Dispensary construction: A community data driven initiative

After data from community meetups elevated health care to the top of his priorities, a local government leader in rural Tanzania is converting his office into a medicine dispensary.
Kyela District, Tanzania

Background

Meet Gwakisa George, a ward executive officer (WEO) from Kyela ward in Kyela district, one of several PEPFAR priority districts in Tanzania that have a high incidence of HIV/AIDS. Kyela is relatively rural area, and most of its citizens are farmers or fisherman due to its proximity to Lake Nyasa in southwestern Tanzania.

As WEO, Gwakisa is responsible for a wide variety of public service delivery efforts, including ensuring that investments and budgets are prioritized to meet the needs of his community

Problem

Every year, Gwakisa has limited resources to spend on improving service delivery in his ward. So, he needs to prioritize his investments and decisions based on what is most needed, and where it’s needed. But poor data quality about these needs prevents him from making decisions with confidence. While Gwakisa does engage with communities to understand these needs, doing so is costly and time consuming, so it can’t be done at a depth or scale sufficient to inform investment decisions that have significant impact.

Solution

In late 2017, Data Zetu partner Sahara Sparks conducted listening campaigns (LCs) – ward-level meetups that engage the local community in identifying and prioritizing challenges that need remedying (also called “pain points”). These LCs are built on the assumption that, as community members, the LC participants are better equipped to understand, define, and analyze their own situations—challenges and opportunities in their local environments—to better advocate for and prioritize resource allocation, as well as support decision making.

The second of the two-day LC in Kyela ward invited local informal and formal leaders to meet with community members to discuss and dig deeper into those pain points. This gave Gwakisa an opportunity to explore and discuss data about his constituents’ priorities.

Process

At the LC, 8 different community groups (such as females in school, females out of school, community-based organizations, etc.) identified and prioritized their challenges. The meetings were brokered in part by Sahara Sparks’ Engagement Fellows — Data Zetu ambassadors at the ward level who know and have the trust of their communities.

The next day, a second round of meetings involved leaders, influential people, and community representatives. This was a workshop setting comprised of a presentation of the collected challenges from the community, followed by a much deeper discussion between the community and their leaders.

Six of the eight community groups independently identified a lack of village dispensaries as among the starkest health challenges faced by the community of Kyela. What’s more, the participants said that too few dispensaries resulted in a high influx in the Kyela District Hospital, which in turn leads to poor medical services at the hospital. This in turn compounds medicine shortages, forcing patients to access pharmaceutical services at Mzomzi, or privately owned medicine access points where medicine costs are too high.

Data Zetu published this information as open data, for others to use to inform or prioritize their projects.¹

Outcomes and Impact

• A sustaining culture of collaboration with citizens: In 2019 Mr. Barnaba Mwang’onda was elected as the new Ward Executive Officer. A deputy WEO during the LC, he reported that “We’ve been able to do a replica of a Listening Campaign session in Kyela Ward” for newly elected LGA officials—demonstrating the downstream impacts of these efforts.
• New investments matched to community needs: Based on this community-generated data, Gwakisa started building a new dispensary in the same building that houses his office. A construction surveyor, engineers, and architects have been consulted already. And in 2019, his successor Barnaba successfully advocated for 1.5mn shillings from the Kyela District Council to support this transformation.
• Greater awareness of community priorities: In his words, “Before the Data Zetu intervention I knew less of the challenges faced by the community I lead, but after the intervention with Data Zetu, I have learned so much of the challenges. Health challenge was one of the issue that stuck in my head, as we have a hospital nearby and I never knew that it wasn’t enough for my people.”
• Adapting service delivery according to changing needs: Barnaba, Gwakisa’s successor, held his own Listening Campaign to learn updated priorities from his citizens which are driving his decision-making towards education sector investments. He told us,
  “today there is a shift in priority needs from a dispensary to classrooms for secondary school in Kyela Ward. We’re currently mobilize for the construction.”
• Improved collaboration with citizens: Gwakisa says, “This really opened up my mind on the importance of working closely and together with my people… Since [the DZ engagement], we have had some great collaboration with the community here in Kyela as we have been able to repair some of the roads and the community has been taking part in doing the work.” This renewed trust and collaboration is paying dividends; Gwakisa’s successor Barnaba collected 700,000 shillings from voluntary community contributions to create the dispensary in his office.
• Making decisions with confidence: In his words: “What I have learned so far is as a leader when you don’t use data in making decision the results are temporary and unsure — but when you use data you make decision with confidence and you know what you are doing, it is very beneficial.”

Key Collaborators