indicators can be measured to bring the desired outcomes. By Evaluating and monitoring the underlying activities to reach the outcomes that create social impact, we ensure that our beneficiaries will be empowered to change their lives and enjoy access to improved services.

Impact goals

• To improve the health condition of the people
• To serve the lives of the people
• To improve government health system by ensure centred services and with high level of transparent

Outcomes

• Improved health systems for emergency health care services
• People have access to health services
• Lives of the people served

Outputs

• Software developed with simprints and tested
• Health facility workers trained on emergency health conditions
• Health facility workers trained on the workability of the software
• Mobile van procured and allocated
• Community sensitization meetings conducted
• Stakeholders meeting conducted
• Feedback meeting and follow-ups conducted
• data available

Activities

• Development of the software with simprint 
• Testing of the software with identified health facilities from village to referral hospitals
• Training of health care providers
• Stakeholders meeting for introducing the idea and inputs
• Procurement of mobile van with installed tools for health care
• Community sensitization meetings
• Conduct health education and retention  

TYEGD relies on conducting Application research that will provide its services quickly and efficiently. The consultant for this area will be the Simprints agency. However, we hope to use the software to bring about change in the health sector in Tanzania, especially in rural areas

TYEGD implements Gender Equality and Social Inclusion Programs to ensure the integration of women, youth, and other vulnerable populations into all program activities. It also works to support and lead the development and maintenance of a Gender Equality and social inclusion action plan to recognize the structural disparities and social norms that limit vulnerable populations participation

The figure below describes on how Fikia Haraka project will work to provide services in the areas. There are three main components of the project starting from a client to the health care workers available in the community and to the health facilities. The developed mobile application serve as hub for providing linkage between clients, health care workers and mobile community van with all the facilities for service provision. After a call for a service, the system automatically generates information and spread to responsible units developed in every health facilities around the region. In a well-organized and coordinated way, the app or system offers recommendation to who should be available to provide the service requested by the client. Depending on the case being reported, community mobile van will be stand-by for any further action to support the client in need on the service

TYEGD has well strategic plan and resource mobilization plan for 2018-2022, where it has depicted its key priority areas including the source of income. The organization depends on members’ contribution, consultation, internal contributions, voluntary contributions or donation and charity walk to fund its activities. However, with all these planned strategies, the only strong means of funding has been through internal contribution, few members’ contribution and donor funds.

Current project of TYEGD is funded by the International Institute of Tropical Agriculture (IITA) to implement the project titled; African Cassava Agronomy Initiative (ACAI). Unlike the donor funded program, TYEGD has a system in place to ensure funds or items are donated by its members to further the organization's goal of reaching out to young people and building their capacity to ensure that young people are the catalyst for development in their areas. The organization uses different ways to secure funds are as follows.

APP service charges

To be financially stable is a good thing for an organization and makes it self-sufficient and growing. TYEGD through Fikia Haraka Project aims to have a small fee for APP usage especially for affluent communities that will use this app (The cost will be for communities that are able to support themselves). The existence of this cost will enable us to make repairs in the event of online challenges. The money raised will also help provide funding for fares for health care providers after phasing out of the project, so access to the underserved community will be available

Membership Dues. Members of TYEGD pays membership fee which is 50,000/= and continue to pay accordingly to the yearly plan, since acquiring grants on a regular basis is very challenging. These members are not only beneficial because of the dues they pay, as they're also often partner institutions for many projects

Fundraising campaigns. The use of social media is the method used by us given that it comes with little to no cost to the organization, and yet delivered effective results. One more method of fund-raising we used was, we conducted food festival big event. Generally, profits from the food sold goes direct to the project planned.

Members’ annual contributions: Each associate pays 100,000 /- every year. Gifts received from any other legitimate sources as permitted by laws. Our organization welcome well-wishers’ individuals/groups/organization both national and international to help us grants in different project ideas so that we can implement. So far, we don’t have any donor or partner. TYEGD has set itself the goal of enrolling 100 members annually as well as conducting community events that will help raise funds to coordinate organizational activities.

• Currently TYEGD has managed to collect membership dues amounting to 3,165,000 TZS for the year 2021/2022.
• For Members ’annual contributions, we have managed to collect 1,790,000 TZ
• So far, TYEGD is receiving funding from the International Institute of Tropical Agriculture (IITA) to implement a project called African Cassava Agronomy Initiative (ACAI) to the tune of $ 49,000,000 to date.  Recently we attended a planning meeting for the implementation of phase three