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Citizen Hearings were held across 5 districts engaging 2,000 citizens, politicians, local leaders and professionals. District leaders and citizens worked together in developing strong joint recommendations on priorities for the updated Global Strategy for Women’s, Children’s & Adolescent’s health - District leaders spoke out to strengthen the call for increased accountability and transparency in decision making and service delivery.


For leaders to be accountable, health policies should be coming from us, citizens and then submitted to government leaders and not otherwise
— Msagati, Citizen
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I recommend for Government plans on MNCH services to give priority to our mothers who stay in villages since most of childbirth deaths happen in villages
— Rehema Haji, Student, Chief Mang'enya Secondary School- Korogwe
Government Commitment of having a health centre in every ward should be taken as a directive like that one of having a secondary school in each ward. This should not be subjected to discussions it should be a must
— Joseph Sanga - Ward Executive Officer, Mnyuzi Ward, Korogwe
Members of Parliament should seriously debate on how to make the government accountable in the reduction of needless mothers and newborns deaths as they have been debating on issues related to abuse of public funds
— Ayubu Bombwe, Citizen from Temeke

Joint Citizen/Politician Recommendations:


1.    To strengthen transparency and accountability in RMNCAH services by making all information available to citizens
2.    Establish District and National level follow up mechanisms for citizens to be able to monitor and get information regarding Maternal and Newborn Health policies
3.    District Political leaders to provide feedback and communicate to citizens about all issues discussed in the last council meetings including the budget for Maternal and Newborns health services. 
4.    Councils to increase and strengthen supervisory role in making sure that all health policies, regulations and guidelines are properly translated into actions and that whoever will go against will be dealt according to the governing laws.
5.    Leaders at both local and central government to work together to improve RMNCAH services
6.    Members of Parliaments to ensure politicians and decision makers are accountable for their promises on health to mothers and newborns.
7.    National and International policies on mothers and newborns health to be informed by citizens’ priorities and submitted to leaders. 
8.    Government should remain custodian of RMNCAH services in the country and they should not entirely depend on Development Partners funding because they may not be consistent.
9.    Citizens will contribute blood to the available blood banks
10.    Provide blood banks in all areas
11.    Renovate existing health centres
12.    Citizens will participate in building health centres with government support
13.    Councils will budget for the construction of houses for health workers.
14.    Ensure ambulances or any designated transport for patients should not at any time run out of fuel
15.    Formulation of a small 'follow up' committee for the purpose of making follow ups for maternal and newborn health services at village, division and ward level.
16.    Members of village health committees will inform citizens on the progress of RMNCAH
17.    Health Facility committee to report on availability of medicines at community feedback meetings 
18.    Council income and expenditures to be placed on facility notice boards for citizens to track performance.   
19.    Citizens to participate in building dispensaries and Health Center in their areas at their level, and the government should provide qualified staff and supplies once completed.
20.    All social groups in the society should be informed about safe motherhood.
21.    Village leaders should be educated by the RCH units in the districts for them to be able to educate their fellow citizens through community meetings.
22.    All Citizens will actively participate in planned meeting
Health-influencing sectors - Social and Economic Determinants of Health
23.    Educating communities around the importance to give birth at Health facilities
24.    Men will accompany their wives to the Health Center as they approach their expected date of delivery to avoid last rush that may endanger the health of the expecting mother and the pregnancy.
25.    Comprehensive emergency obstetric and newborn care services in health centres in every district  - However, there must be enabling environment for all these services to bring about impact in serving lives at childbirth – such as running water supply, staff housing, electricity, operating theatre and laboratories, citizens willingness to make blood donation, adequate and qualified staff and emergency transport. 
26.    Men and communities to ensure women are seeking healthcare and have access to nutrition and rest
27.    Outreach services, like established in Tanga, to refer pregnant women to clinics and provide health education 
28.    Men to prioritize/budget for women when they are pregnant
29.    Women’s right to safe motherhood to be included in the new constitution
30.    Advocate for more predictable international aid flows.
31.    Provide an opportunity for national governments to make domestic financing commitments on an international stage, and report regularly on these.
32.    Empower non-governmental and civil society sectors to advocate for and monitor domestic financing of RMNCAH
33.    The Government to increase budget to support mothers and newborns health by increasing revenue collections and cutting down unnecessary expenditures.
34.    Health Facility Committees to report on availability of medicines at community feedback meetings 
35.    Formulation of a small 'follow up' committee for the purpose of making follow ups for maternal and newborn health services at village, division and ward level
36.    Establish citizens’ score card to assess availability and quality of services

Tanga Region Hearing