MKAJI Programme

Maji Kwa Afya ya Jamii (MKAJI) is Swahili for ‘Water for community health’ . Water supplies in the Dodoma region of Tanzania are either malfunctioning or non-existent. This poses a great health problem, especially at primary health care level where the majority, almost 70%, of the population seeks healthcare services.

On request of the Tanzanian government the MKAJI project started in 2014 to improve conditions in rural healthcare facilities in the central region of Dodoma.  By improving access to safe water and improved sanitation and hygiene, the health facilities can offer better health care services to  pregnant women and mothers with small children, and help prevent infections. Over the past 5 years of implementation the MKAJI project upgraded 94 health facilities out of the total of 404 in the Dodoma region.

The donor of the project is the Swiss Agency for Development and Cooperation (SDC).

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Overall objective

Improve access to water, sanitation and hygiene promotion in 94 selected public primary health care facilities in the Dodoma region’s 8 district councils.

Specific objectives

  1. Improve access to water, sanitation and hygiene in 94 selected public primary health facilities in 8 districts of the Dodoma region
  2. Strengthen the governance and community participation in water management at public primary health facilities
  3. Promote sanitation and hygiene measures and practices at public primary health facilities
  4. Integrate gender and social accountability aspects in the implementation process.
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Public Private Partnership

The project is a public private partnership that works with the Netherlands based engineer consultancy firm Witteveen+Bos, local construction contractors, two local NGO’s and local government authorities. The MKAJI project implements unique custom constructions that are designed by the projects engineers and are up to date with the global standards for WASH in healthcare. For the actual construction of the hardware the project works with local private businesses stimulating the local economy.

Hardware and Software

For the water supply scheme the project specializes in three sustainable designs: rain water harvesting, borehole drilling or a connection to the existing network. The choice of water supply scheme varies per village as it is depend on the context which solution is the best fit. With regards to sanitation and hygiene we implement waste water drainage systems,  construct toilets, bathrooms for women near the labour room, internal pipe works and handwashing basins in every room of the health facility.

However, the construction and implementation of hardware water solutions is only half of the work we do. Training and creating ownership within the communities, the software side, is just as important. All our trainings contribute to the sustainability of knowledge and a lasting effect of the project’s efforts.

Therefore, we train local technicians, community members, health facility staff, traditional birth attendants, local and regional government on WASH practices. This will contribute to the long-term functionality of the constructions and gives the community the know-how to sustain the implemented infrastructure and knowledge. We provide trainings on the following issues:

  • Business models and finance to ensure the water committee in place is equipped with the knowledge to set up a fair and healthy business model for the new water supply.
  • Operation & maintenance of the implemented infrastructures.
  • Water governance. Staff’s from the health facility, the village leaders and the water committee members are trained on the political, social, economic and administrative systems in place that influence water’s use and management. Essentially, who gets what water, when and how, and who has the right to water and related services, and their benefits.
  • Health facility staffs are trained on hygiene measures and protocols for equipment, personal hygiene and hygiene in the building and premises Improving the conditions of their work place to create an infection free environment for the patients, but also for themselves.
  • Traditional birth attendants, community health workers and health facility staff are trained on safe motherhood and hygiene (promoting skilled facility-based deliveries) and the special needs of women in WASH. With this training the MKAJI project aims to reach even those who live most remote and secluded.
  • Social accountability trainings are provided to create a system of regular dialogue between the patients (users) and staff (providers) of the health care facility to discuss problems and find solutions together. From a government perspective the social accountability actions implemented aim to achieve long-term dialogue at various levels through stakeholder meetings and advocacy activities with policy-makers.
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1,419,891 people of the Dodoma region now have access to better quality health care services. The MKAJI project has brought safe, accessible and affordable water, sanitation and improved hygiene to the 94 targeted communities. This has resulted in a pull factor which increased the number of women delivering their babies at health care facilities, reducing unhygienic and dangerous home deliveries. The trainings of MKAJI contribute to a long term knowledge sharing system that includes both women and man equally.

MKAJI ProjectTOTAL 2014-2018
Indicator descriptionTargetsResults
# Health Facilities provided with an adequate, sustainable and safe water supply and sanitation facilities in the eight district councils of Dodoma region9494
# Staff members from health facilities that have been trained on hygiene measures and protocols for equipment, personal hygiene and hygiene in the building and premises282311
# Community members and staff members from health facilities that have been trained on Operation & Maintenance of WASH facilities282183
# Water comittee members that have been trained on WASH Financing and Business models282249
# Community members that have been trained on water governance940800

Situation Approach Result

Programme information

  • Simavi Budget

    € 8,397,392

  • Overal Budget

    € 8,397,392

  • 6 years

  • Location

    Tanzania: Dodoma region

  • Target groups

    The target audience is a mix of: inpatients and outpatients at the health facilities; staff at the health facilities, plus a selected 500 community health workers and traditional birth attendants; community members, with a special focus on women; community health workers (volunteers); village health workers (paid); local government authorities.

  • Implementing partners

    CBHCC, PATUTA, UFUNDIK, Witteveen+Bos

  • Donors

    Swiss Agency for Development and Cooperation (SDC).

  • Role of Simavi

    The project will be managed and implemented by Simavi. Local Simavi office in Tanzania will manage 90%.

Further reading

Do you want to know more about the MKAJI programme?

Please contact our colleague Thea Bongertman.
+255 (0)26 235 13 24

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