TUME YA KUDHIBITI UKIMWI TANZANIA (TACAIDS) TUME YA KUDHIBITI UKIMWI TANZANIA (TACAIDS) TAARIFA YA UFUATILIAJI NA TATHMINI YA UKIMWI MKOA WA MBEYA OKTOBA, 2007 ISBN 978-9987-519-15-6 i
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YALIYOMO Ukurasa Orodha ya Vifupisho iv UtagulizI vii Shukrai xi Sura 1:Maoi a Yaliyobaiika 1 Sura 2: Chagamoto 24 Sura 3: Mafaikio 26 Sura 4: Mapedekezo 32 Hitimisho 33 Vitabu Vilivyorejewa 34 Msamiati wa kiufudi 35 iii
ORODHA YA VIFUPISHO ACCA AIDS ANC ART BACAIDS BAKWATA CARF CBO CHAC CHMT CMAC COPTA CPP CSO DACC DAS DC DED DFID DMO DRC EU FBO GTZ HBC HIV HLM HSIS HTA IEC JICA LGA Udhibiti wa UKIMWI Katika Makampui Afrika Upugufu wa Kiga Mwilii Kliiki ya Wajawazito Tiba ya kuogeza Kiga ya Mwili Tume ya UKIMWI ya BAKWATA Baraza kuu la Waislamu Tazaia Mfumo wa Mwitikio wa Jamii Kuhusu Ukimwi Mashirika ya Kijamii Mratibu wa UKIMWI wa Halmashauri ya Wilaya Timu ya utawala ya Afya ya Halmashauri ya Wilaya Kamati za Kudhibiti UKIMWI katika Mamlaka za Serikali za Mtaa Zaa ya Mipago Shirikishi ya Jamii Dhidi ya UKIMWI Mpago wa ushirikiao wa Jamii Vyama vya Kiraia Mratibu wa Kudhibiti UKIMWI wa Wilaya Katibu Tawala wa Wilaya Mkuu wa Wilaya Afisa Mtedaji wa Wilaya Idara ya Maedeleo ya Kimataifa Afissa Afya wa Wilaya Jamhuri ya Kidemokrasia ya Kogo Umoja wa Ulaya Mashirika ya Kidii Shirika la Ushirikiao wa Kiufudi wa Ujerumai Matuzo ya Nyumbai Virusi vya UKIMWI Vifaa vya Elimu ya Afya Utafiti wa Maambukizo ya Virusi vya UKIMWI/UKIMWI Maeeo Yeye Kasi Kubwa ya Maambukizo ya UKIMWI Habari, Elimu a Mawasiliao Shirika la Ushirikiao la Kimataifa la Japa Mamlaka ya Serikali za Mitaa iv
MARVAD MCC MCH MMRP MOHSW MRACP MSD MTEF NACOPHA NACP NGO OVC PE PEP PLHA PLHIV PLPWHA PMTCT RACC RAS RC REO RFA RMO RS SPW STD STI TAC TACAIDS TAZARA TB TCCIA Utafiti wa Dawa za Kuogeza Kiga ya Mwili Mkoai Mbeya Kampui ya Simeti ya Mbeya Afya ya Mama a Mtoto Mradi wa Utafiti wa Afya Mbeya Wizara ya Afya a Ustawi wa Jamii Mradi wa Kudhibiti UKIMWI Mkoai Mbeya Duka la Vifaa vya Afya Mfumo wa Utekelezaji wa Kati ya Muhula Baraza Kuu la Taifa la Watu Waaoishi a Virusi vya UKIMWI Mpago wa Taifa wa Kudhibiti UKIMWI Asasi Zisizo za Kiserikali Watoto Yatima a Waaoishi Katika Mazigira Magumu Elimu Rika / Mwelimishaji Rika Hadhari Baada ya Hatari Mtu/Watu aayeishi/waaoishi a Virusi vya UKIMWI Mtu/Watu aayeishi/waaoishi a Virusi vya UMIMWI Mtu/Watu aayeishi/waaoishi kwa Matumaii a Virusi vya UKIMWI Uzuiaji wa Uambukizo wa Virusi vya Ukimwi Kutoka kwa Mama Kweda Kwa Mtoto Mratibu wa Kudhibiti UKIMWI wa Mkoa Katibu Tawala wa Mkoa Mkuu wa Mkoa Afisa Elimu wa Mkoa Wakala wa Uwezeshaji wa Mkoa Afisa Afya wa Mkoa Sekretarieti ya Mkoa Umoja wa Waafuzi Duiai Magojwa ya Ziaa Magojwa ya Ziaa Kamati ya Ufudi ya UKIMWI Tume ya kudhibiti UKIMWI Tazaia Shirika la Reli la Tazaia a Zambia Kifua Kikuu Chama cha Wafayabiashara, Weye Viwada a Kilimo v
TGPSH TMAP TOT TRA TV UKIMWI UN UNAIDS UNV VCR VCT VMAC VVU WMAC WPP Mradi wa Afya wa Tazaia a Ujerumai Mpago wa Udhibiti wa UKIMWI Tazaia Uelimishaji wa Waelimishaji Mamlaka ya Mapato Tazaia Luiga Upugufu wa Kiga Mwilii Umoja wa Mataifa Mpago wa Umoja wa Mataifa wa Kudhibiti UKIMWI Watu waaojitolea wa Umoja wa Mataifa Mtambo wa Kuoyeshea Mikada ya Video Ushauri Nasaha a Upimaji wa Hiari wa UKIMWI Kamati ya Kudhibiti UKIMWI ya Kijiji Virusi vya UKIMWI Kamati ya Kudhibiti UKIMWI ya Kata Programu ya UKIMWI Mahali pa Kazi vi
UTANGULIZI Mkoa wa mbeya ua eeo la Kilomita 64,000 za mraba a ua jumla ya idadi ya watu 2,070,046. (waaume 990,825 a waawake 1,079,221). Jumla ya idadi ya watu waliopo katika rika la kuweza kuzaa (miaka 15 hadi 49) i 423,945. Kasi ya maambukizi ya UKIMWI i 13.5%, i ya pili kwa ukubwa chii (Kasi ya maambukizi ya UKIMWI ya taifa i 7%). Mbeya ia mtadao mzuri wa mawasiliao kwai barabara kubwa ziapita mkoai a kuugaisha badari za Dar es Salaam a Mombasa pamoja a Zambia a Malawi a chi yigie za Afrika kupitia barabara a reli a kutegeeza upeyo weye mchagayiko wa watu kati ya chi hizi tatu a zigie za kusii. Lego kuu la timu iliyotafiti a kukusaya habari kuhusu hali ya UKIMWI ya mkoa wa Mbeya lilikuwa i kufaya ufuatiliaji a tathmii ya hali ya UKIMWI ya Mkoa wa Mbeya. Huu i utaratibu wa kawaida wa mara kwa mara wa TACAIDS wa kutembelea Mkoa ili kupata ufahamu bora zaidi kuhusu afua ziazohusiaa a UKIMWI katika Mkoa. Ratiba ilikuwa i yeye kueleweka saa a ilitegeezwa maalum kwa ajili ya kukutaisha timu a vikudi tofauti vya watu wakiwemo mashirika ya kidii, wasichaa a waaume, waawake, watu waishio a virusi vya UKIMWI, vikudi maalumu vya walegwa kama wahudumu wa baa a sekta za serikali kama elimu, kilimo a maedeleo ya jamii. Leo UKIMWI uatambulika si tu kama jambo kubwa la kiafya peke yake, bali pia kama tatizo la kijamii a kimaedeleo katika chi, mkoa, wilaya a jamii kwa ujumla. Ilipokuwa mkoa wa Mbeya timu ilitembelea wilaya e kati ya wilaya ae zilizopo mkoai humo. Wilaya zilizotembelewa zilichaguliwa a mamlaka za mkoa kwa kushirikiaa a mamlaka za wilaya. TACAIDS walitayarisha orodha ya maswali zilizosambazwa kwa vikudi mbalimbali kabla ya kutembelea vikudi hivyo kwa ajili ya kufaya majadiliao. Timu ya TACAIDS iligawaywa katika timu mbalimbali zilizotembelea vikudi tofauti kama vile waawake, vijaa, watu waishio a virusi vya UKIMWI, (wazee, wahudumu wa baa a wafayakazi wa yumba za wagei, mashirika ya kidii, taasisi za elimu, vituo vya utafiti a mashirika mateule makuu ya wakala wa uwezeshaji wa mkoa. Timu ilitembelea wilaya za Kyela, Chuya, Mbarali a Mbozi. Katika wilaya hizi ratiba ya ziara iliadaliwa a Mratibu wa Ukimwi wa Halmashauri wa Wilaya a vikudi mbalimbali zikiwemo asasi zisizo za kiserikali a maafisa wa serikali kama vile wakuu wa idara za kilimo, elimu a utawala za wilaya. Wakuu wa shule za msigi, madiwai wa kata a mashirika ya kidii kama BAKWATA pia yalishiriki katika majadiliao. vii
Mbiu iliyotumika ilikuwa shirikishi ambapo vikudi vyote vilihusika katika majadiliao. Lego la majadiliao lilikuwa i kufahamisha timu kutoka TACAIDS kuhusu utekelezaji wa shughuli za UKIMWI kimkoa a kupata maoi a ushauri kutoka kwa washiriki wa mjadala kuhusu kuboresha shughuli za kudhibiti UKIMWI katika Mkoa. Mikutao ya mashauriao ilisaidia TACAIDS kuhamasisha vikudi vya jamii kuelewa kuwa vita dhidi ya UKIMWI i kwa ajili yao wao weyewe a si watu wegie. Sababu kama hizi dizo ziazochochea washika dau katika gazi za mkoa a wilaya kuedelea kupambaa a ugojwa huu hatari. Faida za mbiu hii ilikuwa pia i kutoa msaada katika masuala ya kiufudi kama vile utaratibu wa kuchagisha a utatuzi wa masuala ya pesa ambapo ilitambulika katika majadiliao kuwa kwa baadhi ya wapokea pesa kulikuwa a tatizo hasa katika ufahamu wa utaratibu. viii
ORODHA YA WASHIRIKI Taarifa ya UKIMWI ya Mkoa wa Mbeya imetayarishwa a TACAIDS, ambao walituma timu kweda Mbeya kufaya ufuatiliaji a tathmii wa hali ya UKIMWI katika Mkoa wa Mbeya. Timu ilikuwa a wafayakazi wa TACAIDS, wawakilishi wa NACOPHA, watumishi wa Wizara ya Afya a Ustawi wa Jamii, mamlaka za afya za kimkoa a kiwilaya, waratibu wa UKIMWI wa Halmashauri za Wilaya, Watumishi wa GTZ (wakala wa uwezeshaji wa mkoa), wabia wa maedeleo kutoka Beki ya Duia a waadishi wa habari. TACAIDS Mh. Lediaa Mg og o, Mb, Kamisha Dr. Fatma H. Mrisho, Mweyekiti Mtedaji Nd. Sam Komba, Mwaasheria Nd. Charles Kamugisha, Idara ya Mwitikio wa Wilaya a Jamii Nd. Chaddy Athoy, Idara ya Sera a Mipago Nd. Simo Keraryo, Uraghibishi a Uhamasishaji Mr. Shedrack Mpabagaya, Idara ya Fedha a Utawala Nd. Hulda Tairo-Urasa, Idara ya Fedha a Utawala Baraza la watu waaoishi a VVU/UKIMWI (NACOPHA) Nd. Vitalis Makayula, Mweyekiti NACOPHA Nd.Grace Mwamhojo, Mjumbe NACOPHA Wizara ya Afya a Ustawi wa Jamii Nd. Joel Ndayogeje, MISO, NACP Mamlaka ya Afya ya Mkoa Mamlaka ya Afya ya Wilaya Waratibu wa UKIMWI wa Halmashauri ya Wilaya Nd. Hebel A.Luvada Nd. A.R. Chavula Nd. Rachel Mbelwa Wakala wa Uwezeshaji wa Mkoa Dr. Bruo Masumbuko, Kiogozi wa Timu Frida Radeguda Godfrey Upedo Chabili ix
Wabia wa Maedeleo Nd. Agelica Schrettebruer, Mratibu wa mradi wa UKIMWI wa GTZ Nd. Yuus Koshuma, GTZ Dr.Emmauel Malagalila, Beki ya duia Waadishi wa Habari Nd. Bey Mwaipaja, ITV Nd. Festo Sikagoamo, ITV (kamera) Nd. Niko Mwaibale, TVT Nd. Ngujua Kalaja, TVT (kamera) Madereva Gabriel Choya Barick Dawa Dasta Kapiga Habib Nzomukoda x
SHUKRANI Tuapeda kutoa Shukrai zetu za dhati kwa wafuatao kwa msaada wao mkubwa katika uadaaji wa taarifa hii: vijaa, waawake, watu waishio a VVU / UKIMWI, wazee, wafayakazi wa baa, wafayakazi wa yumba za kulala wagei, mashirika ya kidii kama vile BAKWATA, taasisi za kidii kama vile shule za msigi a za sekodari, vituo vya utafiti, ashirika mateule makuu a muhimu ya mawakala wa uwezeshaji a kimkoa, madiwai a kata a wakuu wa idara za kilimo, elimu a utawala wa wilaya za Kyela, Chuya, Mbarali a Mbozi. Fatma Mrisho Mweyekiti Mtedaji xi
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SURA YA KWANZA MAONI NA YALIYOBAINIKA 1. Washikadau a vikudi vya walegwa Vikudi vya vijaa Waawake Walemavu WatotoYatima a Waishio katika Mazigira Magumu Kaisa la Katoliki la Mbeya Dayosisi ya Nyada za Juu za Kusii ya Kaisa la Aglikaa Watu waishio a Virusi vya UKIMWI a/au UKIMWI Wafayakazi wa Biashara ya Ngoo Wahudumu wa Mabaa Madereva wa Malori 1. 1. Vikudi vya vijaa Ushiriki wa vijaa ulikuwa i mchagamfu a weye kuzaa matuda katika majadiliao wakati wa ziara ya ufuatiliaji. Walisema wazi wazi kwamba ogezeko la haraka la watu, uhamiaji wa watu kutoka vijijii kweda mijii, matumizi mabaya a ya mara kwa mara ya pombe, matatizo katika familia, umaskii kipato kidogo, ukosefu wa ajira kwa vijaa, mavazi yaayoamsha hisia za kutaka kufaya goo, msukumo wa rika wa kumiliki vitu vya aasa a urahisi wa kupatikaa kwa picha za goo kwa kupitia luiga, mikada ya video a mtadao i miogoi mwa vichocheo vya jaga. Pia ilitambuliwa kuwa waafuzi huwa hatarii waapokuwa jiai kuelekea mashulei a kweye vyumba vyao a mabwei bila usimamizi a ulizi. Idadi ya vikudi vya vijaa wapo makii katika kusambaza elimu kuhusu jisi ya kuudhibiti UKIMWI kwa kupitia jia mbalimbali, kwa mfao maigizo, michezo ya kuigiza a vichekesho. Lakii walisema kuwa waa tatizo la upugufu wa fedha hususai kulipia gharama za usafiri ili kuboresha miradi a shughuli buifu zao. Pia walisema hawaa habari za kutosha a za uhakika kuhusu Virusi Vya UKIMWI a UKIMWI a stadi za maisha. Uwezeshaji i muhimu saa katika maeeo yaliyotambulishwa, pamoja a ogezeko la msaada wa kuhudumia vikudi. 1
1.2. Waawake Katika kudi hili mambo yafuatayo yalidhihirika:- Mavazi yaayoamsha hisia za goo kama vile vimii, kk a vitopu Waawake wamechagamka saa katika biashara a i wepesi Kutokujuaa hali ya afya hususa kuhusu Virusi vya UKIMWI a UKIMWI baia ya washiriki katika tedo la goo Kipato kidogo cha waawake a wasichaa Ushidai wa waawake kwa sababu ya kutumia goo kama chazo cha kipato Ukosefu wa uamiifu baia ya waadoa Ngoo kiyume cha maumbile ilikuwa i kawaida. Waaume walikuwa tayari kulipa hadi Tshs 50,000 ili kufaya goo bila kodomu Kodomu zilikuwa ziapatikaa kirahisi katika mabaa lakii sio kodomu za kike Wasichaa wegi walikuwa i wazazi pekee weye watoto kadhaa. Wateja waapowaahidi mapezi au doa a kuwa wagei wa mara kwa mara, waakuwa sio makii a waagalifu. Baadhi hawakuwa a chazo kigie cha kipato a kulazimika kufaya kazi kweye mabaa. Walieleza haja ya kupatikaa kwa kodomu za kike Baadhi ya wasichaa waaofaya kazi kweye baa walisema waapata mshahara wa Tshs. 15,000 kwa mwezi. Hawakuruhusiwa kujadili kuogezwa mshahara, lakii waliruhusiwa kuchukua zawadi kutoka kwa wateja. Kua umuhimu mkubwa saa wa kuwajegea waawake uwezo wa kiuchumi ili kupuguza utegemezi kwa waaume. 1.3. Walemavu Ukosefu wa habari kuhusu maambukizo ya UKIMWI ulioekaa katika kikudi cha walemavu. Walisema hawakuoa maaa yoyote katika kweda kupima UKIMWI kwa sababu hawakuoa maaa yoyote ya kuwapa ushauri watu waishio a Virusi vya UKIMWI a UKIMWI kuboresha mlo wao wakati wao i maskii. Kikudi hiki kilisema kuwa hakua afua au afua za kutosha ziazowalega wao, wakati waaume huwatogoza wasichaa walemavu kwa imai kuwa hawaa Virusi vya UKIMWI a UKIMWI. Na kwa sababu ya umaskii wao, waaume hupedelea kuuua goo kutoka kwa waawake walemavu. Walieleza haja ya jamii kutambua haki zao, kuwaelimisha a kuwahamasisha kuhusu maambukizo ya UKIMWI ili watakaopata elimu wasambaze elimu hiyo kwa wezao. 2
1.4. Watoto Yatima a Waishio katika Mazigira Magumu Tuwakige watoto a maambukizi ya UKIMWI Ilioekaa kuwa kulikuwa a ogezeko kubwa la watoto yatima a waishio katika mazigira magumu katika jamii. Kila wilaya ia asasi ziazosaidia watoto yatima a waishio katika mazigira magumu. Kwa mfao Kyela kua asasi ya Oaktree, iayosaidia watoto yatima a waishio katika mazigira magumu kwa kuwapatia misaada ya sare za shule, vitabu, ada za shule, elimu ya ufudi, shughuli za kutegeeza kipato a tiba ya afya. Lakii upeo wa huduma hizi i mdogo, a waaoufaika i wachache. Asasi zigie ziazosaidia watoto yatima a waishio katika mazigira magumu katika wilaya ya Kyela i Kituo cha Mtakatifu Joh Hus a USACA, iayohudumia watoto yatima a waishio katika mazigira magumu 521. Zifuatazo i baadhi ya shughuli zilizopagwa katika mkoa:- Kituo cha huduma za afya kwa watoto yatima a waaoishi katika mazigira magumu 192 Kuwasaidia watoto yatima a waaoishi katika mazigira magumu 20 kujiuga a shule za sekodari a watoto yatima a waaoishi katika mazigira magumu 5 kujiuga a vituo vya elimu ya ufudi. Kukusaya a kusambaza aia mbalimbali za mbegu katika vijiji 6 a g ombe wa maziwa 4 kwa kaya 4 ziazolea watoto yatima a waaoishi katika mazigira magumu 3
Kutambua watoto yatima a waaoishi katika mazigira magumu katika kata 17. Walitambuliwa watoto yatima a waaoishi katika mazigira magumu 4370, waawake 2622 a waaume 1748, kati yao 1710 waa umri chii ya miaka 5. Kuratibu usambazaji wa vifaa ya shule kwa watoto yatima a waaoishi katika mazigira magumu 524 1.5. Kaisa la Katoliki la Mbeya Kaisa lia padri aliyeteuliwa kuwa mratibu wa shughuli ziazohusiaa a Virusi vya UKIMWI a UKIMWI a aaratibu shughuli za UKIMWI katika parokia 30 dai ya dayosisi. Afua za sasa hivi ziahusisha ushauri asaha a upimaji wa hiari, matuzo ya yumbai a utoaji wa dawa za kuogeza kiga ya mwili, a ziaedeshwa a hospitali za mishei a wafayakazi wa afya. Kaisa liakutaisha a kuhamasisha vikudi vya vijaa a watu wazima kwa kupitia mtadao wake a kulea watoto yatima a waaoishi katika mazigira magumu 47. Pia waaadaa shughuli za uelimishaji kwa kutumia burudai katika mashule. Na waalizugumzia suala la UKIMWI wakati wa mahubiri. Kaisa la Katoliki lipo kimya kuhusu suala la matumizi ya kodomu. Hawairuhusu wala hawaikatazi. Badala yake, waahamasisha maisha ya kikatoliki yaayosisitiza kusubiri a kuwa mwamiifu. 1.6. Dayosisi ya Nyada za Juu za Kusii ya Kaisa la Aglikaa. Mambo yaliyodhihirika katika eeo hili i kama ifuatavyo: v Kaisa liatoa elimu ya kudhibiti UKIMWI, matuzo a tiba a kupuguza athari zitokaazo a UKIMWI dai ya dayosisi. v UKIMWI uaogezeka Mbeya kwa sababu zifuatazo:- Mbeya iapakaa a Malawi a Zambia Ushidai wa wasichaa kwa sababu ya goo kutumiwa kama chazo cha kipato Ulevi Ndoa za mitala Ukosefu wa uamiifu baia ya waadoa Kipato kidogo cha wasichaa a waawake Uvaaji wa vimii Uhamiaji wa vijaa kweda mijii Waawake wamechagamka saa kibiashara a i wepesi Kua umuhimu mkubwa saa wa kuwajegea uwezo wa kiuchumi waawake ili kupuguza utegemezi kwa waaume. 4
Mapedekezo:- Kampei ya kuhamasisha Ushauri Nasaha a Upimaji wa Hiari iedelezwe kwa vile iafaikiwa Jamii ihamasishwe kuwasaidia watoto yatima a kuelimishwa Uedelezaji wa mbiu edelevu kwa ajili ya afua ambazo ziasaidiwa a wafadhili Wahudumu wa baa waude vikudi ili kujega mshikamao katika mapambao dhidi ya VVU/UKIMWI Afua za VVU/UKIMWI zilege watoto a haja ya kuwa wazi katika majadiliao a mashauri pamoja ao kuhusu VVU/UKIMWI i muhimu Afua za VVU/UKIMWI ziazovuka mipaka ya kimataifa zizigatiwe a kuhusisha washika dau wakiwemo viogozi wa dii Uelimishaji kuhusu VVU/UKIMWI hususa matumizi ya kodomu kwa ajili ya viogozi wa dii 1.7. Watu Waishio a Virusi vya UKIMWI a/au UKIMWI Watu waaoishi a Virusi vya UKIMWI a UKIMWI waaelewa vyema vichocheo vya jaga, vikiwemo idadi kubwa ya wahamiaji a wasafiri, ukaribu wa mipaka a chi tatu (Jamhuri ya Kidemokrasia ya Kogo, Malawi a Zambia), ulevi wa kupidukia, mila a desturi (kwa mfao kurithi wajae), goo hatarishi a ukosefu wa habari kuhusu VVU/UKIMWI.Uelimishaji a uhamasishaji i muhimu saa katika kulishughulikia suala hili kiusahihi Msaada wa kifedha a kiufudi uahitajika saa, kwa mfao baiskeli kwa ajili ya matuzo ya yumbai a uhamasishaji wa jamii ili kupambaa a jaga, udumishaji wa huduma bora kwa watu waishio a VVU/UKIMWI a kuwahusisha katika ugharabaishi, kujega uwezo, kupambaa a ubaguzi kutoka kwa wafayakazi wa afya, a mfuko wa jamii ulioudwa a wilaya. Kwa ujumla ilioekaa kuwa watu waishio a VVU/ UKIMWI walitegemea msaada wa mali lakii hawakuzielewa taratibu za ugawaji wa pesa ziazotumiwa a TACAIDS ili kupata msaada wa kifedha. Kwa hiyo elimu zaidi kuhusu upatikaaji wa fedha kwa watu waishio a VVU/UKIMWI iahitajika ili kuwawezesha kubadili mtazamo wao kuwa wa kuishi kwa matumaii a maisha mapya. Ukosefu wa shughuli a miradi ya kuigiza kipato huwafaya watu waishio a VVU/UKIMWI kuwa tegemezi. Kua imai potofu kuwa misaada ya VVU/UKIMWI i kwa ajili ya watu waishio a VVU/UKIMWI kuishi a kujikimu a kwamba watu wakishajitambua kama waa au hawaa VVU/ UKIMWI i haki yao kulipwa a Serikali. Elimu zaidi kwa watu waishio a VVU/UKIMWI kuhusu sera za VVU/UKIMWI, mbiu a haki zao iahitajika, a misaada iayofaa kwa miradi ili kuiwezesha kuwa huru a kujitegemea. 5
Watu waishio a VVU/UKIMWI wapo katika hatari ya maambukizo. Kutokujuaa hali ya afya kuhusu VVU/UKIMWI baia ya washiriki wa tedo la goo, a kutotambua a kujadili hali zao za afya kuhusu VVU/ UKIMWI huababisha watu waishio a VVU/UKIMWI kujiyayapaa a kuacha kutumia dawa za kuogeza kiga ya mwili kwa sababu mbalimbali kama vile dawa kuwafaya watu waishio a VVU/UKIMWI kuwa wachovu kutokaa a ukali wa dawa, ukosefu wa milo ya mara kwa mara a ya uhakika, a kadhalika. Kwa hiyo, elimu zaidi iahitajika kwa watu waishio a VVU/UKIMWI kuhusu VVU/UKIMWI a jisi utumiaji mbaya wa huduma za dawa za kuogeza kiga za mwili uavyoathiri maisha yao. Pia imai za baadhi ya watu waishio a VVU/UKIMWI a baadhi ya makaisa ziasisitiza kutotumia kodomu a kusitisha huduma za dawa za kuogeza kiga ya mwili kwa watu waishio a VVU/UKIMWI kwa sababu wameokoka (kwa mfao Asemblies, Petekoste ya Ilemi, Kwambogo, Wiers), a kusisitiza kwao kuwa hakua lisilowezekaa kwa jia la Yesu Kristo hujega imai potofu a tabia mbaya. 1.8. Wafayakazi wa Biashara ya Ngoo Makasii Bar waa vipidi vya uelimishaji rika vya afya wakati Nyasaga Bar hawaa. Wafayakazi wa mabaa waude vikudi kujega mshikamao katika kudhibiti UKIMWI Kua utumiaji mkubwa wa kodomu katika baadhi ya sehemu a utumiaji mdogo katika sehemu zigie Upatikaaji wa vifaa vya uelimishaji a kodomu za bure Baada ya kufaya kazi kwa muda mrefu katika mabaa waakuja kuizoea a iakuwa gumu kwao kubadilika a kufaya kazi yigie tofauti. Iligudulika kuwa idadi kubwa ya wateja wao i madereva wa safari defu wa kitazaia a wachache i Wamalawi a Wazambia. Madereva wa Kizambia a wa Kimalawi hawapedi kutumia kodomu. Idadi kubwa ya madereva wa safari defu wa Kitazaia hupedelea goo kiyume a maumbile Wagoi wa muda mrefu hawatumii kodomu wakati wote. Ugumu wa hali ya uchumi huwalazimisha kufaya vitedo hatarishi vya goo kwa sababu waalipwa Tshs 15,000/= tu kwa mwezi Kwa sababu ya hali ya hewa ya ubaridi waahitaji watu wa kulala ao Ukosefu wa usalama kutokaa a fujo a vurugu kutoka kwa wamiliki wa mabaa a walizi. Udhibiti dui wa Virusi vya UKIMWI a UKIMWI wa wamiliki wa mabaa. Ukosefu wa jumuiya ya wafayakazi ya biashara ya goo 6
1.9. Wahudumu wa Mabaa Wahudumu wa mabaa walielewa umuhimu wa matumizi ya kodomu a hutembea azo a kuwavalisha wateja wao, lakii walisema kuwa baadhi ya wateja, hasa kutoka Malawi, walig ag aia kufaya goo bila kodomu Vitedo vya Ngoo kiyume a maumbile vilikuwa i kitu cha kawaida. Waaume walikuwa tayari kulipa hadi Tshs. 50,000 kwa ajili ya kufaya goo bila kodomu. Kodomu ziapatikaa kiurahisi katika mabaa lakii sio kodomu za kike. Wasichaa wegi walikuwa i wazazi pekee weye watoto kadhaa. Wateja wakiwaahidi mapezi au doa a kuaza kuwa wagei wa mara kwa mara, waajisahau a kupoteza umakii. Baadhi yao hawakuwa a chazo kigie cha kipato a hivyo kulazimika kufaya kazi baa. Walieleza umuhimu wa kodomu za kike kuwa rahisi zaidi kupatikaa. 1.10. Madereva wa Malori Madereva wa malori walisema kuwa, kwa sababu ya uwezo mdogo wa vivuko vya mpakai kama vile Tuduma a Kasumulo walilazimika kukaa siku yigi katika vitogoji viliyopo barabarai a viliyojaa watu kama Mbeya, Kyela, Kasumulo a Tuduma kusubiri huduma katika vivuko vya mipaka. Madereva wa malori waatumia muda wao mwigi saa katika uywaji wa pombe a kukimbizaa a wasichaa waaowafuata kwa sababu ya pesa zao. Imai ya kuwa madereva wa malori waabeba pesa yigi imesababisha idadi kubwa ya wafayakazi wa biashara ya goo kuwafuata katika vitogoji hivyo vyeye msogamao wa watu wegi. Utafiti ulioyesha kuwa i madereva wa lori wachache waaotumia kodomu waapofaya vitedo vya goo a wafayakazi wa biashara ya goo. Kwa ujumla, madereva wa malori walilalamika kuwa walihitaji afua_ iayowalega wao kama kikudi, lakii ilikuwa siyo rahisi kuipata. Pia waliomba mamlaka husika kuharakisha kazi za kupitisha mizigo a magari katika vivuko vya mpaka ili kukwepa msogamao wa malori barabarai. 2.0 Vichocheo vya Jaga Yafuatayo i masuala yaliyotajwa kuwa vilichocheo vya jaga katika maeeo tuliyoyatembelea: 7
Umaskii au kipato cha chii husababisha biashara ya goo Ulevi wa kupidukia Ufahamu mdogo kuhusu Virusi vya UKIMWI a UKIMWI Mila a desturi hatarishi Uyayapaa a ubaguzi Uhamiaji wa watu kutoka vijijii kweda mijii Barabara kubwa a mipaka baia ya chi tatu (Zambia, Jamhuri ya Kidemokrasia ya Kogo a Malawi) Sherehe a shughuli za kukesha (Mbio za Mwege, goma, misiba a uyago) Imai potofu a za uogo kuhusu Virusi vya UKIMWI a UKIMWI Matumizi yasiyo ya wakati wote ya kodomu Uwezo mdogo wa vivuko vya mpaka (Tuduma a Kasumulo) uaosababisha msogamao wa watu, magari a mizigo Tuduma, Kasumulo, Kyela a Mbeya. Ukosefu wa ajira uaosababisha vikudi vya vijaa viavyojulikaa kwa jia la mtaai kama vijiwe Mavazi yaayoamsha hisia za kutaka kufaya kitedo cha goo (kwa mfao vimii, bikii k) Kuruhusiwa kuigia a kuhudumiwa kwa wavulaa a wasichaa wadogo katika mabaa, yumba za kulala wagei a vituo vigie vya starehe a burudai Picha za goo katika redio, luiga a mtadao Tabia hatarishi za wafayabiashara kutoka sehemu mbalimbali za chi. Ogezeko la vitedo vya ubakaji (Chuya) Uwepo wa migodi (Chuya) Kuajiriwa kwa wasichaa wadogo (chii ya umri wa miaka 18) katika mabaa a vituo vya starehe a burudai. Hali ya hewa ya ubaridi ya Mbeya pia imeelezwa kuwa i moja ya sababu za ogezeko la kasi ya maambukizo ya Virusi vya UKIMWI a UKIMWI Ushidai kati ya wasichaa kutokaa a goo kutumiwa kama jia ya kupata pesa. Ndoa za mitala Ukosefu wa uamiifu katika doa Urithi wa wajae Mwitikio hafifu wa wamiliki wa baa dhidi ya VVU/UKIMWI 8
3.0. Takwimu Mbalimbali 3.1. Takwimu za Mkoa wa Mbeya Jedwali la 1 1. Idadi ya Watu 2,070,041 Waaume: 990,820 Waawake: 1,079,221 2. Kasi ya maambukizo 13.5% 3. Kasi ya maambukizo kutoka kwa mama kweda kwa watoto 4. Vituo vya Ushauri Nasaha a Upimaji wa Hiari 5. Vituo vya Matuzo a Tiba 6. Kamati za Kudhibiti UKIMWI za Serikali za Mitaa 12.7% 133 (15 za zamai, 32 mpya) Zipo wilaya zote lakii ziatofautiaa ufaisi 7. Matumizi ya Kodomu Tazama Taarifa ya Idadi ya Watu a Afya 8. Kasi ya maambukizo (Magojwa ya Ziaa) 9. Idadi ya Wilaya 8 10. Majia ya Wilaya 11. Majia ya Mamlaka za Mkoa 2.5% 1. Mbeya mjii 2. Mbeya vijijijii 3. Chuya 4. Mbozi 5. Ileje 6. Mbarali 7. Rugwe 8. Kyela Mkuu wa Mkoa Katibu Tawala wa Mkoa Mratibu wa Kudhibiti UKIMWI wa Mkoa 9
12 Majia ya Mamlaka za Wilaya 13. Wakala wa Uwezeshaji wa Kimkoa 14. Kiogozi wa timu ya Wakala wa Uwezeshaji wa Kimkoa 15. Idadi ya Vikudi viavyo hudumiwa a wakala wa uwezeshaji wa kimkoa 16. Kiasi kilichotolewa a TACAIDS katika Mkoa wa Mbeya bila kupitia wakala wa uwezeshaji wa kimkoa 17. Jia la mwakilishi wa NACOPHA 18. Kiasi kiachotolewa kwa Mkoa a Wilaya kila mwaka Wakuu wa Wilaya 1. Chuya: Fatuma Kimaryo 2. Ileje: Esther Wakali 3. Kyela: Hussei H. Mashimba 4. Mbarali: Hawa Ngulume 5. Mbeya Mjii a Mbeya Vijijii: Leoidas Gama 6. Mbozi: Hamali Kihemba 7. Rugwe: Mariam Mgaila Makatibu Tawala wa Wilaya 1. Mbeya Mjii: Elizabeth Muo 2. Mbeya Vijijii: Juliaa Mayage 3. Chuya: Maurice Sapaio 4. Ileje: Yoa L. Maliki 5. Mbarali: George Kagomba 6. Mbozi: Livistoe Siliowa 7. Kyela: S.P. Liuma 8. Rugwe: M.E.M Buliga GTZ Iteratioal Services Dr. Bruo Masumbuko Jumla 84, 47 zeye kuwahi kuwa a mkataba a 37 zeye mikataba mipya. 2005/2006: 2006/2007: Tshs: 6,100,000 hii idadi haihusishi pesa zilizotolewa kwa Halmashauri za wilaya Nd.Grace Mwahogo Misaada kutoka Mfuko wa Mwiitikio wa Jamii kuhusu UKIMWI kwa Vyama vya Kiraia a Mfuko wa Pamoja wa Jamii kwa 2005/6 10
Wilaya 1.Rugwe 2.Kyela 3. Mbeya mjii 4. Mbeya vijijii 5. Mbarali 6. Chuya 7. Ileje 8. Mbozi Jumla TShs kwa vyama vya kiraia 30,837,500 28,741,000 32,238,100 23,755,110 34,077,400 34,500,000 26,020,000 40,662,076 250,833,586 TShs kwa Mfuko wa Pamoja wa Jamii 2,000,000 2,000,000 2,000,000 2,000,000 1,500,000 2,000,000 1,996,500 2,372,000 15,868,500 19. Aia za utafiti uaofayika katika mkoa 20. Asasi ziazoshiriki 1. GTZ (TGPSH) 2. Water Reed 3. PSI 4. CARITAS 5. Abbot Fud 6. LCCB AMREF 21. Lego la Mfumo wa Matumizi la Katikati ya Muhula wa Mbeya 1. Utafiti wa Majaribio ya Kiga 2. Ukaguzi wa zamu 3. Ubora wa huduma za kutibu magomjwa ya ziaa 4. Utafiti wa Maedeleo ya Mgojwa 5. Utafiti wa Maambukizi 6. Utafiti wa tiba za kuogeza kiga 7. Utafiti wa kifua kikuu Kuboresha huduma a kupuguza kasi ya maambukizo ya UKIMWI ifikapo 2010 11
Jedwali la 2 3. 2 Takwimu za Wilaya ya Mbeya Idadi ya watu katika wilaya ya Mbeya kwa jisia a umri. Umri/Rika Waaume Waawake Jumla 80+ 882 1,074 1,956 75 79 773 807 1,580 70 74 1,273 1,532 2,805 65 69 1,428 1,927 3,355 60 64 2,008 2,795 4,803 55 59 2,038 2,489 4,527 50 54 2,718 3,727 6,445 45 49 3,251 4,237 7,488 40 44 4,297 5,218 9,515 35 39 5,373 6,555 11,928 30 34 6,990 8,411 15,401 25 29 8,804 11,483 20,281 20 24 9,332 13,597 22,929 15-19 13,553 14,416 27,969 10-14 16,846 17,380 34,226 5-9 18,825 19,272 38,097 0-4 20,405 20,552 40,957 Jumla 118,597 135,472 254,069 Chazo: Ofisi ya DPLO ya Halmashauri ya Wilaya ya Mbeya 12
Jedwali la 3 Idadi ya Watu Kwa Kata Katika Wilaya ya Mbeya Na. Jia la Kata Idadi ya Vijiji Idadi ya Kaya Waaume Idadi ya Watu Waawake Jumla 1 IHANGO 5 2,855 5,280 5,910 11,190 2 ULENJE 7 3,081 5,178 6,295 11,473 3 TEMBELA 11 3,836 6,604 8,056 14,660 4 IJOMBE 7 2,439 4,081 4,857 8,938 5 SANTILYA 7 3,937 6,926 8,291 15,217 6 ILEMBO 13 5,173 10,082 11,718 21,800 7 IWIJI 5 3,091 6,188 7,077 13,265 8 ISUTO 11 5,275 9,649 11,337 20,986 9 IGALE 9 4,485 8,259 9,628 17,887 10 IWINDI 8 3,789 7,151 8,147 15,298 11 UTENGULE USONGWE 7 10,740 20,897 23,192 44,089 12 MSHEWE 8 2,482 5,230 5,374 10,604 13 IKUKWA 2 1,240 2,375 2,703 5,078 14 IYUNGA MAPINDUZI 5 1,479 2,758 3,043 5,801 15 BONDE LA SONGWE 6 3,953 8,061 8,301 16,362 16 INYALA 8 2,780 5,180 5,923 11,103 17 ILUNGU 7 2,887 4,901 5,417 10,318 JUMLA 126 63,522 118,800 135,269 254,069 Chazo: Ofisi ya Mipago Matokeo ya Sesa ya Watu 2002 Halmashauri ya Wilaya ya Mbeya 13
Jedwali la 4 Vifaa vya Uelimishaji Taarifa ya vifaa vya Uelimishaji Ja Des 2006 Vifaa Salio Zimepokelewa Jumla Zimesambazwa Salio Vipeperujshi - Matumizi ya kodomu 34325 31600 65925 50400 15525 Vipeperushi - STD 24525 32000 56525 45900 10625 Vipeperushi - VCT 23097 32000 55097 44700 10397 Vipeperushi - ARV 32808 32000 64808 40700 24108 Vipeperushi - PMTCT 22408 31000 53408 38600 14808 Vipeperushi - PMTCT 29258 31000 60258 37870 22388 Vitabu - Maswali a Majibu 4799 7350 12149 8680 3469 Vitabu 8 908 5000 5908 5117 791 Vitabu 570 0 570 310 260 Vitabu - Kuelewa kuishi a VVU 7808 0 7808 3480 4328 Vitabu PHEs guide STD V 164 1000 1164 906 258 Vitabu PHEs guide STD VI 84 1000 1084 906 178 Vitabu - PHEs guide STD VII 1340 0 1340 916 424 Mikada ya video 129 0 129 9 120 Vipeperushi 0 15000 15000 12030 2970 Vipeperushi - Hope for Tazaia Part I 91 0 91 17 74 Vikpeperushi - Hope for Tazaia Part II 56 0 56 17 39 Vipeperushi - Wasichaa kama hutaki mimba 0 15000 15000 13650 1350 Mabago 2920 0 2920 1672 1248 Mabago - Ishi upedavyo 0 2000 2000 96 1904 Mabago - Bill boards 0 16 16 16 0 Mabago - Huwezi kutambua VVU Mabago 0 2000 2000 96 1904 Mabago - Uyayapaa 0 4000 4000 2900 1100 Vipeperushi 0 6000 6000 5800 200 Fulaa a Kofia 0 0 0 0 0 Chazo : Taarifa ya VVU/UKIMWI a magojwa ya ziaa ya Mradi wa Kudhibiti UKIMWi ya Mkoa wa Mbeya - 2006 14
3.4 Elimu Rika a) Shule za Msigi Jedwali la 5 Wilaya Idadi ya Shule Shule zeye elimu rika Maelezo zaidi ya ziada Mbeya Rural 125 76 Msaada mwigi kutoka TGPSH Rugwe 196 44 Msaada mwigi kutoka TGPSH Mbozi 202 13 Msaada mwigi kutoka TGPSH Chuya 101 53 Msaada mwigi kutoka TGPSH lakii pia kutoka kweye jamii Ileje 83 0 Hama mafuzo yaliyoedeshwa Mbarali 102 0 Hama mafuzo yaliyoedeshwa Kyela 99 0 Uhamasishaji umefayika kwa walimu a kamati katika shule kumi tu Mbeya Urba 75 51 Msaada mwigi kutoka TGPSH Jumla 983 237 Katika shule yigi elimu rika hutolewa kuazia darasa la tao Ogezeko la shule za msigi zisizo kuwa a elimu rika Mkakati madhubuti i muhimu kwa ajili ya uedelevu Chazo: Taarifa ya VVU/UKIMWI a magojwa ya ziaa ya Mradi wa Kudhibiti UKIMWi ya Mkoa wa Mbeya - 2006 15
Jedwali la 6 b) Maeeo yeye kasi kubwa ya Maambukizo Wilaya Idadi ya maeeo yeye kasi kubwa ya maambukizo Maeeo yeye kasi kubwa ya maambukizo yeye elimu rika Idadi ya waelimishaji rika Mbeya Vijijii 10 10 20 Rugwe 10 10 20 Mbozi 10 10 14 Kyela 3 3 6 Chuya 4 4 8 Ileje 3 2 4 Mbarali 4 4 8 Mbeya Mjii 14 10 20 Jumla 52 50 100 Chazo: Taarifa ya VVU/UKIMWI a magojwa ya ziaa ya Mradi wa Kudhibiti UKIMWi ya Mkoa wa Mbeya - 2006 Jedwali la 7 (c) Afua Makazii Wilaya Idadi ya maeeo ya kazi Idadi ya maeeo ya kazi zeye elimu rika ya afya Mbeya Vijijii 6 4 Rugwe 6 1 Mbozi 15 15 Chuya 5 4 Ileje 4 3 Mbarali 5 0 Kyela 5 3 Mbeya Mjii 13 8 Jumla 59 38 Chazo: Taarifa ya VVU/UKIMWI a magojwa ya ziaa ya Mradi wa Kudhibiti UKIMWi ya Mkoa wa Mbeya - 2006 16
Jedwali la 8 3.5 Uhamasishaji a matumizi ya kodomu Jia la Wilaya Mauzo kwa katoi Jumla ya Ja. Feb. Mar. Apr. Mei. Ju. Jul. Ago. Sep. Okt. Nov. Des. katoi Mbeya mjii 352 595 154 286 435 60 451 582 766 217 330 195 4425 Mbeya vijijii 82 0 13 0 65 0 0 22 56 12 11 22 283 Chuya 22 88 44 33 33 33 22 70 24 56 68 77 514 Kyela 0 77 0 24 70 77 44 44 113 55 39 88 631 Rugwe 0 12 10 26 0 33 35 44 56 22 62 22 322 Mbozi 31 0 66 54 94 22 55 339 0 156 44 33 894 Mbarali 44 0 22 33 88 0 0 55 23 0 113 11 389 Ileje 15 0 66 20 11 22 11 25 11 8 9 11 209 Jumla ya Katoi Jumla ya Kodomu 541 784 375 476 796 544 618 1181 937 529 678 459 7918 311616 451584 216000 274176 458496 313344 355968 680256 539712 304704 390803 264384 4,561,043 Katoi 1 = Kodomu 576 (b) Ugawaji wa kodomu za bure Jumla = Kodomu 1,544,909 Jumla ya idadi ya kodomu zilizo sambazwa: 6,005,952 Chazo: Taarifa ya VVU/UKIMWI a magojwa ya ziaa ya Mradi wa Kudhibiti UKIMWi ya Mkoa wa Mbeya - 2006 17
Jedwali la 9 3.6 Idadi ya wagojwa wa UKIMWI katika makliiki 1. Igogwe 62 2. Isoko 25 3. Kyela 430 4. Matema 198 5. Mbalizi 160 6. Mbarali 8 7. Mbeya Regioal 3 8. Mbozi Missio 54 9. Mwambai 311 10. Tukuyu 50 11. Uyole 106 Jumla 1,407 Chazo: Taarifa ya VVU/UKIMWI a magojwa ya ziaa ya Mradi wa Kudhibiti UKIMWi ya Mkoa wa Mbeya - 2006 18
Jedwali la 10 3.7 Uzuiaji wa Uambukizo wa Virusi vya UKIMWI kutoka kwa Mama kweda kwa Mtoto Chuya Ileje Kyela Mbarali Willaya ya Mbeya t Mji wa mbeya Mbozi Rugwe Jumla Ushauri Nasaha a Upimaji wa Hiari Katika Kliiki za Wajawazito Vituo viavyotoa huduma 2 2 1 1 4 8 3 8 29 Wateja wapya 1939 585 1522 1119 2424 11,573 3358 3882 26,402 Ushauri kabla ya kupima 1969 609 1666 1037 1763 5906 2267 3926 19,143 Waliopima 1594 434 1571 943 1569 5076 1817 3903 16,907 Ushauri baada ya kupima 1594 434 1570 910 1566 5071 1815 3902 16,862 Walio a Virusi vya UKIMWI/UKIMWI 189 26 248 148 230 711 200 393 2145 Walio pewa NVP 50 8 83 69 122 269 116 249 966 Waaochukua tiba ya kuogeza kiga 0 0 0 0 0 1036 67 35 1138 Waume waaokuja kliiki 100 10 48 32 63 169 69 197 688 Waume walio pima UKIMWI 98 10 48 32 63 151 63 188 653 Waume walio a UKIMWI 12 0 17 8 18 27 16 37 135 Waawake waliojifugua 2058 808 1663 1733 1010 11,301 4368 2964 25,905 Waliojua hali yao za UKIMWI kliiki 622 184 695 257 372 1599 695 1410 5834 Waliochukua tiba za Kuogeza Kiga 0 0 0 0 0 340 8 5 353 Waliochukua Nevirapie 66 11 79 62 22 351 105 264 960 Weye watoto waliochukua NVP 65 11 136 62 26 434 106 264 1104 Mama a mototo waliochukua NVP 63 10 122 61 21 350 103 241 971 Wakia mama waathirika waaokusudiwa kuyoyesha 74 10 120 61 24 416 106 261 1072 Wasioathirika waaokusudiwa kutoa huduma mbadala ya kuyoyesha 1 1 16 1 2 18 0 8 47 Watoto waliopima chii ya miezi 18 0 0 0 0 0 73 12 0 85 Watoto walio a UKIMWI 0 0 0 0 0 21 0 0 21 19
Kati ya watoto 24 waliopimwa ambao hawamo katika mpago wa uzuiaji wa maambukizo ya virusi vya UKIMWI kutoka kwa mama kweda kwa motto, 17 walikuwa a VVU a/au UKIMWI (Taarifa ya VVU/UKIMWI a magojwa ya ziaa ya Mradi wa Kudhibiti UKIMWi ya Mkoa wa Mbeya - 2006 Jedwali la 11 3.8 Dalili za Magojwa ya Ziaa Wilaya GUD GDS PID RPR CHANYA MENGINEYO KUKUTANA JUMLA -Me -Ke -Me -Ke -Ke -Me -Ke -Me -Ke -Me -Ke -Me -Ke JUMLA KUU Chuya 751 810 725 1049 1113 157 379 148 286 757 707 2538 4344 6882 Ileje 235 248 236 324 353 66 138 3 71 163 167 703 1301 2004 Kyela 485 474 466 649 526 70 187 88 139 346 324 1455 2299 3754 Mbarali 434 369 513 571 516 113 177 88 105 308 348 1456 2086 3542 Mbeya Vijijii Mbeya Mjii 602 521 645 821 772 123 273 128 169 525 513 2023 3069 5092 492 514 546 689 577 123 310 308 150 432 385 1901 2625 4526 Mbozi 867 894 939 1234 1210 222 452 183 273 746 684 2957 4747 7704 Rugwe 639 647 723 922 1091 213 416 114 227 597 578 2286 3881 6167 Mkoa 4,505 4,477 4,793 6,259 6,158 1,087 2,332 1,060 1,420 3,874 3,706 15,319 24,352 39,671 Chazo: Taarifa ya VVU/UKIMWI a magojwa ya ziaa ya Mradi wa Kudhibiti UKIMWi ya Mkoa wa Mbeya - 2006 20
Jedwali la 12 3.9 Ushauri Nasaha a Matuzo ya Nyumbai (a) Ushauri Nasaha Waaume waliopima Waawake waliopima Jumla Waaume Chaya Waawake Chaya Jumla Chaya Wateja walioshukiwa 332 381 713 209 233 442 Wateja wa ushauri asaha a kupima 16,226 20,590 36,816 4,025 6,227 10,252 Wateja uzuiaji maambukizo kutoka kwa mama kweda kwa mtoto 653 16,907 17,560 135 2,145 2,280 Jumla 17, 211 37,878 55,089 4,369 8,605 12,974 Chazo: Taarifa ya VVU/UKIMWI a magojwa ya ziaa ya Mradi wa Kudhibiti UKIMWi ya Mkoa wa Mbeya - 2006 21
Jedwali la 13 (b) Matuzo ya Nyumbai Jumla ya Idadi ya Mkoa: Wagojwa wapya 4,590, wa zamai 3,415. Jumla 8,005 Usimamizi Wilaya Jumla ya vituo vya afya Waliosimamiwa Kyela 25 18 Mbozi 46 23 Mbeya Mjii 37 17 Mbeya Wilayai 39 21 Chuya 35 19 Rugwe 55 22 Mbarali 47 20 Ileje 24 9 Jumla 340 149 Chazo: Taarifa ya VVU/UKIMWI a magojwa ya ziaa ya Mradi wa Kudhibiti UKIMWi ya Mkoa wa Mbeya - 2006 22
3.10 Matuzo a Tiba Jedwali la 14 Kipiddi cha kuaza kutoa tiba za kuogeza kiga ya Mwili Chimala Kyela Mbarali Matema Vwawa Isoko Uhai MRH Regioal Rugwe JWTZ Igogwe Mwambai Jumla kwa Mkoa A. Wateja waaopata matuzo a tiba 1 2 3. -Me (Miaka 15 a zaidi) -Ke (Miaka 15 a zaidi) Watoto (Chii ya miaka 15) 77 289 119 77 704 4 0 1537 634 572 216 245 142 5156 124 899 46 129 1154 9 0 2694 1265 847 355 175 7657 15 96 68 4 107 0 518 106 118 18 8 1058 B. Wateja waaopata tiba ya vidoge vya kuogeza kiga ya mwili 1. -Me (Miaka 15 a zaidi) 42 827 5 44 273 4 740 366 237 80 74 81 2773 2. -Ke (Miaka 15 a zaidi) 71 394 9 41 335 9 1207 686 247 74 100 92 3265 3. Watoto(Chii ya miaka 15) 3 53 0 3 23 0 256 44 45 6 9 0 442 C. Waaostahili tiba ya kuogeza kiga ya mwili lakii hawajaaza 1. -Me(Miaka 15 a zaidi) 36 178 7 17 156 0 126 19 92 5 4 61 701 2. -Ke (Miaka 15 a zaidi) 51 217 13 14 257 3 175 79 127 8 6 83 1033 3. Watoto (chii ya miaka 15) 13 108 0 1 34 0 36 12 38 6 0 8 256 Chazo: Taarifa ya VVU/UKIMWI a magojwa ya ziaa ya Mradi wa Kudhibiti UKIMWi ya Mkoa wa Mbeya - 2006 23
SURA YA PILI CHANGAMOTO Kua halmashauri ae katika Mkoa wa Mbeya, ambapo mkoa mzima ua wadau waaoziratibu katika masuala yote yaayohusiaa a VVU/UKIMWI. Wakati wa ziara ya timu kutoka TACAIDS ilitambulika kuwa halmashauri kwa kiwago fulai hazitekelezi kazi vyema ipasavyo katika suala zima la kupambaa vita dhidi ya VVU/UKIMWI katika mkoa. Hii ilioekaa wakati wa majadiliao ambapo mipago ya halmashauri ilihusisha shughuli za VVU/UKIMWI lakii iatekelezwa polepole. Sababu kuu i ucheleweshaji wa malipo ya pesa waazogawiwa kwa ajili ya shughuli za VVU/UKIMWI. Kwa hiyo waratibu wa UKIMWI wa Halmashauri za Wilaya walisisitiza kuzihamasisha halmashauri. Hii iatajwa katika tafiti iliyofaywa Mbeya a Dr.Ulrich F. Vogel chii ya mradi wa UNAIDS mamo Machi, 2007. Kama alivyooyesha a ilivyojadiliwa mamo 2005 wakati wa warsha ya kitaifa, kamati za kudhibiti UKIMWI katika mamlaka za serikali za mitaa zilishutumiwa kwa kuwa wazito a kuoa UKIMWI kama biashara kama kawaida a pia kukosa uogozi a ari. Hata hivyo, licha ya hizi shughuli kipade kikubwa cha jamii hakijafikiwa. Kwa hiyo maelezo kuhusu maambukizi ya UKIMWI katika jamii ya wafuga g ombe wa kimasai a waedesha tohara wa kijadi (gariba) hayajulikai. Kumekuwa a ogezeko la huduma za VVU a UKIMWI. Upatikaaji wa elimu iayofaa a sahihi kuhusu UKIMWI uaedelea kuwa chagamoto. Igawa wafayakazi wa biashara ya goo waatambulika kuwa i moja ya vichocheo vikuu vya jaga, kua miraddi michache saa iayowalega wao. Kua mafuzo megi muhimu yaliyopatikaa kutokaa a miradi mbalimbali katika mkoa, lakii migi haiwekewi kumbukumbu wala haihadithiwi. Chagamoto Ugumu wa kupata taarifa hasa kutoka Hospitali ya Rufaa ya Mbeya kwa mfao taarifa kwa ajili ya watoaji damu a wagojwa wa UKIMWI. Idadi kubwa ya watu waishio a VVU/UKIMWI waaostahili tiba za kuogeza kiga ya mwili lakii hawaipati. Usimamizi usiokuwa wa mara kwa mara Upimaji wa kaswede wa mama wajawazito bado hautoshelezi kwai kua vituo 77 vya afya vyeye uwezo wa kupima wajawazito kati ya vituo 340. Mpago wa Afya wa Elimu Rika Makazii haujakamilika Idadi iayopugua ya shule za msigi zeye elimu rika Kazi zito a ukosefu wa uhamasishaji, kwa mfao Elimu Rika katika maeeo ya kasi 24
kubwa ya maambukizi, a wafayakazi wa afya weye kufaya kazi za ziada. Ukosefu wa uhakika katika utegeezaji a usambazaji kutoka Duka la Vifaa vya Afya Uwezo mdogo wa maafisa maedeleo wa kata kutekeleza shughuli za maedeleo katika kata. Hii iasababishwa a upugufu wa pesa za kuedesha mafuzo ya wafayakazi. Uwezo mdogo wa kusimamia a kufuatilia harakati za kupambaa a UKIMWI katika gazi ya kata. Uhusishaji mdogo wa maafisa maedeleo a mashirika yaayofaya kazi katika Maispaa ya Mbeya. Ukosefu wa usafiri wa kuamiika kwa wafayakazi kwai kua kata 36 katika wilaya ya Mbeya vijijii. Mchagayiko wa watu masokoi, viwadai, kweye sherehe za kidii a kweye mabaa. Mchagayiko wa wagei a wasafiri kutoka chi za jirai kama vile Jamhuri ya Kidemokrasia ya Kogo, Malawi a Zambia. Mimba za wasichaa wadogo Mila a desturi, kwa mfao kurithi wajae Kasi kubwa ya maambukizi - 13.5% Uimarishaji wa mbiu zilizopo pamoja a mfumo mpya katika gazi ya mitaa Je, utachagia kupuguza kasi ya maambukizi katika miaka 5 a 10 ijayo? Uyayapaa a ubaguzi Magojwa ya ziaa Ucheleweshaji wa malipo ya pesa Kazi zito kwa wafayakazi wachache. Mtazamo 25
SURA YA TATU MAFANIKIO 1. Elimu rika Maeeo yaayolegwa i maeeo yeye kasi kubwa ya maambukizo, sehemu za kazi a shule za msigi. Kwa upade wa elimu rika katika shule za msigi, semia a mafuzo yameedeshwa kwa vikudi vya walegwa. Mafuzo yaliedelea mwaka huu katika baadhi ya wilaya kwa kuazisha elimu rika katika baadhi ya shule au kwa kuimarisha elimu rika iliyopo sasa katika shule za msigi, igawa katika uwezo tofauti. Elimu Rika katika sehemu za kazi iliimarishwa kwa mafuzo ya siku 3 ya waelimishaji rika wote kutoka hospitali ya mkoa wa Mbeya. Pia, makampui biafsi yaliedesha mafuzo chii ya msaada wa kiufudi wa mkoa a ushauri kutoka kwa waelimishaji wa waelimishaji waliopo katika mkoa. Tuhimize uelimishaji rika Shughuli mbalimbali zilizokuwa ziaedelea katika maeeo yeye kasi kubwa ya maambukizo tofauti ziliimarishwa a kuedelezwa. Mradi uliedesha mafuzo kwa ajili ya wilaya za Mbeya Mjii a Vijijii kwa watu 39. Mafuzo yalitaguliwa a mkutao wa uhamasishaji kwa wafayakazi a wamiliki wa mabaa. Ilifuatiwa a mkutao wa kutambulishaa baia ya matabibu kutoka maeeo yeye kasi kubwa ya maambukizo a waelimishaji rika waliopata mafuzo, a kuishia a mkutao wa waachama wote wa Kamati ya Kudhibiti UKIMWI ya Kata (WMAC). 26
2. Utegeezaji a usambazaji wa vifaa vya uelimishaji Kwa jia ya moja kwa moja au vigievyo mradi huu uafikia jamii a uahitaji vifaa mbalimbali vya uelimishaji ili kuedelea kutoa elimu kwa watu. Jedwali la 4 (Ukurasa wa 10) liaorodhesha aia za vifaa vya elimu ya afya zilizotegeezwa a/au kusambazwa. Vifaa hivyo i pamoja a vipeperushi, vitabu, kaleda, mabago k. Matagazo ya redio yaliyotegeezwa a kurushwa hewai hapo awali, yaaedelea kurushwa hewai mwaka huu. Vifaa vya elimu vimekuwa vikitakiwa a kuhitajika saa dai a je ya mkoa a vimekubalika katika jamii. 3. Maoyesho ya maigizo a filamu. Vikudi 5 vilivyosajiliwa vya maigizo vimekuwa vikifaya maoyesho katika maeeo yao lakii vigie kama KIHUMBE vimekuwa vikifaya maoyesho hadi je ya maeeo yao kwa mialiko maalumu. Idadi ya maeeo yaliyooyesha michezo ya kuigiza i 275 a yalihudhuriwa a watu 255,123 kutoka katika idadi iliyotegemewa ya watu 305,107. Maigizo megie huedeshwa katika maeeo tofauti kwa kutumia vikudi visivyosajiliwa vilivyopo katika kila wilaya. Wilaya zisizokuwa a vikudi vya maigizo vilivyosajiliwa zia mpago wa kuviazisha. Tujielimishe kuhusu UKIMWI Uoyeshaji wa filamu umechagamka katika mkoa a kuwepo kwa luiga a video katika maeeo ya hadharai a hata majumbai uawezesha watu kuoa mikada ya video tofauti majumbai, katika mabaa, vituo vya afya au yumba za wagei. Mara hii maoyesho ya filamu yalifaywa wilaya za Mbeya Vijijii a Mbarali, pamoja a maoyesho ya video. 27
Vikudi vya saaa viaweza kutoa elimu ya UKIMWI kwa umma 4. Mikutao /Mafuzo/Semia/Warsha Chii ya kipegele hiki yafuatayo yalitekelezwa: i) Mafuzo ya siku 5 ya kuedeleza elimu rika katika maeeo yeye kasi kubwa ya maambukizo Mbeya Mjii/Vijijii yaliyoeda sambamba a mkutao wa uhamasishaji kwa wamiliki a wafayakazi wa mkoa a waachama wa Kamati ya Kudhibiti UKIMWI ya Kata kutoka maeeo yeye kasi kubwa ya maambukizo; ii) Kogamao la siku moja la wafayakazi wa hospitali ya mkoa a familia zao lililofayika Siku ya Familia duiai, iii) Mkutao wa UKIMWI wa Arusha 2007; iv) Uadhimishaji wa siku ya UKIMWI duiai, iliyoadhimishwa kimkoa Kyela; v) Hakua mafuzo ya kuazisha elimu rika kwa madereva wa teksi wa mji wa Mbeya; vi) Semia za uhamasishaji kwa Timu ya Afya ya Halmashauri ya Wilaya ili kuazisha elimu rika UKIMWI makazii katika gazi ya hospitali; vii) Mkutao wa afya wa mkoa uliofayika siku tatu kila baada ya miezi mitatu ambapo waachama wa Timu ya Afya ya Halmashauri ya Wilaya /Timu ya Afya ya Halmashauri ya Mkoa pamoja a wataalamu walikutaa kwa lego la kuboresha a kuimarisha huduma za afya katika Mkoa wa Mbeya. Huu pia ulikuwa i mkutao ambapo taarifa ya utekelezaji wa shughuli za Virusi vya UKIMWI/UKIMWI/Magojwa ya ziaa ilijadiliwa.. 28
viii) ix) Utoaji wa msaada wa kiufudi kwa sekta ya umma a biafsi kwa kupitia mafuzo/mikutao katika eeo la Virusi vya UKIMWI/UKIMWI. Warsha iliadaliwa Dar es Salaam kwa msaada wa Mfuko wa Duia ili kupata taarifa ya maedeleo. Mkutao a watu wa vyombo vya habari kwa lego la kuwapatia habari mpya kuhusu Virusi vya UKIMWI/UKIMWI. 5. Uhamasishaji wa Matumizi ya kodomu 6. Utafiti Mkoa wa Mbeya ua kodomu za bure a ziazouzwa ziazowafikia watu kupitia jia tofauti. Hii i ili kuhakikisha kuwa kodomu ziapatikaa muda wote ili watu weye kushidwa kusubiri au kuwa waamiifu wapate matumizi sahihi a hakika ya kodomu. Jumla ya idadi ya kodomu zilizosambazwa i kodomu 6,005,952. Katika kutekeleza lego lake la kufuatilia yedo za jaga, mradi umejihusisha a tafiti tofauti kwa miaka. Mara kwa mara, mradi umekuwa ukitoa taarifa za wagojwa wa UKIMWI kwa Mradi wa Taifa wa Kudhibiti UKIMWI a idadi iliyotolewa mwaka huu ya wagojwa wa UKIMWI i 1,408. Ukusayaji wa takwimu uategemewa kuaza Jauari, 2007 7. Huduma za Matuzo a Tiba Huduma hii iliazishwa Oktoba 2004 katika mkoa. Ujezi wa uwezo kwa ajili ya wafayakazi wa afya katika hospitali ya rufaa ya Mbeya uliedelea a vituo viavyotoa huduma za matuzo a matibabu sasa hivi i pamoja a hospitali za mkoa a rufaa, hospitali zote za wilaya, hospitali ya mishei ya Igogwe, hospitali ya Kilutheri ya Matema, hospitali a kituo cha Uhai Baptist, hospitali ya Mwambai, hospitali ya Isoko a hospitali ya Chimala. Jumla ya wagojwa waliohudumiwa i 13,911; waliopata dawa ya kuogeza kiga ya mwili i 3,480, a waliotakiwa kupata dawa ya kuogeza kiga ya mwili i 8,470. 8. Mradi wa Jamii ya Kiraia Mkoa ulifaikiwa kupata msaada kutoka kwa wakala wa uwezeshaji wa mkoa (GTZ) kutoka Beki ya Duia. Katika eeo hili, mwazo GTZ walifaya utafiti a asasi za kiraia zilizopo Mbeya Mjii a Wilaya ya Kyela. Timu ya Wakala ya Uwezeshaji wa Kimkoa imepaua yaja za utafiti hadi kuhusisha mkoa mzima, ikifuatia kwa kuedesha mafuzo kuhusu uadishi wa miradi a sasa iaeda mbele zaidi ili kuwezesha asasi za kiraia kufaya kazi kikamilifu. Hii iachagia kuogezeka kwa jamii kujihusisha katika mapambao dhidi ya Virusi vya UKIMWI/UKIMWI. 29
9. Upatikaaji wa Pesa kutoka Serikali za Mitaa Kupitia uraghibishi a uhamasishaji baadhi ya shughuli zilipata msaada a pesa kutoka Serikali za Mitaa. Shughuli zilizopata msaada wa pesa i pamoja a usimamizi, elimu rika katika shule za msigi a maeeo yeye kasi kubwa ya maambukizo ya UKIMWI, maigizo a maoyesho ya filamu pamoja a matukio ya kitaifa kama Siku ya Ukimwi Duiai. Juhudi ziaedelea kupata msaada mkubwa zaidi. 10. Uboreshaji wa Usafi wa Vifaa vya Hospitali Katika kuhakikisha kuwa watu hawapati maambukizo ya VVU kwa kupitia vifaa vya hospitali, vituo vyote vya afya huchemsha vifaa vyake kwa kutumia chombo maalumu cha kuodoa vijidudu vyote vya ugojwa kwa kuchemsha au kwa kupasha moto. Pia, wafayakazi wa afya walikuwa waakumbushwa wakati wote kuhusu uwezekao wa kupata maambukizo wakati waafaya kazi au uwezekao wa kumwambukiza Virusi vya Ukimwi mgojwa kutoka kwa mgojwa mwigie kwa bahati mbaya, hivi karibui wafayakazi wote kutoka hospitali ya mkoa ya Mbeya walihudhuria semia ya siku e iliyohusu jisi ya kudhibiti maambukizo. 11. Uzuiaji wa maambukizi ya Virusi vya UKIMWI kutoka kwa Mama Kweda Kwa Mtoto Mkoa uliweza kuogeza huduma hadi kuzifikia wilaya zote a jumla ya idadi ya vituo imefika 29 kutoka vituo 4 vilivyokuwepo kabla. Vyote viasimamiwa mara kwa mara a waawake wajawazito waapata huduma ipasavyo. Jumla ya waawake wajawazito 960 a watoto wachaga 1104 walipata dawa iitwayo Nevirapie. Jumla ya waawake wajawazito waliopata ushauri asaha a kupima Virusi vya UKIMWI i 16,907 kati ya waawake wajawazito 26,402 waliopata huduma ya awali ya kliiki. Waawake wajawazito 2,145 waligudulika kuwa a virusi vya UKIMWI. Waume pia waazidi kuhusishwa. Jumla ya waume 653 walipima a 135 waligudulika kuwa a Virusi vya UKIMWI. Huduma ya Uzuiaji wa maambukizi ya Virusi vya UKIMWI Kutoka kwa Mama Kweda kwa Mtoto iliedelea a jumla ya wateja 2,409 walipimwa. 265 walijiadikisha kweye idadi ya CD 4 a 235 waapata tiba ya vidoge vya kuogeza kiga ya mwili. 12. Udhibiti wa Magojwa Megie ya Ziaa Vituo vya afya 315 kati ya 340 viatoa huduma za tiba za dalili za magojwa. Katika kila kituo cha afya kua wafayakazi wa afya waliopitia mafuzo ya tiba za 30
dalili za magojwa. Mfumo wa kuagiza madawa wa mfumo wa pull umetumiwa mwaka mzima. Lakii bado kua matatizo katika upokeaji wa bidhaa zilizoagizwa. 13. Ushauri Nasaha a Upimaji wa Hiari a Matuzo ya Nyumbai Mkoa ua vituo vya afya 117 vyeye kutoa huduma ya ushauri asaha a kupima a jumla ya idadi ya washauri asaha katika mkoa i 234. Jumla ya idadi ya wateja walioshauriwa a kupima i 55,098. Na katika hawa, 12,983 walikuwa a Virusi vya UKIMWI. Matuzo ya yumbai yaatolewa kwa wateja 8,005. Kwa ujumla kua idadi iayoogezeka ya watu waaopata ushauri asaha a kupima a matuzo ya yumbai. Jamii ayo iazidi kujihusisha katika kutoa huduma ya matuzo a msaada abayo i dalili ya kupugua uyayapaa. Kuhusiaa a ujezi wa uwezo, watoaji huduma ya matuzo ya yumbai 80 kutoka katika jamii walipata mafuzo Rugwe a Mbozi kwa msaada wa ufadhili wa Walter Reed. 14. Usalama wa Damu a Maabara Huduma ya usalama wa damu iliedelezwa a kila kituo cha afya ambapo damu ilipimwa kugudua kama ia Virusi vya UKIMWI. Huduma hii imekuwa ikiogezeka kasi mara kwa mara sambamba a uhamasishaji a uhusishaji wa jamii. 15. Kutembeleaa a Matukio Nae Nae:- Wakati wa tukio hili Mradi wa kudhibiti UKIMWI Mkoa wa Mbeya (MRACP) waliadaa shughuli tofauti ikiwemo ushauri asaha a upimaji wa hiari, huduma ya tiba ya magojwa ya ziaa, uelimishaji, maigizo a maoyesho ya filamu. Jumla ya wateja 1331 walipata huduma za ushauri asaha a kupima, a 109 waligudulika kuwa a Virusi vya UKIMWI. Waafuzi kutoka shule kadhaa za sekodari kama vile Arage, Lyawilo a Tukuyu walitembelea ofisi wakati wa kipidi cha mradi a kupata elimu kuhusu Virusi vya UKIMWI/UKIMWI a magojwa ya ziaa. 16. Usimamizi Usimamizi uliedeshwa, igawa siyo mara kwa mara kwa sababu ya kuigiliaa kwa ratiba ya shughuli za gazi ya kimkoa a za gazi ya taifa. Hata hivyo, kila wilaya ilisimamiwa. 31
SURA YA NNE MAPENDEKEZO Njia ya mbele: Kufuatilia kwa umakii shughuli za asasi zisizo za kiserikali katika gazi ya kata. Shughuli za mapambao dhidi ya UKIMWI ziazotekelezwa katika gazi ya kata zilege maeeo yeye kasi kubwa ya maambukizo. Kujega uwezo wa Kamati za Kudhibiti Ukimwi za Vijiji a za Kata ili kupambaa a jaga katika gazi ya chii. Waratibu wa UKIMWI wa Halmashauri za Wilaya ambao pia i maafisa maedeleo wa wilaya waa kazi yigi saa. Ili kuweza kufaya kazi zao kwa ufaisi zaidi iabidi wafaye kazi za kuratibu shughuli za UKIMWI a si yigiezo za ziada.. Kua haja ya waratibu wa UKIMWI wa Halmashauri za Wilaya kuwashauri Kamati za kudhibiti UKIMWI katika Mamlaka za Serikali za Mtaa jisi ya kugawa pesa kwa usawa kwa asasi za kiraia ziazostahili kupewa pesa hizo kwa ajili ya kugharamia shughuli zao za kupambaa a jaga la UKIMWI. Kama kua asasi isiyo ya kiserikali iayopata pesa kutoka sehemu moja, basi asasi isiyo ya kiserikali isiyokuwa a msaada ipewe kipaumbele. Katika miradi iayofadhiliwa, ufadhili uapokwisha, iabidi itegeezewe ufadhili mbadala ili iwe edelevu. Imepedekezwa kuwa, kwa vile kua utajiri wa ujuzi katika shughuli za Virusi vya UKIMWI/UKIMWI katika gazi ya jamii ambazo haziwekewi kumbukumbu kwa hiyo kua haja ya kuedeleza utamadui wa kuweka kumbukumbu za ujuzi huu, a siyo kusubiri hadi wagei kutoka je waje a kuweka, kuhifadhi a kumiliki kumbukumbu hizo. Watu waaofaya kazi katika maeeo yeye kasi kubwa ya maambukizo i kudi ambalo lipo katika hatari kubwa ya kupata maambukizo ya Virusi vya UKIMWI. Kwa hiyo, kwa vikuddi vilegwa kama wahudumu wa baa, wauzaji wa pombe za kieyeji, watumishi wa yumba za kulala wagei a wasichaa waaohama kutoka baa moja hadi yigie kutafuta waaume, iabidi miradi maalum iedelezwe kuokoa kudi hili la walegwa, ambao waa tazamwa kuwa i wafayakazi wa biashara ya goo. Kwa kuwa kua uhaba wa vifaa vya ujelimishaji chii iabidi kuwasiliaa a wategeezaji wa vifaa hivyo kuhusu uwezekao wa kutegeeza vifaa vigi zaidi a kuviuza kwa taasisi zigie - iabidi itegeezwe ili kujua ii kilichopo a wapi vifaa viapatikaa a habari hizi kusambazwa kwa taasisi mbalimbali. Taasisi ziaweza kuombwa ziagize mapema ili zitegeezwe sambamba a mahitaji. Wahudumu wa baa waude vikudi ili kujega umoja a mshikamao baia yao katika kuedeleza mapambao dhidi ya UKIMWI. Elimu rika zilege watoto a uwazi wakati wa majadiliao ao i muhimu. Uhamasishaji wa matumizi ya kodomu ziedelezwe a zihusishe washika dau tofauti, wakiwemo viogozi wa dii. 32
Utoaji wa elimu kuhusu matumizi ya kodomu kwa viogozi wa dii Kuimarisha a kuedeleza shughuli za kupambaa a virusi vya Ukimwi a/au UKIMWI ambazo i mifao bora. Kuedelea a uadaaji wa kiga. Kuedelea a kuorodhesha a kubaii asasi zote za kiraia a kata ili kutekeleza Mpago wa Jamii wa Pamoja. Imarisha uelimishaji rika kwa sababu zimethibitisha kuwa ziapuguza kasi ya maambukizo ya UKIMWI a magojwa ya ziaa. Ogeza elimu rika katika maeeo yeye kasi kubwa ya maambukizo, shule za msigi a sehemu za kazi, ikiwemo sekta ya afya. Imarisha ukusayaji wa habari hasa ziazohusu wagojwa wa UKIMWI. Kupata mwitikio mkubwa zaidi kutoka kwa jamii sambamba a uogozi bora kutoka serikalii pamoja a asasi za kiraia kwa kupitia Kamati za Kudhibiti UKIMWI katika Serikali za Mitaa. Kuhamasisha jamii kuhusu dawa za kuogeza kiga ya mwili kwa kutumia washika dau. Kuwa a wafayakazi wa afya wegi zaidi a weye mafuzo kuhusu tiba za kuogeza kiga ya mwili. Kuedeleza miradi iayovuka mipaka kwa kushirikiaa a chi jirai (Malawi, Zambia a Jamhuri ya Kidemokrasia ya Kogo). Kama ilivyooekaa, kua mchagayiko a msogamao mkubwa wa watu kutoka Malawi, Zambia, a Jamhuri ya Kidemokrasia ya Kogo katika vitogoji vya mipakai, a imeelezwa kuwa i kichochea kikuu cha jaga la UKIMWI katika mkoa. Kusambaza habari a elimu a kufikia a kugusa, TACAIDS a washika dau wegie iabidi waedelee kuweka kumbukumbu a kuhadithia kuhusu mafudisho yaliyopatikaa kutokaa a shughuli za kupambaa a Virusi vya UKIMWI a UKIMWI. HITIMISHO Kwa vile bado tua idadi kubwa ya watu walio huru a maambukizo ya Virusi vya UKIMWI/UKIMWI, uzuiaji wa maambukizo uabidi upewe kipaumbele kama guzo ya kwaza. Kila mtu awezeshwe kupitia elimu ili kufaya maamuzi ya kisomi kuhusu tabia zao kwai wegi hufaya vitedo kwa sababu ya kutokujua. Hata hivyo, dawa za kuogeza kiga ya mwili kama msaada wa ziada, isiyochukua afasi ya uzuiaji wa maambukizo, iabidi ipewe uzito wake lakii kwa umakii ili kukwepa kuwepesisha suala la maambukizo ya UKIMWI. Cheche iabidi zitoke pembe tofauti ili kuwasha moto mkubwa wa kutosha kupambaa a UKIMWI. 33
VITABU VILIVYOREJEWA 1. Taarifa ya Ziara ya Mkoa wa Mbeya Tume ya kudhibiti UKIMWI Tazaia, Septemba 2007. 2. Takwimmu za Ofissi ya DPLO Halmasshauri ya wilaya ya Mbeya, 2003 3. MMatokeo ya sesa ya watu ya 2002 ya Ofisi ya Mipago Halmashauri ya wilaya ya Mbeya. 4. Taarifa ya VVU/UKIMWI a Magojwa ya ziaa ya Mkoa wa Mbeya - Dr. J. Sewagi, Jui 2007 34
Bila Dalili Bakteria MSAMIATI WA KIUFUNDI Isiyooyesha dalili za ugojwa igawa maambukizo ya ugojwa yapo Vijidudu, baadhi via msaada kwa shughuli za mwili, lakii vigi husababisha magojwa. Chembedamu yeupe Sehemu ya damu iayolida mwili usivamiwe a kuigiliwa a vijidudu vyeye kusababisha magojwa. Dawa ya kutuliza Dalili Huzui Iliougaishwa Kusubiri Kuugua Kodomu Kuambukiza Dawa waazopewa watu weye matatizo ya kupata usigizi Maumivu a matatizo megie yaayoelezwa a mgojwa kwa tabibu Tatizo la kisaikolojia lialotokaa a hisia za huzui kubwa a kupoteza matumaii. Katika matiki hii, kuugaisha huduma za kuzuia/kutibu magojwa ya ziaa a huduma za uzazi wa mpago a matuzo ya afya ya mama a mtoto. Kuachaa a goo kabisa. Hali iayougaisha uchovu mkali pamoja a msogo mkubwa wa kihisia Kifuiko cha mpira kiachovaliwa a uume uliosimama wakati wa tedo la goo ili kuzuia mimba a kuambukizaa a magojwa ya ziaa. kuweka au kuigiza vitu vyeye athari mbaya, kama vile vijidudu vyeye kusababisha magojwa. Kuodoa maambukizo Kuodoa au kutekeleza vitu vyeye athari mbaya, kama vile vijidudu vyeye kusababisha magojwa. Kupeleka Lishe Njia ya maambukizo Mfayakazi wa Afya wa Jamii: Kumpeleka mgojwa kutoka yumbai au kweye jamii kweda kweye kituo cha afya au kutoka kweye kituo cha afya kweda kweye jamii au yumbai. Mlo, Chakula kilichokamilika, yaai cheye virutubisho vyote muhimu viavyohitajiwa mwilii. Jisi ugojwa uavyoambukiza kutoka mtu mmoja kweda kwa mtu mwigie Mtu aliyepitia mafuzo, mara yigi amejitolea, aayefaya kazi katika jamii kuwaelimisha watu kuhusu shughuli za afya, kutoa tiba a kuwaelekeza wagojwa kweye vituo vya afya kwa tiba ya ziada iayohitajika. 35
Matuzo ya Nyumbai Huduma zitolewazo mayumbai kwa wagojwa. Huduma kwa watu waishio a Virusi vya KIMWI/UKIMWI zialega zaidi kweye usafi wa mwili, lishe, tabia za goo, misaada, tiba ya hali ziazohusiaa a UKIMWI a tiba za mazoezi ya mwili Mfumo wa Kiga Maambukizo Moduli Magojwa ya ziaa Maagizo ya daktari Sehemu ya mwili iayopambaa a maambukizo ya magojwa. Uvamizi a uzaliaji katika mwili wa vijidudu vyeye kusababisha magojwa. Katika matiki hii, sehemu ya utaratibu wa mafuzo. Kudi la magojwa ya waawake a waaume yaayoambukizwa kwa kupitia kufaya tedo la goo. Maelezo ya maadishi ya tabibu yaayotambulisha jia la dawa ziazotakiwa kutumiwa a mgojwa, a jisi ya kuzitumia. Myoyeshaji mbadala Mwaamke aayemyoyesha mtoto wa waamke mwigie kama mwaamke mweye mtoto atashidwa kufaya hivyo mweyewe Shauku Tatizo la kisaikolojia lialosababisha hisia za wasiwasi a woga Shahawa Majimaji yeye mbegu za uzazi ziazotegeezwa a mwaaume wakati wa goo Tathmii ya rika Tathmii a maelezo kuhusu elimu au uwezo wa kazi wa mfayakazi mweza Ushauri Nasaha Uchuguzi /Yakii Utoaji wa dawa Usafi wa mazigira Usafi wa Mwili Uamiifu UKIMWI Virusi Vitamii Wazo Mawasiliao kati ya watu wawili ambapo mmoja aa tatizo a mwigie aajaribu kusaidia kulifafaua. Maelezo ya tabibu kuhusu mtu aaaumwa ugojwa gai Jisi dawa ziavyogawiwa kwa mgojwa Kuweka mazigira, yumba, kiwaja k katika hali ya usafi Kuweka mwili a mazigira katika hali ya usafi. Kufaya tedo la goo a mtu mmoja tu, ambaye aye hafayi tedo la goo a mtu yeyote isipokuwa wewe. Upugufu wa kiga Mwilii, ugojwa uaopuguza uwezo wa mwili kujikiga a magojwa, iayosababishwa a kuambukizwa virusi vya UKIMWI. Vijidudu viavyosababisha magojwa Virutubisho vilivyopo katika chakula vyeye umuhimu mkubwa saa kwa shughuli za mwili Fikra 36
TANZANIA COMMISSION FOR AIDS (TACAIDS) FOLLOW UP AND ASSESSMENT REPORT ON HIV AND AIDS MBEYA REGION OCTOBER, 2007 ISBN 978-9987-519-15-6 a
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TABLE OF CONTENTS Page No. List of Abbreviatios... Itroductio...... Ackowledgemet... ii iv vii Chapter 1: Observatios ad Fidigs... 1 Chapter 2: Challeges... 22 Chapter 3: Achievemets... 24 Chapter 4: Recommedatios... 29 Coclusio... 31 Referece... 31 Glossary... 32 i
LIST OF ABBREVIATIONS ACCA AIDS ANC ART BACAIDS BAKWATA CARF CBO CHAC CHMT CMAC CODES COPTA CPP CSO DACC DAS DC DED DFID DMO DRC EU FBO GTZ HBC HIV HLM HSIS HTA IEC JICA LGA MARVAD MCC MCH MMRP MOHSW MRACP AIDS Cotrol i Compaies i Africa Acquired Immue Deficiecy Sydrome Ate Natal Cliic Ati Retroviral BAKWATA Commissio for AIDS Baraza Kuu la Waislamu Tazaia/ Natioal Muslim Coucil Commuity AIDS Respose Fud Commuity Based Orgaizatio Coucil HIV ad AIDS Coordiators Coucil Health Maagemet Team Coucil Multi Sectoral AIDS Committees Cohort Developmet Study Commuity Plaig Tools for AIDS Itervetio Commuity Partership Pla Civil Society Orgaizatio District AIDS Cotrol Coordiator District Admiistrative Secretary District Commissioer District Executive Director Departmet for Iteratioal Developmet District Medical Officer Democratic Republic of Cogo Europea Uio Faith Based Orgaizatio Germa Techical Assistace Home Based Care Huma Immuodeficiecy Virus Health Learig Materials HIV Super Ifectio Study High Trasmissio Area Iformatio Educatio ad Commuicatio Japaese Iteratioal Cooperatio Agecy Local Govermet Authority Mbeya Ati Retroviral Iitiatio Study Mbeya Cemet Compay Materal ad Child Health Mbeya Medical Research Programme Miistry of Health ad Social Welfare Mbeya Regioal AIDS Cotrol Programme ii
MSD MTEF NACOPHA NACP NGO OVC PE PEP PLHA PLHIV PLPWHA PMTCT PSI RACC RAS RC REO RFA RMO RS SPW STD STI TAC TACAIDS TAZARA TB TCCIA TGPSH TMAP TOT TRA TV UN UNAIDS UNV VCR VCT VMAC WMAC WPP Medical Stores Departmet Mid-Term Expediture Framework Natioal Coucil of People Livig with HIV/AIDS Natioal AIDS Cotrol Programme No Govermetal Orgaisatio Orphas ad Vulerable Childre Peer Educator/ Educatio Post Exposure Prophylaxis People Livig with HIV/AIDS People Livig with HIV People Livig Positively with HIV/AIDS Prevetio of Mother to Child Trasmissio Populatio Services Iteratioal Regioal AIDS Cotrol Coordiator Regioal Admiistrative Secretary Regioal Commissioer Regioal Educatio Officer Regioal Facilitatig Agecy Regioal Medical Officer Regioal Secretariat Studets Partership Worldwide Sexually Trasmitted Diseases Sexually Trasmitted Ifectios Techical AIDS Committee Tazaia Commissio for AIDS Tazaia Zambia Railways Authority Tuberculosis Tazaia Chamber of Commerce, Idustry ad Agriculture Tazaia Germa Programme to Support Health Tazaia Multi-Sectoral AIDS Project Traiig of Traiers Tazaia Reveue Authority Televisio Uited Natios Joit Uited Natios AIDS Coordiatig Programme Uited Natios Voluteers Video Cassette Recorder Volutary Couselig ad Testig Village Coucil Multi Sectoral AIDS Committee Ward Coucil Multi Sectoral AIDS Committee Work Place Program iii
INTRODUCTION AND BACKGROUND Mbeya Regio covers a surface area of 64,000 square kilometers ad has a populatio of 2,070,046 (990,825 me ad 1,079,221 wome). The child bearig age (15-49 years) populatio is 423,945. The HIV prevalece rate of Mbeya is 13.5%, the highest i the coutry (the atioal HIV prevalece rate is 7 %). Mbeya has a good commuicatio etwork as highways cross the regio coectig the harbors of Dar es Salaam ad Mombasa with Zambia ad Malawi together with other Africa coutries through road ad railways creatig a corridor of social iteractio betwee the three coutries ad other i the South. The mai objective of the Mbeya Missio Team was to coduct a moitorig ad evaluatio of the HIV/AIDS situatio i Mbeya regio. This was a routie missio of TACAIDS to visit the regio for a better uderstadig of the itervetios related to HIV/AIDS i the regio. The timetable was very comprehesive ad desiged for the team to meet differet groups of people icludig faith based orgaizatios, girls ad boys, wome, people livig with HIV/AIDS, specific target groups such as barmaids ad govermet sectors like educatio, agriculture ad commuity developmet. Today HIV/AIDS is recogized ot oly as a major public health cocer, but also a social ad developmet problem i the coutry, regio, district ad commuity at large. While i Mbeya regio the team visited four districts out of eight i the regio. The districts visited were selected by regioal authorities i cosultatio with the district authorities. TACAIDS had prepared questioaire forms that were distributed to various groups before visitig these respective groups for discussios. The TACAIDS team was divided ito teams which visited differet groups such as wome, youg people, people livig with HIV/AIDS, elderly people, bar workers ad guest house attedats, faith based istitutios, educatioal istitutios, CTC, research ceters ad key selected RFA orgaizatios. The team visited the districts of Kyela, Chuya, Mbarali ad Mbozi. I these districts the visitig schedule was plaed by CHAC ad several groups icludig NGOs ad govermet officials such as district heads of the departmets of agriculture, educatio ad admiistratio. Heads of primary schools, ward couselors ad faith based orgaizatios such as BAKWATA were also ivolved i the deliberatios. The methodology used was participatory whereby all groups were ivolved durig discussio. The aim of the discussio was to elighte the TACAIDS missio o the implemetatio of regioal HIV/AIDS activities, gettig suggestios o what the discussats thik should be doe i order to stregthe HIV/AIDS programmes i the regio. iv
The cosultatio meetigs helped TACAIDS to have a advatage by creatig awareess, advocatig ad sesitizig the commuity groups to uderstad that the war agaist HIV/AIDS is for them ad ot for ayoe else. Such kids of motives motivate the stakeholders at regioal ad district level to keep o fightig this scourge disease. The advatages of this methodology was also to provide techical support o fud raisig modalities ad techical issues such as fudig procedures ad proper settlemet of fuds where it was idetified durig the discussio that to some recipiets there was a problem especially i kowledge of the procedures. ASSESSMENT TEAM The Mbeya Missio Report was prepared by TACAIDS, which set a team to Mbeya to coduct a moitorig ad evaluatio of the HIV/AIDS situatio i Mbeya regio. The team comprised of TACAIDS staff, NACOPHA represetatives, Miistry of Health ad Social Welfare staff, Regioal ad District Health authorities, Coucil HIV ad AIDS coordiators, GTZ (the Regioal Facilitatig Agecy) staff, developmet parters from the World Bak ad jouralists. TACAIDS Ho. Lediaa Mg og o, MP, Commissioer Dr. Fatma H. Mrisho, Executive Chairperso Mr. Sam Komba, Legal Officer Mr. Charles Kamugisha, Departmet of District ad Commuity Respose Mr. Chaddy Athoy, Departmet of Policy ad Plaig Mr. Simo Keraryo, Departmet of Advocacy ad Iformatio Mr. Shedrack Mpabagaya, Departmet of Fiace ad Admiistratio Mrs. Hulda Tairo-Urasa, Departmet of Fiace ad Admiistratio Natioal Coucil of People livig with HIV/AIDS (NACOPHA) Mr.Vitalis Makayula, NACOPHA Chairperso Ms.Grace Mwamhojo, NACOPHA Represetative Miistry of Health ad Social Welfare Mr. Joel Ndayogeje, MISO, NACP Regioal Health Authorities v
District Health Authorities Coucil HIV ad AIDS Coordiators (CHACs) Mr. Hebel A.Luvada Mr. A.R. Chavula Ms. Rachel Mbelwa Regioal Facilitatig Agecy Dr. Bruo Masumbuko, Team Leader Frida Radeguda Godfrey Upedo Chabili Developmet Parters Ms. Agelica Schrettebruer, GTZ AIDS Program Coordiator Mr. Yuus Koshuma, GTZ Dr.Emmauel Malagalila, World Bak (participated o the first day) Jouralists Mr. Bey Mwaipaja, ITV Mr. Festo Sikagoamo, ITV (Camera) Mr. Niko Mwaibale, TVT Mr. Ngujua Kalaja, TVT (Camera) Drivers Gabriel Choya Barick Dawa Dasta Kapiga Habib Nzomukoda vi
ACKNOWLEDGEMENT Ackowledgemets are exteded to the followig idividuals for their ivaluable support ad assistace i the makig of this report : youth, wome, people livig with HIV/AIDS, elderly people, bar workers, guest house attedats, faith based istitutios such as BAKWATA (the Natioal Muslim Coucil of Tazaia), educatioal istitutios such as primary ad secodary schools, research ceters, key RFA selected orgaizatios, ward couselors ad district departmet heads of agriculture, educatio ad admiistratio of Kyela, Chuya, Mbarali ad Mbozi districts. Fatma Mrisho Executive Chairma vii
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CHAPTER ONE OBSERVATIONS AND FINDINGS 1. Stakeholders ad target groups 1.1 Youth groups The participatio of youg people was active ad effective i the discussio durig the moitorig visit. They explicitly metioed that the rapid icrease i populatio, rural to urba migratio, frequet ad excessive use of alcohol, problems i the family, poverty low icome, uemploymet amog youth, idecet provocative dressig, peer pressure to have luxury commodities, ad easy access to porography via TV, videos ad Iteret are amog the drivers of the epidemic. It was also oted that studets are at risk o the way to school ad at their retal houses ad hostels without paretal guidace ad cotrol. A umber of youth groups are active i dissemiatig HIV prevetio iformatio through various meas e.g. theatre, drama ad comedy, but reported beig restraied by shortage of fiacial resources specifically trasport to scale up their iovative activities ad programmes. They also oted ot havig eough ad correct iformatio o HIV/AIDS ad life skills. Capacity buildig is highly eeded i these idetified areas as well as a icrease i support for youth groups. 1.2 Wome Observatios: Sexually arousig dressig - Vimii, KK ad Vitop Wome are very active i busiess ad very mobile There is lack of otificatio of HIV status to a parter Low icome of wome ad girls There are a lot of widows Competitio betwee ad for girls due to sex as a source of icome Polygamy withi the commuity Ufaithful married couples Aal ad oral sex were commo. Me were ready to pay up to 50,000 TShs for sex without codoms. Codoms were readily available i the bars but ot so female codoms. May of the girls were sigle parets havig several childre. Whe 1
cliets promise them love or marriage ad become regular visitors, they ted to become careless. Some of them had o other source of icome ad had o other choice tha workig i bars. They expressed the eed for makig female codoms more available. Some bar girls metioed receivig a basic mothly salary of about 15,000 Tshs. They were ot allowed to egotiate higher pay with the cliet but were allowed to take gifts. 1.3 The Disabled: Iadequate kowledge of HIV trasmissio was oted amogst the group of disabled people. They said that they did ot see sese i goig for HIV test because they do t see sese i the advice geerally give to PLHAS to improve their diet because of their poverty. This group said that o or iadequate itervetios are beig directed to them whereas me do approach disabled girls uder the belief that they are ot ifected with the virus. Ad because of their poverty me prefer sex with disabled girls i exchage for services redered to them. They expressed cocer for the society to recogize their rights, sesitize ad educate them o skills regardig HIV trasmissio so that the educated few could i tur impart such kowledge to their fellows. 1.4 Orphas ad Vulerable Childre It was observed that there has bee a icreased umber of OVC i the commuity. Each district has NGOs supportig orphas ad vulerable childre, e.g. i Kyela there is the NGO Oaktree which is supportig orphas ad vulerable childre through material aid such as school uiforms, books, school fees, vocatioal traiig, icome-geeratig activities ad medical treatmet. The scope is however limited with a relatively small umber of beeficiaries. Other NGOs supportig OVCs i Kyela are St. Joh Hus. Cetre ad USACA, which cares for 521 orphas. The followig are some plaed activities i the regio: To provide health service to 192 OVC groups [CHF fee.] To support 20 OVC studets to joi secodary school ad 5 OVC selected to joi vocatioal ceters. To procure ad distribute differet type of vegetable seeds i 6 village ad 4 dairy goats to 4 OVC care families to 4 villages out of 126 village. 2
Save the childre from HIV/AIDS To idetify OVC i 17 Wards. 4370 OVC are idetified, female 2622 ad male 1748. amog them 1710 are uder 5 years To co-ordiate the distributio of school materials to 524 OVC. 1.5 The Roma Catholic Church i Mbeya: The church has a priest appoited as HIV/AIDS coordiator ad he coordiates all HIV activities i 30 parishes withi the diocese. Curret itervetios iclude: VCT, HBC ad ARV services carried out by their missio hospitals ad health workers. The church mobilizes youth ad adult groups through their etworks ad cares for 47 orphas. They also etertai awareess programmes i schools ad have put HIV o the ageda durig preachig. The Roma Catholic Church is silet o the use of codoms. They are either promotig or forbiddig them. I cotrast, they are promotig the catholic way of life emphasizig abstiece ad beig faithful. 1.6 The Aglica Church Souther Highlad Diocese Observatios The church provides prevetive HIV/AIDS educatio, care ad treatmet ad impact mitigatio withi its dioceses. 3
HIV/AIDS is fluctuatig i Mbeya because of the followig reasos such as; Mbeya is borderig Malawi ad Zambia Competitio betwee ad for girls due to sex beig used as a source of icome Alcohol ad drug addictio Polygamy withi the Christia commuity Ufaithful married couples Low icome of wome ad girls Lack of hard rules i guest houses There are a lot of widows Wearig of mii skirts Youth shiftig from the rural areas to urba areas Wome are very active i busiess ad very mobile Suggested solutios VCT campaig should be cotiued as it is effective The commuity should be sesitized to support the Orphas ad be traied Developmet of exit strategy for itervetios which are door supported The barmaids should form groups i order to create solidarity i the prevetio of HIV/AIDS HIV/AIDS itervetio should focus o the childre ad the eed to be ope durig their HIV/AIDS sessios is essetial Cross border HIV/AIDS itervetio should cosidered with the ivolvemet of differet actors icludig religious leaders. Provisio of HIV/AIDS educatio o codom techology for religious leaders 1.7 People Livig with HIV ad AIDS (PLHAs) People Livig with HIV ad AIDS (PLHIV) clearly uderstad well the drivers of the epidemic, amog the others metioed are a big umber of mobile people (migrats), the closeess of borders to three coutries (DRC Cogo, Malawi ad Zambia), excessive alcoholism, cultural practices (e.g. cleasig ad widow iheritace), usafe sex, ad igorace. Educatio ad sesitizatios are very importat to address it i the correct approach. Fiacial ad techical support are highly eeded e.g Trasport support (bicycles) for HBC ad commuity mobilizatio to address the epidemic, 4
stregthe the good services for PLHIV ad ivolve them i advocacy activities, capacity-buildig, reducig the discrimiatio by health workers, ad commuity fud set up by the district. It was oted that geerally it appears that PLHIV teded to expect material support o a idividual basis ad they were ot clear about fudig criteria applied by TACAIDS so as to get fiacial support. Therefore more educatio o dos ad do ts of fuds availability for PLHIV is highly required for them to shift their paradigm to the PLHIV metaphor ad a ew life. Lack of Icome geeratig project activities made PLHIV depedet. It was oted that, some of the miscoceptio are that HIV ad AIDS fuds/grats are the fuds for PLHIV to be give for their survival ad oce people kow their HIV status as positive it is their right to be paid by the govermet. More educatio for PLHIV o HIV policies, strategies ad their rights is highly eeded, icludig what support for projects is suitable i order for them to become idepedet ad self sufficiet. PLHIV are proe to opportuistic ifectios. The lack of otificatio for HIV status to their parters ad comig out ope i the forum of PLHIV while discussig their HIV status issues leads to self stigmatizatio ad iterruptig takig of ARV because of various reasos icludig e.g. the drugs make the PLHIV to be weak due to drugs toxicity, lack of regular meals, etc. Therefore, more educatio is eeded to PLHIV o how HIV/AIDS ad improper use of ART services affects their life. It was oted that the strog religious beliefs of some PLHIV, ad also some idetified churches isistig o o use of codoms ad ART services for PLHIV because they are bor agai (eg. Assemblies, Petecostals at Ilemi, Kwambogo, Wiers), isistig uder Jesus Christ ame othig is impossible, which leads to the buildig of miscoceptios ad bad habits. 1.8 Commercial Sex Workers Bar teders ad food veders (Commercial Sex Workers) Observatios: Makasii Bar has peer health educatio sessio i place while at Nyasaga Bar they do ot have. The barmaids should form groups i order to create solidarity i the prevetio of HIV/AIDS 5
High frequecy of codom use ad irregular use of codoms i other places Availability of IEC materials ad free codoms After workig log as bar workers they get used to ad they are difficult to chage to a differet activity It was observed that the majority of their customers are Tazaia log distace truck drivers ad a few are Malawias ad Zambias. Zambia ad Malawia drivers resist the use of codoms. The majority of Tazaia truck drivers prefer aal sex Log term relatioship parters ifluece irregular use of codoms Ecoomic hardship forces them to have risky sexual behaviour as they are paid Tshs.15,000/= per moth oly. Due to cold weather they eed parters to sleep with. Iadequate protectio agaist male violece by bar owers ad security guards. Poor respose to HIV/AIDS by bar owers No orgaizatio for sex workers 1.9 Bar maids Bar maids were aware about the importace of codom use ad eve carry codoms with them ad actively put them o cliets, but referred that cliets, particularly from Malaw, isisted o havig sex without codoms. Aal ad oral sex were commo. Me were ready to pay up to 50,000 TSh. for sex without codoms. Codoms were readily available i the bars but ot so female codoms. May of the girls were sigle parets havig several childre. Whe cliets promise them love or marriage ad become regular visitors, they ted to become careless. Some of them had o other source of icome ad had o other choice tha workig i bars. They expressed the eed for makig female codoms more available. 1.10 Truck Drivers: Truck drivers said that due to low capacity of border ports of Tuduma ad Kasumulo they were compelled to sped may days at cogested highway tows like Mbeya city, Kyela, Kasumulo ad Tuduma waitig for clearace services at the ports. Truck drivers sped a lot of their time drikig ad ruig aroud with girls who follow them because of their moey. 6
The belief that truck drivers carry a lot of moey has led to a umber of commercial sex workers to follow them to those cogested ceters. Iterviews idicated that very few truck driver use codoms whe they have sex with the commercial sex workers. Geerally truck drivers complaied that they eeded HIV itervetio which is directed to them as a group but it was ot easily forthcomig. They also requested the authorities cocered to speed up the clearace process of the goods ad trucks at the border port to avoid cogestio of trucks o the highway. Drivers of the Epidemic The followig are the issues that were said to be the drivers of the epidemic i the areas that we visited. Poverty or low icome leadig to prostitutio. Excessive drikig Limited kowledge of HIV/AIDS issues Risky cultural practices Stigma ad discrimiatio Rural to Urba migratio withi ad without Mbeya Presece of highways ad borders betwee three coutries (Zambia, The DRC ad Malawi) Vigil ights (Mwege, Ngoma, burial ceremoies ad Uyago Miscoceptios ad myths about HIV/AIDS Icosistet codom use. Low capacity of border ports (Tuduma ad Kasumulo) leadig to cogestio of traffic at Tuduma, Kaumulo, Kyela ad Mbeya City. Uemploymet that leads to may idle youth groups, commoly kow as vijiwe Sexually arousig clothig (e.g mii skirts, bikiis etc) 7
Acceptace of ad service to youg school boys ad girls i bars, guest houses ad other etertaimet ceters. Porography i the prit ad electroic (radio, televisio, iteret) mediums Risky behaviors of traders ad busiess people from differet parts of the coutry. Icreased rates of rape (Chuya) Presece of miig (Chuya) Employmet of small girls (uder 18) i bars ad etertaimet ceters Cold weather is also said to be aother cause for the spread of HIV i Mbeya Competitio betwee girls due to sex as a source of icome Polygamy withi the Muslim commuity Ufaithful married couples There are a lot of widows. Widows iheritace Wome are very active i busiess ad very mobile Poor respose to HIV/AIDS by bar owers 8
3.0 Statistics 1.1 Table 1 Regioal Statistics 1. Populatio 2,070,041 Me: 990,820 Wome: 1,079,221 2. Rate of ifectio 13.5 % 3. Rate of mother to child ifectio 12.7 % 4. VCT Cetres 133 5. Care ad Treatmet Cetres 15 old, 32 ew (PHC facilities) 6. CMACS Preset i all the Districts but their performace varies from oe DC to aother. 7. Codom Use Refer to Demographic ad Health Survey (DHS) report 8. Rate of ifectio (STI cases) 2.5% 9. Number of Districts. 8 10. Names of Districts 11. Names of Regioal Authorities 1. Mbeya City 2. Mbeya District Coucil 3. Chuya DC 4. Mbozi DC 5. Ileje DC 6. Mbarali DC 7. Rugwe DC 8. Kyela DC RC: Ho. Joh Mwakipesile RAS: Ms Asumta Ndimbo RACC: Dr Julius Sewagi RAC Com. Dev: Aly Chavula (RS HIV/AIDS Focal Perso RMO: Dr Machibya 9
11. Names of Districts Authorities Districts Commissioers 1. Chuya: Fatuma Kimaryo 2. Ileje: Esther Wakali 3. Kyela : Hussei H. Mashimba 4. Mbarali: Hawa Ngulume 5. Mbeya City ad Mbeya DC: Leoidas Gama 6. Mbozi : Hamali Kihemba 7. Rugwe: Mariam Mgaila Districts Executive Directors:- 1. Mbeya City: Elizabeth Muo 2. Mbeya DC : Juliaa Mayage 3. Chuya : Maurice Sapajo 4. Ileje: Yoa L. Malik 5. Mbarali : George Kagomba 6. Mbozi: Livistoe Siliowa 7. Kyela : S.P. Liuma 8. Rugwe : M.E.M Buliga 12. Regioal facilitatio agecy GTZ Iteratioal Services 13. RFA Team Leader Dr Bruo M. Masumbuko 14. Number of groups served by RFA 15. Amout give by TACAIDS i Mbeya Regio without usig RFA 16. Name of NACOPHA represetative 18. Amout give to regio ad districts every year 84 total, amog them 47 with previous cotracts ad 37 ew - 2005/2006 : - 2006/2007 : Tsh 6,100,000 This amout does t iclude the fuds give to the Districts Coucils Ms.Grace Mwahogo CARF grats to CSOs ad CPP for 2005/2006 as follows: Districts Tsh to CSOs Tsh to CPP 1.Rugwe 2.Kyela 3. Mbeya City 4. Mbeya DC 5. Mbarali 6. Chuya 7. Ileje 8. Mbozi Total Mbeya Regio 30,837,500 28,741,000 32,238,100 23,755,110 34,077,400 34,500,000 26,020,000 40,662,076 250,833,586 2,000,000 2,000,000 2,000,000 2,000,000 1,500,000 2,000,000 1,996,500 2,372,000 15,868,500 10
19. Types of research coducted i the regio 20. NGOS Participatig 1. GTZ (TGPSH) 2. Water Reed 3. PSI 4. CARITAS 5. ABBOT FUND 6. LCCB 7. AMREF 21. MTEF Objective of Mbeya 1. HIV Vaccie trial study 2. Setiel surveillace 3. Quality of STI services 4. CODES Cohort Developmet Study 5. HISIS - HIV Super ifectio Study 6. MARVAD Mbeya Atiretroviral Iitiatio Study 7. TB Study To improve services ad reduce HIV/AIDS ifectio by the year 2010. Table 2 3.2 Mbeya District Statistics Populatio The followig table shows the populatio of Mbeya district by sex ad age Age Group Males Females Total 80+ 882 1,074 1,956 75 79 773 807 1,580 70 74 1,273 1,532 2,805 65 69 1,428 1,927 3,355 60 64 2,008 2,795 4,803 55 59 2,038 2,489 4,527 50 54 2,718 3,727 6,445 45 49 3,251 4,237 7,488 40 44 4,297 5,218 9,515 35 39 5,373 6,555 11,928 30 34 6,990 8,411 15,401 25 29 8,804 11,483 20,281 20 24 9,332 13,597 22,929 15-19 13,553 14,416 27,969 10-14 16,846 17,380 34,226 5-9 18,825 19,272 38,097 0-4 20,405 20,552 40,957 TOTAL 118,597 135,472 254,069 Source: DPLO Office Mbeya District Coucil year 2003. 11
Details of the above populatio for each ward i the district are show i the table below. Table 3 Populatio Distributio by Wards i Mbeya District No. Name of No. of No. of Populatio Total Ward Villages Households Male Female IHANGO 5 2,855 5,280 5,910 11,190 2 ULENJE 7 3,081 5,178 6,295 11,473 3 TEMBELA 11 3,836 6,604 8,056 14,660 4 IJOMBE 7 2,439 4,081 4,857 8,938 5 SANTILYA 7 3,937 6,926 8,291 15,217 6 ILEMBO 13 5,173 10,082 11,718 21,800 7 IWIJI 5 3,091 6,188 7,077 13,265 8 ISUTO 11 5,275 9,649 11,337 20,986 9 IGALE 9 4,485 8,259 9,628 17,887 10 IWINDI 8 3,789 7,151 8,147 15,298 11 UTENGULE USONGWE 7 10,740 20,897 23,192 44,089 12 MSHEWE 8 2,482 5,230 5,374 10,604 13 IKUKWA 2 1,240 2,375 2,703 5,078 14 IYUNGA MAPINDUZI 5 1,479 2,758 3,043 5,801 15 BONDE LA SONGWE 6 3,953 8,061 8,301 16,362 16 INYALA 8 2,780 5,180 5,923 11,103 17 ILUNGU 7 2,887 4,901 5,417 10,318 TOTAL 126 63,522 118,800 135,269 254,069 Source: Plaig office-2002 populatio cesus results - Mbeya District Coucil. 12
Table 4 3.3 LEARNING MATERIALS IEC MATERIALS REPORT JANUARY - DECEMBER 2006 ITEMS BALANCE B/F RECEIVED TOTAL DISTRIBUTED BALANCE Codom use leaflets 34325 31600 65925 50400 15525 STD leaflets 24525 32000 56525 45900 10625 VCT leaflets 23097 32000 55097 44700 10397 ARV leaflets 32808 32000 64808 40700 24108 PMTCT leaflets 22408 31000 53408 38600 14808 PMTCT Plus leaflets 29258 31000 60258 37870 22388 Maswali a Majibu Booklets 4799 7350 12149 8680 3469 8 series booklets 908 5000 5908 5117 791 Uderstad livig with HIV/AIDS 570 0 570 310 260 Kuelewa kuishi a VVU 7808 0 7808 3480 4328 PHEs guide STD V 164 1000 1164 906 258 PHEs guide STD VI 84 1000 1084 906 178 PHEs guide STD VII 1340 0 1340 916 424 Video cassettes 129 0 129 9 120 Reproductive leaflets 0 15000 15000 12030 2970 Hope for Tazaia Part I 91 0 91 17 74 Hope for Tazaia Part II 56 0 56 17 39 Wasichaa kama hutaki mimba 0 15000 15000 13650 1350 PMTCT posters 2920 0 2920 1672 1248 Ishi upedavyo posters 0 2000 2000 96 1904 Bill boards 0 16 16 16 0 Huwezi kutambua VVU posters 0 2000 2000 96 1904 Uyayapaa 0 4000 4000 2900 1100 Uzazi wa mpago leaflets 0 6000 6000 5800 200 Tshirts ad caps 0 0 0 0 0 Source: Mbeya Regioal AIDS Cotrol Programme Implemetatio Report o HIV/AIDS/STI - 2006 13
3.4 PEER EDUCATION Table 5 a) Primary schools District Number of schools Schools with PE Remarks Mbeya Rural 125 76 Support maily from TGPSH Rugwe 196 44 Support maily from TGPSH Mbozi 202 13 Support maily from TGPSH Chuya 101 53 Support maily from TGPSH but also from the commuity Ileje 83 0 No refresher traiig coducted Mbarali 102 0 No refresher traiig coducted Kyela 99 0 Oly sesitizatio doe to school teachers ad committees i 10 schools Mbeya Urba 75 51 Support maily from TGPSH Total 983 237 -I most schools std 5 o PE, - icreased umber of p/schools without PE - Multi-sectoral approach is ecessary for sustaiability Source: Mbeya Regioal AIDS Cotrol Programme Implemetatio Report o HIV/AIDS/STI - 2006 14
Table 6 High Trasmissio Areas (HTAs) District Number of HTAs HTAs with PE Number of PE Mbeya rural 10 10 20 Rugwe 10 10 20 Mbozi 10 10 14 Kyela 3 3 6 Chuya 4 4 8 Ileje 3 2 4 Mbarali 4 4 8 Mbeya Urba 14 10 20 Total 52 50 100 Table 7 c) Workplaces itervetio District Number of workplaces Number of workplaces with PHEs Mbeya Rural 6 4 Rugwe 6 1 Mbozi 15 15 Chuya 5 4 Ileje 4 3 Mbarali 5 0 Kyela 5 3 Mbeya Urba 13 8 Total 59 38 Source: Mbeya Regioal AIDS Cotrol Programme Implemetatio Report o HIV/AIDS/STI - 2006 15
Table 8 3.5 CONDOM PROMOTION NAME OF DISTRICT SALES IN CARTON Total JAN FEB MAR APR MAY JUN JULY AUG SEPT OCT NOV DEC cartos Mbeya city 352 595 154 286 435 60 451 582 766 217 330 195 4425 Mbeya District 82 0 13 0 65 0 0 22 56 12 11 22 283 Chuya 22 88 44 33 33 33 22 70 24 56 68 77 514 Kyela 0 77 0 24 70 77 44 44 113 55 39 88 631 Rugwe 0 12 10 26 0 33 35 44 56 22 62 22 322 Mbozi 31 0 66 54 94 22 55 339 0 156 44 33 894 Mbarali 44 0 22 33 88 0 0 55 23 0 113 11 389 Ileje 15 0 66 20 11 22 11 25 11 8 9 11 209 Total carto 541 784 375 476 796 544 618 1181 937 529 678 459 7918 Total pieces 311616 451584 216000 274176 458496 313344 355968 680256 539712 304704 390803 264384 4,561,043 1 carto = 576 pieces (b) Distributio of Free codoms Total = 1,544,909 pieces Total umber of codoms distributed: 6,005,952 pieces Source: Mbeya Regioal AIDS Cotrol Programme Implemetatio Report o HIV/AIDS/STI - 2006 16
Table 9 3.6 CLINICAL AIDS CASES 1. Igogwe 62 2. Isoko 25 3. Kyela 430 4. Matema 198 5. Mbalizi 160 6. Mbarali 8 7. Mbeya Regioal 3 8. Mbozi Missio 54 9. Mwambai 311 10. Tukuyu 50 11. Uyole 106 Total 1,407 Source: Mbeya Regioal AIDS Cotrol Programme Implemetatio Report o HIV/AIDS/STI - 2006 17
Table 10 3.7 PMTCT Chuya Ileje Kyela Mbarali Mbeya District Mbeya Urba Mbozi Rugwe Total ANC Couselig ad testig No. of Implemetig sites 2 2 1 1 4 8 3 8 29 New ANC Attedees 1939 585 1522 1119 2424 11,573 3358 3882 26,402 Pre-test Couselled 1969 609 1666 1037 1763 5906 2267 3926 19,143 HIV Tested 1594 434 1571 943 1569 5076 1817 3903 16,907 Post-test Couselled 1594 434 1570 910 1566 5071 1815 3902 16,862 HIV Positive 189 26 248 148 230 711 200 393 2145 Give NVP at ANC 50 8 83 69 122 269 116 249 966 Wome erolled o ART 0 0 0 0 0 1036 67 35 1138 Male Parters who come to ANC 100 10 48 32 63 169 69 197 688 Male Parters Tested for HIV 98 10 48 32 63 151 63 188 653 Male Parters Tested HIV Positive 12 0 17 8 18 27 16 37 135 Wome delivered 2058 808 1663 1733 1010 11,301 4368 2964 25,905 Wome who kew of HIV status from ANC 622 184 695 257 372 1599 695 1410 5834 Wome who took ART 0 0 0 0 0 340 8 5 353 Wome who took Nevirapie 66 11 79 62 22 351 105 264 960 Wome whose Ifats received NVP 65 11 136 62 26 434 106 264 1104 Mother-Ifat both received NVP 63 10 122 61 21 350 103 241 971 HIV (+) Mothers Iteded to Exclusive breastfeed 74 10 120 61 24 416 106 261 1072 HIV (-) Iteded to give replacemet feedig 1 1 16 1 2 18 0 8 47 Ifats HIV tested (18 moths) 0 0 0 0 0 73 12 0 85 Ifats HIV positive 0 0 0 0 0 21 0 0 21 NB. No-PMTCT ifats tested were 24, positive were 17 Source: Mbeya Regioal AIDS Cotrol Programme Implemetatio Report o HIV/AIDS/STI - 2006 18
Table 11 8.8 STI Sydromes District GUD GDS PID RPR +ves OTHER STIs CONTACT TOTAL Male Female Male Female Female Male Female Male Female Male Female Male Female GRAND TOTAL Chuya 751 810 725 1049 1113 157 379 148 286 757 707 2538 4344 6882 Ileje 235 248 236 324 353 66 138 3 71 163 167 703 1301 2004 Kyela 485 474 466 649 526 70 187 88 139 346 324 1455 2299 3754 Mbarali 434 369 513 571 516 113 177 88 105 308 348 1456 2086 3542 Mbeya District 602 521 645 821 772 123 273 128 169 525 513 2023 3069 5092 Mbeya City 492 514 546 689 577 123 310 308 150 432 385 1901 2625 4526 Mbozi 867 894 939 1234 1210 222 452 183 273 746 684 2957 4747 7704 Rugwe 639 647 723 922 1091 213 416 114 227 597 578 2286 3881 6167 Regio 4,505 4,477 4,793 6,259 6,158 1,087 2,332 1,060 1,420 3,874 3,706 15,319 24,352 39,671 Source: Mbeya Regioal AIDS Cotrol Programme Implemetatio Report o HIV/AIDS/STI - 2006 19
3.9 Couselig ad HBC Table 12 (a) Couselig Tested Male Tested female total +ve male +ve female Total +ve Suspected cliet 332 381 713 209 233 442 VCT cliets 16,226 20,590 36,816 4,025 6,227 10,252 PMTCT cliets 653 16,907 17,560 135 2,145 2,280 Total 17, 211 37,878 55,089 4,369 8,605 12,974 Source: Mbeya Regioal AIDS Cotrol Programme Implemetatio Report o HIV/AIDS/STI - 2006 Table 13 (b) HBC The total regioal umber 4,590 ew cases ad 3,415 old cases makig a total of 8,005 patiets from all districts Supportive supervisio District Total health facility Supervised Kyela 25 18 Mbozi 46 23 Mbeya Urba 37 17 Mbeya District 39 21 Chuya 35 19 Rugwe 55 22 Mbarali 47 20 Ileje 24 9 Total 340 149 Source: Mbeya Regioal AIDS Cotrol Programme Implemetatio Report o HIV/AIDS/STI - 2006 20
3.10 Care ad treatmet Table 14 ART roll out start period specify moth ad year Chimala Kyela Mbarali Matema Vwawa Isoko Uhai MRH Regioal Rugwe JWTZ Igogwe Mwambai A. Cumulative umber of cliets erolled i HIV/AIDS care ad Treatmet Total for the Regio 1 2 Male Adults (15yrs ad above) Female Adults (15 yrs ad above) 77 289 119 77 704 4 0 1537 634 572 216 245 142 5156 124 899 46 129 1154 9 0 2694 1265 847 355 175 7657 3. Childre (below 15 yrs) 15 96 68 4 107 0 518 106 118 18 8 1058 B. Cumulative umber of AIDS patiets o ARV drugs 1. 2. Male Adults (15yrs ad above) Female Adults (15 yrs ad above) 42 827 5 44 273 4 740 366 237 80 74 81 2773 71 394 9 41 335 9 1207 686 247 74 100 92 3265 3. Childre (below 15 yrs) 3 53 0 3 23 0 256 44 45 6 9 0 442 C. Eligible for ARV but ot yet started 1. 2. Male Adults (15yrs ad above) Female Adults (15 yrs ad above) 36 178 7 17 156 0 126 19 92 5 4 61 701 51 217 13 14 257 3 175 79 127 8 6 83 1033 3. Childre (below 15 yrs) 13 108 0 1 34 0 36 12 38 6 0 8 256 Source: Mbeya Regioal AIDS Cotrol Programme Implemetatio Report o HIV/AIDS/STI - 2006 21
CHAPTER TWO CHALLENGES There are eight coucils i Mbeya regio, where the etire regio has DACCs who coordiate them i all issues related to HIV/AIDS. Durig TACAIDS missio it was idetified that coucils are to some extet ot performig well i the whole issue of fightig the war agaist HIV/AIDS i the regio. This was observed durig the discussio whereby the coucil s plas icluded HIV/AIDS activities but they are slow i implemetig them ad the mai cause is delays i the process of the allocatio of fuds disbursed to them for HIV/AIDS activities. Hece CHACC were urged to put more effort i coordiatig coucils so as to be proactive. This explaatio is referred to i the case study doe i Mbeya by Dr. Ulrich F. Vogel uder UNAIDS programme i March 2007. As he poited out ad what was discussed i 2005 durig the atioal workshop that the Coucil Multisectoral AIDS Committees were broadly criticized for beig slow ad regardig HIV/AIDS as busiess as usual ad also lackig leaderships ad vigor However despite these positive itervetios yet quite a oticeable segmet of the commuity has ot bee reached. As a result risk factors of HIV trasmissio i the populatios of Masai cattle keepers ad traditioal circumcisers (garibas) are ot kow. There has bee cosiderable expasio of HIV ad AIDS services. Both urba ad rural commuity access to appropriate ad correct AIDS educatio ad services cotiues to be a challege, Although Commercial sex workers are globally kow to be oe of the most sigificat drivers of the epidemic, there are very few programs that address this group. There are importat lessos leart from various itervetios i the regio, most of these are either documeted limited shared Challeges Difficulty i gettig reports particularly from Mbeya referral hospital e.g. reports for blood doors ad AIDS cases. High demad of ART for PLWHA i Mbeya as compared to those really receivig ART. Irregular supportive supervisio Syphilis screeig coverage to pregat mothers is still ot adequate as we have 77 health facilities with screeig services for pregat wome out of 340 health facilities. 22
Health sector WPP ot well established Decreasig umber of primary schools with PE Workload ad lack of motivatio of differet implemeters e.g. PE at HTA, health workers with extra duty Irregularity i reagets procuremet ad distributio from MSD. The limited capacity of ward commuity developmet officers to implemet commuity developmet activities at the ward level. This is caused by lack of fuds to execute refresher traiig amog the staff; Limited capacity to supervise ad moitor HIV/AIDS itervetios effectively at the ward level; Less ivolvemet of Commuity Developmet Officers by orgaizatios that are workig i Mbeya muicipal Lack of reliable trasport to staff as there 36 wards i Mbeya Rural district High iteractios of people at market places, auctios, religious festivals ad bars; High iteractios of visitors from eighborig coutries such as Democratic Republic of Cogo, Malawi ad Zambia Early pregacies; Cultural practices iheritace of widows ad cleasig High rates of ew ifectio with staggerig prevalece at 13.5% Will the cotiual stregtheig of the existig strategies ad the programme combied with ew orgaizatioal structure at local level cotribute to a sigificat ad sustaied reductio of HIV trasmissio i the ext 5 10 years? Stigma ad discrimiatio Presece of STI ad teeage (uwated) pregacies Late disembursemet of fuds Workload vs shortage of staff Mid set 23
CHAPTER THREE ACHIEVEMENTS 1. Peer Educatio. The areas covered are; High Trasmissio Areas (HTA), workplaces ad primary schools. With regards to PE i primary schools semiars ad traiig have bee coducted to the target groups. The traiig cotiued this year i some districts to either establish PE i some schools or stregthe the existig PE i primary schools however at differet capacity. PE at workplaces was stregtheed through 3 days refresher traiig of all the P/Educators from Mbeya referral/regioal hospital ad regioal headquarters staff. Also the private compaies coducted 2 traiig uder the techical support of the regio ad local cosultacy from the TOT existig i the regio. Ecourage peer Educatio The differet activities that have bee goig o i differet HTA were supervised ad cotiued. To revive this itervetio the programme coducted refresher traiig for Mbeya Urba ad Rural districts to 39 selected idividual. The traiig was preceded by sesitizatio meetig for bar workers ad owers. It was followed by familiarizatio meetig betwee cliicias from the HTA ad the traied PE ad cocluded by sesitizatio meetig for all the WMAC members. 24
2. Productio ad distributio of learig materials The programme either actively or passively reaches the commuity with differet learig materials so as to cotiuously impart kowledge to people. Table 4 lists the differet types of HLM produced ad/or distributed. The materials icluded leaflets, booklets, caledars, billboards, etc. Radio spot developed ad aired previously cotiued to be aired this year. The demad for the materials has bee high both withi ad outside the regio ad the differet learig materials distributed are accepted i the commuity. Get iformatio about HIV/AIDS 3. Drama ad film shows The 5 formal drama groups have bee performig i their local sites but some like KIHUMBE have bee performig eve outside their sites uder special ivitatios. The total umber of sites where drama was performed is 275 with a estimated 255,123 attedees out of expected 305,107 people. Drama is otherwise performed i various areas usig the iformal groups existig i each district. Districts without formal drama groups are plaig to establish. Film show is still active i the regio ad the existece of TV/VCR sets i public places ad eve at the household level is eablig people to see differet video cassettes at home, i bars, heath facilities or guesthouses. This time formal film shows were coducted i Mbeya rural ad Mbarali districts o top of the video shows. Cultural Etertaimet groups ca play a sigificat role i HIV/AIDS 25