•Insufficient awareness on existing policies and structures, ineffective communications and lack of knowledge on the right to have adequate maternal and newborn health
•Minimal involvement of citizens in decision making on issues that affect them e.g. budget, location of health facilities, availability of commodities
•Citizens need to have proactive stand and notion that community representatives are key to processes leading towards change. (they have to be involved in order to make change and stop being passive)
•Structures are not being adequately utilisedby both parties (citizens and duty bearers in terms of communication, feedback, commitments, responsiveness, which affects the dialogue re the key issues at the community level such as budgeting).
Key messages conveyed during the Citizens’ Hearing:
•Concern over shortage of qualified human resources
•Shortage of drug supplies
•Rude language of health facility staff
•Cost of transport to health facility, cost of supplies
•Distance between citizens and health facility
•Transparency of budget processes at community level does not exist
•Little involvement of citizens during planning process ( community health committees either do not exists, or are not effective)
•Information does not trickle down to the community (Viongozi Kata and Diwani do not share info)
•Diwani agreed to ensure structure works, share budgets with citizens by using community notice board to announce info.
•Information and education on citizen rights, responsibility of both citizens and duty bearers to deal with that and actively participate in health related issues. (This may be the root cause of the issues).
CITIZENS’ HEARING CONCLUSIONS:
•Citizens should be involved in setting up MNCH priorities, targets and budgets.
•Citizens should have an active role in monitoring MNCH services, planning and budgeting.
•M&E is the key; need to use the data collected from the communities, health facilities and all reports sent to the Ministry of Health and Social Welfare. M&E must be showing progress at all levels from community to the national.
•Final remark and a slogan of the Citizens’ hearing:
“We all need to play our role, let us be accountable in order to reduce maternal and newborn deaths.”
WHAT HAPPENED AFTER THE CITIZENS’ HEARING?
The summary of the Citizens’ Hearing key asks was presented at the celebration of the 10th White Ribbon Day on the 15 March 2015 by representatives of women, men and children to the Tanga Regional Commissioner, Guest of Honour at the event.
WHY IS IT CONSIDERED A SUCCESS?
•The Citizens’ Hearing included public mobilisationwith extensive child participation, integrated campaigning, social and traditional media. For the first time in Tanzania citizens had a chance to speak out and raise issues bringing together community and government leaders to listen to, and act on, their views on national priorities for women’s, children’s and newborn’s health.
•Citizens will be holding government to account for delivery on MDGs 4 and 5, with citizens and civil society taking a lead role and pushing for an accountable new Global Strategy for Women’s and Children’s Health to be launched later this year.
PLANS FOR THE FUTURE…
•After having district and regional Citizens’ Hearings there was a slot on a very popular Tanzanian TV show at the end of March which which acted as a National Citizens’ Hearing, where viewers could dial in and question participants.
•The results of the Citizens’ Hearing were presented at the high-level reproductive and maternal and newborn health conference organised by East African Community in Uganda on 25 and 26 March.
Citizens’ Hearing has been accepted by all involved as accountability mechanism to be used in planning, monitoring and service utilisationat different levels and as a tool to be used for bridging a gap between government/decision makers and citizens.