MPs fault ‘D by D’ delivery system

ROSE ATHUMANI in Dodoma

THE Decentralisation by Devolution (D by D) strategy has been faulted by MPs, who have said it is not practical, especially in the health and education sectors.

Contributing to the Ministry of Health, Community Development, Gender, the Elderly and Children budget speech, Mr Hussein Bashe (Nzega Urban-CCM) said ‘D by D’ is not practical because the sector is currently under three ministries, including Regional Administration and Local government, TAMISEMI, and Public Service Management, making it difficult to manage.

This was also supported by the National Assembly Speaker, Job Ndugai, who stressed the importance of the House to look into the ‘D by D’ and advise the government accordingly, especially in the health and education sector.

Mr Bashe called on the parliamentarians’ support to have all regional hospitals placed under the management of the ministries of Health; and Community Development, Gender, the Elderly and Children and leaving TAMISEMI to manage the infrastructures.

He said at present, the minister or deputy minister cannot hold any medical officer accountable without going through the executive director. “The National Assembly must take the responsibility to show leadership in the ‘D by D’ issue because it is not practical at all,” he said.

The ‘D by D’ system was adopted by government between 1997/98 as a policy option to devolve powers and authority from the central government to the local government to facilitate participation and quick decisions for local development to improve service delivery.

However, according to the legislator, the system has proved a failure in health and education sector, creating more problems than envisaged. Mr Bashe cited an example in the education sector, when fourth formers fail, saying the Ministry of Education, Science, Technology and Vocational Training is the one that receives all the blames when it does not have the authority other than only managing the education policy.

“Placing all regional hospitals under the ministry would enable us to take the ministry to task whenever there are challenges in the sector as opposed to the current situation. This move will also enable the ministry implement strategies to address challenges including maternal deaths which are currently at 42 women per day,” he explained.

The MP said maternal deaths were caused by, among other reasons, access to proper health services, urging the House to direct the Ministry of Finance and Planning to avail 7.5bn/- to cover pregnant women under the National Health Insurance Fund (NHIF) to assure them of health services. “Statistics show that an average of 1.2 million women give birth every year, under the cover of NHIF at an average of 50,400/- per person, this sums up to 7.5bn/-,” he explained.

Mr Joseph Mbilinyi (Mbeya Urban-Chadema) advised that the whole health system in the country should be placed under the Ministry of Health, Community Development, Gender, the Elderly and Children, noting that the current system is creating a lot of confusion to MPs.

“About 95 per cent of contributions from MPs are on dispensaries and health centres; but all these are under TAMISEMI and not the ministry….. even in employment of health officers there are those employed under the ministry and those under TAMISEMI, making it difficult for them to even cooperate in some issues,” he explained.

Ms Ruth Mollel (Special Seats-Chadema) proposed that the government equip all referral hospitals in the country with modern health equipment, including CT-scans to reduce congestion at the Muhimbili National Hospital (MNH) and reduce the number of people travelling outside the country for treatment.

Ms Farida Bakari (Special Seats-CCM) condemned people killing the elderly in the country, also calling on the ministry’s attention to poor living conditions of the elderly living at Old Age centres, pointing out that a special budget should be set aside for them.

On her part, Ms Esther Bulaya (Bunda Urban-Chadema) commended the Intelligence Security in the country in the fight against illicit drugs but noted that government’s move to channel methano funds through Management Development for Health (MDH) took too long before reaching the targeted people.