The Rural Health Center (Kituo Cha Afya in Swahili language) is the hospital built by CO.P.E. between 2004 and 2007 in the village of Nyololo, Iringa region, Tanzania.
The hospital is located in an area with very low health coverage: it has about 60 beds and basic medical assistance services serving a population of about 40,000. The second nearest hospital is the district of Mafinga and is 63 km away. The aim is to improve health conditions and reduce the causes of mortality with particular attention to maternal and child health and to the treatment and prevention of HIV. The hospital is made up of 5 pavilions: Pediatrics, Maternity, General medicine for women, General medicine for men and Department for Isolation. For each department there are 10 beds, with the exception of that of pediatrics that presents 12. The flagship service of this department is the presence of a free canteen, accompanied by a nutritional service for the treatment of child malnutrition, which represents a exclusive and recognized program at the territorial level.
Internally to the Kituo Cha Afya Project, the government program dedicated to maternal and child health has been implemented, which provides for vaccinations and check-ups for pregnant women and for children under the age of 5, and the program of mobile clinics in neighboring villages where it deals with the control of pregnant women, immunization, child growth and HIV / AIDS counseling. In addition, the Government’s Care and Treatment Center (CTC) for HIV prevention and treatment has been implemented: in addition to the antiretroviral and antibiotic therapy services for infections and psychological support during therapy, the program provides for the VCT. (Voluntary Conselling test) free service that allows the population to carry out the HIV test. The POLE POLE rehabilitation center inside the hospital and realized thanks to the co-funding of Filo Diretto Onlus is addressed to children’s disabilities and includes: monitoring, treatment of minor disabilities and transport in specialized centers for the most severe disabilities. In the last 2 years at Kityo Cha Afya has focused mainly on: the training of local staff and the education of the population through seminars and social and health awareness events open to all citizens. This area of Tanzania has the highest HIV prevalence rates (between 20 and 40%) of national average values, as it is crossed by one of the main arteries of communication between the port of Dar Es Salaam and the other Countries such as Zambia, Mozambique and Malawi.
In the Iringa region about 12% of children under one year of age are malnourished (Iringa Region Socio-economic Profile, 2013) and the level of rickets is one of the highest in the country (51.3%), despite a high agri-food production. Only 8.8% of children between 6 and 23 months have a sufficiently varied diet and 19.2% of children between 6 and 59 months do not receive adequate intake of vitamin A. Furthermore, very few people report wash usually hands before meals, a factor contributing to the spread of bacteria in consumed food (Tanzania National Nutrition Survey, 2014).
The present project intends to reduce the incidence of malnutrition, especially that of children, in five villages surrounding Nyololo: Nyololo Njapanda, Nzivi, Idetelo, Kisada, Kitelewazi. The project will have as its reference point the rural health center Kituo Cha Afya. The population of the five villages reached is equal to 16,052 people. The main economic activity consists of subsistence agriculture and in particular in the cultivation of beans, corn, potatoes and green leafy vegetables. Despite this, there are very high levels of malnutrition: in the district of Mufundi 12.3% of children under one year of age are malnourished (Iringa Region Socio-economic Profile, 2013). Another priority is the problem of the availability of blood with a consequent need to establish a blood bank.
The Kituo Cha Afya has been realized with the contribution of the Italian Episcopal Conference, which allocates part of the 8th one thousand of the total income tax for charitable interventions in favor of the developing countries (CEI, Charitable Interventions in favor of Third World Countries) – 2006) and thanks to the co-financing of the Region of Sicily in 2003 and 2007. The construction of the hospital was started in 2004 in collaboration with the Diocese of Iringa on the joint wish of the Parish of Nyololo and the Archidiocese of Palermo.
Important is also the collaboration undertaken with “Diplomatic Spouses Group” the organization of the brides of the diplomats, who collect funds every year through works of charity and donate them to small local projects.
Origins of intervention
1994. The collaboration between Co.P.E. and the two dioceses had already allowed the construction and commissioning of the Rural Health Center in the village of Migoli, Izazi-Migoli area, south-east of the Mtera basin, in the same region of Iringa.
2002. This collaboration allowed to lay the foundations and conduct the first on-site studies for the realization of the new health cooperation project in the village of Nyololo.
2004. The construction site for the Nyololo Rural Health Center, the only one in the Mufindi District, was started.
2007. KCA inaugurated in June, with the aim of compensating for the lack of medical assistance and serving a population of about 65,000 people.
2010. At the same KCA, but a little ‘aside to ensure greater privacy, the Care and Treatment Clinic CTC, specialized in HIV testing, information service and prevention and treatment of immunodeficiency through the distribution of antiretroviral drugs is inaugurated.
Departments and Health Services
1) OPD (Out Patient Deparment)
The day-care service of the health center includes:
2 medical clinics;
2 rooms for dressings;
1 dental clinic;
1 analysis laboratory;
1 medicine warehouse;
1 administration office;
1 accounting office;
2) Analysis laboratory
Active since 2011, it is the most equipped laboratory in the district. In addition to all routine biochemical tests, it allows the analysis of food parasitosis and sexually transmitted diseases. It also provides immediate and targeted service to HIV patients thanks to the CD4 counting equipment.
3) NHIF Service (National Health Insurance Fund)
In 2015 the KCA joined the government program that guarantees free health care, complete with analysis and supply of medicines, for all patients in possession of NHIF insurance.
4) Hospitalization service
Currently there are 5 hospital wards: pediatrics, maternity, men, women and isolation. For each department there are 10 beds, with the exception of that of pediatrics that presents 12. The flagship service of this department is the presence of a free canteen, accompanied by a nutritional service for the treatment of child malnutrition, which represents a exclusive and recognized program at the territorial level.
5) Delivery room
It is located within the maternity ward and thanks to a government program, it provides free services to pregnant women and is complete with obstetric staff.
6) Oxygen therapy
This is a newly activated unit following the wiring of the Health Center with electricity grid, which has allowed the introduction of electric oxygenators. This unit allows you to cope with emergencies and to support patients with breathing difficulties.
7) RCH (Reproductive Child Health)
Government service that deals with maternal and child health, monitoring during pregnancy, prevention and diagnosis of sexually transmitted diseases; moreover, there are prophylactic treatments against malaria, cures for intestinal worms, anemia and fetal malformations up to the immunizations of mothers and children up to the age of 5 years.
8) PMTCT (Prevention of Mother-To-Child Transmission) and VCT (Voluntary Counseling and Test)
These are two government programs active within the center, which deal respectively with the transmission of HIV from mother to child and the diagnosis, sensitization and counseling on the issue of HIV / AIDS.
9) CTC (Care and Treatment Clinic)
It is a structure entirely used for the treatment of patients with seropositive care, which provides specialized care, specific medicines and psychological support.
10) Ambulance service
Active 24 hours a day, it is a free service for pregnant women and, in case of complications or illnesses that are not negotiable at the facility, allows patients to be transported to the nearest hospital in Mafinga which is located at 63 Km.
11) Dental Department
Structure realized within the project “International Odotoiatric Solidarity” of the Smile Mission Onlus, dedicated to oral health in disadvantaged communities.
New structures to be implemented
Bank of the Blood
Accommodation for medical and nursing staff
Two new hospitalization departments