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<strong>CMI</strong> REPORT DECENTRALISATION AND GENDER R 2008: 9<br />

It is not possible for the managers to hire temporary staff due to lack of funding; salary for<br />

temporary staff has to be funded by the District itself.<br />

The Misungwi DED is a woman. Generally speaking, women managers tend to be more exposed to<br />

criticism than men as most people are still not used to women in management positions and<br />

generally tend to demand more of a female than a male manager.<br />

Some of the staff members stated that they found the councillor criticism “cumbersome” and<br />

difficult. The councillors have participated in the penalizing, transferring or suspending staff. Such<br />

actions are of course justified when it comes to misuse of funds, but may not always be the right<br />

method for improving performance in an organisation with staff shortage.<br />

3.3 Cooperation between the district council and other actors<br />

According to the district plan, there is limited “funding for projects because of bureaucracy, strings<br />

attached to donor funding, mistrust between donors and the district”. One reason for this may be the<br />

unclean audits which have entailed that the district is not eligible for the Local Government Capital<br />

Development Grant. In addition, unclean audits may generally lead to donor mistrust.<br />

NGOs involved in the health sector in Misungwi are CARE, MEDA and AMREF. According to the<br />

district administration, the cooperation varies from NGO to NGO. Some attend joint planning<br />

meetings with the district council, while others seem to be less willing to share information. The<br />

cooperation between the district and the private hospital owned by the Roman Catholic Church<br />

seemed to be good; there are regular meetings between the district and the private hospital to<br />

discuss the cause of maternal deaths. At a joint budget meeting, it was decided to increase the<br />

private hospital share of the Basket Health Funding from 10 to 12% as all parties agreed that this<br />

was a “strategic priority”.<br />

Major donor projects: CARE<br />

CARE initiated a health project in Misungwi in 1997. The project contains a number of<br />

components:<br />

Emphasis on Voluntary Village Health Workers<br />

- Training of voluntary village health workers<br />

- Village health workers track pregnancies and visits 3-4 times to each pregnant women<br />

- Establishment of health committees in all villages encouraging delivery at facilities and<br />

planning in case of emergencies<br />

Community mobilisation<br />

- Establishment of savings clubs –saving of money for delivery transport and other issues<br />

- Involvement of men (CARE saving clubs have 30% men)<br />

- Establishing of community by-laws fining delivery outside the health facility<br />

Improved accessibility and transport<br />

- 9 mobile health clinics to communities far from health facilities<br />

- 1 ambulance<br />

- Transport of pregnant women by tricycles, ox charts, boats<br />

Improved delivery facilities and equipment<br />

- District hospital surgery theatre for caesareans<br />

19

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