TANNA Newsletter

THE OFFICIAL JOURNAL OF THE TANZANIA NATIONAL NURSES

ASSOCIATION (TANNA) WWW.TANNA.OR.TZ

Volume 1 September 2012

Nurses preparedness for Non-Communicable Diseases in Tanzania The nursing workforce up to the challenge but more synergy needed.

NEWSLETTER: JOURNAL OF THE TANZANIA NURSES | Issue 1 ASSOCIATION

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September 2012 Welcome to the first edition of TANNA

Newsletter!

Inside

3.From the Editor A welcome not from the editor.

3.Putting a face to the nursing profession Powerful image builder tips for nursing in Tanzania.

4. Executive Secretary’s Message

TANNA’s role in improving the quality of

nursing and midwifery services in Tanzania.

5. Nursing Services Unit

6. Nurses preparedness for Non-

Communicable Diseases in Tanzania

7. TANNA Events

8. Photographs

10. Experiences from World

Health Assembly meetings held

in Geneva.


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From the editor

Dear readers, welcome to the first edition of our newsletter!

This journal intends to inform its readers about the progress made by the Tanzania National Nurses

Association (TANNA), and series of events that took place inside and outside the country.

We would like to hear from from you, suggestions for improving our future issues. We also request

contribution in terms of articles, reports, research and events so that we can include in future

publications.

Enjoy, looking forward to your contribution.

Elizabeth Kijugu

TANNA NEC Member

Putting a face to the nursing profession Lt. Col. Ntuli Mwambingu: President TANNA

I believe that image of nursing is both a lesson and an opportunity. Nurses are the primary and the largest healthcare workforce in Tanzania.

Individual patients, relatives and the community at large have the right to talk about their experiences in the hospitals with regards to the quality of service and the conduct of nurses who took care of them. Some of the common complains as interviewed by patients were:-“nurses were too harsh, rushed in out of the room, Patients went days without baths or linen changes, medication were given on request “Many of these complaints listed above are due to one of the following reasons; shortage of nurses, competence, supervision, training, poor working condition, poor infrastructures ,an demotivation.

Recruiting new nurses is becoming a problem, when visited at one of the primary school and secondary school through school health programs, one of the question asked about their choice after completing their studies most of them preferred to be: Traffic police, reporters, IT professionals, bankers, lawyers and other professions very few of them preferred to be nurses. Reason for not preferring was due to long duration courses and too much blame from the community.

More experienced nurses are now leaving the profession, stating they are burned out, some are changing professions, migrating to greener pastures and leaving the community to be cared by health attendants who by definition are not nurses.

Nurses need funding for clinical practice, education, and research to resolve the global nursing shortage. And funding will more easily flow to the nursing profession once nurses are given the respect they deserve for serving lives and improving patient outcomes every day.

Today nursing has the chance to shape the health care system. Nurses are the linkage between health professionals and community health. Nurses must use this opportunity to market the nurse’s role. Nurses should always strive for successes; those bad images will eventually vanish. Apart from the strong media campaigns that we have had to use to improve the image of nurses, there is need for action and networking with stakeholders at community, national, regional and international levels to improve nursing image

When we read or see articles about nursing we should respond to editors by going to find out the truth about the said story and see all the stakeholders involved to get a consensus approach and this can be done by involving the association/union within that facility.

It should be born in mind that the most powerful image builder is how nursing presents itself to colleagues and community.

We must let the public understand what nursing is all about by participating in community and political activities


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TANNA: A pivotal role in improving the quality of nursing and midwifery services in Tanzania.

Nurses and midwives are the “front line”

healthcare workforce in Tanzania. It is

estimated that more than 80% of health

services are delivered by nurses and

midwives and about 90% of maternal deaths

can be prevented by midwives and personnel

who are competent at providing services to

maternal and newborn children.

The contribution of nurses in the health sector is well acknowledged by many people. Nurses play a critical role in implementation of the Millennium Development Goals (MDGs) and delivering safe and effective health care. In most working places nurses provide leadership, management, nursing care, training and supervision to community health workers. .

The World Health Organization (WHO) and member states made commitments to make human resources for health and its nursing backbone a strategic priority across the globe since 2006.

The questions before us are; what have we done thus far to place nursing prominently in the national health strategy? Is nursing strategically positioned in subsequent health policies and plans? Is nursing being recognized and being empowered to make decisions in the health sector? What should be done then?

The needs of current nurses must be addressed at ground level as a priority. The current negative image of nursing damages the nurse’s morale. Nurses and Midwives need to show “strong leadership” in making aware of the range of opportunities within the profession, and where they can access support and raise concerns. Leaders should address the levels of education and training undertaken by nurses to give them a “higher profile” from the public. TANNA has been restoring the public confidence in the profession and exploded some of the myths around nursing. We need to give the public a

better understanding of what nursing really is.”

Tanzania National Nurses Association (TANNA) is one among more than 130 Member State Association of the International Council of Nurses (ICN). TANNA is the most influential Association for nurses and midwives in Tanzania. Its vision is to be a vibrant and reputable Association representing all professional nurses, advancing their welfare and promoting excellent nursing and healthcare. TANNA’s mission is to advocate for nurses, promote excellence in nursing and influence health policy.

TANNA represents nurses in Tanzania nationally, regionally and internationally. The purpose of the Association is to promote the highest possible standard of nursing practice, encourage professional and educational advancement for nurses and to ensure that all people irrespective of nationality, race, color or social origin may have optimal nursing care.

TANNA believes that the strategic approach to strengthening nursing and midwifery is to focus on human resources planning and capacity building, management of personnel, evidence-based practice, education, governance and leadership. This can successfully occur through joint efforts from the community, political leaders and other related policy makers. Roles of tomorrow’s nursing and midwifery will only occur if it will respond to the population’s health needs, recognized and involved in health policy making, respond to the changing patterns of health care and contribute to improvement in health system performance.

According to TANNA, the Association is believed to be at a critical stage of its development in the Nursing Leadership arena. The Association itself provides a rich learning environment in which all members who are leaders in their branch level have been trained to take responsibility for own decisions and action implements standards and protocols to guide others and develops the full potential of others to act within them

Other benefits derived from the association on strengthening nurses and midwives, are nurses gain a deeper understanding of

nursing challenges, they become better equipped to build strategic alliances, they are able to identify their leadership strengths and areas of improvement are prepared to take on higher leadership roles nationally and get access to share new ideas, performance and challenges with other Nurses around the world through

International conferences

TANNA believes that training leaders and advocacy lobbying is a very timely operation which strengthens nursing and midwifery profession in the country.

TANNA is also on the move to train nurses in their working places on matters concerning the challenges they face in providing services to their clients. The topics which will be explored particularly in professional nursing will be on managing work place violence, image of nursing, infection prevention control, injection safety, effective communication (Customer Care), advocacy and lobbying, strategic thinking and planning and working with the Media.

With collaborative partners, TANNA will be able to plan and implement various activities where nurses will be able to be volunteers and be honored with a certificate in recognition of their invaluable contributions to TANNA and their nursing profession.

TANNA members recognize the need to work together as a collective body and in collaboration with other health care organizations, and key stakeholders to influence health care policies and to bring about positive changes in the delivery of quality health care to all Tanzanians

"Professionalism and academic excellence will be the benchmark by which nursing services will be valued and respected. TANNA believes that as nurses become more involved in decision making with policy makers they will discover the benchmark where effective nursing midwifery profession will become the vehicle that will influence and shape standards of nursing practice and health policy in each health related organization.

Message from the

Executive Secretary By Romana Sanga


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The Nursing Services Section is an administrative structure led by the Chief Nursing Officer (CNO) who is also the Assistant Director under the Health Quality Assurance Division, Ministry of Health and Social Welfare (MoHSW).

The unit plays an advisory and technical role on matters pertaining to strengthening the capacity for the management and provision of Nursing and Midwifery Services in Tanzania Mainland.

At Zonal level we have Directors, Matron/Patrons offices that oversee and monitor provision of nursing and midwifery services in Consultant and Referral Hospitals. At the regional level, we have Regional Nursing Office that is mandated to oversee, translate health, nursing and midwifery policies for that region.

This level is led by the Regional Nursing Officers (RNO). At the district level we have District Nursing Office that is responsible for all implementation and delivery of nursing and midwifery services. This level is led by the District Nursing Officers (DNO).

Activities that are conducted by Nursing Services Section

To coordinate, monitor and

evaluate the implementation of

National Nursing Services Policy

guidelines and Standards

Conducting annual evaluation

meetings on Nursing and

Midwifery Services to the Regional

Nursing Officer and Matrons of

National Referral Hospitals

Liaise with the Nurses and

Midwives Council on Legal Issues

pertaining to

o Nursing and Midwifery Services

To collaborate with Directors

and Assistant Directors of division,

Units and Sections

o within the MoHSW and Regulatory Bodies on Issues pertaining to specialized o and advancement of

Nursing and Midwifery Services

View nursing patient ratio and

recommends for appropriate

human resource requirements at all

levels of health care

To monitor, evaluate and research

on priority areas on nursing and

midwifery care

Facilitate supportive supervision for

nursing and midwifery services in

the country

Formulating guideline/protocols on

pain management for chronic

illnesses

Conducting pain management

study and disseminate results to

decision maker and stakeholders

Setting standards for essential list

of equipment for carrying nursing

and midwifery procedures

Develop and review nursing

strategic plan for management of

nursing and midwifery service

delivery

Conduct needs assessment study

on risk management, mode of care

and technology that is appropriate

to the delivery of nursing and

midwifery services to the

community

Disseminate nursing and midwifery

policy guideline and

Foster and maintain links with the

rest of health care system in

country, at regional and

international level.

OUR VISION:

To become a vibrant, reputable association representing all professional nurses, advancing their welfare and promoting excellence in nursing and healthcare

OUR MISSION:

To advocate for nurses, promote excellence in nursing and influence health policy.

BENEFIT OF MEMBERSHIP

Share experiences and ideas

nationally and through

international networks

Have a voice in decision- making

about TANNA and the

profession

Access to more resources and

education opportunities

Participation in consultative

meetings of TANNA,

government, others

Nursing Services Unit By Clavery Mpandana Chief Nursing Officer Tanzania


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Nurses preparedness for Non-

Communicable Diseases in

Tanzania

Non-Communicable diseases (NCDs), also known as chronic disease, are medical conditions or diseases which are non-infectious and non-transmissible between persons. They are of long duration and generally low progression. They include autoimmune diseases, heart disease, stroke, many cancers, asthma, diabetes, chronic kidney disease, osteoporosis, Alzheimer’s disease, cataracts and more. Four main types of NCDs are cardiovascular diseases (CVD) (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma) and diabetes.

NCDs are driven by forces that include ageing, rapid unplanned urbanization, and the globalization of unhealthy lifestyles. Four important underlying risk factors for these diseases are tobacco use , unhealthy diet (high consumption of sugar, salt, saturate fats and trans fatty acids), physical inactivity and harmful use of alcohol (WHO 2011), thus referred to as “lifestyle” diseases.

NCDs are the leading cause of death worldwide, killing ever more people each year. Nearly 80 per cent of these deaths occur in low- and middle-income countries. All age groups are affected by NCDs but evidence shows that more than 9 million of all deaths attributed to NCDs occur before the age of 60. Of these "premature" deaths, 90% occurred in low- and middle-income countries (WHO 2011)

In Tanzania there is a concern and growing evidence of escalating burden of the main types of NCDs, these are cardiovascular diseases, cancer, diabetes and chronic respiratory diseases. The concern is not just

health related but also economic because NCDs are often accompanied by long standing disabilities which causes direct economic impact on households and communities both through the uptake of health services and goods that diverts expenditure, and also impact on levels of income or labor productivity. According to the WHO-NCD Country profiles, 2011 NCD mortality estimates for Tanzania in 2008 were as follows:

NCD mortality Male Females Total NCD deaths (000s) 75.7 58.8 NCD deaths under age of 60 42.8 28.5 Percent of all NCDs Age – standardized deaths rate per 100 000 All NCDs 874.0 614.3 Cancers 79.0 73.9 Chronic respiratory diseases 130.5 52.1 Cardiovascular diseases and diabetes 472.7 381.9

Behavioral risk factors 2008 estimated prevalence (%) Male Female Total Current daily tobacco smoking 14.1 1.8 7.9 Physical inactivity …. …. ….

Metabolic risk factors 2008 estimated prevalence (%) Male Female Total Raised blood pressure 40.0 38.3 39.2 Raised blood glucose 6.9 7.5 7.2 Overweight 19.4 24.6 22.1 Obesity 3.4 6.4 5.0 Raised cholesterol 19.9 24.1 22.1

Proportional mortality (% of total deaths, all ages

The impact of NCDs in Tanzania includes a number of challenges in provision of nursing care services. Few examples include increased nursing workload due to shortage of nurses, inadequate equipment and supplies due to increased number of inpatients and long hospital stay, increased hospital acquired infections, patients and relatives dissatisfaction of nursing services without taking into consideration the real situation nurses are working in. Tanzania National Nurses Association (TANNA) -a voice of nurses in Tanzania, has a wider role to play in preventive, control and treatment interventions for NCDs such as advocacy for healthy lifestyles and media campaigns to reduce salt content, replacement of trans fats with polyunsaturated fats, along with public awareness programmes about diet and physical activity. Other measures includes focus on the individual such as screening, counseling and emphasis on drug therapy compliance for people with or at high risk of cardiovascular disease, promoting screening for cervical cancer, and hepatitis B immunization to prevent liver cancer. For effective implementation of the above said preventive, control and treatment interventions, TANNA needs close cooperation and team work with every individual, family and community, all sectors, all levels within government, international partners, civil society, non-governmental organizations and the private sector, because we all have vital roles to play in shaping healthy environments and contributing to the promotion of healthy lifestyle. Message by Valleria P Mushi NEC- Advisory member


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TANNA EVENTS

International Nurses Day On the 18

th through 20

th May 2009 TANNA

joined all nurses in the world to celebrate International Nurses day at Mnazi Mmoja grounds.

“Good Samaritans” In celebration of the Nurses’ day, TANNA members paid homage to some patients and offered some gifts.

FAST FACTS

80% Healthcare Services in Tanzania is provided by Nurses and Midwives

90% Maternal deaths can be prevented by midwives and personnel who are competent at maternal care.

15th

-16th

September 2009 Tanzania Nurses association in collaboration with Common Wealth Nurses Federation held a two days’ workshop to twenty four(24) nurse on 4 safety ( Safe care, safe practice, safe nurses and midwives , safe environment) in Dar-Salaam at Karimjee hall.

24th

-26th

June 2009: Tanzania National Nurses Association Publicity Secretary Mr. Obedi Mgina attended Africa symposium of the International migration of health workers which was held in Gaborone Botswana.

26th

June- 4th

July 2009: Executive Secretary Ms. Romana Sanga Attended an International Council of Nurse Congress Durban South Africa

29th

June -10th

July 2009: Tanzania National Nurses Association (TANNA) in collaboration with Ministry of Health and Social Welfare participated in exhibitions where nurses provided services of screening blood sugar, checking of blood pressure and giving health education to Public members.

11th

-17th

September 2009: Two Nurses participated in a Global Nursing Leadership in Geneva; this was organized and sponsored by International Council of Nurses. (ICN) Thirty (30) countries were represented in this course.

The objectives of this course were to be better equipped and to build strategic alliance, identified our leadership strength. To acquire a deep understanding of global health care challenges, be better positioned to effect positive policy change.

To be better equipped with strategic planning and thinking skills. To be able to take higher leadership roles nationally and globally. To develop international network.

November 2009: Tanzania National Nurses Association conducted a study on needs assessment which was carried out as part of the work of The Tanzania Nursing Initiative (TNI), with a partnership with the University of California, San Francisco School of Nursing, Muhimbili University Health Sciences, and the American International Health Alliance,(AIHA) funded by CDC- Tanzania through PEPFAR.

The objectives was: Recognizing the importance of strong professional organizations in promoting and sustaining nursing’s progress, TNI asses Tanzania Nurses and Midwives Council (TNMC) and Tanzania National Nurses Association (TANNA). The report represented the results of needs assessment of the two organizations carried out in the last quarter of 2009 with the guidance of an Advisory Group in each organization and the use of emails, in person meetings, interviews, focus groups and surveys.

TANNA EVENTS

TANNA Leaders with Government Officials (Centre seated: Prime Minister Hon. Mizengo Pinda)


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26th

-29th

November 2009 The Tanzania National Nurses Association Executive Secretary Ms Romana Sanga participated in the SANNAM DIASPORA workshop in Pretoria South Africa for the purpose of developing an action plan to identify the utilization of skills and other resources with priority of health system strengthen needs in the SANNAM member countries

10th -12th December 2009: Leader’s forum was held in Dar-Es-Salaam at Ubungo, Land Mark Hotel. This was organized by the Tanzania Nurses Association (TANNA) in collaboration with The American International Health Alliance (AIHA) and the

centers for Disease Control (CDC). All TANNA leaders from Tanzania Regions participated in this meeting these three days. The aim of this leader’s forum was to explore challenges facing the association develop strategies, plan and implement according to the priorities.

12th

– 13th

February 2010: SANNAM Annual Networking held in Mbabane Swaziland the theme was managing Nurses Association and exchange of views among Member Countries on issues related to the nursing profession by use of various NNAs

22nd -24th September 2010:38th Annual General Meeting and Scientific Conference for Tanzania National Nurses Association were held at Mtwara Region. The theme was human resources development for nurses.

22th -23th September 2010: Leaders forum was held at Mtwara Region, where important topics such as lobbying was presented

10th

-11th

November 2010: Tanzania Media Campaign workshop was held for two days in Dar es Salaam. The main objectives were to achieve basic requirements that allow good nursing practice and to empower the nursing profession, to lobby for good relations between Ministry and nursing society

2nd

-3rd

March 2011: Leaders forum for Regional TANNA branch Representative was held at Courtyard Hotel in Dar es Salaam, and The major objective was the roles of TNMC, TANNA and CNO in performance of Nursing profession.

18th

– 20th

May 2011: Commemoration and celebration of National Nurses Day and 40 years anniversary of TANNA. TANNA headquarters and TANNA branches in Dar es Salaam provided services to the people resided in Dar es Salaam

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-17th

July 2011: Policy workshop was held in Dar es Salaam – Peak Cock Hotel. The workshop aimed to recognize the need to work together as a collective body and in collaboration with other health care organization and key stakeholders to influence Health Care Policies and to bring

about positive changes in the delivery of quality health care to all.

29th

– 10th

August, 2011: Nanenane exhibition in collaboration with the Ministry of Health

was held in Dodoma by providing serviced to the public i.e screening visitors from the diabetic, education, explaining the roles of TANNA and nursing profession in general

July – September, 2011: TANNA NEC members did Branch visiting to 18 branches between July 2010- September 2011 for the purpose of strengthening the Association. During branch visit presentations, discussions on gaps, successes and challenges facing members were addressed. NEC members visited working places of nurses, nursing schools; mobile library.Visted income generating projects such as retail shops and canteen


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Experiences

and lessons

learnt at World

Health

Assembly

meetings held

in Geneva from

12th to 21st may,

2010. Four representatives from Tanzania Nurses and Midwives Council (TNMC) and Tanzania National Nurses Association (TANNA) were supported by American International Health Alliance (AIHA) and /through Tanzania Nursing Initiative (TNI) to attend meetings organized

Participants from Tanzania, from left is Ms. Romana Sanga, (TANNA), Col. Ntuli Mwambingu (TANNA), Ms. Joyce Safe (TNMC) and Mr. Gustav Moyo (TNMC)

by the International Nurses Council (ICN), International Confederation of Midwives (ICM) and the World Health Assembly (WHA) in Ramada Park Hotel Geneva from 12

th to

22nd

May, 2010. The meetings were conducted in three categories as follows: the meetings of associations and regulators separately, the TRIAD. Participants discussed various issues after these presentations and they agreed to increase collaboration and networking between nurses and midwives.

Triad Communiqué

The Government Chief Nursing Officers and representatives of National Nurses Associations and regulatory bodies finalized and approved a communiqué to be submitted to the 63

rd WHA. The

communiqué addressed issues of economic crisis, the growing burden of chronic disease and health system strengthening. The global economic crisis and the scarcity of appropriate nursing and midwifery work force jeopardize the ability of many countries to reach MDG 4, 5 and 6. The communiqué demanded nurses and midwives to play

leadership role in planning, development and evaluation of health policies and services. Lesson Learned

The global economic crisis has greatly

affected developing countries which has

led severe shortage of health workforce

particularly nurses and midwives.

During the plenary Ministry of Health

presentations it was revealed that

developing countries were the most

faced with challenges towards achieving

MDGs 4 and 5 by year 2015.

There is increased need to address

challenges of Non Communicable

diseases from both developed and

developing Countries

Nurses and Midwives share common

problems particularly in developing

countries such as; acute shortage of

nurses and midwives in workplace, low

pay and lack of recognition from policy

makers.

Participants had an opportunity to

exchange ideas and experiences with

health workers across the World such

as in lobbying skills, empowerment.

In order to bring positive impact in

strengthening health system there is a

need to collaborate with various

stakeholders such as politicians, media

and Members of Parliament.

There are many resolutions adapted by

WHO which have influence for Nursing

and Midwifery but are not known by

Nurses and Midwives in most of the

countries

INTERNATIONAL EVENTS

Ms. Sanga, Mr. Mwambingu, Mama Safe and Mr. Moyo in Geneva

THE OFFICIAL JOURNAL OF THE TANZANIA NATIONAL NURSES

ASSOCIATION (TANNA) WWW.TANNA.OR.TZ

TANNA is supported by the US President’s Emergency Plan for AIDS Relief (PEPFAR) and

CDC/Tanzania through a capacity building partnership managed by the American

International Health Alliance’s HIV/AIDS Twinning Center, which is funded by the US Department of Health and Human Services,

Health Resources and Services Administration.

TANNA Newsletter

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