KWETU LIWALE NA MILA ZETU

KUELEKEA KIJIJI CHA MPIGA MITI

NGOMA ZA UNYAGO ZINAPOCHUKUA MUDA WA WAKAAZI WA KUSINI,KIJIJI CHA KIBUTUKA

VIONGOZI HOJINI MATUMIZI FEDHA ZA CHF-NHIF LINDI

Na Mwandishi Wetu
MFUKO wa Taifa wa Bima ya Afya (NHIF) umeuomba uongozi wa Mkoa wa Lindi kuhakikisha unahoji na kusimamia matumizi ya fedha za tele kwa tele zinazolipwa na Mfuko huo kwa halmashauri.
Fedha hizo ambazo zinalipwa na NHIF zinatakiwa kutumika katika ununuzi wa dawa na uboreshaji wa vituo vya kutolea matibabu ili hatimaye kuondokana na mazingira duni ya kutolea huduma.

Ombi hilo lilitolewa juzi na Meneja wa NHIF, Mkoa wa Lindi Fortunata Raymond katika kikao cha Kamati ya Ushauri cha Mkoa ambacho kilijadili mambo mbalimbali ikiwemo taarifa ya utekelezaji ya Mfuko huo ya mkoa.
Akiwasilisha taarifa hiyo, Raymond alisema changamoto kubwa ambayo Mfuko umekuwa ukipambana nayo ni pamoja na fedha hizo kutotumika kama miongozo inavyotaka.
“Sisi kama Mfuko tunaomba sana mtusaidie katika usimamizi wa fedha hizi ikiwemo kuhoji namna zinavyotumika…haiwezekani vituo viendelee kuwa na hali duni huku fedha zinazoweza kuviboresha zikitumiwa katika matumizi yasiyostahili,” aliomba Raymond.
Alisema kuwa endapo fedha hizo zitatumika kama ilivyoelekezwa wananchi watapata huduma za matibabu zinazostahi na katika mazingira mazuri.
Raymond pia alitumia nafasi hiyo, kuhamasisha viongozi hao kutumia fursa inayotolewa na NHIF ya mikopo ya vifaa tiba na ukarabati wa majengo ili kuboresha huduma hususan katika maeneo ya vijijini.
Akijibu baadhi ya hoja, Mkuu wa Mkoa wa Lindi Lodovick Mwananzila aliwataka wakuu wa wilaya na wakurugenzi wa halmashauri kuhakikisha fedha hizo zinatumika kwa kufuata mwongozo uliopo.
Alisema hatasita kuchukua hatua kali kwa halmashauri itakayobainika kutumia fedha hizo kinyume na malengo yake.
“Afya ni kila kitu, ili wananchi wetu wazalishe ni lazima wawe na uhakika wa kupata matibabu …na natoa mwito kuwahamasisha wananchi kujiunga na Mfuko wa Afya ya Jamii (CHF) kwa kuwa ndio njia pekee ya kuwasaidia.

HALMASHAURI ZITAKAZOTUMIA FEDHA ZA TELE KWA TELE KWA MATUMIZI YASIYOKUSUDIWA KUKIONA-RC LINDI

Mkuu wa Mkoa wa Lindi Ludovick Mwananzila,akiwautubia washiriki wa mkutano wa kamati ya ushauri ya Mkoa (RCC)ambapo yeye ni mwenyekiti wake,mambo mbalimbali ya maendeleo ya Jamii na kiuchumi yalijadiliwa.Mkutano huo umefanyika katika ukumbi wa mkuu wa Mkoa wa Lindi hivi karibuni.
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Meneja mwakilishi wa NHIF ofisi ya Mkoa wa Lindi,Fortunata Raymond,akitoa mada kuhusu utekelezaji wa shughuli za mfuko huo katika Baraza la Ushauri la Mkoa.

Washiriki wa kikao cha baraza la ushauri la Mkoa ambao ni Wakuu wa Wilaya wakifuatilia kwa makini hotuba ya mwenyekiti wa mkutano huo ambaye ni mkuu wa Mkoa wa Lindi Ludovick Mwananzila.

Waheshimiwa wabunge wa Mkoa wa Lindi ni miongoni wa wadau wakubwa kwenye Mkutano wa Baraza la Ushauri wa Mkoa,pichani Mhe. Zainab Kawawa akichangia hoja kwenye mkutano huo. (picha Na. Paul Marenga)

NHIF YATOA MSAADA WA VITABU 50 VYA MASWALI NA MAJIBU YA MTINDO BORA WA MAISHA

BI FORTUNATA RAYMOND MENEJA MWAKILISHI WA NHIF MKOA WA LINDI AKIMKABIDHI BI ANNA MARO MSAADA WA VITABU 50 VYA MTINDO BORA WA MAISHA NA MAGONJWA SUGU YASIYOAMBUKIZWA.


BAADA YA MAKABIDHIANO

TASWIRA KIJIJINI NANGOO WILAYANI MASASI

SAA 7 MCHANA BADALA YA KUJIUNGA NA VIKUNDI VYA UZALISHAJI MALI,MCHEZO WA BAO UNACHUKUA MKONDO

HOYOYO WAIPOKEA CHF KAYA 143 ZAJIANDISHA BAADA YA UHAMASISHAJI

Hakina mama hawakuwa nyuma kama walezi wa familia walihakikisha wanashiriki vyema kwenye kupata elimu ya umuhimu wa kujiunga na CHF.

Wazee hawakuwa nyuma kwenye kampeni za kujiunga na mifuko ya afya ya jamii (CHF)

Baada ya Elimu kilichofuata ni wananchi kujiandikisha,kujihakikishia huduma stahiki za matibabu.

KAMATI YA BUNGE NISHATI NA MADINI YAHUSISHWA NA TUHUMA ZA UFISADI

SPIKA AVUNJA KAMATI YA NISHATI, WAZIRI AELEZA WALIVYOITAFUNA TANESCO

Kizitto Noya na Boniface Meena, Dodoma

WAKATI wabunge wakitoa tuhuma nzito dhidi ya wenzao wanaodaiwa kujihusisha na ufisadi ndani ya Shirika la Umeme Tanzania (Tanesco), imebainishwa kuwa wabunge wenye tabia hiyo ni watano, watatu kutoka chama tawala CCM na wawili upinzani.
Habari zilizopatikana jana mjini Dodoma zimeeleza kuwa baadhi ya wabunge hao wanatoka katika Kamati ya Bunge ya Nishati na Madini, huku wengine wakitoka Kamati ya Bunge ya Hesabu za Mashirika ya Umma.
Kwa mujibu wa taarifa hizo, wabunge hao wamedaiwa kuwa wamekuwa wakitumia nafasi zao za ubunge na ujumbe wa kamati kufanya biashara na Tanesco na kutetea mafisadi ndani ya shirika hilo la umma.

Gazeti hili limefanikiwa kupata majina ya wabunge hao, ambayo leo hatutayataja kwa sababu za kitaaluma.

Baadhi ya wabunge waliochangia hoja hiyo bungeni juzi na jana walisema kuwa, wanawafahamu wabunge hao kwa majina, lakini hawapendi kuwataja kwa kuwa siyo wakati mwafaka.
Moto wa kutaka kutajwa kwa majina ya wabunge hao ulikolezwa jana na Mbunge Vita Kawawa wa Namtumbo(CCM) aliyeomba Mwongozo wa Spika, akitaka jambo hili lijadiliwe na Bunge na kupendekeza kuwa, Kamati za Bunge zinazotuhumiwa kwa rushwa zivunjwe.

“Waheshimiwa wabunge wamejadili suala hili kwenye wizara, lakini kwa mujibu wa kifungu cha 55 (3)f mbunge au waziri anaweza kutoa hoja ili jambo fulani lijadiliwe. Sasa naomba kutoa hoja ya kujadili suala hilo," Kawawa alisema.
Aliliomba pia Bunge likubali kuivunja na kuiunda upya Kamati ya Nishati na Madini na kamati nyingine zilizolalamikiwa kwa rushwa. Hoja hiyo iliungwa mkono na wabunge.

Baada ya hoja hiyo kuungwa mkono Spika wa Bunge, Anne Makinda alisimama na kukubali hoja hiyo ya Kawawa na kutangaza kuivunja Kamati ya Nishati na Madini.

Spika Makinda alisema ameiagiza Kamati ya Haki, Kinga na Maadili ya Bunge kutengeneza kanuni za kuwadhibiti wabunge wenye tabia hiyo ya kupokea rushwa kutoka kwa watu mbalimbali ili kutimiza matakwa yao binafsi.
"Ninakubali kuivunja Kamati ya Nishati na Madini na zingine ambazo zitatajwa kwenye tuhuma hizo. Nalipeleka pia suala hilo kwenye Kamati ya Haki, Maadili na Madaraka ya Bunge, halafu kama ni kutajwa (wabunge hao), basi tutapata mwongozo wa kamati hiyo." alisema Spika Makinda na kuongeza:
"Nasema kwa dhati kabisa, kitendo hiki hakikubaliki ndani ya Bunge hili. Wabunge mkae vizuri. Kama kuna baadhi yetu wanaenda huku na huku kujitafutia masilahi binafsi, tutawezaje kuisimamia Serikali?"
Mbunge Zedi
Baada ya Spika kutangaza kuvunja Kamati ya Nishati na Madini, Mwenyekiti wa Kamati ya Nishati na Madini, Seleman Zedi alisema kuwa ameshtushwa na uamuzi huo na anasubiri uamuzi wa Kamati ya Haki, Kinga na Maadili ya Bunge.
"Nimeshtushwa sana na uamuzi huo, lakini tusubiri Kamati ya Haki, Kinga na Maadili ya Bunge," alisema Zedi.
Waziri Muhongo
Akihitimisha hoja ya wizara yake bungeni jana, Waziri wa Nishati na Madini, Profesa Sospeter Muhongo alisema kuwa baadhi ya wabunge ambao wanashiriki kwenye vikao vya uamuzi vya Tanesco kama wajumbe, wamekuwa wakilihujumu shirika hilo kwa njia mbalimbali ikiwamo kufanya nalo biashara.

"Shirika liliwahi kulipa Pauni za Uingereza 50,000 kwa ajili ya kununua vipuri, lakini kilicholetwa nchini ni masanduku ya misumari,” alisema Profesa Muhongo na kuongeza;
“Hata katika nguzo za umeme kuna biashara inaendelea. Tunajua kuwa nguzo hizo zinazalishwa Iringa na kupelekwa Mombasa kisha kurudishwa nchini kwa maelezo kwamba zimetoka Afrika Kusini."
Waziri Muhongo alisema kuwa mbali na ufisadi huo, baadhi ya wabunge ambao ni wajumbe wa Kamati ya Nishati na Madini wamewahi kuliuzia shirika hilo matairi ya magari kwa bei kubwa, bidhaa ambayo hata hivyo alisema haina ubora unaokubalika.
"Baadhi ya wabunge wanafanya biashara na Tanesco; niseme tu kuwa, hii siyo sahihi. Lakini niombe kwamba mjadala huu tuufunge kwa sababu, tayari tumekabidhi suala hilo kwa Mdhibiti na Mkaguzi Mkuu wa Hesabu za Serikali (CAG)" alisema Waziri Muhongo.
Waziri Muhongo pia alizungumzia jinsi baadhi ya watu na kampuni zinavyoiibia Tanesco kupitia mita za Luku ambapo aliwataja watu hao kuwa ni pamoja na Shule za St. Mary's zinazodaiwa Sh10.5 milioni, Access Bank, Tawi la Tabata Matumbi Sh13.8 milioni na Hoteli ya Akudo Paradaise ya Kariakoo inayodaiwa Sh25.5 milioni.
Alisema kuwa baada ya kubainika kwa wadaiwa hao hutumia umeme kinyume na utaratibu,wahusika wote walikamatwa na kufikishwa kituo cha polisi baada ya kufanyika kwa uchunguzi.
“Baada ya kufanya uchunguzi na kubaini kuwapo kwa watu wanaotumia umeme bila kulipia na kuisababishia Tanesco hasara, tumeamua kuwachukulia hatua ikiwamo kuwafikisha polisi,” alisema Profesa Muhongo na kuongeza:
“Inaonyesha wazi kwamba wizi wa umeme wa Luku umekuwa ukifanyika mara kwa mara na kwamba baada ya kuwakamata hawa, uchunguzi utaendelea na wengine watakaobainika watachukuliwa hatua za kisheria.”
Jenista Mhagama
Katibu wa Wabunge wa CCM, Jenista Mhagama alisema kuwa, amepokea kwa masikitiko taarifa hizo za wabunge wa CCM kuingia katika tuhuma hizo, lakini akasema namna nzuri ya kushughulikia tatizo hilo ni vyombo vya dola kufanya uchunguzi makini ili kujiridhisha na kisha hatua za kisheria kufuatwa.
"Ni taarifa mbaya kwa kweli, lakini mimi niiombe Serikali itusaidie kufanya uchunguzi ili ukweli ubainike na hatua zichukuliwe," alisema Mhagama.
Mbunge Silinde
Naye Katibu wa Wabunge wa Chadema, David Silinde alisema: "Kwa kuwa tumesikia, kama kambi tutafanya uchunguzi juu ya tuhuma hizo. Tutakaa kikao cha kuamua nini cha kufanya. Pia tutatoa tamko juu ya mwenendo mzima wa hizi tuhuma na Bunge kwa ujumla.”
Zitto
Naye Mwenyekiti wa Kamati ya Mashirika ya Umma ambayo imeunganishwa kwenye tuhuma hizo, Zitto Kabwe, alisema tuhuma hizo anazisikia, lakini anaziona kama siasa za majitaka kwa sababu zinarushwa bila ushahidi wowote.
"Hakuna hata mbunge mmoja aliyesimama kusema nani amehongwa nini. Mimi binafsi sijahongwa na mtu yeyote wala mimi sijamtetea mtu isipokuwa natetea taratibu kufuatwa," alisema.
Zitto alibainisha kuwa anaamini tuhuma hizo zimetokana na hasira za yeye kupinga posho za wabunge na sasa wameona hilo ndilo eneo la kumkomoa.
"Kwa kuwa ‘my conscious is clear’, (dhamira yangu safi) sina mashaka, uzushi, uongo na siasa za majitaka hizi zitaumbuliwa na ukweli. Hata hivyo, kwa kuwa tuhuma hizo zinasemwa juu juu tu, tutataka vyombo vya dola vichunguze na ikithibitika hatua zichukuliwe," alisema na kuongeza:
"Kwangu mimi naona hizi ni siasa za urais na hasira za posho. Wenye kutaka urais wa vyama vyote na wapambe wao, wameungana kunichafulia heshima yangu. Wabunge wenye njaa ya posho, wameungana kunikomoa. Ukweli una tabia ya kutopenda kupuuzwa. Mwalimu Nyerere (Julius) alisema katika andiko lake la 'Tujisahihishe'.”
Mbunge huyo wa Kigoma Kaskazini(Chadema) alishauri pia Spika wa Bunge kutumia Kamati ya Maadili kuchunguza tuhuma hizo kwa kuwa hazipaswi kuachwa zikapita hivihivi.

John Cheyo
Mwenyekiti wa Kamati ya Hesabu za Serikali, John Cheyo alisema anasikitika kuona Bunge ambalo kimsingi ni kitovu cha uadilifu limeanza kuvamiwa na mafisadi.
"Very unfortunate, (bahati mbaya sana) Bunge ambalo ni kilele cha uadilifu, nyumba ya waheshimiwa, ambako kunatarajiwa high level of intergrity (uadilifu wa hali ya juu), kuanza kutumika kama perpets (vibaraka) wa mafisadi," alisema.
Cheyo aliongeza: "Ninalaani sana kitendo hicho, lakini niwaambie viongozi wapya wa Wizara ya Nishati na Madini kuwa, waendelee kufanya kazi kwa uadilifu na nguvu yao ni wabunge wengi wema, ambao watawaunga mkono. Wasikate tama," alisema.

Mjadala ya wabunge
Mbunge wa Maswa Magharibi (Chadema), John Shibuda aliliomba Bunge kufanya uchunguzi ili kuwabaini wabunge wanaojihusisha na vitendo vya rushwa.
Alisema baadhi ya wabunge wanatumia nafasi zao vibaya kwa kujihusisha na vitendo vya rushwa ili kuiyumbisha Serikali.
“Namwomba Spika na timu yake yote ikaona kuna haja ya kufanya uchunguzi kwa wabunge ili kuweza kuwabaini wanaotumia nafasi zao vibaya kwa kujihusisha na vitendo vya rushwa ilikuiyumbisha Serikali ,” alisema Shibuda
Mbuge Kangi
Naye Mbunge wa Mwibara, Kangi Lugora alitaka Waziri wa Nishati na Madini awataje wabunge aliowatuhumu ili kuonyesha usawa hasa baada ya kuwataja kwa majina watuhumiwa wengine katika ufisadi wa Tanesco na wale wanaoliibia umeme shirika hilo la umma.
"Tunaomba waziri asema kwa nini asiwataje hao wengine wakati tayari ametutajia kina Freddy na Veronica William Mhando na taasisi za St Mary? " alihoji.
Hoja hiyo ya Lugora ilitupwa na Spika wa Bunge Anne Makinda aliyesema kuwa jambo hilo lina taratibu zake.
Kamata
Vicky Kimata (Viti Maalumu) nusura amwage machozi bungeni juzi jioni, alipozungumza kwa uchungu kupinga hatua ya wabunge hao kujihusisha na ufisadi, huku akieleza kuwa nchi imefika pabaya.
'Watanzania tumefikia hapo! Watu wanatengeneza mgawo wa umeme ili kujipatia hela, Jamani...jamani.. Hammwogopi hata Mungu!"
Said Mussa Zuberi alipendekeza itungwe sheria ya kuwanyonga mafisadi na wahujumu uchumi kwa kuwa matendo hayo pia ni uuaji.
"Katika taifa letu tuna wadudu sijui tuwaite mchwa ambao wanaharibu yaliyotengenezwa kwa maslahi yao. Nawashauri wananchi kwa kuwa sasa tuko kwenye suala la Katiba, wasisahau kupitisha sheria ili watu wahujumu uchumi tuwaue, tena kwa risasi. Chanzo; Gazeti la Mwananchi.

WANANCHI WILAYANI NACHINGWEA WATAKIWA KUHAINISHA VIPAUMBELE VYA MAENDELEO-DC

Mkuu wa Wilaya ya Nachingwea,iliyopo Mkoa wa Lindi Bi Regina Chonjo akiongea na wananchi kuhusu mikakati mbadala ya kusukuma maendeleo ya kiuchumi kupitia fursa zilizopo wilayani humo,mkutano huo umefanyika katika ukumbi wa TTC wilayani humo.

Wananchi wa Wilaya ya Nachingwea wakiagana na Mkuu wa Wilaya yao Bi Regina Chonjo punde baada ya kumaliza mkutano wa pamoja.

Hakunagaa....!

MADIWANI KILWA WATAKIWA KUHAMASISHA WANANCHI KUJITOKEZA KWA WINGI KWENYE ZOEZI LA SENSA-RC LINDI

Mkuu wa mkoa wa Lindi MH.Ludovick Mwananzila akizungumza kwenye baraza la madiwani wa Wilaya ya Kilwa kuhusu uhamasishaji wa wananchi kujitokeza kwenye zoezi la kuhesabiwa litakalofanyika kitaifa nchi nzima,madiwani hao wanaendelea na kikao cha kazi wilayani humo.


Madiwani wa Wilaya ya Kilwa wakimsikiliza Mkuu wa Mkoa Mh.Ludovick Mwananzila hayupo pichani wakati akishiriki kwenye kikao cha baraza hilo.


Mkuu wa Mkoa wa lindi Mh.Ludovick Mwananzila ametoa rai hiyo mbele ya kikao cha baraza la madiwani wa Wilaya ya Kilwa,kuwahamasiha wananchi wengi kujitokeza na kutoa taarifa sahihi kwa maafisa watakao kuwa na jukumu,ili kufanya zoezi kuwa na tija kwa taifa siku ya tarehe 26/08/2012.
mkutano huo wa kitendaji wa baraza la madiwani unaendelea katika ukumbi wa Jumba la Maendeleo chini ya uenyekiti wa Mh.Farida Kikoleka-makamu mwenyekiti wa halmashauri ya wilaya ya kilwa

WAZAMBIA KUJIFUNZA USIMAMIZI WA HUDUMA ZA MATIBABU KUPITIA NHIF TANZANIA

Mkurugenzi Mkuu wa Mfuko wa Taifa wa Bima yaAfya,Dr. Emanuel Humba akizungumza na Ujumbe kutoka Zambia ambao umefika kwa lengo la kujifunzanamna Mfuko huo unavyofanya kazi hapa nchini.

Naibu Mkurugenzi Mkuu wa Mfuko wa Taifa waBima ya Afya,bwn. Hamis Mdee akitoa maelezo ya namna NHIF inavyofanya kazi kwa ujumbe huo muda mfupi kabla ya kuanza mafunzo.

MFUKO wa Taifa wa Bima ya Afya (NHIF), umeziomba nchi za Ukanda wa Afrika Mashariki na Kati kubadilishana uzoefu katika kuwahudumia wananchi wao kwenye setka ya afya.
Ombi hilo limetolewa na Mkurugenzi Mkuu wa Mfuko wa Taifa wa Bima ya Afya Bwana Emanuel Humba wakati akizungumza na ujumbe kutoka Zambia ambao upo hapa nchini kujifunza kuhusu utendaji wa Mfuko huo.

Bwana Humba amesema nchi za Afrika Mashariki na Kati zina mazingira yanayofanana na zina changamaoto sawa za utoaji wa huduma za kijamii ikiwemo afya, hivyo ni vizuri kubadlishana uzoefu katika kuzikabili.
Amesema ili huduma za afya zitolewe kwa mafanikio ni vema watendaji wa sekta ya Afya katika Ukanda wa Afrika Mashariki na Kati wakajenga mazoea ya kukutana na kubadilishana uzoefu mara kwa mara.
Naye Kiongozi wa Ujumbe huo kutoka Zambia, Bwana Mubita Luwabelwa amekiri kuvutiwa na utendaji na mafanikio ya Mfuko wa Taifa wa Bima y Afya (NHIF) na ndio sababu iliyowafanya wakaja kujifunza kutoka hapa nchini ili waweze kutoa huduma bora kwa wananchi wao kama NHIF inavyofanya hapa nchini.
Bwana Luwabelwa amesema yeye na ujumbe wake wanaona fahari kupata fursa ya kujifunza kutoka kwa nchi nyingine ya ukanda wa Afrika Mashariki badala ya kwenda nchi za magharibi kwa kuwa nchi hizi zina mazingira yanayofanana.
Ujumbe huo wa watu wanne ambao utakuwa hapa nchini kwa siku nne umewasili hapa nchini Jumapili, unajumuisha maofisa kutoka Wizara ya Afya, Wizara ya Fedha na Muungano wa Vyama vya Wafanyakazi nchini Zambia.
Kwa upande wake Balozi wa Zambia nchini Tanzania, Judith Kangoma amesema kitendo cha ujumbe wa Wazambia kuja kujifunza ni mwendelezo wa ushirikiano wa muda mrefu baina ya nchi mbili hizo.
“Tunayo mifano mingi ya ushirikiano wetu na Tanzania kama reli ya TAZARA na bomba la mafuta la TAZAMA hivyo ujumbe huu kuja kujifunza kuhusu uendeshaji wa Mifuko ya Afya ni jambo la msingi kwa kuwa Tanzania imefanikiwa sana katika suala hili,” alisema Balozi.
Alisema anaamini kuwa baada ya ujumbe huu kujifunza na kupata uzoefu kutoka NHIF, watatumia uzoefu huo katika kuendeleza shughuli za uendeshaji wa Mifuko ya Afya nchini Zambia.

MADIWANI MERU WACHARUKA WATOA MWEZI MMOJA GARI LA WAGONJWA KUTOA HUDUMA

Na Gladness Mushi wa Fullshangwe-Arusha.

BARAZA la madiwani la halmashauri ya wilaya ya Meru wilayani Arumeru mkoani Arusha limetoa mwezi mmoja kwa idara ya Afya katika halmashauri hiyo kuhakikisha kuwa gari la kubebea wagonjwa (Ambulance) liwe limeshatoka kwenye matengenezo na kuanza kutoa huduma kwa wananchi wake.

Hayo yameelezwa hivi karibuni katika baraza la madiwani hao lililofanyika katika ukumbi wa halmashauri hiyo, kutokana na kuwa Ambulance hiyo imekuwa ikifanyiwa matengenezo kwa muda mrefu sana na wagonjwa kuendelea kuteseka sana hususani wanawake .

Akizungumza katika baraza hilo,Mwenyekiti wa halmashauri hiyo, Godson Majola alisema kuwa , lazima idara hiyo ihakikishe kuwa inafanya liwezekanalo ndani ya mwezi mmoja gari la kubebea wagonjwa liwe limeshatengemaa na kuhudumia wagonjwa kama kawaida kwani wengi wao wanapata shida kubwa sana.

Alisema kuwa,kutokana na kuwepo kwa adha ya gari la kubebea wagonjwa katika wilaya hiyo , wagonjwa wamekuwa wakitumia bajaji kupelekwa hospitali hali ambayo amesema kuwa haisaidii kabisa kwani bajaji hazina uwezo wa kumwahisha mgonjwa aliyezidiwa hospitali.

Aliongeza kuwa, hali hiyo imechangia kwa kiasi kikubwa sana kuzorota kwa huduma za afya katika hospitali mbalimbali kutokana na kutokuwepo kwa usafiri huo na hivyo kuwapelekea wananchi kupata hadha kubwa , kwani bajaji zinazotumika hazifai na wala hazirahisishi huduma kwa wagonjwa hao.

Akichangia mada katika baraza hilo,Diwani wa kata ya Makiba wilayani Arumeru , Mwanaidi Hamis Kimu alisema kuwa, kukosekana kwa gari hiyo ya kubebea wagonjwa imepelekea wanawake kuendelea kuteseka zaidi hususan kipindi cha kutaka kujifungua huku ikilinganishwa kuwa wengi wao wanaishi maeneo yaliyo mbali.

Alisema kuwa, ni vizuri gari hilo likafanyiwa marekebisho haraka iwezekanavyo ili kuokoa maisha ya watu walio wengi ambao ndio wanateseka , wakati gari hilo likiendelea kufanyiwa marekebisho kwa muda mrefu sasa likifanyiwa matengenezo bila kuwepo kwa taarifa za uhakika.

'Ninaombeni jamani tuwe makini na maisha ya wananchi wetu kwani wanaoteseka zaidi ni wanawake wanapoenda kupata huduma za matibabu hususani wanawake wajawazito, kwani wengi wao wamekuwa wakijifungulia hata njiani jamani kutokana na kuwepo kwa changamoto hiyo,naomba idara husika ihakikishe ndani ya huo mwezi gari ifanze kazi ya kuhudumia wananchi 'alisema Mwanaidi.

Katika hatua nyingine , baraza hilo limeagiza kamati ya fedha katika halmashauri hiyo kushughulikia kwa haraka utata unaojitokeza kwenye masoko mbalimbali ya wilaya hiyo ,kutokana na kuwepo kwa malalamiko kutoka kwa baadhi ya wafanyabiashara wadogo wadogo kutozwa ushuru mara mbili.

Aidha kufuatia utata huo, baraza hilo limeitaka kamati kuweka mipango madhubuti ambayo itaondoa utata huo na kuweka utaratibu utakowezesha wafanyabiashara kulipa ushuru mara moja tu .

Kwa upande wake, Mkugenzi wa halmashauri hiyo,Trisias Kagenzi amelieleza baraza hilo kuwepo kwa utaratibu wa kupandisha mishahara na vyeo kwa watumishi wote wa serikali katika halmashauri hiyo kutokana na serikali kuu kurudisha mamlaka hiyo kwenye halmashauri.

Alisema kuwa, hatua hiyo itasaidia kwa kiasi kikubwa sana kurahisisha usumbufu uliokuwepo kwa wafanyakazi hao kufuata fedha zao hazina na wakati mwingine kukuta fedha zao hazijaiingia benki, hivyo kupitia mfumo huo utarahisisha kwa kiasi kikubwa sana wafanyakazi kuweza kupata haki zao kwa wakati na kuondoa malalamiko.

WIZARA YA AFYA NA USTAWI WA JAMII YAFANYA MAZUNGUMZO NA UJUMBE KUTOKA UHOLANZI KUJADILI MABORESHO KATIKA SEKTA YA AFYA

Watendaji wakuu wa Wizara ya Afya na Ustawi wa Jamii wakiwa katika picha ya pamoja na ujumbe wa Biashara na Uwekezaji katika huduma za afya kutoka nchini Netherland .



Meneja Mkuu na mmiliki wa Hospitali zinazojengwa kwa kutumia makontena (Hospitainer) na kuweza kupelekwa kutoa huduma za afya maeneo yoyote kutoka nchini Netherland Bw. Rolof Mulder akiongea na watendaji wa wizara ya Afya na Ustawi wa Jamii kuelezea namna kampuni hiyo inavyofanya kazi zake.


Kaimu mgaga mkuu wa serikali Dkt. Donan Mmbando akizungumza na ujumbe wa Biashara na Uwekezaji katika huduma za afya kutoka nchini Netherland mara baada ya ujumbe huo kuwasili makao makuu ya Wizara ya Afya na Ustawi wa jamii jana jijini Dar es Salaam.

SMZ KUANZISHA MFUKO WA BIMA YA AFYA ILI KUWASAIDIA WANANCHI WAKE.

Na Khadija Khamis –Maelezo Zanzibar

Serikali ya Zanzibar inatarajia kuanzisha mfuko wa bima ya afya ili kuweza kuwaondolea usumbufu wa tiba wananchi wake .

Hayo yamesemwa katika ukumbi wa Baraza la Wawakilishi na Naibu Waziri wa Afya, Dk. Sira Ubwa Mamboya wakati akijibu suala la Jaku Hashim Ayoub Mwakilishi wa Jimbo la Muyuni aliyetaka kujua uanzishwaji mfuko wa bima ya afya kwa Zanzibar.

Dk. Sira alisema kwamba uanzishwaji wa huduma ya bima ya afya kwa Zanzibar ni tayari na hivi sasa iko katika hatua za awali za kufanya tafiti za kuweza kujua utayari wa uwezo wa wananchi .

Alisema kuwa mfuko wa Taifa wa Bima ya Afya imeshawapatia mafunzo wafanyakazi wa Wizara ya afya Zanzibar juu ya jinsi ya kuendeleza mfuko huo kwa hospitali zote za serikali Binafsi na NGO kwa unguja na Pemba .

Dk. Sira alisema mfuko wa bima ya afya ya Zanzibar umeshafungua ofisi yake na kuweza kuwajiri wafanyakazi wake wakiwemo daktari, muhasibu, na dereva .

Aidha alisema kuwa tumaini ni kwamba mfuko huo utafanyakazi vizuri kwa lengo la kuziwezesha hospitali za Serikali za Unguja na Pemba ziweze kunufaika na huduma hiyo.

Akieleza dhamana ya uazishwaji wa mfuko huo alisema itasimamiwa na Ofisi ya Rais, Utumishi wa Umma na Utawala Bora.

Kwa upande wa mfuko wa bima wa taifa,alisema tayari umeanza kufanya kazi zake Zanzibar kuanzia mwaka 2007 na una jumla ya wanachama 5,393 ukichanganya pamoja na familia zao idadi inafikia 28,044 wanafaidika na mfuko huo.

WAZIRI MKUU PINDA AWEKA JIWE LA MSINGI HOSPITALI YA ENDIMENT

FURSA YENYE TIJA: TAFAKURI YA UTUMISHI WANGU KAMA NAIBU KATIBU MKUU WA UMOJA WA MATAIFA”

Hakika kila chenye mwanzo hakikosi mwisho, na kila mwisho wa jambo moja huwa mwanzo wa jingine. Ingawa huenda ni mapema sana kwangu kutoa tafakuri kamili ya muhula wangu katika nafasi ya Naibu Katibu Mkuu wa Umoja wa Mataifa, hapana shaka kabisa kuwa nafasi hiyo imenipa uzoefu maridhawa. Namshukuru Katibu Mkuu BAN Ki-moon kwa kunipa fursa hii, kuniamini na kwa ushirikiano mkubwa wakati wote wa utumishi wangu.

Kukitumikia chombo hiki cha kimataifa kwa muda wa miaka mitano na nusu mfululizo ni heshima ya pekee ambayo daima nitaienzi kama kilele kimojawapo cha maisha yangu ya utumishi wa umma. Kila siku niliyoitumia katika Umoja huo ilikuwa ni darasa la kusukuma mbele mipaka ya ujuzi na elimu. Nimepata kufahamu mengi zaidi kuhusu Shirika lenyewe; kuhusu dunia na watu wake, lakini pia kufahamu ukomo wa uwezo wa Umoja wa Mataifa katika kushughulikia changamoto mbali mbali zinazoikabili dunia yetu.

Utumishi wangu katika Umoja wa mataifa ulikuwa fursa adhimu iliyonipa uzoefu wa pekee. Kazi hii imeujaza moyo wangu na unyenyekevu wa dhati kwani niliingia Umoja wa Mataifa wakati ambapo dunia inachagizwa na madhila makubwa makubwa yakiwemo maradhi, umaskini wa kupindukia, kutokuwapo kwa usawa wa kijinsia, kuongezeka kwa vitendo vya ukatili na udhalilishaji kwa wanawake na watoto; na changamoto nyingine nyingi. Kwa muktadha huu ilikuwa fursa ya pekee kuchangia juhudi za pamoja za kuimarisha Umoja wa Mataifa katika kutekeleza majukumu yake katika kipindi cha mazingira magumu ya kimataifa yaliyojaa changamoto za kipekee kabisa.

Daima nitaendelea kushukuru na kuthamini kwa dhati jinsi Mhe. Rais Jakaya Mrisho Kikwete, Serikali na Watanzania wenzangu walivyonitia moyo na kunienzi katika kipindi chote nilichokuwa Umoja wa Mataifa. Familia yangu, ndugu na marafiki walikuwa karibu nami kwa dua na kunitia nguvu wakati wote wa utumishi wangu. Nawashukuru sana.

Hapana shaka kazi yangu katika Umoja wa Mataifa imeniwezesha kufahamiana kwa karibu na viongozi wengi wa kimataifa na pia watu mbali mbali waliopata mafanikio makubwa duniani. Nimeweza kufahamu kwa undani thamani ya michango yao katika kujenga amani na ustawi wa dunia.

Zaidi ya yote, sitasahau hisia nilizopata kila nilipokutana na watu wanyonge waliokuwa wanahitaji msaada wa Umoja wa Mataifa. Nitakumbuka daima tabasamu ya mwanamke mmoja niliyekutana naye katika moja ya ziara zangu barani Afrika nilipotembelea zahanati mojawapo kati ya kadhaa zinazofadhiliwa na Umoja wa Mataifa. Mama huyo mwenye watoto sita, alikuwa amekikumbatia kitoto chake kimoja kilichokuwa nyonde nyonde; lakini alikuwa na tabasamu iliyojaa faraja na matumaini kwa kuwa alikuwa amefanikiwa kupata bure dawa za kunusuru maisha ya mwanawe.

Maendeleo

Nafasi ya Naibu Katibu Mkuu wa Umoja wa Mataifa iliasisiwa na Baraza Kuu la Umoja wa Mataifa mwaka 1997 kwa madhumuni ya kuongeza ufanisi wa utendaji wa Sekretariati na kuimarisha uongozi wa Umoja Mataifa katika medani za uchumi na maendeleo ya jamii. Majukumu ya Naibu Katibu Mkuu yaliongezeka kadri Shirika lilivyokuwa linapanua shughuli zake. Hatimaye Naibu Katibu Mkuu akakabidhiwa jukumu la kuoanisha na kuratibu idara zote zilizo chini ya mwavuli wa Umoja wa Mataifa. Jukumu hili lilikuwa na manufaa makubwa, hususan tulipoingia katika utekelezaji wa dhana ya “Huduma ya Pamoja ” (Delivering as One - DaO) ili kuleta ufanisi zaidi katika kazi zetu hususan za maendeleo.

Kwa bahati nzuri, ninamaliza kipindi changu kukiwa na maendeleo mazuri yanayotokana na jitihada za kimataifa za kupambana na umaskini. Takwimu za kuaminika za hivi karibuni zinatuambia kuwa juhudi zetu za kupunguza idadi ya watu maskini duniani kufikia angalau nusu ya viwango vya sasa zimeanza kuzaa matunda. Taarifa hii ni ya kutia moyo licha ya ukweli kwamba dunia inapitia dhahama kubwa ya kiuchumi kuliko wakati mwingine wowote katika miaka ya hivi karibuni. Pamoja na majukumu mengine,nguvu zetu tulizielekeza zaidi kwenye kufanikisha malengo ya maendeleo ya milenia na malengo mengine ya maendeleo yaliyokubaliwa kimataifa. Nilihamasika sana na dhamira waliyoionesha wadau na washirika wetu wa maendeleo: serikali, mashirika ya kiraia na mashirika ya biashara. Kwani wote kwa pamoja waliyatumia malengo hayo kama kilingo cha msingi katika kutokomeza umaskini.

Katika kufanikisha utekelezaji madhubuti wa malengo ya maendeleo ya milenia nilipewa jukumu la kukamilisha ahadi ya Katibu Mkuu aliyoitoa kwa nchi wanachama ya kuunda Mfumo Kamilifu wa Utekelezaji wa Malengo ya Maendeleo ya Milenia (MDGs Integrated Implementation Framework ). Ninaona fahari kwamba naondoka Umoja wa Mataifa mfumo huu ukiwa umekamilika ambapo Katibu Mkuu aliuzindua mwezi Juni mwaka huu. Kwa mara ya kwanza mfumo huu umeweka utaratibu ambao utauwezesha Umoja wa Mataifa na wadau wote kufuatilia mwenendo wa utekelezaji wa ahadi za kisera na kifedha. Hapana shaka utaratibu huu utaongeza uwajibikaji wa wadau na upimaji sahihi wa hatua za maendeleo.

Malengo ya Maendeleo ya Milenia (MDGs) Barani Afrika

Kwa mwelekeo huo huo, Katibu Mkuu alizindua Jopo la Viongozi la Kuhimiza Utekelezaji wa Malengo ya Maendeleo ya Milenia Barani Afrika (MDG Africa Steering Group) mwezi September 2007. Kikundi hiki kinajumuisha taasisi zote kuu duniani zilizo mstari wa mbele katika kuchochea kasi ya maendeleo ya Afrika. Nilipata bahati ya kukiongoza kikosi-kazi (MDG Africa Working Group) kilichokuwa mhimili wa Jopo hilo la viongozi. Baada ya miaka mitano ya majadiliano ya kina, Jopo hilo likiongozwa na Katibu Mkuu limetoa mapendekezo kamambe ya utekelezaji. Endapo mapendekezo haya yatazingatiwa basi yatakuwa nyenzo muhimu ya kuweka sera na mikakati madhubuti itakayosaidia maendeleo katika nchi husika na duniani kwa ujumla. Napenda kutoa mwito kwa wadau wote kuyapa umuhimu mapendekezo haya.

Ninafahamu kwamba tathmini kamili ya mafanikio ya utekelezaji wa Malengo ya Maendeleo ya Milenia imepangwa kufanyika Septemba mwaka 2013. Hata hivyo tayari tunaweza kusema kuwa Malengo haya yameleta mabadiliko chanya katika maisha ya watu wa kawaida sehemu nyingi duniani, hususan barani Afrika. Ni dhahiri kuwa jamii nyingi zimenufaika na utekelezaji wa malengo ya maendeleo ya milenia sio kwa kufanyiwa hisani bali kwa wao wenyewe kuwa na mikakati maalum ya kupiga hatua madhubuti za kujiletea maendeleo stahimilivu na yaliyolenga kuleta usawa baina ya watu.

Mkutano wa Rio + 20

Ni jambo la kutia moyo kwamba maendeleo shirikishi na yenye kuleta usawa ni baadhi ya masuala muhimu yaliyojadiliwa katika mkutano wa Rio +20 uliomalizika hivi karibuni. Suala hili litachukua nafasi kubwa pia katika kuandaa mfumo wa maendeleo unaotarajiwa baada ya mwaka 2015, mwaka uliokusudiwa kufikia malengo ya maendeleo ya milenia. Nilipokabidhiwa jukumu la kuratibu maandilizi ya ushiriki wetu kwenye mkutano wa Rio+20 nilitiwa moyo na nia ya dhati ya mashirika ya Umoja wa Mataifa ya kubuni mkakati wa pamoja wa kutekeleza maazimio ya Rio+20. Napenda kuzishukuru nchi wanachama kwa kufikia makubaliano katika masuala mengi yaliyojadiliwa Rio licha ya changamoto nyingi zinazotokana na mtikisiko wa uchumi duniani. Ninafurahi kwamba maazimio ya mkutano huu yatachangia upatikanaji wa maendeleo stahimilivu, shirikishi na yenye kuleta usawa na hususan kuhakikisha kunakuwa na mustakabali mzuri kwa wanawake na wasichana.

Uwezeshaji wa wanawake na usawa wa kijinsia

Tukirejea kwenye suala hili, hata baada ya Mkutano wa Rio + 20 tutawajibika kuendelea na juhudi za uwezeshaji wa wanawake na kuleta usawa wa kijinsia. Wakati wa utumishi wangu Umoja wa Mataifa tumefanya bidii kubwa na kutumia muda mwingi kushughulikia suala hii. Tumetumia hadhi na ushawishi wa ofisi yetu kupaza sauti za wanawake na wasichana na kukuza ushiriki wao katika jamii. Tumeendesha kampeni za kupiga vita ukatili kwa wanawake na wasichana. Tumezihimiza mamlaka katika ngazi za kitaifa na kimataifa kutunga sera na sheria zinazozingatia haki za wanawake na usawa wa kijinsia, na tumetaka wapewe fursa kushika nafasi za uongozi katika jamii. Ndiyo maana kwa upande wetu hatukuweka koleo chini hadi pale tulipokamilisha uanzishwaji wa idara inayojulikana kwa kifupi kama “UN Women” mnamo Julai 2010. Hii ni idara ya Umoja wa Mataifa iliyoundwa kwa madhumuni ya kuongoza masuala ya wanawake na usawa wa kijinsia kwa umakini na ufanisi zaidi kuliko hapo awali. Tumefanya jitihada hizi kwa kuamini kuwa hakuna uamuzi wowote ule, uwe mdogo au mkubwa, unaofanywa na Umoja wa Mataifa bila ya kuzingatia maendeleo na ustawi wa wanawake na wasichana.

Huduma ya Pamoja

Kwa upande mwingine ninapenda kuwapongeza kwa dhati wenzangu wote waliomo katika utumishi wa Umoja wa Mataifa,wake kwa waume,walioutumia ujuzi na weledi wao wote kuchangia maendeleo ya nchi na jamii tunazozihudumia. Natoa shukrani za pekee kwa wale wote waliopo kwenye ofisi na vituo vya Umoja wa Mataifa nje ya Makao Makuu na ambao wanafanya kazi katika mazingira magumu na yenye changamo nyingi. Hao wote wanadhihirisha umuhimu wa kuwapo kwa Shirika hili kama chombo cha kuhimiza maendeleo katika ngazi zote za kitaifa, kikanda na kimataifa. Katika kutekeleza dhana ya “Huduma ya Pamoja” (Delivering as One) Waratibu Wakaazi wa Umoja wa Mataifa wamekuwa na mchango muhimu sana.Uratibu wao umeongeza ubora na wepesi wa utoaji huduma kwa nchi wanamowakilisha Shirika. Hatuna budi kuwashukuru kwa mchango wao mkubwa katika kufanikisha dhana ya “Huduma ya Pamoja”. Ni dhahiri kwamba uwezo wa nchi mwanachama kumiliki mchakato wa maendeleo yake unakuwa imara zaidi pale ambapo kuna mtiririko mzuri wa huduma za Umoja wa Mataifa na fursa za kukuza ushirikiano endelevu na wadau wengine wa maendeleo. Wakati uamuzi rasmi kuhusu maendeleo ya dhana hii ukisubiri kukamilika kwa majadiliano ya nchi wanachama, ninaamini kwa dhati kuwa utaratibu wa kutoa “Huduma ya Pamoja” kupitia mpango mmoja uliokubaliwa na wote ni mwelekeo sahihi na wenye tija.

Nchini mwetu Tanzania, mashirika ya Umoja wa Mataifa yamekuwa yakifanya kazi kwa ushirikiano wa karibu sana toka mwaka 2011 kupitia mpango mmoja uitwao “Mpango wa Umoja wa Mataifa wa Kusaidia Maendeleo” (United Nations Development Plan – UNDAP). Mpango huu unakwenda sambamba na mwaka wa fedha wa Serikali yaani Julai 1 hadi Juni 30 na kwa mantiki hiyo kuuwezesha kuzingatia vipaumbele vya Serikali. Kupitia mpango huu Umoja wa Mataifa umejiwekea utaratibu wa kujipima na kujitathmini ambao unatoa fursa kwa hatua za haraka kuchukuliwa inapobidi. Utaratibu huu unapatikana kwenye tovuti. Kwa upande wa uendeshaji, mfumo huu wa utendaji kazi kwa pamoja umetuwezesha kutekeleza majukumu mengi kwa kutumia raslimali chache ambapo“ziada” iliyopatikana imeelekezwa kwenye shughuli nyingine za maendeleo.

Afya ya Jamii

Katika eneo la afya, ambamo wanawake na watoto ndiyo wanaathirika zaidi, hatua muhimu zinachukuliwa kupunguza vifo na kuhakikisha kwamba kila mwanamke na kila mtoto anakingwa na maradhi, hususan kuzuia maambukizi ya virusi vya UKIMWI kutoka kwa mama kwenda kwa mtoto. Tukiwa Nairobi Aprili mwaka 2011, Katibu Mkuu Ban Ki-moon, Michel Sidibe, Mkurugenzi Mwendeshaji wa Shirika la Umoja wa Mataifa linaloshughulikia UKIMWI (UNAIDS) pamoja nami tulishuhudia mfano hai wa jitihada za Umoja wa Mataifa. Tulipata fursa ya kukutana na mwanamke aliyeathirika na virusi ambaye alijaaliwa kupata mapacha watatu waliozaliwa bila ya maambukizi. Nikiwa mjumbe wa Kamisheni ya Umoja wa Mataifa iliyoshughulikia taarifa na uwajibikaji katika masuala ya afya ya mama na mtoto (Commission on Information and Accountability on Women's and Children's Health) ambayo iliendeshwa kwa umahiri na Rais Kikwete wa Tanzania na Waziri Mkuu Harper wa Canada, nina imani kwamba jumuiya ya kimataifa hivi sasa imepata mfumo madhubuti utakaohakikisha kwamba kunakuwa na ufuatiliaji, usimamizi na uwajibikaji kuhusu afya ya mama na mtoto. Hakuna shaka kwamba mfumo huu utafikia hatua ya utekelezwaji siku za hivi karibuni.

Hali kadhalika, kazi nzuri imekuwa ikifanywa na Mkurugenzi Mwendeshaji wa Shirika la Mpango wa Uzazi Duniani (UNFPA), Babatunde Osotimehin, na Margaret Chan, Mkurugenzi Mkuu wa Shirika la Afya Duniani (WHO) ya kuboresha afya ya mama na mtoto. Matokeo ya jitihada za wenzangu hawa yalikuwa chachu ya utekelezaji wa majukumu ya Naibu Katibu Mkuu katika nyanja zote za maendeleo. Ama kwa hakika matunda ya kazi zao yanaimarisha imani yangu kuwa Umoja wa Mataifa ni Shirika lenye umuhimu mkubwa; na kwamba mchango wetu, japo mdogo, unasaidia sana katika kufikia malengo ya maendeleo ya milenia. Nilijawa na imani kama hiyo nikiwa katika ziara nyingine za kikazi. Kwa mfano nikiwa Montevideo, Uruguay, Novemba 2011, pamoja na wenzangu Michelle Bachelet, Helen Clark na Alicia Barcena, tulisimama kidete kuunga mkono kampeni ya kitaifa ya kupiga vita vitendo vya ukatili kwa wanawake.

Nilipozuru Haiti mwezi Aprili2010, miezi michache baada ya tetemeko ambalo lilikuwa kubwa kuliko yote yaliyowahi kutokea nchini humo kwa kipindi cha takriban karne moja, nilikutana na watu ambao walikuwa wameathirika vibaya sana: waliopoteza familia nzima, waliopata ulemavu wa maisha, waliopoteza mali zao zote! Lakini bado watu hawa walikuwa na nyuso za matumaini wakitarajia mchango wa Umoja wa Mataifa na wa wadau wengine wa jumuiya ya kimataifa. Mnamo Novemba 2010 tulizuru Laos, ambako Umoja wa Mataifa unashirikiana kwa karibu na Serikali na wadau wengine wengi katika utoaji wa misaada muhimu ya maendeleo ikiwa ni pamoja na kuisaidia Laos kupambana na janga la mabaki ya mabomu ya “cluster munitions”.

Hii ni mifano michache tu inayojibu hoja za wakosoaji wa Umoja wa Mataifa.Ujumbe wangu kwao ni huu: wanyonge na wenye kutaabika sehemu zote duniani ni mashuhuda na watetezi wakubwa wa Umoja wa Mataifa. Kwa wanyonge na wahitaji walio wengi Shirika hili ni nguzo ya kutumainiwa katika jitihada zao za kila siku za kujiletea maisha yenye utu na heshima.

Mageuzi katika menejimenti na usimamizi wa mabadiliko

Ukweli huu haumaanishi kuwa Umoja wa Mataifa hauna kasoro au upungufu. La hasha! Ndiyo maana wakati wa utumishi wangu tulijielekeza kikamilifu kwenye kuboresha masuala ya utawala, uendeshaji na namna tunavyofanya kazi. Ni wazi kwamba hivi sasa Umoja wa Mataifa umebadilika kutoka chombo cha huduma za mikutano na kuwa mtendaji mwenye majukumu muhimu nje ya kumbi za mikutano. Kwa ushirikiano na msaada maridhawa wa wafanyakazi wenzangu, tulijikita katika kuhamasisha mabadiliko ya kiutendaji katika Umoja wa Mataifa, ikiwa ni pamoja na kujenga desturi ya uwajibikaji, uadilifu na kufanya kazi kwa tija zaidi huku tukitumia rasilmali chache.

Ilitubidi pia kuweka mifumo thabiti ya kusimamia mabadiliko yaliyokuwa yakijitokeza. Katika kufanya hivyo tulitambua wazi kwamba hakukuwa na njia ya mkato wala njia mbadala ya kuliimarisha Shirika letu na kulifanya liwe la kisasa zaidi katika kutekeleza majukumu yake.Tulihakikisha kwamba utendaji kazi wetu unakwenda sambamba na changamoto zilizopo, lakini pia tulizingatia ufinyu wa bajeti, misimamo tofauti na wakati mwingine inayaokinzana ya nchi wanachama wa Umoja wa Mataifa. Katika hali hii ilitulazimu kuwa wabunifu zaidi ili kuleta muafaka baina ya nchi wanachama na kuhakikisha kwamba raslimali chache zilizopo zinatoa tija kubwa zaidi.

Wafanyakazi ndiyo rasilmali kubwa kupita zote. Hivyo kila tulipoendelea na jitihada za kuboresha Shirika ilitubidi kuwekeza vilivyo kwa wafanyakazi wa Umoja wa Mataifa kwa kuwapatia fursa za mafunzo na msingi imara wa maendeleo yao kazini. Ni jambo lililo dhahiri kuwa wafanyakazi wa Umoja wa Mataifa wanatekeleza majukumu yao katika mazingira hatarishi na yenye kubadilika mara kwa mara. Tunafahamu, tena kwa uchungu mkubwa, kuwa Bendera ya Umoja wa Mataifa - “bendera ya bluu” - hivi sasa si kinga tena. Haituhakikishii usalama kwani wengi wa watumishi wetu mahiri wamekuwa wahanga wa matukio ya kikatili ya ugaidi. Nilishuhudia tukio la aina hii huko Abuja, Nigeria, ambako watumishi wenzetu walipoteza maisha kutokana na shambulio la kigaidi la tarehe 26 Agosti 2011. Na mara nyingi wenzetu wanapotangulia mbele ya haki, wapendwa wao wanaachwa katika hali ngumu ya maisha. Ni faraja kubwa kwangu kuwa miongoni mwa masuala ambayo tuliyasimamia kabla ya kumaliza utumishi wangu ni kuanzisha mchakato wa kubaini namna bora ya kuwasaidia wahanga wa majanga hayo pamoja na familia zao.

Utawala wa sheria

Mojawapo ya majukumu ya Umoja wa Mataifa ni kukuza sera zinazolenga kulinda haki za binadamu na kuendeleza utawala wa sheria katika ngazi za kitaifa na kimataifa. Leo hii, nchi nyingi zimelipa kipaumbele suala la kuimarisha utawala wa sheria, hususan kufuatia umuhimu wake katika ajenda za ujenzi wa amani (peace-building) na maendeleo stahimilivu. Kwa mantiki hiyo, nilifurahi nilipopata fursa ya kusimamia ujenzi wa mfumo madhubuti wa sera na mwongozo wa utekelezaji wa shughuli za utawala wa sheria nikishirikiana na nchi wanachama. Kwa upande wao nchi wanachama zimepanga kufanya mkutano wa ngazi ya juu wakati wa kikao cha Baraza Kuu la Umoja wa Mataifa mwezi Septemba 2012. Nia kubwa ni kuendeleza jitihada katika suala hili ili kukuza heshima ya watu wote duniani na kujenga amani kati ya mataifa.
Hitimisho

Japokuwa muda wangu wa utumishi katika Umoja wa Mataifa umefikia tamati, naamini hakuna tamati katika utekelezaji wa malengo, misingi na maadili ya Umoja wa Mataifa. Ili mradi bado kuna umaskini duniani na mahitaji ya chakula; bado kuna changamoto ya kutunza utu na heshima ya binadamu na haja ya kuimarisha amani duniani basi hakika nitaendelea kuunga mkono jitihada, misingi na malengo ya Umoja wa Mataifa popote pale nitakapokuwa. Kwani ni dhahiri kwamba njia bora ya kukabiliana na changamoto kubwa zilizo mbele yetu ni kujenga ubia na ushirikiano wa karibu baina ya serikali, asasi za kiraia, wafanyabiashara, mashirika ya hisani, taasisi za kitaaluma na watu binafsi.

Aidha, ninaaamini kuwa vijana, kizazi ambacho kina kila sababu ya kuwa na kiu ya kuishi kwenye dunia yenye utu, usawa, haki na amani, watauchukulia Umoja wa Mataifa kuwa mbia wa kuaminika katika kujenga mustakabali wao.


Asha-Rose Migiro

FINANCIAL SUSTAINABILITY AND AFFORDABILITY OF HEALTH-CARE SYSTEM

On average, OECD countries are currently spending almost 10 per cent of the gross domestic product (GDP) on health. In the future, health spending will be a greater part of the economy than it is now, for reasons including technological change, consumer preferences, relative productivity growth and (though to a surprisingly small extent) population ageing. Health will therefore be one of the major drivers of economic growth.

Introduction

There is scarcely a week that goes by without some European country or another reporting that it is cutting spending on health, as part of the attempt to get public spending back in line with tax receipts. This is hardly surprising given pictures such as the one in Figure 1 below: growth in virtually every part of government is minimal – or is negative – in order to be able to pay for the big growth in health spending in the Netherlands in the next few years. The Dutch pattern may be relatively extreme (health spending has been going up particularly rapidly recently) but would be recognized by ministries of finance in many other countries.



Figure 1



Yet there is an apparent paradox here. In the future, health spending will be a greater part of the economy than it is now, for reasons including technological change, consumer preferences, relative productivity growth and population ageing. Health will therefore be one of the major drivers of economic growth. Health spending which seems unsustainable given the state of public budgets cannot also be the driver of economic prosperity in the future, can it?

The problem facing many European health systems is one of fiscal unsustainability. Claims that health spending is good value for money compared to many other things that people purchase are beside the point. Fiscal sustainability needs to be restored in the short term and once this is done, there will still remain the longer term challenge of ensuring economic sustainability, which requires a different agenda of policies – to ensure value for money.

What do we currently spend?

On average, OECD countries are currently spending almost 10 per cent of the gross domestic product (GDP) on health. However, there is almost a three-fold variation between the largest and smallest spenders with Turkey spending approximately 6 per cent of GDP on health and the United tates (US) over 17 per cent (Figure 2).



Figure 1

The public sector is the main source of health financing in OECD countries, and has consistently accounted for 72 per cent of health expenditure over the past twenty years. In 2009, governments accounted for 80 per cent or more of health expenditure in one-third of OECD countries (OECD, 2011a).

Some non-OECD countries such as Brazil and South Africa have levels of health expenditure on a par with OECD countries, both spending around 9 per cent of GDP. Others such as China and Russia spend about half the OECD average while lower-income economies such as India and Indonesia spend substantially less (4 per cent and 2.4 per cent respectively). These expenditure patterns can be partly explained by the observation that as countries grow richer, they tend to spend more on health.

Health spending increased faster than GDP in almost all OECD countries during the past 15 years. However, we can distinguish different patterns among countries. Some countries with low initial levels of funding deliberately increased spending on health in order to bring their health systems up to OECD standards of care and access, thus creating a “catch up effect”. The Republic of Korea and Turkey, for example, saw significant reforms to increase the health-care coverage of the population. There were also rapid increases in health spending in some of the eastern European countries. On the contrary several other countries (e.g. Germany, France and Switzerland), implemented cost-containment measures and more or less succeeded in maintaining health spending growth at the same pace of GDP growth.

What will happen to health spending in the future?

For something so important, surprisingly little is known about the underlying causes of the rapid rise in health spending, other than factors affecting both the supply and demand of health are important.

The demand-side variable that uninformed people expect to have most impact on spending is ageing, but evidence is almost conclusive that this is a minor factor – though it is an important factor in spending on long-term care. The effect of income growth on health spending remains controversial in part due to the lack of consensus around the size of income elasticity i.e. is health care a luxury good with an income elasticity >1 or a necessity with an income elasticity <1? Many expenditure forecasting models make an assumption around the value of unity. Public health, consumers’ health seeking behaviour and underlying societal norms about health and illness have a significant impact on the demand for health services.

Supply-side variables that affect spending include new technologies and labour productivity. Innovation can include new treatments, new modes of service delivery and new financing alternatives, and influence the intensity of care provided to patients, as well as health-care prices. Similarly, treatment practices, such as changes in the intensity of care, are a form of “technological change”. Approximately half of all long-term growth in health-care spending has been associated with technological advances (Congressional Budget Office, 2008). RAND (2011) found that effective new technologies, even those that are inexpensive on their own (such as cancer vaccines), tend to increase health spending. This is particularly the case when a large share of the population will be treated. In the past, rising health prices have also accounted for a significant amount of health spending. The price of health care is increasing relative to the productivity of the health sector which tends to be low relative to other sectors because health services are highly customized and labour intensive.

What has been the impact of the economic crisis on health spending?

A survey conducted in 2010 revealed that consolidation measures affected the health sector in half of OECD countries (OECD, 2011b). In Greece and Ireland, fiscal consolidation measures affecting the health sector accounted for more than 0.7 per cent of GDP. The policies that have achieved this can be divided into those that have targeted the price of health goods and services (particularly pharmaceuticals and wages); those that have tried to reduce demand for health services (co-payments); and those that try to promote structural reform to provide services at lower average cost. In addition, some countries have sought to find new revenue sources to finance health spending.

Measures to increase efficiency

In order to increase efficiency of health spending, countries have adopted a number of strategies including merging hospitals and other institutions; increasing out-patient appointments and day-surgery as well as centralizing purchasing and procurement of services.

Can governments raise additional revenues for health?
In social health insurance systems, contributions raised for health should in principle determine what will be spent on health (though it is possible to override this through deficits), while in tax-funded systems funds are allocated to health each year on the basis of the available budget and other needs for public funding. In several countries, the economic crisis has aggravated pre-existing imbalances between the level of revenue collected for health (or allocated to health in the budgetary process) and the level of spending, especially in countries with social health insurance (e.g. Estonia). Although “health deficits” are not always easy to isolate from general government deficits, we can probably say that most OECD countries already had a “health deficit” and increasing debt before the 2009 recession. The economic crisis added to the problem by severely affecting revenue in the form of taxes and social insurance contributions. Therefore, some of the problems currently facing countries are not because the health system is not spending money wisely, but rather that they simply cannot raise enough money because of current economic conditions.

Policy implications

Countries have sought to restore fiscal sustainability by spending less on health (either by increasing efficiency or cutting services) or by shifting spending from the public to the private sector and, to a lesser extent, by raising revenues from “sin taxes”. Countries’ responses to the short-term problems of fiscal sustainability of health spending, caused by the intense pressure to reduce budget deficits quickly were, generally, quite rational. In order to limit the effect on front-line services, countries focused on reducing the price of services. Wages were cut, and prices paid for pharmaceutical products reduced. These reduced spending – significantly, given the importance of wages in total health spending (accounting for approximately of 70 per cent of spending in a typical country), and given the size of the reductions in pharmaceutical prices. In contrast to previous rounds of public health expenditure cuts, items such as public health spending – which have high rates of return in improving the health of the population, but which take much time to be realized – were largely protected. Moreover, a number of countries including Iceland, Ireland and Portugal introduced various measures to protect vulnerable groups including children, older people and those with serious illness and/or disability.

However, of course even price cuts have negative effects – in causing emigration and early retirement of key professionals, and (potentially) reducing innovative efforts by the pharmaceutical industry and aggravating the trend of lower market growth already observed in many OECD countries. Furthermore, price cuts were insufficient to achieve the desired level of cuts. Some reductions in staff occurred in many countries, and there has been increased use of co-payments.

Through the optic of economic sustainability, price cuts reduce the unit cost of health outputs and thereby increase the attractiveness of health spending relative to other spending. If cuts in the number of staff are accompanied by increased productivity, the same conclusion can be drawn. However, it is less easy to be sanguine about the increase in co-payments. These have often been used to attempt to reduce the demand for health services. The word “attempt” is important here – there is significant evidence that while increased co-payments might reduce demand for the particular health good or service in question, they may shift costs elsewhere, and indeed potentially can even increase total spending (if, for example, they result in decreased compliance with drug plans by patients, or delay consultation with primary carers, leading to more complex problems when they finally do present).

Over the longer term, many of the same comments apply as in the short term. It makes little sense to try to restrict demand for health care (with the vital exceptions of investment in preventing poor lifestyles and early diagnosis of problems) – if people want health care, and are willing to pay for it, then it can be an important contributor to economic growth. Instead, attention should focus on supply side issues – payment systems, co-ordination of care, encouraging greater health labour market productivity. However, fiscal sustainability looks every bit as a big problem for health systems in the long run as it does in the short term. While it is possible to finance 70–80 per cent of health spending publicly when health accounts for 10 per cent of GDP, it is harder to believe that this is the case if health spending accounts for 20 per cent of GDP – the pressure on tax systems would be too great to bear. Hence either public health spending will have to decline as a proportion of total health spending, or else total health spending will have to be limited. The former looks a more desirable approach, suggesting that governments need to consider how to manage the boundaries between what is provided through public or collective social health programmes, and what is left to private individuals. Few countries are yet having that debate.

Extracts of a report presented at the 17th ISSA International Conference of Social Security Actuaries and Statisticians, Berlin, Germany, 30 May to 1 June 2012.

Download the full report>>

Authors: Valérie Moran, Valérie Paris and Mark Pearson, all of the OECD, Paris. Corresponding author is Mark.Pearson@oecd.org . The opinions expressed in this article are those of the authors alone, not of the OECD nor of its member countries. Any errors are the responsibility of the authors.



References

Chevreul, K.; Durand-Zaleski, I.; Bahrami, S.; Hernández-Quevedo, C.; Mladovsky, P. (2010). "Health Systems in Transition", Health System Review , 12(6), France.

Congressional Budget Office. (2008). Growth in Health Care Costs , Washington, CBO.

DREES. (2008). "Le financement de la protection sociale: une analyse par risque social", Etudes et Résultats , No. 648, Paris.

Holahan, J. (2011). "The 2007-2009 Recession and Health Insurance Coverage", Health Affairs , Vol. 30, No. 1, pp. 1 8.

Lusardi, A.; Schneider, D.; Tufano, P. (2010). "The Economic Crisis and Medical Care Usage", Harvard Business School Working Paper , 10-079.

OECD. (2011a). OECD Health Data 2011 , OECD Publishing, Paris.

—. (2011b). Restoring Public Finances , OECD Publishing, Paris.

RAND. (2011). Roybal Centre for Health Simulation: About the Future Elderly Model . http://www.rand.org/labor/roybalhp/about/fem.html.

Thomson, S.; Foubister, T.; Mossialos, E. (2009). Financing Health Care in the European Union Challenges and Policy Responses , World Health Organization 2009, on behalf of the European Observatory on Health Systems and Policies, Copenhagen.

WHO. Global Health Expenditure Database , www.who.int/nha/database.

CHF:EXTENSION OF THE NHIF OF TANZANIA

Community Health Funds: Extension of the National Health
Insurance Fund of Tanzania
Summary
The National Health Insurance Fund (NHIF) was established in 2001, with the basic
objective of providing health insurance to civil servants. Since then, the NHIF has increased
coverage by extending its membership to private, informal and semi-formal sectors. In 2009,
the NHIF was mandated by the Government to manage the Community Health Funds (CHF)
which were initially managed by the local authorities. The main objective of being given this
task was to bring about the growth of the CHF scheme in terms of coverage, number of
members and quality of health services accessible to its beneficiaries.
In fulfilling this task, the NHIF used several innovative approaches and strategies, including
the preparation of the three year implementation plan, training its employees, and conducting
several sensitization and motivation campaigns. Also the NHIF has taken several steps to
conduct monitoring and evaluation on matters pertaining to the scheme.
Through the management of the CHF, the NHIF has learnt several practical lessons about the
CHF and social insurance schemes in general. The application of these lessons can be
extended to similar schemes in the sub-Saharan region.
CRITERIA 1:
What was the issue/problem/challenge addressed by your good
practice? Please provide a short description.
There was a need to introduce a health system that would allow cost sharing on health
services. This system was supposed to involve a large part of the population, including
individuals who were in the informal sector of the economy, and was also supposed to be
guided by a legal framework.
To cater for this need, the Government launched the CHF in 2001 with the primary objective
of establishing a system which would eventually allow all citizens to be covered by a health
insurance scheme. Following the success of the NHIF, the Ministry of Health handed the task
of supervising the CHF to the NHIF so that it could include the means to integrate CHF
beneficiaries with its own beneficiaries in its long term plans. Hence, over time, the NHIF
will cover the majority of Tanzania’s population.
CRITERIA 2:
What were the main objectives and the expected outcomes?
Objective
The main objective of handing the NHIF the task of supervising and managing the CHF was
to bring about the growth of the CHF in terms of coverage, and quality and quantity of health
2
services that would be accessible to its beneficiaries. This was based mainly on the experience
and success that the NHIF had in its own operations.
Expected outcomes
The NHIF’s supervision and management of the CHF was expected to bring about the
following outcomes:
• Bring about cost sharing in health services provision in the country by ensuring that
most citizens – through their CHF contributions – supplement the amount of funds the
Government sets aside for the health sector.
• Improve medical services in order to have a high standard of health care. This would
involve increasing the availability of health personnel, medicines, medical equipment,
and other facilities.
• Give autonomy to the community on issues pertaining to health care, so that they
would be involved in making plans, decisions, and supervision on health matters.
CRITERIA 3:
What is the innovative approach/strategy followed to achieve the
objectives?
After being mandated to manage the CHF, the NHIF undertook research on the CHF, using
various secondary sources, in order to know more about the scheme. Then the NHIF
undertook various tasks related to the CHF, as follows:
• evaluated the net worth of the CHF in the whole country, in September, 2010;
• built capacity in its employees, through providing internal training from August 2009
to June 2010 for its management and other workers;
• prepared a three-year Implementation Plan for the CHF to run from July 2009 to July
2012;
• urged several councils to start CHFs;
• trained various editors and journalists, all over the country to promote the CHF;
• made payments of “Matching Funds” from March 2010;
• reviewed in May 2010 the “Matching Funds Payment” exercise and various contracts
pertaining to the CHF;
• undertook group enrolments in Tanga and Lindi regions.
3
CRITERIA 4:
Have the resources and inputs been used in an optimal way to
achieve the set objectives and the expected outcomes? Please
specify what internal or external evaluations of the practice have
taken place and what impact/results have been identified/achieved
so far.
Optimal way to achieve the set objectives
Since 2009, when the NHIF took on the task of managing the CHF, it has monitored the
scheme, mainly through the direct supervision of district councils. Two supervisions have
been undertaken so far, one in October 2010 and the other in December 2010.
In October 2010, the NHIF supervised the Kigoma district councils. The aim was to enable
these councils to better understand the requirements for requesting Matching Funds. This was
because most of these councils had not been given all the Matching Funds they requested
from the Government. This occurred for several reasons, such as they had excluded important
documentation from their request to the Government soliciting Matching Funds.
In December, 2010, another supportive supervision was done in Mpwapwa, Iramba, and
Singida Rural councils. This supervision had several objectives:
• verify the presence of Matching Funds records;
• monitor the general system of the councils’ record-keeping;
• assess the practicability of the Matching Funds protocol;
• obtain an overview of how CHF activities are carried out;
• provide technical support in several fields.
Results of the practice
By managing the CHF, the NHIF has increased its coverage in terms of the number of
beneficiaries to 15.2 per cent of all Tanzanians as per the National Population Census of 2002,
with 7.9 per cent being covered by the CHF and the remaining 7.3 per cent being covered
directly by the NHIF.
CRITERIA 5:
What lessons have been learned? To what extent would your good
practice be appropriate for replication by other social security
institutions? Please explain briefly.
Through managing the CHF, the NHIF has gained several lessons pertaining to health service
provision, needs, and ideal management and supervision. These have implications for other
entities similar to the NHIF. Some of these lessons are as follows:
• Many people are ready to contribute and join insurance schemes and other
programmes once they are assured of receiving an adequate level of services. For
instance, in the CHF case, a greater assurance of the availability of adequate health
4
services, mainly due to timely payment of Matching Funds, led to an increase in the
number of members.
• The level of coverage of social schemes is highly influenced by the level of campaigns
and awareness programmes. For instance, since 2009 when the NHIF took over the
supervision of the CHF, the number of households covered has increased from about
two hundred thousand to five hundred thousand, mainly due to the high level of
awareness campaigns.

Ooops!......Raila: I am est in reforms, protecting new Constitution Options There are currently too many topics in this group that display first. To M

Raila is not a REFORMIST as he wants many people to believe. Raila is a selfish self-seeker with special interest ego, who joined politics with a mission to build his wealth empire by hooks and crooks through public wealth and resource which was acquired from illegal deals and maneuvers. Everything Raila acquired in money worth, he used public wealth and resources with taxpayer money swindled through irregular political shifts which he lobbyied to build his wealth in Oil, Land and Mineral business trading. Therefore, Raila did not make his riches in a clean business smart enterprising. Many people have a notion that, his political maneuver with Moi granted him the Molasses Plant in Kisumu which many people believed that he under-cut Robert Ouko for the same to be rewarded ownership. Both Molasses and Luo Thrift were initiated and funded by Luo Community contributions for the Community’s Project which later is now wholly and fully owned by Raila & the
Odinga family. What Raila has written in the Standard is a lie meant to fool the world.
This media statement by Raila expecting people to believe that he is a REFORMIST is fake. The proof of the pudding is in the eating. A Reformist stay the course to the end and does not engage in scandal practices of the corrupt in stage-managed conspiracies.
Over the years Raila from his corner-corner political schemes and maneuvers clearly show signs of extreme corrupt, illegal and irregular deals. Raila flip-flops and causes scare tactics in instances when he orders people not to speculate and discuss freely about matters of death or those of shoddy deals by whistle blowers. Many people believe that vision 2030 which he participated in marketing and signing deals (MoUs) at the United Nations’ International and Regional Financial Institutions; the World Banks, IMF, IFAD, UNESCO, COMESA, AfDB etc., is a big scum meant to steal public wealth and resources including the taxpayer collectibles to enrich the corrupt Politicians in the Coalition Government. The transparency and accountability of the same, have not been made public according to public mandate for National Reform Accord.
These are matters that put public in a much dengerous disadvantaged position to pay accruement of debt deficits consumed by those who who conspired to engaged into such corrupt dealings maneuvres. Legal justice must protect public interest before more damage bring Kenya down to Economic Crisis from acts of thievers.

When Raila order Member of Parliaments not to speak to investigators about what they know except for Mr. Kimunya, this was a big blow. It was clear to many that Raila knew more about the helicopter crash of Saitoti and Ojode with the rest of its occupants, and he was obstructing people from discussing or speculating possible reason for the helicopter crash. This made those with information coil back and went underground for fear of being intimidated.

Unless proved otherwise, the truth is that, Raila with those politically corrupt have been engage in a conspiracy to defraud and steal from the Public Wealth Resources; and so, this is how Raila build his wealth. It must go on record that, Raila has all along been making irregular deal of illegal nature scheming through the International Offshore Oil companies making corrupt deals over Public Wealth Resources in Land transfers and Minerals ownership to unscrupulous International Investors for self gain using taxpayer money carelessly and unwisely and have not disclosed to public or made it official; it is a matter known between the two Principal leaders with their network at the Coalition Government. The extreme corruption in Energy, Oil, Land and minerals put in the hands of the Chinese and Iranians etc., under shoddy MoUs and corrupt deals will continue to push the poor and disadvantaged to a point of no return.

This are reasons why the New Constitution is receiving a death blow and has been severed and watered down under their watch in the Coalition Government leadership, so that they are able to escape the legality arm of justice on their misdoings.

The Majimbo/Devolution, Land, Finance and Police Legislation Bill of Rights are not completed. It is simply because the two Principals have Special Interest over the Public Interest and is the reason for the delaying tactics where they both are keeping windows open in the constitution as escape route from facing justice. These are reasons why innocent unsuspecting people are killed carelessly by organized gangs; hit squad and the Police in acts of terrorism actively strategized to kill people like chicken. Others are terminated from organized timed assassinations.

In like manner, we were treated to the same stage-managed acts of terrorism masterminded by some good-for-nothing concubines, using tax-payer money in the organizing the Artur Brothers illegal invasion to Kenya and later, the same woman with her team got rewarded with security guard details paid by taxpayer before the matter is even taken to court to be determined.

These acts of lawlessness of such behaviors cannot be tolerated and are unacceptable. The two Coalition Principals in the Coalition Government must not take people for granted. They both have no business to continue staying in power occupying public offices while heavy casualties and damages are daily in the offing making peoples’ lives miserable.

In an urgent move, both the two Principals in the Coalition Government must be investigated and their corrupt involvement in corrupt cases must be determined and completed thoroughly before they can be allowed to stand in the future politics.

The Triton saga is part of the ongoing oil and oil related corruption deals they decided to shelve and put away from the court so they can pass Chapter 6 and the integrity test. We are not done with him yet from the clearance of “Kazi kwa Vijana” Youth project fund theft in Prime Minister’s Office under Raila’s watch, and the NHIF Saga involving public money which is slowly being pushed aside without proper investigation and reporting delivered. The Saitoti/Ojode and six others in the helicopter crash is another hot issue under speculations why Raila decided to order and silence Ministers from talking to Media over the matter cannot be erased in the minds of many soon. Many people are asking unanswered questions why Raila had to single out Mr. Kimunya to be the only person allowed to be interviewed by Media and where he knows pretty too well how it is public knowledge, Mr. Kimunya cannot be trusted by anyone in Kenya when it comes to corruption
and bad things. How can we trust such a corrupt leader and entrust million of disadvantaged public in their deadly conspiracies.
Esther Arunga's case is now a clock ticking away when fears of such desperate cries from her are in display in public media claiming her life is in danger. This is causing us restlessness. No one in her right mind would make such a claim from no reason. This matter is taking a very tricky and dangerous turn, and we cannot keep quite or take it lightly when her life is continually under threats even after leaving the country. We fear that those who have been after her with Timberlake will not rest until they assassinate them both to silence them.
I am forwarding this matter to the doorstep of The U.S. President Obama under Certificate of Urgency for him to Intervene and act speedily under security and safety for Esther and Timberlake with the rest of Kenyans on humanitarian grounds.


Pressure group for Reform must not relax. They must continue to pressurize and keep pushing for REAL CHANGE in Kenya. They are the True Reformist........Not those who short-change REFORM ACCORD AGENDA with a purpose to steal from public livelihood and survival and accumulate Public Wealth for Special Interest and for the corrupt political agenda of SELFISH EGO.......

We demand for justice and we demand it now......!!!


Judy Miriga
Diaspora Spokesperson
Executive Director
Confederation Council Foundation for Africa Inc.,
USA
http://socioeconomicforum50.blogspot.com

RWANDA INNOVATES TO SUSTAIN UNIVERSAL HEALTH- CARE COVERAGE

Rwanda is known for its remarkable success story in extending access to health care to its entire population. This process took an important further step in July 2011 with the introduction of measures to improve the health-care system’s financial sustainability.

While it has been relatively easy to cover Rwanda’s formal sector (5 per cent of the population), the government has risen to the challenge of extending coverage to those in informal and rural economies. To move towards universal coverage, Community Based Health Insurance (CBHI) has been identified as an instrument to ensure financial protection and access to health care for the majority of the population. By exploiting concepts of community solidarity and participation, it has allowed the most vulnerable and poorest segments of the population to be fully integrated into the health insurance system.
Table 1 shows the rapid expansion of CBHI coverage and utilization of services by the population for the period 2003-2010.

Table 1



CBHI schemes started as pilots in three districts in 1999, with premiums set at RWF 2,500 – RWF 3,500 per household, and following good results were rolled-out in all districts in 2005. From 2005 to June 2011, the premium was RWF 1,000. The table below shows the gradual progress in implementation over the years.

Table 2



However, the rapid expansion of coverage and the low, subsidized, premium contribution of 1,000 Rwanda Francs (RWF) (approx. USD 1.67) per member per year led to a financially unsustainable situation. The revenues generated from contributions proved to be insufficient and led to debts to district hospitals accumulating for the services delivered to CBHI members.

To define a policy response to the weaknesses of the CBHI system, the 2008 Rwanda Health Financing Systems Review: Options for Universal Coverage prepared by the Ministry of Health (MoH) and the World Health Organization provided guidance.

The challenges highlighted in the review can be summarized as: insufficient funds at both district and national risk pooling levels; weak pooling mechanisms; insufficient staff; limited management capabilities; possible abuse at different levels in the system (beneficiaries and providers); and large numbers of people in the informal sector with limited capacity to make contributions and who are difficult to identify. These challenges needed to be addressed if CBHI was to become sustainable.



The CBHI reform process

The objective of the CBHI reform was the development and strengthening of the Rwandan CBHI system, with the larger goal of improving the financial accessibility to health care for the population, protecting households against the financial risks associated with diseases, and strengthening social inclusion in the health sector.
The process included a number of essential interconnected steps:

* MoH-led policy development in collaboration with the CBHI Working Group : To lead the reform process, the MoH convened the CBHI extended team, which brought together policy-makers and development partners. The extended team was led by the MoH CBHI team and all partners in health financing, including representatives of development partners (DPs) working in all 30 districts of the country. Civil society and local government representatives were also consulted during meetings.
* Stop-gap measures to address the current problem : To mitigate the increasing problem of CBHI debt, the Ministry of Finance (MoF) carried out an audit of the financial situation in each district and paid all verified and outstanding debts from government revenues. Intensive training of staff and recruitment of new staff for CBHI were also undertaken.
* Use of historical data and evidence-based policy process : The MoF also conducted a study to estimate the per capita annual cost of services in 2008; the finding of RWF 2,900 was used as the basis of the reform design and new premium contribution after taking into account inflation, an increase in the benefit package and “patient roaming”.
* Development of a nationwide Ubudehe database : Ubudehe is a home-grown initiative aiming to nurture citizen participation in development through collective action. The nationwide categorization of households was developed by collecting information on the socio-economic status of the population and from the villager’s opinions. The categorization system has traditionally been used for socio-economic opportunity distribution. As this was the first time that it had been linked to “contribution payment” rather than “benefits”, a careful validation and quality check was done to ensure its accuracy.
* Public information and political support for the new policy : In December 2010, President Paul Kagame announced the new policy publicly, demonstrating strong political support from the highest possible level. At the same time, the new policy (Rwanda Community Based Health Insurance Policy, 2010) was finalized and preparation began for its implementation from July 2011.



Figure 1



The policy content

The main objective of the new policy was the development and strengthening of the CBHI system in Rwanda, with the larger goal of improving the accessibility to health care, protecting households against the financial risks associated with illness, and strengthening social inclusion in the health sector.

The policy outlines eleven strategic interventions designed to assist in achieving this objective. They are linked to the challenges identified from the original policy and are being addressed by a number of implementation initiatives which characterize the new policy.

Table 3 presents an overview of the challenges that the reform sought to address, and the strategic interventions and initiatives adopted to respond to these. Many of these challenges were related to the day-to-day management of the CBHI system: improving processes and strengthening the capacity of the system at all levels.

Table 3



The reforms which most immediately affected the population were: (1) the introduction of a tiered contribution scheme, based on ability to pay; and (2) patient roaming to use services in districts other than their registered district in emergency and justifiable cases.

Prior to the reform, the premium contribution was a flat rate of RWF 1,000 (US$1.67) with a subsidy of the same amount from the government. Indigents were covered by a combination of government and donor support. Table 4 below shows the new contribution rates and the proportion of the population under each category.



Table 4



Implementation challenges

A number of important implementation challenges arose as the result of the reform process:

* Development and validation of wealth categorization database : As the basis for fair contribution rates in a country with a very small formal sector, the database is a prerequisite. Although it was developed almost a year ahead of schedule, there were constraints in data collection, data input, quality and validation that resulted in the delay of its use. Also, some adaptations of the old tool were required to fit new needs.
* Ensuring continuity in delivery of health services during the transition : The policy was implemented as planned with some stop-gap measures to allow people to be continuously treated using their old CBHI membership card. The MoH informed the population and instructed the providers to ensure that there was no break in service delivery.
* Dip in coverage rates and slow registration of CBHI members : During the 6-month transition to the new policy, there was a lot of speculation and some people adopted a wait and see attitude. Many did not immediately renew their membership at the new premium rates while others waited for the validated wealth categories, leading to very low coverage rates in all districts. The national pooling risk covered the financial gap during the process. Owing to the intensified sensitization campaign and commitment of local authorities, the coverage rate bounced back up to 85 per cent.
* Limited capacity at the CBHI district level to implement the new policy : To address this issue, training on the CBHI procedure manual for all CBHI staff, close supervision by the MoH CBHI Unit and recruitment were undertaken. The number of required local staff was also monitored to ensure efficient services to members.



Major lessons learned from the reform process

* Strong leadership and good governance at the highest political level plus good cooperation among agencies within the government are essential to ensure the successful implementation of such a policy.
* Platforms for social dialogue serve not only to enforce support for the new policy but also encourage social buy-in, community participation and ensure the availability of a venue for civil society to articulate their opinions or concerns.
* Decentralized context and ownership of local leaders are important elements contributing to the success of the new policy. The implementation is anchored on strong community networks, information flows, coordination and local authorities’ commitment to support the change process. This context could also be used to allow more efficient and faster data collection for updating the wealth categorization of the district.
* Strengthen capacities for the implementers to fulfil their role both at the central and local level. The respective roles and tasks of the various stakeholders need to be clearly defined beforehand to ensure all areas are covered as planned. Flexibility and responsiveness of development partners in their technical and financial assistance is highly-valued in the change process.
* Policy change is a complex process that needs to be carefully planned and managed to ensure transitional effects are minimized, if not avoided. The implementers should analyse the implications of the policy and plan mitigation strategies for potentially negative consequences and mobilize multi-stakeholder support for the policy. A well-developed change management strategy is therefore essential to the process.



Where are we now?

After the initial slow uptake of CBHI membership and some teething pains upon the introduction of the policy, coverage has increased to 91 per cent, bringing the national health insurance coverage to 96 per cent. The recently developed Health Sector Strategic Plan III for Rwanda 2013-2017 focuses heavily on reviewing the benefit package to make it more responsive and sustainable and also to building health financing institutional capacity to further consolidate the successes of CBHI within the national system.


Authors
Andrew Makaka, Health Financing Director, Ministry of Health, Rwanda; Sarah Breen, ODI Fellow, Ministry of Health, Rwanda; Dr Agnes Binagwaho, Minister of Health, Rwanda.
The authors thank partners at GIZ Health Rwanda, Olivia Nieveras and Theoneste Twahirwa, for their technical input to this article.