Tanzanian Villagers Unite in Grassroots Advocacy for Health Center

Speeches Shim

A nurse at the Kibaigwa Health Center shows off the newly completed women’s ward.
A nurse at the Kibaigwa Health Center shows off the newly completed women’s ward.
Chemonics International
Local changemakers find their voice to petition government
“We didn’t know what to do. We needed the labor ward. Women weren’t giving birth in a good environment.”

June 2017—Giving birth should be a dignified experience—but until recently, it was anything but that for women in Tanzania’s Kibaigwa village. Without a labor ward at the local health center, expectant mothers had to be rushed 45 kilometers over dirt roads and harsh terrain to the neighboring district.

“We didn’t know what to do,” said Ward Executive Officer Mghanga Gabriel. “We needed the labor ward for women in Kibaigwa, but we didn’t have it. Women weren’t giving birth in a good environment.”

For village residents, it was clear that something had to change—but how, exactly, nobody could be sure.

It’s a common feeling in communities like Kibaigwa—knowing exactly where change is needed most, but not having the means to take action. That’s where the USAID Pamoja Twajenga (Together We Build) program comes in. Recognizing the value of productive and engaged citizens in Tanzania’s development, the program trains community-based organizations to help citizens express their needs to government representatives and hold local institutions accountable.

Although the construction of a new labor ward in Kibaigwa first began in 2012, the site was left vacant and incomplete when funding abruptly ran out. It wasn’t until community members teamed up with a local organization called the Tanzania Council for Social Development in August 2014 that a labor ward once again began to become a reality.

With guidance from Pamoja Twajenga, the council taught community members and local leaders skills like how to monitor shared services and resources, participate in decision-making, and hold government accountable. Once participants had a taste for civic engagement, it wasn’t long before they were calling for change.

They began by negotiating with village leadership to complete the women’s ward, prompting them to petition the district government for funding. Upon convincing their representatives to finance the remaining work, the village committee recruited a local contractor to finalize the process and mobilized community members to inventory available building materials.

Thanks to the persistent advocacy of Kibaigwa residents, construction resumed under village supervision in January 2015. By the following October, the ward was open and serving the community.

Today, inhabitants of Kibaigwa village no longer have merely the desire to effect change in their community, but the knowledge, determination and resources to do so on their own. The ball is in their court now—with a completed health center open for business and serving thousands, it’s only a matter of time before they are tackling their next community initiative.

Since 2013, USAID’s Pamoja Twajenga program has partnered with government accountability institutions—which oversee public services and resources—and community-based organizations to improve citizen engagement and promote transparency in Tanzania. Under the program, communities like Kibaigwa are trained to lead advocacy campaigns of their own, enabling them to address prioritized local challenges.

Not far from Kibaigwa, for example, one community trained locals to identify and respond to gender-based violence. In eastern Tanzania, five villages reformed the way local land is governed to stamp out property disputes once and for all. Another village took action to protect the environment by eliminating illegal logging in the area. Through actions like these, local organizations and the communities they serve contribute to a more democratic future, thereby building resilience and countering threats to stability.


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