HIV Care Improvement Work Positively Affects Children at Day Care Center in Tanzania

URC’s USAID Health Care Improvement Project (HCI) began supporting Tanzania’s Ministry of Health and Social Welfare in 2010. The objective was to build health workers’ capacity to apply quality improvement approaches to improve health care services at health facilities in Iringa, one of the country’s 30 administrative regions.

But for health workers at Nzihi Health Centre, the training did more than just improve the services they provided. After conducting their first outreach clinic for under-five children at the privately owned Kidamali Kipera Farms (KK Farms) at Kidamali Village, they realized that their knowledge of quality improvement could improve health in the community from outside the health facility. 

The KK Farms day care center had been constructed decades earlier to care for children whose parents worked the farms. More than 50 children, most of them under five, spend six days a week at the center.

“When we conducted our first outreach clinic at the center in January 2012, we discovered that most children had malnutrition. Since it was our first visit there, we promised ourselves to follow up on the situation,” Anna Legonga, a health worker at Nzihi Health Centre, told me.

One condition parents had to meet to leave a child at the center was to bring food for the child’s lunch. Most parents brought something in uncovered plastic bowls or on a plate covered with another plate. This was particularly worrisome since the center was dirty. Another problem was a staff shortage: one caregiver and a nurse were the only workers at the center. 

The outreach workers assessed all the children and gave Mebendazole and Vitamin A to those with malnutrition. They also educated the caregiver and nurse on the importance of cleanliness and parents on the importance of keeping food in hot pots so it would still be warm at lunch time. 

Thanks to the outreach workers’ advocacy, the farm owner agreed to hire another caregiver and to give the children nutritious food at least weekly.

The children’s health quickly improved, especially those with malnutrition. The center is cleaner, and the farm owner has promised more improvements, including adding taps to provide water at the center.

Ms. Legonga reports that she and her colleagues are pleased to have helped improve the children’s health: “When we first came to conduct an outreach clinic, we had no idea something big like this would happen. We are very happy to see these children happy and especially with their health improving day after day.” 

The US Agency for International Development (USAID) supports Tanzania’s Ministry of Health and Social Welfare and implementing partners to deliver quality care in the areas of anti-retroviral treatment (ART) and prevention of mother-to-child transmission of HIV (PMTCT), most vulnerable children and home- based care services through the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project, also managed by URC.  For more information on ASSIST's work in Tanzania, please contact Dr. Davis Rumisha.

A group of children play with a ball in the courtyard of KK Farms, a daycare center in Tanzania
Children play at KK Farms, a daycare center in Tanzania. Photo by URC Tanzania staff
November 19, 2013
Regions/ Countries