March 2004

    Diocese of Mpwapwa,

    Anglican Church of Tanzania

    PO Box 2,

    Mpwapwa,

    Tanzania

Tel:    Work +255 (0)26 232 0652

E-mail stlukes@tarlings.com

WEB www.tarlings.com/st_lukes_clinic.htm

    Diocesan Bishop

    PO Box 2,

    Mpwapwa,

    Tanzania

Tel: +255 (0)26 232 4123

E-mail dmp@twiga.com

Building TZS 36, 628, 200/= (£22, 893)

Equipment TZS 7,275,000/= (£4, 547)

Estimated Total for Phase I TZS 43, 903, 200/= (£27, 440)

Building TZS 23, 837, 500/= (£13, 851)

Equipment TZS 12,950,000/= (£7, 525)

Estimated Total for Phase II TZS 36, 787, 500/= (£21, 376)

Tanzania, like many countries of the developing world, is faced with the challenge of providing adequate health services to all her people. However, available national resources, especially finance, are insufficient to implement this mammoth task. Consequently, under the Health Sector Reforms, the Government is working together with a number of other agencies to help realise this goal.

Therefore, in consultation with local Government services, this proposal seeks to strengthen efforts being made especially in terms of Maternal and Child Health Provision

Mpwapwa District lies in central Tanzania, straddling the main road and railway from Dar-es-Salaam to Dodoma. The district has a size of approximately 1600 square miles, mostly consisting of flat scrubland, with a mountainous belt across the centre. It is one of the poorer areas of Tanzania, there being little in the way of light industry or cash crop cultivation. Most of the population are subsistence farmers, and approximately 90% of the people live in small rural villages. In 2000 the district had an estimated population of 239,662.

Mpwapwa town is situated in the centre of the district, with a population of about 30,000. It acts as the administrative centre for the district, with facilities such as a Bank, a Post Office, a Court House, a Veterinary Research Centre, a Secondary School and a Teacher Training College. It lies nestled into the edge of the hills, approximately 80km (about 2½ hours drive) from Dodoma.

St Luke's Clinic is situated in the village of Ving’hawe, on the outskirts of Mpwapwa town.  The village has a population of approximately 5,000, covering a fairly widespread area. About half this number is less than 15 years of age, and about a quarter are under 5.

Facilities in the village include the new All Saints Cathedral of Mpwapwa, a Primary School, and a college of English for adults. The village is served with electricity on the National Grid. It has no piped water supply, the nearest tap being approximately 2km from the village centre.

The Diocese of Mpwapwa is part of the Anglican Church of Tanzania. It was carved out of the Diocese of Central Tanganyika, and inaugurated on 23rd June 1991. Its area fills the boundaries of the political Districts of Mpwapwa and Kongwa.

The Diocesan Bishop, the Rt. Rev. Dr. Simon E. Chiwanga, leads the Diocese. Under him is the Diocesan Secretariat. There are also sixty-four priests and one deacon, working in forty-eight parishes and fourteen sub parishes, all in rural areas. It is estimated that there are 100,000 members of the Diocese, of whom sixty percent are below the age of forty-five years.

The Diocesan secretariat comprises four officers heading the departments of Development Services, Christian Education, Finance, and Stewardship and Evangelism.

St Luke’s Dispensary is led by Dr Rachel Tarling (originally from England, serving with Crosslinks) under the Development Department of the Diocese. St Luke’s Dispensary was established in 1994. In 1998 its services expanded to include Maternal and Child Health (Under 5’s clinics, Antenatal Services and Family Planning), with a mobile clinic to 4 of the neighbouring villages, Makutupa, Bumila, Lupeta and Mang’hangu, as well as a clinic in the Bible School at Chamuhawi.

Health Statistics for the District are as follows: -

Like most of Tanzania, Mpwapwa has a comparatively large proportion of its population under 5. Reliable infant mortality statistics are hard to find, as many children die in the villages without their births or deaths ever being officially registered. As information-collecting systems are improving, a clearer picture will emerge. However, because of the nature of the local environment, with most people depending on subsistence farming rather than being in paid employment or being able to produce cash crops, poverty is widespread and the maternal mortality rate and infant mortality rate, among other health indicators, are considerably higher than the national average.

Maternal statistics for those attending Health Facilities for 1999 MTUHA (65% deliveries are at home): -

Maternal Data

Causes of inpatient maternal deaths in Mpwapwa General Hospital in 1999

2 - anaemia 2y to malaria 1 – Endotoxic shock

1 – Native medicine intoxication 2 – PPH

1 – PIH (Eclamptic fits) 1 – Septicaemia 2y to retained placenta

1 – Post abortion complications 2 - Ruptured Uterus

2 - Unknown

Singleton Births

Multiple Births

Nutrition status of under 5’s in 1999 (MTUHA) was as follows:

Immunization coverage for infants in 1998 was 85%.  The majority (65%+) of deliveries occur at home, mostly because of difficulty for mothers in reaching a suitable facility to deliver. Many of these deliveries are performed by Traditional Birth Attendants, or retired nurses living in the villages, without adequate supervision, or emergency drugs, or in many cases gloves being available.

The total cost of the project is around TZS 80,690,700/= (£48,816 approx), a breakdown of which is shown below

Phase II

Total additional building 83.64m² @ TZS 285,000/= per m²

  Grand (Estimated) total for phase II: TZS 36, 787, 500/=

Phase I: TZS 43, 903, 200/=

St Luke’s Dispensary, Mpwapwa Maternity Wing Project Proposal