HOTUBA YA WAZIRI WA AFYA, MAENDELEO YA JAMII, JINSIA, WAZEE NA WATOTO, MHE. UMMY A. MWALIMU (MB), KUHUSU MAKADIRIO YA MAPATO NA MATUMIZI YA FEDHA KWA MWAKA 2018/2019


A: UTANGULIZI 1. Mheshimiwa Spika, kufuatia taarifa iliyowasilishwa na Mwenyekiti wa Kamati ya Kudumu ya Bunge ya Huduma na Maendeleo ya Jamii ndani ya Bunge lako Tukufu, ambayo imechambua Bajeti ya Wizara ya Afya, Maendeleo ya Jamii, Jinsia, Wazee na Watoto, ninaomba kutoa hoja ili Bunge lako likubali kupokea na kujadili Taarifa ya Utekelezaji wa Kazi za Wizara ya Afya, Maendeleo ya Jamii, Jinsia, Wazee na Watoto kwa mwaka 2017/18 na Vipaumbele vya Wizara kwa mwaka 2018/19. Aidha, ninaliomba Bunge lako Tukufu likubali kupitisha Makadirio na Mapato ya Matumizi ya Kawaida pamoja na Mpango wa Maendeleo ya Wizara ya Afya, Maendeleo ya Jamii, Jinsia, Wazee na Watoto kwa mwaka 2018/19. 2. Mheshimiwa Spika, kwanza napenda kumshukuru Mwenyenzi Mungu kwa kuniwezesha kusimama mbele ya Bunge lako Tukufu na kuwasilisha hotuba yangu siku ya leo. Aidha, ninapenda kutumia fursa hii kwa heshima na unyenyekevu mkubwa kumshukuru kwa dhati Mheshimiwa Dkt. John Pombe Magufuli, Rais wa Jamhuri ya Muungano wa Tanzania kwa uongozi wake imara kwa nchi yetu na maelekezo yake ambayo yamekuwa dira sahihi katika utendaji wangu na katika kuimarisha huduma za Afya na Maendeleo ya Jamii nchini. Aidha, ninampongeza Mheshimiwa Rais kwa kuendelea kuipa kipaumbele Sekta ya Afya kwa kutoa msukumo mkubwa katika uanzishwaji wa viwanda vya kutengeneza Dawa, Vifaa, Vifaa Tiba na Vitendanishi hapa nchini. Msukumo huo utaboresha huduma za afya kwa Watanzania kama nyenzo muhimu ili kufikia Uchumi wa Kati. 3. Mheshimiwa Spika, ninapenda kutoa shukrani za dhati kwa Mheshimiwa Samia Suluhu Hassan, Makamu wa Rais wa Jamhuri ya Muungano wa Tanzania kwa kuwa mstari wa mbele katika jitihada za kuboresha huduma za afya kwa Watanzania hasa katika mapambano dhidi ya ugonjwa wa Kifua Kikuu, Afya ya Mama na Mtoto, Magonjwa Yasiyo ya Kuambukiza pamoja na Afya ya Vijana. Wizara yangu itaendelea kutumia ushauri, nasaha, ushawishi na uzoefu wake ili kuhakikisha Watanzania wanaweza kujikinga na maradhi na kujenga jamii ya Watanzania wenye Afya Bora. 4. Mheshimiwa Spika, ninaomba kuchukua fursa hii kumshukuru Mheshimiwa Majaliwa Kassim Majaliwa (Mb), Waziri Mkuu wa Jamhuri ya Muungano wa Tanzania kwa uongozi wake mahiri unaosaidia kuleta tija na ufanisi katika utendaji na kuimarisha huduma zinazotolewa katika Sekta ya Afya. Aidha, ninampongeza kwa hotuba yake aliyoiwasilisha kwenye Bunge lako tukufu ambayo imetoa dira ya jinsi Serikali itakavyotekeleza majukumu yake katika mwaka 2018/19. 5. Mheshimiwa Spika, ninapenda kukupongeza wewe binafsi kwa kuendelea kutekeleza majukumu yako kwa weledi katika kuliongoza Bunge la Jamhuri ya Muungano wa Tanzania. Aidha, ninampongeza Mheshimiwa Dkt. Tulia Ackson (Mb) katika utekelezaji wa majukumu yake. Vilevile, nitumie fursa hii kuwapongeza Wenyeviti wa Bunge kwa kusimamia vyema mijadala ndani ya Bunge. 6. Mheshimiwa Spika, ninapenda kumshukuru Mheshimiwa Selemani Jaffo (Mb) Waziri wa Nchi, Ofisi ya Rais, Tawala za Mikoa na Serikali za Mitaa, kwa ushirikiano wake ulioniwezesha kusimamia na kuboresha utoaji wa huduma za afya ngazi ya msingi. Pia, ninawashukuru Mawaziri wa Wizara nyingine zote ambazo ushirikiano wao na Wizara yangu umechangia katika utoaji wa huduma za afya na maendeleo ya jamii. 7. Mheshimiwa Spika, kipekee ninapenda kuishukuru Kamati ya Kudumu ya Bunge ya Huduma na Maendeleo ya Jamii, chini ya Mwenyekiti wake Mheshimiwa Peter Serukamba (Mb), na Makamu Mwenyekiti, Mheshimiwa Juma Nkamia (Mb) kwa ushauri na maelekezo waliyoyatoa wakati wa maandalizi ya Bajeti hii. Aidha ninawashukuru Waheshimiwa Wabunge wote kwa ushirikiano mzuri wanaonipatia ikiwemo kutoa ushauri na maoni mbalimbali yenye lengo la kuboresha huduma za afya na maendeleo ya jamii nchini. Ninawaahidi kwamba, Wizara yangu itazingatia ushauri wao na kuendelea kuwapa ushirikiano katika kutekeleza majukumu na kazi zetu za kuwatumikia wananchi ndani na nje ya Bunge. 8. Mheshimiwa Spika, ninatoa pole kwa Watanzania wote, waliopoteza ndugu, jamaa na marafiki zao kutokana na sababu mbalimbali ikiwa ni pamoja na magonjwa, ajali na majanga. Aidha, ninatoa pole kwa wagonjwa na majeruhi wa ajali waliopo hospitalini na majumbani pamoja na wahanga wa vitendo vya ukatili na unyanyasaji wa kijinsia. Ninamuomba Mwenyezi Mungu awaponye haraka ili waweze kuendelea na ujenzi wa Tanzania ya Viwanda. 9. Mheshimiwa Spika, Baada ya kusema hayo, ninapenda sasa kutoa maelezo kuhusu utekelezaji wa shughuli za Wizara kwa mwaka 2017/18, Vipaumbele vya Wizara kwa mwaka 2018/19 pamoja na maombi ya fedha ambazo zitaiwezesha Wizara yangu kutekeleza majukumu yake.   B: MAPITIO YA UTEKELEZAJI WA BAJETI NA MPANGO WA MAENDELEO KWA MWAKA WA FEDHA 2017/18 10. Mheshimiwa Spika, katika kutekeleza majukumu yake, Wizara imeendelea kuzingatia Sera, Mipango Mikakati pamoja na makubaliano ya Kitaifa na Kimataifa yenye lengo la kuimarisha utoaji wa huduma za afya nchini. Maeneo haya ya vipaumbele yameainishwa katika Dira ya Taifa ya Maendeleo (2025), Mpango wa Maendeleo wa Muda wa Kati 2016/17 – 2020/21, Ilani ya Uchaguzi ya Chama cha Mapinduzi (CCM) ya 2015-2020, na Malengo ya Maendeleo Endelevu (SDG’s 2030). Aidha, Wizara imezingatia vipaumbele vilivyoainishwa katika Sera ya Afya (2007) na Mpango Mkakati wa IV wa Sekta ya Afya (2015 – 2020); Sera ya Maendeleo ya Jamii (1996); Sera ya Maendeleo ya Wanawake na Jinsia (2000); Sera ya Taifa ya Mashirika Yasiyo ya Kiserikali (2001); Sera ya Wazee (2003); na Sera ya Maendeleo ya Mtoto (2008); Mkataba wa Kimataifa wa Kuondoa Aina Zote za Ubaguzi Dhidi ya Wanawake (1979); na Mkataba wa Haki za Mtoto (1989) 11. Mheshimiwa Spika, Katika mwaka wa fedha 2017/18, kupitia Fungu 52, Wizara yangu kwa kushirikiana na Wizara nyingine, Idara na Taasisi za Serikali, Wakala wa Serikali na Wadau wa Maendeleo ilipanga kutekeleza afua mbalimbali zenye lengo la kuboresha utoaji huduma za Afya katika maeneo yafuatayo; a) Kuimarisha Huduma za Kinga, Tiba, na kuongeza usawa katika kutoa huduma za afya, b) Kuimarisha huduma za afya ya uzazi na mtoto ili kupunguza vifo vya wanawake wajawazito na watoto, c) Kuimarisha upatikanaji wa dawa, vifaa, vifaa tiba, vitendanishi na chanjo katika vituo vya kutolea huduma za afya, d) Kuimarisha miundombinu kwenye vyuo vya mafunzo ya afya kwa lengo la kuongeza udahili na upatikanaji wa rasilimali watu, e) Kuimarisha matibabu ya kibingwa nchini kwa kuendeleza ujenzi, upanuzi, ukarabati wa miundombinu na kufunga mitambo ya kisasa ya kutolea huduma za afya katika Hospitali ya Taifa Muhimbili, Taasisi ya Mifupa Muhimbili (MOI), Taasisi ya Moyo Jakaya Kikwete (JKCI), Hospitali ya Benjamini Mkapa - Dodoma, Taasisi ya Saratani Ocean Road, Hospitali Maalum za Mirembe na Kibong’oto; pia Hospitali za Rufaa za Kanda; Kanda ya ziwa (Bugando), Kanda ya Kaskazini (KCMC), Hospitali ya Rufaa ya Nyanda za Juu Kusini (Mbeya) na Kanda ya Kusini (Mtwara), f) Kuimarisha mazingira ya ubia na ushirikiano kati ya Serikali na Sekta binafsi (PPP) katika utoaji wa huduma za afya, g) Kuimarisha huduma za lishe na upatikanaji wake katika jamii na vituo vya kutolea Huduma za Afya, h) Uimarishaji wa matumizi ya Teknolojia ya Habari na Mawasiliano (TEHAMA) katika kuboresha huduma za afya, i) Kuhamasisha wananchi kujiunga na Mifuko ya Bima za Afya kwa lengo la kuhakikisha wananchi wote wanapata huduma za afya zenye uhakika. 12. Mheshimiwa Spika, kupitia Fungu 53, Idara Kuu ya Maendeleo ya Jamii, Wizara ilipanga kutekeleza kazi zifuatazo: a) Kuratibu utekelezaji na ufuatiliaji wa Mpango wa Taifa wa Kutokomeza Ukatili Dhidi ya Wanawake na Watoto wa mwaka 2017/18 – 2021/22, kwa kutoa elimu kwa jamii na watoa huduma kwa waathirika wa ukatili kwa wanawake na watoto, uimarishaji wa Kamati za Ulinzi wa Wanawake na Watoto; Kuendeleza kampeni ya kukomesha ndoa za utotoni na mimba za utotoni katika mikoa yenye kiwango kikubwa cha ukatili ya Katavi, Shinyanga, Mara, Dodoma, Singida, Simiyu na Geita; b) Kuimarisha upatikanaji wa haki, maendeleo na ustawi watoto ikiwemo kwa watoto walio katika mkinzano wa Sheria; c) Kuwezesha wazee wasiojiweza na watoto walio katika mazingira hatarishi kupata huduma za msingi; d) Kuhamasisha jamii kushiriki katika shughuli za kujiletea maendeleo kwa kuzingatia rasilimali walizonazo; e) Kuelimisha jamii hususan wanawake na katika ngazi ya Halmashauri kujiunga na VICOBA na SACCOS kwa ajili ya kuwawesha kiuchumi; f) Kuwezesha utoaji wa huduma za ustawi wa jamii katika makazi ya wazee, Makao ya Taifa ya Watoto Kurasini, mahabusu za watoto na Shule ya Maadilisho; na g) Kuboresha mazingira ya kujifunzia na kufundishia katika vyuo na Taasisi za Maendeleo na Ustawi wa Jamii. Mapato na Matumizi ya Fedha – Fungu 52 13. Mheshimiwa Spika, Wizara yangu kupitia Fungu 52 (Afya), hukusanya mapato yake kupitia huduma za tiba zitolewazo na hospitali zilizo chini yake, tozo za huduma katika Taasisi mbalimbali, Bodi na Mabaraza, ada za uchangiaji wa gharama za mafunzo, marejesho ya masurufu, malipo ya ununuzi wa vitabu vya maombi ya zabuni, pamoja na makusanyo yatokanayo na utoaji wa huduma katika Taasisi na Mashirika yaliyo chini ya Wizara. Hadi kufikia mwezi Machi 2018, Wizara pamoja na Taasisi zake imefanikiwa kukusanya kiasi cha Shilingi 162,891,572,942 sawa na asilimia 72 ya lengo la mwaka la kukusanya kiasi cha Shilingi 227,041,160,573 kutoka kwenye vyanzo mbalimbali vya mapato. Mafanikio haya yametokana na utaratibu wa kulipia huduma kupitia benki, uhamasishaji kuhusu kulipa maduhuli ya serikali, udhibiti wa makusanyo, kuongezeka kwa ari ya utendaji kazi, uboreshwaji wa Huduma za Bima na Kuimarishwa kwa mfumo wa malipo kwa njia ya Ki-elektroniki. 14. Mheshimiwa Spika, katika mwaka wa fedha 2017/2018 Wizara iliidhinishiwa na Bunge lako Tukufu kupokea na kutumia jumla ya Shilingi 1,077,701,892,000. Kati ya fedha hizo kiasi cha Shilingi 291,895,940,000 sawa na asilimia 27 ya bajeti yote ni kwa ajili ya Matumizi ya Kawaida, na Shilingi ni Shilingi 785, 805, 952,000 sawa na asilimia 72.9 kwa ajili ya utekelezaji wa Miradi ya Maendeleo. 15. Mheshimiwa Spika, Hadi kufikia Machi 2018, Wizara imepokea jumla ya Shilingi 617,507,623,167 sawa na asilimia 57 ya bajeti iliyoidhinishwa ya Shilingi 1,077,701,892,000 kwa ajili ya utekelezaji wa majukumu ya Wizara. Aidha, fedha zilizopokelewa kwa ajili ya matumizi ya kawaida katika kipindi cha Julai hadi Machi, 2018 ni Shilingi 216,736,325,825,824 sawa na asilimia 74 ya fedha zote zilizotengwa kwa ajili ya matumizi ya kawaida kwa mwaka. Kati ya fedha hizo, Shilingi 68,814,900,939 zilitumika katika Matumizi Mengineyo (OC) ikiwa ni sawa na asilimia 73.3 ya kiasi kilichotengwa na Shilingi 147,921,424,885 zilitumika kulipia mishahara (Fungu 52) sawa na asilimia 65 ya kiasi cha fedha kilichotengwa. Aidha, Wizara imepokea kiasi cha Shilingi 22,500,000,000 kwa ajili ya kulipa madeni ya wazabuni na matibabu nje ya nchi. Kwa upande wa Miradi ya Maendeleo, hadi kufikia Machi, 2018 kiasi cha Shilingi 400,771,297,343 kilipokelewa, sawa na asilimia 51 ya fedha zilizoidhinishwa kutekeleza Miradi ya Maendeleo. Kati ya fedha hizo, kiasi cha Shilingi 79,756,079,206 ni fedha za ndani sawa asilimia 24 ya fedha iliyoidhinishwa. Fedha za nje zilizopokelewa ni Shilingi 321,015,218,137.12 sawa na asilimia 71 ya fedha zilizoidhinishwa. Aidha Wizara ilipokea kiasi cha Shilingi 82,515,009,463.82 na kuzipeleka OR–TAMISEMI kwa ajili ya ukarabati wa vituo vya kutolea huduma za afya ili viweze kutoa huduma za dharura ikiwa ni pamoja na upasuaji wa akina akinamama wajawazito (CEmONC) ili kumtoa mtoto tumboni pindi wanapokabiliwa na uzazi pingamizi. Kati ya fedha hizo Shilingi 63,015,009,462.82 ni kutoka Benki ya Dunia na Shilingi 19,500,000,000.00 kutoka Mfuko wa Afya wa Pamoja (Health Basket Fund). Mapato na Matumizi - Fungu 53 16. Mheshimiwa Spika, katika mwaka 2017/18, Wizara kupitia Fungu 53 (Maendeleo ya Jamii, Jinsia, Wazee na Watoto), ilitarajia kukusanya kiasi cha Shilingi 2,101,874,000 kutokana na ada za wanafunzi kutoka katika Vyuo nane vya Maendeleo ya Jamii vya Buhare, Uyole, Rungemba, Mlale, Misungwi, Ruaha, Mabughai na Monduli; uuzaji nyaraka za zabuni na ada mbalimbali za Mashirika Yasiyo ya Kiserikali. Hadi kufikia tarehe 31 Machi, 2018 jumla ya Shilingi 1,775,466,155 sawa na asilimia 84 zilikusanywa. 17. Mheshimiwa Spika, katika mwaka wa fedha 2017/18, Wizara kupitia Fungu 53 ilitengewa jumla ya Shilingi 37,909,880,000. Kati ya fedha hizo, Shilingi 19,142,252,240 ni bajeti ya Mishahara, Shilingi 16,161,349,760 ni Matumizi Mengineyo na Shilingi 2,606,278,000 ni kwa Miradi ya Maendeleo. Hadi kufikia tarehe 31 Machi, 2018, jumla ya Shilingi 18,352,527,400 sawa na asilimia 48 zilipokelewa. Kati ya fedha hizo, Shilingi 8,848,331,727 sawa na asilimia 55 ni Matumizi Mengineyo; Shilingi 8,470,927,127 sawa na asilimia 44 ni Mishahara ya Idara pamoja na Taasisi zilizo chini ya Wizara; na Shilingi 1,033,268,546 sawa na asilimia 40 fedha za Miradi ya Maendeleo. 18. Mheshimiwa Spika, Utekelezaji wa Majukumu ya Wizara kwa kipindi cha Julai 2017 hadi Machi 2018 ulikuwa kama ifuatavyo: UTEKELEZAJI WA MAJUKUMU CHINI YA IDARA KUU YA AFYA HUDUMA ZA KINGA Chanjo 19. Mheshimiwa Spika, Katika kipindi cha Mwaka 2017/2018, Wizara ilisimamia shughuli za utoaji wa chanjo kwa watoto ili kuhakikisha kuwa malengo yaliyowekwa kitaifa na kimataifa yanafikiwa. Takwimu za Januari hadi Desemba 2017 zinaonyesha kuwa asilimia 101.2 ya Watoto waliolengwa nchini walipatiwa chanjo zote muhimu ili kuwakinga na magonjwa. Mnamo mwezi Desemba 2017, Serikali ya Tanzania ilipongezwa kwa kufikia kiwango cha juu cha chanjo kwa asilimia 97 ya uchanjaji watoto kwa chanjo ya pentavalent kwa takwimu za mwaka 2016. Lengo la Mkakati wa Dunia kupitia Shirika la Afya Duniani ni nchi kufikia kiwango cha uchanjaji wa asilimia 90. Shirika la Afya Duniani na wadau wameipongeza Serikali ya Tanzania kwa kufikia kiwango hicho ambapo inakuwa nchi ya Tatu barani Afrika ikitanguliwa na Zambia yenye kiwango cha asilimia 99 ikifuatiwa na Rwanda yenye asilimia 98. 20. Mheshimiwa Spika, Wizara yangu imeendelea na juhudi za kudhibiti saratani za via vya uzazi (Reproductive cancers) ikiwemo saratani ya mlango wa kizazi, saratani ya matiti na saratani ya Tezidume. Aidha, katika kuhakikisha upatikanaji wa huduma za kupima na matibabu ya Mabadiliko ya awali ya Saratani ya Mlango wa kizazi na saratani ya matiti ambazo ndizo zinazoongoza nchini, Wizara kwa kushirikiana na wadau imeanzisha vituo vipya 100 vya uchunguzi na tiba ya mabadiliko ya awali ya saratani ya mlango wa kizazi katika mikoa ya Mbeya, Mwanza, Songwe, Geita, Dodoma, Singida, Manyara, Arusha, Tanga, Lindi, Mtwara, Simiyu, Mara na Ruvuma. 21. Mheshimiwa Spika, kwa bahati nzuri, saratani ya mlango wa kizazi inazuilika kwa kuwapatia chanjo wasichana kuanzia miaka 9 hadi 14. Katika kukabiliana na saratani hiyo, mwaka 2017/18 Serikali imeanza kutoa chanjo ya saratani ya mlango wa kizazi (HPV Vaccine). Kutokana na upatikanaji wa dozi kutoka kwa wazalishaji, kwa mwaka 2018 chanjo hiyo imeanza kutolewa kwa wasichana wenye miaka 14, ambapo, hadi Desemba 2018, Wizara imelenga kuwafikia wasichana 616,734 wa umri huo. Chanjo hiyo ni salama na inatumika katika nchi mbalimbali za Afrika ikiwemo Rwanda, Uganda, Afrika ya Kusini, Zambia na Lesotho. Kupitia Bunge lako Tukufu, nawasihi wazazi na walezi wenye watoto kuhakikisha binti zetu wanapata chanjo hiyo muhimu ili kuwakinga dhini ya saratani ya mlango wa kizazi. Afya na Usafi wa Mazingira 22. Mheshimiwa Spika, Wizara imeendelea kuratibu utekelezaji wa Kampeni ya Taifa ya Usafi wa Mazingira inayotekelezwa katika Halmashauri zote nchini pamoja na kudhibiti magonjwa ya mlipuko hususan kipindupindu. Shughuli zilizotekelezwa zimeainishwa katika aya 22 mpaka 24 ya Hotuba 23. Mheshimiwa Spika, Hali ya ugonjwa wa Kipindupindu nchini inaendelea kudhibitiwa. Katika kipindi cha Julai 2017 hadi Machi 2018 jumla ya wagonjwa wa kipindupindu 4,508 na vifo 92 viliripotiwa katika Mikoa ya Songwe, Dodoma, Ruvuma na Mbeya. Nitoe rai kwa viongozi katika mikoa yote nchini kulifanya suala la kupambana na ugonjwa wa kipindupindu kuwa ni agenda ya kudumu katika vipaumbele vyao. Afya ya Uzazi, Mama na Mtoto 24. Mheshimiwa Spika, Katika kuimarisha huduma za Afya ya Uzazi, Mama na Mtoto nchini, Wizara imeendelea kutekeleza Mpango Mkakati wa miaka 5 wa mwaka 2016 hadi 2020 unaolenga kuboresha afya ya uzazi, mama, watoto na vijana pamoja na kupunguza vifo vitokanavyo na uzazi kufikia 292 kwa kila vizazi hai 100,000 ifikapo mwaka 2020. Katika kutekeleza mkakati huo, Wizara imezingatia maeneo makuu matatu ambayo ni: huduma ya uzazi wa mpango, huduma wakati wa ujauzito na huduma wakati wa kujifungua. 25. Mheshimiwa Spika, huduma za uzazi wa mpango ni muhimu katika kuimarisha afya ya mama na mtoto pamoja na kupunguza vifo vitokanavyo na uzazi. Katika kipindi cha Julai 2017 hadi Machi 2018, Wizara imenunua na kusambaza dawa za uzazi wa mpango katika vituo vya huduma za afya nchini. Aidha, jumla ya wateja 519,817 walifikiwa na huduma ya uzazi wa Mpango kupitia utaratibu wa mkoba (out reach services) na 424,595 walipata huduma kutoka katika vituo vya kutolea huduma za afya. 26. Mheshimiwa Spika, upatikanaji wa huduma ya afya wakati wa ujauzito ni afua muhimu katika kupunguza vifo vitokanavyo na uzazi, kwani matatizo mengi yanaweza kuzuilika, kugundulika na kutibiwa kama wanawake wajawazito watahudhuria kliniki ya wajawazito na kupimwa na wahudumu wenye ujuzi ndani ya wiki 12 tangu wanapokuwa wamejigundua kuwa wanaujauzito. Katika kipindi cha Julai 2017/18, Wizara iliendelea kuhakikisha kwamba huduma kwa wanawake wajawazito zinapatikana sambamba na kuelimisha wajawazito kuhudhuria kliniki. Aidha, kulingana na taarifa kutoka vituo vya kutolea huduma ya afya, hadi kufikia mwezi Februari 2018 asilimia 81.7 walihudhuria angalau mara moja. Lengo ni kufikisha asilimia 70 ya wanawake wajawazito kuhudhuria kliniki angalau mara 4 katika kipindi cha ujauzito ifikapo mwaka 2020. Nitumie fursa hii kuwahimiza wajawazito wote kuhudhuria kliniki kama inavyoshauriwa. 27. Mheshimiwa Spika, Katika mwaka 2017/18, Wizara kwa kushirikiana na wadau imeendelea kuhamasisha na kuhimiza wanawake wajawazito kujifungulia kwenye vituo vya kutolea huduma. Mwelekeo ni kwamba Idadi ya akinamama wanaojifungulia katika vituo vya kutolea huduma inaendelea kuongezeka hadi kufikia asilimia 68.5 mwezi Machi 2018 katoka asilimia 64 mwaka 2015/16. Napenda kutoa wito kwa wanawake wajawazito wote nchini, wajifungulie kwenye vituo vya kutolea huduma ya afya ili kupunguza vifo na changamoto za uzazi kwa mama na mtoto. 28. Mheshimiwa Spika, kupunguza vifo vya watoto chini ya miaka mitano ni moja ya kipaumbele cha Wizara. Kulingana na Mpango Mkakati wa Afya ya Uzazi na Mtoto wa 2016-2020, Serikali imedhamiria kuwa ifikapo 2020 vifo vya watoto wa chini ya mwezi mmoja vipungue kutoka 21 hadi 16 katika kila vizazi hai 1,000; vifo vya watoto wa chini ya umri wa mwaka mmoja kutoka 45 hadi 25 katika kila vizazi hai 1,000 na vifo vya watoto wa chini ya umri wa miaka mitano kutoka 54 hadi 40 katika kila vizazi hai. 29. Mheshimiwa Spika, Wizara kwa kushirikiana na Wadau wa Maendeleo imeendelea kuboresha miundombinu ya kutolea huduma za afya katika ngazi ya Vituo vya Afya ili viweze kutoa huduma za dharura za upasuaji ikiwa ni pamoja na upasuaji wa kutoa mtoto tumboni (CEmONC) pindi mama mjamzito anapohitajika. Wizara kwa kushirikiana na OR-TAMISEMI inaboresha vituo vya afya takribani 208 (kama ilivyoainishwa katika hotuba ya Ofisi ya Rais – TAMISEMI) ili kuviwezesha kutoa huduma za CEmONC. Hadi Machi 2018, maboresho ya vituo hivyo yalikuwa yapo katika hatua mbalimbali za ukamilishwaji. Maboresho haya yanahusu ujenzi wa vyumba vya upasuaji (Theatres), wodi ya wakinamama wajawazito (Martenity/Labour wards), vyumba vya maabara na nyumba za watumishi. Kukamilika kwa maboresho haya kutaongeza idadi ya vituo vinavyomilikiwa na Serikali vyenye uwezo wa kutoa huduma hiyo ya CEmONC kufikia 283 kati ya Vituo vya Afya 527. Hii itakuwa sawa na asilimia 53.7 ya vituo vya afya vya umma vitakavyoweza kutoa huduma za upasuaji wa dharura kutoka asilimia 21 mwezi Juni 2016. Udhibiti wa UKIMWI 30. Mheshimiwa Spika, katika kipindi cha Julai 2017 hadi Desemba 2017, jumla ya watu wapatao 5,164,297 walipimwa VVU na kupewa majibu ya hali zao za afya, ambapo watu 145,104 (sawa na asilimia 2.8) kati yao waligundulika kuwa na maambukizi na kuanzishiwa dawa za kufubaza virusi vya UKIMWI. Aidha, takwimu za hadi Desemba, 2017 zinaonesha kuwa jumla ya watu wanaoishi na VVU wapatao 965,081 walikuwa wanatumia dawa za kufubaza VVU, ikiwa ni sawa na asilimia 69 ya watu 1,400,000 wanaokadiriwa kuishi na virusi vya UKIMWI nchini na kati yao watoto walikuwa 55,304 ambao ni sawa na asilimia 5.7. Kutokana na takwimu hizo Tanzania tumebakiza asilimia 21 kufikia lengo la dunia la asilimia 90 ya watu wanaoishi na virusi vya UKIMWI kuanzishiwa dawa za kufubaza VVU ifikapo mwaka 2020. Wizara imeweka mikakati mbalimbali ili kufikia lengo hilo. 31. Mheshimiwa Spika, Huduma za kuzuia maambukizi ya VVU kutoka kwa mama kwenda kwa mtoto (PMTCT), zimeendelea kutolewa, ambapo, jumla ya akina mama wajawazito 1,967,260 sawa na asilimia 98.7% ya akina mama 1,993,639 walipatiwa huduma za ushauri nasaha na upimaji wa VVU. Kati yao akina mama 79,242 sawa na asilimia 4 waligundulika kuwa wanaishi na VVU. Akina mama 79,240 sawa na asilimia 99.9 ya akina mama wenye maambukizi ya VVU walipatiwa dawa (ARV) kwa ajili ya kufubaza virusi vya UKIMWI. Aidha jumla ya Watoto 72,960 sawa na asilimia 92 walipata kipimo cha awali cha utambuzi wa maambukizi ya VVU. Mafanikio haya ni matokeo ya matumizi ya mashine zenye uwezo mkubwa kupima sampuli kwa siku zilizofungwa nchini kama ilivyoainishwa katika aya 38 ya Hotuba. Kati ya watoto waliopimwa iligundulika kuwa, watoto 2,918 sawa na asilimia 4 wana maambukizi. Kiwango hicho cha maambukizi kinaashiria kuendelea kupungua kwa maambukizi ya VVU kutoka kwa mama kwenda kwa mtoto, na hivyo kuiwezesha nchi kufikia malengo ya Kimataifa ya kutokomeza kabisa maambukizi ya VVU kwa watoto. Hivi sasa, maambukizi ya VVU kutoka kwa mama kwenda kwa mtoto ni asilimia 4.9 kutoka asilimia 12 mwaka 2011. Huduma za Udhibiti wa Kifua Kikuu na Ukoma 32. Mheshimiwa Spika, Wizara imeendelea na mkakati wake wa Udhibiti wa ugonjwa wa Kifua Kikuu na Ukoma ambapo katika kipindi cha Julai hadi Machi 2017, Serikali ilinunua na kusambaza dawa za Kifua Kikuu na Ukoma. Katika kuhakikisha Serikali inaboresha matibabu ya ugonjwa wa Kifua Kikuu kwa watoto, mwezi Machi 2018, Wizara yangu ilizindua matumizi ya dawa mpya za kifua kikuu kwa watoto. Dawa hizi mpya ni za mseto (RHZ/RH) ulioboreshwa, zina ladha nzuri ya matunda, zinayeyuka kwa urahisi zikiwekwa kwenye maji na hivyo hazihitaji kukatwakatwa ili kupata dozi sahihi. 33. Mheshimiwa Spika, Wizara yangu imeongeza wigo wa upatikanaji wa huduma za ugunduzi wa ugonjwa wa kifua kikuu kwa kutumia vipimo vya vinasaba (gene-xpert) katika wilaya zote nchini ili kuongeza kazi ya kuwagundua wagonjwa wengi wa TB na kuwatibu. Kwa mwaka 2017/18, Serikali kwa kushirikiana na Wadau wa Maendeleo ilinunua na kusambaza mashine za “genexpert” 189 ikilinganishwa na mashine 66 zilizokuwepo mwaka 2015. Mashine hizi zimesambazwa kwenye hospitali zote za rufaa za kanda, mikoa, wilaya na baadhi ya vituo vikubwa vya afya. Teknolojia ya mashine hizi inatuwezesha kupata majibu ndani ya masaa 2 badala ya kusubiri kwa zaidi ya masaa 24 kama ilivyo kwa njia za kawaida za hadubini (Microscopes). Aidha, mashine hizi zina uwezo wa kupima usugu wa dawa za kifua kikuu wakati huo huo wa upimaji wa makohozi, na hivyo kugundua kifua kikuu sugu kwa urahisi zaidi. 34. Mheshimiwa Spika, Katika kudhihirisha nia ya serikali ya kushirikiana na Sekta binafsi katika mapambano dhidi ya ugonjwa wa Kifua Kikuu hasa kuongeza idadi ya wagonjwa wa TB wanaogunduliwa kutoka asilimia 40 hadi asilimia 70 mwaka 2020, Wizara yangu imekabidhi mashine za gene-xpert tano (5) kwa hospitali binafsi za jijini Dar es Salaam. Hospitali zilizopokea mashine hizi ni Aga Khan, Hubert Kairuki, Regency Medical Center, TMJ na Hindul Mandal. Mashine hizo kila moja ina thamani ya Shilingi milioni 38. Tumeanza na hospitali hizi zenye viwango vikubwa vya wagonjwa wanaohudumiwa na pia kwa kuzingatia utayari wa hospitali hizi katika kutoa huduma za kifua kikuu sanjari na malengo ya Serikali yetu ya awamu ya tano ya Mheshimiwa Dkt. John Pombe Magufuli, Rais wa Jamhuri ya Muungano wa Tanzania katika kuhakikisha huduma za afya zinawafikia wananchi wote. Kadhalika, ushirikishwaji huu wa Sekta Binafsi katika kutambua wagonjwa wa kifua kikuu umeonesha ongezeko la wagonjwa wa TB wanaoibuliwa na sekta binafsi kutoka wagonjwa 3,476 mnamo mwaka 2014 hadi wagonjwa 7,281 katika mwaka 2017 ambao ni sawa na 10.4% waligunduliwa na sekta binafsi. Nitumie fursa hii kuwashukuru na kuwapongeza sekta binafsi kwa ushiriki wao katika kutokomeza TB nchini. 35. Mheshimiwa Spika, Wizara yangu imeendelea kuongeza wigo wa huduma za matibabu ya wagonjwa wa kifua kikuu sugu nchini. Katika kipindi cha mwaka 2017 hadi Machi 2018 Wizara iliongeza vituo 41 na kufanya jumla ya vitu vinavyotoa huduma hiyo kufikia vituo 63 ikilingalishwa na kituo kimoja cha hospitali Maalum ya Kibong’oto mwaka 2015. Mikoa yenye vituo hivyo vilivyoweza kuanzisha matibabu ya wagonjwa chini ya ugatuzi ni Dar es salaam, Kagera, Geita, Mtwara, Lindi, Mbeya, Pwani, Morogoro, Tanga, Unguja, Tabora, Kigoma, Mwanza, Arusha, Rukwa na Simiyu. Vile vile, Wizara imeanzisha matibabu ya muda mfupi kwa wagonjwa wa kifua kikuu sugu kufupisha tiba hiyo kutoka miezi ishirini ya hapo awali mpaka miezi tisa kwa wagonjwa wanoakidhi vigezo. 36. Mheshimiwa Spika, kwa upande wa ugonjwa wa Ukoma, Wizara ilifanya uchunguzi wa vimelea vya Ukoma katika ngazi ya jamii kwenye Wilaya 6 zenye maambukizi makubwa katika mikoa ya Geita (Chato), Lindi (Liwale), Mtwara (Nanyumbu), Morogoro (Kilombero) na Tanga (Mkinga na Muheza). Katika zoezi hilo takriban watu 500 wamefanyiwa uchunguzi, ambapo watu 54 sawa na asilimia 10.8 waligundulika kuwa na vimelea vya ugonjwa wa ukoma na kuanzishiwa matibabu, takriban watu 300 wamepatiwa tiba kinga. Udhibiti wa Malaria 37. Mheshimiwa Spika, Malaria imeendelea kuwa sababu ya vifo vya wananchi wengi ambapo kwa takwimu za Januari – Desemba 2017, jumla ya wagonjwa 5,592,844 wameugua ugonjwa huu, kati yao wagonjwa 4,421 walifariki kutokana na ugonjwa wa Malaria. Katika kuendeleza juhudi za kupunguza maambukizi ya malaria nchini; Wizara yangu imeendelea kutekeleza shughuli mbalimbali za udhibiti wa malaria ikiwa ni pamoja na kununua dawa, vifaa, vifaa tiba na vitendanishi na kusambaza katika vituo vya huduma za afya nchini. Ili kuendelea kuwakinga wananchi dhidi ya malaria, na hasa kulenga makundi maalum; wajawazito na watoto chini ya mwaka mmoja, Serikali imesambaza jumla ya vyandarua 4,726,763 kwa jamii bila malipo kupitia wanafunzi shuleni na kupitia kliniki za wajawazito na watoto (Chandarua Kliniki). 38. Mheshimiwa Spika, Katika kutekeleza Agizo la Rais wa Jamhuri ya Muungano wa Tanzania Mhe. Dkt. John Pombe Magufuli, kuhusu Afua ya kuangamiza viluwiluwi vya mbu katika mazalia (larviciding), Wizara kwa kushirikiana na OR-TAMISEMI imeratibu zoezi la usambazaji wa viuadudu vya kibailojia (biolarviciding) jumla ya lita 236,420 katika Halmashauri zote nchini, na Halmashauri zipo katika hatua mbalimbali za utekelezaji wa afua katika maeneo yao. Udhibiti wa Magonjwa Yaliyokuwa Hayapewi Kipaumbele 39. Mheshimiwa Spika, Kutokana na utekelezaji wa afua mbalimbali za kudhibiti magonjwa yaliyokuwa hayapewi kipaumbele zikiwemo zilizoainishwa katika aya 48 na 49 ya Hotuba, jumla ya Halmashauri 93 zimefanikiwa kupunguza kiwango cha maambukizi ya ugonjwa wa matende na mabusha na hivyo kuondolewa kwenye orodha ya Halmashauri zenye maambukizi makubwa zinazoshiriki katika zoezi la Kingatiba kulingana na vigezo vya Shirika la Afya Duniani (WHO). Kiambatisho Na. 1 kinaainisha Halmashauri zilizofanikiwa kupunguza Maambukizi Makubwa ya ugonjwa wa Matende na Mabusha. Haya ni mafanikio makubwa kwani Watanzania wapatao 20,446,532 wanaoishi katika halmashauri hizi hawapo tena katika hatari ya maambukizi ya magonjwa haya. Huduma za Lishe 40. Mheshimiwa Spika, Katika kupambana na utapiamlo nchini, Wizara yangu kwa kushirikiana na wadau wa Lishe imetoa matone ya nyongeza ya vitamin A kwa watoto wa kati ya miezi sita na miaka mitano sambamba na dawa za minyoo kwa watoto wa umri kati ya mwaka mmoja na miaka mitano. Aidha, Wizara yangu imeendelea kutoa huduma za matibabu ya utapiamlo mkali kwa watoto kupitia; kuongeza idadi yaHospitali zinazotoa matibabu ya utapiamlo, kuboresha miundombinu ya hospitali kwenye wodi za kulaza watoto, kuimarisha mfumo wa upatikanaji wa chakula dawa na vifaa vya kupimia hali ya Lishe pamoja na kujengea uwezo wa watoa huduma. Elimu ya Afya kwa Umma 41. Mheshimiwa Spika, Wizara iliendelea kuelimisha na kuhamasisha jamii kutunza afya zao dhidi ya magonjwa, kufanya uchunguzi wa afya mara kwa mara na kujenga tabia inayozingatia kanuni za afya. Wizara kupitia mpango wa Elimu ya Afya kwa Umma imeandaa mkakati wa mawasiliano utakaowezesha namna ya kuwasiliana kwa haraka wakati wa majanga na milipuko ya magonjwa, tayari timu za mikoa ya mipakani zimeelimishwa juu ya mkakati huo. Aidha, Wizara imekamilisha ujenzi wa studio ya radio na televisheni ambavyo vimeanza kurekodi vipindi vitakavyorushwa nchi nzima kwa ajili ya kuelimisha jamii ya Watanzania kuhusu masuala mbalimbali ya afya. HUDUMA YA TIBA Usajili na Usimamizi wa Vituo vya kutolea huduma za Afya 42. Mheshimiwa Spika, Wizara imeendelea kusimamia upatikanaji wa huduma za afya kupitia vituo vya kutolea huduma nchini vikiwemo vya Serikali, binafsi na mashirika ya dini. Hadi kufika Machi 2018, huduma za afya zimeendelea kutolewa katika vituo vya kutolea huduma za afya 7,437 ikilinganishwa na vituo 7,284 mwezi Juni 2017. Aidha, katika kipindi cha Julai 2017 hadi Machi 2018, jumla ya Vituo binafsi 153 vya kutolea huduma za Afya vilisajiliwa. Uimarishaji wa Huduma za Matibabu ya Kibingwa 43. Mheshimiwa Spika, Katika mwaka 2017/18, moja ya jukumu la kipaumbele kwa Wizara ilikuwa ni kuendelea kuboresha na kuimarisha huduma za matibabu ya kibingwa yatolewayo nchini. Maboresho hayo, yanalenga katika kupunguza idadi ya wagonjwa wanaopewa rufaa ya matibabu nje ya nchi ili kupunguza gharama kubwa kwa Serikali katika kupeleka wagonjwa nje ya nchi. Hadi kufikia mwezi Machi 2018, idadi ya Wagonjwa waliopewa rufaa ya Matibabu nje ya nchi ilipungua na kufikia Wagonjwa 103 ikilinganishwa na wagonjwa 304 mwaka 2016/17. Mafanikio haya ni kutokana na maboresho yaliyofanyika katika Hospitali zilizo chini ya Wizara ambapo kwa hivi sasa zimeongezewa uwezo wa kutoa huduma za Kibingwa ambazo awali hazikuwa zikitolewa hapa nchini na hivyo kulazimu wagonjwa kupatiwa rufaa nje ya nchi. Mchanganuo wa idadi ya wagonjwa kwa kila Hospitali umeoneshwa katika Kiambatisho Namba 2 na aya 56, 63, 65, 70, 74, 77, 80, 82, 84 na 86 ya Hotuba yangu. Hospitali ya Taifa Muhimbili (MNH) 44. Mheshimiwa Spika, katika mwaka 2017/18, Hospitali ilifanya ukarabati wa jengo la kutolea huduma za upandikizaji wa Figo na ununuzi wa vifaa Tiba kwa ajili huduma za upandikizaji wa figo iliyoanza kutolewa Mwezi Novemba 2017 ambapo Mgonjwa mmoja (1) alipatiwa huduma hiyo na kwa sasa wagonjwa watano (5) wamepangwa kupatiwa huduma hii mwishoni mwa Mwezi Aprili 2018. Hatua hii imepunguza gharama za kupandikiza figo kwa mgonjwa mmoja nje ya nchi kutoka wastani wa Shilingi milioni mia 100 hadi milioni 20. 45. Mheshimiwa Spika, Hospitali imeanzisha huduma za upandikizaji wa vifaa vya kusaidia kusikia (Cochlea implant), hadi kufikia mwezi Machi 2018, wagonjwa sita (6) walipata huduma ya kuwekewa vifaa vya usikivu. Huduma ya kupandikiza vifaa vya kusaidia kusikia inatolewa kwa wastani wa Shilingi milioni 36 kulinganisha na Shilingi milioni 80 hadi 100 ambazo zingetumika endapo mgonjwa angepelekwa nje ya nchi. 46. Mheshimiwa Spika, ukusanyaji wa mapato ya Hospitali kwa kipindi cha Julai 2017 hadi Machi, 2018 umeongezeka na kufikia kiasi cha Shilingi bilioni 46.51 ikilinganishwa na Shilingi bilioni 31.91 zilizokusanywa katika kipindi kama hicho 2016/17. Hii ni sawa na ongezeko la asilimia 45.7. Mafanikio haya yamewezesha hospitali kukamilisha miradi yake mbalimbali iliyoainishwa katika aya 59 ya Hotuba. Pia katika kipindi cha Julai hadi Machi 2018, Hospitali ilitoa huduma kwa wagonjwa wa msamaha zenye thamani ya Shilingi bilioni 3.4 ikilinganishwa na huduma zenye gharama ya Shilingi bilioni 2.21 zilizotolewa katika kipindi cha Julai hadi Machi, 2017. Taasisi ya Mifupa Muhimbili (MOI) 47. Mheshimiwa Spika, Mnamo mwezi Februari 2018, Taasisi kwa mara ya kwanza imeweza kufanya upasuaji wa mgongo kwa njia ya matundu (Laparascopy) kwa kushirikiana na madaktari wa Hospitali ya BLK ya India. Upasuaji huo ulifanyika kwa mafanikio makubwa, lengo mahsusi ikiwa ni kuwapatia weledi madaktari wa MOI ili waweze kufanya upasuaji huo. Aidha,katika mwaka 2017/18, Taasisi ilikamilisha jengo la MOI awamu ya III pamoja na ununuzi wa Vifaa tiba mbalimbali kutokana na fedha Shilingi Bilioni 16.5 zilizopokelewa mwishoni mwa mwaka wa fedha 2016/2017. Kazi zilizofanyika zimeainishwa katika aya 64 ya Hotuba. Makusanyo katika Hospitali hadi mwezi Februari, 2018 yamefikia kiasi cha Shilingi 10,807,695,141.93 ukilinganisha na kiasi cha Shilingi 6,707,172,559.43 zilizokusanywa kuanzia mwezi Julai 2016 hadi mwezi Februari, 2017. Taasisi ya Moyo - Jakaya Kikwete (JKCI) 48. Mheshimiwa Spika, Taasisi kwa kushirikiana na Madaktari rafiki wa nchi za Marekani, India, Italy, Israel na Australia walifanya kambi maalum za matibabu ya kibingwa ya moyo kwa watoto na watu wazima nchini kwa mafanikio makubwa kama ilivyoainishwa katika aya 66 mpaka 68 ya Hotuba. Vile vile, katika kushiriki maadhimisho ya Siku ya Moyo mwezi Septemba, 2017, Taasisi ilitoa huduma ya vipimo vya afya kwa jamii ambavyo vilihusisha upimaji wa shinikizo la damu, upimaji wa uzito, urefu, na uwiano wa uzito na urefu (BMI) na upimaji wa kiwango cha sukari mwilini ambapo jumla ya watu 800 walipatiwa huduma hizo. Kati ya hao, Watu 400 waligundulika kuwa na matatizo mbalimbali ya kiafya ikiwa ni pamoja na shinikizo la juu la damu. Aidha, Taasisi imeweza kukusanya mapato ya jumla ya Shilingi 8,462,092,000 Katika kipindi cha hadi Machi 2018 ikilinganishwa na kiasi cha Shilingi 4,105,000,000.00 kilichokusanywa katika kipindi hicho mwaka 2016. Taasisi ya Saratani Ocean Road (ORCI) 49. Mheshimiwa Spika, Wizara yangu imeendelea kuboresha huduma kwa wagonjwa wa Saratani ambapo hadi kufikia mwezi Machi 2018, Taasisi imeboresha tiba za mionzi ya nje kwa kufunga kifaa kiitwacho 'multi-leaf collimator' katika mashine ya EQ80 ambacho kimenunuliwa kwa kushirikiana na Shirika la Nguvu za Atomiki Duniani (IAEA). Aidha, Taasisi imenunua vyanzo vipya vya mionzi kupitia Bohari ya Dawa kwa gharama ya Shilingi 473,363,437.50. Hatua hii imeboresha utoaji wa tiba ya mionzi ya ndani kwa kutibu wagonjwa 70 kutoka wagonjwa 30 kwa siku. Vile vile, Taasisi inaendelea kufunga mashine za tiba mpya na za kisasa za mionzi aina ya “Linear Accelerator”, (LINAC) 2 na ‘CT Simulator’ (1) ambazo zimenunuliwa kwa gharama ya Shilingi 9,500,000,000. Mashine hizo zitaiwezesha Taasisi kutoa huduma ya matibabu ya mionzi na kupunguza muda wa wagonjwa kusubiria tiba kutoka wiki 6 sasa kufikia wiki 2 na kuongeza ufanisi katika tiba inayotolewa. Vilevile, Taasisi tayari imewapeleka mafunzoni nje ya nchi watumishi 7 kwa ajili ya kuongeza ujuzi wa kutumia mashine hizo ambao ni Madaktari bingwa 2, Wataalamu wa tiba ya mionzi 2, Medical physicist 2 na Bio-engineer 1. 50. Mheshimiwa Spika, katika mwaka 2017/18, Taasisi imeanzisha huduma za wodi za binafsi ambayo ina vitanda 4 vya VIP na vitanda 20 vya binafsi. Hatua hii imesaidia kuboresha huduma kwa wagonjwa wenye uhitaji huo na pia kuongeza mapato. Lengo la huduma hizi ni kuhakikisha kuwa wananchi wenye uwezo wa kuchangia gharama wanakaa katika wodi binafsi. Kukamilika kwa wadi binafsi kumechangia kuongezeka kwa makusanyo ya Taasisi, ambapo katika kipindi Julai 2017 hadi Machi 2018, jumla ya Shilingi 86,622,300 zilikusanywa ikilinganishwa na kiasi cha Shilingi 40,320,000 kilichokusanywa kwa kipindi cha mwaka 2016/17. Hii ni sawa na ongezeko la asilimia 53. Hospitali ya Benjamin Mkapa –Dodoma 51. Mheshimiwa Spika, Katika kuimarisha huduma za kibingwa, mnamo tarehe 22/3/2018, Hospitali kwa kushirikiana na TOKUSHIKAI Medical group kutoka nchini Japan, ilifanikiwa kufanya upandikizaji figo kwa mara ya kwanza kwa mgonjwa mmoja mwenye umri wa miaka 51. Hali ya mgonjwa inaendelea vizuri na amepewa ruhusa kwenda nyumbani. Aidha, Matayarisho ya kuanzisha huduma za upasuaji wa moyo yapo katika hatua za mwisho za ukamilishwaji. Vile vile, Hospitali iko katika hatua za mwisho za kuanzisha huduma ya kusafisha damu kwa wagonjwa wa figo kwa kutumia mashine maalum (Hemodialysis). Pia, hospitali imefanikiwa kuanzisha huduma za chumba cha wagonjwa mahututi (ICU). Upatikanaji wa dawa katika hospitali ilikuwa kwa asilimia 95.2 kwa kipindi cha Julai 2017 hadi Machi 2018. Uwezo wa hospitali kukusanya mapato umeendelea kuimarika ambapo jumla ya Shilingi 1,892,978,585 kimekusanywa hadi Machi 2018 ukilinganisha na Shilingi 794,162,415 zilizokusanywa katika kipindi cha Julai 2016 hadi Februari 2017 kwa mwaka 2016/17. Hospitali ya Taifa ya Afya ya Akili Mirembe 52. Mheshimiwa Spika, Hospitali ya Mirembe na Tasisi ya Isanga imeendelea kutoa huduma kwa wagonjwa wa afya ya akili ambapo hali ya upatikanaji wa dawa imeendelea kuimarika na kufikia zaidi ya asilimia 90 kwa dawa muhimu za magonjwa ya akili. Hali ya upatikanaji wa dawa muhimu za magonjwa mengine ilikuwa zaidi ya asilimia 80. Aidha, hospitali imeendelea kutoa huduma za kibingwa kwa wagonjwa wa akili wa kawaida na wagonjwa wa akili walio na tuhuma za uvunjaji wa sheria kwa kuwafanyia uchunguzi, kutoa ushauri kwa mahakama, Tiba kwa umeme, Tiba kwa vikundi, Tiba kwa familia, Tiba kwa maongezi na Tiba kwa kazi (Occupational Therapy) kwa wataalamu wa kada mbalimbali ikiwemo madaktari bingwa wa afya ya Akili (Psychiatrist), Saikolojia (Clinical Psychologist), Mishipa ya fahamu (Clinical Neurologist) na wengine. Vile vile, katika mwaka 2017/18, hospitali imeendelea na ujenzi wa Jengo la kuhudumia waathirika wa Dawa za kulevya lililopo chini ya Hospitali ya Mirembe katika eneo la Itega ambapo mkandarasi yupo katika eneo husika anaendelea na kukamilisha ujenzi ili huduma zianze kutolewa mapema. Hospitali ya Rufaa ya Magonjwa ya Kifua Kikuu- Kibong'oto 53. Mheshimiwa Spika, katika mwaka 2017/18, Hospitali iliendelea kutoa huduma za utambuzi na matibabu ya Kifua kikuu, Kifua kikuu sugu, VVU na magonjwa mengine ya kuambukiza. Aidha, Hospitali imeweza Kutoa elimu kwa wataalamu 239 (Madaktari, wauguzi, wataalam wa maabara pamoja na wafamasia) kutoka mikoa mbalimbali nchini kwa ajili ya kuwajengea uwezo wa kuanzisha matibabu ya kifua kikuu sugu (Multi-Drug Resistant TB, MDR TB). Pia Hospitali imeweza kuzindua jengo la kutolea huduma kwa waathirika mahala pa kazi (Occupational Health Services). Pia, Wizara kwa kushirikiana na Southern African Development Community (SADC) imeanzisha huduma za afya kwa wachimbaji Madini na familia za Wachimbaji Madini. Hospitali ya Rufaa Kanda ya Nyanda za Juu Kusini Mbeya 54. Mheshimiwa Spika, Katika kipindi cha 2017/18, Hospitali imeendelea kuboresha huduma za kibingwa kwa kuongeza miundombinu ya kutolea huduma kama ilivyoainishwa katika aya 82 ya Hotuba. Aidha, hospitali inatarajia kupokea madaktari wanne (4) kutoka nchini China ambao ni wa fani za usingizi, mifupa, upasuaji wa watoto na ICU. Vile vile, upatikanaji wa dawa katika hospitali umekuwa katika kiwango cha asilimia 95 hivyo wananchi wameondolewa usumbufu wa kufuata dawa nje ya hospitali. Ukusanyaji wa mapato katika kipindi cha Julai 2017 hadi Machi 2018 ulikuwa Shilingi 9,931,439,974.57 ukilinganisha na Shilingi 5,607,223,511.78 kwa mwaka 2016/17. Hospitali ya Rufaa ya Kanda ya Ziwa Bugando 55. Mheshimiwa Spika, Hospitali ya Rufaa ya Kanda ya Ziwa, Bugando imeendelea kutoa huduma za kibingwa kwa wagonjwa kutoka mikoa 8 ya Kanda ya Magharibi na Kanda ya Ziwa ambayo ni Mwanza, Geita, Mara, Kagera, Simiyu, Kigoma, Shinyanga na Tabora. Kwa kipindi cha Julai 2017 hadi Machi 2018, hospitali ilifanya upasuaji kwa wagonjwa 72 wenye matatizo ya Saratani ya Utumbo mpana, saratani za tumbo, magonjwa ya pua na koo pia uti wa mgongo. Upasuaji huu ulifanywa na Madaktari wazalendo kwa kushirikiana na madaktari kutoka Marekani (Mending Kids). Pia, Hospitali imenunua Mashine ya kutibu mionzi ya ndani (Brachytherapy) kwa kushirikiana na Shirika la nguvu la Atomiki Duniani (IAEA). Kuhusu Huduma ya tiba ya saratani, jumla ya wagonjwa 131 wa saratani ya mlango wa kizazi walipatiwa huduma ya tiba ya saratani kwa njia ya mionzi (Radiotherapy). Vilevile, Hospitali imenunua mashine 2 za vipimo vya moyo na 1 ya ultrasound, pamoja na mashine ya CT Scan (128 slice) kwa gharama ya Shilingi bilioni 1.7 kutokana na mapato ya ndani. Hospitali ya Rufaa ya Kanda Kaskazini (KCMC) 56. Mheshimiwa Spika, katika mwaka 2017/18, Hospitali imeendelea kuboresha na kutoa huduma kwa wananchi wa mikoa ya Kilimanjaro, Arusha, Manyara na Tanga ambapo Hospitali imeweza kuhudumia wagonjwa 1,123 wa saratani ambapo wagonjwa 47 walipatiwa huduma shufaa (Palliative care). Aidha, kwa kuzingatia umuhimu wa elimu kwa jamii juu ya maradhi ya saratani, Hospitali kwa kushirikiana na Taasisi ya “Mission Eine Welt” ya nchini Ujerumani, imeanzisha kampeni maalum mwezi Oktoba 2017 ijulikanayo kama PrevACamp yaani Prevention and Awareness Campaign yenye lengo la kutoa elimu juu ya saratani, kuainisha mila na imani potofu na kufanya uchunguzi wa viashiria vya awali vya saratani. Hospitali za Rufaa za Mikoa 57. Mheshimiwa Spika, Uendeshaji wa Hospitali za Rufaa za Mikoa ulikuwa unasimamiwa na kuratibiwa na OR-TAMISEMI. Hata hivyo, baada ya maelekezo ya Mheshimiwa Dkt. John Pombe Magufuli, Rais wa Jamhuri ya Muungano wa Tanzania aliyoyatoa tarehe 25 Novemba 2017, usimamizi na uendeshaji wa Hospitali hizi sasa upo chini ya Wizara ya Afya, Maendeleo ya Jamii, Jinsia, Wazee na Watoto. Hospitali za Rufaa za Mikoa zilizopo ni 28. Aidha, Wizara imeweka mikakati ya muda mfupi, muda wa kati na mrefu ili kuhakikisha kwamba huduma muhimu za kibingwa za Upasuaji (General Surgery), Magonjwa ya Wanawake na Uzazi (Obstetrics & Gynaecology), Magonjwa ya Watoto (Paediatrics & Child Health), Magonjwa ya ndani (Internal Medicine), Magonjwa ya Kinywa na Meno (Dentistry) na Radiolojia (Radiology)zinazotolewa katika Hospitali hizo zinaboreshwa. Mikakati hiyo ni pamoja na kuboresha miundombinu ya kutoa huduma, kuongeza idadi ya madaktari bingwa, kuboresha upatikanaji wa dawa, kupanga kwa uwiano watumishi wa Hospitali za Rufaa za Mikoa kwa kuzingatia huduma na uzito wa kazi zinazotolewa na hospitali hizo, kuanzisha na kuboresha huduma za afya kwa njia ya masafa (telemedicine) kwa kila Hospitali ya Rufaa ya Mkoa na kufanya huduma hiyo kutumika kama kiunganishi kati ya Hospitali hizo na Hospitali za Rufaa za Kanda na Taifa, kuboresha utoaji wa huduma za uchunguzi wa maabara na radiolojia kwa kupanua na kuimarisha miundombinu ya huduma za uchunguzi ikiwa ni pamoja na kununua na kuweka vifaa vya kisasa vya maabara na radiolojia. Udhibiti wa Magonjwa Yasiyo ya Kuambukiza (NCDs) 58. Mheshimiwa Spika, Napenda kulitaarifu Bunge lako Tukufu kwamba kumekuwa na ongezeko la Magonjwa Yasiyo ya Kuambukiza hapa nchini. Utafiti wa viashiria vya magonjwa yasiyo ya kuambukiza uliofanywa na Wataalam wa Wizara kwa kushirikiana na Taasisi ya utafiti wa magonjwa ya binadamu (NIMR) mwaka 2012, ulionesha kuwa kuna ongezeko kubwa la viashiria vinavyosababisha magonjwa yasiyo ya kuambukiza. Utafiti huo ulionesha kuwa asilimia 15.9 ya wananchi wanavuta sigara, asilimia 29.3 wanakunywa pombe, asilimia 97.2 wanakula mboga mboga na matunda chini ya mara tano kwa wiki. Aidha, utafiti ulionesha kuwa, asilimia 26 ya wananchi ni wanene kupita kiasi, asilimia 26 wana lehemu nyingi mwilini, asilimia 33.8 wana mafuta mengi mwilini, asilimia 9.1 wana kisukari na asilimia 25.9 wana shinikizo kubwa la damu. Utafiti pia ulionesha kwamba, asilimia 25 ya wananchi waliohojiwa hawajishughulishi na kazi zinazotumia nguvu na hawafanyi mazoezi yeyote. 59. Mheshimiwa Spika, mapambano dhidi ya magonjwa yasiyo ya kuambukiza yamekuwa yakiendelea ndani ya Wizara yangu na yamejikita zaidi katika masuala ya Kinga, kama tunavyofahamu kuwa Kinga ni bora kuliko Tiba. Tangu kuanzishwa kwa kampeni ya “Afya Yangu Mtaji Wangu” iliyozinduliwa na Mheshimiwa Samia Suluhu Hassan, Makamu wa Rais wa Jamhuri ya Muungano wa Tanzania, Wizara imeendelea kuhimiza jamii kuhusu umuhimu wa kufanya mazoezi mara kwa mara sambamba na kujiepusha na visababishi vingine vya magonjwa yasiyo ya kuambukiza ikiwemo ulevi kupita kiasi na uvutaji wa sigara na tumbaku. Aidha, Wizara imeendelea kushirikiana na Wadau kufanya Kampeni za uchunguzi wa magonjwa yasiyo ya kuambukiza katika Mikoa yote. Nitumie fursa hii kulipongeza Bunge lako tukufu kwa kuanzisha Jukwaa la Waheshimiwa Wabunge la Kupambana na Magonjwa Yasiyo ya Kuambukiza ili waweze kupata elimu namna ya kujikinga na Magonjwa Yasiyo ya Kuambukiza na kuwaelimisha wananchi juu ya magonjwa hayo. Upatikanaji wa Damu Salama 60. Mheshimiwa Spika, Katika kuhakikisha upatikanaji wa uhakika wa damu salama, Mpango wa Taifa wa Damu Salama umeendelea kukusanya, kuhifadhi na kusambaza damu salama katika vituo vya kutolea huduma za afya. Katika kipindi cha kuanzia Julai 2017 hadi Machi 2018 Mpango ulifanikiwa kukusanya idadi ya chupa za damu 233,953 ambazo ni sawa na asilimia 101 ya lengo la makusanyo kwa mwaka ambalo lilikuwa ni kukusanya chupa za damu 230,000. Nitumie Bunge lako Tukufu kuwashukuru wananchi wote wanaojitolea kuchanga damu. Aidha, nitoe rai kwa watanzania kuchangia damu mara kwa mara ili kuokoa maisha ya wagonjwa hasa wanawake wajawazito na watoto wa umri chini ya miaka 5.   Huduma za Uchunguzi wa Magonjwa 61. Mheshimiwa Spika, Wizara imeendelea kuboresha huduma za maabara ambapo hadi kufikia mwezi Agosti 2017, jumla ya maabara 76 kutoka maabara 66 katika mwaka 2016 ambazo zipo katika ngazi za Mikoa, Wilaya na Vituo vya Afya, zilishiriki kwenye utaratibu wa Shirika la Afya Duniani wa kutoa Ithibati hatua kwa hatua, na kupewa nyota za viwango vya ubora wa huduma za maabara. Maabara 33 ziliweza kupata kuanzia nyota moja (1) mpaka nne (4) za viwango vya ubora. Aidha, Maabara za Taifa, Kanda, Maalum na zile za Binafsi kumi (10) zimepata ithibati ya SADCAS ya kiwango cha kimataifa yaani ISO 15189:2012. Pia, Wizara inaendelea na ujenzi wa maabara ya Taifa ya Afya ya Jamii katika eneo la Mabibo, Dar es salaam. Mradi huu hadi kukamilika unatarajiwa kutumia kiasi cha Shilingi 7,493,193,434.97.00, zinazotolewa na Benki ya Dunia. 62. Mheshimiwa Spika, ili kupambana magonjwa ya mlipuko serikali inaendelea na juhudi za kuimarisha upimaji wa magonjwa ya mlipuko.Serikali kupitia Jumuiya ya Afrika Mashariki kwa ushirikiano na serikali ya Ujerumani inatarajia kuanzisha maabara 3 zinazohamishika, hali itakayosaidia ugunduzi wa magonjwa katika maeneo husika kwani tutaweza kutumia gari maalum iliyobeba vifaa vya maabara hadi eneo la tukio la mlipuko na hivyo kuharakisha uchunguzi, tiba na njia nyingine za kinga. Upatikanaji wa Dawa, Vifaa, Vifaa Tiba na Vitendanishi 63. Mheshimiwa Spika, Katika kipindi cha Julai 2017 hadi Machi 2018, Wizara yangu imeendelea kuhakikisha kwamba hali ya upatikanaji wa dawa, vifaa, vifaa tiba na vitendanishi katika vituo vya kutolea huduma za afya vya umma inaendelea kuimarika. Hali ya upatikanaji wa dawa, vifaa, vifaa tiba na vitendanishi katika Bohari ya Dawa (MSD) imeendelea kuimarika hadi kufikia wastani wa asilimia 81 kwa Dawa muhimu 135. Aidha, katika kipindi hicho, hali ya upatikanaji wa dawa, vifaa, vifaa tiba, vitendanishi na chanjo ilifikia asilimia 92 kwenye vituo vya kutolea huduma za afya nchini. Vilevile, kutokana na kuendelea kuwasili kwa dawa, vifaa, vifaa tiba, vitendanishi na chanjo nchini, na kwa mujibu wa mikataba iliyopo kati ya wazalishaji na Bohari ya Dawa, hali ya upatikanaji wa dawa kwenye hospitali inatarajiwa kuimarika na kufikia asilimia 89 ifikapo mwishoni mwa mwezi Aprili 2018. 64. Mheshimiwa Spika, mbali na kuongezeka kwa hali ya upatikanaji wa dawa, vifaa, vifaa tiba na vitendanishi, matumizi yasiyo sahihi ya dawa yamezidi kuongezeka hasa matumizi yasiyo ya lazima ya dawa aina ya antibiotiki na uchomaji wa sindano usiokuwa wa lazima. Aidha, tabia ya baadhi ya wagonjwa kwenda moja kwa moja kwenye maduka ya dawa na kununua dawa bila ushauri wa daktari wala kuwa na cheti cha dawa imeendelea kuongezeka na hivyo kuathiri matumizi sahihi ya dawa nchini. Vilevile, baadhi ya wagonjwa kusitisha matumizi ya dawa kabla ya muda sahihi wa matumizi pale tu wanapojisikia wamepata unafuu. Katika kukabiliana na changamoto hiyo Wizara yangu imetekeleza afua zilizoainishwa katika aya 105 ya Hotuba. 65. Mheshimiwa Spika, Katika kutekeleza maagizo ya Mheshimiwa Rais wa Jamhuri ya Muungano wa Tanzania ya kuanzisha viwanda vya dawa Nchini ili kuongeza upatikanaji wa dawa na vifaa tiba, Wizara yangu kwa kushirikiana na Wizara ya Viwanda, Biashara na Uwekezaji iliweza kuandaa mkutano mkubwa kwa lengo la kuwaleta pamoja wawekezaji wenye nia ya kuwekeza katika viwanda vya dawa na vifaa tiba. Jumla ya wadau mia nne thelathini (430) walihudhuria mkutano huo na wawekezaji thelathini na nane (38) walijitokeza kwa nia ya kuwekeza katika uzalishaji wa dripu (infusion), uzalishaji wa bomba za sindano, uzalishaji wa vifungashio vya dawa, uzalishaji wa bidhaa za pamba zinazotumika hospitalini na uzalishaji wa dawa za kuhifadhi maiti. Uwepo wa Viwanda hivyo utawezesha Serikali kuokoa fedha nyingi za kigeni zinazotumika kuagiza dawa toka nje ya nchi. Jitihada hizi zitasaidia kuongeza uzalishaji wa ndani ambao kwa sasa hivi ni asilimia 6 hivyo na kupunguza kiwango cha uagizaji wa dawa nje ya nchi ambao kwa sasa ni asilimia 94. UHAKIKI UBORA WA HUDUMA ZA AFYA 66. Mheshimiwa Spika, Wizara imeendelea kufanya Uhakiki na Ukaguzi kwa vituo vya kutolea huduma za Afya. Katika kipindi cha Julai 2017 hadi Machi 2018, Wizara ilifanya zoezi la tathmini ya mara ya pili (re-assessment) ya kutoa nyota kulingana na ubora kwa Vituo vya Kutolea Huduma za Afya ya Msingi (Zahanati, Vituo vya Afya na Hospitali katika Halmashauri/Wilaya) katika mikoa 14 ya Dar es Salaam, Iringa, Geita, Kagera, Katavi, Kigoma, Mara, Mwanza, Pwani, Tanga, Tabora, Singida, Simiyu na Shinyanga. Matokeo yanaonesha vituo 180 sawa na asilimia 4.7 tu ndivyo vimepata nyota sifuri na Vituo 749 sawa na asilimia 19.4 vilipata nyota 3 na zaidi ukilinganisha na matokeo ya tathmini ya awali ya mwaka 2016 ambapo jumla ya vituo 1,244 sawa na asilimia 33 ya vituo vyote 3,713 vilivyofanyiwa tathmini ya ubora katika mikoa vilipata nyota sifuri na vituo 62 sawa na asilimia 2 vilipata nyota 3 au zaidi. Matokea haya yanaonyesha kuimarika kwa ubora wa huduma za afya katika vituo hivyo.. RASILIMALI WATU KATIKA SEKTA YA AFYA 67. Mheshimiwa Spika, Katika kuongeza idadi ya wataalamu wa Afya nchini, Wizara imeendelea kushirikiana na Baraza la Taifa la Elimu ya Ufundi NACTE katika kusimamia ubora wa mafunzo ya kada za Afya zisizo katika kiwango cha shahada.Katika kipindi cha kuanzia Julai 2017 hadi Machi 2018, jumla ya wanafunzi 16,214 walichaguliwa kujiunga na vyuo vya Afya. Kati ya hao wanafunzi 6,564 walichaguliwa kwenye vyuo vya Serikali na 9,650 kwenye vyuo binafsi katika programu za Uuguzi na Ukunga, Sayansi Shirikishi za Afya na wahudumu Afya ya Jamii. Aidha, Jumla ya wanafunzi 23,098 walifanya mitihani ya kuhitimu katika kipindi hiki, kati yao 10,669 ni wa Sayansi Shirikishi za Afya, 7,300 wa Uuguzi na Ukunga na wa Wahudumu Afya ya Jamii 5,129. 68. Mheshimiwa Spika, Wizara imeendelea kushirikiana na wadau mbalimbali wa Maendeleo katika kutoa ufadhili wa mafunzo ya kibingwa ya muda mfupi na muda mrefu yanayolenga kuwajengea uwezo wa kiutendaji watumishi wa sekta ya Afya. Katika kipindi cha Julai 2017 hadi Machi 2018 jumla ya Watumishi 376 wameendelea kulipiwa gharama za masomo yao ndani na nje ya nchi katika ngazi ya shahada ya Uzamili hususan Madaktari Bingwa katika fani za kipaumbele za upasuaji, magonjwa ya wanawake na uzazi, magonjwa ya watoto, magonjwa ya ndani na radiolojia. 69. Mheshimiwa Spika, Katika kipindi cha mwaka 2017/18 ,Wizara yangu, ilipokea kibali cha ajira ya watumishi 3,152 wa kada za afya kutoka Ofisi ya Rais, Menejimenti ya Utumishi wa Umma na Utawala Bora. Kibali hicho kilikuwa na nafasi za Madaktari Daraja la II 45, Madaktari Bingwa (Medical Specialist) 24, Madaktari Washauri (Medical Consultant) – 2, Wauguzi Daraja la II 137 na kada nyingine za Afya 3,081 ambapo mchakato mzima wa kujaza nafasi za ajira ambazo Wizara ilipewa ulikamilika na Watumishi wote walipatikana isipokuwa Madaktari Washauri. Wizara kwa kushirikiana na Ofisi ya Rais, TAMISEMI ilishawapangia Vituo vya kazi Watumishi hao. Aidha Katika kipindi hiki jumla ya Wataalam wa kigeni 35 walipata ajira katika taasisi mbalimbali za Serikali. 70. Mheshimiwa Spika, Wizara yangu, imeendelea kuboresha mazingira ya kufanyia kazi kwa watumishi ambao wanafanya kazi katika maeneo yenye mazingira magumu ili kuwapatia motisha ili kuendelea kutoa huduma za afya katika maeneo hayo. Katika kipindi cha Julai hadi Machi 2018 jumla ya nyumba 30 zimejengwa na kukamilika katika Halmashauri tatu (3) za mkoa wa Manyara, ambazo ni ; Halmashauri za Kiteto 10, Simanjiro 10 na Hanang nyumba 10. Kukamilika kwa nyumba hizo kumeongeza idadi ya nyumba za watumishi zilizojengwa kupitia mradi huu wa ‘Global Fund’ na kufika nyumba 480 katika maeneo yenye mazingira magumu. UGHARAMIAJI WA HUDUMA ZA AFYA 71. Mheshimiwa Spika, Wizara kwa kushirikiana na OR-TAMISEMI pamoja na Mfuko wa Taifa wa Bima ya Afya inaendelea na utekelezaji wa mpango wa Mfuko wa Afya ya Jamii (CHF). Hadi kufikia Machi 2018, Mfuko wa Afya ya Jamii (CHF) ulikuwa na jumla ya kaya 2,096,692 zilizojiunga ukilinganisha na kaya 2,030,666 zilizokuwa zimejiunga mwaka 2016/17. Aidha, wanufaika wameongezeka kutoka 12,183,996 mwaka 2016/17 hadi kufikia wanufaika 12,580,149 Machi 2018 sawa na asilimia 25 ya Watanzania wote. Vilevile, katika kuchangia juhudi za wananchi wanaochangia CHF na kuboresha huduma zitolewazo, Serikali hutoa malipo ya tele kwa tele kwenye Halmashauri kulingana na kiwango cha makusanyo ya CHF. Malipo yaliyofanyika kwa Halmashauri kwa kipindi cha kuanzia Julai 2017 hadi Machi 2018 ni Shilingi bilioni 1.4. na hivyo kuwezesha Mfuko wa Taifa wa Bima ya Afya kulipa malipo ya Tele kwa Tele yenye jumla ya Shilingi bilioni 15.8 kwa Halmashauri mbalimbali nchini tangu Mfuko ulipokabidhiwa jukumu hili mwezi Julai 2009. 72. Mheshimiwa Spika, ili kuongeza idadi ya wananchi watakao kuwa wanahudumiwa na Mfuko huo, Wizara yangu kwa kushirikiana na OR - TAMISEMI imejipanga kuanza kutekeleza CHF iliyoboreshwa (iCHF) kabla ya mwisho wa mwezi Aprili, 2018. Katika maboresho hayo kila mwanachama ataweza kupata huduma kutoka ngazi ya zahanati hadi ngazi ya Hospitali ya Rufaa ya Mkoa bila kujali Kituo/Halmashauri alipojisajili tofauti na ilivyo sasa ambapo mwanachama wa CHF hupata huduma kwenye zahanati hadi ngazi ya Hospitali ya Wilaya/Halmashauri aliyojisajili tu. 73. Kiwango cha chini cha kuchangia kwenye mfuko kitakuwa sawa kwa wananchi wote na kinatarajiwa kuwa Shilingi 30,000.00 kwa mwaka kwa familia ya watu sita.. Nitoe rai kwa Waheshimiwa Wabunge, kwa nafasi zao na ushawishi mkubwa walionao katika jamii tunayoishi, kuendelea kuwaelimisha wananchi wote umuhimu wa kujiunga na kuchangia katika mfuko huo wa bima ya afya ili waweze kupata huduma za tiba bila kikwazo cha fedha. 74. Mheshimiwa Spika, Serikali ipo katika hatua za kuhakikisha inafikia malengo ya afya kwa wote (Universal Health Coverage) ambapo kila mwananchi atakuwa na uhakika wa upatikanaji wa huduma bora za afya bila kuwa na kikwazo cha kifedha. Lengo ni kuwa ifikapo mwaka 2020 asilimia 70 ya wananchi wawe wamejiunga na mifuko ya Bima ya Afya. Hali iliyopo sasa kuwa ni takribani asilimia 32 ya watu wote ndiyo waliopo katika mfumo wa Bima za Afya nchini. Katika kipindi cha Julai 2017 hadi Machi 2018, Wizara iiliandaa na kuwasilisha Rasimu ya Waraka wa Baraza la Mawaziri wenye maelekezo ya kuboresha mfumo wa Bima za Afya nchini ikiwa ni pamoja na kutunga Sheria itakayomtaka kila Mtanzania kujiunga katika Mfumo wa Bima ya Afya. Baada ya kuwasilishwa kwa Rasimu hiyo, ulitolewa ushauri na maelekezo ambayo Wizara tayari imeshayafanyia kazi na tayari imeshaandaa rasimu nyingine ya Waraka wa Baraza la Mawaziri wenye kuzingatia ushauri ambao Wizara ilipatiwa. Rasimu ya Waraka huu unatarajiwa kuwasilishwa katika ngazi za maamuzi ndani ya Serikali kabla ya kuandaliwa kwa muswada wa sheria utakaowasilishwa bungeni kwa dhamira ya kutunga sheria itakayomtaka kila mwananchi kuwa mwanachama wa mfuko wa Bima ya Afya. 75. Mheshimiwa Spika, Wizara kwa kushirikiana na OR-TAMISEMI imeanza utekelezaji wa azimio la kupeleka fedha moja kwa moja katika Vituo vya kutolea huduma za Afya nchini (Direct Health Facility Financing (DHFF) badala ya kuzipeleka kwenye Halmashauri zao.Hatua hii imelenga kuongeza ufanisi wa matumizi ya fedha za afya na kusogeza huduma karibu zaidi na wananchi. Utekelezaji wa azimio hili umeanza katika kipindi cha 2017/2018 ambapo fedha za Mfuko wa Pamoja wa Afya zilizotengwa kwa ajili ya matumizi ya vituo vya kutolea huduma za Afya zilipelekwa moja kwa moja kutoka Hazina kwenda katika Hospitali za Wilaya, Vituo vya Afya na Zahanati. Jumla ya Shilingi 45,751,004,800 zimetolewa na kupelekwa katika vituo 5,170. Hatua hii imechangia kuboresha upatikanaji wa fedha katika vituo kwa wakati na kusaidia vituo kupanga mikakati ya kuboresha huduma na kuleta ufanisi. TEKNOLOJIA YA HABARI NA MAWASILIANO 76. Mheshimiwa Spika, Wizara iliendelea kutekeleza Mpango Mkakati wa eHealth strategy 2013-2018. Katika mwaka 2017/18, Wizara kwa kushirikiana na OR-TAMISEMI na Taasisi ya Bill and Melinda Gates Foundation kupitia mdau wa maendeleo PATH ilizindua Mpango wa Uwekezaji (Digital Health Investment Recommendation Roadmap). Mpango huu umeainisha vipaumbele vinavyohitajika vya matumizi ya mifumo ya kielektroniki ili kuboresha huduma za afya katika ngazi zote, pamoja na umuhimu wa kukusanya taarifa na matumizi sahihi ya takwimu za sekta ya Afya kwa ujumla. Aidha, Wizara imefunga mfumo wa kieletroniki wa ukusanyaji wa taarifa za chanjo katika vituo vya Afya. Hadi kufikia Machi 2018, jumla ya vituo 1,303 vya mikoa ya Arusha, Kilimanjaro Tanga, Manyara na Dodoma vilifungiwa mfumo na kupewa vifaa vya komputa. Vilevile jumla ya watumishi 3,258 walipewa mafunzo ya jinsi ya kutumia mfumo huu. UTEKELEZAJI WA MIRADI YA MAENDELEO INAYOPATA RUZUKU TOKA SERIKALI KUU KWA MWAKA 2017/18 77. Mheshimiwa Spika, Katika mwaka 2017/18, Wizara ilitenga kiasi cha Shilingi 785,805,952,000 kwa ajili ya kutekeleza Miradi ya Maendeleo. Kati ya fedha hizi, Shilingi, 336,300,000,000 ni fedha kutoka vyanzo vya ndani na Shilingi 449,505,952,000 ni fedha kutoka vyanzo vya nje. Miradi iliyotekelezwa kwa fedha za Ndani 78. Mheshimiwa Spika, Katika kipindi cha Julai 2017 hadi Machi 2018, Wizara ilipokea Shilingi 74,756,079,206.00 (Fedha za Ndani) ambazo zilitumika kutekeleza miradi iliyoainishwa kwenye aya 128 ya Hotuba yangu. Miradi iliyotekelezwa kwa fedha za Nje 79. Mheshimiwa Spika, Katika kipindi cha Julai 2017 hadi Machi 2018, Wizara ilipokea fedha, dawa, vifaa na vitendanishi vyenye thamani ya Shilingi 403,530,227,600.94kutoka katika Vyanzo vya Nje kwa ajili ya utekelezaji wa shughuli mbalimbali za kuboresha huduma za afya nchini kwa mchanganuo ufuatao: Mfuko wa Afya wa Pamoja (Health Basket Fund) Kazi zilizotekelezwa kupitia fedha za Mfuko wa Afya wa Pamoja zimeainishwa katika aya 129 ya Hotuba. Mpango wa malipo kwa ufanisi (RBF) 80. Mheshimiwa Spika, Katika kipindi cha Julai hadi Machi 2018, Wizara yangu kwa kushirikiana na OR– TAMISEMI ilikarabati miundombinu ya kutolea huduma za afya katika Vituo 1,325 vya Serikali vya kutolea huduma za afya katika mikoa ya Shinyanga, Mwanza, Pwani, Tabora, Simiyu, Kigoma, Kagera na Geita. Aidha, jumla ya Shilingi 3,425,162,919 zilipelekwa katika Mikoa na Mamlaka za Serikali za Mitaa na kulipwa kama motisha kwa Timu za Uendeshaji wa shughuli za Afya za Mikoa na Mamlaka za Serikali za Mitaa. Uimarishaji wa huduma za dharura za mama na mtoto (CEmONC) 81. Mheshimiwa Spika, moja ya vipaumbele vya Serikali katika mwaka wa fedha 2017/18 ni kupunguza vifo vya akina mama na watoto vitokanavyo na uzazi. Katika kutekeleza azma hiyo serikali kwa kushirikiana na wadau wa maendeleo imeanza kufanya ukarabati/ ujenzi wa miundombinu ya kutolea huduma ikiwemo chumba cha upasuaji, maabara, wodi ya wazazi na wodi ya watoto utakaowezesha upatikanaji wa huduma kamili za uzazi ikiwa ni pamoja na upasuaji wa kumtoa mtoto tumboni, ili kupunguza vifo vya mama na watoto. Kupitia mpango huo, jumla ya vituo vya Afya 208 vinaboreshwa. Katika kutekeleza mradi huu, jumla ya Shilingi 40,000,000,000 kutoka Banki ya Dunia kwa ajili ya kuboresha Vituo vya Afya 100 na Shilingi 19,500,000,000.00 kutoka Denmark kwa ajili ya vituo vya Afya zimepelekwa katika Halmashauri mbalimbali nchini kukamilisha kazi ya ukarabati na ujenzi ambao upo katika hatua mbalimbali chini ya uangalizi wa OR-TAMISEMI na Wizara ya Afya. Aidha, Wizara kwa kushirikiana na TAMISEMI inakamilisha mchanganuo wa vituo vya afya 21 vitakavyoboreshwa kwa kutumia fedha za Mfuko wa Afya wa Pamoja. Mfuko wa Dunia (Global Fund): 82. Mheshimiwa Spika, Katika kipindi cha Julai 2017 hadi Machi 2018, Wizara ilipokea fedha, dawa, vifaa tiba na vitendanishi vyenye thamani ya Shilingi 303,238,541,795.37 kwa ajili ya kupambana na UKIMWI, Kifua Kikuu, na Malaria. UTEKELEZAJI WA MAJUKUMU YA TAASISI CHINI YA IDARA KUU YA AFYA Bohari Kuu ya Dawa (MSD) 83. Mheshimiwa Spika, Katika kipindi cha mwaka wa Fedha 2017/18, Bohari ya Dawa (MSD) imeendelea kutekeleza maelekezo ya Serikali kuhusu kununua dawa moja kwa moja kutoka kwa wazalishaji kwa kuingia makubaliano ya muda mrefu (Framework Agreement) na viwanda vya uzalishaji dawa. Jumla ya wazalishaji 110 tayari wana mikataba na MSD na kati ya hao wazalishaji 10 ni viwanda vya ndani. Mpango huu umewezesha MSD kufanikiwa kupunguza bei ya dawa 109 kwa wastani wa asilimia 40. Hali hiyo imesaidia vituo vya afya kuweza kununua dawa kwa bei nafuu na hivyo kuongeza kiasi cha dawa. Aidha, Bohari Kuu ya Dawa inaendelea kuimarisha mfumo wake wa usambazaji wa dawa ili kuhahikisha upatikanaji wa dawa na vifaa tiba katika vituo vya kutolea huduma za afya vya umma unafikia asilimia 100. Katika kufanikisha hili jumla ya magari 181 yamenunuliwa na Serikali kwa kushirikiana na Global Fund, Magari hayo yalizinduliwa na Mhe. Rais tarehe 26 Machi, 2018. Hali hiyo imewezesha vituo vya kutolea huduma za afya kuwa na dawa muhimu kwa asilimia 89.6. Vilevile, upatikanaji wa dawa za ARVs umeimarika na kuwa kati ya asilimia 92 hadi 100 MFUKO WA TAIFA WA BIMA YA AFYA (NHIF) 84. Mheshimiwa Spika, Mfuko wa Taifa wa Bima ya Afya umeendelea kubuni na kutekeleza mikakati mbalimbali ili kuongeza wigo wa wanufaika wa bima ya afya.kufuatia utekelezaji wa mikakati hiyo, katika kipindi cha Julai 2017 hadi kufikia Machi 2018, Mfuko umeweza kusajili idadi ya wanachama wapya wapatao 167,791 kutoka katika Sekta ya Umma na Binafsi sawa na asilimia 97 ya lengo. Hivyo idadi ya wanachama wachangiaji wa Mfuko wa Taifa wa Bima ya Afya imeongezeka kutoka wanachama 753,992 waliokuwa wameandikishwa mwaka 2016/17 hadi kufikia wanachama 763,068 mwezi Machi 2018. Aidha, idadi ya wanufaika nayo iliongezeka kutoka 3,491,400 mwaka 2016/17 hadi kufikia wanufaika 3,619,697 mwezi Machi 2018 sawa na asilimia 7 ya Watanzania wote. Hii inaonyesha kuwa wanachama wa Mfuko wameongezeka kwa wastani wa asilimia 10 na wanufaika asilimia 7 katika kipindi cha miaka mitano. 85. Mheshimiwa Spika, Wizara kwa kushirikiana na OR-TAMISEMI pamoja na Mfuko wa Taifa wa Bima ya Afya inaendelea na utekelezaji wa mpango wa Mfuko wa Afya ya Jamii (CHF). Katika kipindi cha Julai 2017 hadi Machi 2018 kaya mpya zilizoandikishwa kwenye Mfuko wa Afya ya Jamii (CHF) zilikuwa 66,026 na kufanya jumla ya kaya 2,096,692 zilizojiunga ukilinganisha na kaya 2,030,666 zilizokuwa zimejiunga mwaka 2016/17. Aidha, wanufaika wameongezeka kutoka 12,183,996 mwaka 2016/17 hadi kufikia wanufaika 12,580,149 Machi 2018 sawa na asilimia 25 ya Watanzania wote. Aidha, mafanikio hayo yametokana na juhudi zinazofanywa na Mfuko za kuelimisha wananchi pamoja na kubuni mbinu mbalimbali za kuongeza wigo wa wanachama, kama kuanzishwa kwa mpango wa KIKOA (unaojumuisha kundi la wajasiriamali, vikundi vya vikoba, saccos na wavuvi), TOTO AFYA KADI (unaojumuisha watoto chini ya miaka 18), Wanafunzi wa vyuo vya Elimu ya Juu, Wastaafu na wanachama binafsi. 86. Mheshimiwa Spika, ili kuongeza idadi ya wananchi watakao kuwa wanahudumiwa na Mfuko huu wa Serikali, Mfuko kwa kushirikiana na Tume ya Maendeleo ya Ushirika (TCDC), unatarajia kuanzisha fao la bima linalolenga wakulima walio katika vyama vya ushirika nchini. Kupitia fao hilo lijulikanalo kama Ushirika Afya, wakulima walio katika vyama vya ushirika vya mazao ya Korosho, Pamba, Chai, Tumbaku na Kahawa watafikiwa kwa kuelimishwa na kuandikishwa kuwa wanufaika wa huduma za bima. Kufanikiwa kwa mpango kutawawezesha wakulima kupata huduma za matibabu hata kipindi ambacho si cha msimu kupitia kadi zao. Mpango wa Bima kwa Wanawake Wajawazito na Watoto 87. Mheshimiwa Spika, Serikali kupitia NHIF na kwa kushirikiana na Benki ya Ujerumani (KfW) Ilianza kutekeleza Mpango wa NHIF/CHF kwa Wanawake Wajawazito na Watoto ujulikanao kama Tumaini la Mama mwaka 2012 ambapo kina mama wajawazito hulipiwa kadi za NHIF/CHF na kuwa na uhakika wa kupata matibabu katika kipindi chote cha ujauzito na miezi sita baada ya kujifungua kwa mama na mtoto. Mpango huu una lengo la kupunguza vifo vya kina mama na watoto ili kwenda sambamba na utekelezaji wa malengo ya kimataifa ya maendeleo endelevu (SDGs). Katika kipindi cha kuanzia Julai 2017 mpaka Machi 2018, akina mama 199,954 na watoto 20,998 walikuwa wamesajiliwa na kunufaika na mpango huu. Tangu kuanzishwa kwa mpango, tayari wanawake wapatao 875,375 wamenufaika katika mikoa ya Mbeya, Tanga, Lindi, Mtwara na Songwe. Aidha, shughuli nyingine zinazofanywa na NHIF katika kuboresha huduma za afya zimeainishwa katika aya 141 mpaka 144 ya Hotuba. MAMLAKA YA CHAKULA NA DAWA (TFDA) 88. Mheshimiwa Spika, Wizara yangu kupitia Mamlaka ya Chakula na Dawa, inatekeleza Mpango Mkakati mpya wa miaka mitano (5) wa Mamlaka ya Chakula na Dawa (2017/18 - 2021/22). Mamlaka ilifanya tathmini ya maombi ya usajili wa vyakula na kukagua viwanda vya dawa na viwanda vya vyakula nje ya nchi ambapo matokeo yalikuwa kama ilivyoainishwa kwenye aya 146 na 147 ya Hotuba. Aidha, Mamlaka imeendelea na utoaji wa elimu kwa umma kwa makundi mbalimbali ya wananchi kuhusu madhara ya dawa, vipodozi hatarishi na usalama wa chakula pamoja na jumbe fupi zilirushwa kupitia redio, runinga, magazeti na mitandao mbalimbali ya kijamii. 89. Mheshimiwa Spika, Katika mwaka wa fedha wa 2017/18, mfumo wa kupokea taarifa za usajili wa vitendanishi kwa njia ya mtandao umetengenezwa na kuanza kutumika na hivyo kupungua kwa muda wa kushughulikia maombi yanayowasilishwa na wateja. Mamlaka imeweza kuweka taarifa za bidhaa zote zilizosajiliwa nchini kwenye mtandao ambao umeunganishwa na mfumo wa kielektroniki wa ndani (www.tfda.go.tz/portal/registered-products). Taarifa hizi zinasaidia wananchi na wateja kwa ujumla kuona bidhaa zilizosajiliwa na tarehe za kuisha muda wa usajili. MAMLAKA YA MAABARA YA MKEMIA MKUU WA SERIKALI 90. Mheshimiwa Spika, katika mwaka wa fedha wa 2017/18, Taasisi iliyokuwa Wakala wa Maabara ya Mkemia Mkuu wa Serikali ilibadilishwa rasmi na kuwa Mamlaka ya Maabara ya Mkemia Mkuu wa Serikali kwa sheria Na. 8 ya mwaka 2016. Katika kuhakikisha kwamba Mamlaka inafanya kazi kwa ufanisi, mamlaka imesaini mikataba mitatu (3) ya ununuzi wa mitambo na vifaa vya maabara vyenye thamani ya Shilingi bilioni 1.4, vifaa hivyo vinatarajiwa kupokelewa kabla ya mwezi Juni, 2018. Aidha, ukarabati wa Maabara ya DNA Makao Makuu Dar es Salaam umeanza na unategemewa kumalizika mwezi Juni 2018. TAASISI YA CHAKULA NA LISHE (TFNC) 91. Mheshimiwa Spika, Katika kufuatilia kiwango cha ufanisi katika utekelezaji wa afua za lishe nchini na kuhimiza uwajibikaji kwa watoa huduma, Wizara imeanza kutumia Kadi Alama ya Lishe (Nutrition Score Card). Kadi Alama hii ina jumla ya viashiria 18 ambavyo vinatumika kufuatilia utekelezaji wa afua za lishe na matumizi ya kadi hii yamezingatia uzoefu uliopatikana katika matumizi ya kadi alama nyingine zilizopo nchini kama ile ya Malaria na ile ya Afya ya Uzazi, Mama na Mtoto. Kutokana na ufanisi mkubwa katika matumizi ya kadi alama hii, Serikali ya Ethiopia ilituma wataalam wake sita kutoka Wizara ya Afya kuja Tanzania kujifunza jinsi ya kuandaa na kutumia mfumo huu kuwezesha kadi alama ya lishe ili ianze kutumika katika nchi hiyo. TAASISI YA UTAFITI WA MAGONJWA YA BINADAMU (NIMR) 92. Mheshimiwa Spika, Wizara yangu kupitia Taasisi ya Uchunguzi wa Magonjwa ya Binandamu imeendelea kutekeleza majukumu yake ya Utafiti.Taasisi imefanya tafiti mbalimbali ikiwemo tafiti za Majaribio ya Chanjo ya UKIMWI, Tiba Mbadala, Afya ya mama na mtoto, Malaria na TB. Matokeo ya tafiti hizi yamesaidia kuandaa afua mbalimbali za kuboresha huduma kwa waathirika wa magonjwa hayo. Aidha, tafiti kwenye afya ya mama na mtoto zinalenga kuboresha mfumo wa afya hasa upatikanaji wa huduma ikiwemo chanjo, elimu ya lishe na hatua za kupunguza vifo vya mama na watoto chini ya miaka 5. Taasisi kwa kushirikiana na Wizara na wadau wa Afya imefanya tathmini ya uwepo wa maji salama na usafi wa mazingira (WASH) katika vituo vya afya mbalimbali vinavyotoa huduma za kujifungua. Taarifa zilizopatikana kutokana na utafiti huo ni kwamba, pamoja na Serikali kupitia Sekta ya Afya kusisitiza wananchi kwenda kujifungulia katika vituo vya kutolea huduma za Afya, bado yapo mapungufu makubwa ikiwa ni pamoja na yafuatayo; Asilimia 19 ya vituo hutumia maji toka vyanzo visivyoboreshwa vikiwemo vyanzo wazi kama mito na mabwawa na visima visivyoboreshwa; Asilimia 46.5 ya sampuli za maji zilizopimwa zilionekana kuwa na vimelea vya maambukizi ya magonjwa mbalimbali; Asilimia 42 ya vyumba vya kuzalia havikuwa na sehemu za kunawia mikono; Asilimia 10 ya vituo hasa zahanati vilikuwa na vyoo duni visivyoboreshwa na kuleta hatari ya maambukizi. 93. Mheshimiwa Spika, Wizara imejipanga kufanyia kazi matokeo yaliyobainishwa na utafiti huo kwa kuelekeza msukumo mkubwa katika eneo la afya Kinga ikiwa ni pamoja na kushirikiana na OR-TAMISEMI kuhakikisha kuwa Mamlaka za Serikali za Mitaa zinatenga fedha katika bajeti zao kwa ajili ya kuondoa changamoto zilizobainishwa na utafiti huo. UTEKELEZAJI WA MAJUKUMU CHINI YA IDARA KUU YA MAENDELEO YA JAMII 94. Mheshimiwa Spika, Wizara imeendelea kutekeleza afua kwa kushirikiana wadau mbalimbali katika maeneo muhimu yafuatayo: Uwezeshaji Wanawake 95. Mheshimiwa Spika, katika kuwawezesha wanawake kiuchumi, Wizara yangu iliendelea kuratibu na kusimamia Mfuko wa Maendeleo ya Wanawake (WDF). Katika kipindi cha Julai hadi Disemba 2017, Halmashauri 130 kati ya 185 zilichangia Shilingi bilioni 7.3 katika Mfuko ikilinganishwa na Shilingi bilioni 8.9 zilizochangiwa na Halmashauri kwa mwaka 2016/17. Fedha zilizochangiwa ni sawa na asilimia 26 ya Shilingi bilioni 28.3 zilizopaswa kuchangiwa kwa mwaka 2017/18. Fedha hizo zilitolewa kama mikopo kwa vikundi 4,365 vyenye wanawake wajasiriamali 39,449. 96. Mheshimiwa Spika, Wizara kwa kushirikiana na wadau mbalimbali wakiwemo SIDO, Mfuko wa Fursa Sawa kwa Wote(EOTF) na Baraza la Taifa la Uwezeshaji Wananchi Kiuchumi iliendelea kuwezesha ushiriki wa wanawake katika Maonesho ya Biashara ya Kitaifa na Kimataifa. Katika mwaka 2017/18, wanawake wajasiriamali 1,183 kutoka mikoa 26 ya Tanzania Bara waliwezeshwa kushiriki katika Maonesho ya Sabasaba, Juakali, Nanenane na VICOBA. 97. Mheshimiwa Spika, Katika mwaka 2017/18, wajasiriamali 6,237 (Ke 5,097 na Me 1,140) walipatiwa mikopo na Benki ya Wanawake Tanzania ikilinganishwa na wajasiriamali 6,267 (Ke 4,596 na Me 1,671) mwaka 2016/17. Juhudi hizi zimewesha wajasiriamali 87,063 (Ke 71,744 na Me 15,319) kupata mikopo tangu mwaka 2010. Kwa upande wa thamani ya mikopo iliyotolewa mwaka 2017/18, benki ilitoa mikopo ya Shilingi bilioni 10.1 ikilinganishwa na Shilingi bilioni 13.3 mwaka 2016. Tthamani ya mikopo iliyotolewa tangu mwaka 2010 mpaka Machi, 2018 ni Shilingi bilioni 131.9. 98. Mheshimiwa Spika, Benki ya Wanawake Tanzania imefungua vituo 244 vya kutolea mikopo na mafunzo kwa wanawake wajasiriamali katika mikoa ya Dar es Salaam (115), Mwanza (46), Dodoma (27), Mbeya (5), Iringa (9), Ruvuma (24) na Njombe (18) katika mwaka 2017/18 ikilinganishwa na vituo 88 mwaka 2016/17 sawa na ongezeko la asilimia 177. 99. Mheshimiwa Spika, Katika mwaka 2017/18, jumla ya akaunti 10,415 (Ke 7,811 na Me 2,604) zilifunguliwa hadi kufikia akaunti 88,397 Machi, 2018 katika matawi mawili ya Benki ya Wanawake Tanzania (tawi la Mkwepu na Mjasiriamali) kutoka mwaka 2009. Kati ya akaunti hizo, akaunti 65,419 ni za wateja wanawake sawa na asilimia 74, akaunti 20,961 za wanaume na akaunti 2,017 za makampuni. Maendeleo ya Jamiii 100. Mheshimiwa Spika, Wizara, inaendelea kuamsha ari ya Wananchi kushiriki katika Miradi ya Maendeleo. Katika kipindi cha Julai hadi Machi 2018, Wizara imefanya uhamasishaji katika Mikoa 11 ya Iringa, Dodoma, Mwanza, Pwani, Kigoma, Katavi, Rukwa, Songwe, Mbeya, Kagera na Shinyanga. Uhamasishaji huu umewezesha ujenzi wa majengo ya Kituo cha Afya Mondo, Wilaya ya Misungwi (Mwanza); ujenzi wa bwawa la maji Maghangu Mpwapwa (Dodoma); ujenzi wa Zahanati Ufyambe (Iringa); ujenzi wa shule ya sekondari na kituo cha afya – Uvinza (Kigoma); ujenzi wa shule ya sekondari na kituo cha afya – Mpanda (Katavi); ujenzi wa kituo cha afya – Sumbawanga (Rukwa); ujenzi wa kituo cha afya – Mbozi (Songwe); ujenzi wa shule ya sekondari – Manispaa ya Mbeya (Mbeya); kuchangia fedha na vifaa kwa ajili ya ujenzi wa nyumba ya mtumishi wa Makazi ya wazee (Kagera); kuzindua Kituo cha Mkono kwa Mkono (One Stop Centre) cha wahanga wa ukatili wa kijinsia na ukatili wa watoto Wilaya ya Kahama (Shinyanga) na ujenzi wa madarasa mawili katika Kijiji cha Chambasi, Kisarawe (Pwani). 101. Mheshimiwa Spika, Wizara imeendelea kusimamia na kuratibu uzalishaji wa wataalam wa Maendeleo ya Jamii kutoka katika vyuo 8 vya maendeleo ya jamii vya Buhare, Mlale, Misungwi, Rungemba, Mabughai, Ruaha, Uyole na Monduli. Vyuo hivyo hutoa mafunzo ya Maendeleo ya jamii katika ngazi ya Cheti na Stashahada. Katika mwaka 2017/18, jumla ya wanafunzi 1,588 (Ke 984 na Me 604) walidahiliwa ikilinganishwa na 3,248 (Ke 1,987 na Me 1,261) mwaka 2016/17. Aidha, katika mwaka 2017/18, jumla ya wanafunzi 3,320 (Ke 1,947 na Me 1,373) walihitimu katika Vyuo 8 vya Maendeleo ya Jamii ikilinganishwa na wahitimu 3,694 (Ke 2,228 na Me 1,466) mwaka, 2016/17. Mashirika Yasiyo ya Kiserikali 102. Mheshimiwa Spika, Wizara imeendelea kuratibu Mashirika Yasiyo ya Kiserikali kwa kuweka mazingira wezeshi ya kuchangia katika kuleta maendeleo ya Taifa. Kwa kipindi cha Julai hadi Machi, 2018, jumla ya Mashirika Yasiyo ya Kiserikali 192 yalisajiliwa. Kati ya mashirika yaliyosajiliwa, mashirika 21 yalisajiliwa katika ngazi ya Kimataifa,162 katika ngazi ya Kitaifa na Mashirika 9 ngazi ya Wilaya. Usajili huu umewezesha jumla ya mashirika 8,211 kusajiliwa nchini kuanzia mwaka 2005 hadi Machi, 2018 (Kiambatisho Na.5). 103. Mheshimiwa Spika, Wizara ilihakiki mashirika na hadi kufikia Machi, 2018, Mashirika Yasiyo ya Kiserikali 4,868 yalikuwa yamehakikiwa. Aidha, katika uhakiki huo, wizara imebaini jumla ya mashirika 513 yenye sifa za mashirika ambayo yaliyokuwa yamesajiliwa chini ya Sheria nyingine na kuyajumuisha chini ya Sheria ya Mashirika Yasiyo ya Kiserikali Na.24 ya mwaka 2002. Hatua hii imesaidia kuimarisha uratibu na usimamizi mzuri wa mashirika haya katika misingi ya uwazi, utoaji taarifa na uwajibikaji kwa jamii. Haki na Maendeleo ya Mtoto 104. Mheshimiwa Spika, Katika kukabiliana na tatizo hilo, Wizara kwa kushirikiana na wadau imeendelea kutekeleza Mpango Kazi wa Taifa wa Kutokomeza Ukatili Dhidi ya Wanawake na Watoto (2017/18 – 2021/22). Katika mwaka 2017/18, Kazi zilizofanyika chini ya mpango huu ni kutoa elimu kuhusu athari za mila na desturi zenye madhara kwa jamii ikiwemo ukeketaji, mimba na ndoa za utotoni kwa makundi mbalimbali katika jamii. Jumla ya wananchi 13,020 walipatiwa elimu wakiwemo wanafunzi 8,546, walimu 476, wazee wa mila 56, viongozi wa dini 64, ngariba 38, waendesha bodaboda 168, wazazi/walezi 3,600 na watendaji 72 kutoka mikoa ya Shinyanga, Mara, Tabora, Lindi, Dodoma, Tanga, Dar es Salaam na Katavi. 105. Mheshimiwa Spika, Wizara kwa kushirikiana na wadau imeendelea kuwapatia huduma watoto waliofanyiwa ukatili kupitia Huduma ya Simu kwa Watoto (Child Help Line). Katika mwaka 2017/18, simu 18,464 zilipokelewa kuhusu ukatili dhidi ya watoto. Kati ya simu hizo, simu za watoto 1,072 (Ke 621 na Me 451) ziliwezeshwa kupata huduma (chakula, vifaa vya shule na huduma za sheria na afya) ikilinganishwa na simu za watoto 441 (Ke 325 na Me 96) waliopata huduma mwaka 2016/17 sawa na ongezeko la asilimia 143. 106. Mheshimiwa Spika, katika kuhakikisha watoto wanashiriki katika maendeleo yao na kujitambua, kwa mwaka 2017/18 Wizara imeendelea kuwezesha ushiriki wa watoto katika mabaraza na klabu za wasichana za Kujikinga na mimba za utotoni. Jumla ya mabaraza ya watoto 13 na klabu 600 katika shule za msingi na sekondari zimeanzishwa kwa kipindi cha Julai, 2017 hadi Machi, 2018 na kufikia idadi ya mabaraza 1,669 na Klabu 2,000. Huduma ya Malezi, Makuzi na Maendeleo ya Awali ya Watoto 107. Mheshimiwa Spika, Wizara imeendelea kusimamia utoaji wa huduma ya malezi, makuzi na maendeleo ya awali ya watoto walio chini ya miaka mitano walio katika vituo vya kulelea watoto wadogo mchana (Day Care Centres) vya Serikali na Binafsi. Kwa kipindi cha Julai, 2017 hadi Machi, 2018, vituo 139 vilipatiwa usajili ikilinganishwa na vituo 270 vilivyopatiwa usajili mwaka 2016/17 na hivyo kufikia vituo 1,046 vilivyosajiliwa nchi nzima. Aidha, watoto 6,075 (Ke 4,018 na Me 2,057) waliandikishwa katika vituo vya kulelea watoto wadogo mchana 2016/17 ikilinganishwa na watoto 4,450 (Ke 3,097, Me 1,353) mwaka 2015/16. 108. Mheshimiwa Spika, katika mwaka 2017/18, Wizara imeendelea kuzalisha wataalamu wa malezi, makuzi na maendeleo ya awali ya mtoto katika Chuo cha Ustawi wa Jamii Kisangara. Jumla ya wanafunzi 83 (Ke 58 na Me 25) walidahiliwa kwa mwaka 2017/18 ikilinganishwa na wanafunzi 56 (Ke 39 na Me 17) waliodahiliwa mwaka 2016/17. Aidha, wanafunzi 52 (Ke 35 na Me 17) wahitimu katika mwaka 2017/18 ikilinganishwa na wahitimu 8 wote wanawake mwaka 2016/17. 109. Mheshimiwa Spika, katika mwaka 2017/18, Wizara imeendelea kuzalisha wataalamu wa malezi, makuzi na maendeleo ya awali ya mtoto katika Chuo cha Ustawi wa Jamii Kisangara. Jumla ya wanafunzi 83 (Ke 58 na Me 25) walidahiliwa kwa mwaka 2017/18 ikilinganishwa na wanafunzi 56 (Ke 39 na Me 17) waliodahiliwa mwaka 2016/17. Aidha, wanafunzi 52 (Ke 35 na Me 17) wahitimu katika mwaka 2017/18 ikilinganishwa na wahitimu 8 wote wanawake mwaka 2016/17. Huduma za Ustawi kwa Watoto 110. Mheshimiwa Spika, katika mwaka 2017/18, Wizara kwa kushirikiana na Asasi Zisizo za Kiserikali imeendelea kuhakikisha upatikanaji wa huduma za msingi za malezi, matunzo na ulinzi kwa watoto walio katika mazingira hatarishi nchini. Jumla ya watoto 6,132 (Ke 2,972 na Me 3,160) walio katika mazingira hatarishi walipatiwa huduma za msingi katika makao ya watoto 157 yanayoendeshwa na Taasisi za dini, Mashirika ya watu binafsi na Serikali (Kiambatisho Na. 6) ikilinganishwa na watoto 4,515 (Ke 2519 na Me 1,996) mwaka 2016/17. Kati ya watoto hao, watoto 78 (Ke 43 na Me 35) wanaishi katika Makao ya Taifa ya Watoto Kurasini ambayo yanamilikiwa na Serikali. 111. Mheshimiwa Spika, kwa kipindi cha Julai, 2017 hadi Machi, 2018, jumla ya leseni 14 za usajili wa Makao ya watoto zimetolewa ikilinganishwa na leseni 50 kwa mwaka 2016/17 na kufikia idadi ya makao 157 nchi nzima. Kati ya makao hayo, moja ni la Serikali na 156 yanamilikiwa na kuendeshwa na watu binafsi, Mashirika yasiyo ya Kiserikali ya kijamii au Taasisi za kidini. Nitumie fursa hii kuwataka watu/Taasisi zote zinazotoa huduma za malezi kwa watoto wanaoishi katika mazingira magumu kujisajili katika Halmashauri zao mara moja. 112. Mheshimiwa Spika, Wizara imeendelea kuhakikisha kuwa watoto walio katika mkinzano na Sheria wanapata haki za msingi ikiwa ni pamoja na huduma za sheria na elimu katika mahabusu tano za watoto za Mbeya, Moshi, Tanga, Arusha na Dar es Salaam. Katika mwaka 2017/18, jumla ya watoto 291 (Ke 13 na Me 278) walio katika mkinzano na sheria waliwezeshwa kupata huduma za msingi (chakula, malazi, mavazi, huduma za matibabu na elimu) ikiwa ni pamoja na huduma za msaada wa kisheria ikilinganishwa na watoto 255 (Ke 18 na Me 237) mwaka 2016/17 sawa na ongezeko la asilimia 14. 113. Mheshimiwa Spika, Wizara kwa kushirikiana na Wizara ya Katiba na Sheria imewachepusha watoto 126 (Ke 24 na Me 102) kutoka katika mfumo rasmi wa haki jinai kwa kuwarekebisha tabia na kuwaunganisha na familia zao ikilinganishwa na watoto 72 (Ke 8 na Me 64) waliochepushwa mwaka 2016/17 sawa na ongezeko la asilimia 67. Aidha, katika mwaka 2017/18, Wizara imeendelea kuwezesha huduma za msingi (chakula, malazi, mavazi na huduma za matibabu) ikiwa ni pamoja na marekebisho ya tabia, elimu na mafunzo kwa watoto wa kiume 35 waliobainika na makosa ya jinai waliopo katika Shule ya Maadilisho Irambo Mbeya ikilinganishwa na watoto 72 mwaka 2016/17. 114. Mheshimiwa Spika, katika mwaka 2017/18, Wizara kwa kushirikiana na OR - TAMISEMI imeendelea na juhudi ya kuhakikisha kuwa watoto wanalelewa katika ngazi ya familia kulingana na Sheria ya Mtoto Na.21 ya mwaka 2009 kwa kutoa huduma za malezi ya kambo na uasili. Wizara imewezesha watoto 44 (Ke 24 na Me 20) kuwekwa chini ya malezi ya kambo ikilinganishwa na watoto 54 (Ke 21 na Me 33) mwaka 2016/17. Aidha, watoto 17 (Me 8 na Ke 9) waliasiliwa mwaka 2017/18 ikilinganishwa na watoto 21 (Ke 11 na Me 10) mwaka 2016/17. 115. Mheshimiwa Spika, Wizara imeendelea kuwatambua Watu wa Kuaminika (Fit Persons) ili kulea watoto walio katika mazingira hatarishi. Juhudi hii imewezesha Watu wa Kuaminika 187 kutambuliwa katika Halmashauri 19 mwaka 2017/18. Hadi kufikia Machi, 2018, jumla ya watoto 243 wamepitia kwenye familia za watu wa kuaminika katika Halmashauri 19 za Magu DC, Kasulu DC, Kasulu TC, Musoma Dc, Iringa MC, Iringa DC, Mufindi DC, Njombe DC, Makete DC, Mbeya Jiji, Mbeya DC, Mbarali DC, Hai DC, Temeke DC, Arusha DC, Kakonko DC, Kibondo DC, Misenyi DC na Chunya DC. Huduma za Ustawi kwa Wazee 116. Mheshimiwa Spika, Wizara imeendelea kuratibu upatikanaji wa huduma za msingi kwa wazee wasiojiweza. Katika mwaka 2017/18, jumla ya wazee wasiojiweza 517 (Ke 250 na Me 267) wanaoishi katika makazi 17 ya Serikali walipatiwa huduma za msingi - chakula, malazi, mavazi na matibabu (Kimbatanisho Na.7) ikilinganishwa na wazee 465 (Ke 221 na Me 244) mwaka 2016/17 sawa na ongezeko la asilimia 11. 117. Mheshimiwa Spika, Wizara kwa kushirikiana OR - TAMISEMI iliwezesha wazee 506,943 (Ke 220,312 na Me 286,631) kupata vitambulisho vya matibabu bure katika kipindi cha Julai hadi Machi, 2018 ikilinganishwa na wazee 74,590 waliopata vitambulisho vya matibabu bure mwaka 2016/17. Juhudi hizi zimewezesha kufikia idadi ya wazee 581,533 (Ke 254,793 na Me 326,740) waliopata vitambulisho ikiwa ni asilimia 35 ya wazee 1,657,206 waliotambuliwa katika Halmashauri zote. Huduma za Usuluhisho wa Migogoro ya Ndoa na mashauri ya matunzo kwa watoto 118. Mheshimiwa Spika, katika mwaka 2017/18, Wizara kupitia Baraza la Usuluhishi wa Ndoa lililopo chini ya usimamizi wa Kamishna wa Ustawi wa Jamii na Ofisi za Ustawi wa Jamii za Halmashauri zimeendelea kutoa huduma za usuluhishi wa migogoro ya ndoa kwa familia. Kwa kipindi cha Julai, 2017 hadi Machi, 2018, jumla ya mashauri ya migogoro ya ndoa 13,382 yalipokelewa na kufanyiwa usuluhishi ikilinganishwa na mashauri ya migogoro ya ndoa 8,454 mwaka 2016/17. Kati ya mashauri hayo, mashauri 11,326 sawa na asilimia 85 yamesuluhishwa na yamekamilika, mashauri 1,397 sawa na asilimia 10 yamepelekwa mahakamani na mashauri 659 sawa na asilimia 5 yanaendelea na usuluhishi 119. Mheshimiwa Spika, katika kuhakikisha kuwa, watoto wanapata matunzo kutoka kwa wazazi, Wizara imeendelea kufanyia kazi mashauri ya matunzo ya watoto nchini. Kwa kipindi cha mwezi Julai, 2017 hadi Machi, 2018 jumla ya mashauri ya matunzo ya watoto 11,815 yalipokelewa. Kati ya mashauri hayo, 4,965 yalihusu matunzo ya watoto walio ndani ya migogoro ya ndoa na 5,708 watoto waliozaliwa nje ya ndoa Kati ya mashauri yaliyopokelewa, 10,673 yalikamilika kuwezesha huduma kwa watoto na mashauri 1,142 yaliyopewa rufaa kwenda mahakamani ikilinganishwa mashauri ya matunzo ya watoto 12,406 yaliyokamilika mwaka 2016/17 (matunzo ya watoto walio kwenye migogoro ya ndoa 6,557, matunzo ya watoto waliozaliwa nje ya ndoa 4,133 na mashauri 1,716 yaliyopewa rufaa kwenda mahakamani). UTEKELEZAJI WA MAJUKUMU YA TAASISI CHINI YA IDARA KUU YA MAENDELEO YA JAMII Taasisi ya Maendeleo ya Jamii Tengeru 120. Mheshimiwa Spika, katika mwaka 2017/18, Taasisi ya Maendeleo ya Jamii Tengeru ilidahili jumla ya wanafunzi 1,169 katika fani ya Maendeleo ya Jamii ikiwa ni ongezeko la asilimia 86 ya udahili wa wanafunzi 628 mwaka 2016/17. Kati ya wanafunzi waliodahiliwa, wanafunzi 486 walidahiliwa katika ngazi ya cheti, wanafunzi 83 Stashahada na wanafunzi 600 ngazi ya Shahada. Aidha, wanafunzi 684 walihitimu mwaka 2017/18 ikilinganishwa na wahitimu 609 mwaka 2016/17 ikiwa ni ongezeko la asilimia 12. 121. Mheshimiwa Spika, Taasisi pia imefanya tafiti tatu ambazo ni Tathmini ya mahitaji ya Ushiriki wa Jamii katika kijiji cha Kikwe wilaya ya Arumeru, tafiti kuhusu watoto walio katika mazingira hatarishi katika sekta isiyo rasmi katika Wilaya ya Arumeru (utafiti kuhusu watoto katika masoko ya jamii) na Tathmini ya changamoto inayowakabili Maafisa Maendeleo ya Jamii Tanzania katika Halmashauri. Matokeo ya tafiti hizi yatawezesha Taasisi ya Maendeleo ya Jamii Tengeru na Wizara kuboresha utoaji wa mafunzo na utekelezaji wa shughuli za maendeleo ya jamii. Taasisi ya Ustawi wa Jamii – Kijitonyama 122. Mheshimiwa Spika, Taasisi ya Ustawi wa Jamii - Kijitonyama imeendelea kutoa mafunzo katika ngazi ya Cheti, Diploma, Shahada, Stashahada ya Uzamili na Shahada ya Uzamili. Katika mwaka 2017/18, Taasisi ilidahili wanafunzi 1,185 (Ke 811 na Me 374) katika fani zitolewazo katika ngazi mbalimbali ikiwa upungufu wa asilimia 6.91 ya wanafunzi 1,273 waliodahiliwa mwaka 2016/17. Aidha, wanafunzi 1,122 (Ke 722 na Me 400) walihitimu mwaka 2016/17 katika fani na ngazi mbalimbali ikilinganishwa na wanafunzi 1,172 (Ke 789, Me 383) waliohitimu mwaka 2015/16 sawa na ongezeko la asilimia 4. C: VIPAUMBELE VYA WIZARA KWA MWAKA 2018/19 123. Mheshimiwa Spika, katika mwaka wa fedha 2018/19, Wizara kupitia fungu 52 (Idara kuu ya Afya) imejiwekea vipaumbele vifuatavyo ili kuboresha utoaji wa huduma za afya nchini; i) Kuimarisha huduma za chanjo kwa watoto ili kuendelea kubaki katika viwango vya juu vya utoaji wa huduma za chanjo ili kuwaepusha watoto na magonjwa yanayoweze kuepukika kwa chanjo ii) Kuimarisha huduma za kinga dhidi ya magonjwa yanayotokana na kutozingatia kanuni za usafi na usafi wa mazingira kama magonjwa ya kuhara, kuhara damu na kipindupindu kwa kuongeza uhamasishaji na usimamizi wa usafi na usafi wa mazingira iii) Kuimarisha huduma za kinga dhidi ya magonjwa yasiyoambukiza kama magonjwa ya moyo, kisukari na saratani kwa kuhamasisha jamii kuepukana na tabia hatarishi na kujijengea tabia ya kufanya mazoezi mara kwa mara na kuzingatia ulaji wa vyakula unaofaa ili kujiepusha na hatari ya kupata magonjwa hayo. iv) Kuimarisha huduma za afya ya uzazi na mtoto nchini ili kupunguza idadi ya vifo vya wanawake na watoto vinavyotokana na Uzazi kwa kukarabati na kujenga Wodi Maalum kwa ajili ya Watoto wachanga (Neonatal Care Units) katika Hospitali za Rufaa za Mikoa 7 na Wodi za Wazazi na kujenga vyumba vya wagonjwa mahututi (ICU) wanaotokana na uzazi katika Hospitali za Rufaa za Mikoa (5) mitano yenye viwango vikubwa vya vifo vitokanavyo na uzazi. v) Kupunguza maambukizi ya Malaria, TB na VVU/UKIMWI; vi) Kuimarisha upatikanaji wa damu salama nchini ikiwa ni pamoja na ujenzi wa vituo vya kukusanyia Damu Salama (Satellite Blood Banks) vii) Kuimarisha upatikanaji wa dawa, vifaa, vifaa tiba na vitendanishi katika vituo vyote vya umma vya kutolea huduma za za afya nckiahini viii) Kuimarisha huduma za matibabu ya kibingwa nchini katika Hospitali za Rufaa za Mikoa, Hospitali za Rufaa za Kanda, Hospitali Maaluma na za Kitaifa ili kusogeza huduma hizi karibu zaidi na wananchi na kupunguza rufaa za nje ya nchi zisizo na ulazima ix) Kuimarisha ubora wa huduma zinazotolewa katika vituo vya afya vinavyomilikiwa na Serikali x) Kuboresha vyuo vya mafunzo ya afya ili kuendelea kuzalisha wataalam wenye ubora kwa kufanya upanuzi na ujenzi wa majengo na ukarabati kwenye Vyuo vya Mafunzo ya Afya vya Uuguzi vya Nachingwea, Kibondo, Kagemu, Kondoa, Same na Kiomboi; Vyuo vya Mafunzo ya Maafisa Afya vya Bombo Tanga, Mpwapwa na Ngudu Mwanza; vyuo vya Maafisa Tabibu vya Kibaha, Tanga na katika Chuo cha Maabara cha Singida xi) Kuimarisha Mifumo ya Habari, Takwimu na Teknolojia ili kurahisisha upatikanaji wa Takwimu katika sekta ya Afya. xii) Kuimarisha mfumo wa ugharimiaji wa huduma za afya nchini kwa kuongeza wigo wa huduma za bima ya afya kwa wananchi ili kufikia malengo ya kuwa na bima kwa wananchi wote na kufikia lengo la afya kwa wote (Universal Health Coverage – UHC) 124. Mheshimiwa Spika, ili kutekeleza vipaumbele vilivyoainishwa katika Fungu 52 kwa mwaka 2018/19, kazi zitakazotekelezwa zimeainishwa kwenye aya ya 199 mpaka 205 vya hotuba ya bajeti. 125. Mheshimiwa Spika, katika mwaka wa fedha 2018/19, Wizara kupitia fungu 53 (Idara kuu ya Maendeleo ya Jamii) imejiwekea vipaumbele vifuatavyo ili kuboresha utoaji wa huduma za afya nchini; (i) Kukuza usawa wa jinsia na uwezeshaji wa wanawake kiuchumi; (ii) Kuimarisha upatikanaji wa haki na huduma za ustawi wa jamii kwa wazee na watoto; (iii) Kuwezesha utekelezaji wa Mpango wa Taifa wa Kutokomeza Ukatili Dhidi ya Wanawake na Watoto wa mwaka 2017/18 – 2021/22 ili kupunguza ukatili dhidi yao kwa asilimia 50; (iv) Kuboresha mazingira ya kufundishia na kujifunzia katika Taasisi ya Maendeleo ya Jamii Tengeru na Taasisi ya Ustawi wa Jamii – Kijitonyama; (v) Kuboresha majengo na miundombinu katika makazi ya wazee, Makao ya Taifa ya Watoto Kurasini, mahabusu za watoto na Shule ya Maadilisho (vi) Kuweka mazingira wezeshi ili Mashirika Yasiyo ya Kiserikali kuchangia katika kuleta maendeleo ya Taifa; na (vii) Kuamsha ari ya wananchi kushiriki katika shughuli za maendeleo. 126. Mheshimiwa Spika, ili kutekeleza vipaumbele vilivyoainishwa katika Fungu 53 kwa mwaka 2018/19, kazi zitakazotekelezwa zimeainishwa kwenye aya ya 206 mpaka 213 vya hotuba ya bajeti. D: SHUKRANI 127. Mheshimiwa Spika, napenda kuchukua nafasi hii ya kipekee kuzishukuru nchi wahisani za Denmark, Canada, Ireland, Uswisi na Korea ya Kusini pamoja na Mashirika ya Maendeleo ya Kimataifa ya UNICEF na Benki ya Dunia kwa kutoa misaada katika Mfuko wa Pamoja wa Sekta ya Afya ambao umesaidia kwa kiasi kikubwa kuboresha huduma za afya nchini. Pia shukrani ziende kwa WHO, GAVI na Global Fund kwa mchango wao katika kutekeleza mikakati ya Sekta ya afya. Aidha, napenda kuzishukuru nchi za China, Cuba, Hispania, India, Italia, Japan, Marekani, Misri, Sweden, Uingereza, Ujerumani na Ufaransa na ambazo zimeendelea kuisaidia Sekta ya Afya kwa njia mbalimbali. 128. Mheshimiwa Spika, vilevile nayashukuru mashirika mengine ya Kimataifa kwa ushirikiano wao waliotoa kwa Wizara pamoja na Wadau wa Maendeleo ambao kwa pamoja wamewezesha wizara yangu kutekeleza mikakati ya kisekta na hivyo kuboresha upatikanaji wa huduma za afya nchini Wadau wote hawa wameainishwa kwenye Hotuba yangu kuanzia aya ya 214 mpaka ya 216. 129. Mheshimiwa Spika, katika kipindi hiki cha utendaji wangu wa kazi nikiwa Waziri, nimepata ushirikiano mkubwa kutoka kwa viongozi na wafanyakazi wa Wizara ya Afya, Maendeleo ya Jamii, Jinsia, Wazee na Watoto. Napenda kumshukuru Mheshimiwa Dkt. Faustine Ndugulile (Mb.), Naibu Waziri wa Afya, Maendeleo ya Jamii, Jinsia, Wazee na Watoto kwa ushirikiano anaonipa katika kutekeleza majukumu yangu. Aidha, naomba kuwashukuru Dkt. Mpoki M. Ulisubisya Katibu Mkuu (Afya) na Bibi Sihaba Nkinga Katibu Mkuu (Maendeleo ya Jamii, Jinsia, Wazee na Watoto) kwa mchango wao katika kuwezesha utekelezaji wa majukumu yangu. Vilevile, nawashukuru Prof. Muhammad Bakari Kambi, Mganga Mkuu wa Serikali, Makamishna, Wakurugenzi na Wakuu wa Vitengo vya Wizara. Nawashukuru pia, Mkurugenzi wa Hospitali ya Taifa Muhimbili Prof. Lawrence Museru, Mkurugenzi wa Taasisi ya Mifupa Muhimbili ( MOI) Dr. Respicious Boniface Rwezimula; Mkurugenzi wa Taasisi ya Moyo Jakaya Kikwete (JKCI), Prof. Mohamed Janabi; Mkurugenzi wa Taasisi ya Saratani ya Ocean Road (ORCI); Dr. Julius Mwaiselage; na Mkurugenzi wa Hospitali ya Benjamin Mkapa (BMH) Dkt. Alphonce Chandika; Mkurugenzi wa Hospitali Maalum ya Kibong’oto Dkt. Riziki Kisonga, Mkurugenzi wa Hospitali ya Afya ya Akili Mirembe Dkt. Erasmus Mndeme, Mkurugenzi wa Hospitali ya Rufaa ya Kanda Mbeya Dkt. Godlove Mbwanji; Mkurugenzi wa Hopsitali ya Rufaa ya Kanda Bugando Dkt Abel Makubi; Mkurugenzi wa Hospitali ya Rufaa ya Kanda ya KCMC Dkt Gilead Masenga. Aidha, nichukue fursa hii pia kuzishukuru Taasisi zilizo chini ya Wizara pamoja na Waganga Wakuu wa Mikoa na Wilaya, Waganga Wafawidhi wa Hospitali, Vituo vya Afya na Zahanati, Wakuu wa Vyuo vya Mafunzo vilivyo chini ya Wizara na wafanyakazi wote wa Wizara na Mashirika ya Dini (FBOs), ya kujitolea na Binafsi. Natoa shukrani kwa sekta zote ambazo tunashirikiana nazo katika kutoa huduma za afya, maendeleo ya jamii na ustawi wa jamii pamoja na wananchi wote kwa ushirikiano wao. Nawaasa waendelee kuzingatia misingi ya huduma bora na kufanya kazi kwa bidii kwa manufaa ya taifa letu. 130. Mheshimiwa Spika, natumia fursa hii kuishukuru familia yangu, kwa upendo na uvumilivu na kunitia moyo katika kutekeleza majukumu yangu ya Kitaifa. Aidha, Napenda kuwashukuru wananchi wote wa Mkoa wa Tanga kwa ushirikiano wanaoendelea kunipatia katika kuendeleza Mkoa wetu. Naahidi kuwa nitaendelea kuwatumikia kwa akili na nguvu zangu zote ili kuleta Maendeleo katika Mkoa wetu.   E: MAOMBI YA FEDHA KWA KAZI ZILIZOPANGWA KUTEKELEZWA KATIKA MWAKA WA FEDHA 2018/19 Fungu 52 - Afya Mapato 131. Mheshimiwa Spika, katika mwaka 2018/19 Wizara imekadiria kukusanya mapato ya Shilingi 240,042,508,157.00 Kati ya fedha hizo Shilingi 220,267,010,057.00 zitakusanywa katika mashirika na taasisi zilizo chini ya Wizara na Shilingi 19,775,498,100.00 ni kutoka makao makuu. Matumizi ya Kawaida 132. Mheshimiwa Spika, katika mwaka 2018/19, Wizara inakadiria kutumia kiasi cha Shilingi 304,473,476,000.00 kwa ajili ya Matumizi ya Kawaida. Kati ya fedha hizo, Shilingi 88,465,756,000.00 zitatumika kwa ajili ya Matumizi Mengineyo na Shilingi 216,007,720,000.00 zitatumika kwa ajili ya Mishahara ya Watumishi. Miradi ya Maendeleo 133. Mheshimiwa Spika, kwa upande wa shughuli za maendeleo, Wizara inakadiria kutumia Shilingi 561,759,999,000 kwa ajili ya Miradi ya Maendeleo. Kati ya hizo, fedha za ndani ni Shilingi 184,959,999,000 na fedha za nje ni Shilingi 376,800,000,000.00. Jumla ya Makadirio ya Bajeti kwa 2018/19 kwa Fungu 52 ni Shilingi 866,233,475,000.00 Fungu 53 – Maendeleo ya Jamii, Jinsia, Wazee na Watoto Mapato 134. Mheshimiwa Spika, katika mwaka 2018/19, Wizara imekadiria kukusanya Shilingi 3,090,796,000 kutokana na ada za wanafunzi kutoka Vyuo 8 vya Maendeleo ya Jamii na Chuo cha Ustawi wa Jamii Kisangara, ada ya usajili wa Mashirika Yasiyo ya Kiserikali na mauzo ya vitabu vya zabuni. Matumizi Kwa mwaka 2018/19 135. Mheshimiwa Spika, Bajeti ya Wizara kwa mwaka 2018/19 inakadiriwa kuwa Shilingi 32,140,649,000. Kati ya makadirio hayo, Matumizi ya Kawaida ni Shilingi 27,226,804,000 na Miradi ya Maendeleo ni Shilingi 4,913,845,000. Matumizi ya Kawaida 136. Mheshimiwa Spika, katika mwaka 2018/19, Wizara inakadiria kutumia kiasi cha Shilingi 27,226,804,000 kwa ajili ya Matumizi ya Kawaida. Kati ya fedha hizo, Shilingi 15,116,962,000 ni Mishahara ya watumishi na Shilingi 12,109,842,000 ni Matumizi Mengineyo. Miradi ya Maendeleo 137. Mheshimiwa Spika, kwa upande wa shughuli za maendeleo, Wizara inakadiria kutumia Shilingi 4,913,845,000 kwa ajili ya Miradi ya Maendeleo. Kati ya fedha hizo, Shilingi 1,500,000,000 ni fedha za ndani na Shilingi 3,413,845,000 ni fedha za nje. 138. Mheshimiwa Spika, Jumla kuu ya fedha inayoombwa kwa mwaka 2018/19, kwa Fungu 53 ni Shilingi 32,140,649,000. 139. Mheshimiwa Spika, Jumla kuu ya fedha inayoombwa kwa mwaka 2018/19, Shilingi 898,374,124,000 140. Mheshimiwa Spika, Hotuba hii inapatikana pia katika tovuti za Wizara ya Afya, Maendeleo ya Jamii, Jinsia, Wazee na Watoto www.moh.go.tz. na www.mcdgc.go.tz. 141. Mheshimiwa Spika, naomba kutoa hoja. *************** SUMMARY OF THE BUDGET SPEECH FOR THE FINANCIAL YEAR 2018/19 DELIVERED BY THE MINISTER OF HEALTH, COMMUNITY DEVELOPMENT, GENDER, ELDERLY AND CHILDREN, HONOURABLE UMMY A. MWALIMU (MP) A. INTRODUCTION 1. Honourable Speaker, following the report tabled by the Chairperson of the Parliamentary Standing Committee for Social and Community Development, which reviewed the budget of the Ministry of Health, Community Development, Gender, Elderly and Children, I now request your Parliament to receive and discuss the Ministry’s implementation report as well as the Ministry’s priorities for 2018/19. I would also like to request your esteemed House of Parliament, to accept and approve the estimated recurrent and development expenditures for the Ministry of Health, Community Development, Gender, Elderly and Children for 2018/19. 2. Honourable Speaker, first and foremost I would like to first and foremost, to thank The Almighty God for giving me the privilege to address this parliament. I would like to take this opportunity to humbly thank His Excellency, Dr John Pombe Joseph Magufuli, the President of the United Republic of Tanzania for his strong leadership. His guidance has provided me with clear vision when undertaking my responsibilities on improving health and social welfare services for our country. In addition, I congratulate His Excellency President for his continued support on prioritizing the health sector particularly by giving emphasis to construct local pharmaceutical industries. His Excellence emphasis will lead to the Tanzanians health improvement as an important means to reach middle-income country. 3. Honourable Speaker, I would like to extend my sincere gratitude to the Honourable Samia Suluhu Hassan, the Vice President of the United Republic of Tanzania for being a champion of health services improvement especially in the efforts to fight Tuberculosis, Maternal and Child Health, Non-Communicable diseases and Adolescent Health. My Ministry will continue to use her advice, influence and experience to ensure a healthy population that is free of preventable diseases. 4. Honourable Speaker, I would like to take this opportunity to thank Honourable Kassim Majaliwa (MP), the Prime Minister of the United Republic of Tanzania for his exemplary leadership that has contributed to improved government performance and hence improved health services provided by the Ministry. I would like to applaud him for his speech, which has provided us with a vision on how the Government will implement its obligations in 2018/19. 5. Honourable Speaker, I would like to congratulate you in person for undertaking your duties diligently in leading the National Assembly of the United Republic of Tanzania. I would like as well to congratulate Honourable Dr Tulia Ackson Mwansasu (MP) for undertaking her duties meticulously. I also congratulate all the Chairs of the Parliament for managing well the discussion in the National Assembly. 6. Honourable Speaker, I would like to take this opportunity to extend my sincere gratitude to the Parliamentary Standing Committee for Social Development and Services under the adept leadership of the Chairperson Honourable Peter Joseph Serukamba, (MP) and the Vice Chairperson Honourable Juma Nkamia (MP) for the guidance during the preparation of this budget. I also thank all Honourable Members of Parliament for your advice and cooperation that aim to improve health services and social welfare. Thank you very much. I promise that the Ministry will earnestly take your recommendations given in the implementation of our duties to serve the Tanzanians. 7. Honourable Speaker, please accept my sympathy to all Tanzanians whom have lost their relatives and friends due to many reasons including illness, accident and natural disasters. I sympathize with those admitted in hospitals and in their households and also to the survivors of abuse and gender based violence. I pray to our Almighty God to give them a quick recovery so that they can continue with their responsibilities of building our Nation towards Industrialization. 8. Honourable Speaker, after the above introductory remarks, I would now like to present to your esteemed House of Parliament the progress of activities implemented in the 2017/18 financial year, priorities for the year 2018/19 together with funding request that will allow the implementation of the Ministry’s obligations for year 2018/19. B: THE REVIEW OF BUDGET IMPLEMENTATION AND DEVELOPMENT PLAN FOR THE YEAR 2016/17 FINANCIAL YEAR 9. Honourable Speaker, the Ministry has continued to undertake its mandate as guided by the national and international Policies, Strategies and Plans, which include the Sustainable Development Goals (2015-2030), National Development Vision 2025, the Five Years Development Plan (2016/2017 – 2020/2021), Ruling Party (“Chama Cha Mapinduzi”) Manifesto (2015-2020), Health Policy (2007), Health Sector Strategic Plan IV (2015 – 2020), and agreed priority milestones in Joint Annual Health Sector Review (JAHSR), National Elderly Policy (2003), Social Development Policy (1996), Child Development Policy (2008), Women and Gender Development Policy (2000), Non-Governmental Organization National Policy (2001). 10. Honourable Speaker, In 2017/18 through vote 52, my Ministry in collaboration with other Ministries, Departments and Agencies and Development Partners planned to implement the following priorities in order to improve the provision of health services a. Strengthen Preventive, Curative and improve equity on service delivery, b. Strengthen Reproductive, Maternal, Newborn and Child Health in order to reduce maternal and child mortality, c. Improve availability of medicine, medical equipment, reagents and vaccines in health facilities, d. Improve Health Training Institutions infrastructure with the aim of increasing availability of Human Resource for Health, e. Strengthen country’s medical specialized services through construction, expansion, rehabilitation of infrastructure including health equipment installation at Muhimbili National Hospital (MNH), Muhimbili Orthopaedic Institute (MOI), Jakaya Kikwete Cardiac Institute (JKCI), Benjamin Mkapa Hospital (BMH), Ocean Road Cancer Institute (ORCI), Mirembe and Kibong’oto Specialized Hospitals, Bugando, KCMC, Mbeya and Mtwara Zonal Referral Hospitals, f. Improve Public Private Partnership in health service delivery provision g. Improve availability of nutritional services at community level and health facilities, h. Improve use of Information, Communication and Technology in strengthening health services provision i. Sensitize citizens enrolment to Health Insurance with the aim to ensure all citizens get quality health services 11. Honourable Speaker, through Vote 53, the Ministry planned to implement the following interventions: a) To coordinate implementation and monitoring of the National Plan of Action to End Violence Against Women and Children (2017/18 - 2021/22); b) To strengthen accessibility of rights, development and welfare of the child including children in conflict with the law; c) To facilitate destitutes elderly and most vulnerable children to acquire basic services; d) To sensitize community to build self-help spirit to participate in development; e) To educate community especially women to initiate and join various economic groups including SACCOS and VICOBA; f) To facilitate provision of social welfare services in elderly homes, retention homes, Approved School and National Children Home Kurasini; and g) To improve teaching and learning environment in Community Development Training and Social Welfare Institutes.   REVENUE AND EXPENDITURE -VOTE 52 12. Honourable Speaker, sources of revenue in vote 52 of my Ministry include income from revenue collection from Health Facilities, various Agencies, Boards and Councils that are under the Ministry, fees from Health Training Institutions, imprests retirements, sales of receipt books, sales of tender documents and collections from the services rendered by the Institutions and Agencies under the Ministry. Up to March 2018, the Ministry and its agencies collected TZS 162,891,572,942.00, which is equivalent to 72% of TZS 227,041,160,573.00 as estimated target for 2017/18. These achievements were contributed by: use of banks when making payments for health services, revenue collection sensitization, introduction of effective control mechanisms, improved working morale, strengthened health insurance services and improved use of Information, Communication and Technology in managing collection. 13. Honourable Speaker, during the financial year 2017/18, a total of TZS 1,077,701,892,000.00 was approved by your Parliament as budget to implement various activities. From the total approved budget, TZS 291,895,940,000.00 equivalent to 27 of the total budget was allocated for Recurrent Expenditure, whereas TZS 785,805,952,000.00 was allocated for Development Expenditure. 14. Honourable Speaker, Up to March 2018, the Ministry had received a total of TZS 617,507,623,167.00, which is 57 percent of the approved budget. Out of the received amount, TZS 216,736,325,825,824 equivalent to 74 percent was for Recurrent Expenditure. Out of the received amount for recurrent expenditure, TZS 68,814,900,939, which is equivalent to 73.3 % of allocated budget, was for Other Charges and TZS 147,921,424,885.00 equivalent to 26.7 percent was for Personnel Emolument. In addition, the Ministry received TZS 22,500,000,000 for goods and services and abroad treatment payment. Up to March 2018, the Ministry received TZS 400,771,297,343.00 equivalent to 51 of the approved budget for development. Out of the received budget for development, TZS 79,756,079,206 equivalent to 24 percent was from domestic sources and TZS 321,015,218,137.12 equivalent to 71 percent was received as External Financing. In addition, the Ministry received TZS 82,515,009,463.82 and send these funds to PO-RALG to refurbish health facilities in order to provide Comprehensive Emergency Obstetrics, Neonatal and Children Care (CEmONC). Out of funds sent to PO-RALG, TZS 63,015,009,462.82 was received from the World Bank and TZS 19,500,000,000.00 was received from the Health Basket Fund. Revenue and Expenditure – Vote 53 15. Honourable Speaker, in the year 2017/18, the Ministry through Vote 53 projected to collect a total of Shs. 2,101,874,000.00 as revenue from tuition fees payable by students enrolled in eight Community Development Training Institutes (CDTIs) namely: Buhare, Uyole, Rungemba, Mlale, Misungwi, Ruaha, Mabughai and Monduli; selling of tender document; and NGOs registration fees. Up to 31st March 2018, revenue amounting to Shs. 1,775,466,155, which is equivalent to 84 percent of the projected amount, was collected. 16. Honourable Speaker, in the year 2017/18, a total of Shs. 37,909,880,000 has been approved for the Ministry (Vote 53). Out of that Shs.19, 142,252,240 were for Personnel Emolument (PE), Shs. 16,161,349,760 was for Other Charges (OC) and Shs. 2,606,278,000 was for Development Budget. Up to 31st March 2018, a total of Shs.18, 352,527,400 equivalents to 48 percent of the budget was released and spent. Out of that, Shs. 8,848,331,727 equivalent to 55 percent was for OC, Shs. 8,470,927,127 equivalent to 44 percent was for Personnel Emolument (PE) for the Ministry and institutions under the Ministry; and Shs. 1,033,268,546 equivalent to 40 percent was for Development projects. 17. Honourable Speaker, the progress made in the implementation of Ministry’s priorities from July 2017 to March 2018 is as follows: IMPLEMENTATION OF RESPONSIBILITIES UNDER THE DEPARTMENT OF HEALTH PREVENTIVE SERVICES Immunization and Vaccine Development 18. Honourable Speaker, In 2016/17, the Ministry provided stewardship in children immunization services in order to ensure the national and global targets are met. Data from January to December 2017 shows that 101.2 percent of children targeted for the essential immunization were vaccinated. In December 2017, the Government of Tanzania was congratulated for reaching the highest target of 97 percent of children immunization on pentavalent vaccine according to 2016 statistics. The Global target through the World Health Organization (WHO) is to reach 90 percent of children immunized with pentavalent vaccine. The WHO and development partners congratulated the Government of Tanzania for reaching the target and for getting third position in WHO Afro Region after Zambia which attained 99 percent followed by Rwanda that attained 98 percent. 19. Honourable Speaker, Cervical Cancer is the leading cause of cancer thus led to high rates of deaths among women. Data from Ocean Road Cancer Institute in 2016/17 indicate that 32.8 percent of cancer incidence in the country is due to cervical cancer followed by breast cancer with the incidence of 12.9 percent. I am pleased to inform you that vaccination to girls aged 9 to 14 years can prevent cervical cancer. In 2017/18, the Government started to provide HPV vaccine to prevent cervical cancer. In 2018, the Government is immunizing HPV vaccine to all girls aged 14 due to the availability of the vaccine directly from the manufacturers. The Government targets to reach 616,734 girls with HPV vaccination by December 2018. The vaccination is safe and it is so far used in various African countries including Rwanda, Uganda, South Africa, Zambia and Lesotho. Through your Parliament, I urge parents and guardians with children to ensure girls with recommended age for HPV vaccination are immunized against cervical cancer. Sanitation and Environmental Health 20. Honourable Speaker, the Ministry has continued with the coordination of National Campaign of Sanitation and Environmental Health which is implemented by all councils in order to control disease outbreak particularly cholera. Activities for sanitation and environmental health are highlighted on paragraph 22 to 24 of budget speech. 21. Honourable Speaker, the Ministry has continued with the efforts to control Cholera outbreak in the country. From July 2017 to March 2018, there were 4,508 cholera cases and 92 deaths were reported in Songwe, Dodoma, Ruvuma and Mbeya. I would like to urge Leaders from all regions to ensure efforts control of Cholera outbreak remains a permanent priority in all plans. Reproductive, Maternal and Child Health 22. Honourable Speaker, In the efforts to strengthen Reproductive, Maternal and Child Health, the Ministry has continued with the five years (2016 to 2020) implementation plan which aims to strengthen reproductive, maternal, child and adolescent health. In addition, the plan aims to reduce mortality due to maternal causes to 292 per 100,000 by 2020. In order to implement the plan, the Ministry will focus in three main areas: family planning services, antenatal care and obstetrics services. 23. Honourable Speaker, Family planning services are essential in improving maternal and child health and also to reduce deaths related to maternal causes. From July 2017 to March 2018, the Ministry procured and distributed family planning commodities to health facilities. Family planning services was provided to 519,817 clients through outreach services and whereas 424,595 clients received the services from health facilities.   24. Honourable Speaker, the availability of health services during pregnancy is important intervention to reduce maternal deaths since most complications can be prevented, diagnosed and treated provided pregnant women attend antenatal clinic and attended by skilled attendants within twelve weeks of pregnancy. In 2017/18, the Ministry continued to ensure that antenatal services are provided together with educating pregnant mothers the importance of attending antenatal clinic. By March 2018, data from health facilities indicate that 81.7 of pregnant women attended antenatal clinic at least once through the entire gestation period. The target is to reach 70 percent of pregnant women attending at least 4 times throughout the gestation period. I use this opportunity to emphasize to all pregnant women to attend antenatal clinic as advised by service providers. 25. Honourable Speaker, In 2017/18, the Ministry in collaboration with development partners has continued to sensitize and emphasize pregnant women to deliver from health facilities. The aim is to ensure the number of women delivering from health facilities is increasing to 68.5 percent per month by March 2018 from 64 percent in 2015/16. I would like to emphasize that all pregnant women countrywide to deliver from health facilities in order to reduce maternal and child mortality and complications. 26. Honourable Speaker, reduction of under five mortality is among the Ministry’s priorities. According to One Health Plan for Maternal and Child Health (2016-2020), by 2020, the Government is determined to reduce neonatal mortality to 16 from 21 per 1,000 live births, infant mortality ratio to 25 from 45 per 1,000 live births and under five mortality ration from to 40 from 54 per 1,000 live births. 27. Honourable Speaker, the Ministry in collaboration with stakeholders has continued to improve infrastructure at health facilities to enable provision of Comprehensive Emergency, Obstetrics and Neonatal Care (CEmONC) to pregnant women. The Ministry in collaboration with PO-RALG is improving infrastructure to provide CEmONC services in 208 health facilities (as stated in the PO-RALG budget speech). By March 2018, infrastructure improvement was at different stage of implementation. This improvement is done in the following areas: operating theatres, maternity wards, health laboratory and staff houses. The number of public health facilities providing CEmONC services will increase to 283 out 527 facilities once the infrastructure improvement is completed, 28. Honourable Speaker, My Ministry has continued with the efforts to control reproductive cancers including cervical cancer, breast cancer and prostate cancer. In order to ensure availability of diagnostic and curative services for early signs of cervical and breast cancer, the Ministry in collaboration with stakeholders has established 100 newly established facilities for early detection and treatment of cervical cancer in Mbeya, Mwanza, Songwe, Geita, Dodoma, Singida, Manayara, Arusha, Tanga, Lindi, Mtwara, Simiyu, Mara and Ruvuma. HIV Control 29. Honourable Speaker, From July to December 2017, 5,164,297 individuals were tested and received results of their HIV status. Among those tested, 145,104 equivalent to 2.8 percent were HIV positive and ARV’s was initiated to them. According to December 2017 statistics, there were 965,081 individuals on ARV’s which is 69 percent of 1,400,000 that are estimated to be living with HIV in which 55,034 equivalent to 5.7 percent are children. According to the above statistics, Tanzania is remained with 21 percent to reach the global target of 90 percent of individuals living with HIV to be initiated of ARV’s. The Ministry has put in place various mechanism to ensure the target is reached. 30. Honourable Speaker, The Ministry has continued to provide services for Prevention of Mother to Child Transmission of HIV (PMTCT). By December 2017, a total of 1,967,260 equivalent to 98 percent of 1,993,639 pregnant women had HIV counselling and testing. Among those, 79,242 pregnant women equivalent to 4 percent were HIV positive. Among those tested positive, 79,240 pregnant mothers equivalent to 99.9 percent were initiated with ARV’s. The current status of Mother to Child Transmission of HIV is 4.9 percent compared to 12 percent in 2011. Control of Tuberculosis and Leprosy 31. Honourable Speaker, The Ministry is continuing with efforts to control Tuberculosis (TB) and Leprosy. From July 2017 to March 2018, the Government procured and distributed health commodities fro Tuberculosis and Leprosy. In order to ensure the Government improves Tuberculosis services to children, my Ministry launched a new TB treatment regimen for children. This new regimen is improved combined therapy (RHZ/RH), which has good taste of fruits and it dissolve easily in water thus no need to be broken down for correct dosage. 32. Honourable Speaker, My Ministry has expanded diagnostic services for TB by using gene-Xpert machines. The machines are distributed to all district hospitals in order to increase diagnosis of TB cases. In 2017/18, the Government in collaboration with stakeholders procured and distributed 189 gene-Xpert machines compared to 66 machine that were in the country in 2015. These machines are distributed to all Zonal and Regional Referral hospitals, district hospitals and in some of large health centres. The technology in this machine allows the results to be obtained within two hours instead of 24 hours results from the microscope. In addition, the machines have the ability to diagnose multiple drug resistant TB. 33. Honourable Speaker, Through the Government commitment to collaborate with the Private Sector in fighting against Tuberculosis particularly to increase diagnosis of TB cases from 40 to 70 by 2020, my Ministry distributed five (5) gene-Xpert machines to private hospitals in Dar es Salaam. The hospitals that received the machines in which each one costs TZS 38 million are Agakhan, Hubert Karuk, Regency Medical Centre, TMJ and Hindu Mandal. The Ministry distributed the machines in these Hospitals since they are seeing a large number of patients and also their willingness to diagnose and treat TB cases. In addition, this partnership aligns with the vision of our fifth phase government under the leadership of His Excellency Dr. John Pombe Magufuli, The President Of The United Republic of Tanzania of reaching every household with quality health services. Let me use this opportunity to congratulate the Private Sector for their participation to fight against TB in the country. 34. Honourable Speaker, My Ministry has continued with the effort of increasing the provision of treatment of Multi Drug Resistant TB (MDR-TB). From July 2017 to March 2018, the Ministry increased 41 health facilities and makes a total of 63 health facilities that provide decentralized MDR-TB treatment services compared to only one-facility Kibong’oto Specialized services in 2015. The regions that provide decentralized MDR-TB include Dar es Salaam, Kagera, Geita, Mtwara, Lindi, Mbeya, Pwani, Morogoro, Tanga, Unguja, Tabora, Kigoma, Mwanza, Arusha, Rukwa and Simiyu. In addition, the Ministry has initiated short term MDR TB treatment regimen from twenty to nine months. 35. Honourable Speaker, in the efforts to fight against Leprosy, the Ministry investigated Leprosy at the community level in six regions that have high incidence of Leprosy cases i.e. Geita (Chato), Lindi (Liwale), Mtwara (Nanyumbu), Morogoro (Kilombero) and Tanga (Mkinga and Muheza). In the exercise, 500 individuals were tested whereby 54 individuals equivalent to 10.8 percent were diagnosed with Leprosy and were initiated treatment, and approximately 300 individuals were given preventive treatment. Malaria Control 36. Honourable Speaker, Malaria has continued to be the leading cause of mortality. From January to December 2017, statistics indicates that 5,592,844 individuals had malaria where 4,421 died from the disease. In order to reduce malaria cases, the Ministry has continued with the implementation of various interventions to fight against the disease. These interventions include procurement and distribution of medicines, medical equipment and reagents in health facilities. In order to prevent malaria transmission particularly in special groups i.e. pregnant women and children, the Government distributed 4,726,763 long lasting insecticide nets at no cost through school children and in antenatal and children clinics. 37. Honourable Speaker, In the implementing the directive from President of the United Republic of Tanzania, Hon Dr. John Pombe Magufuli of eliminating malaria by using larvicide, the Ministry in collaboration with PO-RALG has coordinated the distribution of 236,420 liters of biolarvicide in all councils. The implementation of this intervention is on different stages at council level. Control of Neglected Tropical Diseases 38. Honourable Speaker, Through the implementation of various interventions mentioned from paragraph 48 to 49 of budget speech, 93 councils have succeeded to reduce transmission of filariasis and elephantiasis thus being removed from the list of councils participating in preventive exercise according to WHO guideline. This is a great achievement where approximate 20,446,532 are not at a risk to get transmission of those diseases. Nutrition Services 39. Honourable Speaker, In the fight against malnutrition in children, my Ministry in collaboration with nutrition stakeholders has provided vitamin A drops to children from six months to five years together with deworming of children from one to five years. In addition, the Ministry has continued to treat malnourished children by increasing the number of health facilities providing malnutrition treatment, improving infrastructure in facilities admitting malnutrition cases, strengthening system to improve availability of food, medicines and equipment to diagnose nutritional status and capacity building to service providers. Health Promotion 40. Honourable Speaker the Ministry has continued with health promotion and sensitization to community on prevention and undertaking periodic health checks in order to maintain good health. The Ministry through Health Education Unit has developed communication strategy, which will enable quick response in case of emergency or disease outbreaks. Capacity building has been provided to Regional Health Management Teams that are bordering other countries. CURATIVE SERVICES Registration of health care facilities 41. Honourable Speaker, the Ministry continued to ensure availability of health services through public, private and faith based owned health facilities. By March 2018, there were a total of 7,437 health care facilities compared to 7,284 in June 2017. Further, in the period from July 2017 to March 2018, a total of 153 private health facilities were registered. Improving the Provision of Specialised Services 42. Honourable Speaker, in year 2017/18, among the priorities of the Ministry included improving and strengthening provision of specialised services to reduce referrals abroad and cost associated with it. By March 2018, number of patients that were referred abroad for treatment was 103 compared to 304 patients in 2016/17. This is a result of improved specialized services in referral hospitals under the Ministry. A total of 1,090,863 patients were attended in MNH, MOI, JKCI, ORCI, BMH, Mirembe Mental Hospital, Kibong’oto Hospital, Mbeya Zonal Referral Hospital, KCMC and Bugando Medical Center. Details of patients attended is shown in Attachment Number 2 of the budget speech. Muhimbili National Hospital (MNH) 43. Honourable Speaker, in year 2017/18, MNH renovated the building and procured equipment for kidney transplant which started in November 2017. Five patients are planned to get renal transplant by April 2018. This has reduced renal transplant cost from an average of TZS 100 Million abroad to TZS 20 Million when it is done in the country. 44. Honourable Speaker, the hospital has started cochlea implant transplant in which by March 2018, six patients received the service to improve hearing. The service is given at a cost of TZS 36 Million compared to TZS 80 to 100 Million when patients were referred abroad. Muhimbili Orthopaedic Institute (MOI) 45. Honourable Speaker, in February 2018, the institute managed for the first time to conduct laparoscopic spine surgery in collaboration with Doctors from BLK, India. The surgery that was very successful aimed also to build capacity of Doctors at MOI. Further, the institute finalized phase 3 expansion and procurement of equipment using TZS 16.5 Billion received end of financial year 2016/17. Implemented interventions are listed in paragraph 64 of the speech. Jakaya Kikwete Cardiac Institute (JKCI) 46. Honourable Speaker, the JKCI attended a total of 42,029 patients with cardiac problems. 111 patients underwent surgery of which 52 were adults and 59 children. Further 157 patients had cardiac catheterization surgery. The institute can now offer cardiac specialized services at 85 percent that were initially referred abroad. This has reduced Government cost to refer patients abroad in which by March 2018 only 12 cardiac patients were referred compared to 43 patients in 2016/17. Ocean Road Cancer Institute (ORCI) 47. Honourable Speaker, the Ministry continued to improve services for cancer patients in which the institute procured new radiotherapy equipment worthy TZS 473,363,437.50 This has improved number of patients receiving treatment per day from 30 to 70. The institute continue with installation of Linear Accelerator 2 and CT Simulator that were procured at cost of TZS 9.5 Billion. Once the installation is completed it will reduce patients’ treatment waiting time from 6 to 2 weeks and improve treatment outcome. In addition, 7 staff are in training abroad. 48. Honourable Speaker, in year 2017/18, the institute has started private services with 4 VIP rooms and 20 private rooms. This will improve service and increase revenue. Benjamin Mkapa Hospital - Dodoma 49. Honourable Speaker, in improving provision of specialised services, on 22nd March 2018, the hospital in collaboration with TOKUSHIKAI Medical Group from Japan conducted renal transplant for the first time to 51 years old patient. The patient is doing well and has been discharged home. The hospital has established an ICU services. Availability of medicines has been at 95.2 percent for the period from July 2017 to March 2018. Mirembe Mental Health Clinic 50. Honourable Speaker, the Mirembe Mental Health Hospital and Isanga Institute have continued to provide services to mental health patients and availability of medicines have improved into 90 percent for essential mental health drugs. Kibong’oto TB Referral Hospital 51. Honourable Speaker, in year 2017/18, the hospital continued to provide diagnostic and treatment services for Tuberculosis, Multi Drug Resistant Tb, HIV and other infectious diseases. Further, the hospital has trained 239 (Medical Doctors, Nurses, Laboratory Technologists and Pharmacists) from different regions building capacity to initiate MDR-TB treatment. Mbeya Zonal Referral Hospital 52. Honourable Speaker, the hospital has continued to improve infrastructure for provision of specialized services as elaborated in paragraph 82 of the speech. Availability of medicines has been at 95 percent. Bugando Medical Center (BMC) 53. Honourable Speaker, the Lake Zone Referral Hospital, Bugando has continued to provide specialized services in 8 regions in West Lake Zone namely Mwanza, Geita, Mara, Kagera, Simiyu, Kigoma, Shinyanga, and Tabora. In the period from July 2017 to March 2018, the hospital conducted 72 surgeries for patients with large intestine and stomach cancers, Nose, Ear and Throat together with spine diseases. A total of 131 patients with cervical cancer received radiotherapy. In addition, the hospital procured a CT Scan (128 slice) at a cost of TZS 1.7 Billion from own source. Northern Zone Referral Hospital (KCMC) 54. Honourable Speaker, the hospital continued to improve provision of specialized services to people in northen regions of Kilimanjaro, Arusha, Manyar and Tanga. A total of 1,123 cancer patients were managed in which 47 received palliative care. Regional Referral Hospitals 55. Honourable Speaker, the oversight and coordination of Regional Referral hospital that were initially done by the PORALG has been shifted the Ministry. There are 28 Regional Referral Hospitals. In the period from July 2017 to March 2018, a total of 1,637,835 patients received treatment in these hospitals. 56. Honourable Speaker, the Ministry has set long and short term targets to ensure that specialised services are provided in the Regional Referral Hospitals. These services include general surgery, Obstetrics and Gynaecology, Paediatrics and Child Health, Internal Medicine, Dentistry and Radiology. Non-Communicable Diseases (NCDs) 57. Honourable Speaker, I would like to inform your esteemed Parliament that there has been an increase in Non-Communicable Diseases in the country. Study done by NIMR in 2012 has shown that, 26 percent of Tanzanians have obesity, 26 percent have high levels of cholesterol, 9.1 percent have Diabetes Mellitus and 25.9 have Blood Pressure. In addition, the study showed that 25 percent of population participated in the study live sedentary life. 58. Honourable Speaker, the Ministry has continued with the fight against NCD focus being prevention since Prevention is better than cure. Let me congratulate your esteemed parliament for establishing Parliamentarians Platform to fight against NCD in order improve their knowledge for prevention of NCD. Blood Transfusion Services 59. Honourable Speaker, The National Blood Transfusion Services (NBTS) has continued with the collection, storage and distribution of safe blood in health facilities. From July 2017 to March 2018, NBTS collected 233,953 bottles of safe blood, which is 101 percent of the target. I would like to use this forum, to thank all the individuals that donated blood. In addition, I would like to urge all Tanzanians to donate blood frequently in order to save patients lives particularly for pregnant women and under five children. Availability of Medicines, Medical Equipment and Reagents 60. Honourable speaker, My Ministry has continued to ensure medicines; medical equipment and reagents are available in health facilities. Availability of health commodities at MSD has continued to improve and reach an average of 81 percent availability of essential health commodities. In addition, availability of immunization health commodities is 92 percent whereas for ARVs commodities are 100 percent. 61. Honourable speaker, The Ministry in collaboration with the Ministry of Industries and Trade called stakeholders meeting that aim to sensitize local entrepreneurs to construct pharmaceutical industries following the directive from Honourable Dr John Pombe Magufuli, the President of United Republic of Tanzania. A total of 430 stakeholder attended the meeting and 38 investors shoed interest to construct industries that will produce Intravenous Infusions, syringes, and health commodities consumables. The construction of local pharmaceutical industries will lead to financial savings by the government from foreign pharmaceutical procurement; In addition, this initiative will increase local pharmaceutical production from 6 percent and reduce pharmaceutical imports from 94 percent.   HEALTH SERVICE QUALITY ASSURANCE 62. Honourable speaker, the Ministry has continued with Star Rating assessment. From July 2017 to March 2018, the Ministry conducted a second star rating reassessment of primary health facilities in 14 regions (Dar es Salaam, Iringa, Geita, Kagera, Katavi, Kigoma, Mara, Mwanza, Pwani, Tanga, Tabora, Singida, Simiyu and Shinyanga). The results of the reassessment show that, 446 facilities (4.7%) scored zero star and 749 facilities (19.4%) scored 1-4 star compared to the initial assessment of 2016 where 1,233 facilities (33%) of 3,713 facilities scored 0 star and 62 facilities (2%) scored 3 and above rating. These results show improved quality of health service delivery in primary health facilities where majority of the population are getting their services. HUMAN RESOURCES FOR HEALTH 63. Honourable Speaker, the Ministry in collaboration with National Council for Technical Education (NACTE) to ensure provision of quality training for the health care cadres not receiving degree. From July 2017 to March 2018, a total of 16,214 students were enrolled in public and private training health institutions in nursing, allied health and community health programs. 64. Honourable Speaker, the Ministry in collaboration with various development partners continued to provide in service short and long term sponsorship to employees. From July 2017 to March 2018, 376 employees received local and abroad scholarships in Masters Program particularly specialized training in surgery, obstetrics and gynaecology, paediatrics, internal medicine and radiology. 65. Honourable Speaker, In 2017/18, the Ministry received 3,152 employment permits from the Presidents Office – Public Service Management and Good Governance. 66. Honourable Speaker, my Ministry has continued to improve working environment for public service employees particularly those working in hard to reach areas. From July 2017 to March 2018, the Ministry completed 30 staff houses in hard to reach areas of 3 councils (Manyara, Kiteto and Simanjiro) from the Global Fund Health Systems Strengthening (HSS) Program. The completed construction of these houses has increased the number of houses to 480 under the Global Fund HSS program. HEALTH CARE FINANCING 67. Honourable Speaker, the Government endeavours to ensure the targets for Universal Health Coverage (UHC) are reached. In order to reach UHC, each citizen is required to receive health services without financial hardship. The target is to ensure by 2020, 70 percent of the population are enrolled in Health Insurance Fund. Currently, 32 percent of the population is enrolled in various Insurance Funds. I would like to request Honourable Members of Parliament to continue to educate all citizens the importance of enrolling and pay for health insurance in order to get health services without any financial hardships. 68. Honourable Speaker, the Ministry in collaboration with PO-RALG has started the implementation of transferring funds directly to the health facilities known as Direct Health Facility Financing (DHFF) instead of transferring funds to LGAs. This initiative aims to improve efficiency in funds utilization and improve effectiveness of health service coverage. INFORMATION AND COMMUNICATION TECHNOLOGY 69. Honourable Speaker, the Ministry continued to implement eHealth Strategy 2013-2018. In year 2017/18, the Ministry in collaboration with President’s Office Regional Administration and Local Government and Bill and Melinda Gates Foundation through PATH initiated Digital Health Investment Recommendation Roadmap. The Roadmap outlines priorities in in use of electronic systems aiming at improving health services at all levels of service provision and importance of data collection and correct use of data in health sector. In addition, the Ministry have installed electronic immunization information system in 1303 health care facilities in Arusha, Kilimanjaro, Tanga, Manyara and Dodoma regions. A total of 3,258 health care workers have been trained on how to use the system. IMPLEMENTATION OF DEVELOPMENT PROJECTS FUNDED 70. Honourable Speaker, in year 2017/18, the Ministry allocated TZS 785,805,952,000 for implementation of development projects. Out of these TZS 336,300,000,000 were from domestic sources while TZS 449,505,952,000 were from external sources. Projects implemented with domestic resources 71. Honourable Speaker, the Ministry received at total of TZS 74,756,079,206.00 (domestic resources) between July 2017 and March 2018 for implementation of development projects highlighted in paragraph 128 of the Budget Speech. Projects implemented with external resources 72. Honourable Speaker, in the period between July 2017 and March 2018, the Ministry received TZS 403,530,227,600.94 from external resources that included cash and medical commodities (medicines, equipment and reagents) as elaborated below: Health Basket Fund The Health Basket Fund funded implementation of interventions listed in paragraph 129 of the Speech. Result Based Financing 73. Honourable Speaker, from July 2017 to March 2018, the Ministry in collaboration with PORALG renovated a total of 1,325 public owned health facilities in Shinyanga, Mwanza, Coast, Tabora, Simiyu, Kigoma, Kagera and Geita regions. In addition, a total of TZS 3,425,162,919 was disbursed to Regional and Council Health Management Teams for service provision incentive payment at both levels. Improving CEmONC services 74. Honourable Speaker, one of the government priorities in the financial year 2017/18 is reducing maternal and neonatal mortality. The Government in collaboration with development partners have started infrastructure improvement plan to enable selected health centres to provide comprehensive emergency maternal, obstetric and neonatal care services. A total of 208 health centers will benefit using TZS 40,000,000,000.00 from World Bank, TZS 19,500,000,000.00 from Denmark. Funds were disbursed to district councils for implementation and the Ministry and PORALG are providing oversight. In addition, the Ministry in collaboration with PORALG is finalizing a list of additional 21 health centres that will be renovated using Health Basket Fund funds. Global Fund to fight AIDS, TB and Malaria 75. Honourable Speaker, from July 2017 to March 2018, the Ministry received from the Global Fund TZS 303,238,541,795.37 that includes cash and medical commodities for the fight against AIDS, Tuberculosis and Malaria. THE BUDGET IMPLEMENTATION FOR INSTITUTIONS UNDER THE MINISTRY Medical Stores Department (MSD) 76. Honourable Speaker, in financial year 2017/18, the MSD continued to implement he government directive to procure directly from the manufacturers using Framework Agreement. Total of 110 manufacturers have contracts with the MSD, out of which 10 are local manufacturers. This arrangement has resulted into price reduction of 109 medicines by 40 percent. Further, the MSD has continued to improve its distribution in order to ensure constant availability of medicines at health care facilities by 100 percent. Through the GFATM support, a total of 181 fleets have been procured and His Excellence Dr John Pombe Magufuli, the President of the United Republic of Tanzania inaugurated on 26th March 2018. National Health Insurance Fund (NHIF) 77. Honourable Speaker, the NHIF continued to implement different strategies in order to increase members. As a result of implementing the strategies from July 2017 to March 2018, the Fund have managed to enrol 167,791 new members from both public and private sectors that is 97 percent of the target. The beneficiaries have therefore increased from 3,491,400 members in 2016/17 to 3,619,697 members in March 2018, which is seven percent of all Tanzanians. This shows that, members have increased at an average of 10 percent and beneficiaries have increased by 7 percent over a period of five years. 78. Honourable Speaker, the Ministry in collaboration with PORALG and NHIF have continued to implement Community Health Fund (CHF). In the period from July 2017 to March 2018, new family enrolled into CHF was 66,026 and this making up a total of 2,096,692 families compared to 2,030,666 families that were recruited in year 2016/17. Further, beneficiaries have increased from 12,183,996 in 2016/17 to 12,580,149 beneficiaries in March 2018, which makes up a total of 25 percent of all Tanzanians. 79. Honourable Speaker, in the period from July 2017 to March 2018, a total of 199,954 pregnant women and 20,998 children were enrolled in NHIF through Tumaini la Mama Initiative. This makes a total of 875,375 women who have benefited from 2012 in Mbeya, Tanga, Lindi, Mtwara and Songwe regions. In addition, paragraph 141 to 144 of the Speech describes other NHIF achievement during this financial year. Tanzania Food and Drug Authority (TFDA) 80. Honourable Speaker, the Ministry through TFDA is implementing a new five years strategic plan (2017/18 – 2021/22). The TFDA processed applications for registration of new product manufacturers/processors and outcome of the audit and inspection is shown in paragraph 146 and 147 of the budget speech. Further, the TFDA continued with community education through radio, television, newspapers and social media. 81. Honourable Speaker, in year 2017/18, electronic registration system have been developed and in operation. This has reduced registration-processing time. In addition, the TFDA have successful put the information on registered products in the web site hence accessible through www.tfda.go.tz/portal/registered-products. Government Chemist Laboratory Authority (GCLA) 82. Honourable Speaker, in year 2017/18, the institution that was Government Chemist Laboratory Agency was changed to be Government Chemist Laboratory Authority through Act. No. 8 (2016). In order to improve its performance, the Authority has signed three contracts to procure laboratory equipment worthy TZS 1.4 Billion that are expected to be delivered before June 2018. In addition, renovation of the DNA laboratory at Headquarters in Dar es Salaam has started and completion is expected by June 2018. Tanzania Food and Nutrition Centre (TFNC) 83. Honourable Speaker, the TFNC continued to implement its mandate to improve provision of nutrition services in the country. In implementing the Government target to reduce infant mortality, the TFNC coordinated Vitamin A Mass Drug Administration to children aged 6 to 59 months together with drugs for intestinal helminths for children aged 12 to 59 months. Emphasis this time around was to regions that have not reached WHO proposed target of 90 percent. National Institute for Medical Research (NIMR) 84. Honourable Speaker, the Ministry through NIMR continued to conduct research. These include researches on HIV Vaccines trial, alternative medicines, mother and child health, malaria and Tuberculosis. Outcomes of these researches have helped in planning interventions for these diseases. Further, NIMR in collaboration with stakeholders have conducted an assessment on availability of safe water and clean environment in health facilities where delivery services are provided. Results of the study showed that, 19 percent of health facilities use unsafe water sources; 46.5 percent of the tested water had various bacteria; 42 percent of labour wards had no facility for hand washing and 10 percent had poor toilets which increase chances for contacting infection. 85. Honourable Speaker, the Ministry is planning to work on the findings of the researches with aim of improving preventive services in collaboration with PORALG in order to ensure that local government authorities set aside budget to implement the reported weaknesses. IMPLEMENTATION OF RESPONSIBILITIES UNDER COMMUNITY DEVELOPMENT Women Empowerment 86. Honourable Speaker, the Ministry in collaboration with the President’s Office – Regional Administration and Local Government Authorities (PO-RALG) has continued to coordinate implementation of the interventions under the Women Development Fund (WDF). In the year 2017/18, the Ministry continued to advocate and mobilize Local Government Authorities to ensure allocation of five percent of their revenues from own internal sources to WDF. From July 2017 to February 2018, a total of 170 out of 185 LGAs contributed Shs. 7.3 billion to the WDF compared to Shs. 8.9 billion for the 2016/17 allocations. The amount of funds contributed to the Women Development Fund in the year 2017/18 is equivalent to 26 percent of the planned total contributions of Shs. 28.3 billion in the corresponding year. In addition, the allocation benefited a total of 4,365 Women Groups with 39,449 women entrepreneurs through soft loans. I believe that by the end of June 2018 the contributions by LGAs to the WDF will increase to meet the target. I therefore, call upon District Executive Directors from all LGAs to contribute to the WDF as planned. 87. Honourable Speaker, The Ministry in collaboration with Mtwara District Councils has empowered four women’s groups with 20 members on entrepreneurship skills and business management, record keeping, savings and repayment of loans. A total of Shs. 69 million from Ministry’s WDF was given directly to the women groups in Mtwara Region. The loans provided enabled them to construct two dams and to fence them for the purpose of fish farming, increase the areas for horticulture from four acres to eight acres and increase infrastructures/building for poultry farming. 88. Honourable Speaker, during the year 2017/18, the Ministry in collaboration with PO-RALG coordinated sensitization of women to start and join income generating groups (SACCOS na VICOBA) during pretesting of the implementation of the Sensitization Guideline for Women to Establish and Enrol in Economic Groups at Rombo District Council in Kilimanjaro and Mvomero District Council in Morogoro Regions. As a result of the sensitization, a total of 88 groups with a total of 1,807 (Female 1,517 and Male 1,807) were established. These groups have facilitated members to contribute and increase the capital to a total of Shs. 50 million and enabled them to invest in various business and income generating activities including farming and livestock keeping. 89. Honourable Speaker, in the year 2017/18, the Ministry launched and coordinated implementation of the programme of Mentoring Groups. This programme aims at helping inexperienced women entrepreneurs by linking them with the experienced and beneficiaries of WDF and women’s economic groups which are performing well so that they can learn. The programme is being implemented in six Regions in Pwani, Kigoma, Songwe, Katavi, Rukwa and Mbeya. For the period of July 2017 to March 2018, a total of 30 Women entrepreneurship were linked to 25 groups which are performing well in these regions. Furthermore, through this programme, a total of 1,131 women has been trained in entrepreneurship and products improvement and linked with TFDA, TBS and SIDO for the purposes of getting assistance and advice on management of their business and products. 90. Honourable Speaker, the Ministry in collaboration with different stakeholders; SIDO, EOTF and NEEC continued to facilitate involvement of women in International Trade Fair. In the year 2017/18, a total of 1,183 Women Entrepreneurs from 26 Regions of Tanzania were enabled to participate in National Trade Fair (Nane nane), the participants managed to learn different skills for improving their products and obtain experience on market from other participants. 91. Honourable Speaker, the Ministry through Tanzania Women’s Bank continued to provide financial services including soft loans with low interest rate and training in entrepreneurship especially to women in 7 Regions namely; Dar es Salaam, Mwanza, Dodoma, Iringa, Ruvuma, Njombe na Mbeya. In the year 2017/18, 6,237 Entrepreneurs (Female 5,097 and Male 1,140) have been given loan compared to 6,267 Entrepreneurs (Female 4,596 and Male 1,671) in the year 2016/17. These efforts enabled 87,063 Entrepreneurs (Female 71,744 and Male 15,319) to get loan from year 2010. In addiction, in the year 2017/18, the bank issued loans amounting to Shs. 10.1 billion compared to Shs. billion 13.3 in the year 2016. The total amount of loan issued by the Bank since 2010 to March, 2018 amounts to Shs. 131.9 billion. 92. Honourable Speaker, the Women’s Bank opened 244 credit centres for provision of soft loans and training to Women Entrepreneurs in Dar es Salaam (115), Mwanza (46), Dodoma (27), Mbeya (5), Iringa (9), Ruvuma (24) and Njombe (18) Regions in the year 2017/18 as compared to 88 credit centres opened in 2016/17 equivalent to 177 Percent increase. The Tanzania Women’s Bank also sensitized the communities on the importance of income saving through by opening savings bank accounts. In the year 2017/18, a total of 10,415 (Female 7,811 and Male 2,604) were opened and by the end of March, 2018 accounts were opened in two branches of Tanzania Women’s Bank (Mkwepu and Mjasiriamali Branches) from year 2009. In these two branches, 65,419 accounts were women accounts equivalent to 74 Percent, 20,961 accounts were for men and 2,017 accounts were for Companies. 93. Honourable Speaker, Gender based violence is still a challenge in the country. According to the Police Crime Report of 2017, incidents of gender-based violence were 41,416 in year 2017 compared to 31,996 incidents in year 2016. In order to solve this problem the Ministry has been coordinating the implementation of National Plan of Action to end Violence Against Women and Children (2017/18 – 2021/22). The goal of this plan is to reduce the incidence of gender based violence in Tanzania by 50 percent in the year 2022. In the year 2017/18, the Ministry in collaboration with stakeholders has trained Women and Children Protection Committees in the Regions and Local Government on how to deal with Violence against Women and Children. In addition, a total of 52 Coordinators of women and children protection committee from Regional Secretariats have been trained to coordinate interventions on Gender Based Violence. Also Women and Children Committees from 19 Local Government Authorities of Kasulu (W), Kasulu (TC), Kibondo, Kakonko, Kibaha, Ludewa, Kaliua, Wanging’ombe, Rungwe, Kyela, Mbeya (DC), Kiteto, Mkuranga, Busega, Busenga, Dodoma (M), Uyui, Tabora (M) and Rufiji have been trained on protection of violence against women and children. Community Development 94. Honourable Speaker, The Ministry has continued encouraging communities to participate in development activities in their localities and getting them involved in development projects through labour contribution and use of locally available resources. In a period between July 2017 to March 2018, Ministry has conducted substantial sensitizations in 11 regions; Iringa, Dodoma, Mwanza, Pwani, Kigoma, Katavi, Rukwa, Songwe, Mbeya, Kagera and Shinyanga. Through that; construction of Mondo Health Centre, in Misungwi District (Mwanza) has been accomplished; construction of water dam Maghangu Mpwapwa (Dodoma) has been done; construction of Ufyambe Dispensary (Iringa); construction of Secondary School and Health Centre – Uvinza (Kigoma); construction of Secondary School and Health Centre – Mpanda (Katavi); construction of Health Centre – Sumbawanga (Rukwa); construction of Health Centre – Mbozi (Songwe); construction of Secondary School – Mbeya Municipal (Mbeya) has been completed; cash contribution and facilities by local community for staff house construction responsible for Elderly Resident House (Kagera); launching of One Stop Centre for GBV and Child Abuse Kahama District (Shinyanga); construction of classrooms Chambasi Village, Kisarawe (Pwani). All these projects cost a total of 229,127,100 Tanzanian Shillings, out of which 112,341,250 Tanzanian Shillings equivalent to 49.03 percent is in kind community contribution and save part of the money that could initially be used for the projects. In addition, it has brought a sense of project ownership among community members and ensures sustainability. 95. Honourable Speaker, In the year 2017/18, 175 community development experts from 26 regional secretariats and 184 from Local Authorities were capacitated on how to motivate communities to participate in country industrialization initiatives, implementation of National Plan of Action to End Violence Against Women and Children (2017/18 - 2021/22) and on women economic empowerment particularly on production of agriculture, livestock and fisheries products that will then produce raw materials to feed micro and small industries in their respective areas. 96. Honourable Speaker, Ministry has continued supervising and coordinating production of Community Development experts in its 8 Community Development Training Institutes (CDTIs) namely; Buhare, Mlale, Misungwi, Rungemba, Mabughai, Ruaha, Uyole and Monduli. These institutes are offering Community Development training in Certificate and Diploma levels. In 2017/18, a total of 1,588 students (984 females and 604 males) were admitted compared to 3,248 students (1,987 females and 1,261 males) admitted in 2016/17. Moreover, in 2017/18, a total of 3,320 students (1,947 females and 1,373 males) graduated in all 8 CDTIs compared to 3,694 graduands (2,228 females and 1,466 males) in 2016/17. 97. Honourable Speaker, Ministry has reviewed curriculum for community development training to produce competent graduates to meet the existing labour market demand as well as the evolving science and technology. The reviewed curriculum will be used in 6 CDTIs of Buhare, Ruaha, Uyole, Mlale, Monduli and Rungemba. On the other hand, curriculum on Community Development and Civil Engineering was reviewed in 2016/17. Non-Governmental Organizations 98. Honourable Speaker, the Ministry have continued to coordinate Non Governmental Organizations through creation of enabling environment for NGOs to operate effectively and efficiently in bringing sustainable national development. From July 2017 to March 2018 a total of 192 NGO’s were registered. Out of the 21 NGOs were registered at International level, 162 National levels and 9 District level. This made up a total number of 8,211 NGO’s registered from 2005 to March 2018. These NGOs have contributed towards improving social services delivery in sectors of Health, Education, Water, Environment, Agriculture, Human rights, Good Governance, Gender Development, Livestock and Fisheries, Wildlife and Energy. 99. Honourable Speaker, in ensuring that NGOs operates in accordance to laws, rules and regulations of the country, the Ministry conducted verification exercise of NGOs whereby 4,868 NGOs were verified. However, during the process the Ministry identified 513 NGOs that were registered under other legislations and incorporated them under the NGOs Act No. 24, 2002. The exercise has strengthened coordination of NGOs in the areas of transparency, information sharing and accountability. Child Rights and Development 100. Honourable Speaker, Violence against children is still a major problem in the country. According to the Crime and Traffic Incidents Statistics Report of 2017, the incidents of child abuse were 13,457 compared to 10,551 incidents in 2016, which is equivalent to an increase of 28 percent. We believe that the increase is due to the ongoing Parenting Education to families, which has been provided by the Government. The training has raised awareness to community to understand the importance of reporting incident of violence in the relevant authority. In addressing the problem, the Ministry in collaboration with stakeholders has continued to implement the National Plan of Action to End Violence Against Women and Children (2017/18 - 2021/22). In 2017/18, the activities implemented included to provide education on the impact of cultural and cultural practices such as Female Genital Mutilation, teenage pregnancy and early marriages in various group in communities. A total of 13,020 community members were provide education on the effects of harmful traditional practices; whereby 8,546 students, 476 teachers, 56 traditional leaders, 64 religious leaders, 38 “ngariba”, 168 bodaboda drivers, 3,600 parents/guardians and 72 community and local authority from Shinyanga, Mara, Tabora, Lindi, Dodoma, Tanga, Dar es Salaam and Katavi. 101. Honourable Speaker, The Ministry in collaboration with the stakeholders has continued to provide care for victims of child abuse through the Child Help Line. In 2017/18, a total number of 18,464 calls were received about violence against children. Out of which 1,072 (female 621 and Male 451) children calls concerns were facilitated through access to different services (food, school supplies, legal services and health) compared to 441 children (female 325 and Male 96) who received the services in 2016/17 which is equivalent to an increase of 143 percent. 102. Honourable Speaker, The Ministry has continued to take action to prevent child abuse by building the capacity of 1,192 caregivers of victims to violence on how to handle cases of children who has experienced violence. The service providers include: Regional Police Investigators, Regional Police, Military Police Officers, Community Development Officers, Social Welfare Officers and members of child protection teams from 15 Councils in 7 regions. 103. Honourable Speaker, Girls have been experiencing various obstacles in achieving their goals including: teenage pregnancy and early marriages. According to the Maternal and Child Health Survey and Tanzania Malaria Indicators of 2015/16, teenage pregnancy is 27 percent. The leading regions are Katavi (45%), Tabora (43%), Dodoma (39%), Morogoro (39%) and Mara (37%). In dealing with child marriages and teenage pregnancies, the Ministry has launched a campaign to end teenage Pregnancy in primary and secondary schools “Mimi msichana najitambua Elimu ndio Mpango Mzima”: The campaign was launched during the commemoration of International Day of the Girl Child which was done in Tarime - Mara on 11/10/2017. The campaign aims at promoting awareness to girls in primary and secondary schools to focus on their education, self-awareness and reporting of any violations of their rights. In addition, 13,284 community members, (8,546) students, (476) teachers, (110) religious leaders, 90 traditional and influential leaders, (38) ngariba, (261) bodaboda drivers, (3,600) parents/guardians and (113) community and local authority leaders from Shinyanga, Tabora, Lindi, Dodoma, Dar es Salaam, Tanga, Mara and Katavi were given education about the effects of pregnancy and childhood. 104. Honourable Speaker, in ensuring that children participate fully in their development issue, in 2017/18 the Ministry has continued to facilitate child participation in junior councils and girls' clubs that aimed at preventing teenage pregnancies and increase their participation in the development agenda. The total of 13 children's councils and 600 clubs in primary and secondary schools have been established for the period from July 2017 to March 2018, with a total of 1,669 councils and 2,000 clubs. The Early Childhood, Care and Development Services 105. Honourable Speaker, the Ministry continued to support and coordinated the provision of Early Childhood, Care and Development Services in the country for the year 2017/18 to children under 5 years in the Day Care Centres for both public and private owned. From July, 2017 to March, 2018 a total of 139 were registered and issued with licences as compared to 270 Day Care Centres registered and issued with licences in the year 2016/17. This makes a total of 1,046 Day Care Centres which have been registered in the country. Furthermore, a total of 6,075 children (girls 4,018 and boys 2,057) were registered in Day Care Centres in the year 2016/17 as compared to 4,450 children (girls 3,097 and boys 1,353) in the year 2015/16. 106. Honourable Speaker, in order to ensure that the care givers provide required care and support to children registered in these day care centres, the Ministry trained a total 600 care givers from Municipalities of Ubungo, Temeke, Ilala and Kigamboni. Care givers were trained on early childhood care and development and the establishment and management of day care centres. In addition, the Ministry directed the owners of the Day Care Centres to recruit and deploy qualified care givers as per the government guidelines and directives. Up to March, 2018, a total of 1,882 care givers were deployed as compared to 1,652 care givers who were deployed in the year 2016/17 equivalent to an increase of 14 percent. 107. Honourable Speaker, in the year 2017/18, the Ministry continued to produce experts on early childhood care and development through Kisangara Training Institute of Social Welfare. A total of 83 students were enrolled for certificate course of Early Childhood Care and Development (58 females and 25 males) compared to 56 students (females 39 and 17 males) who were enrolled during the year 2016/17. In additional, a total of 52 students (35 females and 17 males) graduated in the year 2017/18 compared to 8 female graduates in the year 2016/17. Child Welfare Services 108. Honourable Speaker, in the year 2017/18 the Ministry in collaboration with Civil Society Organizations (CSOs) continued to ensure that the Most Vulnerable Children access their basic care, support and protection services. A total of 6,132 Most Vulnerable Children (2,972 girls and 3,160 boys) received basic care, support and protection services from 157 children’s homes owned by both government and private owned children’s homes compared to 4,515 Most Vulnerable Children (2519 girls and 1,996 boys) in the year 2016/17. Out of the Most Vulnerable Children cared for in these homes, a total of 78 children (43 girls and 35 boys) are cared for in the National Children Home Kurasini. Furthermore, for the period of July, 2017 to March, 2018, a total of 14 licences were issued compared to 50 licences which were issued for the same period in the year 2016/17, this makes a total of 157 registered children’s homes in the country, including one national owned children home. The rest of these children’s homes are privately owned. I would like to take this opportunity to call upon all children’s home managers who have not registered their homes to do so immediately in their respective councils. 109. Honourable Speaker, in the year 2017/18, the Ministry in collaboration with the Railway Children Africa (RCA) conducted assessment of the children living and working in streets in 12 councils namely Ilala, Kinondoni, Temeke, Kigamboni, Ubungo, Arusha, Iringa, Mbeya City, Mbeya DC, Dodoma DC, Nyamagana MC na Ilemela MC. A total number of 6,393 (1,528 girls and 4,865 boys) working and living on the streets were identified from December 2017 to January, 2018. Out of identified children, a total of 1,385 children (410 girls and 975 boys) were living and working in the streets during the night time. The Ministry is currently implementing the strategy (Community Based Rehabilitation Programme) to ensure that children living and working in the street are reunified with their families. Out of identified children, a total of 952 children (83 girls and 869 boys) have been reunified with their families. 110. Honourable Speaker, The Ministry continued to ensure that children who are in conflict with the law, access basic rights including; legal services and education in five retention homes of Mbeya, Moshi, Tanga, Arusha and Dar es Salaam. In 2017/18, a total of 291 children in conflict with the law (13 females and 278 males) were facilitated with basic services such as food, shelter, clothes, medical services and education including legal services compared to 255 children (18 females and Me males) in 2016/17 equivalent to an increase of 14 percent. In addition, the Ministry in collaboration with Roman Catholic Church Arch Diocese of Dar es Salaam improved the infrustructure at Dar es Salaam retention home by drilling the borehore well together with instalation of water tank with capacity of 10,000 litres. 111. Honourable Speaker, the Ministry in collaboration with the Ministry of Constitution and Legal Affairs has diverted a total of 126 children (24 female and 102males) from the formal criminal system by rehabilitating their behaviour and reunifying them with their families compared with 72 children (8 female and 64 males) diverted in 2016/17 equivalent to an increase of 67 percent. Likewise, in 2017/18, the Ministry continued to provide basic needs (food, shelter, clothes and medical services) including rehabilitation of behaviour, education and training to 35 male children who committed criminal offences residing at Irambo Approved School in Mbeya compared to 72 children in 2016/17. In 2017, Irambo Approved School ranked number one in National Standard VII Mock Examination at Mbeya DC and all children passed the Standard VII National Examination. 112. Honourable Speaker, In 2017/18, the Ministry in collaboration with PORALG continued to ensure that children are cared at the family level according to the Law of the Child Act No. 21 of 2009 by providing foster care and adoption services. The Ministry facilitated the foster care services to 44 children (24 females and 20 males) compared to 54 children (21 female and 33 male) in 2016/17. Moreover, 17 children (8 males and 9 females) were adopted in 2017/18 compared to 21 children (11 female and 10 male) in 2016/17. 113. Honourable Speaker, the Ministry continued to recruit Fit Persons in order to provide care, support and protection to most vulnerable children. This effort enabled the identification of 187 Fit Persons in 19 councils by 2017/18. Up to March, 2018, a total of 243 has been cared by Fit Persons in 19 councils which are; Magu DC, Kasulu DC, Kasulu TC, Musoma DC, Iringa MC, Iringa DC, Mufindi DC, Njombe DC, Makete DC, Mbeya Jiji, Mbeya DC, Mbarali DC, Hai DC, Temeke DC, Arusha DC, Kakonko DC, Kibondo DC, Misenyi DC na Chunya DC. Fit Persons are selected by community members within the community to care for Most Vulnerable Children. Elderly Welfare Services 114. Honourable Speaker, the Ministry continued to coordinate accessibility of basic services to destitutes elderly. In 2017/18, total of 517 destitutes elderly (Ke 250 na Me 267) cared in 17 government elderly homes provided with basic services such as - food, shelter, clothes and medical services compared to 465 destitutes elderly (221 female and 244 male) in 2016/17 equivalent to an increase of 11 percent. In addition, the Ministry continued to improve environment for provision of social welfare services at 17 gonernment owned erlderly by constructing the dormitory with the capacity to accommodate 20 destitutes elderly (10 female and 10 males) at Kolandoto elderly home and facilitate of 10 tri-motor cycle, kitchen utensils and first aid kits in all 17 elderly homes. 115. Honourable Speaker, the Ministry in collaboration with PO-RALG has facilitated 506,943 elderly (female 220,312 and male 286,631) to acquire health identity cards for free medical services for the period of July, 2017 to March, 2018 compared to 74,590 elderly who acquired health identity cards in 2016/17. This effort makes a total of 581,533 elderly (female 254,793 and male 326,740) who acquired health identity cards which is 35 percent of 1,657,206 elderly identified in all Councils. Provision of health identity cards for free medical a service is a transitional stage towards acquire National Health Insurance Cards which will facilitate smooth accessibility of free Health services. In addition, during the commemoration of the International World Elderly Day held in Dodoma on 01/10/2017 whereby a total of 320 elderly undergone medical check up and advice. Marriage Disputes Reconciliation and Maintenance to Children 116. Honourable Speaker, in the year 2017/18 the Ministry through Marriage Reconciliation Board which is under the Commissioner for Social Welfare and Social Welfare Offices at the council levels has continued to provide reconciliation and counselling services to families. For the period of July, 2017 to March, 2018, a total of 13,382 marriage disputes were received and reconciliated in various councils and under the Commissioner Marriage Reconciliation Board compared to 8,454 marriage disputes in the year 2016/17. Out of marriage cases received, 11,326 cases equivalent to 85 percent were reconciliated, 1,397 equivalent to 10 percent were sent to court and 659 cases equivalent to 5 percent are still in progress. 117. Honourable Speaker, in ensuring that children receive basic services from their parents, the Ministry continued to work on maintenance cases reported in the country. For the period of July, 2017 to March, 2018, a total of 11,815 maintenance cases were received. Out of received cases, a total of 4,965 maintenance cases were children in matrimonial and 5,708 were affiliation cases. In addition, out of maintenance cases received, 10,673 cases were closed and 1,142 cases were referred to court compared to 12,406 cases closed in 2016/17 (matrimonial cases 6,557, affiliation cases 4,133 and 1,716 cases refereed to court). NATIONAL AND INTERNATIONAL COOPERATION 118. Honourable Speaker, the Ministry in collaboration with PO-RALG and sectoral stakeholders will continue to commemorate various National and International Community and Social Welfare Services for the aim of sensitizing and convey message to the public. Some of those days are; Women, Children, Family, Elderly and Girl Child Days IMPLEMENTATION OF RESPONSIBILITIES OF INSTITUTIONS UNDER COMMUNITY DEVELOPMENT Tengeru Institute of Community Development 119. Honourable Speaker, in 2017/18, Tengeru Institute of Community Development registered a total of 1,169 students equivalent to 86 per cent increase compared to 628 students registered in 2016/17. Out of registered students, 486 were enrolled at Certificate level, 83 Diploma and 600 Bachelor Degree. Likewise, 684 students graduated in 2017/18 compared to 609 students graduated in 2016/17 which is 12 per cent increase. 120. Honourable Speaker, Institute has conducted three major researches; Baseline Survey in Kikwe Village – Arumeru District, Vulnerability of Children in Informal Sector – Arumeru District (Children working on Public Markets) and Challenges Confronting Community Development Officers in Local Government Authorities. Findings of these researches will improve trainings on community development as well as implementation of community development activities in Local Government Authorities (LGAs). Institute of Social Welfare – Kijitonyama 121. Honourable Speaker, the Institute of Social Welfare – Kijitonyama continued to offer social welfare training at certificate, diploma, bachelor’s degree, postgraduate diploma and master’s degree. In the year 2017/18, a total of 1,185 students (female 811 and male 374) were enrolled in different courses. Out of students enrolled, 421 students were enrolled at certificate level, 409 students at diploma level, 315 students at degree level, 28 students at postgraduate diploma level and 12 students at master’s degree level. In addition, a total of 1122 students (female 722 and male 400) graduated in the year 2016/17 in various levels and courses compared to 1,172 students (female 789 and male 383) graduated in the year 2015/16 with an increase of 4.2 percent. C: THE MINISTRY’S PRIORITIES IN YEAR 2018/19 122. 117. Honourable Speaker, in year 2018/19, the Ministry through Vote 52 (Health Department) has set the following priorities in order to improve health care services in the country; i. To strengthen immunization services for children to maintain the high coverage in order to prevent children from diseases that can be prevented with vaccination. ii. To strengthen preventive services for diseases that are prevented through adhering to cleanliness regulations including clean environment such as diarrhoeal diseases. iii. To strengthen preventive services against non-communicable diseases such as Cardiac diseases, Diabetes Mellitus and cancers through raising public awareness to prevent themselves from risk behaviour and build a habit to exercise regularly. iv. To strengthen maternal and child health services in the country in order to reduce maternal and neonatal mortality through renovation of neonatal care units in seven Regional Referral Hospital and postnatal wards and ICU in five RRH in the regions with highest maternal mortality. v. To reduce HIV/AIDS, TB and Malaria new infections. vi. To improve availability of safe blood including construction of satellite blood banks. vii. To improve availability of medicines, equipment and reagents in all public health facilities in the country. viii. To strengthen availability of specialized services in RRH, Zonal Referral Hospitals and National Special Hospital. ix. To improve quality of services provided in the public health facilities. x. To improve health training institutions infrastructure in Nursing Training Institutions of Nachingwe, Kibondo, Kagemu, Kondoa, Same and Kiomboi; Clinical Officers Training Institutions of Tanga, Mpwapwa and Ngudu; Assistant Medical Officer Training Institutions of Kibaha and Tanga; Singida Laboratory Training Institution. xi. To improve Informationa communication Technology in order to improve availability of data in health sector. xii. To strengthen health financing system and increase coverage of pre-payment schemes towards universal health coverage-UHC. 123. Honourable Speaker, to implement the highlighted priorities in Vote 52 for year 2018/19, the interventions are listed in paragraph 199 to 205 of the budget speech. However, I would like to mention high priority interventions below: i. Procure and distribute children vaccines andHPV vaccines for girls between 9 and 14 years in which TZS 30 Billion is allocated. ii. Scale up TB case identification countrywide. A total of TZS 5 Billion is allocated. iii. Renovate and construct neonatal care units in seven RRH of Dar es Salaam, Katavi, Geita, Rukwa, Kilimanjaro, Iringa and Kigoma. A total of TZS 900 Million is allocated for this activity. iv. To expand maternity ward and establish ICU in RRH in five regions of Mbeya, Shinyanga, Morogoro, Coast and Kigoma, TZS 1 Billion will be used. v. To improve availability of safe blood through construction of Satellite Blood Banks in 12 regions of Manyara, Katavi, Rukwa, Ruvuma, Njombe, Tanga, Arusha, Coast, Singida, Songwe, Geita and Simiyu in which TZS 4.3 Billion is allocated. vi. To procure and distribute Sulphadoxine+Pyrimethamine anti malaria for pregnant women and all other lifesaving medicines for pregnant women. A total of TZS 8.5 Billion is allocated. vii. To procure and distribute beds, mattresses, bed sheets and delivery beds in which TZS 4.9 is allocated. viii. To improve medicines, equipment and reagents availability. A total of TZS 270 Billion is set aside. ix. To continue with renal transplant services at Muhimbili National Hospital and Benjamin Mkapa Hospital. x. To continue with cochlear transplant services at MNH. xi. To procure and install modern cancer diagnostic and treatment equipment at Ocean Road Cancer Institute in which TZS 14.5 Billion is allocated. xii. To continue with construction of bunkers and procurement of radiotherapy equipment for Mbeya Zonal Referral Hospital. xiii. To procure and distribute 27 ambulances in order to improve referral system in the country. xiv. To renovate RRH in which a total of TZS 20 Billion is allocated. xv. To continue with construction of RRH in regions with no RRH namely Simiyu, Katavi, Songwe, Mara and Njombe in which TZS 10 Billion is allocated. xvi. To renovate health training institutions and a total of TZS 8 Billion is allocated. MINISTRY’S PRIORITIES FOR THE YEAR 2018/19 - VOTE 53 124. Honourable Speaker, In the year 2018/19, Ministry through vote 53 will implement the following priorities: (i) Improve gender equality and women empowerment; (ii) Strengthen accessibility to the social welfare services and rights to elderly and children; (iii) Facilitate implementation of the National Plan of Action to end Violence Against Women and Children in order to reduce it by 50%. (iv) Improve teaching and learning environment at Tengeru Institute of Community Development and Institute of Social Welfare – Kijitonyama; (v) Improve buildings and infrastructure in Elderly Homes, National Children Home - Kurasini, Retention Homes and Approved School - Irambo; (vi) Enable friendly environment for NGOs to contribute in national development initiatives; and (vii) Sensitize community to build self-help spirit to participate in development. 125. Honourable Speaker, In order to implement the priorities for the year 2018/19, the Ministry will implement the following activities: Promoting Gender Equality and Women Empowerment 126. Honourable Speaker, the Ministry will continue to implement various interventions in promoting gender equality and women empowerment by undertaking the following activities: (i) To coordinate sensitization of women to initiate and join various economic groups including SACCOS and VICOBA and link them with loans opportunities; (ii) To mainstream gender issues in the Policy, Plans and Sectoral Strategies; and (iii) To eliminate gender based violence especially against women by implementing the National Plan of Action to end Violence Against Women and Children (2017/2018 – 2021/22). Community Development 127. Honourable Speaker, in implementation of the priorities for 2018/19, the Ministry will do the following: (i) Continue to revive community self-esteem and morale on participating in implementation of development projects in their localities; (ii) Evaluate Community Development Policy of 1996; and (iii) Improve learning and teaching environment in Community Development Institutes. Non-Government Organizations 128. Honourable Speaker, The Ministry will continue to enhance enabling environment for NGOs effective participation in contributing towards social welfare and national development through implementing the following: i. Register Non-Governmental Organizations; ii. Monitor implementation of NGOs undertakings to ensure their contribution towards development and to comply with NGOs Act, No.24, 2002; and iii. Evaluate performance of the NGOs Policy of 2001. Child Rights and Development 129. Honourable Speaker, during the year 2018/19, the Ministry will continue implementing various measures/interventions to ensure that children obtain their rights by implementing the following: (i) Assessing the implementation of the Child Development Policy of 2008; (ii) Strengthening the status of the child's basic rights; Assessing the implementation of the 2008 Child Development Policy; (iii) Promote awareness of the community in protecting child rights, welfare of the development; with (iv) Continuing to implement the National Plan of Action to End violence Against Women and Children in 2017/18 - 2021/22. Social Welfare Services 130. Honourable Speaker, in the year 2018/19 the Ministry in collaboration with partners will continue to implement the following: (i) To facilitate rehabilitation of infrastructures at Mwanzage, Bukumbi and Misufini elderly homes; (ii) To complete construction of Mtwara Retention Home and rehabilitate Mbeya and Arusha Retention Homes; (iii) To strengthen child protection services; (iv) To facilitate the accessibility of early childhood care and development services; (v) To provide basic services to most vulnerable children and children in conflict with the law; (vi) To register homes for most vulnerable children (vii) To improve the accessibility of rights and services to the destitute elderly. Human Resource for Community and Social Welfare Sector 131. Honourable Speaker, the Ministry will continue to oversee provision of community development and social welfare training at eight Community Development Training Institutes (CDTIs), Kisangara Institute of Social Welfare, Tengeru Institute of Community Development and Institute of Social Welfare – Kijitonyama. In the year 2018/19, the Ministry will implement the following activities: (i) To enroll 6,848 students. Of whom 3,653 students will be enrolled at eight CDTIs, 50 students at Kisangara Institute of Social Welfare, 1,200 students at Tengeru Institute of Community Development and 1,945 students at Institute of Social Welfare – Kijitonyama; (ii) To facilitate provision of on-job training to lecturers and tutors at Master’s and PhD levels; (iii) To improve infrastructures at Mlale, Misungwi and Uyole CDTIs; and (iv) To employ tutors and lecturers at CDTIs, Kisangara Institute of Social Welfare, Tengeru Institute of Community Development and Institute of Social Welfare – Kijitonyama. ACKNOWLEDGEMENTS 132. Honourable Speaker, I would like to take this opportunity to express my appreciation to Denmark, Canada, Ireland, Switzerland and South Korea together with UNICEF and World Bank for their contribution to the Health Basket Fund which has contributed largely in improving health services in the country. In addition, special thanks should go to WHO, GAVI and GFATM for their huge contribution in implementation of the health sector strategic plan. Further, I would like to thank China, Cuba, Spain, India, Italy, Japan, United States of America, Egypt, Sweden, United Kingdom, Germany and France that have continued to support the health sector through various modalities. 133. Honourable Speaker, I would like to also thank all other International organizations for the support and collaboration to improve the health sector. They are all listed in paragraph 214 to 216 of the budget speech. 134. Honourable Speaker, in my current role as a Minister, I have received great support from the management and employees of the Ministry of Health, Community Development, Gender, Elderly and Children. I would to thank Honourable Dr Faustine Ndungulile (MP), Deputy Minister of Health, Community Development, Gender, Elderly and Children for his collaboration in implementation of my responsibilities as a Minister. I also thank Dr Mpoki M. Ulisubisya, Permanent Secretary (Health) and Ms Sihaba Nkinga, Permanent Secretary (Community Development, Gender, Elderly and Children) for their contribution while executing my duties. In addition, I would like to thank Prof. Muhammad Bakari Kambi, the Chief Medical Officer, Commissioners, Directors and Head of Sections in the Ministry. My gratitude also goes to the Director of Muhimbili National Hospital, Prof. Lawrence Museru, Director of Muhimbili Orthopaedic Institute (MOI), Dr. Respicious Boniface Rwezimula; Directors of Jakaya Kikwete Heart Institute, Prof. Mohamed Janabi; Directors of Ocean Road Cancer Institute, Dr Julius Mwaiselage; Directors of Benjamin Mkapa Hospital, Dr Alphonce Chandika; Directors of Kibong’oto Special Hospital, Dr Riziki Kisonga; Directors of Mirembe Mental Health Hospital, Dr Erasmus Mndeme; Directors of Mbeya Zonal Referral Hospital, Dr Godlove Mbwanji; Directors of KCMC Zonal Referral Hospital, Dr Gilead Masenga. Directors of the Institutions under my Ministry, Regional and District Medical Officers, Medical Officers In charge in Hospitals, Health Centres and Dispensaries, Principals of Health Training Institutions which are under the Ministry and all the employees under the Ministry and Faith Based Organizations, Voluntary Organizations and Private Sector. I thank all other sectors that we collaborate with in providing health, community development and social welfare to all citizens for their collaboration. I urge them to continue focusing on the principals of quality services and work diligently for the benefit of our nation. 135. Honourable Speaker, may I now express my sincere gratitude to my family for their love, patience and encouragement that have enabled me to implement my duties of serving the nation. I also take this opportunity to thank the people of Tanga region for their cooperation and commitment in developing our region. I would like to assure you that I will continue to serve you diligently in order to accelerate development in our region. THE FUND REQUEST FOR THE IMPLEMENTATION OF PLANNED ACTIVITIES FOR THE YEAR 2017/18 Vote 52- Health Revenue 136. Honourable Speaker, for the year 2018/19, the Ministry has estimated to collect revenue amounting to TZS 240,042,508,157.00. From this amount the institutions under the Ministry will collect TZS 220,267,010,057.00 while TZS 19,775,498,100.00 will be collected from the Ministry’s Headquarters. Recurrent Expenditure 137. Honourable Speaker, for the year 2018/19, the Ministry estimates to use TZS 304,473,476,000.00 for recurrent expenditure. From this amount, TZS 88,465,756,000.00 will be used for Other Charges expenditure whereas TZS 216,007,720,000.00 will be used for Personnel Emolument expenditure. Development Projects 138. Honourable Speaker, for the year 2018/19, the Ministry estimates to use TZS 561,759,999,000.00 for the Development Projects. From this amount, the domestic source is TZS 184,956,999,000.00 whereas from external source is TZS 376,800,000,000.00. The Total Budget estimates for 2018/19 in vote 52 is TZS 866,233,475,000.00 139. Honourable Speaker, the total Budget that is requested for the Ministry for 2018/19, is TZS 898,374,124,000.00 140. Honourable Speaker, The Ministry budget speech is also available at the Ministry of Health, Community Development, Gender, Elderly and Children Websites www.moh.go.tz and www.mcdgc.go.tz 141. Honourable Speaker, I beg to Submit.

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