APPLICATION FORM Corona - Fund Mission EineWelt - ELCT

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Applicant: Lugala Lutheran Hospital

Dr. Emmanuel E. Chogo
Medical Officer Incharge
P O Box 11
Malinyi, Tanzania
Telephone: +255 786 665 800
Electronic mail: emmanuel.chogo@gmail.com

Project/measure: Strategic Preparedness and Response Project to Combat

COVID-19 Pandemic will aim at preventing infection in
vulnerable high risk groups, treat sick patients and protect
front line health workers through purchase of medical and
hygiene equipment and awareness and prevention work.

Person in charge: Dr. Steven M. Kyelula

Assistant Medical Officer Incharge
Lugala Lutheran Hospital
P O Box 11
Malinyi, Tanzania
Telephone: +255 789 936 993
Electronic mail: stevenkyelula@gmail.com

Duration: This project will cover a period of thirty (30) days for
implementation of project activities starting from 11th of
May 2020 through 9th of June 2020.

Requested amount: Amount requested from Mission EineWelt is Five

Thousand Euros Only (€ 5,000).

Other requested support: The diocese has not applied for other funding in response
to COVID-19 pandemic.

Account holder: Lugala Lutheran Hospital

Account number: 21603500093
Bank name: National Microfinance Bank
Bank branch: Ifakara Branch
Address: P O Box 33, Ifakara, Morogoro. Tanzania
SWIFT CODE: NMIBTZTZ

1.0 Short project description:

1.1 Where will it (project) take place?

This project will be based at Lugala Lutheran Hospital positioned at Lugala Village in
Malinyi District in Morogoro Region with its dispensaries of Ngalimila and Tanganyika
in Kilombero District in Morogoro Region. Geographical coordinates of the hospital
are Latitudes of 8°55'28"South and Longitudes 36°08'16"East. Ngalimila Dispensary
is located at Ngalimila Village in Kilombero District with geographical coordinates of
Latitudes 8o57'0"South and Longitudes 35º50'0"East and Tanganyika Dispensary is
located at Tanganyika Village in Kilombero District with geographical coordinates of
Latitudes 9o7'0"South and Longitudes 35o39'0"East.

1.2 Which problem related to the Covid-19 Pandemic is it aiming to solve?

Statistical indicators and daily experience on the spread of COVID-19 pandemic

indicate that the disease will lead to severe mortality and morbidity if will remain
poorly controlled or only partially mitigated. Lugala Lutheran Hospital expects the
impact of COVID-19 epidemic on people living in low-income settings or affected by
humanitarian crises to be much more severe due larger household sizes, intense
social mixing, poor housing situation making isolation or quarantine near impossible,
specific cultural and faith practices such as mass prayer gatherings, large funerals
and overcrowded settlement patterns, high prevalence of comorbidities and higher
case-fatality. Therefore, to save lives in resource-poor settings, the hospital has
defined high impact action lines including protection of front-line health workers as a
top priority through provision of personal protective equipment while ensuring
continuation of essential health services, establishment of triage at the entrance in
order to identify suspected COVID-19 patients and assign to designated area,
separate from other patients; and support hygiene supply for health facilities such as
soap for hand wash, alcohol, chlorine; hygiene equipment like buckets, basin, mops
and cloths so as to provide hand-washing facilities and establish strict hand hygiene
protocols in health facilities as needed.

1.3 How will you organise the project/measure (purchase, distribution)?

The following COVID-19 specific interventions will be implemented at Lugala

Lutheran Hospital, Ngalimila Dispensary and Tanganyika Dispensary as health
facilities identified by the management of the hospital to contain spread of the
disease and mitigate its impacts:

(1) Activity 1 - Facilitate capacity building of health care workers on COVID-19 and
health education for patients at the health facilities: Lugala Lutheran Hospital,
Ngalimila Dispensary and Tanganyika Dispensary.

(2) Activity 2 - Provision of personal protection equipment such as masks, gloves,

goggles and gowns and supplies for hand hygiene such as hand sanitizers,
soap for health care workers who will be working in isolation wards and support
transport for suspected COVID-19 cases to isolation centres.

(3) Activity 3 - Monitoring and evaluation of implementation of project and provision

of feedback so that operational plans can be improved and actions taken where
needed to correct shortfalls and constraints in order to attain efficient and
effective performance standards.

1.4 How many people will benefit from the project/measure?

Direct beneficiaries of this project will be 162 (80 females and 82 males) health care
workers of the hospital with its dispensaries whom 125 (56 females and 69 males)
front-line health workers as top priority and will receive special training, mentoring
and coaching and provided with personal protective equipment to protect them from
infection of the virus while continuing delivering essential health services. Indirect
beneficiaries will be 161,701 (81,557 females and 80,144 males) people in Malinyi
District and southern part of Kilombero District and it is a first referral health institution
within the country’s public and district health system.

1.5 How will they be selected?

Front line health workers of the hospital and its dispensaries who are particularly
vulnerable group will be selected by the management of the hospital as beneficiaries
based on rate of vulnerability due to their exposure to the virus, thus protecting them
from infection will be of paramount importance in combating COVID-19 and
maintaining primary health care through provision of personal protective equipment
while ensuring continuation of essential health services. Other health workers will be
selected based on their roles and responsibilities to assist delivery of medical support
for weak health systems confronted with a threatening COVID-19 epidemic, thus are
particularly vulnerable group due to their exposure to the virus and will be provided
with personal protective equipment and awareness raising to protect against
infection. Entire population in Malinyi District and southern part of Kilombero District
will be selected based on their locality being with the catchment area of the hospital
and its dispensaries as the only referral health institutions.

1.6 Description of financial reporting/proof

Financial reporting will comply the reporting standards of Mission OneWorld that
require a breakdown of sources of funding including funds contributed by
implementing partner and how funding was spent in project implementation. Financial
reporting form in Microsoft Excel will be used to report expenditure of funds adhering
to the financial reporting procedures of the Development and Mission of Evangelical
Lutheran Church in Bavaria providing detailed breakdown of activity costs with
corresponding numbered receipts arranged systematically by ascending order in
which earlier receipts preceding later receipts and will be scanned and sent to
Mission OneWorld together with narrative and financial reports. Receipts that will be
produced by EFD machines will be photocopied immediately to avoid fading.

2.0 Cost and financing plan

2.1 Project costs

Cost per item Total

Items Quantity
(local currency) (local currency)
Activity 1 - Facilitate capacity building of health care workers on COVID-19 and health
education for patients at the health facilities: Lugala Lutheran Hospital, Ngalimila Dispensary
and Tanganyika Dispensary
Breakfast 4,000 125 persons 500,000
Lunch 10,000 125 persons 1,250,000
Refreshment 2,000 125 persons 250,000
Upkeep for participants 10,000 125 persons 1,250,000
Ball pens 500 125 persons 62,500
Notebooks 1,500 125 persons 187,500
Marker pens 10,000 2 boxes 20,000
Flipcharts 10,000 2 pcs 20,000
Masking tapes 4,000 4 pcs 16,000
Training room 100,000 3 sessions 300,000
Transport costs for facilitator 2,300 50 litres 115,000
DSA for facilitator 80,000 3 sessions 240,000
 DSA for driver of facilitator 60,000 3 sessions 180,000
Cost per item Total
Items Quantity
(local currency) (local currency)
Activity 2 - Provision of personal protection equipment such as masks, gloves, goggles and
gowns and supplies for hand hygiene such as hand sanitizers, soap for health care workers
who will be working in isolation wards and support transport for suspected COVID-19 cases
to isolation centres
Sanitisers 65,000 20 gallons 1,300,000
Gloves 7,500 100 pcs 750,000
Chlorine 33,400 20 gallons 668,000
Liquid soaps 9,800 20 bottles 196,000
Surgical masks 100,000 50 cartons 5,000,000
Oxygen masks 6,000 100 pcs 600,000
Goggles 10,000 50 pcs 500,000
Heavy gloves 4,000 40 pcs 160,000
Apron 10,000 5 pcs 50,000
Hand washing buckets 25,000 10 pcs 250,000
Mob set 90,000 1 pc 90,000
Activity 3 - Monitoring and evaluation of implementation of project and provision of feedback
so that operational plans can be improved and actions taken where needed to correct
shortfalls and constraints in order to attain efficient and effective performance standards
Paper ream 10,000 4 pc 30,000
Cartridge HP 05A 185,000 2 pc 370,000
Scanning documents 1,000 60 pages 60,000
Photocopying 100 300 pages 30,000
Fuel for administrative activities 2,300 100 litres 230,000
TOTAL / / 14,675,000

2.2 Financing plan

Activity Summary MEW Diocese Total

Activity 1 - Capacity building to front-line health workers 2,889,000 1,502,000 4,391,000

Activity 2 - Purchase personal protective equipment 9,564,000 - 9,564,000

Activity 3 - Monitoring and evaluation - 720,000 720,000

TOTAL COSTS 12,453,000 2,222,000 14,675,000

N.B: Please note that the actual exchange rate of the LMC (TZS to the EURO) will
be used (Euro 1 = TZS 2,490.60).

30.04.2020 Dr. Emmanue E. Chogo (MD)

Medical Officer Incharge
Date Signature stamp name and position