Popular soap opera helps raise contraceptive use. Tanzania.

PubMed

1996-01-01

The latest Demographic and Health Surveys Report on Knowledge, Attitudes, and Practice documents an increase in the level of use of modern contraceptive methods in Tanzania between 1991 and 1994 from 5.9% to 11.3% of reproductive-age women. 53.2% of all women of reproductive age were exposed to mass media messages about family planning, which large majorities of men and women consider acceptable. 48.3% were exposed through radio, 22.9% reported listening to the US Agency for International Development-funded family planning promotional radio soap opera "Zinduka]", 22.5% read newspaper items, 17.5% saw posters, and 7.3% saw leaflets. 4.5% were visited by a family planning worker, 24.7% discussed family planning with a friend or relative, and 24.7% discussed family planning with health facility personnel. Zinduka], a popular 52-episode soap opera, depicts how the lives of Bomu wa Kabuma's family, in Msongano Town and Tawanya village in Tanzania, are affected because he is unable to provide for his eight children, parents, wife, mistress, and the mistress's child. The soap was produced with technical assistance from the Johns Hopkins University Center for Communication Programs Population Communication Services project. The 15-minute episodes were first broadcast in Swahili on Radio Tanzania from October 1993 through October 1994. The series was then resumed in September 1995 for another 12 months.

Motivation and incentives of rural maternal and neonatal health care providers: a comparison of qualitative findings from Burkina Faso, Ghana and Tanzania

PubMed Central

2013-01-01

Background In Burkina Faso, Ghana and Tanzania strong efforts are being made to improve the quality of maternal and neonatal health (MNH) care. However, progress is impeded by challenges, especially in the area of human resources. All three countries are striving not only to scale up the number of available health staff, but also to improve performance by raising skill levels and enhancing provider motivation. Methods In-depth interviews were used to explore MNH provider views about motivation and incentives at primary care level in rural Burkina Faso, Ghana and Tanzania. Interviews were held with 25 MNH providers, 8 facility and district managers, and 2 policy-makers in each country. Results Across the three countries some differences were found in the reasons why people became health workers. Commitment to remaining a health worker was generally high. The readiness to remain at a rural facility was far less, although in all settings there were some providers that were willing to stay. In Burkina Faso it appeared to be particularly difficult to recruit female MNH providers to rural areas. There were indications that MNH providers in all the settings sometimes failed to treat their patients well. This was shown to be interlinked with differences in how the term ‘motivation’ was understood, and in the views held about remuneration and the status of rural health work. Job satisfaction was shown to be quite high, and was particularly linked to community appreciation. With some important exceptions, there was a strong level of agreement regarding the financial and non-financial incentives that were suggested by these providers, but there were clear country preferences as to whether incentives should be for individuals or teams. Conclusions Understandings of the terms and concepts pertaining to motivation differed between the three countries. The findings from Burkina Faso underline the importance of gender-sensitive health workforce planning. The training that all

Evolution of Elections Management in Tanzania

ERIC Educational Resources Information Center

Norman, A. S.; Mdegella, O. M.; Lubawa, R. M.

2011-01-01

This paper provides a discussion on the evolution of elections management in Tanzania with a focus on technological advancement in administering registration of voters. The paper provides the merits that permanent voters register has brought over the thumb practice. It traces the management of elections during colonialism, after independence…

Maritime and Underwater Cultural Heritage Initiatives in Tanzania and Mozambique

NASA Astrophysics Data System (ADS)

Jeffery, Bill; Parthesius, Robert

2013-06-01

The aim of this paper is provide an overview of the capacity building programmes in maritime and underwater cultural heritage (MUCH) conducted by the authors in Tanzania and Mozambique. Tanzania and Mozambique have long histories of indigenous cultures, foreign contacts and influences and African adaptations beginning in the late Greco-Roman period, when the coastal populations exploited the peoples and riches of the interior. Today the coastline contains numerous examples of indigenous tangible and intangible heritage and many sites and histories related to the Swahili culture. Some exploratory research and training has been conducted in Tanzania and Mozambique, but the implementation by local residents of their own MUCH programme is still at an early stage. Under a UNESCO agreement framework, Tanzania in particular has started to develop a MUCH programme, which can assist in highlighting their extensive histories, cultural landscapes and cultural identity.

Tanzania Country Analysis Brief

EIA Publications

2016-01-01

Tanzania is a small natural gas producer, but the country is planning to become an exporter of liquefied natural gas (LNG) in the future. There have been several natural gas discoveries made in offshore southern Tanzania since 2010 large enough to support an LNG plant.

Pregnancy desire and dual method contraceptive use among people living with HIV attending clinical care in Kenya, Namibia and Tanzania.

PubMed

Antelman, Gretchen; Medley, Amy; Mbatia, Redempta; Pals, Sherri; Arthur, Gilly; Haberlen, Sabina; Ackers, Marta; Elul, Batya; Parent, Julie; Rwebembera, Anath; Wanjiku, Lucy; Muraguri, Nicholas; Gweshe, Justice; Mudhune, Sandra; Bachanas, Pamela

2015-01-01

To describe factors associated with pregnancy desire and dual method use among people living with HIV in clinical care in sub-Saharan Africa. Sexually active HIV-positive adults were enrolled in 18 HIV clinics in Kenya, Namibia and Tanzania. Demographic, clinical and reproductive health data were captured by interview and medical record abstraction. Correlates of desiring a pregnancy within the next 6 months, and dual method use [defined as consistent condom use together with a highly effective method of contraception (hormonal, intrauterine device (IUD), permanent)], among those not desiring pregnancy, were identified using logistic regression. Among 3375 participants (median age 37 years, 42% male, 64% on antiretroviral treatment), 565 (17%) desired a pregnancy within the next 6 months. Of those with no short-term fertility desire (n=2542), 686 (27%) reported dual method use, 250 (10%) highly effective contraceptive use only, 1332 (52%) condom use only, and 274 (11%) no protection. Respondents were more likely to desire a pregnancy if they were from Namibia and Tanzania, male, had a primary education, were married/cohabitating, and had fewer children. Factors associated with increased likelihood of dual method use included being female, being comfortable asking a partner to use a condom, and communication with a health care provider about family planning. Participants who perceived that their partner wanted a pregnancy were less likely to report dual method use. There was low dual method use and low use of highly effective contraception. Contraceptive protection was predominantly through condom-only use. These findings demonstrate the importance of integrating reproductive health services into routine HIV care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Early Child Development and Care in Tanzania: Challenges for the Future

ERIC Educational Resources Information Center

Mtahabwa, Lyabwene

2009-01-01

Much remains unknown about the status of early child development and care in Tanzania. The little information available has never been put together to provide a holistic picture of the progress so far made in this important area. This paper intends to synchronise the information available in Tanzania for the purpose of depicting the country's…

Conventialization of Numerals in Tanzania

ERIC Educational Resources Information Center

Kajoro, Peter

2012-01-01

The supposed pre-eminence of an external examination can exert a disproportionate influence on a curriculum and the associated learning and teaching. Teaching can easily subordinate learning and understanding to curriculum coverage if the society develops a culture that appears to make such demands. This study focuses on Tanzania and provides the…

Mantle transition zone structure beneath Tanzania, east Africa

NASA Astrophysics Data System (ADS)

Owens, Thomas J.; Nyblade, Andrew A.; Gurrola, Harold; Langston, Charles A.

2000-03-01

We apply a three-dimensional stacking method to receiver functions from the Tanzania Broadband Seismic Experiment to determine relative variations in the thickness of the mantle transition zone beneath Tanzania. The transition zone under the Eastern rift is 30-40 km thinner than under areas of the Tanzania Craton in the interior of the East African Plateau unaffected by rift faulting. The region of transition zone thinning under the Eastern rift is several hundred kilometers wide and coincides with a 2-3% reduction in S wave velocities. The thinning of the transition zone, as well as the reduction in S wave velocities, can be attributed to a 200-300°K increase in temperature. This thermal anomaly at >400 km depth beneath the Eastern rift cannot be easily explained by passive rifting and but is consistent with a plume origin for the Cenozoic rifting, volcanism and plateau uplift in East Africa.

Huntington's disease in Tanzania.

PubMed Central

Scrimgeour, E M

1981-01-01

Huntington's disease was studied in a Bantu community in northern Tanzania. Although there is evidence to suggest that the disease has been present here for over one hundred years, this is the first report of the condition in Tanzania. A survey of published reports indicates that the disease is infrequently reported in persons of Negro ancestry. PMID:6453998

Creating a new class of pharmaceutical services provider for underserved areas: the Tanzania accredited drug dispensing outlet experience.

PubMed

Rutta, Edmund; Senauer, Katie; Johnson, Keith; Adeya, Grace; Mbwasi, Romuald; Liana, Jafary; Kimatta, Suleiman; Sigonda, Margareth; Alphonce, Emmanuel

2009-01-01

In developing countries, the most accessible source of treatment for common conditions is often an informal drug shop, where drug sellers are untrained and operations are unmonitored. We sought to describe a public-private initiative in Tanzania that created a new class of provider in government-accredited drug outlets, which improved the quality of medicines and pharmaceutical services in previously underserved areas. The accredited drug-dispensing outlet program combines changing behavior and expectations of community members who use, own, regulate, and work in drug shops. Success resulted from including community stakeholders from the beginning of the process. Addressing shortages in qualified health care providers by training and accrediting private sector drug dispensers to recognize common conditions and provide quality pharmaceutical products and services is feasible in a developing country, when supported by an appropriate policy and regulatory environment. Scaling up and sustaining the program will be a challenge.

AgriSense-STARS: Advancing Methods of Agricultural Monitoring for Food Security in Smallholder Regions - the Case for Tanzania

NASA Astrophysics Data System (ADS)

Dempewolf, J.; Becker-Reshef, I.; Nakalembe, C. L.; Tumbo, S.; Maurice, S.; Mbilinyi, B.; Ntikha, O.; Hansen, M.; Justice, C. J.; Adusei, B.; Kongo, V.

2015-12-01

In-season monitoring of crop conditions provides critical information for agricultural policy and decision making and most importantly for food security planning and management. Nationwide agricultural monitoring in countries dominated by smallholder farming systems, generally relies on extensive networks of field data collectors. In Tanzania, extension agents make up this network and report on conditions across the country, approaching a "near-census". Data is collected on paper which is resource and time intensive, as well as prone to errors. Data quality is ambiguous and there is a general lack of clear and functional feedback loops between farmers, extension agents, analysts and decision makers. Moreover, the data are not spatially explicit, limiting the usefulness for analysis and quality of policy outcomes. Despite significant advances in remote sensing and information communication technologies (ICT) for monitoring agriculture, the full potential of these new tools is yet to be realized in Tanzania. Their use is constrained by the lack of resources, skills and infrastructure to access and process these data. The use of ICT technologies for data collection, processing and analysis is equally limited. The AgriSense-STARS project is developing and testing a system for national-scale in-season monitoring of smallholder agriculture using a combination of three main tools, 1) GLAM-East Africa, an automated MODIS satellite image processing system, 2) field data collection using GeoODK and unmanned aerial vehicles (UAVs), and 3) the Tanzania Crop Monitor, a collaborative online portal for data management and reporting. These tools are developed and applied in Tanzania through the National Food Security Division of the Ministry of Agriculture, Food Security and Cooperatives (MAFC) within a statistically representative sampling framework (area frame) that ensures data quality, representability and resource efficiency.

Perceived barriers and attitudes of health care providers towards Provider-Initiated HIV Testing and Counseling in Mbeya region, southern highland zone of Tanzania.

PubMed

Ntuli, A Kapologwe; Kabengula, Julieth S; Msuya, Sia E

2011-01-01

Provider-initiated testing and counseling (PITC) is a routine HIV testing and counseling, it encompases two strategies including; diagnostic HIV testing and HIV screening. In Tanzania PITC started in 2007, to date it is almost through out the country. This study aimed at assessing the perceived barriers and attitudes of health care providers towards PITC services. A cross sectional study was conducted for one month between April and May, 2010 in the goverment health care facilities of the Mbeya City Council. A multi-stage sampling technique was used to select both health facilities and health care providers. A total of 402 (95%) subjects were interviewed. Their mean (±SD) age was 41±9.5 years, where majority (65%) were females. All the participants reported to be aware about PITC services. However, about 35% of them had negative attitude towards PITC services. Various perceived barriers to effective PITC provision were reported, including; too many patients (57.7%) and inadequate space (46%) for PITC provision. Although PITC is an effective strategy for identification of unrecognized HIV infections, there is still missed opportunity which occurs at the health facilities, as some of health care providers had negative attitude and others faces various barriers in offering the PITC service.

Staff experiences of providing maternity services in rural southern Tanzania – a focus on equipment, drug and supply issues

PubMed Central

2013-01-01

Background The poor maintenance of equipment and inadequate supplies of drugs and other items contribute to the low quality of maternity services often found in rural settings in low- and middle-income countries, and raise the risk of adverse patient outcomes through delaying care provision. We aim to describe staff experiences of providing maternal and neonatal care in rural health facilities in Southern Tanzania, focusing on issues related to equipment, drugs and supplies. Methods Focus group discussions and in-depth interviews were conducted with different staff cadres from all facility levels in order to explore experiences and views of providing maternity care in the context of poorly maintained equipment, and insufficient drugs and other supplies. A facility survey quantified the availability of relevant items. Results The facility survey, which found many missing or broken items and frequent stock outs, corroborated staff reports of providing care in the context of missing or broken care items. Staff reported increased workloads, reduced morale, difficulties in providing optimal maternity care, and carrying out procedures with potential health risks to themselves as a result. Conclusions Inadequately stocked and equipped facilities compromise the health system’s ability to reduce maternal and neonatal mortality and morbidity by affecting staff personally and professionally, which hinders the provision of timely and appropriate interventions. Improving stock control and maintaining equipment could benefit mothers and babies, not only through removing restrictions to the availability of care, but also through improving staff working conditions. PMID:23410228

Adult Students go to Tanzania

ERIC Educational Resources Information Center

Harvey, Brian

1976-01-01

A preparatory course and a three-week study safari to Tanzania were conducted jointly by the University of Southampton and Nottingham University. The course sought to increase the participants' understanding of Tanzania's geography, economy, politics, education, and social systems. The actual visit is also described. (Author/EC)

Effectiveness of artemether-lumefantrine provided by community health workers in under-five children with uncomplicated malaria in rural Tanzania: an open label prospective study.

PubMed

Ngasala, Billy E; Malmberg, Maja; Carlsson, Anja M; Ferreira, Pedro E; Petzold, Max G; Blessborn, Daniel; Bergqvist, Yngve; Gil, José P; Premji, Zul; Mårtensson, Andreas

2011-03-16

Home-management of malaria (HMM) strategy improves early access of anti-malarial medicines to high-risk groups in remote areas of sub-Saharan Africa. However, limited data are available on the effectiveness of using artemisinin-based combination therapy (ACT) within the HMM strategy. The aim of this study was to assess the effectiveness of artemether-lumefantrine (AL), presently the most favoured ACT in Africa, in under-five children with uncomplicated Plasmodium falciparum malaria in Tanzania, when provided by community health workers (CHWs) and administered unsupervised by parents or guardians at home. An open label, single arm prospective study was conducted in two rural villages with high malaria transmission in Kibaha District, Tanzania. Children presenting to CHWs with uncomplicated fever and a positive rapid malaria diagnostic test (RDT) were provisionally enrolled and provided AL for unsupervised treatment at home. Patients with microscopy confirmed P. falciparum parasitaemia were definitely enrolled and reviewed weekly by the CHWs during 42 days. Primary outcome measure was PCR corrected parasitological cure rate by day 42, as estimated by Kaplan-Meier survival analysis. This trial is registered with ClinicalTrials.gov, number NCT00454961. A total of 244 febrile children were enrolled between March-August 2007. Two patients were lost to follow up on day 14, and one patient withdrew consent on day 21. Some 141/241 (58.5%) patients had recurrent infection during follow-up, of whom 14 had recrudescence. The PCR corrected cure rate by day 42 was 93.0% (95% CI 88.3%-95.9%). The median lumefantrine concentration was statistically significantly lower in patients with recrudescence (97 ng/mL [IQR 0-234]; n = 10) compared with reinfections (205 ng/mL [114-390]; n = 92), or no parasite reappearance (217 [121-374] ng/mL; n = 70; p ≤ 0.046). Provision of AL by CHWs for unsupervised malaria treatment at home was highly effective, which provides evidence base for

Corporal Punishment in Tanzania's Schools

ERIC Educational Resources Information Center

Feinstein, Sheryl; Mwahombela, Lucas

2010-01-01

The purpose of this survey was to acquire descriptive information regarding corporal punishment in Tanzania's O-level secondary schools. 448 individuals participated in the study: 254 teachers and 194 students, all from government or private secondary schools in the Iringa Region of Tanzania. In addition, 14 students and 14 teachers were…

Laboratory quality improvement in Tanzania.

PubMed

Andiric, Linda R; Massambu, Charles G

2015-04-01

The article describes the implementation and improvement in the first groups of medical laboratories in Tanzania selected to participate in the training program on Strengthening Laboratory Management Toward Accreditation (SLMTA). As in many other African nations, the selected improvement plan consisted of formalized hands-on training (SLMTA) that teaches the tasks and skills of laboratory management and provides the tools for implementation of best laboratory practice. Implementation of the improvements learned during training was verified before and after SLMTA with the World Health Organization African Region Stepwise Laboratory Improvement Process Towards Accreditation checklist. During a 4-year period, the selected laboratories described in this article demonstrated improvement with a range of 2% to 203% (cohort I) and 12% to 243% (cohort II) over baseline scores. The article describes the progress made in Tanzania's first cohorts, the obstacles encountered, and the lessons learned during the pilot and subsequent implementations. Copyright© by the American Society for Clinical Pathology.

Toward a nitrogen footprint calculator for Tanzania

NASA Astrophysics Data System (ADS)

Hutton, Mary Olivia; Leach, Allison M.; Leip, Adrian; Galloway, James N.; Bekunda, Mateete; Sullivan, Clare; Lesschen, Jan Peter

2017-03-01

We present the first nitrogen footprint model for a developing country: Tanzania. Nitrogen (N) is a crucial element for agriculture and human nutrition, but in excess it can cause serious environmental damage. The Sub-Saharan African nation of Tanzania faces a two-sided nitrogen problem: while there is not enough soil nitrogen to produce adequate food, excess nitrogen that escapes into the environment causes a cascade of ecological and human health problems. To identify, quantify, and contribute to solving these problems, this paper presents a nitrogen footprint tool for Tanzania. This nitrogen footprint tool is a concept originally designed for the United States of America (USA) and other developed countries. It uses personal resource consumption data to calculate a per-capita nitrogen footprint. The Tanzania N footprint tool is a version adapted to reflect the low-input, integrated agricultural system of Tanzania. This is reflected by calculating two sets of virtual N factors to describe N losses during food production: one for fertilized farms and one for unfertilized farms. Soil mining factors are also calculated for the first time to address the amount of N removed from the soil to produce food. The average per-capita nitrogen footprint of Tanzania is 10 kg N yr-1. 88% of this footprint is due to food consumption and production, while only 12% of the footprint is due to energy use. Although 91% of farms in Tanzania are unfertilized, the large contribution of fertilized farms to N losses causes unfertilized farms to make up just 83% of the food production N footprint. In a developing country like Tanzania, the main audiences for the N footprint tool are community leaders, planners, and developers who can impact decision-making and use the calculator to plan positive changes for nitrogen sustainability in the developing world.

Health Libraries and Information Services in Tanzania: A Strategic Assessment.

PubMed

Haruna, Hussein; Mtoroki, Majaliwa; Gerendasy, Dan D; Detlefsen, Ellen G

The intention of the Government of Tanzania is to establish more health information resource canters in all health facilities. With this regard, health information science personnel are needed to provide adequate and accurate health information services. However, availability of these personnel remains to be a challenge because of their non-existence. To identify the current status and local impact of health sciences libraries and user perception of these libraries, as a prerequisite to the development of a competence-based curriculum for health information science training in Tanzania. A needs assessment was carried out using a convenience sample of local respondents, including librarians, trainers, academicians, students, health care providers, and patients and families, drawn from national, referral, regional, district hospitals, health training institutions, and universities from both government and nongovernment entities in Tanzania. A focus group approach was used to gather data from respondents. Results from this assessment revealed that health science libraries in Tanzania are faced with the challenges of insufficient infrastructure, old technology, limited facilities and furniture, inadequate and incompetent library staff, lack of health sciences librarians, outdated and insufficient resources, and low knowledge and use of information technologies by library clients. Most respondents would prefer to have both physical and electronic libraries, as well as librarians with specialized health information science skills, to cope with changing nature of the medical field. The findings obtained from this assessment are strong enough to guide the development of a curriculum and training strategy and an operational plan and training packages for health information professionals. The development of a training curriculum for health information science professionals will mean better health information service delivery for Tanzania. Copyright © 2016 Icahn School of

Protecting the rights of people with HIV. Tanzania.

PubMed

Temba, P

1997-04-01

In Tanzania, preliminary efforts are underway to protect the human rights of people with HIV/AIDS. Tanzania, which has been criticized for failing to recognize human rights abuses against people with HIV/AIDS, is the 15th country in sub-Saharan Africa to establish a regional network of physicians, lawyers, and nongovernmental organizations seeking to protect the rights of people with HIV/AIDS and those vulnerable to the infection with appropriate legislation and policies. Discrimination, which hastens spread of the disease by forcing it underground, is found even among medical personnel who disclose patient information without consent or refuse to treat patients with HIV/AIDS. Certain laws also compromise the rights of infected people by requiring physicians to tender medical reports before the courts, permitting employers to force employees to undergo HIV testing, or requiring rape victims to provide an excessive burden of proof. Participants at a recent workshop recommended a review of national AIDS policy and changes in the law. A computer database will be used to track HIV/AIDS-related human rights abuses in Tanzania.

Assessment of health facility capacity to provide newborn care in Bangladesh, Haiti, Malawi, Senegal, and Tanzania

PubMed Central

Winter, Rebecca; Yourkavitch, Jennifer; Wang, Wenjuan; Mallick, Lindsay

2017-01-01

Background Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women’s use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities’ capacity to provide newborn care services in low and middle income countries. Methods In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally–representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program. In particular, we examine whether key newborn–related services are available at the facility (ie, service availability, measured by the availability of basic emergency obstetric care (BEmOC) signal functions, newborn signal functions, and routine perinatal services), and whether the facility has the equipment, medications, training and knowledge necessary to provide those services (ie, service readiness, measured by general facility requirements, equipment, medicines and commodities, and guidelines and staffing) in five countries with high levels of neonatal mortality and recent SPA data: Bangladesh, Haiti, Malawi, Senegal, and Tanzania. Findings In each country, we find that key services and commodities needed for comprehensive delivery and newborn care are missing from a large percentage of facilities with delivery services. Of three domains of service availability examined, scores for routine care availability are highest, while scores for newborn signal function availability are lowest. Of four domains of service readiness examined, scores for general requirements and equipment are highest, while scores for guidelines and staffing are lowest. Conclusions Both service availability and readiness tend to be highest in hospitals and facilities in urban areas, pointing to

Exposure to Aflatoxin and Fumonisin in Children at Risk for Growth Impairment in Rural Tanzania

USDA-ARS?s Scientific Manuscript database

Background. Stunted growth is a major public health issue for children in Tanzania. We examined dietary exposures to aflatoxin and fumonisin and their potential roles in growth impairment in children under 36 months of age in Haydom, Tanzania. Methods. Plasma samples collected at 24 months of age ...

Domestic pigs as potential reservoirs of human and animal trypanosomiasis in Northern Tanzania

PubMed Central

2013-01-01

Background Pig keeping is becoming increasingly common across sub-Saharan Africa. Domestic pigs from the Arusha region of northern Tanzania were screened for trypanosomes using PCR-based methods to examine the role of pigs as a reservoir of human and animal trypanosomiasis. Methods A total of 168 blood samples were obtained from domestic pigs opportunistically sampled across four districts in Tanzania (Babati, Mbulu, Arumeru and Dodoma) during December 2004. A suite of PCR-based methods was used to identify the species and sub-species of trypanosomes including: Internally Transcribed Sequence to identify multiple species; species specific PCR to identify T. brucei s. l. and T. godfreyi and a multiplex PCR reaction to distinguish T. b. rhodesiense from T. brucei s. l. Results Of the 168 domestic pigs screened for animal and human infective trypanosome DNA, 28 (16.7%) were infected with one or more species of trypanosome; these included: six pigs infected with Trypanosoma vivax (3.6%); three with Trypanosoma simiae (1.8%); two with Trypanosoma congolense (Forest) (1%) and four with Trypanosoma godfreyi (2.4%). Nineteen pigs were infected with Trypanosoma brucei s. l. (10.1%) of which eight were identified as carrying the human infective sub-species Trypanosoma brucei rhodesiense (4.8%). Conclusion These results show that in Tanzania domestic pigs may act as a significant reservoir for animal trypanosomiasis including the cattle pathogens T. vivax and T. congolense, the pig pathogen T. simiae, and provide a significant reservoir for T. b. rhodesiense, the causative agent of acute Rhodesian sleeping sickness. PMID:24499540

Comparing Methods of Assessing Dog Rabies Vaccination Coverage in Rural and Urban Communities in Tanzania

PubMed Central

Sambo, Maganga; Johnson, Paul C. D.; Hotopp, Karen; Changalucha, Joel; Cleaveland, Sarah; Kazwala, Rudovick; Lembo, Tiziana; Lugelo, Ahmed; Lushasi, Kennedy; Maziku, Mathew; Mbunda, Eberhard; Mtema, Zacharia; Sikana, Lwitiko; Townsend, Sunny E.; Hampson, Katie

2017-01-01

Rabies can be eliminated by achieving comprehensive coverage of 70% of domestic dogs during annual mass vaccination campaigns. Estimates of vaccination coverage are, therefore, required to evaluate and manage mass dog vaccination programs; however, there is no specific guidance for the most accurate and efficient methods for estimating coverage in different settings. Here, we compare post-vaccination transects, school-based surveys, and household surveys across 28 districts in southeast Tanzania and Pemba island covering rural, urban, coastal and inland settings, and a range of different livelihoods and religious backgrounds. These approaches were explored in detail in a single district in northwest Tanzania (Serengeti), where their performance was compared with a complete dog population census that also recorded dog vaccination status. Post-vaccination transects involved counting marked (vaccinated) and unmarked (unvaccinated) dogs immediately after campaigns in 2,155 villages (24,721 dogs counted). School-based surveys were administered to 8,587 primary school pupils each representing a unique household, in 119 randomly selected schools approximately 2 months after campaigns. Household surveys were conducted in 160 randomly selected villages (4,488 households) in July/August 2011. Costs to implement these coverage assessments were $12.01, $66.12, and $155.70 per village for post-vaccination transects, school-based, and household surveys, respectively. Simulations were performed to assess the effect of sampling on the precision of coverage estimation. The sampling effort required to obtain reasonably precise estimates of coverage from household surveys is generally very high and probably prohibitively expensive for routine monitoring across large areas, particularly in communities with high human to dog ratios. School-based surveys partially overcame sampling constraints, however, were also costly to obtain reasonably precise estimates of coverage. Post

Job satisfaction and turnover intentions among health care staff providing services for prevention of mother-to-child transmission of HIV in Dar es Salaam, Tanzania.

PubMed

Naburi, Helga; Mujinja, Phares; Kilewo, Charles; Orsini, Nicola; Bärnighausen, Till; Manji, Karim; Biberfeld, Gunnel; Sando, David; Geldsetzer, Pascal; Chalamila, Guerino; Ekström, Anna Mia

2017-09-06

Option B+ for the prevention of mother-to-child transmission (PMTCT) of HIV (i.e., lifelong antiretroviral treatment for all pregnant and breastfeeding mothers living with HIV) was initiated in Tanzania in 2013. While there is evidence that this policy has benefits for the health of the mother and the child, Option B+ may also increase the workload for health care providers in resource-constrained settings, possibly leading to job dissatisfaction and unwanted workforce turnover. From March to April 2014, a questionnaire asking about job satisfaction and turnover intentions was administered to all nurses at 36 public-sector health facilities offering antenatal and PMTCT services in Dar es Salaam, Tanzania. Multivariable logistic regression models were used to identify factors associated with job dissatisfaction and intention to quit one's job. Slightly over half (54%, 114/213) of the providers were dissatisfied with their current job, and 35% (74/213) intended to leave their job. Most of the providers were dissatisfied with low salaries and high workload, but satisfied with workplace harmony and being able to follow their moral values. The odds of reporting to be globally dissatisfied with one's job were high if the provider was dissatisfied with salary (adjusted odds ratio (aOR) 5.6, 95% CI 1.2-26.8), availability of protective gear (aOR 4.0, 95% CI 1.5-10.6), job description (aOR 4.3, 95% CI 1.2-14.7), and working hours (aOR 3.2, 95% CI 1.3-7.6). Perceiving clients to prefer PMTCT Option B+ reduced job dissatisfaction (aOR 0.2, 95% CI 0.1-0.8). The following factors were associated with providers' intention to leave their current job: job stability dissatisfaction (aOR 3.7, 95% CI 1.3-10.5), not being recognized by one's superior (aOR 3.6, 95% CI 1.7-7.6), and poor feedback on the overall unit performance (aOR 2.7, 95% CI 1.3-5.8). Job dissatisfaction and turnover intentions are comparatively high among nurses in Dar es Salaam's public-sector maternal care

Cost of microbial larviciding for malaria control in rural Tanzania.

PubMed

Rahman, Rifat; Lesser, Adriane; Mboera, Leonard; Kramer, Randall

2016-11-01

Microbial larviciding may be a potential supplement to conventional malaria vector control measures, but scant information on its relative implementation costs and effectiveness, especially in rural areas, is an impediment to expanding its uptake. We perform a costing analysis of a seasonal microbial larviciding programme in rural Tanzania. We evaluated the financial and economic costs from the perspective of the public provider of a 3-month, community-based larviciding intervention implemented in twelve villages in the Mvomero District of Tanzania in 2012-2013. Cost data were collected from financial reports and invoices and through discussion with programme administrators. Sensitivity analysis explored the robustness of our results to varying key parameters. Over the 2-year study period, approximately 6873 breeding sites were treated with larvicide. The average annual economic costs of the larviciding intervention in rural Tanzania are estimated at 2014 US$ 1.44 per person protected per year (pppy), US$ 6.18 per household and US$ 4481.88 per village, with the larvicide and staffing accounting for 14% and 58% of total costs, respectively. We found the costs pppy of implementing a seasonal larviciding programme in rural Tanzania to be comparable to the costs of other larviciding programmes in urban Tanzania and rural Kenya. Further research should evaluate the cost-effectiveness of larviciding relative to, and in combination with, other vector control strategies in rural settings. © 2016 John Wiley & Sons Ltd.

Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania

PubMed Central

2011-01-01

Background Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs). Methods This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140), Laos (136), Senegal (100) and Tanzania (121). Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. Results The survey achieved a 75% response rate (372/497) across Ghana (107/140), Laos (136/136), Senegal (51/100) and Tanzania (78/121). Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13%) or self-reported performing all five clinical practices according to established evidence (2%). Statistically significant factors associated with higher knowledge within each country included: 1) training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73); and 2) ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70). Statistically significant factors associated with better clinical practices within each country include: 1) reading scientific journals from their own country (OR 1.67, 95% CI

Introducing payment for performance in the health sector of Tanzania- the policy process.

PubMed

Chimhutu, Victor; Tjomsland, Marit; Songstad, Nils Gunnar; Mrisho, Mwifadhi; Moland, Karen Marie

2015-09-02

Prompted by the need to achieve progress in health outcomes, payment for performance (P4P) schemes are becoming popular policy options in the health systems in many low income countries. This paper describes the policy process behind the introduction of a payment for performance scheme in the health sector of Tanzania illuminating in particular the interests of and roles played by the Government of Norway, the Government of Tanzania and the other development partners. The study employed a qualitative research design using in-depth interviews (IDIs), observations and document reviews. Thirteen IDIs with key-informants representing the views of ten donor agencies and government departments influential in the process of introducing the P4P scheme in Tanzania were conducted in Dar es Salaam, Tanzania and Oslo, Norway. Data was collected on the main trends and thematic priorities in development aid policy, countries and actors perceived to be proponents and opponents to the P4P scheme, and P4P agenda setting in Tanzania. The initial introduction of P4P in the health sector of Tanzania was controversial. The actors involved including the bilateral donors in the Health Basket Fund, the World Bank, the Tanzanian Government and high level politicians outside the Health Basket Fund fought for their values and interests and formed alliances that shifted in the course of the process. The process was characterized by high political pressure, conflicts, changing alliances, and, as it evolved, consensus building. The P4P policy process was highly political with external actors playing a significant role in influencing the agenda in Tanzania, leaving less space for the Government of Tanzania to provide leadership in the process. Norway in particular, took a leading role in setting the agenda. The process of introducing P4P became long and frustrating causing mistrust among partners in the Health Basket Fund.

Incidence of Induced Abortion and Post-Abortion Care in Tanzania

PubMed Central

Keogh, Sarah C.; Kimaro, Godfather; Muganyizi, Projestine; Philbin, Jesse; Kahwa, Amos; Ngadaya, Esther; Bankole, Akinrinola

2015-01-01

Background Tanzania has one of the highest maternal mortality ratios in the world, and unsafe abortion is one of its leading causes. Yet little is known about its incidence. Objectives To provide the first ever estimates of the incidence of unsafe abortion in Tanzania, at the national level and for each of the 8 geopolitical zones (7 in Mainland plus Zanzibar). Methods A nationally representative survey of health facilities was conducted to determine the number of induced abortion complications treated in facilities. A survey of experts on abortion was conducted to estimate the likelihood of women experiencing complications and obtaining treatment. These surveys were complemented with population and fertility data to obtain abortion numbers, rates and ratios, using the Abortion Incidence Complications Methodology. Results In Tanzania, women obtained just over 405,000 induced abortions in 2013, for a national rate of 36 abortions per 1,000 women age 15–49 and a ratio of 21 abortions per 100 live births. For each woman treated in a facility for induced abortion complications, 6 times as many women had an abortion but did not receive care. Abortion rates vary widely by zone, from 10.7 in Zanzibar to 50.7 in the Lake zone. Conclusions The abortion rate is similar to that of other countries in the region. Variations by zone are explained mainly by differences in fertility and contraceptive prevalence. Measures to reduce the incidence of unsafe abortion and associated maternal mortality include expanding access to post-abortion care and contraceptive services to prevent unintended pregnancies. PMID:26361246

Sustainability and Long Term-Tenure: Lion Trophy Hunting in Tanzania

PubMed Central

Brink, Henry; Skinner, Kirsten; Leader-Williams, Nigel

2016-01-01

It is argued that trophy hunting of large, charismatic mammal species can have considerable conservation benefits but only if undertaken sustainably. Social-ecological theory suggests such sustainability only results from developing governance systems that balance financial and biological requirements. Here we use lion (Panthera leo) trophy hunting data from Tanzania to investigate how resource ownership patterns influence hunting revenue and offtake levels. Tanzania contains up to half of the global population of free-ranging lions and is also the main location for lion trophy hunting in Africa. However, there are concerns that current hunting levels are unsustainable. The lion hunting industry in Tanzania is run by the private sector, although the government leases each hunting block to companies, enforces hunting regulation, and allocates them a species-specific annual quota per block. The length of these leases varies and theories surrounding property rights and tenure suggest hunting levels would be less sustainable in blocks experiencing a high turnover of short-term leases. We explored this issue using lion data collected from 1996 to 2008 in the Selous Game Reserve (SGR), the most important trophy hunting destination in Tanzania. We found that blocks in SGR with the highest lion hunting offtake were also those that experienced the steepest declines in trophy offtake. In addition, we found this high hunting offtake and the resultant offtake decline tended to be in blocks under short-term tenure. In contrast, lion hunting levels in blocks under long-term tenure matched more closely the recommended sustainable offtake of 0.92 lions per 1000 km2. However, annual financial returns were higher from blocks under short-term tenure, providing $133 per km2 of government revenue as compared to $62 per km2 from long-term tenure blocks. Our results provide evidence for the importance of property rights in conservation, and support calls for an overhaul of the system in

Sustainability and Long Term-Tenure: Lion Trophy Hunting in Tanzania.

PubMed

Brink, Henry; Smith, Robert J; Skinner, Kirsten; Leader-Williams, Nigel

2016-01-01

It is argued that trophy hunting of large, charismatic mammal species can have considerable conservation benefits but only if undertaken sustainably. Social-ecological theory suggests such sustainability only results from developing governance systems that balance financial and biological requirements. Here we use lion (Panthera leo) trophy hunting data from Tanzania to investigate how resource ownership patterns influence hunting revenue and offtake levels. Tanzania contains up to half of the global population of free-ranging lions and is also the main location for lion trophy hunting in Africa. However, there are concerns that current hunting levels are unsustainable. The lion hunting industry in Tanzania is run by the private sector, although the government leases each hunting block to companies, enforces hunting regulation, and allocates them a species-specific annual quota per block. The length of these leases varies and theories surrounding property rights and tenure suggest hunting levels would be less sustainable in blocks experiencing a high turnover of short-term leases. We explored this issue using lion data collected from 1996 to 2008 in the Selous Game Reserve (SGR), the most important trophy hunting destination in Tanzania. We found that blocks in SGR with the highest lion hunting offtake were also those that experienced the steepest declines in trophy offtake. In addition, we found this high hunting offtake and the resultant offtake decline tended to be in blocks under short-term tenure. In contrast, lion hunting levels in blocks under long-term tenure matched more closely the recommended sustainable offtake of 0.92 lions per 1000 km2. However, annual financial returns were higher from blocks under short-term tenure, providing $133 per km2 of government revenue as compared to $62 per km2 from long-term tenure blocks. Our results provide evidence for the importance of property rights in conservation, and support calls for an overhaul of the system in

Childhood Sexual Abuse among University Students in Tanzania

ERIC Educational Resources Information Center

McCrann, Denis; Lalor, Kevin; Katabaro, Joviter Kamugisha

2006-01-01

Objectives: There are no prevalence data for childhood sexual abuse among Tanzanian university students. This investigation addressed this paucity. The nature of sexual abuse was also investigated. Method: Participants (N=487) from a university in Tanzania completed a questionnaire which assessed abusive childhood sexual experiences, gathering…

Implementing Educational Policies in Tanzania. World Bank Discussion Papers No. 86. Africa Technical Department Series.

ERIC Educational Resources Information Center

Galabawa, C. J.

Of the three East African British colonies (Kenya, Uganda, and Tanzania), Tanzania was the least well off at the time of independence in 1961. At that time, only 16,691 students were enrolled in secondary schools, and all general education at higher levels was provided outside the country. Thus, the goals of post-independence educational policy…

An analysis of pre-service family planning teaching in clinical and nursing education in Tanzania

PubMed Central

2014-01-01

Background Promoting family planning (FP) is a key strategy for health, economic and population growth. Sub-Saharan Africa, with one of the lowest contraceptive prevalence and highest fertility rates globally, contributes half of the global maternal deaths. Improving the quality of FP services, including enhancing pre-service FP teaching, has the potential to improve contraceptive prevalence. In efforts to improve the quality of FP services in Tanzania, including provider skills, this study sought to identify gaps in pre-service FP teaching and suggest opportunities for strengthening the training. Methods Data were collected from all medical schools and a representative sample of pre-service nursing, Assistant Medical Officer (AMO), Clinical Officer (CO) and assistant CO schools in mainland Tanzania. Teachers responsible for FP teaching at the schools were interviewed using a semi-structured questionnaire. Observations on availability of teaching resources and other evidence of FP teaching and evaluation were documented. Relevant approved teaching documents were assessed for their suitability as competency-based FP teaching tools against predefined criteria. Quantitative data were analyzed using EPI Info 6 and qualitative data were manually analyzed using content analysis. Results A total of 35 pre-service schools were evaluated for FP teaching including 30 technical education and five degree offering schools. Of the assessed 11 pre-service curricula, only one met the criteria for suitability of FP teaching. FP teaching was typically theoretical with only 22.9% of all the schools having systems in place to produce graduates who could skillfully provide FP methods. Across schools, the target skills were the same level of competence and skewed toward short acting methods of contraception. Only 23.3% (n = 7) of schools had skills laboratories, 76% (n = 22) were either physically connected or linked to FP clinics. None of the degree providing schools practiced

Why do health workers in rural Tanzania prefer public sector employment?

PubMed Central

2012-01-01

Background Severe shortages of qualified health workers and geographical imbalances in the workforce in many low-income countries require the national health sector management to closely monitor and address issues related to the distribution of health workers across various types of health facilities. This article discusses health workers' preferences for workplace and their perceptions and experiences of the differences in working conditions in the public health sector versus the church-run health facilities in Tanzania. The broader aim is to generate knowledge that can add to debates on health sector management in low-income contexts. Methods The study has a qualitative study design to elicit in-depth information on health workers' preferences for workplace. The data comprise ten focus group discussions (FGDs) and 29 in-depth interviews (IDIs) with auxiliary staff, nursing staff, clinicians and administrators in the public health sector and in a large church-run hospital in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in Tanzania. Results The study found a clear preference for public sector employment. This was associated with health worker rights and access to various benefits offered to health workers in government service, particularly the favourable pension schemes providing economic security in old age. Health workers acknowledged that church-run hospitals generally were better equipped and provided better quality patient care, but these concerns tended to be outweighed by the financial assets of public sector employment. In addition to the sector specific differences, family concerns emerged as important in decisions on workplace. Conclusions The preference for public sector employment among health workers shown in this study seems to be associated primarily with the favourable pension scheme. The overall shortage of health workers and the distribution between health facilities is a challenge in a

Cost analysis of large-scale implementation of the 'Helping Babies Breathe' newborn resuscitation-training program in Tanzania.

PubMed

Chaudhury, Sumona; Arlington, Lauren; Brenan, Shelby; Kairuki, Allan Kaijunga; Meda, Amunga Robson; Isangula, Kahabi G; Mponzi, Victor; Bishanga, Dunstan; Thomas, Erica; Msemo, Georgina; Azayo, Mary; Molinier, Alice; Nelson, Brett D

2016-12-01

Helping Babies Breathe (HBB) has become the gold standard globally for training birth-attendants in neonatal resuscitation in low-resource settings in efforts to reduce early newborn asphyxia and mortality. The purpose of this study was to do a first-ever activity-based cost-analysis of at-scale HBB program implementation and initial follow-up in a large region of Tanzania and evaluate costs of national scale-up as one component of a multi-method external evaluation of the implementation of HBB at scale in Tanzania. We used activity-based costing to examine budget expense data during the two-month implementation and follow-up of HBB in one of the target regions. Activity-cost centers included administrative, initial training (including resuscitation equipment), and follow-up training expenses. Sensitivity analysis was utilized to project cost scenarios incurred to achieve countrywide expansion of the program across all mainland regions of Tanzania and to model costs of program maintenance over one and five years following initiation. Total costs for the Mbeya Region were $202,240, with the highest proportion due to initial training and equipment (45.2%), followed by central program administration (37.2%), and follow-up visits (17.6%). Within Mbeya, 49 training sessions were undertaken, involving the training of 1,341 health providers from 336 health facilities in eight districts. To similarly expand the HBB program across the 25 regions of mainland Tanzania, the total economic cost is projected to be around $4,000,000 (around $600 per facility). Following sensitivity analyses, the estimated total for all Tanzania initial rollout lies between $2,934,793 to $4,309,595. In order to maintain the program nationally under the current model, it is estimated it would cost $2,019,115 for a further one year and $5,640,794 for a further five years of ongoing program support. HBB implementation is a relatively low-cost intervention with potential for high impact on perinatal

BARRIERS TO ACCESS REPRODUCTIVE HEALTHCARE FOR PREGNANT ADOLESCENT GIRLS: A QUALITATIVE STUDY IN TANZANIA

PubMed Central

Hokororo, Adolfine; Kihunrwa, Albert F.; Kalluvya, Samuel; Changalucha, John; Fitzgerald, Daniel W; Downs, Jennifer A.

2015-01-01

Aims In Tanzania, approximately 25% of adolescents give birth and 50% more become sexually active during adolescence. We hypothesised that reproductive health education and services for adolescent girls are inaccessible and conducted this study to gain insights into their perceptions of sexually-transmitted infections (STIs) and barriers to reproductive health service utilisation in rural Mwanza, Tanzania. Methods We conducted nine focus group among pregnant adolescents aged 15–20 years. Data was transcribed, translated, and coded for relevant themes using NVivo10 software for qualitative data analysis. Results Most participants were aware of the dangers of STIs to themselves and their unborn babies, but did not perceive themselves as at risk of acquiring STIs. They viewed condoms as ineffective for preventing STIs and pregnancies and unnecessary for those in committed relationships. Stigma, and long waiting times and lack of privacy in the clinics discouraged young females from seeking reproductive healthcare. Conclusion Reproductive healthcare for adolescent girls who are not pregnant is practically nonexistent in Tanzania. Healthcare access for pregnant young women is also limited. Targeted changes to increase clinic accessibility and to provide reproductive health education to all rather than only pregnant women have the potential to address these gaps. PMID:25473729

Knowledge, attitudes and acceptability to provider-initiated HIV testing and counseling: patients' perspectives in Moshi and Rombo Districts, Tanzania.

PubMed

Manongi, Rachel; Mahande, Michael; Njau, Bernard

2014-10-01

Provider-initiated HIV testing and counseling (PITC) is referred to as routine testing in a clinical setting as part of a standard programme of medical services. PITC is initiated in order to avoid missed opportunities for people to get tested for HIV. While advocated as a strategy, there is dearth of information on patients' views on PITC in a number of districts in Tanzania. The objective of this study was to assess the knowledge, attitude and acceptability to PITC services among patients attending health care facilities in rural and urban settings in Kilimanjaro region A total of 12 focus group discussions (FGDs) were conducted with 99 (73 female and 26 male) patients enrolled into out-patient clinics in 8 (2 hospitals and 6 primary care centers) health facilities in Moshi Urban and Rombo districts in northern Tanzania. The study explored on knowledge, attitudes and acceptability of PITC, perceived benefits and barriers of PITC, and ethical issues related to PITC. Interviews were audio taped, transcribed, translated, and analyzed using Non-numerical Unstructured Data Indexing and Theorizing (NUDIST) software. Knowledge about PITC services was generally low. Compared to men, women had a more positive attitude towards PITC services, because of its ability to identify and treat undiagnosed HIV cases. HIV stigma was regarded as a major barrier to patients' uptake of PITC. Institutional factors such as lack of supplies and human resources were identified as barriers to successful provision of PITC. In conclusion, the findings highlight both opportunities and potential barriers in the successful uptake of PITC, and underscore the importance of informed consent, counseling and confidentiality and the need for specific strategies on advocacy for the service.

Improvements in access to malaria treatment in Tanzania after switch to artemisinin combination therapy and the introduction of accredited drug dispensing outlets - a provider perspective

PubMed Central

2010-01-01

Background To improve access to treatment in the private retail sector a new class of outlets known as accredited drug dispensing outlets (ADDO) was created in Tanzania. Tanzania changed its first-line treatment for malaria from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (ALu) in 2007. Subsidized ALu was made available in both health facilities and ADDOs. The effect of these interventions on access to malaria treatment was studied in rural Tanzania. Methods The study was carried out in the villages of Kilombero and Ulanga Demographic Surveillance System (DSS) and in Ifakara town. Data collection consisted of: 1) yearly censuses of shops selling drugs; 2) collection of monthly data on availability of anti-malarials in public health facilities; and 3) retail audits to measure anti-malarial sales volumes in all public, mission and private outlets. The data were complemented with DSS population data. Results Between 2004 and 2008 access to malaria treatment greatly improved and the number of anti-malarial treatment doses dispensed increased by 78%. Particular improvements were observed in the availability (from 0.24 shops per 1,000 people in 2004 to 0.39 in 2008) and accessibility (from 71% of households within 5 km of a shop in 2004 to 87% in 2008) of drug shops. Despite no improvements in affordability this resulted in an increase of the market share from 49% of anti-malarial sales 2005 to 59% in 2008. The change of treatment policy from SP to ALu led to severe stock-outs of SP in health facilities in the months leading up to the introduction of ALu (only 40% months in stock), but these were compensated by the wide availability of SP in shops. After the introduction of ALu stock levels of the drug were relatively high in public health facilities (over 80% months in stock), but the drug could only be found in 30% of drug shops and in no general shops. This resulted in a low overall utilization of the drug (19% of all anti-malarial sales) Conclusions

"Hakuna Matata": Lakeside Literacy in Tanzania.

ERIC Educational Resources Information Center

Watson, Alan J.

This paper begins by telling the story of Edward, a preacher/teacher in Tanzania who, although poor and uneducated himself, managed to teach his parishioners how to read. The paper describes the experience of one man and his wife who spent 4 years at Katoke Teachers College in northwest Tanzania during the early 1970s, after which they returned to…

Motivation and incentives of rural maternal and neonatal health care providers: a comparison of qualitative findings from Burkina Faso, Ghana and Tanzania.

PubMed

Prytherch, Helen; Kagoné, Moubassira; Aninanya, Gifty A; Williams, John E; Kakoko, Deodatus C V; Leshabari, Melkidezek T; Yé, Maurice; Marx, Michael; Sauerborn, Rainer

2013-04-25

In Burkina Faso, Ghana and Tanzania strong efforts are being made to improve the quality of maternal and neonatal health (MNH) care. However, progress is impeded by challenges, especially in the area of human resources. All three countries are striving not only to scale up the number of available health staff, but also to improve performance by raising skill levels and enhancing provider motivation. In-depth interviews were used to explore MNH provider views about motivation and incentives at primary care level in rural Burkina Faso, Ghana and Tanzania. Interviews were held with 25 MNH providers, 8 facility and district managers, and 2 policy-makers in each country. Across the three countries some differences were found in the reasons why people became health workers. Commitment to remaining a health worker was generally high. The readiness to remain at a rural facility was far less, although in all settings there were some providers that were willing to stay. In Burkina Faso it appeared to be particularly difficult to recruit female MNH providers to rural areas. There were indications that MNH providers in all the settings sometimes failed to treat their patients well. This was shown to be interlinked with differences in how the term 'motivation' was understood, and in the views held about remuneration and the status of rural health work. Job satisfaction was shown to be quite high, and was particularly linked to community appreciation. With some important exceptions, there was a strong level of agreement regarding the financial and non-financial incentives that were suggested by these providers, but there were clear country preferences as to whether incentives should be for individuals or teams. Understandings of the terms and concepts pertaining to motivation differed between the three countries. The findings from Burkina Faso underline the importance of gender-sensitive health workforce planning. The training that all levels of MNH providers receive in

Educational, scientific, tourist and outreach potential of the September 1, 2016 Annular Solar Eclipse in Tanzania

NASA Astrophysics Data System (ADS)

Tayabali Jiwaji, Noorali

2015-08-01

Tanzania will witness a major astronomical spectacle of an annular eclipse on September 1, 2016. The central part of the eclipse will pass through southern Tanzania, crossing national parks and game reserves such as Katavi and the world famous Selous. For the rest of Tanzania and neighbouring countries it will be a memorable event with large of the proportion of the Sun being covered up. The climate in Tanzania during September is cool and dry which will provide ideal viewing conditions. Solar eclipse events attract "eclipse chasers" from around the globe.Scientific interest in measuring the properties of the Sun and the effects of the eclipse on the atmosphere will allow local scientists to partner with leading scientists to gain valuable experience and knowledge.Local population's wonder and interest in eclipses can be exploited through public-private partnerships by encouraging students and local people to travel to the central path or to observe from their backyards. Large number of eclipse glasses can be manufactured cheaply using safe solar filters for supplying to students and general population in Tanzania and neigbouring countries. This will raise science awareness about the wonders of our Universe.When combined with the attraction of Tanzania's treasures in the north and the 16 tonne Mbozi meteorite in southern Tanzania, the touristic potential of this event can be exploited through tour packages and worldwide advertisements during the coming year.

Anti-mosquito plants as an alternative or incremental method for malaria vector control among rural communities of Bagamoyo District, Tanzania

PubMed Central

2014-01-01

Background Plants represent one of the most accessible resources available for mosquito control by communities in Tanzania. However, no documented statistics exist for their contribution in the management of mosquitoes and other insects except through verbal and some publications. This study aimed at assessing communities’ knowledge, attitudes and practices of using plants as an alternative method for mosquito control among selected communities in a malaria-prone area in Tanzania. Methods Questionnaires were administered to 202 respondents from four villages of Bagamoyo District, Pwani Region, in Tanzania followed by participatory rural appraisal with village health workers. Secondary data collection for plants mentioned by the communities was undertaken using different search engines such as googlescholar, PubMED and NAPRALERT. Results Results showed about 40.3% of respondents used plants to manage insects, including mosquitoes. A broad profile of plants are used, including “mwarobaini” (Azadirachta indica) (22.5%), “mtopetope” (Annona spp) (20.8%), “mchungwa/mlimau” (Citrus spp) (8.3%), “mvumbashi/uvumbati” (Ocimum spp) (7.4%), “mkorosho” (Anacadium occidentale) (7.1%), “mwembe” (5.4%) (Mangifera indica), “mpera” (4.1%) (Psidium spp) and “maganda ya nazi” (4.1%) (Cocos nucifera). Majority of respondents collected these plants from the wild (54.2%), farms (28.9%) and/or home gardens (6%). The roles played by these plants in fighting mosquitoes is reflected by the majority that deploy them with or without bed-nets (p > 0.55) or insecticidal sprays (p >0.22). Most respondents were aware that mosquitoes transmit malaria (90.6%) while few respondents associated elephantiasis/hydrocele (46.5%) and yellow fever (24.3%) with mosquitoes. Most of the ethnobotanical uses mentioned by the communities were consistent with scientific information gathered from the literature, except for Psidium guajava, which is reported for the first time in

Factors Affecting Exclusive Breastfeeding among Women in Muheza District Tanga Northeastern Tanzania: A Mixed Method Community Based Study.

PubMed

Maonga, Aubrey R; Mahande, Michael J; Damian, Damian J; Msuya, Sia E

2016-01-01

Estimates shows exclusive breastfeeding (EBF) has the potential to prevent 11.6% of all under-five deaths in developing countries. Prevalence of EBF is low globally (35%), and in sub Saharan Africa ranges between 22 and 33%. Like other developing countries the prevalence of EBF is 50% in Tanzania. There is limited information in Tanzania on factors influencing EBF apart from information specific for HIV positive women. This study aimed at examining factors that affect EBF practice among women in Muheza district, Tanga region, northeastern Tanzania. A community based cross-sectional study using both qualitative and quantitative methods was conducted from April to June 2014. To collect relevant information, a total of 316 women with infants aged 6-12 months were interviewed using a questionnaire and 12 key informants using in-depth interview guide. Qualitative data was analyzed using thematic analysis while bivariate and multivariate logistic regression analysis were used assess association between EBF and predictor variables. The prevalence of EBF was 24.1%. The perception that mothers' breast milk is insufficient for child's growth, child being thirsty and the need to introduce herbal medicine for cultural purposes were among the important factors for early mixed feeding. In multivariate analysis advanced maternal age (OR 2.6; 95% CI 1.18-5.59) and knowledge on EBF duration and advantages (OR 2.2; 95% CI 1.2-3.8) remained significantly associated with EBF practice. The prevalence of EBF in our study is low compared with the national prevalence. Strategies to target beliefs that breast milk is insufficient for growth need to be strengthened in the community. Furthermore opportunity to increase EBF training during ante and postnatal visits for women should be enhanced as more than 90% of women in the district use skilled attendants during pregnancy and delivery.

An analysis of pre-service family planning teaching in clinical and nursing education in Tanzania.

PubMed

Muganyizi, Projestine S; Ishengoma, Joyce; Kanama, Joseph; Kikumbih, Nassoro; Mwanga, Feddy; Killian, Richard; McGinn, Erin

2014-07-12

Promoting family planning (FP) is a key strategy for health, economic and population growth. Sub-Saharan Africa, with one of the lowest contraceptive prevalence and highest fertility rates globally, contributes half of the global maternal deaths. Improving the quality of FP services, including enhancing pre-service FP teaching, has the potential to improve contraceptive prevalence. In efforts to improve the quality of FP services in Tanzania, including provider skills, this study sought to identify gaps in pre-service FP teaching and suggest opportunities for strengthening the training. Data were collected from all medical schools and a representative sample of pre-service nursing, Assistant Medical Officer (AMO), Clinical Officer (CO) and assistant CO schools in mainland Tanzania. Teachers responsible for FP teaching at the schools were interviewed using a semi-structured questionnaire. Observations on availability of teaching resources and other evidence of FP teaching and evaluation were documented. Relevant approved teaching documents were assessed for their suitability as competency-based FP teaching tools against predefined criteria. Quantitative data were analyzed using EPI Info 6 and qualitative data were manually analyzed using content analysis. A total of 35 pre-service schools were evaluated for FP teaching including 30 technical education and five degree offering schools. Of the assessed 11 pre-service curricula, only one met the criteria for suitability of FP teaching. FP teaching was typically theoretical with only 22.9% of all the schools having systems in place to produce graduates who could skillfully provide FP methods. Across schools, the target skills were the same level of competence and skewed toward short acting methods of contraception. Only 23.3% (n = 7) of schools had skills laboratories, 76% (n = 22) were either physically connected or linked to FP clinics. None of the degree providing schools practiced FP at its own teaching hospital

Health Libraries and Information Services in Tanzania: A Strategic Assessment

PubMed Central

Haruna, Hussein; Mtoroki, Majaliwa; Gerendasy, Dan D.; Detlefsen, Ellen G.

2016-01-01

Objective To identify the current status and local impact of health sciences libraries and the perception of these libraries by their users, as a pre-requisite to the development of a competence-based curriculum for health information science training in Tanzania. Methodology A needs assessment was carried out using a convenience sample of local respondents, including librarians, trainers, academicians, students, health care providers and patients and families, drawn from national, referral, regional, district hospitals, health training institutions, and Universities from both government and non-government entities in Tanzania. A focus group approach was used to gather data from respondents. Results Results from this assessment revealed that health science libraries in Tanzania are faced with the challenges of insufficient infrastructure, old technology, limited facilities and furniture, inadequate and incompetent library staff, lack of health sciences librarians, outdated and insufficient resources, as well as low knowledge and use of information technologies by library clients. Most respondents would prefer to have both physical and electronic libraries, as well as librarians with specialized health information science skills, to cope with changing nature of the medical field. Conclusion The findings obtained from this assessment are strong enough to guide the development of a curriculum and training strategy and an operational plan and training packages for health information professionals. The development of a training curriculum for health information science professionals will mean better health information service delivery for Tanzania. PMID:28283146

Malaria control in Tanzania

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yhdego, M.; Majura, P.

A review of the malaria control programs and the problem encountered in the United Republic of Tanzania since 1945 to the year 1986 is discussed. Buguruni, one of the squatter areas in the city of Dar es Salaam, is chosen as a case study in order to evaluate the economic advantage of engineering methods for the control of malaria infection. Although the initial capital cost of engineering methods may be high, the cost effectiveness requires a much lower financial burden of only about Tshs. 3 million compared with the conventional methods of larviciding and insecticiding which requires more than Tshs.more » 10 million. Finally, recommendations for the adoption of engineering methods are made concerning the upgrading of existing roads and footpaths in general with particular emphasis on drainage of large pools of water which serve as breeding sites for mosquitoes.« less

Spatial Heterogeneity of Habitat Suitability for Rift Valley Fever Occurrence in Tanzania: An Ecological Niche Modelling Approach

PubMed Central

Sindato, Calvin; Stevens, Kim B.; Karimuribo, Esron D.; Mboera, Leonard E. G.; Paweska, Janusz T.; Pfeiffer, Dirk U.

2016-01-01

Background Despite the long history of Rift Valley fever (RVF) in Tanzania, extent of its suitable habitat in the country remains unclear. In this study we investigated potential effects of temperature, precipitation, elevation, soil type, livestock density, rainfall pattern, proximity to wild animals, protected areas and forest on the habitat suitability for RVF occurrence in Tanzania. Materials and Methods Presence-only records of 193 RVF outbreak locations from 1930 to 2007 together with potential predictor variables were used to model and map the suitable habitats for RVF occurrence using ecological niche modelling. Ground-truthing of the model outputs was conducted by comparing the levels of RVF virus specific antibodies in cattle, sheep and goats sampled from locations in Tanzania that presented different predicted habitat suitability values. Principal Findings Habitat suitability values for RVF occurrence were higher in the northern and central-eastern regions of Tanzania than the rest of the regions in the country. Soil type and precipitation of the wettest quarter contributed equally to habitat suitability (32.4% each), followed by livestock density (25.9%) and rainfall pattern (9.3%). Ground-truthing of model outputs revealed that the odds of an animal being seropositive for RVFV when sampled from areas predicted to be most suitable for RVF occurrence were twice the odds of an animal sampled from areas least suitable for RVF occurrence (95% CI: 1.43, 2.76, p < 0.001). Conclusion/Significance The regions in the northern and central-eastern Tanzania were more suitable for RVF occurrence than the rest of the regions in the country. The modelled suitable habitat is characterised by impermeable soils, moderate precipitation in the wettest quarter, high livestock density and a bimodal rainfall pattern. The findings of this study should provide guidance for the design of appropriate RVF surveillance, prevention and control strategies which target areas with

The economic costs of malaria in children in three sub-Saharan countries: Ghana, Tanzania and Kenya

PubMed Central

2013-01-01

Background Malaria causes significant mortality and morbidity in sub-Saharan Africa (SSA), especially among children less than five years of age (U5 children). Although the economic burden of malaria in this region has been assessed previously, the extent and variation of this burden remains unclear. This study aimed to estimate the economic costs of malaria in U5 children in three countries (Ghana, Tanzania and Kenya). Methods Health system and household costs previously estimated were integrated with costs associated with co-morbidities, complications and productivity losses due to death. Several models were developed to estimate the expected treatment cost per episode per child, across different age groups, by level of severity and with or without controlling for treatment-seeking behaviour. Total annual costs (2009) were calculated by multiplying the treatment cost per episode according to severity by the number of episodes. Annual health system prevention costs were added to this estimate. Results Household and health system costs per malaria episode ranged from approximately US$ 5 for non-complicated malaria in Tanzania to US$ 288 for cerebral malaria with neurological sequelae in Kenya. On average, up to 55% of these costs in Ghana and Tanzania and 70% in Kenya were assumed by the household, and of these costs 46% in Ghana and 85% in Tanzania and Kenya were indirect costs. Expected values of potential future earnings (in thousands) lost due to premature death of children aged 0–1 and 1–4 years were US$ 11.8 and US$ 13.8 in Ghana, US$ 6.9 and US$ 8.1 in Tanzania, and US$ 7.6 and US$ 8.9 in Kenya, respectively. The expected treatment costs per episode per child ranged from a minimum of US$ 1.29 for children aged 2–11 months in Tanzania to a maximum of US$ 22.9 for children aged 0–24 months in Kenya. The total annual costs (in millions) were estimated at US$ 37.8, US$ 131.9 and US$ 109.0 nationwide in Ghana, Tanzania and Kenya and included average

Relationships matter: contraceptive choices among HIV-positive women in Tanzania.

PubMed

Nyanja, Tabitha Alexandria Njeri; Tulinius, Charlotte

2017-07-01

Efforts to eliminate mother-to-child transmission of HIV in Tanzania are guided by a four-prong strategy advocated by the World Health Organization (WHO). Prong 2, prevention of unintended pregnancies among women living with HIV, has, however, received the least attention and contraceptive use to prevent unintended pregnancies remains low. This study explored the perceived barriers to the use of modern methods of contraception, and factors influencing contraceptive choice among HIV-positive women in urban Dar-es-Salaam, Tanzania. A qualitative multi-site study was conducted, utilising in-depth interviews and focus group discussions with 37 sexually active HIV-positive women aged between 20 and 44 years, attending three health facilities within Dar-es-Salaam. The theoretical framework was a patient centred model. Four barriers were identified: the influence of the women's spousal relationships; personal beliefs and the relationship of these in understanding her disease; the influence of the social demands on the woman and her relationships; and the importance of a woman's relationship with her healthcare provider/healthcare system. Being the bearers of bad news (HIV-positive status) the pregnant women experienced conflicts, violence, abandonment and rejection. The loss in negotiating power for the women was in relation to their intimate partners, but also in the patient-healthcare provider relationship. The role of the male partner as a barrier to contraceptive use cannot be understated. Therefore, the results suggest that healthcare providers should ensure patient-focused education and provide support that encompasses the importance of their relationships. Additional research is required to elucidate the functional association between contraceptive choices and personal and social relationships.

Molecular Characterization of Foot-and-Mouth Disease Viruses Collected in Tanzania Between 1967 and 2009.

PubMed

Kasanga, C J; Wadsworth, J; Mpelumbe-Ngeleja, C A R; Sallu, R; Kivaria, F; Wambura, P N; Yongolo, M G S; Rweyemamu, M M; Knowles, N J; King, D P

2015-10-01

This paper describes the molecular characterization of foot-and-mouth disease viruses (FMDV) recovered from outbreaks in Tanzania that occurred between 1967 and 2009. A total of 44 FMDV isolates, containing representatives of serotypes O, A, SAT 1 and SAT 2 from 13 regions of Tanzania, were selected from the FAO World Reference Laboratory for FMD (WRLFMD) virus collection. VP1 nucleotide sequences were determined for RT-PCR amplicons, and phylogenetic reconstructions were determined by maximum likelihood and neighbour-joining methods. These analyses showed that Tanzanian type O viruses fell into the EAST AFRICA 2 (EA-2) topotype, type A viruses fell into the AFRICA topotype (genotype I), type SAT 1 viruses into topotype I and type SAT 2 viruses into topotype IV. Taken together, these findings reveal that serotypes O, A, SAT 1 and SAT 2 that caused FMD outbreaks in Tanzania were genetically related to lineages and topotypes occurring in the East African region. The close genetic relationship of viruses in Tanzania to those from other countries suggests that animal movements can contribute to virus dispersal in sub-Saharan Africa. This is the first molecular description of viruses circulating in Tanzania and highlights the need for further sampling of representative viruses from the region so as to elucidate the complex epidemiology of FMD in Tanzania and sub-Saharan Africa. © 2014 The Authors. Transboundary and Emerging Diseases Published by Blackwell Verlag GmbH.

Anti-mosquito plants as an alternative or incremental method for malaria vector control among rural communities of Bagamoyo District, Tanzania.

PubMed

Innocent, Ester; Hassanali, Ahmed; Kisinza, William Nw; Mutalemwa, Prince Pp; Magesa, Stephen; Kayombo, Edmund

2014-07-11

Plants represent one of the most accessible resources available for mosquito control by communities in Tanzania. However, no documented statistics exist for their contribution in the management of mosquitoes and other insects except through verbal and some publications. This study aimed at assessing communities' knowledge, attitudes and practices of using plants as an alternative method for mosquito control among selected communities in a malaria-prone area in Tanzania. Questionnaires were administered to 202 respondents from four villages of Bagamoyo District, Pwani Region, in Tanzania followed by participatory rural appraisal with village health workers. Secondary data collection for plants mentioned by the communities was undertaken using different search engines such as googlescholar, PubMED and NAPRALERT. Results showed about 40.3% of respondents used plants to manage insects, including mosquitoes. A broad profile of plants are used, including "mwarobaini" (Azadirachta indica) (22.5%), "mtopetope" (Annona spp) (20.8%), "mchungwa/mlimau" (Citrus spp) (8.3%), "mvumbashi/uvumbati" (Ocimum spp) (7.4%), "mkorosho" (Anacadium occidentale) (7.1%), "mwembe" (5.4%) (Mangifera indica), "mpera" (4.1%) (Psidium spp) and "maganda ya nazi" (4.1%) (Cocos nucifera). Majority of respondents collected these plants from the wild (54.2%), farms (28.9%) and/or home gardens (6%). The roles played by these plants in fighting mosquitoes is reflected by the majority that deploy them with or without bed-nets (p > 0.55) or insecticidal sprays (p >0.22). Most respondents were aware that mosquitoes transmit malaria (90.6%) while few respondents associated elephantiasis/hydrocele (46.5%) and yellow fever (24.3%) with mosquitoes. Most of the ethnobotanical uses mentioned by the communities were consistent with scientific information gathered from the literature, except for Psidium guajava, which is reported for the first time in insect control. This survey has indicated some knowledge gap

Towards a National Research Information Service for Tanzania.

ERIC Educational Resources Information Center

Hjerppe, Roland

This report documents initiatives taken to establish scientific and technical information services in Tanzania. The program has as a short term goal the establishment of a national information service for research by the Tanzania National Scientific Research Council with the cooperation and assistance of the Swedish Royal Institute of Technology…

Science Education in Tanzania: Challenges and Policy Responses

ERIC Educational Resources Information Center

Semali, Ladislaus M.; Mehta, Khanjan

2012-01-01

Students in rural and urban areas in Tanzania, and elsewhere in Africa, continue to have limited or lack access to culturally and employment-relevant science education. The current case study, a 2007-2009 examination of barriers to the reform movement of science education in Tanzania, uses data from interviews, classroom observations, document…

Access to HIV prevention services among gender based violence survivors in Tanzania

PubMed Central

Mboya, Beati; Temu, Florence; Awadhi, Bayoum; Ngware, Zubeda; Ndyetabura, Elly; Kiondo, Gloria; Maridadi, Janneth

2012-01-01

Introduction Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. Methods In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach. Results Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection. Conclusion GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended. PMID:23467278

Staff experiences of providing maternity services in rural southern Tanzania - a focus on equipment, drug and supply issues.

PubMed

Penfold, Suzanne; Shamba, Donat; Hanson, Claudia; Jaribu, Jennie; Manzi, Fatuma; Marchant, Tanya; Tanner, Marcel; Ramsey, Kate; Schellenberg, David; Schellenberg, Joanna Armstrong

2013-02-14

The poor maintenance of equipment and inadequate supplies of drugs and other items contribute to the low quality of maternity services often found in rural settings in low- and middle-income countries, and raise the risk of adverse patient outcomes through delaying care provision. We aim to describe staff experiences of providing maternal and neonatal care in rural health facilities in Southern Tanzania, focusing on issues related to equipment, drugs and supplies. Focus group discussions and in-depth interviews were conducted with different staff cadres from all facility levels in order to explore experiences and views of providing maternity care in the context of poorly maintained equipment, and insufficient drugs and other supplies. A facility survey quantified the availability of relevant items. The facility survey, which found many missing or broken items and frequent stock outs, corroborated staff reports of providing care in the context of missing or broken care items. Staff reported increased workloads, reduced morale, difficulties in providing optimal maternity care, and carrying out procedures with potential health risks to themselves as a result. Inadequately stocked and equipped facilities compromise the health system's ability to reduce maternal and neonatal mortality and morbidity by affecting staff personally and professionally, which hinders the provision of timely and appropriate interventions. Improving stock control and maintaining equipment could benefit mothers and babies, not only through removing restrictions to the availability of care, but also through improving staff working conditions.

A review on prevalence, control measure, and tolerance of Tanzania Shorthorn Zebu cattle to East Coast fever in Tanzania.

PubMed

Laisser, E L K; Chenyambuga, S W; Karimuribo, E D; Msalya, G; Kipanyula, M J; Mwilawa, A J; Mdegela, R H; Kusiluka, L J M

2017-04-01

In Tanzania, control of East Coast fever (ECF) has predominantly relied on tick control using acaricides and chemotherapy, little on ECF vaccination, and very little on dissemination regarding animal immunization. In this paper, the prevalence, control measure, and tolerance of Tanzania Shorthorn Zebu (TSHZ) cattle to ECF are reviewed. In addition, the opportunities available for reducing the use of acaricides for the benefit of the farmers in terms of reduction of costs of purchasing acaricides and environmental pollution are described. The tick distribution and epidemiological factors for ECF such as the agro-ecological zones (AEZ), livestock production systems (LPS), strain, and age of the animals are also described. These factors influence the epidemiology of ECF and the distribution of TSHZ strains in different geographic locations of Tanzania. We have further showed that there is a tendency of farmers to select among the strains of TSHZ for animals which can tolerate ticks and ECF and crossbreed them with their local strains with the aim of benefiting from the inherent characteristics of the most tolerant strains. Generally, many strains of TSHZ cattle are tolerant to tick infestation and ECF infection and can be bred to respond to the needs of the people. In this review paper, we recommend that in future, ECF epidemiological studies should account for factors such as livestock production system, agro-climate, breed of animal, tick control strategy, and the dynamic interactions between them. In conclusion, we have demonstrated that an integrated control method involving use of acaricides, immunization, and ECF-tolerant/-resistant animals is required.

Mount Kilimanjaro, Tanzania

NASA Image and Video Library

1996-01-20

STS072-722-004 (11-20 Jan. 1996) --- Mount Kilimanjaro in Tanzania is featured in this 70mm frame exposed from the Earth-orbiting Space Shuttle Endeavour. Orient with the clouds trailing to the left; then the view is southwest from Kenya past Kilimanjaro to Mount Meru, in Tanzania. Mount Kilimanjaro is about three degrees south of the Equator, but at nearly 6,000 meters has a permanent snowfield. The mountain displays a classic zonation of vegetation types from seasonally dry savannah on the plains at 1,000 meters, to the cloud forest near the top. The mountain is being managed experimentally as an international biosphere reserve. A buffer zone of "traditional" agriculture and pastoral land use is designated around the closed-canopy forest reserve. Specialists familiar with this area say management is partially successful so far, but cleared areas of the forest can be seen on this photograph as light green "nibbles" or "cookie cuts" extending into the dark forest region.

Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania.

PubMed

Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Ndossi, Godwin D; Osei, Eric J A; Sidibe, Mintou Fall; Boupha, Boungnong

2011-12-13

Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs). This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140), Laos (136), Senegal (100) and Tanzania (121). Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. The survey achieved a 75% response rate (372/497) across Ghana (107/140), Laos (136/136), Senegal (51/100) and Tanzania (78/121). Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13%) or self-reported performing all five clinical practices according to established evidence (2%). Statistically significant factors associated with higher knowledge within each country included: 1) training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73); and 2) ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70). Statistically significant factors associated with better clinical practices within each country include: 1) reading scientific journals from their own country (OR 1.67, 95% CI 1.10-2.54); 2) working

Tanzania.

PubMed

1992-05-01

Background notes on Tanzania present a profile of nationality, population count of 26 million, growth rate of 3.5%, ethnic groups (130), religions (33% Muslim, 33% animist, 33% Christian), languages, education (86% primary), literacy (79%), health (infant mortality of 106/1000), and work force (90% agriculture). Geographic data are given for the area, cities, terrain, and climate. The Tanzanian government is a republic with executive, legislative, and judicial branches of government. There is 1 political party and everyone 18 years is eligible to vote. 4% of the gross domestic product (GDP) ($5.9 billion) is devoted to defense. Economic growth is 4.3%/year and person income is $240/capita. Natural resources, agriculture, industry, and trade are identified. $400 million has been received between 1970-92 in US economic aid. The 1992 official exchange rate is 300 Tanzanian shillings to the US dollar. Descriptive text is given for the population, the history of Tanganyika and Zanzibar, the government, principal government officials (President, 1st Vice President [VP], 2nd VP and President of Zanzibar, Prime Minister, Foreign Affairs Minister, Ambassador to the US, Ambassador to the UN, and US embassy address and phone number), political conditions, the economy, the defense, foreign relations, and US-Tanzanian relations. Principal US officials are identified for the Ambassador, Deputy Chief of Mission, USAID Director, and Public Affairs Officer; the US embassy address is given also. The population is 80% rural with a density of 1/sq km in arid areas, 51/sq km on the mainland, and 134/sq km on Zanzibar. The new capital will be Dodoma in central Tanzania. Most residents are of Bantu stock; nomadic groups are the Masai and the Luo. 1% are non-Africans. Government has a strong central executive. The current President is Ali Hassan Mwinyi. The Revolutionary Party is in the primary policymaking body and provides all government leaders. The government seeks to foster the

Determinants of community health fund membership in Tanzania: a mixed methods analysis.

PubMed

Macha, Jane; Kuwawenaruwa, August; Makawia, Suzan; Mtei, Gemini; Borghi, Josephine

2014-11-20

In many developing countries, initiatives are underway to strengthen voluntary community based health insurance as a means of expanding access to affordable care among the informal sector. However, increasing coverage with voluntary health insurance in low income settings can prove challenging. There are limited studies on determinants of enrolling in these schemes using mixed methods. This study aims to shed light on the characteristics of those joining a community health fund, a type of community based health insurance, in Tanzania and the reasons for their membership and subsequent drop out using mixed methods. A cross sectional survey of households in four rural districts was conducted in 2008, covering a total of 1,225 (524 members of CHF and 701 non-insured) households and 7,959 individuals. In addition, 12 focus group discussions were carried out with CHF members, non-scheme members and members of health facility governing committees in two rural districts. Logistic regression was used to assess the determinants of CHF membership while thematic analysis was done to analyse qualitative data. The quantitative analysis revealed that the three middle income quintiles were more likely to enrol in the CHF than the poorest and the richest. CHF member households were more likely to be large, and headed by a male than uninsured households from the same areas. The qualitative data supported the finding that the poor rather than the poorest were more likely to join as were large families and of greater risk of illness, with disabilities or persons with chronic diseases. Households with elderly members or children under-five years were also more likely to enrol. Poor understanding of risk pooling deterred people from joining the scheme and was the main reason for not renewing membership. On the supply side, poor quality of public care services, the limited benefit package and a lack of provider choice were the main factors for low enrolment. Determinants of CHF

The Political Economy of Biofuels and Farming: The Case of Smallholders in Tanzania

NASA Astrophysics Data System (ADS)

Winters, Kristen

Following decades of neoliberal policies promoting commodity driven export production, the small scale farming sector in many developing countries has suffered from declining market share, lessening productivity and deepening poverty. In recent years, biofuels have been promoted within developing countries to foster rural development and provide new markets for the smallholders. Using Tanzania as a case study, this thesis evaluates the extent to which the emerging biofuel sector provides opportunities for smallholders to gain beneficial access to markets -- or whether the sector is following the trajectory of other export-oriented commodity projects of the past and resulting in the marginalisation of smallholders. This thesis asserts that the biofuel sector in Tanzania presents more threats than benefits for smallholders; a pattern can be witnessed that favours foreign investors and dispossesses farmers of existing land, while providing few opportunities at a local level for income generation and employment.

Counsellors' perspectives on the experience of providing HIV counselling in Kenya and Tanzania: the Voluntary HIV-1 Counselling and Testing Efficacy Study.

PubMed

Grinstead, O A; van der Straten, A

2000-10-01

Demand for HIV counselling services is increasing in developing counties, but there have been few previous studies that describe counsellors' roles and experiences providing HIV-related counselling in developing countries. Such information can be used to better supervise and support counsellors and thereby improve counselling services. As a sub-study of the Voluntary Counseling and Testing Efficacy Study, we conducted focus groups and individual interviews with 11 counsellors and counselling supervisors providing HIV counselling services in Kenya and Tanzania. Counsellors told us that their jobs were both rewarding and stressful. In addition to their obligations in the counselling relationship (providing information, protecting confidentiality and being non-judgemental), they perceived pressure to provide information and be good role models in their communities. Additional stresses were related to external (economic and political) conditions, 'spillover' of HIV issues from their personal lives and providing counselling in a research setting. Counsellor stress might be reduced and their effectiveness and retention improved by (1) allowing work flexibility; (2) providing supportive, non-evaluative supervision; (3) offering alternatives to client behaviour change as the indication of counsellor performance; (4) acknowledging and educating about 'emotional labour' in counselling; (5) providing frequent information updates and intensive training; and (6) encouraging counsellor participation in the development of research protocols.

Electronic Field Data Collection in Support of Satellite-Based Food Security Monitoring in Tanzania

NASA Astrophysics Data System (ADS)

Nakalembe, C. L.; Dempewolf, J.; Justice, C. J.; Becker-Reshef, I.; Tumbo, S.; Maurice, S.; Mbilinyi, B.; Ibrahim, K.; Materu, S.

2016-12-01

In Tanzania agricultural extension agents traditionally collect field data on agriculture and food security on paper, covering most villages throughout the country. The process is expensive, slow and cumbersome and prone to data transcription errors when the data get entered at the district offices into electronic spreadsheets. Field data on the status and condition of agricultural crops, the population's nutritional status, food storage levels and other parameters are needed in near realtime for early warning to make critical but most importantly timely and appropriate decisions that are informed with verified data from the ground. With the ubiquitous distribution of cell phones, which are now used by the vast majority of the population in Tanzania including most farmers, new, efficient and cost-effective methods for field data collection have become available. Using smartphones and tablets data on crop conditions, pest and diseases, natural disasters and livelihoods can be collected and made available and easily accessible in near realtime. In this project we implemented a process for obtaining high quality electronic field data using the GeoODK application with a large network of field extension agents in Tanzania and Uganda. These efforts contribute to work being done on developing an advanced agriculture monitoring system for Tanzania, incorporating traditional data collection with satellite information and field data. The outcomes feed directly into the National Food Security Bulletin for Tanzania produced by the Ministry of Agriculture as well as a form a firm evidence base and field scale monitoring of the disaster risk financing in Uganda.

Cost-effectiveness of live oral attenuated human rotavirus vaccine in Tanzania.

PubMed

Ruhago, George M; Ngalesoni, Frida N; Robberstad, Bjarne; Norheim, Ole F

2015-01-01

Globally, diarrhoea is the second leading cause of morbidity and mortality, responsible for the annual loss of about 10% of the total global childhood disease burden. In Tanzania, Rotavirus infection is the major cause of severe diarrhoea and diarrhoeal mortality in children under five years. Immunisation can reduce the burden, and Tanzania added rotavirus vaccine to its national immunisation programme in January 2013. This study explores the cost effectiveness of introducing rotavirus vaccine within the Tanzania Expanded Programme on Immunisation (EPI). We quantified all health system implementation costs, including programme costs, to calculate the cost effectiveness of adding rotavirus immunisation to EPI and the existing provision of diarrhoea treatment (oral rehydration salts and intravenous fluids) to children. We used ingredients and step down costing methods. Cost and coverage data were collected in 2012 at one urban and one rural district hospital and a health centre in Tanzania. We used Disability Adjusted Life Years (DALYs) as the outcome measure and estimated incremental costs and health outcomes using a Markov transition model with weekly cycles up to a five-year time horizon. The average unit cost per vaccine dose at 93% coverage is US$ 8.4, with marked difference between the urban facility US$ 5.2; and the rural facility US$ 9.8. RV1 vaccine added to current diarrhoea treatment is highly cost effective compared to diarrhoea treatment given alone, with incremental cost effectiveness ratio of US$ 112 per DALY averted, varying from US$ 80-218 in sensitivity analysis. The intervention approaches a 100% probability of being cost effective at a much lower level of willingness-to-pay than the US$609 per capita Tanzania gross domestic product (GDP). The combination of rotavirus immunisation with diarrhoea treatment is likely to be cost effective when willingness to pay for health is higher than USD 112 per DALY. Universal coverage of the vaccine will

Tsetse fly feeding preference as determined by vehicular trapping in Tanzania.

PubMed

Gates, D B; Williamson, D L

1984-06-01

In eastern Tanzania an electric grid trap carried in the back of a moving pick-up truck was used to capture engorged Glossina morsitans morsitans and G. pallidipes for an analysis of their food sources. Although 12 000 head of domestic cattle represented c. 75% of the animal biomass in the survey area, they provided only 5.6% of the total blood meals, while 74.8% were from warthogs and bushpigs. The percentage of females among the captured flies was 12 and 47 for G. m. morsitans and G. pallidipes, respectively. The incidence of engorged flies captured by this method ranged from 15 to 20% in males and 26 to 42% in females.

Students' Attitudes towards School-Based Sex and Relationships Education in Tanzania

ERIC Educational Resources Information Center

Mkumbo, Kitila A. K.

2014-01-01

Objective: The objective of this paper was to assess students' attitudes towards school-based sex and relationships education (SRE). Design: This study featured a cross-sectional survey design. Method: A sample of 715 students from two districts in Tanzania completed a survey questionnaire assessing various aspects related to their attitudes…

The Costs of Climate Change: A Study of Cholera in Tanzania

PubMed Central

Trærup, Sara L. M.; Ortiz, Ramon A.; Markandya, Anil

2011-01-01

Increased temperatures and changes in rainfall patterns as a result of climate change are widely recognized to entail potentially serious consequences for human health, including an increased risk of diarrheal diseases. This study integrates historical data on temperature and rainfall with the burden of disease from cholera in Tanzania and uses socioeconomic data to control for the impacts of general development on the risk of cholera. The results show a significant relationship between temperature and the incidence of cholera. For a 1 degree Celsius temperature increase the initial relative risk of cholera increases by 15 to 29 percent. Based on the modeling results, we project the number and costs of additional cases of cholera that can be attributed to climate change by 2030 in Tanzania for a 1 and 2 degree increase in temperatures, respectively. The total costs of cholera attributable to climate change are shown to be in the range of 0.32 to 1.4 percent of GDP in Tanzania 2030. The results provide useful insights into national-level estimates of the implications of climate change on the health sector and offer information which can feed into both national and international debates on financing and planning adaptation. PMID:22408580

Career development expectations and challenges of midwives in Urban Tanzania: a preliminary study.

PubMed

Tanaka, Nao; Horiuchi, Shigeko; Shimpuku, Yoko; Leshabari, Sebalda

2015-01-01

Approaches to addressing the shortage of midwives are a great need especially in Sub-Saharan Africa including Tanzania. The midwifery shortage in Tanzania consists of two major causes; the first is the shortage of pre-service nursing training and the second is the low rate of retention as it is difficult to sustain midwives' career motivations. Lack of opportunities for career development, is one of the most related problems to keep midwives motivated. Continuing education as an approach to career development can heighten midwives' motivation and cultivate more skilled midwives who can educate other midwives or students and who could raise the status of midwives. Effective continuing education is ongoing, interactive, contextually relevant and based on needs assessment, however there is very limited research that describes Tanzanian midwives perspective of expectations for career development; hence this research is significant for revealing important and meaningful professional desires of midwives in Tanzania. This was a preliminary qualitative study, using snowball sampling to recruit 16 midwives in Tanzania. The researchers used a semi-structured interview including probing questions with both a focus group and several individuals. The data were collected from July to December 2013 and coded into categories and sub-categories. There were 14 midwives in the focus group interview and two midwives in the individual interviews. Through data analysis, four major categories (with subcategories) emerged: (1) motivation for learning (to achieve the MDGs, and to raise reproductive health), (2) knowledge is power (to provide good practice based on knowledge, to be a role model, knowledge gives higher position and courage, and knowledge enables one to approach to the government), (3) there is no end to learning (hunger for learning, and ripple effect). From findings, four major categories plainly showed midwives' desire for learning, however they experienced a number of

Sources of community health worker motivation: a qualitative study in Morogoro Region, Tanzania

PubMed Central

2013-01-01

Background There is a renewed interest in community health workers (CHWs) in Tanzania, but also a concern that low motivation of CHWs may decrease the benefits of investments in CHW programs. This study aimed to explore sources of CHW motivation to inform programs in Tanzania and similar contexts. Methods We conducted semi-structured interviews with 20 CHWs in Morogoro Region, Tanzania. Interviews were digitally recorded, transcribed, and coded prior to translation and thematic analysis. The authors then conducted a literature review on CHW motivation and a framework that aligned with our findings was modified to guide the presentation of results. Results Sources of CHW motivation were identified at the individual, family, community, and organizational levels. At the individual level, CHWs are predisposed to volunteer work and apply knowledge gained to their own problems and those of their families and communities. Families and communities supplement other sources of motivation by providing moral, financial, and material support, including service fees, supplies, money for transportation, and help with farm work and CHW tasks. Resistance to CHW work exhibited by families and community members is limited. The organizational level (the government and its development partners) provides motivation in the form of stipends, potential employment, materials, training, and supervision, but inadequate remuneration and supplies discourage CHWs. Supervision can also be dis-incentivizing if perceived as a sign of poor performance. Conclusions Tanzanian CHWs who work despite not receiving a salary have an intrinsic desire to volunteer, and their motivation often derives from support received from their families when other sources of motivation are insufficient. Policy-makers and program managers should consider the burden that a lack of remuneration imposes on the families of CHWs. In addition, CHWs’ intrinsic desire to volunteer does not preclude a desire for external rewards

Memoir of Tanzania: Learning about Early Childhood Projects in Developing Countries

ERIC Educational Resources Information Center

Penn, Helen

2017-01-01

This article considers the contribution of memoir as a method for understanding complex early childhood issues. It recounts the author's first visit to Tanzania, a low-income country with a chequered history of independence from colonial rule. The article uses memories from that initial visit to reflect on the changing interpretations of colonial…

Knowledge, attitudes and practice pertaining to depression among primary health care workers in Tanzania

PubMed Central

Mbatia, Joseph; Shah, Ajit; Jenkins, Rachel

2009-01-01

Background Examination of consultation data in a variety of primary care settings in Tanzania shows that, while psychoses are routinely diagnosed and treated at primary care level, depression is rarely recorded as a reason for consultation. Since, epidemiological studies elswhere show that depression is a much more common disorder than psychosis, a series of studies were undertaken to elucidate this apparent paradox in Tanzania and inform mental health policy; firstly, a household prevalence study to ascertain the prevalence of common mental disorders at community level in Tanzania; secondly, a study to ascertain the prevalence of common mental disorders in primary care attenders; and thirdly, a study to ascertain the current status of the knowledge, attitude and practice pertaining to depression among primary health care workers. This paper reports the findings of the latter study. Methods All the primary health care workers (N = 14) in four primary health care centres in Tanzania were asked to complete the Depression Attitude Questionnaire, which assesses the health worker's knowledge and attitude towards the causes, consequences and treatment of depression. Results The majority of respondents felt that rates of depression had increased in recent years, believed that life events were important in the aetiology of depression, and generally held positive views about pharmacological and psychological treatments of depression, prognosis and their own involvement in the treatment of depressed patients. However, the majority of respondents felt that becoming depressed is a way that people with poor stamina deal with life difficulties. Conclusion The findings suggest a need to strengthen the training of primary health care workers in Tanzania about the detection of depression, pharmacological and psychological treatments, and psychosocial interventions. PMID:19243596

Results of Co-Teaching Instruction to Special Education Teacher Candidates in Tanzania

ERIC Educational Resources Information Center

Frey, Laura M.; Kaff, Marilyn S.

2014-01-01

This mixed-method descriptive pilot investigation addressed co-teaching as an inclusive school practice for special education teacher candidates at Sebastian Kolowa Memorial University (SEKOMU) in Tanzania. The investigation results, though preliminary, indicate that course content and instruction in co-teaching had a positive impact on the…

Is Development Assistance for Health fungible? Findings from a mixed methods case study in Tanzania.

PubMed

Martínez Álvarez, Melisa; Borghi, Josephine; Acharya, Arnab; Vassall, Anna

2016-06-01

The amount of Development Assistance for Health (DAH) available to low- and middle-income countries has increased exponentially over the past decade. However, there are concerns that DAH increases have not resulted in increased spending on health at the country level. This is because DAH may be fungible, resulting from the recipient government decreasing its contribution to the health sector as a result of external funding. The aim of this research is to assess whether DAH funds in Tanzania are fungible, by exploring government substitution of its own resources across sectors and within the health sector. A database containing 28140 projects of DAH expenditure between 2000 and 2010 was compiled from the Organisation for Economic Co-operation and Development's Creditor Reporting System (OECD-CRS) and AidData databases. Government health expenditure data for the same period were obtained from the Government of Tanzania, World Bank, public expenditure reviews and budget speeches and analysed to assess the degree of government substitution. 22 semi-structured interviews were conducted with Development Partners (DPs), government and non-government stakeholders between April and June 2012 to explore stakeholder perceptions of fungibility. We found some evidence of substitution of government funds at the health sector and sub-sector levels and two mechanisms through which it takes place: the resource allocation process and macro-economic factors. We found fungibility of external funds may not necessarily be detrimental to Tanzania's development (as evidence suggests the funds displaced may be reallocated to education) and the mechanisms used by DPs to prevent substitution were largely ineffective. We recommend DPs engage more effectively in the priority-setting process, not just with the Ministry of Health and Social Welfare (MoHSW), but also with the Ministry of Finance, to agree on priorities and mutual funding responsibilities at a macroeconomic level. We also call for

Tetanus in adult males, Bugando Medical Centre, United Republic of Tanzania.

PubMed

Aziz, Riaz; Peck, Robert N; Kalluvya, Samuel; Kenemo, Bernard; Chandika, Alphonce; Downs, Jennifer A

2017-11-01

In the United Republic of Tanzania, the incidence of non-neonatal circumcision-related tetanus is probably underreported. We analysed charts and extracted information on outcome and wound location for non-neonatal cases of tetanus admitted to the intensive care unit of Bugando Medical Centre between 2001 and 2016. Bugando Medical Centre, which is one of four teaching referral hospitals in the United Republic of Tanzania, has a 13-bed intensive care unit that manages all admitted patients with tetanus. Within the United Republic of Tanzania, formal programmes of tetanus immunization are targeted at infants or women. From our inpatient logs, we identified six patients with non-neonatal tetanus among male patients with a recent history of circumcision. Only one of these patients had been circumcised within a subnational programme of voluntary medical male circumcision. The other five had been circumcised outside of the programme - e.g. at small rural dispensaries or by a traditional provider with no formal medical training. The six patients were aged 11-55 years and five (83%) of them died in hospital - all of overwhelming sepsis. Within the Tanzanian programme of voluntary medical male circumcision, education on wound hygiene probably helps to reduce the incidence of non-neonatal circumcision-related tetanus. The corresponding incidence among the boys and men who are circumcised beyond this subnational programme is probably higher. The training of all circumcision providers in wound care and a vaccination programme to ensure that male Tanzanians receive tetanus immunization post-infancy are recommended.

Academia-Industry-Government Linkages in Tanzania: Trends, Challenges and Prospects

ERIC Educational Resources Information Center

Mpehongwa, Gasper

2013-01-01

This paper analyzed trends, challenges and prospects of academia-industry-government linkages in Tanzania. Using case study design, and documentary review to gather the required data, the study sought to answer three research questions: (1) what are the trends of academia-industry-government linkages in Tanzania?, (2) what are the challenges…

USAID and FINCA: helping women in Tanzania.

PubMed

Henderson, K

2000-01-01

In Tanzania, the international microfinance network FINCA set up shop and began training its first Village Banking Groups in June 1998, disbursing its first loans in July with a grant from the US Agency for International Development. Within 2 months, the program reached 757 low-income women and distributed loans worth US$57,183 using the group support system in which 30-50 neighbors come together to guarantee one another's loans. With the loans from FINCA, entrepreneurs quickly became involved in a range of business activities, from selling tomatoes to starting a hair salon. Located in Mwanza, in the Lake Zone, FINCA Tanzania's clients include many members of the Sukuma tribe. It is noted that in this region there are a few job opportunities in the formal economy. In 1999, FINCA Tanzania reached 3632 clients, exceeding its targets despite a difficult economic environment. In that same year, FINCA partnered with Freedom from Hunger in launching a program that offers some of its members health education and basic business training at Village Banking Group meetings.

Breaking ground in Tanzania. GO-NGO collaboration.

PubMed

1998-05-01

JOICFP's reproductive health(RH)-oriented Integrated Project (IP) is being implemented by JOICFP's counterpart, the Family Planning Association of Tanzania (UMATI). The Japanese government usually provides support to help governmental programs. However, through this collaborative effort, the government of Japan is providing commodity and equipment assistance to support the RH/family planning and safe motherhood activities promoted by UMATI in collaboration with the Tanzanian government, with support provided through multilateral-bilateral assistance in collaboration with UNFPA. The Japanese government has agreed to provide US$170,000 annually in commodity and equipment assistance to the project over the period 1997-2000. The funds will be used to support family planning/maternal and child health clinics and dispensaries in project areas run by the government, as well as to support UMATI activities.

Clusters and Factors Associated with Complementary Basic Education in Tanzania Mainland

ERIC Educational Resources Information Center

Edwin, Paul; Amina, Msengwa S.; Godwin, Naimani M.

2017-01-01

Complimentary Basic Education in Tanzania (COBET) is a community-based programme initiated in 1999 to provide formal education system opportunity to over aged children or children above school age. The COBET program was analyzed using secondary data collected from 21 regions from 2008 to 2012. Cluster analysis was applied to classify the 21…

Corporal punishment in Tanzania's schools

NASA Astrophysics Data System (ADS)

Feinstein, Sheryl; Mwahombela, Lucas

2010-10-01

The purpose of this survey was to acquire descriptive information regarding corporal punishment in Tanzania's O-level secondary schools. 448 individuals participated in the study: 254 teachers and 194 students, all from government or private secondary schools in the Iringa Region of Tanzania. In addition, 14 students and 14 teachers were interviewed. It was found that corporal punishment was the most common form of punishment in secondary schools. The majority of teachers supported its continued use, but believed in moderation. The majority of students and teachers were unaware of national laws to restrict corporal punishment. There was agreement between students and teachers that corporal punishment was used for major and minor student offences such as misbehaviour and tardiness. Students reported disliking the practice and believed it was ineffective and resulted in emotional, as well as physical, distress.

Impediments of E-Learning Adoption in Higher Learning Institutions of Tanzania: An Empirical Review

ERIC Educational Resources Information Center

Mwakyusa, Wilson Pholld; Mwalyagile, Neema Venance

2016-01-01

It is experienced that most of the Higher Learning Institutions (HLIs) in developing countries including Tanzania fails to fully implement e-learning system as a an alternative method of delivering education to a large population in the universities. However, some of HLIs are practicing the blended method by which both elearning and traditional…

A Modernized System for Agricultural Monitoring for Food Security in Tanzania

NASA Astrophysics Data System (ADS)

Dempewolf, J.; Nakalembe, C. L.; Becker-Reshef, I.; Justice, C. J.; Tumbo, S.; Mbilinyi, B.; Maurice, S.; Mtalo, M.

2016-12-01

Accurate and timely information on agriculture, particularly in many countries dominated by complex smallholder, subsistence agricultural systems is often difficult to obtain or not available. This includes up-to-date information during the growing season on crop type, crop area and crop condition such as developmental stage, damage from pests and diseases, drought or flooding. These data are critical for government decision making on production forecasts, planning for commodity market transactions, food aid delivery, responding to disease outbreaks and for implementing agricultural extension and development efforts. In Tanzania we have been working closely with the National Food Security Division (NFSD) at the Ministry of Agriculture, Livestock and Fisheries (MALF) on designing and implementing an advanced agricultural monitoring system, utilizing satellite remote sensing, smart phone and internet technologies. Together with our local implementing partner, the Sokoine University of Agriculture we trained a large number of agricultural extension agents in different regions of Tanzania to deliver field data in near-realtime. Using our collaborative internet portal (Crop Monitor) the team of analysts compiles pertinent information on current crop and weather conditions from throughout the country in a standardized, consistent manner. Using the portal traditionally collected data are combined with electronically collected field data and MODIS satellite image time series from GLAM East-Africa (Global Agricultural Monitoring System, customized for stakeholders in East Africa). The main outcome of this work has been the compilation of the National Food Security Bulletin for Tanzania with plans for a public release and the intention for it to become the main avenue to dispense current updates and analysis on agriculture in the country. The same information is also a potential contribution to the international Early Warning Crop Monitor, which currently covers Tanzania

Access to HIV prevention services among gender based violence survivors in Tanzania.

PubMed

Mboya, Beati; Temu, Florence; Awadhi, Bayoum; Ngware, Zubeda; Ndyetabura, Elly; Kiondo, Gloria; Maridadi, Janneth

2012-01-01

Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach. Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection. GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended.

Human migration, protected areas, and conservation outreach in Tanzania.

PubMed

Salerno, Jonathan D; Borgerhoff Mulder, Monique; Kefauver, Shawn C

2014-06-01

A recent discussion debates the extent of human in-migration around protected areas (PAs) in the tropics. One proposed argument is that rural migrants move to bordering areas to access conservation outreach benefits. A counter proposal maintains that PAs have largely negative effects on local populations and that outreach initiatives even if successful present insufficient benefits to drive in-migration. Using data from Tanzania, we examined merits of statistical tests and spatial methods used previously to evaluate migration near PAs and applied hierarchical modeling with appropriate controls for demographic and geographic factors to advance the debate. Areas bordering national parks in Tanzania did not have elevated rates of in-migration. Low baseline population density and high vegetation productivity with low interannual variation rather than conservation outreach explained observed migration patterns. More generally we argue that to produce results of conservation policy significance, analyses must be conducted at appropriate scales, and we caution against use of demographic data without appropriate controls when drawing conclusions about migration dynamics. © 2014 Society for Conservation Biology.

Building an Agricultural Extension Services System Supported by ICTs in Tanzania: Progress Made, Challenges Remain

ERIC Educational Resources Information Center

Sanga, C.; Kalungwizi, V. J.; Msuya, C. P.

2013-01-01

The conventional agricultural extension service in Tanzania is mainly provided by extension officers visiting farmers to provide agricultural advisory service. This system of extension service provision faces a number of challenges including the few number of extension officers and limited resources. This article assesses the effectiveness of an…

Why do health workers in rural Tanzania prefer public sector employment?

PubMed

Songstad, Nils Gunnar; Moland, Karen Marie; Massay, Deodatus Amadeus; Blystad, Astrid

2012-04-05

Severe shortages of qualified health workers and geographical imbalances in the workforce in many low-income countries require the national health sector management to closely monitor and address issues related to the distribution of health workers across various types of health facilities. This article discusses health workers' preferences for workplace and their perceptions and experiences of the differences in working conditions in the public health sector versus the church-run health facilities in Tanzania. The broader aim is to generate knowledge that can add to debates on health sector management in low-income contexts. The study has a qualitative study design to elicit in-depth information on health workers' preferences for workplace. The data comprise ten focus group discussions (FGDs) and 29 in-depth interviews (IDIs) with auxiliary staff, nursing staff, clinicians and administrators in the public health sector and in a large church-run hospital in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in Tanzania. The study found a clear preference for public sector employment. This was associated with health worker rights and access to various benefits offered to health workers in government service, particularly the favourable pension schemes providing economic security in old age. Health workers acknowledged that church-run hospitals generally were better equipped and provided better quality patient care, but these concerns tended to be outweighed by the financial assets of public sector employment. In addition to the sector specific differences, family concerns emerged as important in decisions on workplace. The preference for public sector employment among health workers shown in this study seems to be associated primarily with the favourable pension scheme. The overall shortage of health workers and the distribution between health facilities is a challenge in a resource constrained health system

Research Trends in Emerging Contaminants on the Aquatic Environments of Tanzania

PubMed Central

Miraji, H.; Othman, O. C.; Ngassapa, F. N.; Mureithi, E. W.

2016-01-01

The continuity for discovery and production of new chemicals, allied products, and uses has currently resulted into generation of recent form of contaminants known as Emerging Contaminants (ECs). Once in the aquatic environment ECs are carcinogenic and cause other threats to both human's and animals' health. Due to their effects this study was aimed at investigating research trends of ECs in Tanzania. Findings revealed that USA and EU countries were leading in ECs researches, little followed by Asia, South Africa, and then Zambia. Only few guidelines from USA-EPA, WHO, Canada, and Australia existed. Neither published guidelines nor regulations for ECs existed in Tanzania; rather only the occurrence of some disinfection by-products and antibiotics was, respectively, reported in Arusha and Dar es Salaam, Tanzania. As these reports had a limited coverage of ECs, henceforth, these findings constitute the first-line reference materials for ECs research in Tanzania which shall be useful for future monitoring and regulation planning. PMID:26998381

Spatial and Temporal Climatic Variation in Coastal Tanzania

NASA Astrophysics Data System (ADS)

Rohli, R. V.; Ates, S.; Rivera-Monroy, V. H.; Polito, M. J.; Midway, S. R.; Gold, A.; Castañeda-Moya, E.; Uchida, E.; Suwa, M.; Mangora, M. M.

2017-12-01

Climatic controls are particularly important to the natural and human systems in coastal Tanzania, where mangrove vegetation is a major component of world-renowned biodiversity. This research provides an improved understanding of the climatic features and forcing mechanisms that support the critical mangroves of Tanzania and the livelihoods of its populace, using updated and complete datasets. Updated data confirm that coastal Tanzania falls in the tropical wet-dry Köppen-Geiger climatic type, except for the extreme north, where tropical rain forest exists north of Pangani. The northeast monsoon, known as the kaskazi, largely corresponds to the rainy November-December and March-May months. The southeast monsoon - known as the kusi - overlaps with the drier June-September. Results suggest that El Niño-Southern Oscillation (ENSO) and Indian Ocean Dipole (IOD) are key modulators of precipitation variability in the entire area. More specifically, September-November positive precipitation anomalies occur during positive IOD, especially when combined with El Niño, with slightly negative anomalies during negative IOD, especially when combined with La Niña. The rest of the year tends to show similar precipitation during both IOD phases (March-August) or less precipitation during the positive phase (December-February). Because the literature suggests likelihood of more frequent positive IOD mode and a strengthened relationship of these events to warm-ENSO events, changes to the hydrologic cycle in east Africa may be likely in the future, with a potential for an expanded secondary rainy season and a drier "saddle" between the secondary and primary rainy seasons (i.e., December-February). Therefore, future research should investigate in more detail the influence of the IOD and ENSO on various components of the climatic water balance. Results may be useful to earth, environmental, and social scientists as they seek further understanding of the drivers of ecological and

Quantitative market survey of non-woody plants sold at Kariakoo Market in Dar es Salaam, Tanzania.

PubMed

Posthouwer, Chantal; Veldman, Sarina; Abihudi, Siri; Otieno, Joseph N; van Andel, Tinde R; de Boer, Hugo J

2018-04-30

In Tanzania, traditional medicine plays a significant role in health care and local economies based on the harvesting, trade and sale of medicinal plant products. The majority of this plant material is said to originate from wild sources, and both traditional healers and vendors are concerned about the increasing scarcity of certain species. A market survey of non-powdered, non-woody medicinal plants was conducted at Kariakoo Market in Dar es Salaam, the major hub for medicinal plant trade in Tanzania, to assess sustainability of traded herbal medicine. For this study, fresh and dried herbs, seeds and fruits were collected and interviews were conducted to obtain information on vernacular names, preparation methods, monthly sales, uses and prices. Bundles of herbal medicine offered for sale were weighed and counted to calculate the value and volumes of daily stock at the market. A total of 71 medicinal plant products belonging to 62 to 67 different species from at least 41 different plant families were identified. We identified 45 plant products to species level, 20 products to genus level and four to family level. Plant species most encountered at the market were Suregada zanzibariensis, Myrothamnus flabellifolia and Sclerocarya birrea. The major use categories reported by the vendors were ritual purposes, digestive disorders and women's health. Annual sales are estimated to be in excess of 30 t and close to 200,000 USD, and trade in herbal medicine at Kariakoo Market provides subsistence income to many local vendors. A large diversity of wild-harvested plant species is traded as medicinal products in Tanzania, including species listed on CITES Appendices. Identifying and monitoring temporal changes in availability per season and from year to year will reveal which species are most affected by this trade, and help relevant authorities in Tanzania to find alternative sources of income for dependent stakeholders and initiate targeted efforts to protect threatened

Improvements in access to malaria treatment in Tanzania after switch to artemisinin combination therapy and the introduction of accredited drug dispensing outlets - a provider perspective.

PubMed

Alba, Sandra; Hetzel, Manuel W; Goodman, Catherine; Dillip, Angel; Liana, Jafari; Mshinda, Hassan; Lengeler, Christian

2010-06-15

To improve access to treatment in the private retail sector a new class of outlets known as accredited drug dispensing outlets (ADDO) was created in Tanzania. Tanzania changed its first-line treatment for malaria from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (ALu) in 2007. Subsidized ALu was made available in both health facilities and ADDOs. The effect of these interventions on access to malaria treatment was studied in rural Tanzania. The study was carried out in the villages of Kilombero and Ulanga Demographic Surveillance System (DSS) and in Ifakara town. Data collection consisted of: 1) yearly censuses of shops selling drugs; 2) collection of monthly data on availability of anti-malarials in public health facilities; and 3) retail audits to measure anti-malarial sales volumes in all public, mission and private outlets. The data were complemented with DSS population data. Between 2004 and 2008 access to malaria treatment greatly improved and the number of anti-malarial treatment doses dispensed increased by 78%. Particular improvements were observed in the availability (from 0.24 shops per 1,000 people in 2004 to 0.39 in 2008) and accessibility (from 71% of households within 5 km of a shop in 2004 to 87% in 2008) of drug shops. Despite no improvements in affordability this resulted in an increase of the market share from 49% of anti-malarial sales 2005 to 59% in 2008. The change of treatment policy from SP to ALu led to severe stock-outs of SP in health facilities in the months leading up to the introduction of ALu (only 40% months in stock), but these were compensated by the wide availability of SP in shops. After the introduction of ALu stock levels of the drug were relatively high in public health facilities (over 80% months in stock), but the drug could only be found in 30% of drug shops and in no general shops. This resulted in a low overall utilization of the drug (19% of all anti-malarial sales) The public health and private retail

Tanzania: Country Status Report.

ERIC Educational Resources Information Center

Robson, Barbara

A survey of the status of language usage in Tanzania begins with an overview of the three levels of language use: (1) Swahili, the national and official language, used in public life; (2) English, used in international affairs and in technical and intellectual matters; and (3) the over 120 vernacular languages used in family and religious life,…

Mapping of Mycobacterium tuberculosis Complex Genetic Diversity Profiles in Tanzania and Other African Countries

PubMed Central

Mbugi, Erasto V.; Katale, Bugwesa Z.; Streicher, Elizabeth M.; Keyyu, Julius D.; Kendall, Sharon L.; Dockrell, Hazel M.; Michel, Anita L.; Rweyemamu, Mark M.; Warren, Robin M.; Matee, Mecky I.; van Helden, Paul D.; Couvin, David; Rastogi, Nalin

2016-01-01

The aim of this study was to assess and characterize Mycobacterium tuberculosis complex (MTBC) genotypic diversity in Tanzania, as well as in neighbouring East and other several African countries. We used spoligotyping to identify a total of 293 M. tuberculosis clinical isolates (one isolate per patient) collected in the Bunda, Dar es Salaam, Ngorongoro and Serengeti areas in Tanzania. The results were compared with results in the SITVIT2 international database of the Pasteur Institute of Guadeloupe. Genotyping and phylogeographical analyses highlighted the predominance of the CAS, T, EAI, and LAM MTBC lineages in Tanzania. The three most frequent Spoligotype International Types (SITs) were: SIT21/CAS1-Kili (n = 76; 25.94%), SIT59/LAM11-ZWE (n = 22; 7.51%), and SIT126/EAI5 tentatively reclassified as EAI3-TZA (n = 18; 6.14%). Furthermore, three SITs were newly created in this study (SIT4056/EAI5 n = 2, SIT4057/T1 n = 1, and SIT4058/EAI5 n = 1). We noted that the East-African-Indian (EAI) lineage was more predominant in Bunda, the Manu lineage was more common among strains isolated in Ngorongoro, and the Central-Asian (CAS) lineage was more predominant in Dar es Salaam (p-value<0.0001). No statistically significant differences were noted when comparing HIV status of patients vs. major lineages (p-value = 0.103). However, when grouping lineages as Principal Genetic Groups (PGG), we noticed that PGG2/3 group (Haarlem, LAM, S, T, and X) was more associated with HIV-positive patients as compared to PGG1 group (Beijing, CAS, EAI, and Manu) (p-value = 0.03). This study provided mapping of MTBC genetic diversity in Tanzania (containing information on isolates from different cities) and neighbouring East African and other several African countries highlighting differences as regards to MTBC genotypic distribution between Tanzania and other African countries. This work also allowed underlining of spoligotyping patterns tentatively grouped within the newly designated EAI3-TZA

The societal cost of Taenia solium cysticercosis in Tanzania.

PubMed

Trevisan, Chiara; Devleesschauwer, Brecht; Schmidt, Veronika; Winkler, Andrea Sylvia; Harrison, Wendy; Johansen, Maria Vang

2017-01-01

Taenia solium is a zoonotic parasite prevalent in many low income countries throughout Latin America, Asia and sub-Saharan Africa, including Tanzania. The parasite is recognized as a public health threat; however the burden it poses on populations of Tanzania is unknown. The aim of this study was to estimate the societal cost of T. solium cysticercosis in Tanzania, by assessing both the health and economic burden. The societal cost of T. solium cysticercosis was assessed in humans and pigs based on data obtained by a systematic review. Experts' opinion was sought in cases where data were not retrievable. The health burden was assessed in terms of annual number of neurocysticercosis (NCC) associated epilepsy incident cases, deaths and disability-adjusted life years (DALYs), while the economic burden was assessed in terms of direct and indirect costs imposed by NCC-associated epilepsy and potential losses due to porcine cysticercosis. Based on data retrieved from the systematic review and burden assessments, T. solium cysticercosis contributed to a significant societal cost for the population. The annual number of NCC-associated epilepsy incident cases and deaths were 17,853 (95% Uncertainty Interval (UI), 5666-36,227) and 212 (95% UI, 37-612), respectively. More than 11% (95% UI, 6.3-17) of the pig population was infected with the parasite when using tongue examination as diagnostic method. For the year 2012 the number of DALYs per thousand person-years for NCC-associated epilepsy was 0.7 (95% UI, 0.2-1.6). Around 5 million USD (95% UI, 797,535-16,933,477) were spent due to NCC-associated epilepsy and nearly 3 million USD (95% UI, 1,095,960-5,366,038) were potentially lost due to porcine cysticercosis. Our results show that T. solium imposes a serious public health, agricultural and economic threat for Tanzania. We urge that a One Health approach, which involves the joint collaboration and effort of veterinarians, medical doctors, agricultural extension officers

Economic cost of primary prevention of cardiovascular diseases in Tanzania

PubMed Central

Ngalesoni, Frida; Ruhago, George; Norheim, Ole F; Robberstad, Bjarne

2015-01-01

Tanzania is facing a double burden of disease, with non-communicable diseases being an increasingly important contributor. Evidence-based preventive measures are important to limit the growing financial burden. This article aims to estimate the cost of providing medical primary prevention interventions for cardiovascular disease (CVD) among at-risk patients, reflecting actual resource use and if the World Health Organization (WHO)’s CVD medical preventive guidelines are implemented in Tanzania. In addition, we estimate and explore the cost to patients of receiving these services. Cost data were collected in four health facilities located in both urban and rural settings. Providers’ costs were identified and measured using ingredients approach to costing and resource valuation followed the opportunity cost method. Unit costs were estimated using activity-based and step-down costing methodologies. The patient costs were obtained through a structured questionnaire. The unit cost of providing CVD medical primary prevention services ranged from US$30–41 to US$52–71 per patient per year at the health centre and hospital levels, respectively. Employing the WHO’s absolute risk approach guidelines will substantially increase these costs. The annual patient cost of receiving these services as currently practised was estimated to be US$118 and US$127 for urban and rural patients, respectively. Providers’ costs were estimated from two main viewpoints: ‘what is’, that is the current practice, and ‘what if’, reflecting a WHO guidelines scenario. The higher cost of implementing the WHO guidelines suggests the need for further evaluation of whether these added costs are reasonable relative to the added benefits. We also found considerably higher patient costs, implying that distributive and equity implications of access to care require more consideration. Facility location surfaced as the main explanatory variable for both direct and indirect patient costs in

Estimating Leptospirosis Incidence Using Hospital-Based Surveillance and a Population-Based Health Care Utilization Survey in Tanzania

PubMed Central

Biggs, Holly M.; Hertz, Julian T.; Munishi, O. Michael; Galloway, Renee L.; Marks, Florian; Saganda, Wilbrod; Maro, Venance P.; Crump, John A.

2013-01-01

Background The incidence of leptospirosis, a neglected zoonotic disease, is uncertain in Tanzania and much of sub-Saharan Africa, resulting in scarce data on which to prioritize resources for public health interventions and disease control. In this study, we estimate the incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania. Methodology/Principal Findings We conducted a population-based household health care utilization survey in two districts in the Kilimanjaro Region of Tanzania and identified leptospirosis cases at two hospital-based fever sentinel surveillance sites in the Kilimanjaro Region. We used multipliers derived from the health care utilization survey and case numbers from hospital-based surveillance to calculate the incidence of leptospirosis. A total of 810 households were enrolled in the health care utilization survey and multipliers were derived based on responses to questions about health care seeking in the event of febrile illness. Of patients enrolled in fever surveillance over a 1 year period and residing in the 2 districts, 42 (7.14%) of 588 met the case definition for confirmed or probable leptospirosis. After applying multipliers to account for hospital selection, test sensitivity, and study enrollment, we estimated the overall incidence of leptospirosis ranges from 75–102 cases per 100,000 persons annually. Conclusions/Significance We calculated a high incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania, where leptospirosis incidence was previously unknown. Multiplier methods, such as used in this study, may be a feasible method of improving availability of incidence estimates for neglected diseases, such as leptospirosis, in resource constrained settings. PMID:24340122

Incidence of Induced Abortion and Post-Abortion Care in Tanzania.

PubMed

Keogh, Sarah C; Kimaro, Godfather; Muganyizi, Projestine; Philbin, Jesse; Kahwa, Amos; Ngadaya, Esther; Bankole, Akinrinola

2015-01-01

Tanzania has one of the highest maternal mortality ratios in the world, and unsafe abortion is one of its leading causes. Yet little is known about its incidence. To provide the first ever estimates of the incidence of unsafe abortion in Tanzania, at the national level and for each of the 8 geopolitical zones (7 in Mainland plus Zanzibar). A nationally representative survey of health facilities was conducted to determine the number of induced abortion complications treated in facilities. A survey of experts on abortion was conducted to estimate the likelihood of women experiencing complications and obtaining treatment. These surveys were complemented with population and fertility data to obtain abortion numbers, rates and ratios, using the Abortion Incidence Complications Methodology. In Tanzania, women obtained just over 405,000 induced abortions in 2013, for a national rate of 36 abortions per 1,000 women age 15-49 and a ratio of 21 abortions per 100 live births. For each woman treated in a facility for induced abortion complications, 6 times as many women had an abortion but did not receive care. Abortion rates vary widely by zone, from 10.7 in Zanzibar to 50.7 in the Lake zone. The abortion rate is similar to that of other countries in the region. Variations by zone are explained mainly by differences in fertility and contraceptive prevalence. Measures to reduce the incidence of unsafe abortion and associated maternal mortality include expanding access to post-abortion care and contraceptive services to prevent unintended pregnancies.

Focal mechanisms and the stress regime in NE and SW Tanzania, East Africa

NASA Astrophysics Data System (ADS)

Brazier, Richard A.; Nyblade, Andrew A.; Florentin, Juliette

2005-07-01

We report 12 new focal mechanisms from earthquakes in NE and SW Tanzania where the stress regime within the East African rift system is not well constrained. Focal mechanisms for events at the intersection of the Lake Tanganyika and Rukwa rifts in SW Tanzania indicate a complicated stress pattern with possible dextral strike-slip motion on some faults but oblique motion on others (either sinistral on NW striking faults or dextral on NE striking faults). Within the Rukwa rift, focal mechanisms indicate normal dip-slip motion with NE-SW opening. In NE Tanzania where the Eastern rift impinges on the margin of the Tanzania Craton, fault motions are consistent with a zone of distributed block faults and sub E-W extension. All twelve earthquakes likely nucleated within the crust.

Palliative care in northern Tanzania: doing a lot with a little.

PubMed

Bond, Melissa J; Knopp, Andrea

2018-06-02

The number of people in need of palliative care is growing worldwide, particularly in the developing world. The World Health Organization recognises palliative care as a basic human right, but there are many challenges for delivering palliative care in low- and middle-income countries. In the African continent, the African Palliative Care Association (APCA) provides guidance for political advocacy for developing palliative care programmes and has developed the APCA Palliative Outcome Score (POS), an evidence-based tool for measuring outcomes of palliative care. This article focuses on palliative care delivery in Shirati, Tanzania, located in the Rorya District in the Mara Region in northern Tanzania, highlighting the impressive work done with limited resources and despite many challenges. Recommendations for future research include evaluation of outcomes using the APCA POS, the application of mobile technology, and governmental advocacy for increased access to opioid medications, which have shown promise in broadening the reach of palliative care in the East African Community.

Sexual practices among unmarried adolescents in Tanzania

PubMed Central

Kazaura, Method R; Masatu, Melkiory C

2009-01-01

Background Sexual activities are increasingly changing from the cultural point of view what they used to be. Knowledge of these practices among adolescents may be a basis to create awareness among adolescents on practices that involve risks. This study aims to assess sexual practices among unmarried adolescents in Tanzania. Methods A cross-sectional survey was conducted among in-school and out-of-school but unmarried adolescents aged 10 to 19 in five locations in Tanzania. A questionnaire was used to collect information and to characterize sexual practices among these adolescents. Results About 32% of adolescents reported being sexually active; a higher proportion being males than females. The only inquired and reported sexual practices include vaginal sex, masturbation, oral and anal sex. About 15% of sexually active adolescents reported having multiple sexual partners. Significantly more males reported having multiple partners than females. Nearly 42% of sexually active adolescents reported having used a condom during most recent sexual act. Females reported older partners at first sexual act. Conclusion Adolescents experience several sexual practices that include penetrative and non-penetrative. More males reported being sexually active than females. Despite adolescents reporting having multiple sexual partners, reported condom use during the most recent sexual act was low. We advocate for a more enhanced approach of reproductive health education that includes safer sex to adolescents without forgetting those in-schools. PMID:19804651

New footprints from Laetoli (Tanzania) provide evidence for marked body size variation in early hominins

PubMed Central

Masao, Fidelis T; Ichumbaki, Elgidius B; Cherin, Marco; Barili, Angelo; Boschian, Giovanni; Iurino, Dawid A; Menconero, Sofia; Moggi-Cecchi, Jacopo; Manzi, Giorgio

2016-01-01

Laetoli is a well-known palaeontological locality in northern Tanzania whose outstanding record includes the earliest hominin footprints in the world (3.66 million years old), discovered in 1978 at Site G and attributed to Australopithecus afarensis. Here, we report hominin tracks unearthed in the new Site S at Laetoli and referred to two bipedal individuals (S1 and S2) moving on the same palaeosurface and in the same direction as the three hominins documented at Site G. The stature estimates for S1 greatly exceed those previously reconstructed for Au. afarensis from both skeletal material and footprint data. In combination with a comparative reappraisal of the Site G footprints, the evidence collected here embodies very important additions to the Pliocene record of hominin behaviour and morphology. Our results are consistent with considerable body size variation and, probably, degree of sexual dimorphism within a single species of bipedal hominins as early as 3.66 million years ago. DOI: http://dx.doi.org/10.7554/eLife.19568.001 PMID:27964778

The Integration Of Adult Education In Tanzania.

ERIC Educational Resources Information Center

Mhaiki, Paul J.; Hall, Budd L.

Brief historical background of Tanzania; Links between adult education and development objectives, Links between Adult Education and Formal Education are outlined. Importance of adult education is emphasized. (NF)

Wildlife and wildlife management in Tanzania.

PubMed

Caro, Tim; Davenport, Tim R B

2016-08-01

Tanzania, arguably mainland Africa's most important nation for conservation, is losing habitat and natural resources rapidly. Moving away from a charcoal energy base and developing sustainable finance mechanisms for natural forests are critical to slowing persistent deforestation. Addressing governance and capacity deficits, including law enforcement, technical skills, and funding, across parts of the wildlife sector are key to effective wildlife protection. These changes could occur in tandem with bringing new models of natural resource management into play that include capacity building, corporate payment for ecosystem services, empowering nongovernmental organizations in law enforcement, greater private-sector involvement, and novel community conservation strategies. The future of Tanzania's wildlife looks uncertain-as epitomized by the current elephant crisis-unless the country confronts issues of governance, embraces innovation, and fosters greater collaboration with the international community. © 2015 Society for Conservation Biology.

Health worker motivation in the context of HIV care and treatment challenges in Mbeya Region, Tanzania: A qualitative study

PubMed Central

2011-01-01

Background Health worker motivation can potentially affect the provision of health services. The HIV pandemic has placed additional strain on health service provision through the extra burden of increased testing and counselling, treating opportunistic infections and providing antiretroviral treatment. The aim of this paper is to explore the challenges generated by HIV care and treatment and their impact on health worker motivation in Mbeya Region, Tanzania. Methods Thirty in-depth interviews were conducted with health workers across the range of health care professions in health facilities in two high HIV-prevalence districts of Mbeya Region, Tanzania. A qualitative framework analysis was adopted for data analysis. Results The negative impact of HIV-related challenges on health worker motivation was confirmed by this study. Training seminars and workshops related to HIV contributed to the shortage of health workers in the facilities. Lower status workers were frequently excluded from training and were more severely affected by the consequent increase in workload as seminars were usually attended by higher status professionals who controlled access. Constant and consistent complaints by clients have undermined health workers' expectations of trust and recognition. Health workers were forced to take responsibility for dealing with problems arising from organisational inefficiencies within the health system. Conclusion HIV-related challenges undermine motivation among health workers in Mbeya, Tanzania with the burden falling most heavily on lower status workers. Strained relations between health workers and the community they serve, further undermine motivation of health workers. PMID:21992700

Spatial and Temporal Pattern of Rift Valley Fever Outbreaks in Tanzania; 1930 to 2007

PubMed Central

Sindato, Calvin; Karimuribo, Esron D.; Pfeiffer, Dirk U.; Mboera, Leonard E. G.; Kivaria, Fredrick; Dautu, George; Bernard, Bett; Paweska, Janusz T.

2014-01-01

Background Rift Valley fever (RVF)-like disease was first reported in Tanzania more than eight decades ago and the last large outbreak of the disease occurred in 2006–07. This study investigates the spatial and temporal pattern of RVF outbreaks in Tanzania over the past 80 years in order to guide prevention and control strategies. Materials and Methods A retrospective study was carried out based on disease reporting data from Tanzania at district or village level. The data were sourced from the Ministries responsible for livestock and human health, Tanzania Meteorological Agency and research institutions involved in RVF surveillance and diagnosis. The spatial distribution of outbreaks was mapped using ArcGIS 10. The space-time permutation model was applied to identify clusters of cases, and a multivariable logistic regression model was used to identify risk factors associated with the occurrence of outbreaks in the district. Principal Findings RVF outbreaks were reported between December and June in 1930, 1947, 1957, 1960, 1963, 1968, 1977–79, 1989, 1997–98 and 2006–07 in 39.2% of the districts in Tanzania. There was statistically significant spatio-temporal clustering of outbreaks. RVF occurrence was associated with the eastern Rift Valley ecosystem (OR = 6.14, CI: 1.96, 19.28), total amount of rainfall of >405.4 mm (OR = 12.36, CI: 3.06, 49.88), soil texture (clay [OR = 8.76, CI: 2.52, 30.50], and loam [OR = 8.79, CI: 2.04, 37.82]). Conclusion/Significance RVF outbreaks were found to be distributed heterogeneously and transmission dynamics appeared to vary between areas. The sequence of outbreak waves, continuously cover more parts of the country. Whenever infection has been introduced into an area, it is likely to be involved in future outbreaks. The cases were more likely to be reported from the eastern Rift Valley than from the western Rift Valley ecosystem and from areas with clay and loam rather than sandy soil texture. PMID:24586433

Evaluation of an E-Learning Course for Clubfoot Treatment in Tanzania: A Multicenter Study.

PubMed

Vaca, Silvia D; Warstadt, Nicholus M; Ngayomela, Isidor H; Nungu, Rachel; Kowero, Emmanuel S; Srivastava, Sakti

2018-01-01

In total, 80% of clubfoot cases occur in low- and middle-income countries, where lack of clinical knowledge of the Ponseti method of treatment presents as a major barrier to treatment. This study aims to determine the effectiveness of an electronic learning course to teach clinicians in Tanzania Ponseti method theory. A total of 30 clinicians were recruited from clinics with high referral rates for clubfoot patients and invited to 1 of 3 training sites: Mbeya (n = 15), Zanzibar (n = 10), and Mwanza (n = 5). Baseline knowledge, measured through a pretest, was compared to performance on a posttest after e-learning course completion. Scores for Mbeya and Zanzibar participants improved from 44 ± 12.5 to 69.8 ± 16.5 ( P  < .0001) and 44.3 ± 14.0 to 67.9 ± 21.4 ( P  = .01), respectively. Our results suggest that an e-learning course may be an effective method of disseminating Ponseti method theory in Tanzania. Successful implementation requires an understanding of the device availability and technology literacy of the users.

Evaluation of an E-Learning Course for Clubfoot Treatment in Tanzania: A Multicenter Study

PubMed Central

Vaca, Silvia D; Warstadt, Nicholus M; Ngayomela, Isidor H; Nungu, Rachel; Kowero, Emmanuel S; Srivastava, Sakti

2018-01-01

In total, 80% of clubfoot cases occur in low- and middle-income countries, where lack of clinical knowledge of the Ponseti method of treatment presents as a major barrier to treatment. This study aims to determine the effectiveness of an electronic learning course to teach clinicians in Tanzania Ponseti method theory. A total of 30 clinicians were recruited from clinics with high referral rates for clubfoot patients and invited to 1 of 3 training sites: Mbeya (n = 15), Zanzibar (n = 10), and Mwanza (n = 5). Baseline knowledge, measured through a pretest, was compared to performance on a posttest after e-learning course completion. Scores for Mbeya and Zanzibar participants improved from 44 ± 12.5 to 69.8 ± 16.5 (P < .0001) and 44.3 ± 14.0 to 67.9 ± 21.4 (P = .01), respectively. Our results suggest that an e-learning course may be an effective method of disseminating Ponseti method theory in Tanzania. Successful implementation requires an understanding of the device availability and technology literacy of the users. PMID:29780890

Pn wave velocities beneath the Tanzania Craton and adjacent rifted mobile belts, east Africa

NASA Astrophysics Data System (ADS)

Brazier, Richard A.; Nyblade, Andrew A.; Langston, Charles A.; Owens, Thomas J.

2000-08-01

P wave travel times from regional earthquakes recorded by the Tanzania Broadband Seismic Experiment have been inverted for long wavelength (>100 km) Pn velocity variations beneath Tanzania using a generalized inverse algorithm. Pn velocities, on average, are 8.40 to 8.45 km/s beneath the center of the Tanzania Craton, 8.30-8.35 km/s beneath the terminus of the Eastern Branch of the rift system, and 8.35-8.40 km/s beneath the Western Branch. These velocities indicate that there are no broad (>100 km wide) thermal anomalies in the uppermost mantle beneath areas of rifting in Tanzania, and suggest that thermal anomalies present deeper in the mantle have not yet reached the base of the crust.

Structural connectivity at a national scale: Wildlife corridors in Tanzania.

PubMed

Riggio, Jason; Caro, Tim

2017-01-01

Wildlife corridors can help maintain landscape connectivity but novel methods must be developed to assess regional structural connectivity quickly and cheaply so as to determine where expensive and time-consuming surveys of functional connectivity should occur. We use least-cost methods, the most accurate and up-to-date land conversion dataset for East Africa, and interview data on wildlife corridors, to develop a single, consistent methodology to systematically assess wildlife corridors at a national scale using Tanzania as a case study. Our research aimed to answer the following questions; (i) which corridors may still remain open (i.e. structurally connected) at a national scale, (ii) which have been potentially severed by anthropogenic land conversion (e.g., agriculture and settlements), (iii) where are other remaining potential wildlife corridors located, and (iv) which protected areas with lower forms of protection (e.g., Forest Reserves and Wildlife Management Areas) may act as stepping-stones linking more than one National Park and/or Game Reserve. We identify a total of 52 structural connections between protected areas that are potentially open to wildlife movement, and in so doing add 23 to those initially identified by other methods in Tanzanian Government reports. We find that the vast majority of corridors noted in earlier reports as "likely to be severed" have actually not been cut structurally (21 of 24). Nonetheless, nearly a sixth of all the wildlife corridors identified in Tanzania in 2009 have potentially been separated by land conversion, and a third now pass across lands likely to be converted to human use in the near future. Our study uncovers two reserves with lower forms of protection (Uvinza Forest Reserve in the west and Wami-Mbiki Wildlife Management Area in the east) that act as apparently crucial stepping-stones between National Parks and/or Game Reserves and therefore require far more serious conservation support. Methods used in this

Structural connectivity at a national scale: Wildlife corridors in Tanzania

PubMed Central

Caro, Tim

2017-01-01

Wildlife corridors can help maintain landscape connectivity but novel methods must be developed to assess regional structural connectivity quickly and cheaply so as to determine where expensive and time-consuming surveys of functional connectivity should occur. We use least-cost methods, the most accurate and up-to-date land conversion dataset for East Africa, and interview data on wildlife corridors, to develop a single, consistent methodology to systematically assess wildlife corridors at a national scale using Tanzania as a case study. Our research aimed to answer the following questions; (i) which corridors may still remain open (i.e. structurally connected) at a national scale, (ii) which have been potentially severed by anthropogenic land conversion (e.g., agriculture and settlements), (iii) where are other remaining potential wildlife corridors located, and (iv) which protected areas with lower forms of protection (e.g., Forest Reserves and Wildlife Management Areas) may act as stepping-stones linking more than one National Park and/or Game Reserve. We identify a total of 52 structural connections between protected areas that are potentially open to wildlife movement, and in so doing add 23 to those initially identified by other methods in Tanzanian Government reports. We find that the vast majority of corridors noted in earlier reports as “likely to be severed” have actually not been cut structurally (21 of 24). Nonetheless, nearly a sixth of all the wildlife corridors identified in Tanzania in 2009 have potentially been separated by land conversion, and a third now pass across lands likely to be converted to human use in the near future. Our study uncovers two reserves with lower forms of protection (Uvinza Forest Reserve in the west and Wami-Mbiki Wildlife Management Area in the east) that act as apparently crucial stepping-stones between National Parks and/or Game Reserves and therefore require far more serious conservation support. Methods used in

Reforming Teacher Education in Tanzania

ERIC Educational Resources Information Center

Hardman, Frank; Abd-Kadir, Jan; Tibuhinda, Audax

2012-01-01

It is widely acknowledged that in order to improve the quality of education in primary schools in developing countries there is a need to place pedagogy and its training implications at the centre of teacher education reform. Like many countries in Eastern and Southern Africa, Tanzania has introduced various initiatives and reforms to improve the…

Perceived unfairness in working conditions: The case of public health services in Tanzania

PubMed Central

2011-01-01

Background The focus on the determinants of the quality of health services in low-income countries is increasing. Health workers' motivation has emerged as a topic of substantial interest in this context. The main objective of this article is to explore health workers' experience of working conditions, linked to motivation to work. Working conditions have been pointed out as a key factor in ensuring a motivated and well performing staff. The empirical focus is on rural public health services in Tanzania. The study aims to situate the results in a broader historical context in order to enhance our understanding of the health worker discourse on working conditions. Methods The study has a qualitative study design to elicit detailed information on health workers' experience of their working conditions. The data comprise focus group discussions (FGDs) and in-depth interviews (IDIs) with administrators, clinicians and nursing staff in the public health services in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in the same part of Tanzania. Results The article provides insights into health workers' understanding and assessment of their working conditions. An experience of unsatisfactory working conditions as well as a perceived lack of fundamental fairness dominated the FGDs and IDIs. Informants reported unfairness with reference to factors such as salary, promotion, recognition of work experience, allocation of allowances and access to training as well as to human resource management. The study also revealed that many health workers lack information or knowledge about factors that influence their working conditions. Conclusions The article calls for attention to the importance of locating the discourse of unfairness related to working conditions in a broader historical/political context. Tanzanian history has been characterised by an ambiguous and shifting landscape of state regulation, economic reforms

Unpredictable checks of yellow fever vaccination certificates upon arrival in Tanzania.

PubMed

Schönenberger, Selina; Hatz, Christoph; Bühler, Silja

2016-05-01

Yellow fever (YF) is a mosquito-borne disease, which can be prevented by vaccination. While YF vaccination (YFV) is not generally recommended for travellers to Tanzania, proof of YFV may be required upon arrival. In April 2013, the World Health Organization concluded that one dose of YFV confers lifelong protection and countries have started to adapt their entry requirements. The traveller's consultant has to balance the risk of YFV and the risk of encountering problems when entering a country without a valid YFV, especially because countries are slowly implementing the requirements. We performed a survey among 421 travellers to Tanzania with a pre-travel consultation at the Travel Clinic of the University of Zurich about their experiences with YFV certificate inspections upon arrival in Tanzania between January and November 2015. There were three main findings: (i) most vaccine card checks were done while crossing the land border of Tanzania. Inspections were frequently conducted at Arusha airport, less often in Dar es Salaam and Zanzibar. In the latter a significantly larger percentage of individuals arriving by ferry/boat were checked than those arriving by plane. (ii) Checks appeared to be non-systematic. They were also performed in travellers who did not enter Tanzania from a YF-endemic country. No seasonal or daytime pattern could be identified; the thoroughness of checks varied widely. (iii) In the case of travel without valid YFV, an exemption certificate was always accepted. In travellers with neither a valid YFV nor an exemption certificate, travellers reported forced YF vaccination and fines before entry was granted. We recommend YFV or a YF exemption certificate for all travellers to Tanzania until further notice. The decision of whether to vaccinate against YF or to issue an exemption should be based on exposure risk to YF infection in other countries during travel. © International Society of Travel Medicine, 2016. All rights reserved. Published by

A review of pig pathology in Tanzania.

PubMed

Wilson, Richard Trevor; Swai, Emmanuel

2013-08-01

The approximately 1.58 million pigs in Tanzania represent 3.7% of the national population of quadruped meat-producing animals. Pigs are kept mainly by small producers who own 99.5% of the national stock in units that average 3.04 animals (range 2-48). Government policy has had little practical application. African swine fever, foot-and-mouth disease and Cysticercosis are important diseases. The first two are notifiable diseases under Tanzania legislation; the last has widespread distribution and relevance as a major zoonosis. Ascariasis (Ascaris suum), hydatidosis (Echinococcus granulosus), leptospirosis (Leptospira interrogans) and thermophilic Campylobacter are other zoonoses associated with pigs. Gastrointestinal helminths and external parasites, especially Sarcoptes scabiei, are common. Risk factors associated with cysticercosis for humans working with pigs or eating their meat include the free-range or semi-confined management systems, the use of rivers or ponds as a source of water, lack of household sanitation, informal home slaughter, pork not being inspected at slaughter slabs and undercooked and barbecued meat. Pigs are a minor component of Tanzania's livestock sector but there is potential for increasing their contribution to human welfare. Prospects are enhanced by the shorter life cycle, greater number of young produced per year and the possibility of producing high-quality animal protein at a lower cost than meat produced by cattle and small ruminants.

Albinism, stigma, subjectivity and global-local discourses in Tanzania.

PubMed

Brocco, Giorgio

2016-12-01

Societal ideas and explanations of albinism at the local level in Tanzania are conceived in terms of family history, social relations, economic status, moral-religious positions, global-local flows of information and humanitarian actions on behalf of people with the congenital condition. This paper aims to show how the subjectivities of people with albinism in Tanzania are shaped and re-shaped through local moral conceptions as well as globalizing (bio)medical explanations of albinism. An exemplary case study of a 28-year-old woman, plus episodes from the lives of seven other informants with the condition, are analyzed in order to understand, on the one hand, local social relationships between people with albinism and other individuals in family and community settings, and on the other hand, the interconnections between persons with albinism and global humanitarian actors and the broadcast media. When stigma and marginalizing behaviors are perceived by individuals with albinism in Tanzania as impeding their social lives, they employ different coping strategies and discourses to enhance social acceptance.

Science-based health innovation in Tanzania: bednets and a base for invention

PubMed Central

2010-01-01

Background Tanzania is East Africa’s largest country. Although it is socially diverse, it has experienced general political stability since independence in 1964. Despite gradual economic development and Tanzania’s status as one of the biggest recipients of aid in Africa, health status remains poor. This paper explores Tanzania’s science-based health innovation system, and highlights areas which can be strengthened. Methods Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents, and through open-ended, face-to-face interviews with 52 people from across the science-based health innovation system over two visits to Tanzania from July to October 2007. Results and discussion Tanzania has a rich but complex S&T governance landscape, with the public sector driving the innovation agenda through a series of different bodies which are not well-coordinated. It has some of the leading health research on the continent at the University of Dar es Salaam, Muhimbili University of Health and Applied Sciences, the National Institute for Medical Research and the Ifakara Medical Institute, with strong donor support. Tanzania has found developing an entrepreneurial culture difficult; nevertheless projects such as the clusters initiative at the University of Dar es Salaam are encouraging low-tech innovation and overcoming knowledge-sharing barriers. In the private sector, one generics company has developed a South-South collaboration to enable technology transfer and hence the local production of anti-retrovirals. Local textile company A to Z Textiles is now manufacturing 30 million insecticide impregnated bednets a year. Conclusions To have a coherent vision for innovation, Tanzania may wish to address some key issues: coordination across stakeholders involved with health research, increasing graduates in health-related disciplines, and building capabilities in biological testing, preclinical testing

Science-based health innovation in Tanzania: bednets and a base for invention.

PubMed

Shah, Ronak; Singer, Peter A; Daar, Abdallah S

2010-12-13

Tanzania is East Africa's largest country. Although it is socially diverse, it has experienced general political stability since independence in 1964. Despite gradual economic development and Tanzania's status as one of the biggest recipients of aid in Africa, health status remains poor. This paper explores Tanzania's science-based health innovation system, and highlights areas which can be strengthened. Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents, and through open-ended, face-to-face interviews with 52 people from across the science-based health innovation system over two visits to Tanzania from July to October 2007. Tanzania has a rich but complex S&T governance landscape, with the public sector driving the innovation agenda through a series of different bodies which are not well-coordinated. It has some of the leading health research on the continent at the University of Dar es Salaam, Muhimbili University of Health and Applied Sciences, the National Institute for Medical Research and the Ifakara Medical Institute, with strong donor support. Tanzania has found developing an entrepreneurial culture difficult; nevertheless projects such as the clusters initiative at the University of Dar es Salaam are encouraging low-tech innovation and overcoming knowledge-sharing barriers. In the private sector, one generics company has developed a South-South collaboration to enable technology transfer and hence the local production of anti-retrovirals. Local textile company A to Z Textiles is now manufacturing 30 million insecticide impregnated bednets a year. To have a coherent vision for innovation, Tanzania may wish to address some key issues: coordination across stakeholders involved with health research, increasing graduates in health-related disciplines, and building capabilities in biological testing, preclinical testing, formulation and standardization, and related areas important

Tanzania national survey on iodine deficiency: impact after twelve years of salt iodation

PubMed Central

Assey, Vincent D; Peterson, Stefan; Kimboka, Sabas; Ngemera, Daniel; Mgoba, Celestin; Ruhiye, Deusdedit M; Ndossi, Godwin D; Greiner, Ted; Tylleskär, Thorkild

2009-01-01

Background In many low-income countries, children are at high risk of iodine deficiency disorders, including brain damage. In the early 1990s, Tanzania, a country that previously suffered from moderate to severe iodine deficiency, adopted universal salt iodation (USI) as an intervention strategy, but its impact remained unknown. Methods We report on the first national survey in mainland Tanzania, conducted in 2004 to assess the extent to which iodated salt was used and its apparent impact on the total goitre prevalence (TGP) and urinary iodine concentrations (UIC) among the schoolchildren after USI was initiated. In 2004, a cross-sectional goitre survey was conducted; covering 140,758 schoolchildren aged 6 - 18 years were graded for goitre according to new WHO goitre classification system. Comparisons were made with district surveys conducted throughout most of the country during the 1980s and 90s. 131,941 salt samples from households were tested for iodine using rapid field test kits. UIC was determined spectrophotometrically using the ammonium persulfate digestion method in 4523 sub-sampled children. Results 83.6% (95% CI: 83.4 - 83.8) of salt samples tested positive for iodine. Whereas the TGP was about 25% on average in the earlier surveys, it was 6.9% (95%CI: 6.8-7.0) in 2004. The TGP for the younger children, 6-9 years old, was 4.2% (95%CI: 4.0-4.4), n = 41,965. In the 27 goitre-endemic districts, TGP decreased from 61% (1980s) to 12.3% (2004). The median UIC was 204 (95% CF: 192-215) μg/L. Only 25% of children had UIC <100 μg/L and 35% were ≥ 300 μg/L, indicating low and excess iodine intake, respectively. Conclusion Our study demonstrates a marked improvement in iodine nutrition in Tanzania, twelve years after the initiation of salt iodation programme. The challenge in sustaining IDD elimination in Tanzania is now two-fold: to better reach the areas with low coverage of iodated salt, and to reduce iodine intake in areas where it is excessive

Factors affecting vasectomy acceptability in Tanzania.

PubMed

Bunce, Arwen; Guest, Greg; Searing, Hannah; Frajzyngier, Veronica; Riwa, Peter; Kanama, Joseph; Achwal, Isaac

2007-03-01

Calls for increased inclusion of men in matters of reproductive health emphasize the need for research into vasectomy acceptability and decision making. Vasectomy is a safe, simple and effective method of contraception, but is underused worldwide. Focus group discussions and in-depth interviews were conducted with potential and actual sterilization clients and their partners in the Kigoma Region of Tanzania. Content analysis was used to search for emergent themes related to vasectomy decision making. Six themes emerged as overarching factors contributing to the vasectomy decision-making process: economics, spousal influence, religion, provider reputation and availability, uncertainty about the future, and poor vasectomy knowledge and understanding. There was substantial communication between partners regarding the vasectomy decision, and wives had a strong influence on the outcome; however, men and women agreed that husbands would resist vasectomy if wives initially raised the topic. Vasectomy acceptance is limited by the scarcity of skilled vasectomy providers and by the fact that men and women hold many of the same misunderstandings about vasectomy, including a fear of decreased sexual performance as a result of the procedure. Spousal discussions are important in the decision to get a vasectomy, but these discussions should be initiated by the male partner. Programs need to educate men about contraceptive options, including vasectomies. Detailed, culturally relevant knowledge of the barriers and facilitators individuals experience during their decision- making process will enable vasectomy promotion programs to more successfully target appropriate populations.

The Challenges of Providing Postpartum Education in Dar es Salaam, Tanzania: Narratives of Nurse-Midwives and Obstetricians.

PubMed

Mselle, Lilian Teddy; Aston, Megan; Kohi, Thecla W; Mbekenga, Columba; Macdonald, Danielle; White, Maureen; Price, Sheri; Tomblin Murphy, Gail; O'Hearn, Shawna; Jefferies, Keisha

2017-10-01

Postpartum education can save lives of mothers and babies in developing countries, and the World Health Organization recommends all mothers receive three postpartum consultations. More information is needed to better understand how postpartum education is delivered and ultimately improves postpartum health outcomes. The purpose of this qualitative study was to examine how postpartum care was delivered in three postnatal hospital clinics in Dar es Salaam, Tanzania. Semistructured interviews with 10 nurse-midwives and three obstetricians were conducted. Feminist poststructuralism guided the research process. Postpartum education was seen to be an urgent matter; there was a lack of supportive resources and infrastructure in the hospital clinics, and nurse-midwives and obstetricians had to negotiate conflicting health and traditional discourses using various strategies. Nurse-midwives and obstetricians are well positioned to deliver life-saving postpartum education; however, improvements are required including increased number of nurse-midwives and obstetricians.

Factors that influence women's health in Tanzania.

PubMed

Lugina, H I

1994-01-01

A descriptive account of factors that influence women's health in Tanzania is given. The social and cultural processes that enhance or undermine women's health are emphasized. Recommendations for changes to improve women's health are made.

Implementation of a national anti-tuberculosis drug resistance survey in Tanzania

PubMed Central

Chonde, Timothy M; Doulla, Basra; van Leth, Frank; Mfinanga, Sayoki GM; Range, Nyagosya; Lwilla, Fred; Mfaume, Saidi M; van Deun, Armand; Zignol, Matteo; Cobelens, Frank G; Egwaga, Saidi M

2008-01-01

Background A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Methods Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Results Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Conclusion Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey. PMID:19116022

Restoring dignity: social reintegration after obstetric fistula repair in Ukerewe, Tanzania.

PubMed

Pope, Rachel; Bangser, Maggie; Requejo, Jennifer Harris

2011-01-01

This study explores barriers and facilitating factors women experience re-integrating into society after treatment of an obstetric fistula in rural Tanzania. A total of 71 women were interviewed in the Mwanza region of Tanzania, including a community control group. The majority of the women who received successful surgical repairs reported that, over time, they were able to resume many of the social and economic activities they engaged in prior to the development of a fistula. Familial support facilitated both accessing repair and recovery. For 60% of the women recovering from an obstetric fistula, work was the most important factor in helping them feel 'normal again'. However, physical limitations and other residual problems often hampered their ability to continue working. All of the treated women expressed interest in follow-up discussions with health care providers regarding their health and concerns about future pregnancies. Special attention is needed for women who are not completely healed and/or for those who experience other related medical or emotional problems after repair, especially if they lack a social network.

Context and characteristics of illicit drug use in coastal and interior Tanzania.

PubMed

Tiberio, Jenny; Laurent, Yovin Ivo; Ndayongeje, Joel; Msami, Amani; Welty, Susie; Ngonyani, Alois; Mwankemwa, Syangu; Makumbuli, Moza; McFarland, Willi; Morris, Meghan D

2018-01-01

An increase in heroin seizures in East Africa may signal wider local consumption of illicit drugs. Most information about drug use in Tanzania is from the economic capital, Dar es Salaam, and well-travelled Zanzibar. More data are needed on the extent, trends, and characteristics of illicit drug use in the vast coast and interior of the country. The study was a rapid assessment, triangulating data from in-depth interviews of primary key informants (people who use drugs [PWUD]), secondary informants (police, community members, service providers), and ethnographic mapping of hotspots in 12 regions of Tanzania. We conducted 436 in-depth interviews from September 2013 to August 2014. Regions were categorized as (1) nascent: drug use is beginning to take root; (2) established: drug use has existed for some time; or (3) pervasive: drug use is spreading into new sub-groups/areas. Multiple sources corroborated that illicit drug use has been increasing in all regions. Most PWUD worked in the cash economy as bus touts, labourers, fishermen, miners, or sex workers, or stole to survive or support their habit. PWUD congregated around bus stops along transit corridors, in abandoned buildings, and in low-income residential areas. Informants described less visible PWUD among military, police, and working-class people. Cannabis was the most common, smoked alone or with tobacco and heroin ("cocktail"). Heroin was available in all regions. Cocaine was less common, likely due to high price and variable availability. Substances such as petrol, shoe polish, and glue were used as inhalants. Illicit drug use is widespread with variable features beyond cosmopolitan areas of Tanzania. Improving transportation infrastructure and economic opportunities combined with poverty and inequality appear key factors for increasing use. Findings call attention to increasing and widening drug use in Tanzania and the need to plan prevention, treatment, and harm-reduction measures nationally. Copyright �

The Tanzania Field Epidemiology and Laboratory Training Program: building and transforming the public health workforce

PubMed Central

Mmbuji, Peter; Mukanga, David; Mghamba, Janeth; Ahly, Mohamed; Mosha, Fausta; Azima, Simba; Senga, Sembuche; Moshiro, Candida; Semali, Innocent; Rolle, Italia; Wiktor, Stefan; McQueen, Suzzane; McElroy, Peter; Nsubuga, Peter

2011-01-01

The Tanzania Field Epidemiology and Laboratory Training Program (TFELTP) was established in 2008 as a partnership among the Ministry of Health and Social Welfare (MOHSW), Muhimbili University of Health and Allied Sciences, National Institute for Medical Research, and local and international partners. TFELTP was established to strengthen the capacity of MOHSW to conduct public health surveillance and response, manage national disease control and prevention programs, and to enhance public health laboratory support for surveillance, diagnosis, treatment and disease monitoring. TFELTP is a 2-year full-time training program with approximately 25% time spent in class, and 75% in the field. TFELTP offers two tracks leading to an MSc degree in either Applied Epidemiology or, Epidemiology and Laboratory Management. Since 2008, the program has enrolled a total of 33 trainees (23 males, 10 females). Of these, 11 were enrolled in 2008 and 100% graduated in 2010. All 11 graduates of cohort 1 are currently employed in public health positions within the country. Demand for the program as measured by the number of applicants has grown from 28 in 2008 to 56 in 2011. While training the public health leaders of the country, TFELTP has also provided essential service to the country in responding to high-profile disease outbreaks, and evaluating and improving its public health surveillance systems and diseases control programs. TFELTP was involved in the country assessment of the revised International Health Regulations (IHR) core capabilities, development of the Tanzania IHR plan, and incorporation of IHR into the revised Tanzania Integrated Disease Surveillance and Response (IDSR) guidelines. TFELTP is training a competent core group of public health leaders for Tanzania, as well as providing much needed service to the MOHSW in the areas of routine surveillance, outbreak detection and response, and disease program management. However, the immediate challenges that the program must

Water supply development and tariffs in Tanzania: From free water policy towards cost recovery

NASA Astrophysics Data System (ADS)

Mashauri, Damas A.; Katko, Tapio S.

1993-01-01

The article describes the historical development of water tariff policy in Tanzania from the colonial times to present. After gaining independence, the country introduced “free” water policy in its rural areas. Criticism against this policy was expressed already in the 1970s, but it was not until the late 1980s that change became unavoidable. All the while urban water tariffs continued to decline in real terms. In rural and periurban areas of Tanzania consumers often have to pay substantial amounts of money for water to resellers and vendors since the public utilities are unable to provide operative service. Besides, only a part of the water bills are actually collected. Now that the free water supply policy has been officially abandoned, the development of water tariffs and the institutions in general are a great challenge for the country.

The costs of providing antiretroviral therapy services to HIV-infected individuals presenting with advanced HIV disease at public health centres in Dar es Salaam, Tanzania: Findings from a randomised trial evaluating different health care strategies.

PubMed

Kimaro, Godfather Dickson; Mfinanga, Sayoki; Simms, Victoria; Kivuyo, Sokoine; Bottomley, Christian; Hawkins, Neil; Harrison, Thomas S; Jaffar, Shabbar; Guinness, Lorna

2017-01-01

Understanding the costs associated with health care delivery strategies is essential for planning. There are few data on health service resources used by patients and their associated costs within antiretroviral (ART) programmes in Africa. The study was nested within a large trial, which evaluated screening for cryptococcal meningitis and tuberculosis and a short initial period of home-based adherence support for patients initiating ART with advanced HIV disease in Tanzania and Zambia. The economic evaluation was done in Tanzania alone. We estimated costs of providing routine ART services from the health service provider's perspective using a micro-costing approach. Incremental costs for the different novel components of service delivery were also estimated. All costs were converted into US dollars (US$) and based on 2012 prices. Of 870 individuals enrolled in Tanzania, 434 were enrolled in the intervention arm and 436 in the standard care/control arm. Overall, the median (IQR) age and CD4 cell count at enrolment were 38 [31, 44] years and 52 [20, 89] cells/mm3, respectively. The mean per patient costs over the first three months and over a one year period of follow up following ART initiation in the standard care arm were US$ 107 (95%CI 101-112) and US$ 265 (95%CI 254-275) respectively. ART drugs, clinic visits and hospital admission constituted 50%, 19%, and 19% of the total cost per patient year, while diagnostic tests and non-ART drugs (co-trimoxazole) accounted for 10% and 2% of total per patient year costs. The incremental costs of the intervention to the health service over the first three months was US$ 59 (p<0.001; 95%CI 52-67) and over a one year period was US$ 67(p<0.001; 95%CI 50-83). This is equivalent to an increase of 55% (95%CI 51%-59%) in the mean cost of care over the first three months, and 25% (95%CI 20%-30%) increase over one year of follow up.

Feasibility of Cloud Computing Implementation for eLearning in Secondary Schools in Tanzania

ERIC Educational Resources Information Center

Mwakisole, Kennedy F.; Kissaka, Mussa M.; Mtebe, Joel S.

2018-01-01

This article assessed the feasibility of implementing eLearning systems in a cloud-based infrastructure for secondary schools in Tanzania. The study adopted questionnaire and document reviews as data collection tools. A total of 820 students successfully returned the questionnaire from seven secondary schools in Tanzania. The study found that 11%…

Dengue data and surveillance in Tanzania: a systematic literature review.

PubMed

Ward, Tara; Samuel, Moody; Maoz, Dorit; Runge-Ranzinger, Silvia; Boyce, Ross; Toledo, Joao; Velayudhan, Raman; Horstick, Olaf

2017-08-01

Although there is evidence that dengue virus is circulating in Tanzania, the country lacks a dengue surveillance system. Consequently, the true estimate of dengue seroprevalence, as well as the incidence in the population, the frequency and magnitude of outbreaks is unknown. This study therefore sought to systematically review available dengue data from Tanzania. The systematic review was conducted and reported using the PRISMA tool. Five databases (PubMed, Embase, Web of Science, WHOLIS and Google Scholar) were searched for articles using various keywords on the illness, data and geographical location. Identified articles were assessed for inclusion based on predefined eligibility criteria. Data were extracted from included articles, analysed and reported. Based on the 10 seroprevalence studies in defined populations with estimates of acute confirmed infections that were included in the review, the estimated seroprevalence of past dengue infection in Tanzania ranged from 50.6% in a health facility-based study to 11% in a population-based study. Acute confirmed infections of dengue were estimated to be as high as 38.2% of suspected cases. Only one study reported on an outbreak. It is evident that dengue needs to become part of regular disease surveillance in Tanzania. Control measures need to be instituted with a focus on building human resource capacity and integrating dengue control measures in ongoing health programmes, for both preventive and curative interventions. Systematic reviews are valuable in assessing health issues when surveillance data are not available. © 2017 John Wiley & Sons Ltd.

Exploring local knowledge and perceptions on zoonoses among pastoralists in northern and eastern Tanzania.

PubMed

Mangesho, Peter Ernest; Neselle, Moses Ole; Karimuribo, Esron D; Mlangwa, James E; Queenan, Kevin; Mboera, Leonard E G; Rushton, Jonathan; Kock, Richard; Häsler, Barbara; Kiwara, Angwara; Rweyemamu, Mark

2017-02-01

Zoonoses account for the most commonly reported emerging and re-emerging infectious diseases in Sub-Saharan Africa. However, there is limited knowledge on how pastoral communities perceive zoonoses in relation to their livelihoods, culture and their wider ecology. This study was carried out to explore local knowledge and perceptions on zoonoses among pastoralists in Tanzania. This study involved pastoralists in Ngorongoro district in northern Tanzania and Kibaha and Bagamoyo districts in eastern Tanzania. Qualitative methods of focus group discussions, participatory epidemiology and interviews were used. A total of 223 people were involved in the study. Among the pastoralists, there was no specific term in their local language that describes zoonosis. Pastoralists from northern Tanzania possessed a higher understanding on the existence of a number of zoonoses than their eastern districts' counterparts. Understanding of zoonoses could be categorized into two broad groups: a local syndromic framework, whereby specific symptoms of a particular illness in humans concurred with symptoms in animals, and the biomedical framework, where a case definition is supported by diagnostic tests. Some pastoralists understand the possibility of some infections that could cross over to humans from animals but harm from these are generally tolerated and are not considered as threats. A number of social and cultural practices aimed at maintaining specific cultural functions including social cohesion and rites of passage involve animal products, which present zoonotic risk. These findings show how zoonoses are locally understood, and how epidemiology and biomedicine are shaping pastoralists perceptions to zoonoses. Evidence is needed to understand better the true burden and impact of zoonoses in these communities. More studies are needed that seek to clarify the common understanding of zoonoses that could be used to guide effective and locally relevant interventions. Such studies should

Exploring local knowledge and perceptions on zoonoses among pastoralists in northern and eastern Tanzania

PubMed Central

Mangesho, Peter Ernest; Neselle, Moses Ole; Karimuribo, Esron D.; Mlangwa, James E.; Queenan, Kevin; Mboera, Leonard E. G.; Rushton, Jonathan; Kock, Richard; Häsler, Barbara; Kiwara, Angwara; Rweyemamu, Mark

2017-01-01

Background Zoonoses account for the most commonly reported emerging and re-emerging infectious diseases in Sub-Saharan Africa. However, there is limited knowledge on how pastoral communities perceive zoonoses in relation to their livelihoods, culture and their wider ecology. This study was carried out to explore local knowledge and perceptions on zoonoses among pastoralists in Tanzania. Methodology and principal findings This study involved pastoralists in Ngorongoro district in northern Tanzania and Kibaha and Bagamoyo districts in eastern Tanzania. Qualitative methods of focus group discussions, participatory epidemiology and interviews were used. A total of 223 people were involved in the study. Among the pastoralists, there was no specific term in their local language that describes zoonosis. Pastoralists from northern Tanzania possessed a higher understanding on the existence of a number of zoonoses than their eastern districts' counterparts. Understanding of zoonoses could be categorized into two broad groups: a local syndromic framework, whereby specific symptoms of a particular illness in humans concurred with symptoms in animals, and the biomedical framework, where a case definition is supported by diagnostic tests. Some pastoralists understand the possibility of some infections that could cross over to humans from animals but harm from these are generally tolerated and are not considered as threats. A number of social and cultural practices aimed at maintaining specific cultural functions including social cohesion and rites of passage involve animal products, which present zoonotic risk. Conclusions These findings show how zoonoses are locally understood, and how epidemiology and biomedicine are shaping pastoralists perceptions to zoonoses. Evidence is needed to understand better the true burden and impact of zoonoses in these communities. More studies are needed that seek to clarify the common understanding of zoonoses that could be used to guide

Children's medicines in Tanzania: a national survey of administration practices and preferences.

PubMed

Adams, Lisa V; Craig, Sienna R; Mmbaga, Elia John; Naburi, Helga; Lahey, Timothy; Nutt, Cameron T; Kisenge, Rodrick; Noel, Gary J; Spielberg, Stephen P

2013-01-01

The dearth of age-appropriate formulations of many medicines for children poses a major challenge to pediatric therapeutic practice, adherence, and health care delivery worldwide. We provide information on current administration practices of pediatric medicines and describe key stakeholder preferences for new formulation characteristics. We surveyed children aged 6-12 years, parents/caregivers over age 18 with children under age 12, and healthcare workers in 10 regions of Tanzania to determine current pediatric medicine prescription and administration practices as well as preferences for new formulations. Analyses were stratified by setting, pediatric age group, parent/caregiver education, and healthcare worker cadre. Complete data were available for 206 children, 202 parents/caregivers, and 202 healthcare workers. Swallowing oral solid dosage forms whole or crushing/dissolving them and mixing with water were the two most frequently reported methods of administration. Children frequently reported disliking medication taste, and many had vomited doses. Healthcare workers reported medicine availability most significantly influences prescribing practices. Most parents/caregivers and children prefer sweet-tasting medicine. Parents/caregivers and healthcare workers prefer oral liquid dosage forms for young children, and had similar thresholds for the maximum number of oral solid dosage forms children at different ages can take. There are many impediments to acceptable and accurate administration of medicines to children. Current practices are associated with poor tolerability and the potential for under- or over-dosing. Children, parents/caregivers, and healthcare workers in Tanzania have clear preferences for tastes and formulations, which should inform the development, manufacturing, and marketing of pediatric medications for resource-limited settings.

Information, Affect and Action: Motivating Reduction of Risk Behaviors for HIV/AIDS in Kenya and Tanzania

ERIC Educational Resources Information Center

Hardre, Patricia L.; Garcia, Fe; Apamo, Peter; Mutheu, Lucy; Ndege, Monica

2012-01-01

This study reports assessment of motivational and perceptual components of a youth and community AIDS awareness education program, focusing on effectiveness across program sites. The design of this investigation was quasi-experimental, with two intervention districts and one control each, in Kenya and Tanzania. Methods included questionnaires…

Barriers to access reproductive health care for pregnant adolescent girls: a qualitative study in Tanzania.

PubMed

Hokororo, Adolfine; Kihunrwa, Albert F; Kalluvya, Samuel; Changalucha, John; Fitzgerald, Daniel W; Downs, Jennifer A

2015-12-01

In Tanzania, approximately 25% of adolescents give birth and 50% more become sexually active during adolescence. We hypothesised that reproductive health education and services for adolescent girls are inaccessible and conducted this study to gain insights into their perceptions of sexually transmitted infections (STIs) and barriers to reproductive health service utilisation in rural Mwanza, Tanzania. We conducted nine focus groups among pregnant adolescents aged 15-20 years. Data were transcribed, translated and coded for relevant themes using NVivo10 software for qualitative data analysis. Most participants were aware of the dangers of STIs to themselves and their unborn babies, but did not perceive themselves as at risk of acquiring STIs. They viewed condoms as ineffective for preventing STIs and pregnancies and unnecessary for those in committed relationships. Stigma, long waiting times, and lack of privacy in the clinics discouraged adolescent girls from seeking reproductive health care. Reproductive health care for adolescent girls who are not pregnant is practically nonexistent in Tanzania. Healthcare access for pregnant young women is also limited. Targeted changes to increase clinic accessibility and to provide reproductive health education to all rather than only pregnant women have the potential to address these gaps. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

The influence of climate change on Tanzania's hydropower sustainability

NASA Astrophysics Data System (ADS)

Sperna Weiland, Frederiek; Boehlert, Brent; Meijer, Karen; Schellekens, Jaap; Magnell, Jan-Petter; Helbrink, Jakob; Kassana, Leonard; Liden, Rikard

2015-04-01

Economic costs induced by current climate variability are large for Tanzania and may further increase due to future climate change. The Tanzanian National Climate Change Strategy addressed the need for stabilization of hydropower generation and strengthening of water resources management. Increased hydropower generation can contribute to sustainable use of energy resources and stabilization of the national electricity grid. To support Tanzania the World Bank financed this study in which the impact of climate change on the water resources and related hydropower generation capacity of Tanzania is assessed. To this end an ensemble of 78 GCM projections from both the CMIP3 and CMIP5 datasets was bias-corrected and down-scaled to 0.5 degrees resolution following the BCSD technique using the Princeton Global Meteorological Forcing Dataset as a reference. To quantify the hydrological impacts of climate change by 2035 the global hydrological model PCR-GLOBWB was set-up for Tanzania at a resolution of 3 minutes and run with all 78 GCM datasets. From the full set of projections a probable (median) and worst case scenario (95th percentile) were selected based upon (1) the country average Climate Moisture Index and (2) discharge statistics of relevance to hydropower generation. Although precipitation from the Princeton dataset shows deviations from local station measurements and the global hydrological model does not perfectly reproduce local scale hydrographs, the main discharge characteristics and precipitation patterns are represented well. The modeled natural river flows were adjusted for water demand and irrigation within the water resources model RIBASIM (both historical values and future scenarios). Potential hydropower capacity was assessed with the power market simulation model PoMo-C that considers both reservoir inflows obtained from RIBASIM and overall electricity generation costs. Results of the study show that climate change is unlikely to negatively affect the

Assessment of HIV/AIDS and Life Skills Delivery in Primary Schools in Tanzania

ERIC Educational Resources Information Center

Rushahu, Bernadetha Gabriel

2015-01-01

This study was conducted to assess the effectiveness of HIV/AIDS and the Life Skills Education delivery in primary schools in Tanzania. Specifically the study investigated pupils' views about the effect of HIV/AIDS and Life Skills teaching in primary schools in Tanzania; assessed pupils' knowledge related to HIV/AIDS and Life Skills education, and…

New Phlugidia species (Orthoptera: Tettigoniidae: Meconematinae, Phlugidini) from the Eastern Arc Mountains of Tanzania, Africa.

PubMed

Hemp, Claudia

2013-01-01

Two new species of Phlugidia (Orthoptera: Tettigoniidae: Meconematinae) are described from the Eastern Arc Mountains of Tanzania. P. planicercus Hemp n. sp. occurs in lowland forest at the foothills of the Uluguru Mountains, while P. ob- tusicercus Hemp n. sp. was collected in the Nguru Mountains. A key to Phlugidia species is provided.

Capture-recapture analysis of East Coast fever in smallholder dairy herds in the Dar es Salaam region of Tanzania.

PubMed

Kivaria, F M; Noordhuizen, J P T M

2010-05-01

The prevalence of and case fatality rate due to East Coast fever (ECF) were estimated in 1402 dairy cattle in 87 small herds in the Dar es Salaam region of Tanzania, from January 2003 to January 2005 using a capture-recapture method. Information on clinical cases and deaths due to ECF were obtained from farm records and from a questionnaire-based cross-sectional survey conducted between July 2003 and March 2005 as part of longitudinal studies of bovine mastitis in these herds. The number of clinical cases identified was 567 (from farm records) and 496 (from the questionnaire), and the number of deaths recorded were 305 (from farm records) and 251 (from the questionnaire). In all, 450 clinical cases and 191 deaths due to ECF were identified from the two sources, giving an observed prevalence of 32% (CI(95%) 30-35%) and observed case fatality rate of 42% (CI(95%) 38-47%). Following application of the capture-recapture method, the estimated number of clinical cases and deaths was 625 (CI(95%) 617-633) and 401 (CI(95%) 384-418), respectively. The respective prevalence and case fatality rates were 45% (CI(95%) 41-48%) and 64% (CI(95%) 60-68%). The estimates obtained using the capture-recapture method are higher than those identified by traditional cross-sectional studies conducted in the same study area, and probably provide a more accurate epidemiological picture of ECF in this region of Tanzania. Copyright 2009 Elsevier Ltd. All rights reserved.

High Prevalence of Faecal Carriage of ESBL-Producing Enterobacteriaceae among Children in Dar es Salaam, Tanzania.

PubMed

Tellevik, Marit G; Blomberg, Bjørn; Kommedal, Øyvind; Maselle, Samuel Y; Langeland, Nina; Moyo, Sabrina J

2016-01-01

Faecal carriage of ESBL-producing bacteria is a potential risk for transmission and infection. Little is known about faecal carriage of antibiotic resistance in Tanzania. This study aimed to investigate the prevalence of faecal carriage of ESBL-producing Enterobacteriaceae and to identify risk factors for carriage among young children in Tanzania. From August 2010 to July 2011, children below 2 years of age were recruited in Dar es Salaam, including healthy community children (n = 250) and children hospitalized due to diarrhoea (n = 250) or other diseases (n = 103). ChromID ESBL agar and ChromID CARBA SMART agar were used for screening. Antimicrobial susceptibility testing was performed by the disk diffusion method. ESBL genotypes were identified by Real-Time PCR and sequencing. The overall prevalence of ESBL carriage was 34.3% (207/ 603). The prevalence of ESBL carriage was significantly higher among hospitalized children (50.4%), compared to community children (11.6%; P < 0.001; OR = 7.75; 95% CI: 4.99-12.03). We found high prevalence of Multidrug-resistance (94%) among Escherichia coli and Klebsiella pneumoniae isolates. No resistance to carbapenems was detected. For the majority of isolates (94.7%) we detected a blaCTX-M-15-like gene. In addition, the plasmid mediated AmpC beta-lactamase CMY-2 was detected for the first time in Tanzania. ESBL prevalence was significantly higher among HIV positive (89.7%) than HIV negative (16.9%) children (P = 0.001; OR = 9.99; 95% CI: 2.52-39.57). Use of antibiotics during the past 14 days and age below 1 year was also associated with ESBL carriage. We report a high rate of faecal carriage of ESBL-producing Enterobacteriaceae among children below 2 years of age in Tanzania, particularly those with HIV-infection. Resistance to a majority of the available antimicrobials commonly used for children in Tanzania leaves few treatment options for infections when caused by these bacteria.

Education and Poverty Reduction in Tanzania

ERIC Educational Resources Information Center

Wedgwood, Ruth

2007-01-01

This paper reviews research on the returns to education in Tanzania, both financial and non-financial, and considers whether these returns translate into poverty reduction. It looks at reasons why achievement of high primary enrolment rates in the past did not lead to the realisation of the associated developmental outcomes, considering factors…

Nutritional Problems and Policy in Tanzania. Cornell International Nutrition Monograph Series, Number 7 (1980).

ERIC Educational Resources Information Center

Mgaza, Olyvia

This monograph discusses policies designed to deal with food and nutrition problems in Tanzania. Available information on food supplies and nutritional conditions in Tanzania clearly shows that the country faces nutritional problems; protein energy malnutrition is the most serious and requires priority action. Iron deficiency anemia, goiter, and…

Schistosomiasis and US Peace Corps volunteers in Tanzania.

PubMed

Outwater, Anne H; Mpangala, Edith

2005-01-01

Schistosoma haematobium and Schistosoma mansoni are endemic to East Africa. US Peace Corps volunteers (PCVs) serving in Tanzania were not experiencing symptoms of infection, but in 1998 when comprehensive testing was instituted, more than one-quarter were found to be infected with schistosomiasis at the close of their 27-month tour of service. An education campaign was instituted by the in-country Peace Corps Medical Officers. At their close of service, all PCVs had a medical examination and blood, urine, and stool samples were tested for schistosomiasis. PCVs also answered a survey that included questions about their knowledge of the blood fluke and the disease, symptoms, where and how many times they had gone swimming, and what precautionary measures they had taken. PCVs in Tanzania are most susceptible to infection from recreational activities within the Lake Victoria ecosystem. After an education campaign, incident cases dropped quickly. Vigorous toweling after exposure may have decreased the risk of disease for those PCVs who went swimming in freshwater. Although schistosomiasis is common in Tanzania and PCVs are highly susceptible, it is possible for them to spend their entire tour without contracting the disease, even if they live by Lake Victoria. People should be encouraged not to swim in Lake Victoria. The possibility that vigorous toweling immediately after exposure to infected waters is a useful protective measure warrants further investigation.

A SWOT Analysis of the Integration of E-Learning at a University in Uganda and a University in Tanzania

ERIC Educational Resources Information Center

Zhu, Chang; Justice Mugenyi, Kintu

2015-01-01

This research examines the strengths, weaknesses, opportunities and threats (SWOT) to integrating e-learning perceived by academic staff at a university in Uganda and a university in Tanzania. Mixed-methods research was used in which a main qualitative study was complemented by a quantitative method. The sample participants were academic staff…

Acute Pesticide Poisoning in Children: Hospital Review in Selected Hospitals of Tanzania.

PubMed

Lekei, Elikana; Ngowi, Aiwerasia V; London, Leslie

2017-01-01

Acute pesticide poisoning (APP) is a serious problem worldwide. Because the burden of childhood APP is unknown in Tanzania, this study describes the distribution, circumstances, and patterns of APP involving children under 18 years in Tanzania. A 12-month prospective study was conducted in 10 Tanzanian healthcare facilities in 2006 using a data collection tool for surveillance. Of 53 childhood poisoning cases identified, 56.6% were female. The most common poisoning circumstances were accidents (49.1%) and suicide (30.2%). The most vulnerable children were 16-17 years old (30.2%). Suicide was significantly more common in females (PRR females/males = 1.66; 95% CI = 1.03-2.68) and accidental cases were more common in children aged 10 years or younger. Suicide was concentrated in children over 10 years, comprising 53% of cases in this age group. Organophosphates (OPs), zinc phosphide, and endosulfan were common amongst reported poisoning agents. The annual APP incidence rate was 1.61/100,000. APP is common among children in this region of Tanzania. Prevention of suicide in older children should address mental health issues and control access to toxic pesticides. Prevention of accidents in younger children requires safer storage and hygiene measures. Diverse interventions are needed to reduce pesticide poisoning among children in Tanzania.

Malaria entomological profile in Tanzania from 1950 to 2010: a review of mosquito distribution, vectorial capacity and insecticide resistance.

PubMed

Kabula, Bilali; Derua, Yahya A; Tungui, Patrick; Massue, Dennis J; Sambu, Edward; Stanley, Grades; Mosha, Franklin W; Kisinza, William N

2011-12-01

In Sub Saharan Africa where most of the malaria cases and deaths occur, members of the Anopheles gambiae species complex and Anophelesfunestus species group are the important malaria vectors. Control efforts against these vectors in Tanzania like in most other Sub Saharan countries have failed to achieve the set objectives of eliminating transmission due to scarcity of information about the enormous diversity of Anopheles mosquito species and their susceptibility status to insecticides used for malaria vector control. Understanding the diversity and insecticide susceptibility status of these vectors and other factors relating to their importance as vectors (such as malaria transmission dynamics, vector biology, ecology, behaviour and population genetics) is crucial to developing a better and sound intervention strategies that will reduce man-vector contact and also manage the emergency of insecticide resistance early and hence .a success in malaria control. The objective of this review was therefore to obtain the information from published and unpublished documents on spatial distribution and composition of malaria vectors, key features of their behaviour, transmission indices and susceptibility status to insecticides in Tanzania. All data available were collated into a database. Details recorded for each data source were the locality, latitude/longitude, time/period of study, species, abundance, sampling/collection methods, species identification methods, insecticide resistance status, including evidence of the kdr allele, and Plasmodium falciparum sporozoite rate. This collation resulted in a total of 368 publications, encompassing 806,273 Anopheles mosquitoes from 157 georeferenced locations being collected and identified across Tanzania from 1950s to 2010. Overall, the vector species most often reported included An. gambiae complex (66.8%), An. funestus complex (21.8%), An. gambiae s.s. (2.1%) and An. arabiensis (9%). A variety of sampling/ collection and

Tanzania Higher Education--Fifty Years after Independence

ERIC Educational Resources Information Center

Mnubi, Godfrey M.

2013-01-01

As Tanzania celebrates fifty years of independence at the crossroads of globalization, the country has experienced a changing landscape and a major transformation in higher learning education with spectacular expansion in student enrollment rates. This requires its higher education institutions, particularly universities, to function effectively…

Tanzania: Background and Current Conditions

DTIC Science & Technology

2010-12-08

movement of refugees. Societal violence against women and persons with albinism and women persisted. Female genital mutilation (FGM), especially of...Zanzibar /islands over 99% Muslim Literacy: Male, 77.5%; Female , 66.2% (2003) Under-5 Mortality: 165 deaths/1,000 live births HIV/AIDS adult...infection rate: 6.2% (2007) Life Expectancy, years at birth: Male, 50.5 Female , 53.5 (2009 est.) Sources: CIA World Factbook 2010. Tanzania

Tanzania: Background and Current Conditions

DTIC Science & Technology

2010-07-23

persons with albinism and women persisted. Female genital mutilation (FGM), especially of young girls, continued to be practiced. Trafficking in...35%; Zanzibar /islands over 99% Muslim Literacy: Male, 77.5%; Female , 66.2% (2003) Under-5 Mortality: 165 deaths/1,000 live births HIV/AIDS adult...infection rate: 6.2% (2007) Life Expectancy, years at birth: Male, 50.5 Female , 53.5 (2009 est.) Sources: CIA World Factbook 2010. Tanzania

Perceptions of caring for children with disabilities: Experiences from Moshi, Tanzania

PubMed Central

McNally, Anna

2013-01-01

Background Although there exist laws, policies and standards in Tanzania that serve to protect and improve the lives of children with disabilities, the individual human experiences and feelings of the carers and parents still remain the realities of caring for children with disabilities. There is a lack of qualitative studies examining experiences in a developing context. This research aimed to fill that gap. Objectives The objective of this research was to gain an insight into how having a child with a disability impacts upon participants lives and to examine both negative and positive experiences of care through the use of qualitative methods. Method This was a qualitative, exploratory study and followed a phenomenological method. Purposive convenience sampling methods were used to recruit 14 carers in Moshi, Tanzania. Qualitative, semi-structured interviews were undertaken with all 14 participants. Results Five main themes emerged from the data which shed light on the carers experiences, namely, objective challenges in terms of financial challenges, employment issues and demands of care; subjective challenges in the form of stigma, isolation and pity; positive experiences such as the child’s progress, respect and happiness; material and financial needs; and coping mechanisms which included beliefs, support and attitudes. Conclusion The findings of this research were that objective challenges are common and more significant than subjective challenges. Positive experiences were not as easily identified by the participants as the challenges faced. However, having analysed the data, carers do not experience their roles as entirely negative. They simply need the resources to deal with objective challenges which in a developing context are not easily attainable. PMID:28729981

Sickle cell disease in Africa: an overview of the integrated approach to health, research, education and advocacy in Tanzania, 2004–2016

PubMed Central

Tluway, Furahini; Makani, Julie

2017-01-01

Summary Sickle cell disease (SCD) is the single most important genetic cause of childhood mortality globally. Tanzania has one of the highest annual births of SCD individuals in the world, estimated to reach 11 000 births a year. Without intervention, 50–90% of children will die in childhood. However, cost-effective interventions have the potential to reduce childhood mortality by up to 70%. The effects of SCD are multi-dimensional, ranging from causing high morbidity and mortality, and reducing the quality of life, to imposing a high socio-economic burden on individuals, families and health systems. In the past 12 years, the SCD programme in Tanzania has developed, with local and global partnerships, a systematic framework for comprehensive research that is integrated into providing healthcare, training and advocacy in SCD. This report outlines the approach and achievements of collective initiatives for management and control of SCD in Tanzania. PMID:28295224

Geologic map of Oldonyo Lengai (Oldoinyo Lengai) Volcano and surroundings, Arusha Region, United Republic of Tanzania

USGS Publications Warehouse

Sherrod, David R.; Magigita, Masota M.; Kwelwa, Shimba

2013-01-01

The geology of Oldonyo Lengai volcano and the southernmost Lake Natron basin, Tanzania, is presented on this geologic map at scale 1:50,000. The map sheet can be downloaded in pdf format for online viewing or ready to print (48 inches by 36 inches). A 65-page explanatory pamphlet describes the geologic history of the area. Its goal is to place the new findings into the framework of previous investigations while highlighting gaps in knowledge. In this way questions are raised and challenges proposed to future workers. The southernmost Lake Natron basin is located along the East African rift zone in northern Tanzania. Exposed strata provide a history of volcanism, sedimentation, and faulting that spans 2 million years. It is here where Oldonyo Lengai, Tanzania’s most active volcano of the past several thousand years, built its edifice. Six new radiometric ages, by the 40Ar/39Ar method, and 48 new geochemical analyses from Oldonyo Lengai and surrounding volcanic features deepen our understanding of the area. Those who prefer the convenience and access offered by Geographic Information Systems (GIS) may download an electronic database, suitable for most GIS software applications. The GIS database is in a Transverse Mercator projection, zone 36, New (1960) Arc datum. The database includes layers for hypsography (topography), hydrography, and infrastructure such as roads and trails.

Development and Education in Appalachia and Tanzania.

ERIC Educational Resources Information Center

Parker, Franklin

Development and education in Appalachia and the Republic of Tanzania (Africa) are discussed in this paper. Major topics on Appalachia include geography, early settlers, history, the literary discovery of Appalachia, the missionary discovery of Appalachia, exploitation, depression and welfarism, and the Appalachian Regional Commission. Topics on…

Conservation biology: lion attacks on humans in Tanzania.

PubMed

Packer, Craig; Ikanda, Dennis; Kissui, Bernard; Kushnir, Hadas

2005-08-18

Large carnivores inspire opposition to conservation efforts owing to their impact on livestock and human safety. Here we analyse the pattern of lion attacks over the past 15 years on humans in Tanzania, which has the largest population of lions in Africa, and find that they have killed more than 563 Tanzanians since 1990 and injured at least 308. Attacks have increased dramatically during this time: they peak at harvest time each year and are most frequent in areas with few prey apart from bush pigs (Potamochoerus larvatus), the most common nocturnal crop pest. Our findings provide an important starting point for devising strategies to reduce the risk to rural Tanzanians of lion attacks.

Provision of Pre-Primary Education as a Basic Right in Tanzania: Reflections from Policy Documents

ERIC Educational Resources Information Center

Mtahabwa, Lyabwene

2010-01-01

This study sought to assess provision of pre-primary education in Tanzania as a basic right through analyses of relevant policy documents. Documents which were published over the past decade were considered, including educational policies, action plans, national papers, the "Basic Education Statistics in Tanzania" documents, strategy…

Disparities in Risk Factors Associated with Obesity between Zanzibar and Tanzania Mainland among Women of Reproductive Age Based on the 2010 TDHS

PubMed Central

Mtumwa, Abdalla H.; Ntwenya, Julius Edward; Vuai, Said A. H.

2016-01-01

The occurrence of overweight and obesity has serious health implications. The 2010 Tanzania Demographic and Health Survey data set was reanalysed to compare the prevalences of overweight and obesity between Mainland Tanzania and Zanzibar and to determine how demographic factors can predict overweight and obesity across the United Republic of Tanzania. About 7.92% of the Tanzanian women of reproductive age were obese, 15% were overweight, and 11.5% were underweight. Women from Mainland Tanzania (6.56%) were significantly less likely (AOR = 0.66, 95% CI: 0.53–0.82) to be affected by obesity as compared to women from Zanzibar (12.19%). The common predictors of obesity in Mainland Tanzania and Zanzibar were wealth index, marital status, and age. Whereas the place of residence and education level emerged as predictors of obesity in the Mainland Tanzania alone, the number of meals per day did so in Zanzibar. Most importantly, Zanzibar had a greater prevalence of obesity compared to Mainland Tanzania. PMID:27721990

Obesity as a public health problem among adult women in rural Tanzania

PubMed Central

Keding, Gudrun B; Msuya, John M; Maass, Brigitte L; Krawinkel, Michael B

2013-01-01

ABSTRACT Background: For many developing countries, obesity and its sequelae have become a challenge of a magnitude similar to hunger and undernutrition. The main objective of this study was, therefore, to investigate the weight status of women in rural Tanzania with reference to season as well as the link between women's weight, food consumption, and attitudes toward obesity. Methods: Three cross-sectional surveys in 3 different seasons within 1 year interviewed the same 210 women, ages 17–45 years, from 3 rural districts of northeastern and central Tanzania. These surveys assessed body mass index (BMI), food intake, and dietary diversity through 24-hour recalls, women's attitudes toward obesity, vegetable production, and socioeconomic status. Results: Although 71% of the women had a normal BMI, 7% were underweight, 16% overweight, and 6% obese. The BMI was correlated with the Dietary Diversity Score (DDS), the Food Variety Score (FVS), with the consumption of foods from the food groups “bread/cakes,” “sugar,” and “tea,” and with the production of exotic vegetables. In a multiple regression model, FVS was directly associated with BMI. When asked to describe the typical characteristics of an obese person, women mentioned more negative than positive characteristics. Conclusion: The prevalence of overweight and obesity was 3 times higher than that of underweight. Apparently, even in rural areas of Tanzania, a nutrition transition is underway. No direct association was identified between vegetable consumption and BMI. Although this study did not assess behavioral factors, such behavioral factors as activity levels as well as attitudes need to be considered, even in rural settings, to address all facets of malnutrition. PMID:25276549

Acute schistosomiasis in European students returning from fieldwork at Lake Tanganyika, Tanzania.

PubMed

Steiner, Florian; Ignatius, Ralf; Friedrich-Jaenicke, Barbara; Dieckmann, Sebastian; Harms, Gundel; Poppert, Sven; Mockenhaupt, Frank P

2013-01-01

Schistosomiasis is common in many African regions and poses a risk for travelers and the local population. So far, schistosomiasis in travelers or expatriates returning from the Tanzanian bank of Lake Tanganyika has not been reported. We report a group of students who sought treatment with signs of acute schistosomiasis after having returned from Lake Tanganyika, Tanzania. Information as to travel and exposure as well as clinical and laboratory data were collected. Schistosomiasis was diagnosed in 8 of 16 students from Berlin, Germany, who had returned from a 2- to 3-month stay of fieldwork in Kigoma District at Lake Tanganyika, Tanzania. All 16 students reported frequent freshwater exposure at the lake. Six patients showed signs of acute schistosomiasis and had fever, and some of them also had cough, weakness, headache, or abdominal pain. Eosinophilia was present in five of the six symptomatic individuals. Notably, two serologically enzyme-linked immunosorbent assay (ELISA)-positive individuals did not report or present with symptoms or abnormal laboratory parameters. Schistosoma mansoni eggs were found in one symptomatic and one asymptomatic individual each. Blood and stool samples from the other eight individuals who were equally exposed to freshwater yielded negative results. This is the first report of an outbreak of acute schistosomiasis imported from the Tanzanian shore of Lake Tanganyika and highlights the risk for travelers and the local population of acquiring the infection in that part of Tanzania. It provides arguments for routine serological screening for schistosomiasis in individuals who had prior freshwater contact in endemic areas, irrespective of symptoms or other laboratory findings. © 2013 International Society of Travel Medicine.

Early Cenozoic tropical climate: report from the Tanzania Onshore Paleogene Integrated Coring (TOPIC) workshop

NASA Astrophysics Data System (ADS)

Pearson, P. N.; Hudson, W.

2014-12-01

We are currently developing a proposal for a new International Continental Scientific Drilling Program (ICDP) project to recover a stratigraphic and paleoclimatic record from the full succession of Eocene hemipelagic sediments that are now exposed on land in southern Tanzania. Funding for a workshop was provided by ICDP, and the project was advertised in the normal way. A group of about 30 delegates assembled in Dar-es-Salaam for 3 intensive days of discussion, project development, and proposal writing. The event was hosted by the Tanzania Petroleum Development Corporation (TPDC) and was attended by several geologists, geochemists, geophysicists, and micropaleontologists from TPDC and the University of Dar-es-Salaam. International delegates were from Canada, Germany, India, Ireland, Italy, the Netherlands, United Kingdom, and United States (and we also have project partners from Australia, Belgium, and Sweden who were not able to attend). Some of the scientists are veterans of previous scientific drilling in the area, but over half are new on the scene, mostly having been attracted by Tanzania's reputation for world-class paleoclimate archives. Here we outline the broad aims of the proposed drilling and give a flavor of the discussions and the way our proposal developed during the workshop. A video of the workshop with an introduction to the scientific goals and interviews of many of the participants is available at http://vimeo.com/107911777.

A categorization of water system breakdowns: Evidence from Liberia, Nigeria, Tanzania, and Uganda.

PubMed

Klug, Tori; Cronk, Ryan; Shields, Katherine F; Bartram, Jamie

2018-04-01

In rural sub-Saharan Africa, one in three handpumps are non-functional at any time. While there is some evidence describing factors associated with non-functional water systems, there is little evidence describing the categories of water system breakdowns that commonly occur. Insufficient water availability from broken down systems can force people to use unimproved water sources, which undermines the health benefits of an improved water source. We categorized common water system breakdowns using quantitative and qualitative monitoring data from Liberia, Nigeria, Tanzania, and Uganda (each N>3600 water systems) and examined how breakdown category varies by water system type and management characteristics. Specific broken parts were mentioned more frequently than all other reasons for breakdown; hardware parts frequently found at fault for breakdown were aprons (Liberia), pipes (Tanzania and Uganda), taps/spouts (Tanzania and Uganda), and lift mechanisms (Nigeria). Statistically significant differences in breakdown category were identified based on system type, age, management type, and fee collection type. Categorization can help to identify common reasons for water system breakdown. The analysis of these data can be used to develop improved monitoring instruments to inform actors of different breakdown types and provide reasons for system non-functionality. Improved monitoring instruments would enable actors to target appropriate resources to address specific breakdowns likely to arise based on system type and management characteristics in order to inform improved implementation of and post-construction support for water systems in sub-Saharan Africa. Copyright © 2017 Elsevier B.V. All rights reserved.

Societal Incentives for Work: Lessons from Tanzania.

ERIC Educational Resources Information Center

Bjorkquist, David C.

1993-01-01

A study of work and economics, technology, and culture in Tanzania reveals that (1) material returns to rural workers were barely life sustaining; (2) people live dignified lives without consuming much; (3) simpler technological solutions were better; (4) tension exists between competitiveness and humaneness; and (5) tribal traditions contribute…

Country watch: Tanzania.

PubMed

Kishe, F; Mtweve, S P

1995-01-01

This article describes the approach of the KIWAKKUKI women's group in helping to change sex behavior among youth and to inform community women's groups in Moshi, Tanzania. The group concluded after four years of experience that people change risky sexual behavior most when participatory methods based on local culture are used in educational programs. KIWAKKUKI established discussion groups for primary and secondary school students in the schools. The approach included use of videos, clothboards, chalkboards, and sometimes role plays. The mothers engaged in discussions with children other than their own, which reduced some embarrassment. Sex education discussion groups were also conducted among church youth and community women's groups. Monthly meetings drew a membership of about 356 persons, of whom 30-50 were trainers and advocates. Some of the topics of conversation were knowledge about physical bodies and personalities, assertiveness and the ability to say "no," laws and regulations relating to marriage, inheritance, sexual harassment, abuse, and AIDS. Other topics focused on the cultural understanding of circumcision, teeth extraction, wife inheritance, and women's income generation. The basic premise of their operation is empowerment of women and the belief that women can make a difference in changing culture. Men, who indicated an interest in forming a group, were redirected to their own group formation.

Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania: evidence from two rural districts

PubMed Central

2012-01-01

Background Since its introduction in the national antenatal care (ANC) system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs) in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp) services in the national ANC clinics and the implications such motivation and performance might have had on HWs and services' compliance with the recommended IPTp delivery guidelines. This paper describes the supply-related drivers of motivation and performance of HWs in administering IPTp doses among other ANC services delivered in public and private health facilities (HFs) in Tanzania, using a case study of Mkuranga and Mufindi districts. Methods Interviews were conducted with 78 HWs participating in the delivery of ANC services in private and public HFs and were supplemented by personal communications with the members of the district council health management team. The research instrument used in the data collection process contained a mixture of closed and open-ended questions. Some of the open-ended questions had to be coded in the form that allowed their analysis quantitatively. Results In both districts, respondents acknowledged IPTp as an essential intervention, but expressed dissatisfaction with their working environments constraining their performance, including health facility (HF) unit understaffing; unsystematic and unfriendly supervision by CHMT members; limited opportunities for HW career development; and poor (HF) infrastructure and staff houses. Data also suggest that poor working conditions negatively affect health workers' motivation to perform for ANC (including IPTp) services. Similarities and differences were noted in terms of motivational factors for ANC service delivery between the HWs employed in private HFs and those in public HFs: those in private facilities were more comfortable with staff residential houses, HF buildings, equipment, availability of water

Acute Pesticide Poisoning in Children: Hospital Review in Selected Hospitals of Tanzania

PubMed Central

London, Leslie

2017-01-01

Background Acute pesticide poisoning (APP) is a serious problem worldwide. Because the burden of childhood APP is unknown in Tanzania, this study describes the distribution, circumstances, and patterns of APP involving children under 18 years in Tanzania. Methodology A 12-month prospective study was conducted in 10 Tanzanian healthcare facilities in 2006 using a data collection tool for surveillance. Results Of 53 childhood poisoning cases identified, 56.6% were female. The most common poisoning circumstances were accidents (49.1%) and suicide (30.2%). The most vulnerable children were 16-17 years old (30.2%). Suicide was significantly more common in females (PRR females/males = 1.66; 95% CI = 1.03–2.68) and accidental cases were more common in children aged 10 years or younger. Suicide was concentrated in children over 10 years, comprising 53% of cases in this age group. Organophosphates (OPs), zinc phosphide, and endosulfan were common amongst reported poisoning agents. The annual APP incidence rate was 1.61/100,000. Conclusion APP is common among children in this region of Tanzania. Prevention of suicide in older children should address mental health issues and control access to toxic pesticides. Prevention of accidents in younger children requires safer storage and hygiene measures. Diverse interventions are needed to reduce pesticide poisoning among children in Tanzania. PMID:29441090

Effects of Cooking Fuels on Acute Respiratory Infections in Children in Tanzania

PubMed Central

Kilabuko, James H.; Nakai, Satoshi

2007-01-01

Biomass fuels, charcoal and kerosene are the most used cooking fuels in Tanzania. Biomass fuel use has been linked to Acute Respiratory Infections (ARI) in children. It is not clear whether the use of charcoal and kerosene has health advantage over biomass fuels. In this study, the effects of biomass fuels, charcoal/kerosene on ARI in children under five years old in Tanzania are quantified and compared based on data from Tanzania Demographic and Health survey conducted between 2004 and 2005. Approximately 85% and 15% of children were from biomass fuels and charcoal/kerosene using homes respectively. Average ARI prevalence was about 11%. The prevalence of ARI across various fuel types used for cooking did not vary much from the national prevalence. Odds ratio for ARI, adjusting for child’s sex, age and place of residence; mother’s education, mother’s age at child birth and household living standard, indicated that the effect of biomass fuels on ARI is the same as the effect of charcoal/kerosene (OR 1.01; 95% CI: 0.78–1.42). The findings suggest that to achieve meaningful reduction of ARI prevalence in Tanzania, a shift from the use of biomass fuels, charcoal and kerosene for cooking to clean fuels such as gas and electricity may be essential. Further studies, however, are needed for concrete policy recommendation. PMID:18180538

Access to artemisinin-based anti-malarial treatment and its related factors in rural Tanzania

PubMed Central

2013-01-01

Background Artemisinin-based combination treatment (ACT) has been widely adopted as one of the main malaria control strategies. However, its promise to save thousands of lives in sub-Saharan Africa depends on how effective the use of ACT is within the routine health system. The INESS platform evaluated effective coverage of ACT in several African countries. Timely access within 24 hours to an authorized ACT outlet is one of the determinants of effective coverage and was assessed for artemether-lumefantrine (Alu), in two district health systems in rural Tanzania. Methods From October 2009 to June 2011we conducted continuous rolling household surveys in the Kilombero-Ulanga and the Rufiji Health and Demographic Surveillance Sites (HDSS). Surveys were linked to the routine HDSS update rounds. Members of randomly pre-selected households that had experienced a fever episode in the previous two weeks were eligible for a structured interview. Data on individual treatment seeking, access to treatment, timing, source of treatment and household costs per episode were collected. Data are presented on timely access from a total of 2,112 interviews in relation to demographics, seasonality, and socio economic status. Results In Kilombero-Ulanga, 41.8% (CI: 36.6–45.1) and in Rufiji 36.8% (33.7–40.1) of fever cases had access to an authorized ACT provider within 24 hours of fever onset. In neither of the HDSS site was age, sex, socio-economic status or seasonality of malaria found to be significantly correlated with timely access. Conclusion Timely access to authorized ACT providers is below 50% despite interventions intended to improve access such as social marketing and accreditation of private dispensing outlets. To improve prompt diagnosis and treatment, access remains a major bottle neck and new more innovative interventions are needed to raise effective coverage of malaria treatment in Tanzania. PMID:23651521

Comparing the Role of Education in Serving Socioeconomic and Political Development in Tanzania and Cuba.

ERIC Educational Resources Information Center

Mtonga, Harry L.

1993-01-01

Compares Tanzania and Cuba to show how, in each case, the state has used education in political and socioeconomic development as a means of achieving socialism. In Cuba, the school system has contributed to creation of the new society, whereas Tanzania continues with piecemeal reconstruction of the educational system. (SLD)

The challenge to avoid anti-malarial medicine stock-outs in an era of funding partners: the case of Tanzania

PubMed Central

2014-01-01

Background Between 2007 and 2013, the Tanzanian public sector received 93.1 million doses of first-line anti-malarial artemisinin-based combination therapy (ACT) in the form of artemether-lumefantrine entirely supplied by funding partners. The introduction of a health facility ACT stock monitoring system using SMS technology by the National Malaria Control Programme in mid 2011 revealed a high frequency of stock-outs of ACT in primary care public health facilities. The objective of this study was to determine the pattern of availability of ACT and possible causes of observed stock-outs across public health facilities in Tanzania since mid-2011. Methods Data were collected weekly by the mobile phone reporting tool SMS for Life on ACT availability from over 5,000 public health facilities in Tanzania starting from September 2011 to December 2012. Stock data for all four age-dose levels of ACT across health facilities were summarized and supply of ACT at the national level was also documented. Results Over the period of 15 months, on average 29% of health facilities in Tanzania were completely stocked out of all four-age dose levels of the first-line anti-malarial with a median duration of total stock-out of six weeks. Patterns of total stock-out by region ranged from a low of 9% to a high of 52%. The ACT stock-outs were most likely caused by: a) insufficient ACT supplies entering Tanzania (e.g. in 2012 Tanzania received 10.9 million ACT doses compared with a forecast demand of 14.4 million doses); and b) irregular pattern of ACT supply (several months with no ACT stock). Conclusion The reduced ACT availability and irregular pattern of supply were due to cumbersome bureaucratic processes and delays both within the country and from the main donor, the Global Fund to Fight AIDS, Tuberculosis and Malaria. Tanzania should invest in strengthening both the supply system and the health information system using mHealth solutions such as SMS for Life. This will continue to

Prevalence and risk factors associated with Theileria parva infection in cattle in three regions of Tanzania.

PubMed

Kerario, Isack I; Simuunza, Martin C; Chenyambuga, Sebastian W; Koski, Marja; Hwang, Seong-Gu; Muleya, Walter

2017-12-01

Ticks and tickborne diseases (TBDs) are serious constraints to cattle production in Tanzania and other tropical and subtropical countries. Among the TBDs, East Coast fever (ECF) is the most important as it causes significant economic losses to the cattle industry in Tanzania. However, control of ECF in Tanzania has continued to be a challenge due to inadequate epidemiological information. The main objective of this study was to determine the epidemiological situation of Theileria parva infections in cattle kept under pastoral and agro-pastoral farming systems in Mara, Singida, and Mbeya regions of Tanzania. Blood samples were collected from 648 cattle in the three regions. Genomic DNA was extracted and amplified in a polymerase chain reaction (PCR) using T. parva-specific primers targeting the 104-kD antigen (P104) gene. In addition, information was collected on the possible risk factors of T. parva infection (animal age, region, animal sex, tick burden, tick control method, and frequency of acaricide application). The prevalence of T. parva across the three regions was 14.2%. There was variation in prevalence among the three regions with Mara (21.8%) having a significantly higher (p = 0.001) prevalence than the other regions. Moreover, Mbeya exhibited relatively lower prevalence (7.4%) compared to the other regions. Factors found to be significantly associated with an animal being PCR positive for T. parva were region (p = 0.001) and tick burden (p = 0.003). Other factors were not found to be significant predictors of being PCR positive for T. parva. The present study showed high variation in tick burden and T. parva prevalence across the regions. Therefore, different strategic planning and cost-effective control measures for ticks and T. parva infection should be implemented region by region in order to reduce losses caused by ticks and ECF in the study area.

Diagnosis of human fascioliasis in Arusha region, northern Tanzania by microscopy and clinical manifestations in patients.

PubMed

Lukambagire, Abdul-Hamid Settenda; Mchaile, Deborah N; Nyindo, Mramba

2015-12-23

Human fascioliasis (HF) is a zoonotic disease that has been identified in many countries worldwide. This report concerns the identification and clinical management of cases of human fascioliasis in the suburbs of Arusha city, northern Tanzania in 2013. Fascioliasis is included among the WHO's Neglected Tropical Diseases as a plant transmitted trematode infection. Human fascioliasis has not been described before in the East Africa region, including Tanzania. Patients presenting at a primary healthcare centre in Arusha Region, northern Tanzania provided fresh stool samples for routine ova and parasite screening (saline and iodine preparations). Subsequent stool samples were preserved in 5 % formalin in saline and subjected to ether sedimentation for examination. Out of 1460 patients, 305 (21 %) were diagnosed positive for fascioliasis based on the demonstration of brownish, oval eggs with inconspicuous opercula in stool. Two distinct egg sizes were identified; large 170-212.5 by 115-150 μm (mean 194.5 by 130.5 μm) and smaller eggs 120-150 by 87.5 - 112.5 μm (mean 138.8 by 101 μm). Clinically, patients presented with fever (39 - 40 °C) and abdominal pain. Some patients had pruritis around the mouth and their lips were swollen. 3 patients were treated and cured with single dose Triclabendazole. The remaining 302 patients were treated with Nitazoxanide and 122 (40 %) were cleared of infection with a single course. Snails of the genus Lymnaea were found in the surroundings. This report serves to remind medical professionals in East Africa that HF is a probable differential diagnosis in patients presenting with similar symptoms. It is possible to diagnose fascioliasis by light microscopy although specific antigen tests are required for confirmation. Human fascioliasis however, has not been described or reported in Tanzania before and begs further investigation.

Independent Origin of Plasmodium falciparum Antifolate Super-Resistance, Uganda, Tanzania, and Ethiopia

PubMed Central

Alifrangis, Michael; Schousboe, Mette L.; Ishengoma, Deus; Lusingu, John; Pota, Hirva; Kavishe, Reginald A.; Pearce, Richard; Ord, Rosalynn; Lynch, Caroline; Dejene, Seyoum; Cox, Jonathan; Rwakimari, John; Minja, Daniel T.R.; Lemnge, Martha M.; Roper, Cally

2014-01-01

Super-resistant Plasmodium falciparum threatens the effectiveness of sulfadoxine–pyrimethamine in intermittent preventive treatment for malaria during pregnancy. It is characterized by the A581G Pfdhps mutation on a background of the double-mutant Pfdhps and the triple-mutant Pfdhfr. Using samples collected during 2004–2008, we investigated the evolutionary origin of the A581G mutation by characterizing microsatellite diversity flanking Pfdhps triple-mutant (437G+540E+581G) alleles from 3 locations in eastern Africa and comparing it with double-mutant (437G+540E) alleles from the same area. In Ethiopia, both alleles derived from 1 lineage that was distinct from those in Uganda and Tanzania. Uganda and Tanzania triple mutants derived from the previously characterized southeastern Africa double-mutant lineage. The A581G mutation has occurred multiple times on local Pfdhps double-mutant backgrounds; however, a novel microsatellite allele incorporated into the Tanzania lineage since 2004 illustrates the local expansion of emergent triple-mutant lineages. PMID:25061906

Effects of trophy hunting on lion and leopard populations in Tanzania.

PubMed

Packer, C; Brink, H; Kissui, B M; Maliti, H; Kushnir, H; Caro, T

2011-02-01

Tanzania holds most of the remaining large populations of African lions (Panthera leo) and has extensive areas of leopard habitat (Panthera pardus), and both species are subjected to sizable harvests by sport hunters. As a first step toward establishing sustainable management strategies, we analyzed harvest trends for lions and leopards across Tanzania's 300,000 km(2) of hunting blocks. We summarize lion population trends in protected areas where lion abundance has been directly measured and data on the frequency of lion attacks on humans in high-conflict agricultural areas. We place these findings in context of the rapidly growing human population in rural Tanzania and the concomitant effects of habitat loss, human-wildlife conflict, and cultural practices. Lion harvests declined by 50% across Tanzania between 1996 and 2008, and hunting areas with the highest initial harvests suffered the steepest declines. Although each part of the country is subject to some form of anthropogenic impact from local people, the intensity of trophy hunting was the only significant factor in a statistical analysis of lion harvest trends. Although leopard harvests were more stable, regions outside the Selous Game Reserve with the highest initial leopard harvests again showed the steepest declines. Our quantitative analyses suggest that annual hunting quotas be limited to 0.5 lions and 1.0 leopard/1000 km(2) of hunting area, except hunting blocks in the Selous Game Reserve, where harvests should be limited to 1.0 lion and 3.0 leopards/1000 km(2) . ©2010 Society for Conservation Biology.

Risk Factors for Human Brucellosis in Northern Tanzania.

PubMed

Cash-Goldwasser, Shama; Maze, Michael J; Rubach, Matthew P; Biggs, Holly M; Stoddard, Robyn A; Sharples, Katrina J; Halliday, Jo E B; Cleaveland, Sarah; Shand, Michael C; Mmbaga, Blandina T; Muiruri, Charles; Saganda, Wilbrod; Lwezaula, Bingileki F; Kazwala, Rudovick R; Maro, Venance P; Crump, John A

2018-02-01

Little is known about the epidemiology of human brucellosis in sub-Saharan Africa. This hampers prevention and control efforts at the individual and population levels. To evaluate risk factors for brucellosis in northern Tanzania, we conducted a study of patients presenting with fever to two hospitals in Moshi, Tanzania. Serum taken at enrollment and at 4-6 week follow-up was tested by Brucella microagglutination test. Among participants with a clinically compatible illness, confirmed brucellosis cases were defined as having a ≥ 4-fold rise in agglutination titer between paired sera or a blood culture positive for Brucella spp., and probable brucellosis cases were defined as having a single reciprocal titer ≥ 160. Controls had reciprocal titers < 20 in paired sera. We collected demographic and clinical information and administered a risk factor questionnaire. Of 562 participants in the analysis, 50 (8.9%) had confirmed or probable brucellosis. Multivariable analysis showed that risk factors for brucellosis included assisting goat or sheep births (Odds ratio [OR] 5.9, 95% confidence interval [CI] 1.4, 24.6) and having contact with cattle (OR 1.2, 95% CI 1.0, 1.4). Consuming boiled or pasteurized dairy products was protective against brucellosis (OR 0.12, 95% CI 0.02, 0.93). No participants received a clinical diagnosis of brucellosis from their healthcare providers. The under-recognition of brucellosis by healthcare workers could be addressed with clinician education and better access to brucellosis diagnostic tests. Interventions focused on protecting livestock keepers, especially those who assist goat or sheep births, are needed.

Health and self-reliance: the experience of Tanzania.

PubMed

Tarimo, E

1978-01-01

Since its independence, Tanzania has consistently followed a socialist policy with a strong emphasis on the development of the rural areas and on an equal distribution of goods and services. In the health field, this policy has taken the form of establishing a network of rural health centers, training auxiliaries, and involving the communities through mass mobilization campaigns. Community participation in health care services is hindered by 3 sets of problems related to lack of cohesion, lack of structure, and the autonomous and sometimes paternalist attitude of the health profession. In Tanzania much emphasis is placed on self-reliance. It is in the field of education that policies of self-reliance have been most successfully implemented. Traditional practitioners represent 1 of the health resources that can be tapped. The medical profession cannot claim credit for the major improvements in health, for at times it has even blocked health development. Health standards and quality are important in the 3rd world. Staff must be properly trained to function at a particular level, supplies must be provided regularly, and there must be constant supervision. A health care system that is appropriate to the 3rd world must also emphasize disease prevention. To increase health coverage there must be a program of health service that is within reach of the people, including the rural population. Health cannot be furthered by the health services as tradtionally conceived; an intersectoral approach is essential. It is important that a commitment to an integrated development of the rural areas, with health as a component, be made.

Incentives and provider payment methods.

PubMed

Barnum, H; Kutzin, J; Saxenian, H

1995-01-01

The mode of payment creates powerful incentives affecting provider behavior and the efficiency, equity and quality outcomes of health finance reforms. This article examines provider incentives as well as administrative costs, and institutional conditions for successful implementation associated with provider payment alternatives. The alternatives considered are budget reforms, capitation, fee-for-service, and case-based reimbursement. We conclude that competition, whether through a regulated private sector or within a public system, has the potential to improve the performance of any payment method. All methods generate both adverse and beneficial incentives. Systems with mixed forms of provider payment can provide tradeoffs to offset the disadvantages of individual modes. Low-income countries should avoid complex payment systems requiring higher levels of institutional development.

Situation Report--Australia, The Gambia, Papua and New Guinea, Rhodesia, Sri Lanka, Taiwan, Tanzania, Tonga, and Western Samoa.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in nine foreign countries are presented in these situation reports. Countries included are Australia, The Gambia, Papua and New Guinea, Rhodesia, Sri Lanka, Taiwan, Tanzania, Tonga, and Western Somoa. Information is provided under three topics, statistical information, general background information,…

"Experiences with disclosure of HIV-positive status to the infected child": Perspectives of healthcare providers in Dar es Salaam, Tanzania.

PubMed

Sariah, Adellah; Rugemalila, Joan; Somba, Magreat; Minja, Anna; Makuchilo, Margareth; Tarimo, Edith; Urassa, David; Siril, Helen

2016-10-13

The specific age to which an HIV infected child can be disclosed to is stipulated to begin between ages 4 and 6 years. It has also been documented that before disclosure of HIV positive status to the infected child. Health care providers should consider children's cognitive-developmental ability. However, observation and situation analysis show that, health care providers still feel uncomfortable disclosing the HIV positive status to the infected child. The aim of the study was to explore healthcare providers' experiences in disclosure of HIV-positive status to the infected child. A qualitative study involving 20 health care providers who attend HIV-positive children was conducted in September, 2014 in Dar es Salaam, Tanzania. Participants were selected from ten HIV care and treatment clinics (CTC) by purposive sampling. An interview guide, translated into participants' national language (Kiswahili) was used during in-depth interviews. Sampling followed the principle of data saturation. The interviews focused on perspectives of health-care providers regarding their experience with paediatric HIV disclosure. Data from in-depth interviews were transcribed into text; data analysis followed qualitative content analysis. The results show how complex the process of disclosure to children living with HIV can be to healthcare providers. Confusion was noted among healthcare providers about their role and responsibility in the process of disclosing to the HIV infected child. This was reported to be largely due to unclear guidelines and lack of standardized training in paediatric HIV disclosure. Furthermore, healthcare providers were concerned about parental hesitancy to disclose early to the child due to lack of disclosure skills and fear of stigma. In order to improve the disclosure process in HIV infected children, healthcare providers recommended further standardized training on paediatric HIV disclosure with more emphasis on practical skills and inclusion of disclosure

Provision of family planning services in Tanzania: a comparative analysis of public and private facilities.

PubMed

Kakoko, Deodatus C; Ketting, Evert; Kamazima, Switbert R; Ruben, Ruerd

2012-12-01

Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based on 529 health facilities. Majority of public facilities (95.4%) offered family planning services, whereas more than half of private facilities (52.1%) did not offer those. Public facilities were more likely to offer modern contraceptives as compared to private facilities. However, private facilities were more likely to offer counseling on natural methods of family planning [AOR = 2.12 (1.15-3.92), P < or = 0.001]. Public facilities were more likely to report having guidelines or protocols for family planning services and various kinds of visual aids for family planning and STIs when compared to private facilities. This comparative analysis entails the need to enforce the standards of family planning services in Tanzania.

Estimating the costs of the vaccine supply chain and service delivery for selected districts in Kenya and Tanzania.

PubMed

Mvundura, Mercy; Lorenson, Kristina; Chweya, Amos; Kigadye, Rosemary; Bartholomew, Kathryn; Makame, Mohammed; Lennon, T Patrick; Mwangi, Steven; Kirika, Lydia; Kamau, Peter; Otieno, Abner; Murunga, Peninah; Omurwa, Tom; Dafrossa, Lyimo; Kristensen, Debra

2015-05-28

Having data on the costs of the immunization system can provide decision-makers with information to benchmark the costs when evaluating the impact of new technologies or programmatic innovations. This paper estimated the supply chain and immunization service delivery costs and cost per dose in selected districts in Kenya and Tanzania. We also present operational data describing the supply chain and service delivery points (SDPs). To estimate the supply chain costs, we collected resource-use data for the cold chain, distribution system, and health worker time and per diems paid. We also estimated the service delivery costs, which included the time cost of health workers to provide immunization services, and per diems and transport costs for outreach sessions. Data on the annual quantities of vaccines distributed to each facility, and the occurrence and duration of stockouts were collected from stock registers. These data were collected from the national store, 2 regional and 4 district stores, and 12 SDPs in each country for 2012. Cost per dose for the supply chain and immunization service delivery were estimated. The average annual costs per dose at the SDPs were $0.34 (standard deviation (s.d.) $0.18) for Kenya when including only the vaccine supply chain costs, and $1.33 (s.d. $0.82) when including immunization service delivery costs. In Tanzania, these costs were $0.67 (s.d. $0.35) and $2.82 (s.d. $1.64), respectively. Both countries experienced vaccine stockouts in 2012, bacillus Calmette-Guérin vaccine being more likely to be stocked out in Kenya, and oral poliovirus vaccine in Tanzania. When stockouts happened, they usually lasted for at least one month. Tanzania made investments in 2011 in preparation for planned vaccine introductions, and their supply chain cost per dose is expected to decline with the new vaccine introductions. Immunization service delivery costs are a significant portion of the total costs at the SDPs. Copyright © 2015 Elsevier Ltd. All

Sources of community health worker motivation: a qualitative study in Morogoro Region, Tanzania.

PubMed

Greenspan, Jesse A; McMahon, Shannon A; Chebet, Joy J; Mpunga, Maurus; Urassa, David P; Winch, Peter J

2013-10-10

There is a renewed interest in community health workers (CHWs) in Tanzania, but also a concern that low motivation of CHWs may decrease the benefits of investments in CHW programs. This study aimed to explore sources of CHW motivation to inform programs in Tanzania and similar contexts. We conducted semi-structured interviews with 20 CHWs in Morogoro Region, Tanzania. Interviews were digitally recorded, transcribed, and coded prior to translation and thematic analysis. The authors then conducted a literature review on CHW motivation and a framework that aligned with our findings was modified to guide the presentation of results. Sources of CHW motivation were identified at the individual, family, community, and organizational levels. At the individual level, CHWs are predisposed to volunteer work and apply knowledge gained to their own problems and those of their families and communities. Families and communities supplement other sources of motivation by providing moral, financial, and material support, including service fees, supplies, money for transportation, and help with farm work and CHW tasks. Resistance to CHW work exhibited by families and community members is limited. The organizational level (the government and its development partners) provides motivation in the form of stipends, potential employment, materials, training, and supervision, but inadequate remuneration and supplies discourage CHWs. Supervision can also be dis-incentivizing if perceived as a sign of poor performance. Tanzanian CHWs who work despite not receiving a salary have an intrinsic desire to volunteer, and their motivation often derives from support received from their families when other sources of motivation are insufficient. Policy-makers and program managers should consider the burden that a lack of remuneration imposes on the families of CHWs. In addition, CHWs' intrinsic desire to volunteer does not preclude a desire for external rewards. Rather, adequate and formal financial

Tanzania national survey on iodine deficiency: impact after twelve years of salt iodation.

PubMed

Assey, Vincent D; Peterson, Stefan; Kimboka, Sabas; Ngemera, Daniel; Mgoba, Celestin; Ruhiye, Deusdedit M; Ndossi, Godwin D; Greiner, Ted; Tylleskär, Thorkild

2009-09-03

In many low-income countries, children are at high risk of iodine deficiency disorders, including brain damage. In the early 1990s, Tanzania, a country that previously suffered from moderate to severe iodine deficiency, adopted universal salt iodation (USI) as an intervention strategy, but its impact remained unknown. We report on the first national survey in mainland Tanzania, conducted in 2004 to assess the extent to which iodated salt was used and its apparent impact on the total goitre prevalence (TGP) and urinary iodine concentrations (UIC) among the schoolchildren after USI was initiated. In 2004, a cross-sectional goitre survey was conducted; covering 140,758 schoolchildren aged 6 - 18 years were graded for goitre according to new WHO goitre classification system. Comparisons were made with district surveys conducted throughout most of the country during the 1980s and 90s. 131,941 salt samples from households were tested for iodine using rapid field test kits. UIC was determined spectrophotometrically using the ammonium persulfate digestion method in 4523 sub-sampled children. 83.6% (95% CI: 83.4 - 83.8) of salt samples tested positive for iodine. Whereas the TGP was about 25% on average in the earlier surveys, it was 6.9% (95%CI: 6.8-7.0) in 2004. The TGP for the younger children, 6-9 years old, was 4.2% (95%CI: 4.0-4.4), n = 41,965. In the 27 goitre-endemic districts, TGP decreased from 61% (1980s) to 12.3% (2004). The median UIC was 204 (95% CF: 192-215) microg/L. Only 25% of children had UIC <100 microg/L and 35% were > or = 300 microg/L, indicating low and excess iodine intake, respectively. Our study demonstrates a marked improvement in iodine nutrition in Tanzania, twelve years after the initiation of salt iodation programme. The challenge in sustaining IDD elimination in Tanzania is now two-fold: to better reach the areas with low coverage of iodated salt, and to reduce iodine intake in areas where it is excessive. Particular attention is needed in

Occupational injuries and fatalities in a tanzanite mine: Need to improve workers safety in Tanzania

PubMed Central

Boniface, Respicious; Museru, Lawrence; Munthali, Victoria; Lett, Ronald

2013-01-01

Introduction Work related injuries are common, and the mining industry accounts for a significant proportion of these injuries. Tanzania is among the countries with high rates of mining injuries, nevertheless pre-hospital care is almost non existant and health care service deliveries are poor. This study sought to identify factors associated with injuries and fatalities among miners in Mererani, Tanzania. Methods A Cross - Sectional study of miners who sustained injuries and seen at Mererani health centre between January 2009 and May 2012. Results In the selected period 248 injury patients were seen. All were males, and 54% were between 18 - 30 years age-group. Almost all (98.7%) didn’t use protective gears at work, and worked for more than 12 hours daily. Falling rocks were the leading cause of injury (18.2%), and majority sustained multiple injuries (33%). Of the patients seen, 41.3% died. The following were more likely to die than others; Primary education (p = 0.04), Less than 5 years work experience (p = 0.000), unintentional injuries (p = 0.000), fall injuries (p = 0.000) and sustaining multiple injuries (p = 0.000). Conclusion The burden of injuries and fatalities demonstrated in this study, point to the need for implementation and monitoring of the use of safety equipment and operating procedures of the mines by government and other regulatory authorities. Initiation of pre hospital care at the mines and improved emergency medical service delivery at health centers in Tanzania. PMID:24778757

Innovation in Distance Education Learning Systems: The Case of the National Correspondence Institute of Tanzania, 1972-2002

ERIC Educational Resources Information Center

Mutanyatta, J. N. S.

2008-01-01

The paper attempts to provide relevant data on the achievements, albeit quantitatively, of the National Correspondence Institute of Tanzania over the past 30 years as a case study in distance education innovation. The case-study data reveal reasons for the near collapse of the distance education programme during the 1990s, and the renewed policy…

Evaluation of a Short-term Training Program in Bedside Emergency Ultrasound in Southwestern Tanzania.

PubMed

Shaffer, Mark; Brown, Heather A; McCoy, Chloé; Bashaka, Prosper

2017-03-01

To evaluate the effect of a short-term training program in emergency ultrasound on physician skills and attitudes in southwestern Tanzania. Eight registrar physicians at Mbeya Zonal Referral Hospital (Mbeya, Tanzania) underwent a 5-day course in bedside emergency ultrasound, focusing primarily on the focused assessment with sonography for trauma examination, including didactic sessions, practical sessions, and on-job training. The impact on ultrasound knowledge was assessed by pretest and posttest evaluations. Provider skill was evaluated by a standardized observed simulated patient encounter. Attitudes toward ultrasound training, utility, and self-confidence were assessed by a post-training questionnaire. All 8 physicians who began the training completed the course and successfully passed their objective structured clinical examination. There was a statistically significant improvement in written ultrasound test scores from 31% to 66% (P < .01) after the course. Most trainees felt confident performing and interpreting a basic focused assessment with sonography for trauma examination at the end of the course, and 7 of 8 stated that they would consider paying tuition for similar courses in the future. Main concerns with the course revolved around insufficient time dedicated to practicing under supervision. Registrar physicians in Tanzania can effectively learn basic emergency ultrasound skills in a short-term training program. Similar future programs may consider heavier emphasis on practical hands-on training with experts. Ongoing data collection is required to understand the true impact of such training on long-term ultrasound use and patient outcomes. © 2017 by the American Institute of Ultrasound in Medicine.

Pre-referral Rectal Artesunate Treatment by Community-Based Treatment Providers in Ghana, Guinea-Bissau, Tanzania, and Uganda (Study 18): A Cluster-Randomized Trial

PubMed Central

Warsame, Marian; Gyapong, Margaret; Mpeka, Betty; Rodrigues, Amabelia; Singlovic, Jan; Babiker, Abdel; Mworozi, Edison; Agyepong, Irene; Ansah, Evelyn; Azairwe, Robert; Biai, Sidu; Binka, Fred; Folb, Peter; Gyapong, John; Kimbute, Omari; Machinda, Zena; Kitua, Andrew; Lutalo, Tom; Majaha, Melkzedik; Mamadu, Jao; Mrango, Zakayo; Petzold, Max; Rujumba, Joseph; Ribeiro, Isabela; Gomes, Melba

2016-01-01

Background. If malaria patients who cannot be treated orally are several hours from facilities for injections, rectal artesunate prior to hospital referral can prevent death and disability. The goal is to reduce death from malaria by having rectal artesunate treatment available and used. How best to do this remains unknown. Methods. Villages remote from a health facility were randomized to different community-based treatment providers trained to provide rectal artesunate in Ghana, Guinea-Bissau, Tanzania, and Uganda. Prereferral rectal artesunate treatment was provided in 272 villages: 109 through community-based health workers (CHWs), 112 via trained mothers (MUMs), 25 via trained traditional healers (THs), and 26 through trained community-chosen personnel (COMs); episodes eligible for rectal artesunate were established through regular household surveys of febrile illnesses recording symptoms eligible for prereferral treatment. Differences in treatment coverage with rectal artesunate in children aged <5 years in MUM vs CHW (standard-of-care) villages were assessed using the odds ratio (OR); the predictive probability of treatment was derived from a logistic regression analysis, adjusting for heterogeneity between clusters (villages) using random effects. Results. Over 19 months, 54 013 children had 102 504 febrile episodes, of which 32% (31 817 episodes) had symptoms eligible for prereferral therapy; 14% (4460) children received treatment. Episodes with altered consciousness, coma, or convulsions constituted 36.6% of all episodes in treated children. The overall OR of treatment between MUM vs CHW villages, adjusting for country, was 1.84 (95% confidence interval [CI], 1.20–2.83; P = .005). Adjusting for heterogeneity, this translated into a 1.67 higher average probability of a child being treated in MUM vs CHW villages. Referral compliance was 81% and significantly higher with CHWs vs MUMs: 87% vs 82% (risk ratio [RR], 1.1 [95% CI, 1.0–1.1]; P < .0001

Decentralisation and health services delivery in Tanzania: Analysis of decision space in planning, allocation, and use of financial resources.

PubMed

Kigume, Ramadhani; Maluka, Stephen; Kamuzora, Peter

2018-04-01

While decentralisation of health systems has been on the policy agenda in low-income and middle-income countries since the 1970s, many studies have focused on understanding who has more decision-making powers but less attention is paid to understand what those powers encompass. Using the decision space approach, this study aimed to understand the amount of decision-making space transferred from the central government to institutions at the periphery in the decentralised health system in Tanzania. The findings of this study indicated that the decentralisation process in Tanzania has provided authorities with a range of decision-making space. In the areas of priority setting and planning, district health authorities had moderate decision space. However, in the financial resource allocation and expenditure of funds from the central government, the districts had narrow decision-making space. The districts, nevertheless, had wider decision-making space in mobilising and using locally generated financial resources. However, the ability of the districts to allocate and use locally generated resources was constrained by bureaucratic procedures of the central government. The study concludes that decentralisation by devolution which is being promoted in the policy documents in Tanzania is yet to be realised at the district and local levels. The study recommends that the central government should provide more space to the decentralised district health systems to incorporate locally defined priorities in the district health plans. Copyright © 2018 John Wiley & Sons, Ltd.

Artisan Training and Employment Outcomes in Tanzania

ERIC Educational Resources Information Center

Bennell, Paul; Mukyanuzi, Faustin; Kasogela, Maurice; Mutashubirwa, Francis; Klim, Mikkel

2006-01-01

This article presents the main findings of a tracer survey of graduates from two artisan training centres in Tanzania, which was undertaken in early 2002. The two institutions are the Chang'ombe Regional Vocational Training and Service Centre (RVTSC) in Dar es Salaam and the Iringa RVTSC, which are owned and managed by the Vocational Education and…

Child Sexual Abuse: Community Concerns in Urban Tanzania

ERIC Educational Resources Information Center

Kisanga, Felix; Nystrom, Lennarth; Hogan, Nora; Emmelin, Maria

2011-01-01

The aim of this study was to explore community perceptions about child sexual abuse in Tanzania. Thirteen focus group discussions were conducted with adult community members. The core category, "children's rights challenged by lack of agency", was supported by eight categories. "Aware but distressed" portrayed feelings of…

Role of condom negotiation on condom use among women of reproductive age in three districts in Tanzania

PubMed Central

2012-01-01

Background HIV/AIDS remains being a disease of great public health concern worldwide. In regions such as sub-Saharan Africa (SSA) where women are disproportionately infected with HIV, women are reportedly less likely capable of negotiating condom use. However, while knowledge of condom use for HIV prevention is extensive among men and women in many countries including Tanzania, evidence is limited about the role of condom negotiation on condom use among women in rural Tanzania. Methods Data originate from a cross-sectional survey of random households conducted in 2011 in Rufiji, Kilombero and Ulanga districts in Tanzania. The survey assessed health-seeking behaviour among women and children using a structured interviewer-administered questionnaire. A total of 2,614 women who were sexually experienced and aged 15-49 years were extracted from the main database for the current analysis. Linkage between condom negotiation and condom use at the last sexual intercourse was assessed using multivariate logistic regression. Results Prevalence of condom use at the last sexual intercourse was 22.2% overall, ranging from12.2% among married women to 54.9% among unmarried (single) women. Majority of the women (73.4%) reported being confident to negotiate condom use, and these women were significantly more likely than those who were not confident to have used a condom at the last sexual intercourse (OR = 3.13, 95% CI 2.22-4.41). This effect was controlled for marital status, age, education, religion, number of sexual partners, household wealth and knowledge of HIV prevention by condom use. Conclusion Confidence to negotiate condom use is a significant predictor of actual condom use among women in rural Tanzania. Women, especially unmarried ones, those in multiple partnerships or anyone needing protection should be empowered with condom negotiation skills for increased use of condoms in order to enhance their sexual and reproductive health outcomes. PMID:23256530

Epidemiology and control of human schistosomiasis in Tanzania

PubMed Central

2012-01-01

In Tanzania, the first cases of schistosomiasis were reported in the early 19th century. Since then, various studies have reported prevalences of up to 100% in some areas. However, for many years, there have been no sustainable control programmes and systematic data from observational and control studies are very limited in the public domain. To cover that gap, the present article reviews the epidemiology, malacology, morbidity, and the milestones the country has made in efforts to control schistosomiasis and discusses future control approaches. The available evidence indicates that, both urinary and intestinal schistosomiasis are still highly endemic in Tanzania and cause significant morbidity.Mass drug administration using praziquantel, currently used as a key intervention measure, has not been successful in decreasing prevalence of infection. There is therefore an urgent need to revise the current approach for the successful control of the disease. Clearly, these need to be integrated control measures. PMID:23192005

The "politics of the queue": the politicization of people living with HIV/AIDS in Tanzania.

PubMed

Beckmann, Nadine; Bujra, Janet

2010-01-01

Starting from a body of literature on movements around "biological citizenship," this article analyses the political significance of HIV-positive people's collective action in Tanzania. We explore reasons for the limited impact of Tanzanian AIDS activism on the wider political scene, concluding that the formation of a "movement" is still in its infancy and faces many constraints, though some breakthroughs have been made. Participation in PLHA groups in Tanzania encourages politicizing struggles over representation, democratic forms and gender that can lead to a process of political socialization in which members learn to recognize and confront abuses of power. It is in such low-level, less visible social transformations that the greatest potential of participation in collective action around HIV/AIDS in Tanzania lies.

Instructor Support Services: An Inevitable Critical Success Factor in Blended Learning in Higher Education in Tanzania

ERIC Educational Resources Information Center

Raphael, Christina; Mtebe, Joel S.

2016-01-01

The adoption of blended learning to widen access, reduce cost, and improve the quality of education is becoming prevalent in higher education in sub-Saharan Africa and Tanzania in particular. University of Dar es Salaam and the Open University of Tanzania offer various blended learning courses using Moodle system via regional centres scattered…

Tanzania at the Turn of the Century: Background Papers and Statistics. A World Bank Country Study.

ERIC Educational Resources Information Center

World Bank, Washington, DC.

This report presents lessons from Tanzania's development experience of the past four decades, with emphasis on the period since the last report (1996), and assesses the imperatives for higher sustained growth and better livelihood for its citizens in the future. The background papers review and assess Tanzania's actual growth and poverty reduction…

The Social and Political Context of Literacy Education for Pastoral Societies: The Case of the Maasai of Tanzania.

ERIC Educational Resources Information Center

Semali, Ladislaus

Part of a large study in Tanzania, a study provides a broad context of obstacles to literacy, particularly those affecting migratory subpopulation groups. Subjects, 480 adults who participated in national literacy programs and belonged to one of two communities of the Maasai, were interviewed. The first group--the Maasai of Longido--represent a…

Stakeholders' opinions and questions regarding the anticipated malaria vaccine in Tanzania.

PubMed

Mtenga, Sally; Kimweri, Angela; Romore, Idda; Ali, Ali; Exavery, Amon; Sicuri, Elisa; Tanner, Marcel; Abdulla, Salim; Lusingu, John; Kafuruki, Shubi

2016-04-05

Within the context of combined interventions, malaria vaccine may provide additional value in malaria prevention. Stakeholders' perspectives are thus critical for informed recommendation of the vaccine in Tanzania. This paper presents the views of stakeholders with regards to malaria vaccine in 12 Tanzanian districts. Quantitative and qualitative methods were employed. A structured questionnaire was administered to 2123 mothers of under five children. Forty-six in-depth interviews and 12 focus group discussions were conducted with teachers, religious leaders, community health workers, health care professionals, and scientists. Quantitative data analysis involved frequency distributions and cross tabulations using Chi square test to determine the association between malaria vaccine acceptability and independent variables. Qualitative data were analysed thematically. Overall, 84.2% of the mothers had perfect acceptance of malaria vaccine. Acceptance varied significantly according to religion, occupation, tribe and region (p < 0.001). Ninety two percent reported that they will accept the malaria vaccine despite the need to continue using insecticide-treated nets (ITNs), while 88.4% reported that they will accept malaria vaccine even if their children get malaria less often than non-vaccinated children. Qualitative results revealed that the positive opinions towards malaria vaccine were due to a need for additional malaria prevention strategies and expectations that the vaccine will reduce visits to the health facility, deaths, malaria episodes and treatment-related expenses. Vaccine related questions included its side effects, efficacy, protective duration, composition, interaction with other medications, provision schedule, availability to the pregnant women, mode of administration (oral or injection?) and whether a child born of HIV virus or with a chronic illness will be eligible for the vaccine? Stakeholders had high acceptance and positive opinions towards the

East Coast fever immunisation field trial in crossbred dairy cattle in Hanang and Handeni districts in northern Tanzania.

PubMed

Lynen, Godelieve; Yrjö-Koskinen, Alma E; Bakuname, Christine; Di Giulio, Giuseppe; Mlinga, Nevil; Khama, Isaac; Hanks, James; Taylor, Nick M; James, Andrew D; McKeever, Declan; Peters, Andy R; Rushton, Jonathan

2012-03-01

East Coast fever (ECF) causes considerable mortality and production losses in the Tanzania smallholder dairy sector and limits the introduction of improved dairy breeds in areas where the disease is present. The infection and treatment method (ITM) was adopted by smallholder dairy farms for ECF immunisation in Hanang and Handeni districts of Tanzania. This study recorded incidence rates for ECF and other tick-borne diseases (TBDs) for ECF-immunised and non-immunised cattle between 1997 and 2000. Approximately 80% of smallholder households from both sites (n = 167) participated in this longitudinal study, with immunisations carried out at the request of the livestock owners. Efficacy of ITM for preventing ECF cases in these crossbred dairy cattle was estimated at 97.6%, while that for preventing ECF deaths was 97.9%. One percent of the cattle developed clinical ECF as a result of immunisation. Since ECF immunisation permits a reduction in acaricide use, an increase in other TBDs is a potential concern. Sixty-three percent of farmers continued to use the same acaricide after immunisation, with 80% of these reducing the frequency of applications. Overall, 78% of farmers increased the acaricide application interval after immunisation beyond that recommended by the manufacturer, resulting in annual savings in the region of USD 4.77 per animal. No statistical difference was observed between the immunised and non-immunised animals in the incidence of non-ECF TBDs. However, immunised animals that succumbed to these diseases showed fewer case fatalities. ITM would therefore appear to be a suitable method for ECF control in Tanzania's smallholder dairy sector.

Surgical task-shifting in a low-resource setting: outcomes after major surgery performed by nonphysician clinicians in Tanzania.

PubMed

Beard, Jessica H; Oresanya, Lawrence B; Akoko, Larry; Mwanga, Ally; Mkony, Charles A; Dicker, Rochelle A

2014-06-01

Little is known about the breadth and quality of nonobstetric surgical care delivered by nonphysician clinicians (NPCs) in low-resource settings. We aimed to document the scope of NPC surgical practice and characterize outcomes after major surgery performed by nonphysicians in Tanzania. A retrospective records review of major surgical procedures (MSPs) performed in 2012 was conducted at seven hospitals in Pwani Region, Tanzania. Patient and procedure characteristics and level of surgical care provider were documented for each procedure. Rates of postoperative morbidity and mortality after nonobstetric MSPs performed by NPCs and physicians were compared using multivariate logistic regression. There were 6.5 surgical care providers per 100,000 population performing a mean rate of 461 procedures per 100,000 population during the study period. Of these cases, 1,698 (34.7 %) were nonobstetric MSPs. NPCs performed 55.8 % of nonobstetric MSPs followed by surgical specialists (28.7 %) and medical officers (15.5 %). The most common nonobstetric MSPs performed by NPCs were elective groin hernia repair, prostatectomy, exploratory laparotomy, and hydrocelectomy. Postoperative mortality was 1.7 % and 1.5 % in cases done by NPCs and physicians respectively. There was no significant difference in outcomes after procedures performed by NPCs compared with physicians. Surgical output is low and the workforce is limited in Tanzania. NPCs performed the majority of major surgical procedures during the study period. Outcomes after nonobstetric major surgical procedures done by NPCs and physicians were similar. Task-shifting of surgical care to nonphysicians may be a safe and sustainable way to address the global surgical workforce crisis.

Modelling and mapping the topsoil organic carbon content for Tanzania

NASA Astrophysics Data System (ADS)

Kempen, Bas; Kaaya, Abel; Ngonyani Mhaiki, Consolatha; Kiluvia, Shani; Ruiperez-Gonzalez, Maria; Batjes, Niels; Dalsgaard, Soren

2014-05-01

Soil organic carbon (SOC), held in soil organic matter, is a key indicator of soil health and plays an important role in the global carbon cycle. The soil can act as a net source or sink of carbon depending on land use and management. Deforestation and forest degradation lead to the release of vast amounts of carbon from the soil in the form of greenhouse gasses, especially in tropical countries. Tanzania has a high deforestation rate: it is estimated that the country loses 1.1% of its total forested area annually. During 2010-2013 Tanzania has been a pilot country under the UN-REDD programme. This programme has supported Tanzania in its initial efforts towards reducing greenhouse gas emission from forest degradation and deforestation and towards preserving soil carbon stocks. Formulation and implementation of the national REDD strategy requires detailed information on the five carbon pools among these the SOC pool. The spatial distribution of SOC contents and stocks was not available for Tanzania. The initial aim of this research, was therefore to develop high-resolution maps of the SOC content for the country. The mapping exercise was carried out in a collaborative effort with four Tanzanian institutes and data from the Africa Soil Information Service initiative (AfSIS). The mapping exercise was provided with over 3200 field observations on SOC from four sources; this is the most comprehensive soil dataset collected in Tanzania so far. The main source of soil samples was the National Forest Monitoring and Assessment (NAFORMA). The carbon maps were generated by means of digital soil mapping using regression-kriging. Maps at 250 m spatial resolution were developed for four depth layers: 0-10 cm, 10-20 cm, 20-30 cm, and 0-30 cm. A total of 37 environmental GIS data layers were prepared for use as covariates in the regression model. These included vegetation indices, terrain parameters, surface temperature, spectral reflectances, a land cover map and a small

Evaluating a School-Based Trachoma Curriculum in Tanzania

ERIC Educational Resources Information Center

Lewallen, Susan; Massae, Patrick; Tharaney, Manisha; Somba, Margareth; Geneau, Robert; MacArthur, Chad; Courtright, Paul

2008-01-01

Trachoma remains a public health problem in a number of sub-Saharan Africa countries; behavioral change and environmental improvements are cornerstones of prevention efforts. Evidence of successful health education are few in Africa. Health education efforts through primary schools have recently been developed and adopted in Tanzania. We evaluated…

The Demand for Cigarettes in Tanzania and Implications for Tobacco Taxation Policy.

PubMed

Kidane, Asmerom; Mduma, John; Naho, Alexis; Ngeh, Ernest Tingum; Hu, Teh-Wei

2015-10-01

The study attempts to estimate the demand for cigarettes in Tanzania and presents simulation results on the effect of the cigarette excise tax on smoking participation, government revenue, and related topics. After briefly summarizing the magnitude and spread of cigarette consumption in the country, the paper reviews some empirical estimates from African and other countries. The 2008 Tanzanian household budget survey was used to estimate the demand for cigarettes in Tanzania. The descriptive statistics suggest that the smoking prevalence for Tanzania is 15.35 percent with low variability across expenditure (income) groups. Smoking intensity and per capita consumption were estimated at 7.08 cigarettes and 1.33 cigarettes, respectively, a relatively low value. A two-part demand equation model was used to estimate various elasticities. For the overall equation, the price elasticities of smoking participation, smoking intensity, and total elasticity were estimated at -0.879, -0.853, and -1.732, respectively. Compared to similar results in other developing countries, the estimates appear quite high. When estimated by expenditure (income) groups, the magnitude of the elasticity appears higher among high expenditure groups than among low expenditure groups. Two simulation exercises were undertaken. First, the effect of different excise rates on smoking participation rate, cigarette consumption, tax revenue, and related responses was estimated and highlighted. Second, the same exercise was undertaken to determine the effect of a given increase in the cigarette excise tax on various expenditure groups. The overall results suggest that an increase in the excise tax on cigarettes in Tanzania would reduce cigarette consumption and increase government tax revenue.

Anaemia in Pregnancy: Prevalence, Risk Factors, and Adverse Perinatal Outcomes in Northern Tanzania

PubMed Central

Stephen, Grace; Hussein Hashim, Tamara; Katanga, Johnson; Stray-Pedersen, Babill; Msuya, Sia Emmanueli

2018-01-01

Background and Objective Anaemia in pregnancy is a public health problem in developing countries. This study aimed to determine the prevalence, risk factors, and adverse perinatal outcomes of anaemia among pregnant women in Moshi Municipal, Northern Tanzania. Methods This was a follow-up study conducted from October 2013 to June 2015. A total of 539 pregnant women were enrolled in this study. Interviews were conducted followed by determination of haemoglobin level. Women were followed up at delivery and at 7 days and 28 days after delivery. Results A total of 529 women were included in this analysis. Their mean age was 25.8 (SD 5.73). The prevalence of anaemia was 18.0% and 2% had severe anaemia. The clinic of recruitment and low education level of the women were the factors that were independently associated with anaemia during pregnancy. At delivery, there were 10 stillbirths, 16 low birth weight (LBW) newborns, and 2 preterm birth cases. No association was found between anaemia and LBW, preterm birth, or stillbirths. Conclusion Anaemia in pregnancy was a mild public health problem in the study setting of Northern Tanzania. PMID:29854446

Health and social support services to HIV/AIDS infected individuals in Tanzania: employees and employers perceptions

PubMed Central

2014-01-01

Background HIV is a major public health problem in the world, especially in sub-Saharan Africa. It often leads to loss of productive labour and disruption of existing social support system which results in deterioration of population health. This poses a great challenge to infected people in meeting their essential goods and services. This paper examines health and social support services provided by employers to HIV/AIDS infected employees in Tanzania. Methods This was a cross-sectional study, which employed qualitative and quantitative methods in data collection and analysis. Structured questionnaires and in-depth interviews were used to assess the health and social support services provision at employers and employees perspectives. The study participants were employees and employers from public and private organizations. Results A total of 181 employees and 23 employers from 23 workplaces aged between 18–68 years were involved. The results show that 23.8% (i.e., 20.4% males and 27.3% females) of the employees had at least one member of the family or close relatives living with HIV at the time of the study. Fifty six percent of the infected employees reported to have been receiving health or social support from their employers. Employees’ responses were consistent with those reported by their employers. A total of 12(52.2%) and 11(47.8%) employers reported to have been providing health and social supports respectively. Female employees (58.3%) from the private sector (60.0%) were more likely to receive supports than male employees (52.6%) and than those from the public sector (46.2%). The most common health and social support received by the employees were treatment, and nutritional support and reduction of workload, respectively. Conclusions HIV/AIDS infected employees named treatment and nutritional support, and soft loans and reduced workload respectively, as the most important health and social supports they needed from their employers. This study

Pharmacoeconomics and its implication on priority-setting for essential medicines in Tanzania: a systematic review.

PubMed

Mori, Amani Thomas; Robberstad, Bjarne

2012-09-27

Due to escalating treatment costs, pharmacoeconomic analysis has been assigned a key role in the quest for increased efficiency in resource allocation for drug therapies in high-income countries. The extent to which pharmacoeconomic analysis is employed in the same role in low-income countries is less well established. This systematic review identifies and briefly describes pharmacoeconomic studies which have been conducted in Tanzania and further assesses their influence in the selection of essential medicines. Pubmed, Embase, Cinahl and Cochrane databases were searched using "economic evaluation", "cost-effectiveness analysis", "cost-benefit analysis" AND "Tanzania" as search terms. We also scanned reference lists and searched in Google to identify other relevant articles. Only articles reporting full economic evaluations about drug therapies and vaccines conducted in Tanzania were included. The national essential medicine list and other relevant policy documents related to the identified articles were screened for information regarding the use of economic evaluation as a criterion for medicine selection. Twelve pharmacoeconomic studies which met our inclusion criteria were identified. Seven studies were on HIV/AIDS, malaria and diarrhoea, the three highest ranked diseases on the disease burden in Tanzania. Six studies were on preventive and treatment interventions targeting pregnant women and children under the age of five years. The national essential medicine list and the other identified policy documents do not state the use of economic evaluation as one of the criteria which has influenced the listing of the drugs. Country specific pharmacoeconomic analyses are too scarce and inconsistently used to have had a significant influence on the selection of essential medicines in Tanzania. More studies are required to fill the existing gap and to explore whether decision-makers have the ability to interpret and utilise pharmacoeconomic evidence. Relevant health

The challenges of developing an instrument to assess health provider motivation at primary care level in rural Burkina Faso, Ghana and Tanzania

PubMed Central

Prytherch, Helen; Leshabari, Melkidezek T.; Wiskow, Christiane; Aninanya, Gifty A.; Kakoko, Deodatus C.V.; Kagoné, Moubassira; Burghardt, Juliane; Kynast-Wolf, Gisela; Marx, Michael; Sauerborn, Rainer

2012-01-01

Background The quality of health care depends on the competence and motivation of the health workers that provide it. In the West, several tools exist to measure worker motivation, and some have been applied to the health sector. However, none have been validated for use in sub-Saharan Africa. The complexity of such tools has also led to concerns about their application at primary care level. Objective To develop a common instrument to monitor any changes in maternal and neonatal health (MNH) care provider motivation resulting from the introduction of pilot interventions in rural, primary level facilities in Ghana, Burkina Faso, and Tanzania. Design Initially, a conceptual framework was developed. Based upon this, a literature review and preliminary qualitative research, an English-language instrument was developed and validated in an iterative process with experts from the three countries involved. The instrument was then piloted in Ghana. Reliability testing and exploratory factor analysis were used to produce a final, parsimonious version. Results and discussion This paper describes the actual process of developing the instrument. Consequently, the concepts and items that did not perform well psychometrically at pre-test are first presented and discussed. The final version of the instrument, which comprises 42 items for self-assessment and eight for peer-assessment, is then shown. This is followed by a presentation and discussion of the findings from first use of the instrument with MNH providers from 12 rural, primary level facilities in each of the three countries. Conclusions It is possible to undertake work of this nature at primary health care level, particularly if the instruments are kept as straightforward as possible and well introduced. However, their development requires very lengthy preparatory periods. The effort needed to adapt such instruments for use in different countries within the region of sub-Saharan Africa should not be underestimated. PMID

Status of Occupational Health and Safety and Related Challenges in Expanding Economy of Tanzania.

PubMed

Mrema, Ezra J; Ngowi, Aiwerasia V; Mamuya, Simon H D

2015-01-01

Occupational health and safety is related with economic activities undertaken in the country. As the economic activities grow and expand, occupational injuries and diseases are more likely to increase among workers in different sectors of economy such as agriculture, mining, transport, and manufacture. This may result in high occupational health and safety services demand, which might be difficult to meet by developing countries that are prioritizing economic expansion without regard to their impact on occupational health and safety. To describe the status of occupational health and safety in Tanzania and outline the challenges in provision of occupational health services under the state of an expanding economy. Tanzania's economy is growing steadily, with growth being driven by communications, transport, financial intermediation, construction, mining, agriculture, and manufacturing. Along with this growth, hazards emanating from work in all sectors of the economy have increased and varied. The workers exposed to these hazards suffer from illness and injuries and yet they are not provided with adequate occupational health services. Services are scanty and limited to a few enterprises that can afford it. Existing laws and regulations are not comprehensive enough to cover the entire population. Implementation of legislation is weak and does not protect the workers. Most Tanzanians are not covered by the occupational health and safety law and do not access occupational health services. Thus an occupational health and safety services strategy, backed by legislations and provided with the necessary resources (competent experts, financial and technological resources), is a necessity in Tanzania. The existing legal provisions require major modifications to meet international requirements and standards. OHS regulations and legislations need refocusing, revision, and strengthening to cover all working population. Capacities should be improved through training and research

Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

PubMed Central

2011-01-01

Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health

The make or buy debate: considering the limitations of domestic production in Tanzania.

PubMed

Wilson, Kinsley Rose; Kohler, Jillian Clare; Ovtcharenko, Natalia

2012-06-29

In order to ensure their population's regular access to essential medicines, many least developed countries and developing countries are faced with the policy question of whether to import or manufacture drugs locally, in particular for life-saving antiretroviral medicines for HIV/AIDS patients. In order for domestic manufacturing to be viable and cost-effective, the local industry must be able to compete with international suppliers of medicines by producing sufficiently low cost ARVs. This paper considers the 'make-or-buy' dilemma by using Tanzania as a case study. Key informant interviews, event-driven observation, and purposive sampling of documents were used to evaluate the case study. The case study focused on Tanzania's imitation technology transfer agreement to locally manufacture a first-line ARV (3TC + d4T + NVP), reverse engineering the ARV. Tanzania is limited by weak political support for the use of TRIPS flexibilities, limited production capacity for ARVs and limited competitiveness in both domestic and regional markets. The Ministry of Health and Social Welfare encourages the use of flexibilities while others push for increased IP protection. Insufficient production capacity and lack of access to donor-financed tenders make it difficult to obtain economies of scale and provide competitive prices. Within the "make-or-buy" context, it was determined that there are significant limitations in domestic manufacturing for developing countries. The case study highlights the difficulty of governments to make use of economies of scale and produce low-cost medicines, attract technology transfer, and utilize the flexibilities of the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). The results demonstrate the importance of evaluating barriers to the use of TRIPS flexibilities and long-term planning across sectors in future technology transfer and manufacturing initiatives.

Geospatial Resource Access Analysis In Hedaru, Tanzania

NASA Astrophysics Data System (ADS)

Clark, Dylan G.; Premkumar, Deepak; Mazur, Robert; Kisimbo, Elibariki

2013-12-01

Populations around the world are facing increased impacts of anthropogenic-induced environmental changes and rapid population movements. These environmental and social shifts are having an elevated impact on the livelihoods of agriculturalists and pastoralists in developing countries. This appraisal integrates various tools—usually used independently— to gain a comprehensive understanding of the regional livelihood constraints in the rural Hedaru Valley of northeastern Tanzania. Conducted in three villages with different natural resources, using three primary methods: 1) participatory mapping of infrastructures; 2) administration of quantitative, spatially-tied surveys (n=80) and focus groups (n=14) that examined land use, household health, education, and demographics; 3) conducting quantitative time series analysis of Landsat- based Normalized Difference Vegetation Index images. Through various geospatial and multivariate linear regression analyses, significant geospatial trends emerged. This research added to the academic understanding of the region while establishing pathways for climate change adaptation strategies.

Assessment of the patient, health system, and population effects of Xpert MTB/RIF and alternative diagnostics for tuberculosis in Tanzania: an integrated modelling approach.

PubMed

Langley, Ivor; Lin, Hsien-Ho; Egwaga, Saidi; Doulla, Basra; Ku, Chu-Chang; Murray, Megan; Cohen, Ted; Squire, S Bertel

2014-10-01

Several promising new diagnostic methods and algorithms for tuberculosis have been endorsed by WHO. National tuberculosis programmes now face the decision on which methods to implement and where to place them in the diagnostic algorithm. We used an integrated model to assess the effects of different algorithms of Xpert MTB/RIF and light-emitting diode (LED) fluorescence microscopy in Tanzania. To understand the effects of new diagnostics from the patient, health system, and population perspective, the model incorporated and linked a detailed operational component and a transmission component. The model was designed to represent the operational and epidemiological context of Tanzania and was used to compare the effects and cost-effectiveness of different diagnostic options. Among the diagnostic options considered, we identified three strategies as cost effective in Tanzania. Full scale-up of Xpert would have the greatest population-level effect with the highest incremental cost: 346 000 disability-adjusted life-years (DALYs) averted with an additional cost of US$36·9 million over 10 years. The incremental cost-effectiveness ratio (ICER) of Xpert scale-up ($169 per DALY averted, 95% credible interval [CrI] 104-265) is below the willingness-to-pay threshold ($599) for Tanzania. Same-day LED fluorescence microscopy is the next most effective strategy with an ICER of $45 (95% CrI 25-74), followed by LED fluorescence microscopy with an ICER of $29 (6-59). Compared with same-day LED fluorescence microscopy and Xpert full rollout, targeted use of Xpert in presumptive tuberculosis cases with HIV infection, either as an initial diagnostic test or as a follow-on test to microscopy, would produce DALY gains at a higher incremental cost and therefore is dominated in the context of Tanzania. For Tanzania, this integrated modelling approach predicts that full rollout of Xpert is a cost-effective option for tuberculosis diagnosis and has the potential to substantially reduce

District health managers’ perceptions of supervision in Malawi and Tanzania

PubMed Central

2013-01-01

Background Mid-level cadres are being used to address human resource shortages in many African contexts, but insufficient and ineffective human resource management is compromising their performance. Supervision plays a key role in performance and motivation, but is frequently characterised by periodic inspection and control, rather than support and feedback to improve performance. This paper explores the perceptions of district health management teams in Tanzania and Malawi on their role as supervisors and on the challenges to effective supervision at the district level. Methods This qualitative study took place as part of a broader project, “Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers”. Semi-structured interviews were conducted with 20 district health management team personnel in Malawi and 37 council health team members in Tanzania. The interviews covered a range of human resource management issues, including supervision and performance assessment, staff job descriptions and roles, motivation and working conditions. Results Participants displayed varying attitudes to the nature and purpose of the supervision process. Much of the discourse in Malawi centred on inspection and control, while interviewees in Tanzania were more likely to articulate a paradigm characterised by support and improvement. In both countries, facility level performance metrics dominated. The lack of competency-based indicators or clear standards to assess individual health worker performance were considered problematic. Shortages of staff, at both district and facility level, were described as a major impediment to carrying out regular supervisory visits. Other challenges included conflicting and multiple responsibilities of district health team staff and financial constraints. Conclusion Supervision is a central component of effective human resource management. Policy level attention is crucial to ensure a systematic, structured process that

Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa

PubMed Central

Blaauw, Duane; Ditlopo, Prudence; Maseko, Fresier; Chirwa, Maureen; Mwisongo, Aziza; Bidwell, Posy; Thomas, Steve; Normand, Charles

2013-01-01

Background Job satisfaction is an important determinant of health worker motivation, retention, and performance, all of which are critical to improving the functioning of health systems in low- and middle-income countries. A number of small-scale surveys have measured the job satisfaction and intention to leave of individual health worker cadres in different settings, but there are few multi-country and multi-cadre comparative studies. Objective The objective of this study was to compare the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa. Methods We undertook a cross-sectional survey of a stratified cluster sample of 2,220 health workers, 564 from Tanzania, 939 from Malawi, and 717 from South Africa. Participants completed a self-administered questionnaire, which included demographic information, a 10-item job satisfaction scale, and one question on intention to leave. Multiple regression was used to identify significant predictors of job satisfaction and intention to leave. Results There were statistically significant differences in job satisfaction and intention to leave between the three countries. Approximately 52.1% of health workers in South Africa were satisfied with their jobs compared to 71% from Malawi and 82.6% from Tanzania (χ2=140.3, p<0.001). 18.8% of health workers in Tanzania and 26.5% in Malawi indicated that they were actively seeking employment elsewhere, compared to 41.4% in South Africa (χ2=83.5, p<0.001). The country differences were confirmed by multiple regression. The study also confirmed that job satisfaction is statistically related to intention to leave. Conclusions We have shown differences in the levels of job satisfaction and intention to leave between different groups of health workers from Tanzania, Malawi, and South Africa. Our results caution against generalising about the effectiveness of interventions in different contexts and highlight the need for less

Introducing eHealth strategies to enhance maternal and perinatal health care in rural Tanzania.

PubMed

Nyamtema, Angelo; Mwakatundu, Nguke; Dominico, Sunday; Kasanga, Mkambu; Jamadini, Fadhili; Maokola, Kelvin; Mawala, Donald; Abel, Zabron; Rumanyika, Richard; Nzabuhakwa, Calist; van Roosmalen, Jos

2017-01-01

Globally, eHealth has attracted considerable attention as a means of supporting maternal and perinatal health care. This article describes best practices, gains and challenges of implementing eHealth for maternal and perinatal health care in extremely remote and rural Tanzania. Teleconsultation for obstetric emergency care, audio teleconferences and online eLearning systems were installed in ten upgraded rural health centres, four rural district hospitals and one regional hospital in Tanzania. Uptake of teleconsultation and teleconference platforms were evaluated retrospectively. A cross sectional descriptive study design was applied to assess performance and adoption of eLearning. In 2015 a total of 38 teleconsultations were attended by consultant obstetricians and 33 teleconferences were conducted and attended by 40 health care providers from 14 facilities. A total of 240 clinical cases mainly caesarean sections (CS), maternal and perinatal morbidities and mortalities were discussed and recommendations for improvement were provided. Four modules were hosted and 43 care providers were registered on the eLearning system. For a period of 18-21 months total views on the site, weekly conference forum, chatroom and learning resources ranged between 106 and 1,438. Completion of learning modules, acknowledgment of having acquired and utilized new knowledge and skills in clinical practice were reported in 43-89% of 20 interviewed health care providers. Competencies in using the eLearning system were demonstrated in 62% of the targeted users. E-Health presents an opportunity for improving maternal health care in underserved remote areas in low-resource settings by broadening knowledge and skills, and by connecting frontline care providers with consultants for emergency teleconsultations.

District health managers' perceptions of supervision in Malawi and Tanzania.

PubMed

Bradley, Susan; Kamwendo, Francis; Masanja, Honorati; de Pinho, Helen; Waxman, Rachel; Boostrom, Camille; McAuliffe, Eilish

2013-09-05

Mid-level cadres are being used to address human resource shortages in many African contexts, but insufficient and ineffective human resource management is compromising their performance. Supervision plays a key role in performance and motivation, but is frequently characterised by periodic inspection and control, rather than support and feedback to improve performance. This paper explores the perceptions of district health management teams in Tanzania and Malawi on their role as supervisors and on the challenges to effective supervision at the district level. This qualitative study took place as part of a broader project, "Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers". Semi-structured interviews were conducted with 20 district health management team personnel in Malawi and 37 council health team members in Tanzania. The interviews covered a range of human resource management issues, including supervision and performance assessment, staff job descriptions and roles, motivation and working conditions. Participants displayed varying attitudes to the nature and purpose of the supervision process. Much of the discourse in Malawi centred on inspection and control, while interviewees in Tanzania were more likely to articulate a paradigm characterised by support and improvement. In both countries, facility level performance metrics dominated. The lack of competency-based indicators or clear standards to assess individual health worker performance were considered problematic. Shortages of staff, at both district and facility level, were described as a major impediment to carrying out regular supervisory visits. Other challenges included conflicting and multiple responsibilities of district health team staff and financial constraints. Supervision is a central component of effective human resource management. Policy level attention is crucial to ensure a systematic, structured process that is based on common understandings of the

Investigating Motivations for Women's Skin Bleaching in Tanzania

ERIC Educational Resources Information Center

Lewis, Kelly M.; Robkin, Navit; Gaska, Karie; Njoki, Lillian Carol

2011-01-01

Why do many African women continue to use damaging skin-bleaching cosmetics that contain dangerous chemicals (e.g., mercury) that may increase their rates of infertility, skin cancer, and serious skin/brain/kidney disease? To address this question, our study investigated motivations driving the preservation of skin-bleaching practices in Tanzania.…

Higher Education System and Jobless Graduates in Tanzania

ERIC Educational Resources Information Center

Ndyali, Lyata

2016-01-01

The Tanzania's higher education institutions haven't raised much of expectations the graduates lack the skills required by the labor market and this trend results in mass graduate unemployment, otherwise this would have assisted them to be more self-reliant. The study explores the importance of higher-level business education human resources…

Agricultural Development, Land Change, and Livelihoods in Tanzania's Kilombero Valley

NASA Astrophysics Data System (ADS)

Connors, John Patrick

The Kilombero Valley lies at the intersection of a network of protected areas that cross Tanzania. The wetlands and woodlands of the Valley, as well as the forest of surrounding mountains are abundant in biodiversity and are considered to be critical areas for conservation. This area, however, is also the home to more than a half million people, primarily poor smallholder farmers. In an effort to support the livelihoods and food security of these farmers and the larger Tanzanian population, the country has recently targeted a series of programs to increase agricultural production in the Kilombero Valley and elsewhere in the country. Bridging concepts and methods from land change science, political ecology, and sustainable livelihoods, I present an integrated assessment of the linkages between development and conservation efforts in the Kilombero Valley and the implications for food security. This dissertation uses three empirical studies to understand the process of development in the Kilombero Valley and to link the priorities and perceptions of conservation and development efforts to the material outcomes in food security and land change. The first paper of this dissertation examines the changes in land use in the Kilombero Valley between 1997 and 2014 following the privatization of agriculture and the expansion of Tanzania's Kilimo Kwanza program. Remote sensing analysis reveals a two-fold increase in agricultural area during this short time, largely at the expense of forest. Protected areas in some parts of the Valley appear to be deterring deforestation, but rapid agricultural growth, particularly surrounding a commercial rice plantation, has led to loss of extant forest and sustained habitat fragmentation. The second paper focuses examines livelihood strategies in the Valley and claims regarding the role of agrobiodiversity in food security. The results of household survey reveal no difference or lower food security among households that diversify their

Soil Correlates and Mortality from Giraffe Skin Disease in Tanzania.

PubMed

Bond, Monica L; Strauss, Megan K L; Lee, Derek E

2016-10-01

Giraffe skin disease (GSD) is a disorder of undetermined etiology that causes lesions on the forelimbs of Masai giraffe ( Giraffa camelopardalis tippelskirchi) in Tanzania, East Africa. We examined soil correlates of prevalence of GSD from 951 giraffe in 14 sites in Tanzania, and estimated mortality using 3 yr of longitudinal mark-recapture data from 382 giraffe with and without GSD lesions, in Tarangire National Park (TNP). Spatial variation in GSD prevalence was best explained by soil fertility, measured as cation exchange capacity. We found no mortality effect of GSD on adult giraffe in TNP. Based on our findings, GSD is unlikely to warrant immediate veterinary intervention, but continued monitoring is recommended to ensure early detection if GSD-afflicted animals begin to show signs of increased mortality or other adverse effects.

The make or buy debate: Considering the limitations of domestic production in Tanzania

PubMed Central

2012-01-01

Background In order to ensure their population’s regular access to essential medicines, many least developed countries and developing countries are faced with the policy question of whether to import or manufacture drugs locally, in particular for life-saving antiretroviral medicines for HIV/AIDS patients. In order for domestic manufacturing to be viable and cost-effective, the local industry must be able to compete with international suppliers of medicines by producing sufficiently low cost ARVs. Methods This paper considers the ‘make-or-buy’ dilemma by using Tanzania as a case study. Key informant interviews, event-driven observation, and purposive sampling of documents were used to evaluate the case study. The case study focused on Tanzania’s imitation technology transfer agreement to locally manufacture a first-line ARV (3TC + d4T + NVP), reverse engineering the ARV. Results Tanzania is limited by weak political support for the use of TRIPS flexibilities, limited production capacity for ARVs and limited competitiveness in both domestic and regional markets. The Ministry of Health and Social Welfare encourages the use of flexibilities while others push for increased IP protection. Insufficient production capacity and lack of access to donor-financed tenders make it difficult to obtain economies of scale and provide competitive prices. Conclusions Within the “make-or-buy” context, it was determined that there are significant limitations in domestic manufacturing for developing countries. The case study highlights the difficulty of governments to make use of economies of scale and produce low-cost medicines, attract technology transfer, and utilize the flexibilities of the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). The results demonstrate the importance of evaluating barriers to the use of TRIPS flexibilities and long-term planning across sectors in future technology transfer and manufacturing initiatives

Development of a Brief Intervention to Improve Knowledge of Autism and Behavioral Strategies among Parents in Tanzania

ERIC Educational Resources Information Center

Harrison, Ashley Johnson; Long, Kristin A.; Manji, Karim P.; Blane, Karyn K.

2016-01-01

Despite the global presence of autism spectrum disorder (ASD), a paucity of treatment services exists in Tanzania and other low- and middle-income countries. The effect of delayed or low-quality treatments is enduring and contributes to lifelong variability in ASD-related functional impairments. Service disparities in Tanzania derive in part from…

The Demand for Cigarettes in Tanzania and Implications for Tobacco Taxation Policy

PubMed Central

Kidane, Asmerom; Mduma, John; Naho, Alexis; Ngeh, Ernest Tingum; Hu, Teh-wei

2016-01-01

The study attempts to estimate the demand for cigarettes in Tanzania and presents simulation results on the effect of the cigarette excise tax on smoking participation, government revenue, and related topics. After briefly summarizing the magnitude and spread of cigarette consumption in the country, the paper reviews some empirical estimates from African and other countries. The 2008 Tanzanian household budget survey was used to estimate the demand for cigarettes in Tanzania. The descriptive statistics suggest that the smoking prevalence for Tanzania is 15.35 percent with low variability across expenditure (income) groups. Smoking intensity and per capita consumption were estimated at 7.08 cigarettes and 1.33 cigarettes, respectively, a relatively low value. A two-part demand equation model was used to estimate various elasticities. For the overall equation, the price elasticities of smoking participation, smoking intensity, and total elasticity were estimated at −0.879, −0.853, and −1.732, respectively. Compared to similar results in other developing countries, the estimates appear quite high. When estimated by expenditure (income) groups, the magnitude of the elasticity appears higher among high expenditure groups than among low expenditure groups. Two simulation exercises were undertaken. First, the effect of different excise rates on smoking participation rate, cigarette consumption, tax revenue, and related responses was estimated and highlighted. Second, the same exercise was undertaken to determine the effect of a given increase in the cigarette excise tax on various expenditure groups. The overall results suggest that an increase in the excise tax on cigarettes in Tanzania would reduce cigarette consumption and increase government tax revenue. PMID:27358905

Willingness and ability to pay for artemisinin-based combination therapy in rural Tanzania

PubMed Central

Saulo, Eleonor C; Forsberg, Birger C; Premji, Zul; Montgomery, Scott M; Björkman, Anders

2008-01-01

Background The aim of this study was to analyse willingness to pay (WTP) and ability to pay (ATP) for ACT for children below five years of age in a rural setting in Tanzania before the introduction of artemisinin-based combination therapy (ACT) as first-line treatment for uncomplicated malaria. Socio-economic factors associated with WTP and expectations on anti-malaria drugs, including ACT, were also explored. Methods Structured interviews and focus group discussions were held with mothers, household heads, health-care workers and village leaders in Ishozi, Gera and Ishunju wards in north-west Tanzania in 2004. Contingent valuation method (CVM) was used with "take-it-or-leave-it" as the eliciting method, expressed as WTP for a full course of ACT for a child and households' opportunity cost of ACT was used to assess ATP. The study included descriptive analyses with multivariate adjustment for potential confounding factors. Results Among 265 mothers and household heads, 244 (92%, CI = 88%–95%) were willing to pay Tanzanian Shillings (TSh) 500 (US$ 0.46) for a child's dose of ACT, but only 55% (49%–61%) were willing to pay more than TSh 500. Mothers were more often willing to pay than male household heads (adjusted odds ratio = 2.1, CI = 1.2–3.6). Socio-economic status had no significant effect on WTP. The median annual non-subsidized ACT cost for clinical malaria episodes in an average household was calculated as US$ 6.0, which would represent 0.9% of the average total consumption expenditures as estimated from official data in 2001. The cost of non-subsidized ACT represented 7.0% of reported total annual expenditure on food and 33.0% of total annual expenditure on health care. "Rapid effect," "no adverse effect" and "inexpensive" were the most desired features of an anti-malarial drug. Conclusion WTP for ACT in this study was less than its real cost and a subsidy is, therefore, needed to enable its equitable affordability. The decision taken in Tanzania to

Brucellosis among Hospitalized Febrile Patients in Northern Tanzania

PubMed Central

Bouley, Andrew J.; Biggs, Holly M.; Stoddard, Robyn A.; Morrissey, Anne B.; Bartlett, John A.; Afwamba, Isaac A.; Maro, Venance P.; Kinabo, Grace D.; Saganda, Wilbrod; Cleaveland, Sarah; Crump, John A.

2012-01-01

Acute and convalescent serum samples were collected from febrile inpatients identified at two hospitals in Moshi, Tanzania. Confirmed brucellosis was defined as a positive blood culture or a ≥ 4-fold increase in microagglutination test titer, and probable brucellosis was defined as a single reciprocal titer ≥ 160. Among 870 participants enrolled in the study, 455 (52.3%) had paired sera available. Of these, 16 (3.5%) met criteria for confirmed brucellosis. Of 830 participants with ≥ 1 serum sample, 4 (0.5%) met criteria for probable brucellosis. Brucellosis was associated with increased median age (P = 0.024), leukopenia (odds ratio [OR] 7.8, P = 0.005), thrombocytopenia (OR 3.9, P = 0.018), and evidence of other zoonoses (OR 3.2, P = 0.026). Brucellosis was never diagnosed clinically, and although all participants with brucellosis received antibacterials or antimalarials in the hospital, no participant received standard brucellosis treatment. Brucellosis is an underdiagnosed and untreated cause of febrile disease among hospitalized adult and pediatric patients in northern Tanzania. PMID:23091197

Leptospirosis among Hospitalized Febrile Patients in Northern Tanzania

PubMed Central

Biggs, Holly M.; Bui, Duy M.; Galloway, Renee L.; Stoddard, Robyn A.; Shadomy, Sean V.; Morrissey, Anne B.; Bartlett, John A.; Onyango, Jecinta J.; Maro, Venance P.; Kinabo, Grace D.; Saganda, Wilbrod; Crump, John A.

2011-01-01

We enrolled consecutive febrile admissions to two hospitals in Moshi, Tanzania. Confirmed leptospirosis was defined as a ≥ 4-fold increase in microscopic agglutination test (MAT) titer; probable leptospirosis as reciprocal MAT titer ≥ 800; and exposure to pathogenic leptospires as titer ≥ 100. Among 870 patients enrolled in the study, 453 (52.1%) had paired sera available, and 40 (8.8%) of these met the definition for confirmed leptospirosis. Of 832 patients with ≥ 1 serum sample available, 30 (3.6%) had probable leptospirosis and an additional 277 (33.3%) had evidence of exposure to pathogenic leptospires. Among those with leptospirosis the most common clinical diagnoses were malaria in 31 (44.3%) and pneumonia in 18 (25.7%). Leptospirosis was associated with living in a rural area (odds ratio [OR] 3.4, P < 0.001). Among those with confirmed leptospirosis, the predominant reactive serogroups were Mini and Australis. Leptospirosis is a major yet underdiagnosed cause of febrile illness in northern Tanzania, where it appears to be endemic. PMID:21813847

An Overview of HIV Prevention Interventions for People Who Inject Drugs in Tanzania

PubMed Central

Ratliff, Eric A.; McCurdy, Sheryl A.; Mbwambo, Jessie K. K.; Lambdin, Barrot H.; Voets, Ancella; Pont, Sandrine; Maruyama, Haruka; Kilonzo, Gad P.

2013-01-01

In the past decade, Tanzania has seen a rapid rise in the number of people who inject drugs (PWID), specifically heroin. While the overall HIV prevalence in Tanzania has declined recently to 5.6%, in 2009, the HIV prevalence among PWID remains alarmingly high at 35%. In this paper, we describe how the Tanzania AIDS Prevention Program (TAPP), Médecins du Monde France (MdM-F), and other organisations have been at the forefront of addressing this public health issue in Africa, implementing a wide array of harm reduction interventions including medication-assisted treatment (MAT), needle and syringe programs (NSP), and “sober houses” for residential treatment in the capital, Dar es Salaam, and in Zanzibar. Looking toward the future, we discuss the need to (1) extend existing services and programs to reach more PWID and others at risk for HIV, (2) develop additional programs to strengthen existing programs, and (3) expand activities to include structural interventions to address vulnerabilities that increase HIV risk for all Tanzanians. PMID:23346410

Willingness and ability to pay for artemisinin-based combination therapy in rural Tanzania.

PubMed

Saulo, Eleonor C; Forsberg, Birger C; Premji, Zul; Montgomery, Scott M; Björkman, Anders

2008-10-31

The aim of this study was to analyse willingness to pay (WTP) and ability to pay (ATP) for ACT for children below five years of age in a rural setting in Tanzania before the introduction of artemisinin-based combination therapy (ACT) as first-line treatment for uncomplicated malaria. Socio-economic factors associated with WTP and expectations on anti-malaria drugs, including ACT, were also explored. Structured interviews and focus group discussions were held with mothers, household heads, health-care workers and village leaders in Ishozi, Gera and Ishunju wards in north-west Tanzania in 2004. Contingent valuation method (CVM) was used with "take-it-or-leave-it" as the eliciting method, expressed as WTP for a full course of ACT for a child and households' opportunity cost of ACT was used to assess ATP. The study included descriptive analyses with multivariate adjustment for potential confounding factors. Among 265 mothers and household heads, 244 (92%, CI = 88%-95%) were willing to pay Tanzanian Shillings (TSh) 500 (US$ 0.46) for a child's dose of ACT, but only 55% (49%-61%) were willing to pay more than TSh 500. Mothers were more often willing to pay than male household heads (adjusted odds ratio = 2.1, CI = 1.2-3.6). Socio-economic status had no significant effect on WTP. The median annual non-subsidized ACT cost for clinical malaria episodes in an average household was calculated as US$ 6.0, which would represent 0.9% of the average total consumption expenditures as estimated from official data in 2001. The cost of non-subsidized ACT represented 7.0% of reported total annual expenditure on food and 33.0% of total annual expenditure on health care."Rapid effect," "no adverse effect" and "inexpensive" were the most desired features of an anti-malarial drug. WTP for ACT in this study was less than its real cost and a subsidy is, therefore, needed to enable its equitable affordability. The decision taken in Tanzania to subsidize Coartem fully at governmental health

The reality of task shifting in medicines management- a case study from Tanzania.

PubMed

Wiedenmayer, Karin A; Kapologwe, Ntuli; Charles, James; Chilunda, Fiona; Mapunjo, Siana

2015-01-01

Tanzania suffers a severe shortage of pharmaceutical staff. This negatively affects the provision of pharmaceutical services and access to medicines, particularly in rural areas. Task shifting has been proposed as a way to mitigate the impact of health worker shortfalls.The aim of this study was to understand the context and extent of task shifting in pharmaceutical management in Dodoma Region, Tanzania. We explored 1) the number of trained pharmaceutical staff as compared to clinical cadres managing medicines, 2) the national establishment for staffing levels, 3) job descriptions, 4) supply management training conducted and 5) availability of medicines and adherence to Good Storage Practice. A cross-sectional study was conducted in 270 public health facilities in 2011. A pre-tested questionnaire was administered to the person in charge of the facility to collect data on staff employed and their respective pharmaceutical tasks. Availability of 26 tracer medicines and adherence to Good Storage Practice guidelines was surveyed by direct observation. The national establishments for pharmaceutical staffing levels and job descriptions of facility cadres were analysed. While required staffing levels in 1999 were 50, the region employed a total of only 14 pharmaceutical staff in 2011. Job descriptions revealed that, next to pharmaceutical staff, only nurses were required to provide dispensing services and adherence counselling. In 95.5% of studied health facilities medicines management was done by non-pharmaceutically trained cadres, predominantly medical attendants. The first training on supply management was provided in 2005 with no refresher training thereafter. Mean availability of tracer medicines was 53%, while 56% of health facilities fully met criteria of Good Storage Practice. Task shifting is a reality in the pharmaceutical sector in Tanzania and it occurs mainly as a coping mechanism rather than a formal response to the workforce crisis. In Dodoma Region

Health and social support services to HIV/AIDS infected individuals in Tanzania: employees and employers perceptions.

PubMed

Kassile, Telemu; Anicetus, Honest; Kukula, Raphael; Mmbando, Bruno P

2014-06-20

HIV is a major public health problem in the world, especially in sub-Saharan Africa. It often leads to loss of productive labour and disruption of existing social support system which results in deterioration of population health. This poses a great challenge to infected people in meeting their essential goods and services. This paper examines health and social support services provided by employers to HIV/AIDS infected employees in Tanzania. This was a cross-sectional study, which employed qualitative and quantitative methods in data collection and analysis. Structured questionnaires and in-depth interviews were used to assess the health and social support services provision at employers and employees perspectives. The study participants were employees and employers from public and private organizations. A total of 181 employees and 23 employers from 23 workplaces aged between 18-68 years were involved. The results show that 23.8% (i.e., 20.4% males and 27.3% females) of the employees had at least one member of the family or close relatives living with HIV at the time of the study. Fifty six percent of the infected employees reported to have been receiving health or social support from their employers. Employees' responses were consistent with those reported by their employers. A total of 12(52.2%) and 11(47.8%) employers reported to have been providing health and social supports respectively. Female employees (58.3%) from the private sector (60.0%) were more likely to receive supports than male employees (52.6%) and than those from the public sector (46.2%). The most common health and social support received by the employees were treatment, and nutritional support and reduction of workload, respectively. HIV/AIDS infected employees named treatment and nutritional support, and soft loans and reduced workload respectively, as the most important health and social supports they needed from their employers. This study provides baseline information for further studies

Explaining Electronic Learning Management Systems (ELMS) Continued Usage Intentions among Facilitators in Higher Education Institutions (HEIs) in Tanzania

ERIC Educational Resources Information Center

Muries, Bruckse; Masele, Juma James

2017-01-01

This study sought to explain ELMS continued usage intentions among HEIs in Tanzania. The study was guided by main research question, "What explains ELMS continued usage intentions among facilitators in HEIs in Tanzania?" The study used descriptive cross sectional design administered to 264 respondents drawn from five universities…

Exploring Competence Based Education (CBE) in Rural Secondary Schools in Tanzania: English Language Teachers' Conceptions and Experiences

ERIC Educational Resources Information Center

Lukindo, Jesse John

2016-01-01

This study aimed at getting an insight on the implementation of Competence Based Education in Tanzania (CBE) in Tanzania. A study was conducted in Changchun, Jilin in China due to limited time the researcher had. The study was guided by the following research objective; specifically this study did the following; to assess the knowledge that rural…

An eye for inequality: how trachoma relates to poverty in Tanzania and Vietnam.

PubMed

Jansen, Evertjan; Baltussen, Rob M P M; van Doorslaer, Eddy; Ngirwamungu, Edith; Nguyen, Mai P; Kilima, Peter M

2007-01-01

An important challenge for trachoma control strategies is to break the circle of poverty, poor hygiene and poor health by bringing its benefits to the poor. This article aims to assess to what extent trachoma is a disease of the poor, and trachoma services reach the poor in Tanzania and Vietnam. Individual level data on trachoma prevalence (active trachoma and trichiasis) and utilization of trachoma-related services were collected in both countries in 2004. Prevalence data were also available for Vietnam in 2001. We used household level data to construct an asset index as our living standards measure. Next, we related trachoma prevalence and service use to living standards, and used concentration indices to summarize and test the degree of inequality. Trachoma prevalence was higher among the poorest groups in Tanzania. No such relation could be established in Vietnam where prevalence declined over the period 2001-2004 and particularly so among the least poor. Antibiotics were used more by the poorest in Tanzania and by the less poor in Vietnam. In both countries, there was no unequivocal pattern for the relation between living standards and the use of trachoma services. Trachoma is found to be a disease of the poorest in Tanzania, but not in Vietnam. In the latter country there are indications that district characteristics have an important impact on trachoma prevalence. The higher use of antibiotics among the better-off in Vietnam may have contributed to their larger decline in active trachoma prevalence between 2001 and 2004 compared to the poorer segments.

Origins and development of adult education innovations in Tanzania

NASA Astrophysics Data System (ADS)

Mushi, Philemon A. K.

1991-09-01

A number of adult education innovations were introduced in Tanzania in the late 1960s and early 1970s. This article analyzes the context of three innovations, namely functional literacy, workers' education and the programme of the Folk Development Colleges. The analysis reveals that these innovations had firm roots within the socio-economic conditions prevailing in the country in the 1960s and 1970s, Nyerere's influence as President and Party leader, Tanzania's ideology of development, the policy of popular participation, the roots of educational policy in a humanistic philosophy of education, and indigenous education. Some of the factors which affected their implementation included lack of trained educators, inadequate financial resources, ineffective evaluation mechanisms, and a mis-match between participants' needs and actual programmes. It is suggested that there is a need to introduce economic innovations alongside educational innovations, to involve participants in determining their training needs, and to train and retain adult educators with a view to improving adult education initiatives in the country.

Community perceptions of intimate partner violence - a qualitative study from urban Tanzania

PubMed Central

2011-01-01

Background Intimate partner violence against women is a prevailing public health problem in Tanzania, where four of ten women have a lifetime exposure to physical or sexual violence by their male partners. To be able to suggest relevant and feasible community and health care based interventions, we explored community members' understanding and their responses to intimate partner violence. Methods A qualitative study using focus group discussions with 75 men and women was conducted in a community setting of urban Tanzania. We analysed data using a grounded theory approach and relate our findings to the ecological framework of intimate partner violence. Results The analysis resulted in one core category, "Moving from frustration to questioning traditional gender norms", that denoted a community in transition where the effects of intimate partner violence had started to fuel a wish for change. At the societal level, the category "Justified as part of male prestige" illustrates how masculinity prevails to justify violence. At the community level, the category "Viewed as discreditable and unfair" indicates community recognition of intimate partner violence as a human rights concern. At the relationship level, the category "Results in emotional entrapment" shows the shame and self-blame that is often the result of a violent relationship. At the individual level, the risk factors for intimate partner violence were primarily associated with male characteristics; the category "Fed up with passivity" emerged as an indication that community members also acknowledge their own responsibility for change in actions. Conclusions Prevailing gender norms in Tanzania accept women's subordination and justify male violence towards women. At the individual level, an increasing openness makes it possible for women to report, ask for help, and become proactive in suggesting preventive measures. At the community level, there is an increased willingness to intervene but further

Tanzania Images Highlight Improvements in Full-Resolution SRTM Africa Data

NASA Image and Video Library

2014-09-24

A site in the Crater Highlands of Tanzania reveals the difference between NASA Shuttle Radar Topography Mission SRTM digital elevation model data as originally released in 2004 left and as now released at full resolution in 2014 right.

Stakeholders’ participation in planning and priority setting in the context of a decentralised health care system: the case of prevention of mother to child transmission of HIV programme in Tanzania

PubMed Central

2013-01-01

Background In Tanzania, decentralisation processes and reforms in the health sector aimed at improving planning and accountability in the sector. As a result, districts were given authority to undertake local planning and set priorities as well as allocate resources fairly to promote the health of a population with varied needs. Nevertheless, priority setting in the health care service has remained a challenge. The study assessed the priority setting processes in the planning of the prevention of mother to child transmission of HIV (PMTCT) programme at the district level in Tanzania. Methods This qualitative study was conducted in Mbarali district, south-western Tanzania. The study applied in-depth interviews and focus group discussions in the data collection. Informants included members of the Council Health Management Team, regional PMTCT managers and health facility providers. Results Two plans were reported where PMTCT activities could be accommodated; the Comprehensive Council Health Plan and the Regional PMTCT Plan that was donor funded. As donors had their own globally defined priorities, it proved difficult for district and regional managers to accommodate locally defined PMTCT priorities in these plans. As a result few of these were funded. Guidelines and main priority areas of the Ministry of Health and Social Welfare (MoHSW) also impacted on the ability of the districts and regions to act, undermining the effectiveness of the decentralisation policy in the health sector. Conclusion The challenges in the priority setting processes revealed within the PMTCT initiative indicate substantial weaknesses in implementing the Tanzania decentralisation policy. There is an urgent need to revive the strategies and aims of the decentralisation policy at all levels of the health care system with a view to improving health service delivery. PMID:23849730

Marriage and contraception among the Pare of northern Tanzania.

PubMed

Hollos, Marida; Larsen, Ulla

2004-05-01

The purpose of the research reported here is to examine the connection between contraception and those aspects of a woman's position that are related to her marriage. The research was conducted in two villages among the Pare of northern Tanzania where a shift from hoe cultivation as primary occupation to wage labour has brought about major changes in social relations. The major hypothesis is that a change from a 'traditional' marital union to a 'companionate' marriage is instrumental in the acceptance of contraception and in lowering fertility. The latter type of relationship between marital partners is related to the status of women. The research methodology consisted of a combination of an ethnographic study, demographic surveys and in-depth interviews. Findings show that approximately half of the women in this community ever used contraception. Of current users, a third are sterilized and half are using a modern reversible method. The determining factor for using modern reversible methods is the nature of the conjugal union.

Does Personalized Water and Hand Quality Information Affect Attitudes, Behavior, and Health in Dar es Salaam, Tanzania?

NASA Astrophysics Data System (ADS)

Davis, J.; Pickering, A.; Horak, H.; Boehm, A.

2008-12-01

Tanzania (TZ) has one of the highest rates of child mortality due to enteric disease in the world. NGOs and local agencies have introduced numerous technologies (e.g., chlorine tablets, borewells) to increase the quantity and quality of water in Dar es Salaam, the capital of Tanzania, in hopes of reducing morbidity and mortality of waterborne disease. The objective of the present study is to determine if providing personalized information about water quality and hand surface quality, as determined by concentrations of enterococci and E. coli, results in improved health and water quality in households. A cohort study was completed in June-September 2008 in 3 communities ranging from urban to per-urban in Dar es Salaam, Tanzania to achieve our objective. The study consisted of 4 cohorts that were visited 4 times over the 3 month study. One cohort received no information about water and hand quality until the end of the summer, while the other groups received either just information on hand surface quality, just information on water quality, and information on both hand surface and water quality after the first (baseline) household visit. We report concentrations of enterococci and E. coli in water sources (surface waters and bore wells), water stored in households, and environmental waters were children and adults swim and bathe. In addition, we report concentrations of enterococci and E. coli on hands of caregivers and children in households. Preliminary results of surveys on health and perceptions of water quality and illness from the households are provided. Ongoing work will integrate the microbiological and sociological data sets to determine if personalized information interventions resulted in changes in health, water quality in the household, or perceptions of water quality, quantity and relation to human health. Future work will analyze DNA samples from hands and water for human-specific Bacteroides bacteria which are only present in human feces. Our study

Maternal and newborn healthcare providers in rural Tanzania: in-depth interviews exploring influences on motivation, performance and job satisfaction.

PubMed

Prytherch, H; Kakoko, D C V; Leshabari, M T; Sauerborn, R; Marx, M

2012-01-01

Major improvements in maternal and neonatal health (MNH) remain elusive in Tanzania. The causes are closely related to the health system and overall human resource policy. Just 35% of the required workforce is actually in place and 43% of available staff consists of lower-level cadres such as auxiliaries. Staff motivation is also a challenge. In rural areas the problems of recruiting and retaining health staff are most pronounced. Yet, it is here that the majority of the population continues to reside. A detailed understanding of the influences on the motivation, performance and job satisfaction of providers at rural, primary level facilities was sought to inform a research project in its early stages. The providers approached were those found to be delivering MNH care on the ground, and thus include auxiliary staff. Much of the previous work on motivation has focused on defined professional groups such as physicians and nurses. While attention has recently broadened to also include mid-level providers, the views of auxiliary health workers have seldom been explored. In-depth interviews were the methodology of choice. An interview guideline was prepared with the involvement of Tanzanian psychologists, sociologists and health professionals to ensure the instrument was rooted in the socio-cultural setting of its application. Interviews were conducted with 25 MNH providers, 8 facility and district managers, and 2 policy-makers. Key sources of encouragement for all the types of respondents included community appreciation, perceived government and development partner support for MNH, and on-the-job learning. Discouragements were overwhelmingly financial in nature, but also included facility understaffing and the resulting workload, malfunction of the promotion system as well as health and safety, and security issues. Low-level cadres were found to be particularly discouraged. Difficulties and weaknesses in the management of rural facilities were revealed. Basic steps

Significance of Trends on Enrolment, Budget and Actual Expenditure in the Examination of Higher Education Financing in Tanzania

ERIC Educational Resources Information Center

Memba, Albert Zephaniah; Feng, Zhao Jun

2016-01-01

Financing of higher education in Tanzania is considered a crucial factor in realizing the country's development vision. It is for these reasons that Tanzania has been financing its higher education since its inception. Diminishing resource capacity and competing interests for government finance plunged the higher education into financial doldrums.…

Pattern and Distribution of Colorectal Cancer in Tanzania: A Retrospective Chart Audit at Two National Hospitals

PubMed Central

Katalambula, Leonard K.; Ntwenya, Julius Edward; Ngoma, Twalib; Buza, Joram; Mpolya, Emmanuel

2016-01-01

Background. Colorectal cancer (CRC) is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (χ 2) tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06%) and females (49.94%), although gender likelihood of diagnosis type (i.e., rectal or colon) was significantly different (P = 0.027). More than 60% of patients were between 40 and 69 years. Conclusions. Age (P = 0.0183) and time (P = 0.004) but not gender (P = 0.0864) were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender (P = 0.0405), age (P = 0.0015), and time (P = 0.0075) were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate. PMID:27965709

Molecular Typing and Antimicrobial Susceptibility of Methicillin-Resistant Staphylococcus aureus Isolated from Bovine Milk in Tanzania.

PubMed

Mohammed, Jibril; Ziwa, Michael Henry; Hounmanou, Yaovi Mahuton Gildas; Kisanga, Adela; Tuntufye, Huruma Nelwike

2018-01-01

Methicillin-resistant Staphylococcus aureus (MRSA) in raw milk can be transmitted from animals to humans, and in Tanzania raw milk is sold in local markets and consumed as purchased. This study was performed to determine the molecular characteristics and antimicrobial susceptibility pattern of MRSA strains isolated from raw bovine milk sold at local markets in Tanzania. A total of 117 raw milk samples were cultured on Baird-Parker medium to isolate S. aureus and PCR was used for amplification of gltB gene for S. aureus identification and the presence of mecA gene for methicillin-resistant strains. Coagulase-negative (CN) S. aureus were reconfirmed using tube coagulase, DNase, and API Staph tests. MRSA isolates were spa typed whereas antimicrobial susceptibility testing was performed by the disc diffusion method. Forty-six coagulase positives (CP) and two CN S. aureus were identified. Most strains were resistant to penicillin (72%), and 3 isolates: 2 CN S. aureus and 1 coagulase-negative Staphylococci (CNS), were phenotypically resistant to vancomycin, oxacillin, and cefoxitin and were confirmed to carry mecA. Resistance to clindamycin, trimethoprim-sulfamethoxazole, and tetracycline was 23.9%, 30.4%, and 41.3%, respectively. Twelve isolates exhibited multidrug resistance; however, only one mecA positive strain among the three was typeable and belonged to spa type t2603. This study reports for the first time the presence of CN variant of MRSA, which was assigned the spa type t2603, and the presence of multidrug resistant S. aureus isolates from bovine milk in Morogoro, Tanzania.

Molecular Typing and Antimicrobial Susceptibility of Methicillin-Resistant Staphylococcus aureus Isolated from Bovine Milk in Tanzania

PubMed Central

Mohammed, Jibril; Ziwa, Michael Henry; Kisanga, Adela; Tuntufye, Huruma Nelwike

2018-01-01

Methicillin-resistant Staphylococcus aureus (MRSA) in raw milk can be transmitted from animals to humans, and in Tanzania raw milk is sold in local markets and consumed as purchased. This study was performed to determine the molecular characteristics and antimicrobial susceptibility pattern of MRSA strains isolated from raw bovine milk sold at local markets in Tanzania. A total of 117 raw milk samples were cultured on Baird-Parker medium to isolate S. aureus and PCR was used for amplification of gltB gene for S. aureus identification and the presence of mecA gene for methicillin-resistant strains. Coagulase-negative (CN) S. aureus were reconfirmed using tube coagulase, DNase, and API Staph tests. MRSA isolates were spa typed whereas antimicrobial susceptibility testing was performed by the disc diffusion method. Forty-six coagulase positives (CP) and two CN S. aureus were identified. Most strains were resistant to penicillin (72%), and 3 isolates: 2 CN S. aureus and 1 coagulase-negative Staphylococci (CNS), were phenotypically resistant to vancomycin, oxacillin, and cefoxitin and were confirmed to carry mecA. Resistance to clindamycin, trimethoprim-sulfamethoxazole, and tetracycline was 23.9%, 30.4%, and 41.3%, respectively. Twelve isolates exhibited multidrug resistance; however, only one mecA positive strain among the three was typeable and belonged to spa type t2603. This study reports for the first time the presence of CN variant of MRSA, which was assigned the spa type t2603, and the presence of multidrug resistant S. aureus isolates from bovine milk in Morogoro, Tanzania. PMID:29721021

Country watch. Tanzania / Uganda / Zaire.

PubMed

Senturias, E N

1994-01-01

A participatory action research program was implemented in Tanzania, Uganda, and Zaire to sensitize and encourage church leaders and members to more actively participate in HIV/AIDS prevention and care. Communities had a major role in the process, even defining research questions. The program effectively helped sensitize individuals at the community and international levels, with its effects ongoing even though the program has officially ended. Collective community consciousness was raised on the need to address the epidemic, while identifying important issues to confront. Focus group discussions and the conference generated open and frank discussions on condom use, culture, and sexual behavior.

Effectiveness of a nutrition education package in improving feeding practices, dietary adequacy and growth of infants and young children in rural Tanzania: rationale, design and methods of a cluster randomised trial.

PubMed

Kulwa, Kissa B M; Verstraeten, Roosmarijn; Bouckaert, Kimberley P; Mamiro, Peter S; Kolsteren, Patrick W; Lachat, Carl

2014-10-16

intervention and context at 8 and 15 months. Results of the trial will provide evidence of the effectiveness of the nutrition education package in community settings of rural Tanzania. They will provide recommendations for strengthening the nutrition component of health education in child health services. ClinicalTrials.gov Identifier: NCT02249754, September 25, 2014.

United Nations High Commissioner for Refugees feeding program performance in Kenya and Tanzania: a retrospective analysis of routine Health Information System data.

PubMed

Tappis, Hannah; Doocy, Shannon; Haskew, Christopher; Wilkinson, Caroline; Oman, Allison; Spiegel, Paul

2012-06-01

The United Nations High Commissioner for Refugees (UNHCR) Health Information System is a primary source of routine nutrition program data and provides a comprehensive assessment of UNHCR selective feeding programs in more than 90 refugee camps in 18 countries worldwide. To evaluate the coverage and effectiveness of UNHCR supplementary and therapeutic feeding programs for malnourished children under 5 years of age in Kenya and Tanzania refugee camps. Analysis of Kenya and Tanzania refugee camp population, growth monitoring and nutrition program data from the UNHCR Health Information System. UNHCR-supported implementing partners in Kenya and Tanzania admitted nearly 45,000 malnourished refugee children in selective feeding programs between January 2006 and May 2009. Average recovery rates of 77.1% and 84.6% in the therapeutic and supplementary programs, respectively, mortality rates of less than 1%, and average readmission below 5% suggest that feeding programs had a beneficial effect on enrolled children. Increasing admission and enrollment in supplementary feeding programs was successful in preventing cases of severe malnutrition in some camps. Further attention to these camps would be likely to yield sizeable benefits in terms of absolute reductions in malnutrition prevalence and mortality rates.

CBDs take messages to communities in Tanzania.

PubMed

1996-02-01

The Family Planning Association of Tanzania (UMATI)/JOICFP Integrated Project to promote the use of contraceptive methods was launched in 1984 to a target population of 20,000 spread over three villages. The project now covers 117 villages with a total population of 356,000. In initial project areas, the project has increased the contraceptive prevalence rate (CPR) to more than 50% compared to the national average of 11.3% in five years. In overwhelmingly Catholic areas in Mgeta, Morogoro Region, the CPR increased from 1.0% in 1990 at the project start to reach 50.4% in 1994. The community-based distribution (CBD) system is one of the most impressive aspects of the UMATI/JOICFP project. The flexibility and ready accessibility of CBD personnel have made them more effective in reaching community people than clinical services. CBD personnel also work closely with government health workers. To further improve the CBD system, UMATI is concentrating upon the development of an effective CBD supervision system.

Content Analysis of the Status and Place of Sexuality Education in the National School Policy and Curriculum in Tanzania

ERIC Educational Resources Information Center

Mkumbo, Kitila A.

2009-01-01

In Tanzania, sexuality education in schools is not provided as a standalone subject; rather it is mainstreamed in other subjects, namely Social Studies, Science, Civics and Biology. However, it is not clear how much sexuality education is covered in these subjects. The purpose of this study was to examine the status of sexuality education in the…

Women's Preferences for Place of Delivery in Rural Tanzania: A Population-Based Discrete Choice Experiment

PubMed Central

Paczkowski, Magdalena; Mbaruku, Godfrey; de Pinho, Helen; Galea, Sandro

2009-01-01

Objectives. We fielded a population-based discrete choice experiment (DCE) in rural western Tanzania, where only one third of women deliver children in a health facility, to evaluate health-system factors that influence women's delivery decisions. Methods. Women were shown choice cards that described 2 hypothetical health centers by means of 6 attributes (distance, cost, type of provider, attitude of provider, drugs and equipment, free transport). The women were then asked to indicate which of the 2 facilities they would prefer to use for a future delivery. We used a hierarchical Bayes procedure to estimate individual and mean utility parameters. Results. A total of 1203 women completed the DCE. The model showed good predictive validity for actual facility choice. The most important facility attributes were a respectful provider attitude and availability of drugs and medical equipment. Policy simulations suggested that if these attributes were improved at existing facilities, the proportion of women preferring facility delivery would rise from 43% to 88%. Conclusions. In regions in which attended delivery rates are low despite availability of primary care facilities, policy experiments should test the effect of targeted quality improvements on facility use. PMID:19608959

Perceptions about the cultural practices of male partners during postpartum care in rural Tanzania: a qualitative study

PubMed Central

Reuben Mahiti, Gladys; Mbekenga, Columba K.; Dennis Kiwara, Angwara; Hurtig, Anna-Karin; Goicolea, Isabel

2017-01-01

ABSTRACT Background: Men play an important role in maternal health. The postpartum period is a critical stage, yet there is a scarcity of research that explores men’s involvement during this stage. Objective: The aim of the study was to explore male partners’ perceptions of the cultural practices during postpartum care in rural Tanzania. Methods: Fourteen focus group discussions were conducted with 93 men, with an age range of 19–65 years, in August 2013. The study was conducted in the Kongwa District, located in the Dodoma region in central Tanzania. Qualitative data were digitally recorded, transcribed verbatim and analyzed using content analysis. Results: Four categories emerged, namely: ‘Men as providers and, occasionally, care takers’, ‘Men as decision makers’, ‘Diverse perceptions of sexual abstinence’ and ‘Barriers for men in using/accompanying partners to use reproductive and child healthcare services’. The cross-category theme ‘Men during postpartum: remaining powerful but excluded’ refers to how men are in a powerful position above women in different aspects of life. Elderly women played an important role in caring for postpartum mothers and their newborns, but men were the ones making the final decision about where to seek care. Traditional practices isolated men from their partners for a certain period, and enforced sexual abstinence for the women during the postpartum period. However, cultural norms permitted men to engage in extramarital relations. Reproductive and child healthcare services were perceived by men as not welcoming the male partners, and local gender norms discouraged men from accompanying their partners to seek services. Conclusions: In this study, we found that men perceived their role during the postpartum period as financial providers, decision makers and, occasionally, care givers. Men also held diverse perceptions with regard to sexual abstinence and felt excluded from participating in maternal healthcare

Design, implementation and evaluation of a national campaign to distribute nine million free LLINs to children under five years of age in Tanzania

PubMed Central

2011-01-01

Background After a national voucher scheme in 2004 provided pregnant women and infants with highly subsidized insecticide-treated nets (ITNs), use among children under five years (U5s) in mainland Tanzania increased from 16% in 2004 to 26.2% in 2007. In 2008, the Ministry of Health and Social Welfare planned a catch-up campaign to rapidly and equitably deliver a free long-lasting insecticidal net (LLIN) to every child under five years in Tanzania. Methods The ITN Cell, a unit within the National Malaria Control Programme (NMCP), coordinated the campaign on behalf of the Ministry of Health and Social Welfare. Government contractors trained and facilitated local government officials to supervise village-level volunteers on a registration of all U5s and the distribution and issuing of LLINs. The registration results formed the basis for the LLIN order and delivery to village level. Caregivers brought their registration coupons to village issuing posts during a three-day period where they received LLINs for their U5s. Household surveys in five districts assessed ITN ownership and use immediately after the campaign. Results Nine donors contributed to the national campaign that purchased and distributed 9.0 million LLINs at an average cost of $7.07 per LLIN, including all campaign-associated activities. The campaign covered all eight zones of mainland Tanzania, the first region being covered separately during an integrated measles immunization/malaria LLIN distribution in August 2008, and was implemented one zone at a time from March 2009 until May 2010. ITN ownership at household level increased from Tanzania's 2008 national average of 45.7% to 63.4%, with significant regional variations. ITN use among U5s increased from 28.8% to 64.1%, a 2.2-fold increase, with increases ranging from 22.1-38.3% percentage points in different regions. Conclusion A national-level LLIN distribution strategy that fully engaged local government authorities helped avoid additional burden on

Costs and Impacts of Scaling up Voluntary Medical Male Circumcision in Tanzania

PubMed Central

Menon, Veena; Gold, Elizabeth; Godbole, Ramona; Castor, Delivette; Mahler, Hally; Forsythe, Steven; Ally, Mariam; Njeuhmeli, Emmanuel

2014-01-01

Background Given the proven effectiveness of voluntary medical male circumcision (VMMC) in preventing the spread of HIV, Tanzania is scaling up VMMC as an HIV prevention strategy. This study will inform policymakers about the potential costs and benefits of scaling up VMMC services in Tanzania. Methodology The analysis first assessed the unit costs of delivering VMMC at the facility level in three regions—Iringa, Kagera, and Mbeya—via three currently used VMMC service delivery models (routine, campaign, and mobile/island outreach). Subsequently, using these unit cost data estimates, the study used the Decision Makers' Program Planning Tool (DMPPT) to estimate the costs and impact of a scaled-up VMMC program. Results Increasing VMMC could substantially reduce HIV infection. Scaling up adult VMMC to reach 87.9% coverage by 2015 would avert nearly 23,000 new adult HIV infections through 2015 and an additional 167,500 from 2016 through 2025—at an additional cost of US$253.7 million through 2015 and US$302.3 million from 2016 through 2025. Average cost per HIV infection averted would be US$11,300 during 2010–2015 and US$3,200 during 2010–2025. Scaling up VMMC in Tanzania will yield significant net benefits (benefits of treatment costs averted minus the cost of performing circumcisions) in the long run—around US$4,200 in net benefits for each infection averted. Conclusion VMMC could have an immediate impact on HIV transmission, but the full impact on prevalence and deaths will only be apparent in the longer term because VMMC averts infections some years into the future among people who have been circumcised. Given the health and economic benefits of investing in VMMC, the scale-up of services should continue to be a central component of the national HIV prevention strategy in Tanzania. PMID:24802022

‘Essential but not always available when needed’ – an interview study of physicians’ experiences and views regarding use of obstetric ultrasound in Tanzania

PubMed Central

Åhman, Annika; Kidanto, Hussein Lesio; Ngarina, Matilda; Edvardsson, Kristina; Small, Rhonda; Mogren, Ingrid

2016-01-01

Background The value of obstetric ultrasound in high-income countries has been extensively explored but evidence is still lacking regarding the role of obstetric ultrasound in low-income countries. Objective We aimed to explore experiences and views among physicians working in obstetric care in Tanzania, on the role of obstetric ultrasound in relation to clinical management. Design A qualitative study design was applied. Data were collected in 2015, through 16 individual interviews with physicians practicing in obstetric care at hospitals in an urban setting in Tanzania. Data were analyzed using qualitative content analysis. Results Use of obstetric ultrasound in the management of complicated pregnancy was much appreciated by participating physicians, although they expressed considerable concern about the lack of ultrasound equipment and staff able to conduct the examinations. These limitations were recognized as restricting physicians’ ability to manage complications adequately during pregnancy and birth. Better availability of ultrasound was requested to improve obstetric management. Concerns were also raised regarding pregnant women's lack of knowledge and understanding of medical issues which could make counseling in relation to obstetric ultrasound difficult. Although the physicians perceived a positive attitude toward ultrasound among most pregnant women, occasionally they came across women who feared that ultrasound might harm the fetus. Conclusions There seems to be a need to provide more physicians in antenatal care in Tanzania with ultrasound training to enable them to conduct obstetric ultrasound examinations and interpret the results themselves. Physicians also need to acquire adequate counseling skills as counseling can be especially challenging in this setting where many expectant parents have low levels of education. Providers of obstetric care and policy makers in Tanzania will need to take measures to ensure appropriate use of the scarce

The internal migration between public and faith-based health providers: a cross-sectional, retrospective and multicentre study from southern Tanzania.

PubMed

Tabatabai, Patrik; Prytherch, Helen; Baumgarten, Inge; Kisanga, Oberlin M E; Schmidt-Ehry, Bergis; Marx, Michael

2013-07-01

To assess the magnitude, direction and underlying dynamics of internal health worker migration between public and faith-based health providers from a hospital perspective. Two complementary tools were implemented in 10 public and six faith-based hospitals in southern Tanzania. A hospital questionnaire assessed magnitude and direction of staff migration between January 2006 and June 2009. Interviews with 42 public and 20 faith-based maternity nurses evaluated differences in staff perspectives and motives for the observed migration patterns. The predominant direction of staff movement was from the faith-based to the public sector: 69.1% (n = 105/152) of hospital staff exits and 60.6% (n = 60/99) of hospital staff gains. Nurses were the largest group among the migrating health workforce. Faith-based hospitals lost 59.3% (n = 86/145) of nurses and 90.6% (n = 77/85) of registered nurses to the public sector, whereby public hospitals reported 13.5% (n = 59/436) of nurses and 24.4% (n = 41/168) of registered nurses being former faith-based employees. Interviews revealed significantly inferior staff perspectives among faith-based respondents than their public colleagues. Main differences were identified regarding career development and training, management support, employee engagement and workload. This study revealed considerable internal health worker migration from the faith-based to the public sector. Staff retention and motivation within faith-based hospitals are not restricted to financial considerations, and salary gaps can no longer uniquely explain this movement pattern. The consequences for the catchment area of faith-based hospitals are potentially severe and erode cooperation potential between the public and private health sector.

Improving the Quality of Basic Education through the Use of Gender-Sensitive Student Councils: Experience of Six Selected Districts in Tanzania

ERIC Educational Resources Information Center

Mnubi, Godfrey Magoti

2017-01-01

This paper analyses whether the gender-sensitive and democratically elected student councils helped in strengthening school leadership and providing a platform for increased awareness and advocacy for male and female students to address their needs and rights in primary and secondary schools in Tanzania. The data were collected through qualitative…

Strengthening medical education in haematology and blood transfusion: postgraduate programmes in Tanzania

PubMed Central

Makani, Julie; Lyimo, Magdalena; Magesa, Pius; Roberts, David J.

2017-01-01

Summary Haematology and blood transfusion, as a clinical and laboratory discipline, has a far-reaching impact on healthcare both through direct patient care as well as provision of laboratory and transfusion services. Improvement of haematology and blood transfusion may therefore be significant in achieving advances in health in Africa. In 2005, Tanzania had one of the lowest distributions of doctors in the world, estimated at 2·3 doctors per 100 000 of population, with only one haematologist, a medical doctor with postgraduate medical education in haematology and blood transfusion. Here, we describe the establishment and impact of a postgraduate programme centred on Master of Medicine and Master of Science programmes to build the capacity of postgraduate training in haematology and blood transfusion. The programme was delivered through Muhimbili University of Health and Allied Sciences (MUHAS) with partnership from visiting medical and laboratory staff from the UK and complemented by short-term visits of trainees from Tanzania to Haematology Departments in the UK. The programme had a significant impact on the development of human resources in haematology and blood transfusion, successfully training 17 specialists with a significant influence on delivery of health services and research. This experience shows how a self-sustaining, specialist medical education programme can be developed at low cost within Lower and Middle Income Countries (LMICs) to rapidly enhance delivery of capacity to provide specialist services. PMID:28369755

Bovine tuberculosis at the human-livestock-wildlife interface: is it a public health problem in Tanzania? A review.

PubMed

Katale, Bugwesa Z; Mbugi, Erasto V; Kendal, Sharon; Fyumagwa, Robert D; Kibiki, Gibson S; Godfrey-Faussett, Peter; Keyyu, Julius D; Van Helden, Paul; Matee, Mecky I

2012-06-20

Despite the apparent public health concern about Bovine tuberculosis (BTB) in Tanzania, little has been done regarding the zoonotic importance of the disease and raising awareness of the community to prevent the disease. Bovine tuberculosis is a potential zoonotic disease that can infect a variety of hosts, including humans. The presence of multiple hosts including wild animals, inefficient diagnostic techniques, absence of defined national controls and eradication programs could impede the control of bovine TB. In Tanzania, the diagnosis of Mycobacterium bovis in animals is mostly carried out by tuberculin skin testing, meat inspection in abattoirs and only rarely using bacteriological techniques. The estimated prevalence of BTB in animals in Tanzania varies and ranges across regions from 0.2% to 13.3%, which is likely to be an underestimate if not confirmed by bacteriology or molecular techniques. Mycobacterium bovis has been detected and isolated from different animal species and has been recovered in 10% of apparently healthy wildebeest that did not show lesions at post-mortem. The transmission of the disease from animals to humans can occur directly through the aerosol route and indirectly by consumption of raw milk. This poses an emerging disease threat in the current era of HIV confection in Tanzania and elsewhere. Mycobacterium bovis is one of the causative agents of human extra pulmonary tuberculosis. In Tanzania there was a significant increase (116.6%) of extrapulmonary cases reported between 1995 and 2009, suggesting the possibility of widespread M. bovis and Mycobacterium tuberculosis infection due to general rise of Human Immunodeficiency virus (HIV). This paper aims to review the potential health and economic impact of bovine tuberculosis and challenges to its control in order to safeguard human and animal population in Tanzania.

Did Tanzania Achieve the Second Millennium Development Goal? Statistical Analysis

ERIC Educational Resources Information Center

Magoti, Edwin

2016-01-01

Development Goal "Achieve universal primary education", the challenges faced, along with the way forward towards achieving the fourth Sustainable Development Goal "Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all". Statistics show that Tanzania has made very promising steps…

Comparison of detection methods to estimate asexual Plasmodium falciparum parasite prevalence and gametocyte carriage in a community survey in Tanzania.

PubMed

Mwingira, Felista; Genton, Blaise; Kabanywanyi, Abdu-Noor M; Felger, Ingrid

2014-11-18

The use of molecular techniques to detect malaria parasites has been advocated to improve the accuracy of parasite prevalence estimates, especially in moderate to low endemic settings. Molecular work is time-consuming and costly, thus the effective gains of this technique need to be carefully evaluated. Light microscopy (LM) and rapid diagnostic tests (RDT) are commonly used to detect malaria infection in resource constrained areas, but their limited sensitivity results in underestimation of the proportion of people infected with Plasmodium falciparum. This study aimed to evaluate the extent of missed infections via a community survey in Tanzania, using polymerase chain reaction (PCR) to detect P. falciparum parasites and gametocytes. Three hundred and thirty individuals of all ages from the Kilombero and Ulanga districts (Tanzania) were enrolled in a cross-sectional survey. Finger prick blood samples were collected for parasite detection by RDT, LM and molecular diagnosis using quantitative 18S rRNA PCR and msp2 nPCR. Gametocytes were detected by LM and by amplifying transcripts of the gametocyte-specific marker pfs25. Results from all three diagnostic methods were available for a subset of 226 individuals. Prevalence of P. falciparum was 38% (86/226; 95% CI 31.9-44.4%) by qPCR, 15.9% (36/226; 95% CI 11.1-20.7%) by RDT and 5.8% (13/226; 95% CI 2.69- 8.81%) by LM. qPCR was positive for 72% (26/36) of the RDT-positive samples. Gametocyte prevalence was 10.6% (24/226) by pfs25-qRT-PCR and 1.2% by LM. LM showed the poorest performance, detecting only 15% of P. falciparum parasite carriers identified by PCR. Thus, LM is not a sufficiently accurate technique from which to inform policies and malaria control or elimination efforts. The diagnostic performance of RDT was superior to that of LM. However, it is also insufficient when precise prevalence data are needed for monitoring intervention success or for determining point prevalence rates in countrywide surveillance

Health policy for sickle cell disease in Africa: experience from Tanzania on interventions to reduce under-five mortality.

PubMed

Makani, Julie; Soka, Deogratias; Rwezaula, Stella; Krag, Marlene; Mghamba, Janneth; Ramaiya, Kaushik; Cox, Sharon E; Grosse, Scott D

2015-02-01

Tanzania has made considerable progress towards reducing childhood mortality, achieving a 57% decrease between 1980 and 2011. This epidemiological transition will cause a reduction in the contribution of infectious diseases to childhood mortality and increase in contribution from non-communicable diseases (NCDs). Haemoglobinopathies are amongst the most common childhood NCDs, with sickle cell disease (SCD) being the commonest haemoglobinopathy in Africa. In Tanzania, 10,313 children with SCD under 5 years of age (U5) are estimated to die every year, contributing an estimated 7% of overall deaths in U5 children. Key policies that governments in Africa are able to implement would reduce mortality in SCD, focusing on newborn screening and comprehensive SCD care programmes. Such programmes would ensure that interventions such as prevention of infections using penicillin plus prompt diagnosis and treatment of complications are provided to all individuals with SCD. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Characterization of the common bean host and Pseudocercospora griseola the causative agent of angular leaf spot disease in Tanzania

USDA-ARS?s Scientific Manuscript database

Angular leaf spot (ALS) caused by the fungus Pseudocercospora griseola is one of the most important diseases of common bean in Tanzania. Breeding for resistance to this disease is complicated by the variable nature of the pathogen. In Tanzania no thorough analysis of the variability of this pathogen...

Notes from the Field: Chlorination Strategies for Drinking Water During a Cholera Epidemic - Tanzania, 2016.

PubMed

Wang, Alice; Hardy, Colleen; Rajasingham, Anangu; Martinsen, Andrea; Templin, Lindsay; Kamwaga, Stanislaus; Sebunya, Kiwe; Jhuthi, Brenda; Habtu, Michael; Kiberiti, Stephen; Massa, Khalid; Quick, Rob; Mulungu, Jane; Eidex, Rachel; Handzel, Thomas

2016-10-21

Since August 2015, the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) of Tanzania has been leading the response to a widespread cholera outbreak. As of June 9, 2016, cholera had affected 23 of 25 regions in Tanzania, with 21,750 cumulative cases and 341 deaths reported (Ally Nyanga, MoHCDGEC Emergency Operations Center, personal communication, June 2016). Approximately one fourth of all cases occurred in the Dar es Salaam region on the east coast. Regions surrounding Lake Victoria, in the north, also reported high case counts, including Mwanza with 9% (Ally Nyanga, MoHCDGEC Emergency Operations Center, personal communication, June 2016). Since the start of the outbreak, MoHCDGEC and the Ministry of Water (MOW) have collaborated with the Tanzania Red Cross Society, United Nations Children's Fund (UNICEF), World Health Organization (WHO), and CDC to enhance the water, sanitation, and hygiene (WASH) response to prevent the further spread of cholera.

Resistance to Information Technology in Public Procurement in Tanzania

ERIC Educational Resources Information Center

Nditi, Christopher

2010-01-01

Organizations have become more dependent on information technology (IT) in the 21st century. But IT implementation and use is resisted in certain sectors of Tanzania, particularly in government-run enterprises. The purpose of this study was to investigate the causes and consequences of resistance to IT development and implementation in the…

Educating a Nation towards Self-Reliance: Tanzania's Journey in Search for an Education That Is Meaningful to Its People

ERIC Educational Resources Information Center

Wabike, Paul

2015-01-01

Since independence in 1961, Tanzania's political ideology (known as Ujamaa-familyhood) has gone hand in hand with the country's education philosophy. The most important feature of this combination is that people should be educated to fit in Tanzania's environment and culture. Education should emancipate man from mental slavery inherited from…

Ruminant methane reduction through livestock development in Tanzania. Final report for US Department of Energy and US Initiative on Joint Implementation--Activities Implemented Jointly

DOE Office of Scientific and Technical Information (OSTI.GOV)

Livingston, Roderick

1999-07-01

This project was designed to help develop the US Initiative on Joint Implementation activities in Eastern Africa. It has been communicated in meetings with representatives from the Ministry of Environment of Tanzania and the consultant group that developed Tanzania's National Climate Change Action Plan, the Centre for Energy, Environment, Science and Technology, that this project fits very well with the developmental and environmental goals of the Government of Tanzania. The goal of the Activities Implemented Jointly ruminant livestock project is to reduce ruminant methane emissions in Eastern Africa. The project plans a sustainable cattle multiplication unit (CMU) at Mabuki Ranchmore » in the Mwanza Region of Tanzania. This CMU will focus on raising genetically improved animals to be purchased by farmers, developmental organizations, and other CMUs in Tanzania. Through the purchase of these animals farmers will raise their income generation potential and reduce ruminant methane emissions.« less

Development and promotion of a national website to improve dissemination of information related to the prevention of mother-to-child HIV transmission (PMTCT) in Tanzania.

PubMed

Stephan, Gudila; Hoyt, Mary Jo; Storm, Deborah S; Shirima, Sylvia; Matiko, Charles; Matechi, Emmanuel

2015-10-22

Websites that address national public health issues provide an important mechanism to improve health education and services in resource limited countries. This article describes the development, promotion and initial evaluation of a national website to increase access to information and resources about prevention of mother-to-child transmission of HIV (PMTCT) among healthcare workers and PMTCT stakeholders in Tanzania. A participatory approach, involving the Tanzania Ministry of Health and Social Welfare (MOHSW) and key PMTCT stakeholders, was used to develop and manage the online PMTCT National Resource Center (NRC), http://pmtct.or.tz/ . The website was created with a content management system software system that does not require advanced computer skills and facilitates content updates and site management. The PMTCT NRC hosts related regularly updated PMTCT-related news, resources and publications. Website implementation, access and performance were evaluated over two years using Google Analytics data about visits, page views, downloads, bounce rates and location of visitors, supplemented by anecdotal feedback. Following its launch in July 2013, the PMTCT NRC website received a total of 28,400 visits, with 66,463 page views, over 2 years; 30 % of visits were from returning visitors. During year 1, visits increased by 80 % from the first to second 6 month period and then declined slightly (9-11 %) but remained stable in Year 2. Monthly visits spiked by about 70 % during October 2013 and January 2014 in response to the release and promotion of revised national PMTCT guidelines and training manuals. The majority of visitors came from primarily urban areas in Tanzania (50 %) and from other African countries (16 %). By year 2, over one-third of visitors used mobile devices to access the site. The successfully implemented PMTCT NRC website provides centralized, easily accessed information designed to address the needs of clinicians, educators and program partners in

"If really we are committed things can change, starting from us": Healthcare providers' perceptions of postpartum care and its potential for improvement in low-income suburbs in Dar es Salaam, Tanzania.

PubMed

Pallangyo, Eunice N; Mbekenga, Columba; Källestål, Carina; Rubertsson, Christine; Olsson, Pia

2017-03-01

To explore healthcare providers' perceptions of the current postpartum care (PPC) practice and its potential for improvement at governmental health institutions in low-resource suburbs in Dar es Salaam, Tanzania. Qualitative design, using focus group discussions (8) and qualitative content analysis. Healthcare institutions (8) at three levels of governmental healthcare in Ilala and Temeke suburbs, Dar es Salaam. Registered, enrolled and trained nurse-midwives (42); and medical and clinical officers (13). The healthcare providers perceived that PPC was suboptimal and that they could have prevented maternal deaths. PPC was fragmented at understaffed institutions, lacked guidelines and was organized in a top-down structure of leadership. The participants called for improvement of: organization of space, time, resources, communication and referral system; providers' knowledge; and supervision and feedback. Their motivation to enhance PPC quality was high. The HCP awareness of the suboptimal quality of PPC, its potential for promoting health and their willingness to engage in improving care are promising for the implementation of interventions to improve quality of care. Provision of guidelines, sensitization of providers to innovate and maximize utilization of existing resources, and supportive supervision and feedback are likely to contribute to the sustainability of any improvement. Copyright © 2016 Elsevier B.V. All rights reserved.

Leptospirosis and Human Immunodeficiency Virus Co-Infection Among Febrile Inpatients in Northern Tanzania

PubMed Central

Biggs, Holly M.; Galloway, Renee L.; Bui, Duy M.; Morrissey, Annie B.; Maro, Venance P.

2013-01-01

Abstract Background Leptospirosis and human immunodeficiency virus (HIV) infection are prevalent in many areas, including northern Tanzania, yet little is known about their interaction. Methods We enrolled febrile inpatients at two hospitals in Moshi, Tanzania, over 1 year and performed HIV antibody testing and the microscopic agglutination test (MAT) for leptospirosis. Confirmed leptospirosis was defined as ≥four-fold rise in MAT titer between acute and convalescent serum samples, and probable leptospirosis was defined as any reciprocal MAT titer ≥800. Results Confirmed or probable leptospirosis was found in 70 (8.4%) of 831 participants with at least one serum sample tested. At total of 823 (99.0%) of 831 participants had HIV testing performed, and 203 (24.7%) were HIV infected. Among HIV-infected participants, 9 (4.4%) of 203 had confirmed or probable leptospirosis, whereas among HIV-uninfected participants 61 (9.8%) of 620 had leptospirosis. Leptospirosis was less prevalent among HIV-infected as compared to HIV-uninfected participants [odds ratio (OR) 0.43, p=0.019]. Among those with leptospirosis, HIV-infected patients more commonly presented with features of severe sepsis syndrome than HIV-uninfected patients, but differences were not statistically significant. Among HIV-infected patients, severe immunosuppression was not significantly different between those with and without leptospirosis (p=0.476). Among HIV-infected adolescents and adults, median CD4 percent and median CD4 count were higher among those with leptospirosis as compared to those with other etiologies of febrile illness, but differences in CD4 count did not reach statistical significance (p=0.015 and p=0.089, respectively). Conclusions Among febrile inpatients in northern Tanzania, leptospirosis was not more prevalent among HIV-infected patients. Although some indicators of leptospirosis severity were more common among HIV-infected patients, a statistically significant difference was not

New evidence of mating swarms of the malaria vector, Anopheles arabiensis in Tanzania

PubMed Central

Kaindoa, Emmanuel W.; Ngowo, Halfan S.; Limwagu, Alex; Mkandawile, Gustav; Kihonda, Japhet; Masalu, John Paliga; Bwanary, Hamis; Diabate, Abdoulaye; Okumu, Fredros O.

2017-01-01

Background: Malaria mosquitoes form mating swarms around sunset, often at the same locations for months or years. Unfortunately, studies of Anopheles swarms are rare in East Africa, the last recorded field observations in Tanzania having been in 1983. Methods: Mosquito swarms were surveyed by trained volunteers between August-2016 and June-2017 in Ulanga district, Tanzania. Identified Anopheles swarms were sampled using sweep nets, and collected mosquitoes killed by refrigeration then identified by sex and taxa. Sub-samples were further identified by PCR, and spermatheca of females examined for mating status. Mosquito ages were estimated by observing female ovarian tracheoles and rotation of male genitalia. GPS locations, types of swarm markers, start/end times of swarming, heights above ground, mosquito counts/swarm, and copulation events were recorded. Results: A total of 216 Anopheles swarms were identified, characterized and mapped, from which 7,142 Anopheles gambiae s.l and 13 Anopheles funestus were sampled. The An. gambiae s.l were 99.6% males and 0.4% females, while the An. funestus were all males. Of all An. gambiae s.l analyzed by PCR, 86.7% were An. arabiensis, while 13.3% returned non-amplified DNA. Mean height (±SD) of swarms was 2.74±0.64m, and median duration was 20 (IQR; 15-25) minutes. Confirmed swarm markers included rice fields (25.5%), burned grounds (17.2%), banana trees (13%), brick piles (8.8%), garbage heaps (7.9%) and ant-hills (7.4%). Visual estimates of swarm sizes by the volunteers was strongly correlated to actual sizes by sweep nets (R=0.94; P=<0.001). All females examined were nulliparous and 95.6% [N=6787] of males had rotated genitalia, indicating sexual maturity. Conclusions: This is the first report of Anopheles swarms in Tanzania in more than three decades. The study demonstrates that the swarms can be identified and characterized by trained community-based volunteers, and highlights potential new interventions, for example

Determinants of moderate-to-severe anaemia among women of reproductive age in Tanzania: analysis of data from the 2010 Tanzania Demographic and Health Survey.

PubMed

Wilunda, Calistus; Massawe, Siriel; Jackson, Caroline

2013-12-01

To identify determinants of moderate-to-severe anaemia among women of reproductive age in Tanzania. We included participants from the 2010 Tanzania Demographic and Health Survey, which collected data on socio-demographic and maternal health and determined haemoglobin levels from blood samples. We performed logistic regression to calculate adjusted odds ratios for associations between socio-demographic, contextual, reproductive and lifestyle factors, and moderate-to-severe anaemia and investigated interactions between certain risk factors. Of 9477 women, 20.1% were anaemic. Pregnancy was significantly associated with anaemia (adjusted OR 1.75, 95% CI 1.43-2.15), but the effect varied significantly by urban/rural residence, wealth and education. The effect of pregnancy was stronger in women without education and those who were in lower wealth groups, with significant interactions observed for each of these factors. Education was associated with a lower anaemia risk, particularly in the poorest group (OR 0.58, 95% CI 0.43-0.80), and in pregnant women. The risk of anaemia fell with rising iron supplementation coverage. Lack of toilet facilities increased anaemia risk (OR 1.26, 95% CI 1.00-1.60), whereas using hormonal contraception reduced it. There was no association with age, urban/rural residence, wealth or type of cooking fuel in adjusted analysis. Pregnant women in Tanzania are particularly at risk of moderate-to-severe anaemia, with the effect modified by urban/rural residence, education and wealth. Prevention interventions should target women with lower education or without proper sanitation facilities, and women who are pregnant, particularly if they are uneducated or in lower wealth groups. © 2013 John Wiley & Sons Ltd.

Reforms: a quest for efficiency or an opportunity for vested interests'? A case study of pharmaceutical policy reforms in Tanzania.

PubMed

Mori, Amani Thomas; Kaale, Eliangiringa Amos; Risha, Peter

2013-07-13

Regulation of the pharmaceutical sector is a challenging task for most governments in the developing countries. In Tanzania, this task falls under the Food and Drugs Authority and the Pharmacy Council. In 2010, the Pharmacy Council spearheaded policy reforms in the pharmaceutical sector aimed at taking over the control of the regulation of the business of pharmacy from the Tanzania Food and Drugs Authority. This study provides a critical analysis of these reforms. The study employed a qualitative case-study design. Data was collected through in-depth interviews, focus group discussions and document reviews. Data was analyzed thematically using a policy triangle framework. The analysis was done manually. The reforms adopted an incremental model of public policy-making and the process was characterized by lobbying for political support, negotiations and bargaining between the interest groups. These negotiations were largely centred on vested interests and not on the impact of the reforms on the efficiency of pharmaceutical regulations in the country. Stakeholders from the micro and meso levels were minimally involved in the policy reforms. Recent pharmaceutical regulation reforms in Tanzania were overshadowed by vested interests, displacing a critical analysis of optimal policy options that have the potential to increase efficiency in the regulation of the business of pharmacy. Politics influenced decision-making at different levels of the reform process.

Healthcare Cost of Smoking Induced Cardiovascular Disease in Tanzania.

PubMed

Kidane, Asmerom; Hepelwa, Aloyce; Ngeh, Ernest Tingum; Hu, Teh-Wei

2015-01-01

The study presented here estimates the total health care cost attributable to smoking induced cardiovascular disease in Tanzania. The study based on a survey conducted at a referral university hospital in Dar es Salaam in 2014. Assuming a 2% prevalence rate of cardiovascular disease and a population of 47.2 million, it was estimated that there are 943,800 cardiovascular patients in Tanzania. The proportion of ever smokers among the surveyed patients was found to be 25 percent yielding 240,400 patients who suffer from smoking induced cardiovascular diseases. Per capita annual expenditure per patient is estimated to be 566.6 US dollars and total annual expenditure for the country was estimated to be 136.1 million US dollars. On a per capita basis more direct and indirect cost is incurred on males compared to females; more is spent on the elderly (40 or more years) compared to the youth (less than 20 years). When compared with the mean annual household income of the surveyed population, the smoking induced per capita expenditure constitutes 35% of household income.

Health insurance is important in improving maternal health service utilization in Tanzania-analysis of the 2011/2012 Tanzania HIV/AIDS and malaria indicator survey.

PubMed

Kibusi, Stephen M; Sunguya, Bruno Fokas; Kimunai, Eunice; Hines, Courtney S

2018-02-13

Maternal mortality rates vary significantly from region to region. Interventions such as early and planned antenatal care attendance and facility delivery with skilled health workers can potentially reduce maternal mortality rates. Several factors can be attributed to antenatal care attendance, or lack thereof, including the cost of health care services. The aim of this study was to examine the role of health insurance coverage in utilization of maternal health services in Tanzania. Secondary data analysis was conducted on the nationally representative sample of men and women aged 15-49 years using the 2011/12 Tanzania HIV and Malaria Indicator Survey. It included 4513 women who had one or more live births within three years before the survey. The independent variable was health insurance coverage. Outcome variables included proper timing of the first antenatal care visit, completing the recommended number of antenatal care (ANC) visits, and giving birth under skilled worker. Data were analyzed both descriptively and using regression analyses to examine independent association of health insurance and maternal health services. Of 4513 women, only 281 (6.2%) had health insurance. Among all participants, only 16.9%, 7.1%, and 56.5%, respectively, made their first ANC visit as per recommendation, completed the recommended number of ANC visits, and had skilled birth assistance at delivery. A higher proportion of women with health insurance had a proper timing of 1st ANC attendance compared to their counterparts (27.0% vs. 16.0%, p < 0.001). Similar trend was for skilled birth attendance (77.6% vs. 55.1%, p < 0.001). After adjusting for other confounders and covariates, having health insurance was associated with proper timing of 1st ANC attendance (AOR = 1.89, p < 0.001) and skilled birth attendance (AOR = 2.01, p < 0.01). Health insurance coverage and maternal health services were low in this nationally representative sample in Tanzania. Women

The use of social media among adolescents in Dar es Salaam and Mtwara, Tanzania.

PubMed

Pfeiffer, Constanze; Kleeb, Matthis; Mbelwa, Alice; Ahorlu, Collins

2014-05-01

Social media form part of the rapid worldwide digital development that is re-shaping the life of many young people. While the use of social media by youths is increasingly researched in the North, studies about youth in the South are missing. It therefore remains unclear how social media can be included in interventions that aim at informing young people in many countries of the global South about sexual and reproductive health. This paper presents findings of a mixed-methods study of young people's user behaviour on the internet and specifically of social media as a platform for sexual health promotion in Tanzania. The study used questionnaires with 60 adolescents and in-depth interviews with eight students aged 15 to 19 years in Dar es Salaam, and in Mtwara, Southern Tanzania. Findings show that youth in Dar es Salaam and Mtwara access the internet mainly through mobile phones. Facebook is by far the most popular internet site. Adolescents highlighted their interest in reproductive and sexual health messages and updates being delivered through humorous posts, links and clips, as well as by youth role models like music stars and actors that are entertaining and reflect up-to-date trends of modern youth culture. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Establishing an Anaesthesia and Intensive Care partnership and aiming for national impact in Tanzania.

PubMed

Ulisubisya, Mpoki; Jörnvall, Henrik; Irestedt, Lars; Baker, Tim

2016-03-18

Anaesthesia and Intensive Care is a neglected specialty in low-income countries. There is an acute shortage of health workers - several low-income countries have less than 1 anaesthesia provider per 100,000 population. Only 1.5% of hospitals in Africa have the intensive care resources needed for managing patients with sepsis. Health partnerships between institutions in high and low-income countries have been proposed as an effective way to strengthen health systems. The aim of this article is to describe the origin and conduct of a health partnership in Anaesthesia and Intensive Care between institutions in Tanzania and Sweden and how the partnership has expanded to have an impact at regional and national levels.The Muhimbili-Karolinska Anaesthesia and Intensive Care Collaboration was initiated in 2008 on the request of the Executive Director of Muhimbili National Hospital in Dar es Salaam. The partnership has conducted training courses, exchanges, research projects and introduced new equipment, routines and guidelines. The partnership has expanded to include all hospitals in Dar es Salaam. Through the newly formed Life Support Foundation, the partnership has had a national impact assisting the reanimation of the Society of Anaesthesiologists of Tanzania and has seen a marked increase of the number of young doctors choosing a residency in Anaesthesia and Intensive Care.

Contextualized IT Education in Tanzania: Beyond Standard IT Curricula

ERIC Educational Resources Information Center

Tedre, Matti; Bangu, Nicholas; Nyagava, Seth I.

2009-01-01

Tumaini University at Iringa, Tanzania, started a new B.Sc. program in IT in 2007. In the course of planning and implementation of the program, we found out that standard ACM/IEEE IT curricula are not adequate for an IT program in a poor, developing country. The standard curricula describe, in detail, the competences that IT specialists in…

Literacy and Power--The Cases of Tanzania and Rwanda

ERIC Educational Resources Information Center

Wedin, Asa

2008-01-01

In this paper it is claimed that the relation between literacy and power is complex. What people do with literacy has effects on power relations but literacy is not democratic "per se". Drawing from two cases from Tanzania and Rwanda it is argued that plans for adult education and literacy education should consider the perspectives of…

Sexual practices among unmarried adolescents in Tanzania.

PubMed

Kazaura, Method R; Masatu, Melkiory C

2009-10-06

Sexual activities are increasingly changing from the cultural point of view what they used to be. Knowledge of these practices among adolescents may be a basis to create awareness among adolescents on practices that involve risks. This study aims to assess sexual practices among unmarried adolescents in Tanzania. A cross-sectional survey was conducted among in-school and out-of-school but unmarried adolescents aged 10 to 19 in five locations in Tanzania. A questionnaire was used to collect information and to characterize sexual practices among these adolescents. About 32% of adolescents reported being sexually active; a higher proportion being males than females. The only inquired and reported sexual practices include vaginal sex, masturbation, oral and anal sex. About 15% of sexually active adolescents reported having multiple sexual partners. Significantly more males reported having multiple partners than females. Nearly 42% of sexually active adolescents reported having used a condom during most recent sexual act. Females reported older partners at first sexual act. Adolescents experience several sexual practices that include penetrative and non-penetrative. More males reported being sexually active than females. Despite adolescents reporting having multiple sexual partners, reported condom use during the most recent sexual act was low. We advocate for a more enhanced approach of reproductive health education that includes safer sex to adolescents without forgetting those in-schools.

Increasing the availability and quality of caesarean section in Tanzania.

PubMed

Nyamtema, A; Mwakatundu, N; Dominico, S; Mohamed, H; Shayo, A; Rumanyika, R; Kairuki, C; Nzabuhakwa, C; Issa, O; Lyimo, C; Kasiga, I; van Roosmalen, J

2016-09-01

To describe the results of increasing availability and quality of caesarean deliveries and anaesthesia in rural Tanzania. Before-after intervention study design. Rural Tanzania. Ten health centres located in rural areas were upgraded to provide comprehensive emergency obstetric care (CEmOC) and the four related district hospitals were supported. Upgrading entailed constructing and equipping maternity blocks, operation rooms and laboratories; installing solar systems, backup generators and water supply systems. Associate clinicians were trained in anaesthesia and in CEmOC. Mentoring and audit of reasons for caesarean section (CS) and maternal deaths were carried out. Measures of interest were compared using analysis of variance (ANOVA) statistical tests. Trends in CS rates, proportion of unjustified CS, use of spinal anaesthesia, and the risk of death from complications related to CS and anaesthesia. During the audit period (2012-2014), 5868 of 58 751 deliveries were by CS (10%). The proportion of CS considered to be unjustified decreased from 30 to 17% in health centres (P = 0.02) and from 37 to 20% in hospitals (P < 0.001). Practice of spinal anaesthesia for CS increased from 10% to 64% in hospitals (P < 0.001). Of 110 maternal deaths, 18 (16.4%) were associated with complications of CS, giving a risk of 3.1 per 1000 CS; three (2.7%) were judged to be anaesthetic-associated deaths with a risk of 0.5 per 1000 caesarean deliveries. Increasing availability and quality of CS by improving infrastructure, training and audit of reasons for CS is feasible, acceptable and required in low resource settings. Increasing availability and quality of CS in rural Africa is feasible. © 2016 Royal College of Obstetricians and Gynaecologists.

Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania.

PubMed

Beyanga, Medard; Kidenya, Benson R; Gerwing-Adima, Lisa; Ochodo, Eleanor; Mshana, Stephen E; Kasang, Christa

2018-03-06

Tuberculosis (TB) contact tracing is a key strategy for containing TB and provides addition to the passive case finding approach. However, this practice has not been implemented in Tanzania, where there is unacceptably high treatment gap of 62.1% between cases estimated and cases detected. Therefore calls for more aggressive case finding for TB to close this gap. We aimed to determine the magnitude and predictors of bacteriologically-confirmed pulmonary TB among household contacts of bacteriologically-confirmed pulmonary TB index cases in the city of Mwanza, Tanzania. This study was carried out from August to December 2016 in Mwanza city at the TB outpatient clinics of Tertiary Hospital of the Bugando Medical Centre, Sekou-Toure Regional Hospital, and Nyamagana District Hospital. Bacteriologically-confirmed TB index cases diagnosed between May and July 2016 were identified from the laboratory registers book. Contacts were traced by home visits by study TB nurses, and data were collected using a standardized TB screening questionnaire. To detect the bacterioriologically-confirmed pulmonary TB, two sputum samples per household contact were collected under supervision for all household contacts following standard operating procedures. Samples were transported to the Bugando Medical Centre TB laboratory for investigation for TB using fluorescent smear microscopy, GeneXpert MTB/RIF and Löwenstein-Jensen (LJ) culture. Logistic regression was used to determine predictors of bacteriologically-confirmed pulmonary TB among household contacts. During the study period, 456 household contacts from 93 TB index cases were identified. Among these 456 household contacts, 13 (2.9%) were GeneXpert MTB/RIF positive, 18 (3.9%) were MTB-culture positive and four (0.9%) were AFB-smear positive. Overall, 29 (6.4%) of contacts had bacteriologically-confirmed pulmonary TB. Predictors of bacteriologically-confirmed pulmonary TB among household contacts were7being married (Odds ratio [OR

Prevalence and risk factors associated with female anal sex in the context of HIV/AIDS in the selected districts of Tanzania.

PubMed

Shayo, Elizabeth H; Kalinga, Akili A; Senkoro, Kesheni P; Msovela, Judith; Mgina, Erick J; Shija, Angela E; Materu, Godlisten; Kilima, Stella P; Mboera, Leonard E G; Massaga, Julius J

2017-03-27

Female anal sex is a receptive type of sexual practice among heterosexual couples where the penis is inserted into the anus of a female partner. In the Western world, a number of studies and interventions have been carried out on anal sex among men due to its potential risks to HIV transmission. In African countries, including Tanzania, there is dearth of information on the risks inherent in practices associated with female anal sex in the general population. The objective of this study was to determine the prevalence and risk factors associated with female anal sex in fuelling HIV transmission in selected districts of Tanzania. This study was conducted in four districts of Tanzania of Kinondoni, Tanga Urban, Makete and Siha. Both quantitative and qualitative methods i.e. household interviews and focus group discussions were employed in data collection. Study participants included community members of aged 15 and above such as heads of the household, adolescents, bar workers and commercial sex workers. A total of 903 individuals were interviewed, 60.6% of whom were females. When respondents were asked to indicate whether they had ever been tempted to practise FAS, 167 (18.5%) reported to have been tempted in the past 12 months. Of these, 44 (26.3%) respondents had at least practised FAS. Risky practices associated with FAS were forced sex, multiple partners, frequency of engaging in FAS, low use of condoms during FAS, low rates of HIV testing among partakers, poor perception of the risks to acquire HIV through FAS and use of lubricants. In this population, the frequency of FAS practice was rather low. And yet, FAS practice attendant risk factors are likely to exacerbate HIV transmission. As such, there is a need for further exploratory studies to determine and document drivers of FAS. In addition, public health education should be provided with regard to the risks of contracting HIV associated with FAS practices.

Smallholder Information Sources and Communication Pathways for Cashew Production and Marketing in Tanzania: An Ex-Post Study in Tandahimba and Lindi Rural Districts, Southern Tanzania

ERIC Educational Resources Information Center

Nyambo, Brigitte; Ligate, Elly

2013-01-01

Purpose: To identify and review production and marketing information sources and flows for smallholder cashew (Anacardium occidentale L.) growers in Tanzania and recommend systems improvements for better technology uptake. Design/methodology/approach: Two-stage purposive samples were drawn. First, two districts in the main cashew producing areas,…

Community validation of the IDEA study cognitive screen in rural Tanzania.

PubMed

Gray, William K; Paddick, Stella Maria; Collingwood, Cecilia; Kisoli, Aloyce; Mbowe, Godfrey; Mkenda, Sarah; Lissu, Carolyn; Rogathi, Jane; Kissima, John; Walker, Richard W; Mushi, Declare; Chaote, Paul; Ogunniyi, Adesola; Dotchin, Catherine L

2016-11-01

The dementia diagnosis gap in sub-Saharan Africa (SSA) is large, partly because of difficulties in screening for cognitive impairment in the community. As part of the Identification and Intervention for Dementia in Elderly Africans (IDEA) study, we aimed to validate the IDEA cognitive screen in a community-based sample in rural Tanzania METHODS: Study participants were recruited from people who attended screening days held in villages within the rural Hai district of Tanzania. Criterion validity was assessed against the gold standard clinical dementia diagnosis using DSM-IV criteria. Construct validity was assessed against, age, education, sex and grip strength and instrumental activities of daily living (IADLs). Internal consistency and floor and ceiling effects were also examined. During community screening, the IDEA cognitive screen had high criterion validity, with an area under the receiver operating characteristic curve of 0.855 (95% CI 0.794 to 0.915). Higher scores on the screen were significantly correlated with lower age, male sex, having attended school, better grip strength and improved performance in activities of daily living. Factor analysis revealed a single factor with an eigenvalue greater than one, although internal consistency was only moderate (Cronbach's alpha = 0.534). The IDEA cognitive screen had high criterion and construct validity and is suitable for use as a cognitive screening instrument in a community setting in SSA. Only moderate internal consistency may partly reflect the multi-domain nature of dementia as diagnosed clinically. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The Burden of Rabies in Tanzania and Its Impact on Local Communities

PubMed Central

Sambo, Maganga; Cleaveland, Sarah; Ferguson, Heather; Lembo, Tiziana; Simon, Cleophas; Urassa, Honorati; Hampson, Katie

2013-01-01

Background Rabies remains a major public health threat in many parts of the world and is responsible for an estimated 55,000 human deaths annually. The burden of rabies is estimated to be around US$20 million in Africa, with the highest financial expenditure being the cost of post-exposure prophylaxis (PEP). However, these calculations may be substantial underestimates because the costs to households of coping with endemic rabies have not been investigated. We therefore aimed to estimate the household costs, health-seeking behaviour, coping strategies, and outcomes of exposure to rabies in rural and urban communities in Tanzania. Methods and Findings Extensive investigative interviews were used to estimate the incidence of human deaths and bite exposures. Questionnaires with bite victims and their families were used to investigate health-seeking behaviour and costs (medical and non-medical costs) associated with exposure to rabies. We calculated that an average patient in rural Tanzania, where most people live on less than US$1 per day, would need to spend over US$100 to complete WHO recommended PEP schedules. High costs and frequent shortages of PEP led to poor compliance with PEP regimens, delays in presentation to health facilities, and increased risk of death. Conclusion The true costs of obtaining PEP were twice as high as those previously reported from Africa and should be considered in re-evaluations of the burden of rabies. PMID:24244767

Mobile Phone Use and Human-Wildlife Conflict in Northern Tanzania

NASA Astrophysics Data System (ADS)

Lewis, Ashley L.; Baird, Timothy D.; Sorice, Michael G.

2016-07-01

Throughout the developing world, mobile phones are spreading rapidly into rural areas where subsistence livelihoods, biodiversity conservation, and human-wildlife conflict (HWC) are each common. Despite this trend, little is known about the relationship between mobile phones and HWC in conservation landscapes. This paper examines this relationship within ethnically Maasai communities in northern Tanzania on the border of Tarangire National Park. Mixed qualitative and quantitative methods of data collection and analysis are used to (1) describe how Maasai agro-pastoralists use phones to manage human-wildlife interactions; and (2) assess the relationship between phone use and measures of HWC, controlling for other factors. The findings indicate that households use phones to reduce the number and severity of HWC events and that the relationship between phones and HWC varies according to the type of HWC.

Mobile Phone Use and Human-Wildlife Conflict in Northern Tanzania.

PubMed

Lewis, Ashley L; Baird, Timothy D; Sorice, Michael G

2016-07-01

Throughout the developing world, mobile phones are spreading rapidly into rural areas where subsistence livelihoods, biodiversity conservation, and human-wildlife conflict (HWC) are each common. Despite this trend, little is known about the relationship between mobile phones and HWC in conservation landscapes. This paper examines this relationship within ethnically Maasai communities in northern Tanzania on the border of Tarangire National Park. Mixed qualitative and quantitative methods of data collection and analysis are used to (1) describe how Maasai agro-pastoralists use phones to manage human-wildlife interactions; and (2) assess the relationship between phone use and measures of HWC, controlling for other factors. The findings indicate that households use phones to reduce the number and severity of HWC events and that the relationship between phones and HWC varies according to the type of HWC.

Strengthening medical education in haematology and blood transfusion: postgraduate programmes in Tanzania.

PubMed

Makani, Julie; Lyimo, Magdalena; Magesa, Pius; Roberts, David J

2017-06-01

Haematology and blood transfusion, as a clinical and laboratory discipline, has a far-reaching impact on healthcare both through direct patient care as well as provision of laboratory and transfusion services. Improvement of haematology and blood transfusion may therefore be significant in achieving advances in health in Africa. In 2005, Tanzania had one of the lowest distributions of doctors in the world, estimated at 2·3 doctors per 100 000 of population, with only one haematologist, a medical doctor with postgraduate medical education in haematology and blood transfusion. Here, we describe the establishment and impact of a postgraduate programme centred on Master of Medicine and Master of Science programmes to build the capacity of postgraduate training in haematology and blood transfusion. The programme was delivered through Muhimbili University of Health and Allied Sciences (MUHAS) with partnership from visiting medical and laboratory staff from the UK and complemented by short-term visits of trainees from Tanzania to Haematology Departments in the UK. The programme had a significant impact on the development of human resources in haematology and blood transfusion, successfully training 17 specialists with a significant influence on delivery of health services and research. This experience shows how a self-sustaining, specialist medical education programme can be developed at low cost within Lower and Middle Income Countries (LMICs) to rapidly enhance delivery of capacity to provide specialist services. © 2017 John Wiley & Sons Ltd.

Qualitative Assessment of the Integration of HIV Services With Infant Routine Immunization Visits in Tanzania

PubMed Central

Wallace, Aaron; Kimambo, Sajida; Dafrossa, Lyimo; Rusibamayila, Neema; Rwebembera, Anath; Songoro, Juma; Arthur, Gilly; Luman, Elizabeth; Finkbeiner, Thomas; Goodson, James L.

2015-01-01

Background In 2009, a project was implemented in 8 primary health clinics throughout Tanzania to explore the feasibility of integrating pediatric HIV prevention services with routine infant immunization visits. Methods We conducted interviews with 64 conveniently sampled mothers of infants who had received integrated HIV and immunization services and 16 providers who delivered the integrated services to qualitatively identify benefits and challenges of the intervention midway through project implementation. Findings Mothers’ perceived benefits of the integrated services included time savings, opportunity to learn their child's HIV status and receive HIV treatment, if necessary. Providers’ perceived benefits included reaching mothers who usually would not come for only HIV testing. Mothers and providers reported similar challenges, including mothers’ fear of HIV testing, poor spousal support, perceived mandatory HIV testing, poor patient flow affecting confidentiality of service delivery, heavier provider workloads, and community stigma against HIV-infected persons; the latter a more frequent theme in rural compared with urban locations. Interpretation Future scale-up should ensure privacy of these integrated services received at clinics and community outreach to address stigma and perceived mandatory testing. Increasing human resources for health to address higher workloads and longer waiting times for proper patient flow is necessary in the long term. PMID:24326602

HIV-1 pol Diversity among Female Bar and Hotel Workers in Northern Tanzania

PubMed Central

Kiwelu, Ireen E.; Novitsky, Vladimir; Kituma, Elimsaada; Margolin, Lauren; Baca, Jeannie; Manongi, Rachel; Sam, Noel; Shao, John; McLane, Mary F.; Kapiga, Saidi H.; Essex, M.

2014-01-01

A national ART program was launched in Tanzania in October 2004. Due to the existence of multiple HIV-1 subtypes and recombinant viruses co-circulating in Tanzania, it is important to monitor rates of drug resistance. The present study determined the prevalence of HIV-1 drug resistance mutations among ART-naive female bar and hotel workers, a high-risk population for HIV-1 infection in Moshi, Tanzania. A partial HIV-1 pol gene was analyzed by single-genome amplification and sequencing in 45 subjects (622 pol sequences total; median number of sequences per subject, 13; IQR 5–20) in samples collected in 2005. The prevalence of HIV-1 subtypes A1, C, and D, and inter-subtype recombinant viruses, was 36%, 29%, 9% and 27%, respectively. Thirteen different recombination patterns included D/A1/D, C/A1, A1/C/A1, A1/U/A1, C/U/A1, C/A1, U/D/U, D/A1/D, A1/C, A1/C, A2/C/A2, CRF10_CD/C/CRF10_CD and CRF35_AD/A1/CRF35_AD. CRF35_AD was identified in Tanzania for the first time. All recombinant viruses in this study were unique, suggesting ongoing recombination processes among circulating HIV-1 variants. The prevalence of multiple infections in this population was 16% (n = 7). Primary HIV-1 drug resistance mutations to RT inhibitors were identified in three (7%) subjects (K65R plus Y181C; N60D; and V106M). In some subjects, polymorphisms were observed at the RT positions 41, 69, 75, 98, 101, 179, 190, and 215. Secondary mutations associated with NNRTIs were observed at the RT positions 90 (7%) and 138 (6%). In the protease gene, three subjects (7%) had M46I/L mutations. All subjects in this study had HIV-1 subtype-specific natural polymorphisms at positions 36, 69, 89 and 93 that are associated with drug resistance in HIV-1 subtype B. These results suggested that HIV-1 drug resistance mutations and natural polymorphisms existed in this population before the initiation of the national ART program. With increasing use of ARV, these results highlight the importance of drug

HIV-1 pol diversity among female bar and hotel workers in Northern Tanzania.

PubMed

Kiwelu, Ireen E; Novitsky, Vladimir; Kituma, Elimsaada; Margolin, Lauren; Baca, Jeannie; Manongi, Rachel; Sam, Noel; Shao, John; McLane, Mary F; Kapiga, Saidi H; Essex, M

2014-01-01

A national ART program was launched in Tanzania in October 2004. Due to the existence of multiple HIV-1 subtypes and recombinant viruses co-circulating in Tanzania, it is important to monitor rates of drug resistance. The present study determined the prevalence of HIV-1 drug resistance mutations among ART-naive female bar and hotel workers, a high-risk population for HIV-1 infection in Moshi, Tanzania. A partial HIV-1 pol gene was analyzed by single-genome amplification and sequencing in 45 subjects (622 pol sequences total; median number of sequences per subject, 13; IQR 5-20) in samples collected in 2005. The prevalence of HIV-1 subtypes A1, C, and D, and inter-subtype recombinant viruses, was 36%, 29%, 9% and 27%, respectively. Thirteen different recombination patterns included D/A1/D, C/A1, A1/C/A1, A1/U/A1, C/U/A1, C/A1, U/D/U, D/A1/D, A1/C, A1/C, A2/C/A2, CRF10_CD/C/CRF10_CD and CRF35_AD/A1/CRF35_AD. CRF35_AD was identified in Tanzania for the first time. All recombinant viruses in this study were unique, suggesting ongoing recombination processes among circulating HIV-1 variants. The prevalence of multiple infections in this population was 16% (n = 7). Primary HIV-1 drug resistance mutations to RT inhibitors were identified in three (7%) subjects (K65R plus Y181C; N60D; and V106M). In some subjects, polymorphisms were observed at the RT positions 41, 69, 75, 98, 101, 179, 190, and 215. Secondary mutations associated with NNRTIs were observed at the RT positions 90 (7%) and 138 (6%). In the protease gene, three subjects (7%) had M46I/L mutations. All subjects in this study had HIV-1 subtype-specific natural polymorphisms at positions 36, 69, 89 and 93 that are associated with drug resistance in HIV-1 subtype B. These results suggested that HIV-1 drug resistance mutations and natural polymorphisms existed in this population before the initiation of the national ART program. With increasing use of ARV, these results highlight the importance of drug

Validation of the Identification and Intervention for Dementia in Elderly Africans (IDEA) cognitive screen in Nigeria and Tanzania.

PubMed

Paddick, Stella-Maria; Gray, William K; Ogunjimi, Luqman; Lwezuala, Bingileki; Olakehinde, Olaide; Kisoli, Aloyce; Kissima, John; Mbowe, Godfrey; Mkenda, Sarah; Dotchin, Catherine L; Walker, Richard W; Mushi, Declare; Collingwood, Cecilia; Ogunniyi, Adesola

2015-04-25

We have previously described the development of the Identification and Intervention for Dementia in Elderly Africans (IDEA) cognitive screen for use in populations with low levels of formal education. The IDEA cognitive screen was developed and field-tested in an elderly, community-based population in rural Tanzania with a relatively high prevalence of cognitive impairment. The aim of this study was to validate the IDEA cognitive screen as an assessment of major cognitive impairment in hospital settings in Nigeria and Tanzania. In Nigeria, 121 consecutive elderly medical clinic outpatients reviewed at the University College Hospital, Ibadan were screened using the IDEA cognitive screen. In Tanzania, 97 consecutive inpatients admitted to Mawenzi Regional Hospital (MRH), Moshi, and 108 consecutive medical clinic outpatients attending the geriatric medicine clinic at MRH were screened. Inter-rater reliability was assessed in Tanzanian outpatients attending St Joseph's Hospital in Moshi using three raters. A diagnosis of dementia or delirium (DSM-IV criteria) was classified as major cognitive impairment and was provided independently by a physician blinded to the results of the screening assessment. The area under the receiver operating characteristic (AUROC) curve in Nigerian outpatients, Tanzanian outpatients and Tanzanian inpatients was 0.990, 0.919 and 0.917 respectively. Inter-rater reliability was good (intra-class correlation coefficient 0.742 to 0.791). In regression models, the cognitive screen did not appear to be educationally biased. The IDEA cognitive screen performed well in these populations and should prove useful in screening for dementia and delirium in other areas of sub-Saharan Africa.

Knowledge of obstetric danger signs among recently-delivered women in Chamwino district, Tanzania: a cross-sectional study.

PubMed

Bintabara, Deogratius; Mpembeni, Rose N M; Mohamed, Ahmed Abade

2017-08-29

Low knowledge of danger signs has been shown to delay seeking obstetric care which leads to high maternal mortality and morbidity worldwide. In Tanzania about half of pregnant women are informed about obstetric danger signs during antenatal care, but the proportion of those who have full knowledge of these obstetric danger signs is not known. This study assessed the knowledge of obstetric danger signs and its associated factors among recently-delivered women in Chamwino District, Tanzania. A community-based cross-sectional study was conducted in January 2014 in Chamwino District, Tanzania. A woman was considered knowledgeable if she spontaneously mentioned at least five danger signs in any of the three phases of childbirth (pregnancy, childbirth and postpartum) with at least one in each phase. Multistage cluster sampling was used to recruit study participants. Descriptive and bivariate analyses were conducted. Multivariable logistic regression analyses were performed to control for confounding and other important covariates. A total of 428 women were interviewed. The median age (IQR) was 26.5 (22-33) years. Only 25.2% of respondents were knowledgeable about obstetric danger signs during pregnancy, childbirth/labour and postpartum. Significant explanatory variables of being knowledgeable about obstetric danger signs were found to be maternal education (AOR = 1.96; 95% CI: 1.01, 3.82), maternal occupation (AOR = 2.23; 95% CI; 1.10, 4.52), spouse occupation (AOR = 2.10; 95% CI: 1.02, 4.32) and counseling on danger signs (AOR = 3.42; 95% CI: 1.36, 8.62) after controlling for the clustering effect, confounding and important covariates. A low proportion of women was found to be knowledgeable about obstetric danger signs in Chamwino district. Therefore, we recommend the Ministry of Health to design and distribute the maternal health booklets that highlight the obstetric danger signs, and encourage antenatal care providers and community health workers to provide frequent

The Implementation of Curricular Reform: Tanzania and Papua New Guinea.

ERIC Educational Resources Information Center

Saunders, Murray; Vulliamy, Graham

1983-01-01

Discusses the origins and policy characteristics of the Education for Self Reliance project in Tanzania and the Secondary Schools Community Extension Project in Papua New Guinea. Compares the sociopolitical climate, the policy characteristics, the role of academic assessment, policy change, and examples of the existing policy in the two countries.…

Adult Education in Tanzania: Life-Long Process for National Development.

ERIC Educational Resources Information Center

Mbunda, Daniel

For Tanzanians, education to be meaningful implies human development through education. Tanzania's commitment to build a socialist state, based on traditional African socialism, is also a commitment to socialist education, the necessary tool for social development. Since work is a lifelong duty for any socialist, work-oriented education is also a…

National and Global: A History of Scholars' Experiences with Research at the University of Dar Es Salaam, Tanzania (1961-Present)

ERIC Educational Resources Information Center

Jamison, Amy J.

2010-01-01

In this dissertation, I draw on research carried out at the University of Dar es Salaam (UDSM), Tanzania in 2008 to examine Tanzanian academics' experience with research throughout the history of this institution. This dissertation is designed as an historical case study and investigates how economic and political changes in Tanzania's…

Intimate partner violence (IPV): The validity of an IPV screening instrument utilized among pregnant women in Tanzania and Vietnam

PubMed Central

Rasch, Vibeke; Van, Toan Ngo; Nguyen, Hanh Thi Thuy; Manongi, Rachel; Mushi, Declare; Meyrowitsch, Dan W.; Gammeltoft, Tine; Wu, Chun Sen

2018-01-01

Background Intimate partner violence (IPV) is a global problem that affects one-third of all women. The present study aims to develop and determine the validity of a screening instrument for the detection of IPV in pregnant women in Tanzania and Vietnam and to determine the minimum number of questions needed to identify IPV. Method An IPV screening instrument based on eight questions was tested on 1,116 Tanzanian and 1,309 Vietnamese women who attended antenatal care before 24 gestational weeks. The women were re-interviewed during their 30th-34th gestational week where the World Health Organization (WHO) IPV questionnaire was used as the gold standard. In all, 255 combinations of eight different questions were first tested on the Tanzanian study population where sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. In the evaluation of the performance of the question combinations, different IPV types and the frequency of abusive acts were considered. The question combinations that performed best in Tanzania were subsequently evaluated in the Vietnamese study population. Results In Tanzania, a combination of three selected questions including one question on emotional IPV, one on physical IPV and one on sexual IPV was found to be most effective in identifying women who are exposed to at least one type of IPV during pregnancy (sensitivity = .80; specificity = .74). The performance of the identified combination was slightly less effective in Vietnam (sensitivity = .74; specificity = .68). Focusing on different IPV types, the best performance was found for exposure to physical IPV in both Tanzania (sensitivity = .93; specificity = .70) and Vietnam (sensitivity = .96; specificity = .55). In both countries, the sensitivity increased with the frequency of abuse whereas the specificity decreased. Conclusion By asking pregnant women three simple questions we were able to identify women who were exposed to IPV during

Malignant lymphomas (ML) and HIV infection in Tanzania

PubMed Central

2008-01-01

Background HIV infection is reported to be associated with some malignant lymphomas (ML) so called AIDS-related lymphomas (ARL), with an aggressive behavior and poor prognosis. The ML frequency, pathogenicity, clinical patterns and possible association with AIDS in Tanzania, are not well documented impeding the development of preventive and therapeutic strategies. Methods Sections of 176 archival formalin-fixed paraffin-embedded biopsies of ML patients at Muhimbili National Hospital (MNH)/Muhimbili University of Health and Allied Sciences (MUHAS), Tanzania from 1996–2001 were stained for hematoxylin and eosin and selected (70) cases for expression of pan-leucocytic (CD45), B-cell (CD20), T-cell (CD3), Hodgkin/RS cell (CD30), histiocyte (CD68) and proliferation (Ki-67) antigen markers. Corresponding clinical records were also evaluated. Available sera from 38 ML patients were screened (ELISA) for HIV antibodies. Results The proportion of ML out of all diagnosed tumors at MNH during the 6 year period was 4.2% (176/4200) comprising 77.84% non-Hodgkin (NHL) including 19.32% Burkitt's (BL) and 22.16% Hodgkin's disease (HD). The ML tumors frequency increased from 0.42% (1997) to 0.70% (2001) and 23.7% of tested sera from these patients were HIV positive. The mean age for all ML was 30, age-range 3–91 and peak age was 1–20 years. The male:female ratio was 1.8:1. Supra-diaphragmatic presentation was commonest and histological sub-types were mostly aggressive B-cell lymphomas however, no clear cases of primary effusion lymphoma (PEL) and primary central nervous system lymphoma (PCNSL) were diagnosed. Conclusion Malignant lymphomas apparently, increased significantly among diagnosed tumors at MNH between 1996 and 2001, predominantly among the young, HIV infected and AIDS patients. The frequent aggressive clinical and histological presentation as well as the dominant B-immunophenotype and the HIV serology indicate a pathogenic association with AIDS. Therefore, routine

Towards the Social and Economic Promotion of Rural Women in Tanzania

ERIC Educational Resources Information Center

Kokuhirwa, Hilda

1975-01-01

The report describes the changing image of women in rural Tanzania and the various agencies responsible for their social, economic, cultural, and political promotion in rural areas, including the Tanganyika African National Union (TANU), and the Union of Women in Tanganyika (UWT). (LH)

Myopia in secondary school students in Mwanza City, Tanzania: the need for a national screening programme

PubMed Central

Wedner, S H; Ross, D A; Todd, J; Anemona, A; Balira, R; Foster, A

2002-01-01

Background/aims: The prevalence of significant refractive errors and other eye diseases was measured in 2511 secondary school students aged 11–27 years in Mwanza City, Tanzania. Risk factors for myopia were explored. Methods: A questionnaire assessed the students’ socioeconomic background and exposure to near work followed by visual acuity assessment and a full eye examination. Non-cycloplegic objective and subjective refraction was done on all participants with visual acuity of worse than 6/12 in either eye without an obvious cause. Results: 154 (6.1%) students had significant refractive errors. Myopia was the leading refractive error (5.6%). Amblyopia (0.4%), strabismus (0.2%), and other treatable eye disorders were uncommon. Only 30.3% of students with significant refractive errors wore spectacles before the survey. Age, sex, ethnicity, father’s educational status, and a family history of siblings with spectacles were significant independent risk factors for myopia. Conclusion: The prevalence of uncorrected significant refractive errors is high enough to justify a regular school eye screening programme in secondary schools in Tanzania. Risk factors for myopia are similar to those reported in European, North-American, and Asian populations. PMID:12386067

Introducing vouchers for malaria prevention in Ghana and Tanzania: context and adoption of innovation in health systems.

PubMed

de Savigny, Don; Webster, Jayne; Agyepong, Irene Akua; Mwita, Alex; Bart-Plange, Constance; Baffoe-Wilmot, Aba; Koenker, Hannah; Kramer, Karen; Brown, Nick; Lengeler, Christian

2012-10-01

There are striking similarities in health system and other contexts between Tanzania and Ghana that are relevant to the scaling up of continuous delivery of insecticide treated nets (ITNs) for malaria prevention. However, specific contextual factors of relevance to ITN delivery have led implementation down very different pathways in the two countries. Both countries have made major efforts and investments to address this intervention through integrating consumer discount vouchers into the health system. Discount vouchers require arrangements among the public, private and non-governmental sectors and constitute a complex intervention in both health systems and business systems. In Tanzania, vouchers have moved beyond the planning agenda, had policies and programmes formulated, been sustained in implementation at national scale for many years and have become as of 2012 the main and only publicly supported continuous delivery system for ITNs. In Ghana national-scale implementation of vouchers never progressed beyond consideration on the agenda and piloting towards formulation of policy; and the approach was replaced by mass distribution campaigns with less dependency on or integration with the health system. By 2011, Ghana entered a phase with no publicly supported continuous delivery system for ITNs. To understand the different outcomes, we compared the voucher programme timelines, phases, processes and contexts in both countries in reference to the main health system building blocks (governance, human resources, financing, informatics, technologies and service delivery). Contextual factors which provided an enabling environment for the voucher scheme in Tanzania did not do so in Ghana. The voucher scheme was never seen as an appropriate national strategy, other delivery systems were not complementary and the private sector was under-developed. The extensive time devoted to engagement and consensus building among all stakeholders in Tanzania was an important and

Factors Contributing to the Accumulation of Primary Teacher's Debts to the Government of Tanzania: A Case Study for Dar Es Salaam Region

ERIC Educational Resources Information Center

Kombo, Ibun

2015-01-01

This paper presents the findings of the study which was conducted to determine factors contributing to the accumulation of primary school teacher's debts to the Government of Tanzania, a case study of Dar es Salaam Region in its three municipalities namely, Ilala, Kinondoni and Temeke. Data was obtained through sampling method which also helped to…

The Influence of Community Members on Participation by Youth in an HIV Vaccine Trial in Tanzania

PubMed Central

Mbunda, Theodora; Tarimo, Edith A. M.; Bakari, Muhammad; Sandström, Eric; Kulane, Asli

2016-01-01

In sub-Saharan Africa, the burden of HIV is high among young people and it is of the utmost importance that they be recruited into vaccination trials. Since community members influence the willingness of young people to participate in the vaccination trials, ascertaining their opinions is essential to overcoming barriers to such participation. Here, in seven focus group discussions we explored the views of 44 community members identified as someone they felt close by youth in Tanzania. The transcripts of these discussions were examined using content analysis. Our participants expressed that community members would be directly involved in the decisions of young people about whether or not to participate in an HIV vaccine trial. In general, they felt that community members would provide social support for youth during the trial and perceived that youth might have misconceptions concerning the vaccine and trial process. The participants pointed out structural factors such as substance use, poverty, stigma and unemployment that are barriers to participation. In conclusion, involvement of community members could be an integral part of the recruitment and retention of young people in HIV vaccine trials in Tanzania. PMID:27997617

Etiologies of Autism in a Case-Series from Tanzania

ERIC Educational Resources Information Center

Mankoski, Raymond E.; Collins, Martha; Ndosi, Noah K.; Mgalla, Ella H.; Sarwatt, Veronica V.; Folstein, Susan E.

2006-01-01

Most autism has a genetic cause although post-encephalitis cases are reported. In a case-series (N = 20) from Tanzania, 14 met research criteria for autism. Three (M:F = 1:2) had normal development to age 22, 35, and 42 months, with onset of autism upon recovery from severe malaria, attended by prolonged high fever, convulsions, and in one case…

Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular diseases in Tanzania

PubMed Central

Ngalesoni, Frida; Ruhago, George; Mayige, Mary; Oliveira, Tiago Cravo; Robberstad, Bjarne; Norheim, Ole Frithjof; Higashi, Hideki

2017-01-01

Background Tobacco consumption contributes significantly to the global burden of disease. The prevalence of smoking is estimated to be increasing in many low-income countries, including Tanzania, especially among women and youth. Even so, the implementation of tobacco control measures has been discouraging in the country. Efforts to foster investment in tobacco control are hindered by lack of evidence on what works and at what cost. Aims We aim to estimate the cost and cost-effectiveness of population-based tobacco control strategies in the prevention of cardiovascular diseases (CVD) in Tanzania. Materials and methods A cost-effectiveness analysis was performed using an Excel-based Markov model, from a governmental perspective. We employed an ingredient approach and step-down methodologies in the costing exercise following a government perspective. Epidemiological data and efficacy inputs were derived from the literature. We used disability-adjusted life years (DALYs) averted as the outcome measure. A probabilistic sensitivity analysis was carried out with Ersatz to incorporate uncertainties in the model parameters. Results Our model results showed that all five tobacco control strategies were very cost-effective since they fell below the ceiling ratio of one GDP per capita suggested by the WHO. Increase in tobacco taxes was the most cost-effective strategy, while a workplace smoking ban was the least cost-effective option, with a cost-effectiveness ratio of US$5 and US$267, respectively. Conclusions Even though all five interventions are deemed very cost-effective in the prevention of CVD in Tanzania, more research on budget impact analysis is required to further assess the government’s ability to implement these interventions. PMID:28767722

Understanding the strategies employed to cope with increased numbers of AIDS-orphaned children in families in rural settings: a case of Mbeya Rural District, Tanzania.

PubMed

Fauk, Nelsensius Klau; Mwakinyali, Silivano Edson; Putra, Sukma; Mwanri, Lillian

2017-02-07

The purpose of this study was to understand the strategies employed by families that adopt Acquired Immune Deficiency Syndrome (AIDS)-orphaned children (Adoptive families) for coping with and mitigating the impact of AIDS in Mbeya Rural District, Tanzania. High numbers of AIDS-orphaned children aged below 18 years in Mbeya Region have led to increasing the burden of families caring for them. Understanding the coping strategies and impact mitigation activities employed by adoptive families is important in order to develop programmes to help them. This study employed a qualitative method for data collection (one-on-one in-depth interviews). The respondents included 12 male and 8 female heads of families that provide essential care for AIDS-orphaned children in Mbeya Rural District in Tanzania. The framework approach was used to analyse the data that were collected from 15 July to 15 August 2010. The study findings revealed that adoptive families faced several challenges including financial constraints due to increased needs for basic essentials such as health care expenses, school fees and food. Further impacts on adoptive families included shortage of work opportunities and limited time to address these challenges. To mitigate these challenges, adoptive families employed a range of coping strategies including selling family assets and renting out parts of cultivable land for extra cash. Task reallocation which involved the AIDS-orphaned children entering the labour force was also employed as a strategy to mitigate challenges and involved de-enrolling of children from schools so they could take part in income-generating activities in order to earn supplementary family income. The creation of additional income-generating activities such as poultry farming were other coping mechanisms employed, and these received support from both non-governmental organisations (NGOs) and governmental organisations, including the Isangati Agricultural Development Organization (local

CONCENTRATION AND DRUG PRICES IN THE RETAIL MARKET FOR MALARIA TREATMENT IN RURAL TANZANIA

PubMed Central

GOODMAN, CATHERINE; KACHUR, S. PATRICK; ABDULLA, SALIM; BLOLAND, PETER; MILLS, ANNE

2009-01-01

SUMMARY The impact of market concentration has been little studied in markets for ambulatory care in the developing world, where the retail sector often accounts for a high proportion of treatments. This study begins to address this gap through an analysis of the consumer market for malaria treatment in rural areas of three districts in Tanzania. We developed methods for investigating market definition, sales volumes and concentration, and used these to explore the relationship between antimalarial retail prices and competition. The market was strongly geographically segmented and highly concentrated in terms of antimalarial sales. Antimalarial prices were positively associated with market concentration. High antimalarial prices were likely to be an important factor in the low proportion of care seekers obtaining appropriate treatment. Retail sector distribution of subsidised antimalarials has been proposed to increase the coverage of effective treatment, but this analysis indicates that local market power may prevent such subsidies from being passed on to rural customers. Policymakers should consider the potential to maintain lower retail prices by decreasing concentration among antimalarial providers and recommending retail price levels. PMID:19301420

Induced abortion, pregnancy loss and intimate partner violence in Tanzania: a population based study

PubMed Central

2012-01-01

Background Violence by an intimate partner is increasingly recognized as an important public and reproductive health issue. The aim of this study is to investigate the extent to which physical and/or sexual intimate partner violence is associated with induced abortion and pregnancy loss from other causes and to compare this with other, more commonly recognized explanatory factors. Methods This study analyzes the data of the Tanzania section of the WHO Multi-Country Study on Women's Health and Domestic Violence, a large population-based cross-sectional survey of women of reproductive age in Dar es Salaam and Mbeya, Tanzania, conducted from 2001 to 2002. All women who answered positively to at least one of the questions about specific acts of physical or sexual violence committed by a partner towards her at any point in her life were considered to have experienced intimate partner violence. Associations between self reported induced abortion and pregnancy loss with intimate partner violence were analysed using multiple regression models. Results Lifetime physical and/or sexual intimate partner violence was reported by 41% and 56% of ever partnered, ever pregnant women in Dar es Salaam and Mbeya respectively. Among the ever pregnant, ever partnered women, 23% experienced involuntary pregnancy loss, while 7% reported induced abortion. Even after adjusting for other explanatory factors, women who experienced intimate partner violence were 1.6 (95%CI: 1.06,1.60) times more likely to report an pregnancy loss and 1.9 (95%CI: 1.30,2.89) times more likely to report an induced abortion. Intimate partner violence had a stronger influence on induced abortion and pregnancy loss than women's age, socio-economic status, and number of live born children. Conclusions Intimate partner violence is likely to be an important influence on levels of induced abortion and pregnancy loss in Tanzania. Preventing intimate partner violence may therefore be beneficial for maternal health and

The Role of Vernacularization in Tanzania: Swahili as Political Tool.

ERIC Educational Resources Information Center

Russell, Joan

A discussion of the role of Swahili in Tanzania looks at its elaboration as an indigenous language, involving both internal modification of the written language and the extension of its institutionalized domains of use. Because of its role as the lingua franca of the independence movement, Swahili became a vehicle for national political…

Women's Access to Higher Education in Tanzania: A Qualitative Study

ERIC Educational Resources Information Center

Johnson, Megan Patricia

2011-01-01

The purpose of this study was to reveal the ways in which first-generation women in Tanzania explained their success in pursuing a university education despite cultural and social obstacles. Such obstacles include social policies, socio-cultural factors, and academic factors. A review of the literature revealed that issues such as patriarchy,…

Pregnancy history and current use of contraception among women of reproductive age in Burundi, Kenya, Rwanda, Tanzania and Uganda: analysis of demographic and health survey data.

PubMed

Bakibinga, Pauline; Matanda, Dennis J; Ayiko, Rogers; Rujumba, Joseph; Muiruri, Charles; Amendah, Djesika; Atela, Martin

2016-03-10

To examine the relationship between pregnancy history and the use of contraception among women of reproductive age (15-49 years) in East Africa. Demographic and Health Surveys data from Burundi (2010), Kenya (2008-2009), Rwanda (2010), Tanzania (2010) and Uganda (2011) were used in the analysis. Logistic regression was used to determine the effects of women's pregnancy history on their use of contraception. Burundi, Kenya, Rwanda, Tanzania and Uganda. 3226, 2377, 4396, 3250 and 2596 women of reproductive age (15-49 years) from Burundi, Kenya, Rwanda, Tanzania and Uganda, respectively, were included in the analysis. Women who had experienced a mistimed pregnancy were more likely to use a modern contraceptive method during their most recent sexual encounter in Kenya, Rwanda, Burundi and Uganda. Other significant correlates of women's contraceptive use were: desire for more children, parity, household wealth, maternal education and access information through radio. In-country regional differences on use of modern contraceptive methods were noted across five East African countries. Women's birth histories were significantly associated with their decision to adopt a modern contraceptive method. This highlights the importance of considering women's birth histories, especially women with mistimed births, in the promotion of contraceptive use in East Africa. Variations as a result of place of residency, educational attainment, access to family planning information and products, and wealth ought to be addressed in efforts to increase use of modern contraceptive methods in the East African region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

PubMed

Hutchinson, Paul L; Do, Mai; Agha, Sohail

2011-08-24

Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory

Acridine Orange for malaria diagnosis: its diagnostic performance, its promotion and implementation in Tanzania, and the implications for malaria control.

PubMed

Keiser, J; Utzinger, J; Premji, Z; Yamagata, Y; Singer, B H

2002-10-01

One hundred years ago, Giemsa's stain was employed for the first time for malaria diagnosis. Giemsa staining continues to be the method of choice in most malarious countries, although, in the recent past, several alternatives have been developed that exhibit some advantages. Considerable progress has been made with fluorescent dyes, particularly with Acridine Orange (AO). The literature on the discovery, development and validation of the AO method for malaria diagnosis is reviewed here. Compared with conventional Giemsa staining, AO shows a good diagnostic performance, with sensitivities of 81.3%-100% and specificities of 86.4%-100%. However, sensitivities decrease with lower parasite densities, and species differentiation may occasionally be difficult. The most notable advantage of the AO method over Giemsa staining is its promptness; results are readily available within 3-10 min, whereas Giemsa staining may take 45 min or even longer. This is an important advantage for the organization of health services and the provision of effective treatment of malaria cases. The national malaria control programme of Tanzania, together with the Japan International Co-operation Agency, began to introduce the AO method in Tanzania in 1994. So far, AO staining has been introduced in 70 regional and district hospitals, and 400 laboratory technicians have been trained to use the method. The results of this introduction, which are reviewed here and have several important implications, indicate that AO is a viable alternative technique for the laboratory diagnosis of malaria in highly endemic countries.

Field evaluation of the photo-induced electron transfer fluorogenic primers (PET) real-time PCR for the detection of Plasmodium falciparum in Tanzania

PubMed Central

2014-01-01

Background Accurate diagnosis of malaria infections remains challenging, especially in the identification of submicroscopic infections. New molecular diagnostic tools that are inexpensive, sensitive enough to detect low-level infections and suitable in laboratory settings of resource-limited countries are required for malaria control and elimination programmes. Here the diagnostic potential of a recently developed photo-induced electron transfer fluorogenic primer (PET) real-time polymerase chain reaction (PCR) called PET-PCR was investigated. This study aimed to (i) evaluate the use of this assay as a method for the detection of both Plasmodium falciparum and other Plasmodium species infections in a developing country’s diagnostic laboratory; and, (ii) determine the assay’s sensitivity and specificity compared to a nested 18S rRNA PCR. Methods Samples used in this study were obtained from a previous study conducted in the region of Iringa, Tanzania. A total of 303 samples from eight health facilities in Tanzania were utilized for this evaluation. All samples were screened using the multiplex PET-PCR assay designed to detect Plasmodium genus and P. falciparum initially in laboratory in Tanzania and then repeated at a reference laboratory at the CDC in the USA. Microscopy data was available for all the 303 samples. A subset of the samples were tested in a blinded fashion to find the sensitivity and specificity of the PET-PCR compared to the nested 18S rRNA PCR. Results Compared to microscopy, the PET-PCR assay was 59% more sensitive in detecting P. falciparum infections. The observed sensitivity and specificity were 100% (95% confidence interval (CI0.95) = 94-100%) and (CI0.95 = 96-100%), respectively, for the PET-PCR assay when compared to nested 18S rRNA PCR. When compared to 18S rRNA PCR, microscopy had a low sensitivity of 40% (CI0.95 = 23-61%) and specificity of 100% (CI0.95 = 96-100%). The PET-PCR results performed in the field laboratory

Australian nursing and midwifery educators delivering evidence-based education in Tanzania: A qualitative study.

PubMed

Gower, Shelley; van den Akker, Jose; Jones, Mark; Dantas, Jaya A R; Duggan, Ravani

2016-05-01

Since 2011, Western Australian nursing and midwifery educators have been providing evidence-based continuing education to Tanzanian health professionals. Despite thorough preparation before departure, differences in local resource levels and available facilities have necessitated impromptu adaptation of curriculum content and delivery methods to ensure an effective program was delivered. This study explored the personal, cultural and teaching strategies utilised by Western Australian nursing and midwifery educators in Tanzania and examined if the transferability of education packages was influenced by the educators' cultural competence. Using a qualitative exploratory approach, data was collected from 15 Western Australian nursing and midwifery educators using a demographic survey and in-depth individual semi-structured interviews. The core themes identified from the analysis were Determination to learn, Assessing needs, Communication skills and Greater understanding. These findings are described using the conceptual framework of Campinha-Bacote's The Process of Cultural Competence in the Delivery of Healthcare Services. With appropriate levels of cultural competence, international health professionals can be effective at providing ongoing professional development to colleagues in developing country contexts, which may help address difficulties with retention and motivation of staff. It is essential that prior to departure cultural competence training is provided to educators to enhance their teaching capacity and effectiveness in international settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Is there a threshold level of maternal education sufficient to reduce child undernutrition? Evidence from Malawi, Tanzania and Zimbabwe.

PubMed

Makoka, Donald; Masibo, Peninah Kinya

2015-08-22

Maternal education is strongly associated with young child nutrition outcomes. However, the threshold of the level of maternal education that reduces the level of undernutrition in children is not well established. This paper investigates the level of threshold of maternal education that influences child nutrition outcomes using Demographic and Health Survey data from Malawi (2010), Tanzania (2009-10) and Zimbabwe (2005-06). The total number of children (weighted sample) was 4,563 in Malawi; 4,821 children in Tanzania; and 3,473 children in Zimbabwe Demographic and Health Surveys. Using three measures of child nutritional status: stunting, wasting and underweight, we employ a survey logistic regression to analyse the influence of various levels of maternal education on child nutrition outcomes. In Malawi, 45% of the children were stunted, 42% in Tanzania and 33% in Zimbabwe. There were 12% children underweight in Malawi and Zimbabwe and 16% in Tanzania.The level of wasting was 6% of children in Malawi, 5% in Tanzania and 4% in Zimbabwe. Stunting was significantly (p values < 0.0001) associated with mother's educational level in all the three countries. Higher levels of maternal education reduced the odds of child stunting, underweight and wasting in the three countries. The maternal threshold for stunting is more than ten years of schooling. Wasting and underweight have lower threshold levels. These results imply that the free primary education in the three African countries may not be sufficient and policies to keep girls in school beyond primary school hold more promise of addressing child undernutrition.

Risk factors for genital human papillomavirus among men in Tanzania.

PubMed

Olesen, Tina Bech; Mwaiselage, Julius; Iftner, Thomas; Kahesa, Crispin; Rasch, Vibeke; Frederiksen, Kirsten; Munk, Christian; Kjaer, Susanne K

2017-02-01

The objective of the study was to assess risk factors for Human Papillomavirus (HPV) among men in Tanzania, both overall and in relation to HIV status. In a cross-sectional study conducted among 1,813 men in Tanzania, penile swabs were tested for HPV using Hybrid Capture 2 (HC2). Study participants were offered HIV testing. Risk factors for HPV (HC2 high-risk and/or low-risk positivity) were assessed using logistic regression with adjustment for age, lifetime number of sexual partners, and HIV status. Altogether, 372 men (20.5%) were HPV-positive. Among men tested for HIV (n = 1,483), the HIV prevalence was 9.4%. The odds ratio (OR) of HPV increased with increasing age. HIV-positivity was associated with an increased odds ratio of HPV (OR = 1.91; 95%CI: 1.30-2.82), whereas the odds of HPV tended to be lower in circumcised men than in uncircumcised men (OR = 0.77; 95%CI: 0.54-1.09). When stratifying by HIV status, we found lower odds of HPV in overweight HIV-positive men (BMI > 25) than in normal weight HIV-positive men (OR = 0.25; 95%CI: 0.08-0.78). This did not apply to HIV-negative men. Circumcision tended to decrease the odds of HPV both in HIV-positive men and in HIV-negative men, although not being statistically significant. In conclusion, HIV is a strong risk factor for HPV among men in Tanzania. Additionally, in HIV-positive men a high BMI seems to be associated with a lower risk of HPV. Finally, we observed a tendency toward a lower risk of HPV both among HIV-positive and HIV-negative circumcised men compared to their uncircumcised counterparts. J. Med. Virol. 89:345-351, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Successful Community Nutrition Programming: Lessons from Kenya, Tanzania, and Uganda.

ERIC Educational Resources Information Center

Iannotti, Lora; Gillespie, Stuart

This report on the key findings from a series of assessments of successful community nutrition programming conducted in Kenya, Tanzania, and Uganda between 1999 and 2000. The aim of the assessments was to identify key lessons learned from the successful processes and outcomes in these programs. The report is divided into eight chapters: (1)…

Schooling, Child Labor, and the Returns to Healthcare in Tanzania

ERIC Educational Resources Information Center

Adhvaryu, Achyuta R.; Nyshadham, Anant

2012-01-01

We study the effects of accessing better healthcare on the schooling and labor supply decisions of sick children in Tanzania. Using variation in the cost of formal-sector healthcare to predict treatment choice, we show that accessing better healthcare decreases length of illness and changes children's allocation of time to school and work.…

Diversity of human immunodeficiency virus type 1 subtypes in Kagera and Kilimanjaro regions, Tanzania.

PubMed

Nyombi, Balthazar M; Kristiansen, Knut I; Bjune, Gunnar; Müller, Fredrik; Holm-Hansen, Carol

2008-06-01

A strategy to prevent the spread of HIV-1 worldwide is complicated by the high genetic diversity of the virus. To gain a better understanding of the HIV-1 genetic diversity in Tanzania, a molecular epidemiological investigation was conducted in Kagera and Kilimanjaro regions. While several studies have addressed HIV-1 subtypes in Tanzania, this is the first study to describe the virus subtypes circulating in Kagera. The Kagera region is the epicenter of the HIV-1 epidemic in Africa, and it was therefore of interest to compare the prevalence of HIV subtypes in this region and Kilimanjaro. Blood samples were obtained from 246 HIV-1-infected pregnant women attending antenatal clinics. Plasma HIV-1 RNA was extracted, amplified, and sequenced in the env C2V3 and/or pol regions from 209 samples. Based on the analysis of env C2V3 and pol sequences, 47.4% had concordant subtypes, 19.1% were discordant indicating recombination, and for 33.5% sequences were obtained for only one region. The distribution HIV-1 subtypes based on the phylogenetic analysis of paired env C2V3/ pol sequences in Kagera region was A/A (27.8%), C/C (29.6%), D/D (16.7%), and unique recombinant forms (25.9%), and in Kilimanjaro region was A/A (32.9%), C/C (25.9%), D/D (10.6%), CRF10_CD (1.2%), and unique recombinant forms (29.4%). The env C2V3 subsubtype A2 and env C2V3/pol CRF10_CD were also observed indicating that these recombinants are circulating in Tanzania. The high diversity of HIV-1 subtypes and the high prevalence of recombinants demonstrated in this study necessitate expanded and continuous monitoring of the epidemic in Tanzania. The trend may have implications for current national control strategies against the HIV-1 epidemic.

Contrasting rainfall declines in northern and southern Tanzania: Potential differential impacts of west Pacific warming and east Pacific cooling

NASA Astrophysics Data System (ADS)

Harrison, L.; Funk, C. C.; Verdin, J. P.; Pedreros, D. H.; Shukla, S.; Husak, G. J.

2015-12-01

Here, we present analysis of a new 1900-2014 rainfall record for the Greater Horn of Africa with high station density (CenTrends), and evaluate potential climate change "hot spots" in Tanzania. We identify recent (1981-2014) downward trends in Tanzanian rainfall, use CenTrends to place these in a longer historical context, and relate rainfall in these regions to decadal changes in global sea surface temperatures (SSTs). To identify areas of concern, we consider the potential food security impacts of the recent rainfall declines and also rapid population growth. Looking forward, we consider what the links to SSTs might mean for rainfall in the next several decades based on SST projections. In addition to CenTrends, we use a variety of geographic data sets, including 1981-2014 rainfall from the Climate Hazards group InfraRed Precipitation with Stations (CHIRPSv2.0), simulated crop stress from the USGS Geospatial Water Requirement Satisfaction Index (GeoWRSI) model, NOAA Extended Reconstructed SSTs (ERSST v4), SST projections from the Coupled Model Intercomparison Project (CMIP5), and land cover and population maps from SERVIR, WorldPOP, and CIESIN's Gridded Population of the World. The long-term CenTrends record allows us to suggest an interesting dichotomy in decadal rainfall forcing. During the March to June season, SSTs in the west Pacific appear to be driving post-1980 rainfall reductions in northern Tanzania. In the 2000s, northern Tanzania's densely populated Pangani River, Internal Drainage, and Lake Victoria basins experienced the driest period in more than a century. During summer, negative trends in southern Tanzania appear linked to a negative SST trend in the Nino3.4 region. Since the SST trend in the west (east) Pacific appears strongly influenced by global warming (natural decadal variability), we suggest that water resources in northern Tanzania may face increasing challenges, but that this will be less the case in southern Tanzania.

Developing and Piloting Interactive Physics Experiments for Secondary Schools in Tanzania

ERIC Educational Resources Information Center

Msoka, Vidate C.; Mtebe, Joel S.; Kissaka, Mussa M.; Kalinga, Ellen C.

2015-01-01

Students in secondary schools in Tanzania have been facing difficulties in conducting laboratory experiments. This has been due to the acute shortage of laboratory facilities and poor teaching methodologies. Consequently, students perceive science subjects as unattractive, difficult and irrelevant to understanding the world around them. An…

Navigating the AIDS industry: being poor and positive in Tanzania.

PubMed

Boesten, Jelke

2011-01-01

This article shows how poor people living with HIV/AIDS in Tanzania navigate a myriad of actors, agencies and organizations to obtain the aid they need to survive. It focuses on community-based organizations which establish networks of care through which people obtain care, treatment and financial support. A case study of a roadside town in Tanzania illustrates that these community-based networks of care — essential to the survival of many — are partly the product of the AIDS industry, which encourages the establishment of community-based organizations and voluntary service delivery rather than more formalized systems of care. Community-based organizations, however, are so poorly supported that they often deploy self-destructive strategies. The need to strategically navigate the AIDS industry creates tension and even conflict among HIV-positive activists, the people they represent and the wider community, which undermines rather than strengthens community-based interventions. Whilst the AIDS industry promises inclusion of HIV-positive people in the response to HIV/AIDS, it succeeds only partially, with the result that it may potentially do more harm than good.

Mycobacteria in Terrestrial Small Mammals on Cattle Farms in Tanzania

PubMed Central

Durnez, Lies; Katakweba, Abdul; Sadiki, Harrison; Katholi, Charles R.; Kazwala, Rudovick R.; Machang'u, Robert R.; Portaels, Françoise; Leirs, Herwig

2011-01-01

The control of bovine tuberculosis and atypical mycobacterioses in cattle in developing countries is important but difficult because of the existence of wildlife reservoirs. In cattle farms in Tanzania, mycobacteria were detected in 7.3% of 645 small mammals and in cow's milk. The cattle farms were divided into “reacting” and “nonreacting” farms, based on tuberculin tests, and more mycobacteria were present in insectivores collected in reacting farms as compared to nonreacting farms. More mycobacteria were also present in insectivores as compared to rodents. All mycobacteria detected by culture and PCR in the small mammals were atypical mycobacteria. Analysis of the presence of mycobacteria in relation to the reactor status of the cattle farms does not exclude transmission between small mammals and cattle but indicates that transmission to cattle from another source of infection is more likely. However, because of the high prevalence of mycobacteria in some small mammal species, these infected animals can pose a risk to humans, especially in areas with a high HIV-prevalence as is the case in Tanzania. PMID:21785686

Mobile Phone Use in Two Secondary Schools in Tanzania

ERIC Educational Resources Information Center

Joyce-Gibbons, Andrew; Galloway, David; Mollel, Andrew; Mgoma, Sylvester; Pima, Madeleke; Deogratias, Enos

2018-01-01

Mobile phone technology in Tanzania has grown rapidly but there is insufficient data on its application in schools. This paper aims to show how students in the first and third year (F1 and F3) teachers in two rural secondary schools perceived its use. F1 and F3 students completed a questionnaire. Teachers and students in F1 and F3 discussed the…

Waiting for attention and care: birthing accounts of women in rural Tanzania who developed obstetric fistula as an outcome of labour

PubMed Central

2011-01-01

Background Obstetric fistula is a physically and socially disabling obstetric complication that affects about 3,000 women in Tanzania every year. The fistula, an opening that forms between the vagina and the bladder and/or the rectum, is most frequently caused by unattended prolonged labour, often associated with delays in seeking and receiving appropriate and adequate birth care. Using the availability, accessibility, acceptability and quality of care (AAAQ) concept and the three delays model, this article provides empirical knowledge on birth care experiences of women who developed fistula after prolonged labour. Methods We used a mixed methods approach to explore the birthing experiences of women affected by fistula and the barriers to access adequate care during labour and delivery. Sixteen women were interviewed for the qualitative study and 151 women were included in the quantitative survey. All women were interviewed at the Comprehensive Community Based Rehabilitation Tanzania in Dar es Salaam and Bugando Medical Centre in Mwanza. Results Women experienced delays both before and after arriving at a health facility. Decisions on where to seek care were most often taken by husbands and mothers-in-law (60%). Access to health facilities providing emergency obstetric care was inadequate and transport was a major obstacle. About 20% reported that they had walked or were carried to the health facility. More than 50% had reported to a health facility after two or more days of labour at home. After arrival at a health facility women experienced lack of supportive care, neglect, poor assessment of labour and lack of supervision. Their birth accounts suggest unskilled birth care and poor referral routines. Conclusions This study reveals major gaps in access to and provision of emergency obstetric care. It illustrates how poor quality of care at health facilities contributes to delays that lead to severe birth injuries, highlighting the need to ensure women's rights to

Comparing actual and perceived causes of fever among community members in a low malaria transmission setting in northern Tanzania

PubMed Central

Hertz, Julian T.; Munishi, O. Michael; Sharp, Joanne P.; Reddy, Elizabeth A.; Crump, John A.

2013-01-01

Objective To compare actual and perceived causes of fever in northern Tanzania. Methods In a standardized survey, heads of households in 30 wards in Moshi, Tanzania, were asked to identify the most common cause of fever for children and for adults. Responses were compared to data from a local hospital-based fever etiology study that used standard diagnostic techniques. Results Of 810 interviewees, the median (range) age was 48 (16, 102) years and 62.8% were females. Malaria was the most frequently identified cause of fever, cited by 56.7% and 43.6% as the most common cause of fever for adults and children, respectively. In contrast, malaria accounted for 2.0% of adult and 1.3% of pediatric febrile admissions in the fever etiology study. Weather was the second-most frequently cited cause of fever. Participants who identified a non-biomedical explanation such as weather as the most common cause of fever were more likely to prefer a traditional healer for treatment of febrile adults (OR 2.7, p<0.001). Bacterial zoonoses were the most common cause of fever among inpatients, but no interviewees identified infections from animal contact as the most common cause of fever for adults; 0.2% identified these infections as the most common cause of fever for children. Conclusions Malaria is perceived to be a much more common cause of fever than hospital studies indicate whereas other important diseases are under-appreciated in northern Tanzania. Belief in non-biomedical explanations of fever is common locally and has important public health consequences. PMID:24103083

Uvulectomy, a traditional surgical procedure in Tanzania.

PubMed

Manni, J J

1984-02-01

Uvulectomy is carried out by traditional healers of Tanzania. The Department of Otorhinolaryngology of the Muhimbili Medical Centre, University of Dar es Salaam, has regularly treated patients who suffered complications arising from this procedure. In April 1980 the author attended the practice of a traditional healer (mganga) in Dar es Salaam and saw many uvulectomies performed. The procedure is described and its indications and complications reviewed. The study illustrates that knowledge and comprehension of traditional medicine is important for the medical profession in those countries where traditional medical procedures are still in use.

The application of Signalling Theory to health-related trust problems: The example of herbal clinics in Ghana and Tanzania.

PubMed

Hampshire, Kate; Hamill, Heather; Mariwah, Simon; Mwanga, Joseph; Amoako-Sakyi, Daniel

2017-09-01

In contexts where healthcare regulation is weak and levels of uncertainty high, how do patients decide whom and what to trust? In this paper, we explore the potential for using Signalling Theory (ST, a form of Behavioural Game Theory) to investigate health-related trust problems under conditions of uncertainty, using the empirical example of 'herbal clinics' in Ghana and Tanzania. Qualitative, ethnographic fieldwork was conducted over an eight-month period (2015-2016) in eight herbal clinics in Ghana and ten in Tanzania, including semi-structured interviews with herbalists (N = 18) and patients (N = 68), plus detailed ethnographic observations and twenty additional key informant interviews. The data were used to explore four ST-derived predictions, relating to herbalists' strategic communication ('signalling') of their trustworthiness to patients, and patients' interpretation of those signals. Signalling Theory is shown to provide a useful analytical framework, allowing us to go beyond the primary trust problem addressed by other researchers - cataloguing observable indicators of trustworthiness - and providing tools for tackling the trickier secondary trust problem, where the trustworthiness of those indicators must be ascertained. Signalling Theory also enables a basis for comparative work between different empirical contexts that share the underlying condition of uncertainty. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Disease patterns and clinical outcomes of patients admitted in intensive care units of tertiary referral hospitals of Tanzania.

PubMed

Sawe, Hendry R; Mfinanga, Juma A; Lidenge, Salum J; Mpondo, Boniventura C T; Msangi, Silas; Lugazia, Edwin; Mwafongo, Victor; Runyon, Michael S; Reynolds, Teri A

2014-09-23

In sub-Saharan Africa the availability of intensive care unit (ICU) services is limited by a variety of factors, including lack of financial resources, lack of available technology and well-trained staff. Tanzania has four main referral hospitals, located in zones so as to serve as tertiary level referral centers. All the referral hospitals have some ICU services, operating at varying levels of equipment and qualified staff. We analyzed and describe the disease patterns and clinical outcomes of patients admitted in ICUs of the tertiary referral hospitals of Tanzania. This was a retrospective analysis of ICU patient records, for three years (2009 to 2011) from all tertiary referral hospitals of Tanzania, namely Muhimbili National Hospital (MNH), Kilimanjaro Christian Medical Centre (KCMC), Mbeya Referral Hospital (MRH) and Bugando Medical Centre (BMC). MNH is the largest of the four referral hospitals with 1300 beds, and MRH is the smallest with 480 beds. The ratio of hospital beds to ICU beds is 217:1 at MNH, 54:1 at BMC, 39:1 at KCMC, and 80:1 at MRH. KCMC had no infusion pumps. None of the ICUs had a point-of-care (POC) arterial blood gas (ABG) analyzer. None of the ICUs had an Intensive Care specialist or a nutritionist. A masters-trained critical care nurse was available only at MNH. From 2009-2011, the total number of patients admitted to the four ICUs was 5627, male to female ratio 1.4:1, median age of 34 years. Overall, Trauma (22.2%) was the main disease category followed by infectious disease (19.7%). Intracranial injury (12.5%) was the leading diagnosis in all age groups, while pneumonia (11.7%) was the leading diagnosis in pediatric patients (<18 years). Patients with tetanus (2.4%) had the longest median length ICU stay: 8 (5,13) days. The overall in-ICU mortality rate was 41.4%. The ICUs in tertiary referral hospitals of Tanzania are severely limited in infrastructure, personnel, and resources, making it difficult or impossible to provide optimum care

Comparison of carbon dioxide-baited trapping systems for sampling outdoor mosquito populations in Tanzania.

PubMed

Mboera LEG; Knols BGJ; Braks MAH; Takken, W

2000-09-01

For collecting mosquitoes (Diptera: Culicidae) the outdoor catching efficiency of four types of trapping devices baited with carbon dioxide (CO2, 300 ml/ min) was evaluated and compared in two areas of Tanzania. The types of traps employed were: the CDC miniature trap with the incandescent light bulb switched on or off; electric nets (ENT) and a Counterflow Geometry (CFG) trap. In Njage, southeast Tanzania, Anopheles gambiae Giles sensu stricto was the most abundant of the seven mosquito species obtained, comprising of 74.3% of the total number caught (n=2,171). In Muheza, north-east Tanzania, Culex quinquefasciatus Say was the predominant species (90.9%) among 1,080 caught. At both localities the CFG trap was superior to the CDC trap with light-on or light-off for sampling both An. gambiae and Cx. quinquefasciatus. Efficiency of the CFG trap and ENT were similar for sampling these species of mosquitoes (P > 0.05). However, ENT was superior to the CDC trap with light-off for collecting both species. Significantly more (P < 0.05) Cx. quinquefasciatus were obtained by the CDC trap with light-off than with light-on, especially outdoors. It is concluded that both ENT and the CFG are effective tools for sampling populations of An. gambiae and Cx. quinquefasciatus outdoors.

From emergency to sustainability: shifting objectives in the US Government's HIV response in Tanzania.

PubMed

Marten, Meredith G

2017-08-01

The US President's Emergency Plan for AIDS Relief (PEPFAR) was originally designed as an emergency initiative, operating with considerable funds, immediate roll-out, fast scale-up, and top-down technocratic administration. In a more recent iteration, PEPFAR shifted its focus from an emergency response to more closely account for healthcare sustainability. This transition came on the heels of the 2008 financial crisis, which threatened to stall the 'marvellous momentum' of the 2000's boom in donor aid for global health overall. Now many programmes are having to do more with less as funding flattens or decreases. This paper examines how this transition took shape in Tanzania in 2011-2012, and the successes and challenges associated with it, using participant observation and interview data from 20 months of fieldwork in rural and urban healthcare settings. In particular, I discuss (1) efforts to increase sustainability and country ownership of HIV programmes in Tanzania, focusing on the shift from PEPFAR-funded American non-governmental organisations to Tanzanian partner organisations; (2) principal challenges stakeholders encountered during the transition, including fragmented systems of healthcare delivery and a weakened healthcare workforce; and (3) strategies informants identified to better integrate services in order to build a stronger, more equitable, and sustainable health system in Tanzania.

First report of Phakopsora pachyrhizi on soybean causing rust in Tanzania

USDA-ARS?s Scientific Manuscript database

Phakopsora pachyrhizi Syd. was reported on legume hosts other than soybean in Tanzania as early as 1979. Soybean rust (SBR), caused by P. pachyrhizi, was first reported on soybean in Africa in Uganda in 1996, and its introduction into Africa was proposed to occur through urediniospores blowing from ...

Affirmative Action, Gender Equity and University Admissions--Kenya, Uganda and Tanzania

ERIC Educational Resources Information Center

Onsongo, Jane

2009-01-01

The article examines the outcomes of affirmative action policies aimed at improving access for women students to university education in Kenya, Uganda and Tanzania. Different interpretations of affirmative action are found in the three countries. These include lower entry scores, remedial pre-university programmes and financial assistance. There…

Adaptive livelihood strategies for coping with water scarcity in the drylands of central Tanzania

NASA Astrophysics Data System (ADS)

Liwenga, Emma T.

In this paper, it is argued that local knowledge for adapting to water scarcity is important for integrated resource management by taking into consideration both the natural and social constraints in a particular setting based on accumulated experience. The paper examines the relevance of local knowledge in sustaining agricultural production in the semiarid areas of central Tanzania. The paper specifically focuses on how water scarcity, as the major limiting factor, is addressed in the study area using local knowledge to sustain livelihoods of its people. The study was conducted in four villages; Mzula, Ilolo, Chanhumba and Ngahelezi, situation in Mvumi Division in Dodoma Region. The study mainly employed qualitative data collection techniques. Participatory methods provided a means of exploring perceptions and gaining deeper insights regarding natural resource utilization in terms of problems and opportunities. The main data sources drawn upon in this study were documentation, group interviews and field observations. Group interviews involved discussions with a group of 6-12 people selected on the basis of gender, age and socio-economic groups. Data analysis entailed structural and content analysis within the adaptive livelihood framework in relation to management of water scarcity using local knowledge. The findings confirm that rainfall is the main limiting factor for agricultural activities in the drylands of Central Tanzania. As such, local communities have developed, through time, indigenous knowledge to cope with such environments utilizing seasonality and diversity of landscapes. Use of this local knowledge is therefore effective in managing water scarcity by ensuring a continuous production of crops throughout the year. This practice implies increased food availability and accessibility through sales of such agricultural products. Local innovations for water management, such as cultivation in sandy rivers, appear to be very important means of accessing

Ixodid Tick Infestation in Cattle and Wild Animals in Maswa and Iringa, Tanzania

PubMed Central

Kwak, You Shine; Kim, Tae Yun; Nam, Sung-Hyun; Lee, In-Yong; Kim, Hyung-Pyo; Mduma, Simon; Keyyu, Julius; Fyumagwa, Robert

2014-01-01

Ticks and tick-borne diseases are important in human and livestock health worldwide. In November 2012, ixodid ticks were collected and identified morphologically from cattle and wild animals in the Maswa district and Iringa urban, Tanzania. Amblyomma gemma, A. lepidum, and A. variegatum were identified from Maswa cattle, and A. variegatum was the predominant species. A. marmoreum, Hyalomma impeltatum, and Rhipicephalus pulchellus were identified from Iringa cattle in addition to the above 3 Amblyomma species, and A. gemma was the most abundant species. Total 4 Amblyomma and 6 Rhipicephalus species were identified from wild animals of the 2 areas. A. lepidum was predominant in Maswa buffaloes, whereas A. gemma was predominant in Iringa buffaloes. Overall, A. variegatum in cattle was predominant in the Maswa district and A. gemma was predominant in Iringa, Tanzania. PMID:25352709

Ixodid tick infestation in cattle and wild animals in Maswa and Iringa, Tanzania.

PubMed

Kwak, You Shine; Kim, Tae Yun; Nam, Sung-Hyun; Lee, In-Yong; Kim, Hyung-Pyo; Mduma, Simon; Keyyu, Julius; Fyumagwa, Robert; Yong, Tai-Soon

2014-10-01

Ticks and tick-borne diseases are important in human and livestock health worldwide. In November 2012, ixodid ticks were collected and identified morphologically from cattle and wild animals in the Maswa district and Iringa urban, Tanzania. Amblyomma gemma, A. lepidum, and A. variegatum were identified from Maswa cattle, and A. variegatum was the predominant species. A. marmoreum, Hyalomma impeltatum, and Rhipicephalus pulchellus were identified from Iringa cattle in addition to the above 3 Amblyomma species, and A. gemma was the most abundant species. Total 4 Amblyomma and 6 Rhipicephalus species were identified from wild animals of the 2 areas. A. lepidum was predominant in Maswa buffaloes, whereas A. gemma was predominant in Iringa buffaloes. Overall, A. variegatum in cattle was predominant in the Maswa district and A. gemma was predominant in Iringa, Tanzania.

“Bend a fish when the fish is not yet dry”: Adolescent Boys’ Perceptions of Sexual Risk in Tanzania

PubMed Central

Sommer, Marni; Likindikoki, Samuel; Kaaya, Sylvia

2015-01-01

Despite decades of effort, the spread of HIV/AIDS continues among many African young people. A key contributor is unsafe sexual behavior that is desired, persuaded or coerced. We explored the masculinity norms shaping pubescent boys’ perceptions of and engagement in (unsafe) sexual behaviors in Tanzania. Through a comparative case study in rural and urban Tanzania, qualitative and participatory methods were used with 160 adolescent boys in and out of school to better understand the social and contextual factors promoting unsafe sexual behaviors. Adolescent boys in both the rural and urban sites reported struggling with intense sexual desires, strong peer pressures to have sex, and social norms dissuading condom use. A growing “normalization” of AIDS suggests messages promoting the dangers of HIV infection may be less effective. Findings reinforce the need for interventions with very young adolescents. Research is needed to identify more effective approaches for promoting safer sexual practices among boys in sub-Saharan Africa. Harm reduction approaches and gender transformative approaches might prove more effective than current HIV prevention efforts focused on youth. PMID:25583374

User fee exemptions are not enough: out-of-pocket payments for 'free' delivery services in rural Tanzania.

PubMed

Kruk, Margaret E; Mbaruku, Godfrey; Rockers, Peter C; Galea, Sandro

2008-12-01

To identify the main drivers of costs of facility delivery and the financial consequences for households among rural women in Tanzania, a country with a policy of delivery fee exemptions. We selected a representative sample of households in a rural district in western Tanzania. Women who given birth within 5 years were asked about payments for doctor's/nurse's fees, drugs, non-medical supplies, medical tests, maternity waiting home, transport and other expenses. Wealth was assessed using a household asset index. We estimated the proportion of women who cut down on spending or borrowed money/sold household items to pay for delivery in each wealth group. In all, 73.3% of women with facility delivery reported having made out-of-pocket payments for delivery-related costs. The average cost was 6272 Tanzanian shillings (TZS), [95% Confidence Interval (CI): 4916, 7628] or 5.0 United States dollars. Transport costs (53.6%) and provider fees (26.6%) were the largest cost components in government facilities. Deliveries in mission facilities were twice as expensive as those in government facilities. Nearly half (48.3%) of women reported cutting down on spending or borrowing money/selling household assets to pay for delivery, with the poor reporting this most frequently. Out-of-pocket payments for facility delivery were substantial and were driven by high transport costs, unofficial provider payments, and preference for mission facilities, which levy user charges. Novel approaches to financing maternal health services, such as subsidies for transport and care from private providers, are required to reduce the cost barriers to attended delivery.

Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania: evidence from two rural districts.

PubMed

Mubyazi, Godfrey M; Bloch, Paul; Byskov, Jens; Magnussen, Pascal; Bygbjerg, Ib C; Hansen, Kristian S

2012-02-18

Since its introduction in the national antenatal care (ANC) system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs) in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp) services in the national ANC clinics and the implications such motivation and performance might have had on HWs and services' compliance with the recommended IPTp delivery guidelines. This paper describes the supply-related drivers of motivation and performance of HWs in administering IPTp doses among other ANC services delivered in public and private health facilities (HFs) in Tanzania, using a case study of Mkuranga and Mufindi districts. Interviews were conducted with 78 HWs participating in the delivery of ANC services in private and public HFs and were supplemented by personal communications with the members of the district council health management team. The research instrument used in the data collection process contained a mixture of closed and open-ended questions. Some of the open-ended questions had to be coded in the form that allowed their analysis quantitatively. In both districts, respondents acknowledged IPTp as an essential intervention, but expressed dissatisfaction with their working environments constraining their performance, including health facility (HF) unit understaffing; unsystematic and unfriendly supervision by CHMT members; limited opportunities for HW career development; and poor (HF) infrastructure and staff houses. Data also suggest that poor working conditions negatively affect health workers' motivation to perform for ANC (including IPTp) services. Similarities and differences were noted in terms of motivational factors for ANC service delivery between the HWs employed in private HFs and those in public HFs: those in private facilities were more comfortable with staff residential houses, HF buildings, equipment, availability of water, electricity and cups for

What Factors are Responsible for Higher Prevalence of HIV Infection among Urban Women than Rural Women in Tanzania?

PubMed

Singh, Rakesh K; Patra, Shraboni

2015-10-01

Tanzania is the country hit the hardest by the HIV epidemic in Sub-Saharan Africa. The present study was carried out to examine the factors of HIV infection among women who lived in an urban area in Tanzania. The Tanzania HIV/AIDS and Malaria Indicator Survey (2011-12) data was used. The sample size for urban and rural women who had been tested for HIV and ever had sex was 2227 and 6210 respectively. Bivariate and multivariate logistic regression analyses were used. The present study found that rural women were significantly less likely to be HIV-infected compared to urban women (OR = 0.612, p<0.00). About 10% urban women were HIV-infected whereas 5.8% women in rural areas were HIV positive. Women who had more than five sex partners were significantly four times more likely to be HIV-infected as compared to women who had one sex partner (OR = 4.49, p<0.00). The results of this study suggest that less-educated women, women belonging to poor or poorer quintile, women spending nights outside and women having more than one sex partner were significantly more likely to have HIV infection among urban women as compared to rural women. There is an urgent need for a short and effective program to control the HIV epidemic in urban areas of Tanzania especially for less-educated urban women.

Sex, Grades and Power in Higher Education in Ghana and Tanzania

ERIC Educational Resources Information Center

Morley, Louise

2011-01-01

Quantitative increases tell a partial story about the quality of women's participation in higher education. Women students' reporting of sexual harassment has been noteworthy in a recent study that I directed on widening participation in higher education in Ghana and Tanzania. The hierarchical and gendered power relations within universities have…

Impacts of Community-Based Natural Resource Management on Wealth, Food Security and Child Health in Tanzania.

PubMed

Pailler, Sharon; Naidoo, Robin; Burgess, Neil D; Freeman, Olivia E; Fisher, Brendan

2015-01-01

Community-based natural resource management (CBNRM) is a major global strategy for enhancing conservation outcomes while also seeking to improve rural livelihoods; however, little evidence of socioeconomic outcomes exists. We present a national-level analysis that empirically estimates socioeconomic impacts of CBNRM across Tanzania, while systematically controlling for potential sources of bias. Specifically, we apply a difference-in-differences model to national-scale, cross-sectional data to estimate the impact of three different CBNRM governance regimes on wealth, food security and child health, considering differential impacts of CBNRM on wealthy and poor populations. We also explore whether or not longer-standing CBNRM efforts provide more benefits than recently-established CBNRM areas. Our results show significant improvements in household food security in CBNRM areas compared with non-CBNRM areas, but household wealth and health outcomes in children are generally not significantly different. No one CBNRM governance regime demonstrates consistently different welfare outcomes than the others. Wealthy households benefit more from CBNRM than poor households and CBNRM benefits appear to increase with longer periods of implementation. Perhaps evidence of CBNRM benefits is limited because CBNRM hasn't been around long enough to yield demonstrable outcomes. Nonetheless, achieving demonstrable benefits to rural populations will be crucial for CBNRM's future success in Tanzania.

Impacts of Community-Based Natural Resource Management on Wealth, Food Security and Child Health in Tanzania

PubMed Central

Pailler, Sharon; Naidoo, Robin; Burgess, Neil D.; Freeman, Olivia E.; Fisher, Brendan

2015-01-01

Community-based natural resource management (CBNRM) is a major global strategy for enhancing conservation outcomes while also seeking to improve rural livelihoods; however, little evidence of socioeconomic outcomes exists. We present a national-level analysis that empirically estimates socioeconomic impacts of CBNRM across Tanzania, while systematically controlling for potential sources of bias. Specifically, we apply a difference-in-differences model to national-scale, cross-sectional data to estimate the impact of three different CBNRM governance regimes on wealth, food security and child health, considering differential impacts of CBNRM on wealthy and poor populations. We also explore whether or not longer-standing CBNRM efforts provide more benefits than recently-established CBNRM areas. Our results show significant improvements in household food security in CBNRM areas compared with non-CBNRM areas, but household wealth and health outcomes in children are generally not significantly different. No one CBNRM governance regime demonstrates consistently different welfare outcomes than the others. Wealthy households benefit more from CBNRM than poor households and CBNRM benefits appear to increase with longer periods of implementation. Perhaps evidence of CBNRM benefits is limited because CBNRM hasn’t been around long enough to yield demonstrable outcomes. Nonetheless, achieving demonstrable benefits to rural populations will be crucial for CBNRM’s future success in Tanzania. PMID:26186210

Monitoring the health of selected eastern arc forests in Tanzania

Treesearch

Seif Madoffe; Gerard D. Hertel; Paul Rodgers [Rogers; Barbra [Barbara] O' Connel; Raymond Killenga

2006-01-01

The eastern arc mountains (EAMs) are a chain of isolated mountains (534,000 ha) in Kenya and Tanzania surrounded by arid woodlands and influenced by the Indian Ocean. In 1900 there was three times the amount of forest cover there is today. Much of the original forests have been converted into agricultural crops. These mountains are recognized as a globally important...

The Success of Students' Loans in Financing Higher Education in Tanzania

ERIC Educational Resources Information Center

Nyahende, Veronica R.

2013-01-01

Students' loans in financing higher education in Tanzania have been subjected to many researches. However, less information is available on how the success of students' loans in financing higher education can be revealed. Therefore the purpose of this study is to examine the factors indicating the success of students' loans in financing higher…

5 CFR 1640.6 - Methods of providing information.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Methods of providing information. 1640.6 Section 1640.6 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD PERIODIC PARTICIPANT STATEMENTS § 1640.6 Methods of providing information. The TSP will furnish the information described in this...

5 CFR 1640.6 - Methods of providing information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Methods of providing information. 1640.6 Section 1640.6 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD PERIODIC PARTICIPANT STATEMENTS § 1640.6 Methods of providing information. The TSP will furnish the information described in this...

The challenge to avoid anti-malarial medicine stock-outs in an era of funding partners: the case of Tanzania.

PubMed

Mikkelsen-Lopez, Inez; Shango, Winna; Barrington, Jim; Ziegler, Rene; Smith, Tom; deSavigny, Don

2014-05-11

Between 2007 and 2013, the Tanzanian public sector received 93.1 million doses of first-line anti-malarial artemisinin-based combination therapy (ACT) in the form of artemether-lumefantrine entirely supplied by funding partners. The introduction of a health facility ACT stock monitoring system using SMS technology by the National Malaria Control Programme in mid 2011 revealed a high frequency of stock-outs of ACT in primary care public health facilities. The objective of this study was to determine the pattern of availability of ACT and possible causes of observed stock-outs across public health facilities in Tanzania since mid-2011. Data were collected weekly by the mobile phone reporting tool SMS for Life on ACT availability from over 5,000 public health facilities in Tanzania starting from September 2011 to December 2012. Stock data for all four age-dose levels of ACT across health facilities were summarized and supply of ACT at the national level was also documented. Over the period of 15 months, on average 29% of health facilities in Tanzania were completely stocked out of all four-age dose levels of the first-line anti-malarial with a median duration of total stock-out of six weeks. Patterns of total stock-out by region ranged from a low of 9% to a high of 52%. The ACT stock-outs were most likely caused by: a) insufficient ACT supplies entering Tanzania (e.g. in 2012 Tanzania received 10.9 million ACT doses compared with a forecast demand of 14.4 million doses); and b) irregular pattern of ACT supply (several months with no ACT stock). The reduced ACT availability and irregular pattern of supply were due to cumbersome bureaucratic processes and delays both within the country and from the main donor, the Global Fund to Fight AIDS, Tuberculosis and Malaria. Tanzania should invest in strengthening both the supply system and the health information system using mHealth solutions such as SMS for Life. This will continue to assist in tracking ACT availability across

Homicide of children in Dar es Salaam, Tanzania, 2005

PubMed Central

Outwater, Anne; Mgaya, Edward; Campbell, Jacquelyn C.; Becker, Stan; Kinabo, Linna; Menick, Daniel Mbassa

2014-01-01

Background Although data are sparse, it has been estimated that the highest rates of homicide death amongst children are in Africa. Little information is available on ages 0 -< 15 years. No reliable quantitative surveillance analysis of neonaticide (killed at less than one week) has been done. Methods A Violent Death Survey following WHO/CDC Guidelines was completed in Dar es Salaam region, Tanzania (DSM) (population 2.845 million) in 2005. Qualitative and quantitative data were gathered and analyzed using mixed methods techniques. Results The overall age adjusted rate of discarded and killed children in DSM was 2.05. The rate of neonaticide was 27.7 per 100,000) while the rate of homicide incidence for children > one day was Discussion The overall estimated homicide rate for Africa of children under age 15 was 4.53 per 100,000, whereas. The estimated global rate is 1.7 per 100,000 closer to DSM‘s rate. The results in DSM show that broad age groupings such as ” <1 year” or “0–4 years” or “0 – <15 years” may mask a high incidence of neonaticide and an otherwise low incidence of murdered children. The print media provided good in-depth coverage for a few cases but it is not known if the reported cases are representative. Conclusion Eighty percent of homicides of children in DSM are neonaticides. Since it is believed that the forces behind neonaticide are fundamentally different than homicides of older children, it is suggested that data of future surveys be parsed to include neonates, until the phenomenon is more clearly understood and addressed. Further understanding of the mother and father of the deceased is needed. Continued surveillance data collection is important to expand the sample size. PMID:22066333

Planning and Budgeting for Nutrition Programs in Tanzania: Lessons Learned From the National Vitamin A Supplementation Program.

PubMed

Lyatuu, Margaret Benjamin; Mkumbwa, Temina; Stevenson, Raz; Isidro, Marissa; Modaha, Francis; Katcher, Heather; Dhillon, Christina Nyhus

2016-05-03

Micronutrient deficiency in Tanzania is a significant public health problem, with vitamin A deficiency (VAD) affecting 34% of children aged 6 to 59 months. Since 2007, development partners have worked closely to advocate for the inclusion of twice-yearly vitamin A supplementation and deworming (VASD) activities with budgets at the subnational level, where funding and implementation occur. As part of the advocacy work, a VASD planning and budgeting tool (PBT) was developed and is used by district officials to justify allocation of funds. Helen Keller International (HKI) and the Tanzania Food and Nutrition Centre (TFNC) conduct reviews of VASD funds and health budgets annually in all districts to monitor the impact of advocacy efforts. This paper presents the findings of the fiscal year (FY) 2010 district budget annual review. The review was intended to answer the following questions regarding district-level funding: (1) how many funds were allocated to nutrition-specific activities in FY 2010? (2) how many funds were allocated specifically to twice-yearly VASD activities in FY 2010? and (3) how have VASD funding allocations changed over time? Budgets from all 133 districts in Tanzania were accessed, reviewed and documented to identify line item funds allocated for VASD and other nutrition activities in FY 2010. Retrospective data from prior annual reviews for VASD were used to track trends in funding. The data were collected using specific data forms and then transcribed into an excel spreadsheet for analysis. The total funds allocated in Tanzania's districts in FY 2010 amounted to US$1.4 million of which 92% were for VASD. Allocations for VASD increased from US$0.387 million to US$1.3 million between FY 2005 and FY 2010. Twelve different nutrition activities were identified in budgets across the 133 districts. Despite the increased trend, the percentage of districts allocating sufficient funds to implement VAS (as defined by cost per child) was just 21%. District

How to make rural jobs more attractive to health workers. Findings from a discrete choice experiment in Tanzania.

PubMed

Kolstad, Julie Riise

2011-02-01

The geographical imbalance of the health workforce in Tanzania represents a serious problem when it comes to delivering crucial health services to a large share of the population. This study provides new quantitative information about how to make jobs in rural areas more attractive to newly educated clinical officers (COs). A unique data set stemming from a discrete choice experiment with CO finalists in Tanzania is applied. The results show that offering continuing education after a certain period of service is one of the most powerful recruitment instruments the authorities have available. Increased salaries and hardship allowances will also substantially increase recruitment in rural areas. Offers of decent housing and good infrastructure, including the provision of equipment, will increase recruitment to rural remote areas but not as much as higher wages and offers of education. Women are less responsive to pecuniary incentives and are more concerned with factors that directly allow them to do a good job, while those with parents living in a remote rural area are generally less responsive to the proposed policies. When the willingness to help other people is a strong motivating force, policies that improve the conditions for helping people appear particularly effective.

AIDSCAP initiative. Innovation in NGO capacity building: Tanzania AIDS project.

PubMed

Dadian, M J

1998-01-01

Tanzania has since the mid-1980s experienced some of the highest rates of HIV infection in the world, with data now showing the mean levels of HIV seroprevalence nationwide to be greater than 13%, and even higher than 30% in some districts. By 2000, as many as 2.4 million Tanzanians will be infected with HIV and more than 850,000 Tanzanian children will be orphaned by the epidemic. The Tanzania AIDS Project (TAP), funded by the US Agency for International Development (USAID), was implemented through the AIDS Control and Prevention (AIDSCAP) Project by Family Health International (FHI) during 1993-97. TAP will receive support throughout 1998 through a cooperative agreement between USAID and FHI. Nongovernmental organization (NGO) representatives meet on a regular basis in Dar es Salaam and in 8 other regions of the country to plan and coordinate the major aspects of TAP's HIV/AIDS prevention activities in each area. The author describes the evolution of the idea to bring NGOs together into geographic clusters, the diversity of talents enjoyed from using the cluster concept, building institutional capacity, the challenges facing TAP's 9 clusters, and working with traditional communities.

Supradapedon revisited: geological explorations in the Triassic of southern Tanzania

PubMed Central

da Rosa, Átila A.S.; Montefeltro, Felipe C.

2017-01-01

The upper Triassic deposits of the Selous Basin in south Tanzania have not been prospected for fossil tetrapods since the middle of last century, when Gordon M. Stockley collected two rhynchosaur bone fragments from the so called “Tunduru beds”. Here we present the results of a field trip conducted in July 2015 to the vicinities of Tunduru and Msamara, Ruvuma Region, Tanzania, in search for similar remains. Even if unsuccessful in terms of fossil discoveries, the geological mapping conducted during the trip improved our knowledge of the deposition systems of the southern margin of the Selous Basin during the Triassic, allowing tentative correlations to its central part and to neighbouring basins. Moreover, we reviewed the fossil material previously collected by Gordon M. Stockley, confirming that the remains correspond to a valid species, Supradapedon stockleyi, which was incorporated into a comprehensive phylogeny of rhynchosaurs and found to represent an Hyperodapedontinae with a set of mostly plesiomorphic traits for the group. Data gathered form the revision and phylogenetic placement of Su. stockleyi helps understanding the acquisition of the typical dental traits of Late Triassic rhynchosaurs, corroborating the potential of hyperodapedontines as index fossils of the Carnian-earliest Norian. PMID:29152419

Expanding Cervical Cancer Screening and Treatment in Tanzania: Stakeholders’ Perceptions of Structural Influences on Scale-Up

PubMed Central

Giattas, Mary Rose; Sahasrabuddhe, Vikrant V.; Jolly, Pauline E.; Martin, Michelle Y.; Usdan, Stuart Lawrence; Kohler, Connie; Lisovicz, Nedra

2015-01-01

Tanzania has the highest burden of cervical cancer in East Africa. This study aims to identify perceived barriers and facilitators that influence scale-up of regional and population-level cervical cancer screening and treatment programs in Tanzania. Convenience sampling was used to select participants for this qualitative study among 35 key informants. Twenty-eight stakeholders from public-sector health facilities, academia, government, and nongovernmental organizations completed in-depth interviews, and a seven-member municipal health management team participated in a focus group discussion. The investigation identified themes related to the infrastructure of health services for cervical cancer prevention, service delivery, political will, and sociocultural influences on screening and treatment. Decentralizing service delivery, improving access to screening and treatment, increasing the number of trained health workers, and garnering political will were perceived as key facilitators for enhancing and initiating screening and treatment services. In conclusion, participants perceived that system-level structural factors should be addressed to expand regional and population-level service delivery of screening and treatment. Implications for Practice: Tanzanian women have a high burden of cervical cancer. Understanding the perceived structural factors that may influence screening coverage for cervical cancer and availability of treatment may be beneficial for program scale-up. This study showed that multiple factors contribute to the challenge of cervical cancer screening and treatment in Tanzania. In addition, it highlighted systematic developments aimed at expanding services. This study is important because the themes that emerged from the results may help inform programs that plan to improve screening and treatment in Tanzania and potentially in other areas with high burdens of cervical cancer. PMID:25926351

Isolation, biochemical and molecular identification of Nocardia species among TB suspects in northeastern, Tanzania; a forgotten or neglected threat?

PubMed

Hoza, Abubakar S; Mfinanga, Sayoki G S; Moser, Irmgard; König, Brigitte

2017-06-08

Pulmonary nocardiosis mimic pulmonary tuberculosis in most clinical and radiological manifestations. In Tanzania, where tuberculosis is one of the major public health threat clinical impact of nocardiosis as the cause of the human disease remains unknown. The objective of the present study was to isolate and identify Nocardia isolates recovered from TB suspects in Northeastern, Tanzania by using biochemical and molecular methods. The study involved 744 sputum samples collected from 372 TB suspects from four periphery diagnostic centers in Northeastern, Tanzania. Twenty patients were diagnosed as having presumptively Nocardia infections based on microscopic, cultural characteristics and biomèrieux ID 32C Yeast Identification system and confirmed using 16S rRNA and hsp65 gene specific primers for Nocardia species and sequencing. Biochemically, the majority of the isolates were N. asteroides (n = 8/20, 40%), N. brasiliensis (n = 4/20, 20%), N. farcinica (n = 3/20, 15%), N. nova (n = 1/20, 5%). Other aerobic actinomycetales included Streptomyces cyanescens (n = 2/20, 10%), Streptomyces griseus, Actinomadura madurae each (n = 1/20, 5%). Results of 16S rRNA and hsp65 sequencing were concordant in 15/17 (88. 2%) isolates and discordant in 2/17 (11.8%) isolates. Majority of the isolates belonged to N. cyriacigeorgica and N. farcinica, four (23.5%) each. Our findings suggest that Nocardia species may be an important cause of pulmonary nocardiosis that is underdiagnosed or ignored. This underscores needs to consider pulmonary nocardiosis as a differential diagnosis when there is a failure of anti-TB therapy and as a possible cause of human infections.

Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania.

PubMed

Kamuhabwa, Appolinary Ar; Gordian, Richard; Mutagonda, Ritah F

2016-01-01

In 2011, Tanzania adopted a policy for provision of daily co-trimoxazole prophylaxis to HIV-infected pregnant women for prevention of malaria and other opportunistic infections. As per the policy, HIV-infected pregnant women should not be given sulfadoxine-pyrimethamine (SP) for intermittent preventive therapy. The challenges associated with this policy change and the extent to which the new policy for prevention of malaria in pregnant women coinfected with HIV was implemented need to be assessed. To assess the implementation of malaria-preventive therapy policy among HIV-infected pregnant women in the public health facilities in Dar es Salaam, Tanzania. The study was conducted in Kinondoni Municipality, Dar es Salaam, Tanzania, from January 2015 to July 2015. Three hundred and fifty-three HIV-infected pregnant women who were attending antenatal clinics (ANCs) and using co-trimoxazole for prevention of malaria were interviewed. Twenty-six health care workers working at the ANCs were also interviewed regarding provision of co-trimoxazole prophylaxis to pregnant women. A knowledge scale was used to grade the level of knowledge of health care providers. Focus group discussions were also conducted with 18 health care workers to assess the level of implementation of the policy and the challenges encountered. Twenty-three (6.5%) pregnant women with known HIV serostatus were using co-trimoxazole for prevention of opportunistic infections even before they became pregnant. Out of the 353 HIV-infected pregnant women, eight (2.5%) were coadministered with both SP and co-trimoxazole. Sixty (16.7%) pregnant women had poor adherence to co-trimoxazole prophylaxis. Out of the 26 interviewed health care providers, 20 had high level of knowledge regarding malaria-preventive therapy in HIV-infected pregnant women. Lack of adequate supply of co-trimoxazole in health facilities and inadequate training of health care providers were among the factors causing poor implementation of co

Children's Behavioral Adjustment in Pre-Primary Schools in Tanzania: A Multilevel Approach

ERIC Educational Resources Information Center

Shavega, Theresia J.; Brugman, Daniel; van Tuijl, Cathy

2014-01-01

Research Findings: The present study concerns children's behavioral adjustment in the context of pre-primary schools in Tanzania. Twenty teachers and 320 children from 20 pre-primary schools participated in the study. Teacher-child relationships, children's behavioral adjustment, and teachers' cultural beliefs were reported by teachers; classroom…

Pathogenic seedborne viruses are rare but Phaseolus vulgaris endornaviruses are common in bean varieties grown in Nicaragua and Tanzania.

PubMed

Nordenstedt, Noora; Marcenaro, Delfia; Chilagane, Daudi; Mwaipopo, Beatrice; Rajamäki, Minna-Liisa; Nchimbi-Msolla, Susan; Njau, Paul J R; Mbanzibwa, Deusdedith R; Valkonen, Jari P T

2017-01-01

Common bean (Phaseolus vulgaris) is an annual grain legume that was domesticated in Mesoamerica (Central America) and the Andes. It is currently grown widely also on other continents including Africa. We surveyed seedborne viruses in new common bean varieties introduced to Nicaragua (Central America) and in landraces and improved varieties grown in Tanzania (eastern Africa). Bean seeds, harvested from Nicaragua and Tanzania, were grown in insect-controlled greenhouse or screenhouse, respectively, to obtain leaf material for virus testing. Equal amounts of total RNA from different samples were pooled (30-36 samples per pool), and small RNAs were deep-sequenced (Illumina). Assembly of the reads (21-24 nt) to contiguous sequences and searches for homologous viral sequences in databases revealed Phaseolus vulgaris endornavirus 1 (PvEV-1) and PvEV-2 in the bean varieties in Nicaragua and Tanzania. These viruses are not known to cause symptoms in common bean and are considered non-pathogenic. The small-RNA reads from each pool of samples were mapped to the previously characterized complete PvEV-1 and PvEV-2 sequences (genome lengths ca. 14 kb and 15 kb, respectively). Coverage of the viral genomes was 87.9-99.9%, depending on the pool. Coverage per nucleotide ranged from 5 to 471, confirming virus identification. PvEV-1 and PvEV-2 are known to occur in Phaseolus spp. in Central America, but there is little previous information about their occurrence in Nicaragua, and no information about occurrence in Africa. Aside from Cowpea mild mosaic virus detected in bean plants grown from been seeds harvested from one region in Tanzania, no other pathogenic seedborne viruses were detected. The low incidence of infections caused by pathogenic viruses transmitted via bean seeds may be attributable to new, virus-resistant CB varieties released by breeding programs in Nicaragua and Tanzania.

Determination of essential and toxic elements in clay soil commonly consumed by pregnant women in Tanzania

NASA Astrophysics Data System (ADS)

Mwalongo, D.; Mohammed, N. K.

2013-10-01

A habit of eating clay soil especially among pregnant women is a common practice in Tanzania. This practice known as geophagy might introduce toxic elements in the consumer's body to endanger the health of the mother and her child. Therefore it is very important to have information on the elemental composition of the eaten soil so as to assess the safety nature of the habit. In this study 100 samples of clay soil, which were reported to be originating from five regions in Tanzania and are consumed by pregnant women were analyzed to determine their levels of essential and toxic elements. The analysis was carried out using energy dispersive X-ray fluorescent technique (EDXRF) of Tanzania Atomic Energy Commission, Arusha. Essential elements Fe, Zn, Cu, Se and Mn and toxic elements As, Pb, Co, Ni, U and Th were detected in concentrations above WHO permissible limits in some of the samples. The results from this study show that the habit of eating soil is exposing the pregnant mothers and their children to metal toxicity which is detrimental to their health. Hence, further actions should be taken to discourage the habit of eating soil at all levels.

Knowledge and perception on tuberculosis transmission in Tanzania: Multinomial logistic regression analysis of secondary data.

PubMed

Ismail, Abbas; Josephat, Peter

2014-01-01

Tuberculosis (TB) is one of the most important public health problems in Tanzania and was declared as a national public health emergency in 2006. Community and individual knowledge and perceptions are critical factors in the control of the disease. The objective of this study was to analyze the knowledge and perception on the transmission of TB in Tanzania. Multinomial Logistic Regression analysis was considered in order to quantify the impact of knowledge and perception on TB. The data used was adopted as secondary data from larger national survey 2007-08 Tanzania HIV/AIDS and Malaria Indicator Survey. The findings across groups revealed that knowledge on TB transmission increased with an increase in age and level of education. People in rural areas had less knowledge regarding tuberculosis transmission compared to urban areas [OR = 0.7]. People with the access to radio [OR = 1.7] were more knowledgeable on tuberculosis transmission compared to those who did not have access to radio. People who did not have telephone [OR = 0.6] were less knowledgeable on tuberculosis route of transmission compared to those who had telephone. The findings showed that socio-demographic factors such as age, education, place of residence and owning telephone or radio varied systematically with knowledge on tuberculosis transmission.

Implementation of a national anti-tuberculosis drug resistance survey in Tanzania.

PubMed

Chonde, Timothy M; Doulla, Basra; van Leth, Frank; Mfinanga, Sayoki G M; Range, Nyagosya; Lwilla, Fred; Mfaume, Saidi M; van Deun, Armand; Zignol, Matteo; Cobelens, Frank G; Egwaga, Saidi M

2008-12-30

A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey.

Perceived improvement in integrated management of childhood illness implementation through use of mobile technology: qualitative evidence from a pilot study in Tanzania.

PubMed

Mitchell, Marc; Getchell, Maya; Nkaka, Melania; Msellemu, Daniel; Van Esch, Jan; Hedt-Gauthier, Bethany

2012-01-01

This study examined health care provider and caretaker perceptions of electronic Integrated Management of Childhood Illness (eIMCI) in diagnosing and treating childhood illnesses. The authors conducted semi-structured interviews among caretakers (n = 20) and health care providers (n = 11) in the Pwani region of Tanzania. This qualitative study was nested within a larger quantitative study measuring impact of eIMCI on provider adherence to IMCI protocols. Caretakers and health care workers involved in the larger study provided their perceptions of eIMCI in comparison with the conventional paper forms. One health care provider from each participating health center participated in qualitative interviews; 20 caretakers were selected from 1 health center involved in the quantitative study. Interviews were conducted in Swahili and lasted 5-10 min each. Providers expressed positive opinions of eIMCI, noting that the personal digital assistants were faster and easier to use than were the paper forms and encouraged adherence to IMCI procedures. Caretakers also held a positive view of eIMCI, noting improved service from providers, more thorough examination of their child, and a perception that providers who used the personal digital assistants were more knowledgeable. Research indicates widespread nonadherence to IMCI guidelines, suggesting improved methods for implementing IMCI are necessary. The authors conclude that eIMCI represents a promising method for improving health care delivery because it improves health care provider and caretaker perception of the clinical encounter. Further investigation into this technology is warranted.

Public and private maternal health service capacity and patient flows in Southern Tanzania: using a geographic information system to link hospital and national census data.

PubMed

Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M E; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

2014-01-01

Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health programming. Inclusive partnerships could increase

Planning and Budgeting for Nutrition Programs in Tanzania: Lessons Learned From the National Vitamin A Supplementation Program

PubMed Central

Lyatuu, Margaret Benjamin; Mkumbwa, Temina; Stevenson, Raz; Isidro, Marissa; Modaha, Francis; Katcher, Heather; Dhillon, Christina Nyhus

2016-01-01

Background: Micronutrient deficiency in Tanzania is a significant public health problem, with vitamin A deficiency (VAD) affecting 34% of children aged 6 to 59 months. Since 2007, development partners have worked closely to advocate for the inclusion of twice-yearly vitamin A supplementation and deworming (VASD) activities with budgets at the subnational level, where funding and implementation occur. As part of the advocacy work, a VASD planning and budgeting tool (PBT) was developed and is used by district officials to justify allocation of funds. Helen Keller International (HKI) and the Tanzania Food and Nutrition Centre (TFNC) conduct reviews of VASD funds and health budgets annually in all districts to monitor the impact of advocacy efforts. This paper presents the findings of the fiscal year (FY) 2010 district budget annual review. The review was intended to answer the following questions regarding district-level funding: (1) how many funds were allocated to nutrition-specific activities in FY 2010? (2) how many funds were allocated specifically to twice-yearly VASD activities in FY 2010? and (3) how have VASD funding allocations changed over time? Methods: Budgets from all 133 districts in Tanzania were accessed, reviewed and documented to identify line item funds allocated for VASD and other nutrition activities in FY 2010. Retrospective data from prior annual reviews for VASD were used to track trends in funding. The data were collected using specific data forms and then transcribed into an excel spreadsheet for analysis. Results: The total funds allocated in Tanzania’s districts in FY 2010 amounted to US$1.4 million of which 92% were for VASD. Allocations for VASD increased from US$0.387 million to US$1.3 million between FY 2005 and FY 2010. Twelve different nutrition activities were identified in budgets across the 133 districts. Despite the increased trend, the percentage of districts allocating sufficient funds to implement VAS (as defined by cost per

Malaria treatment in the retail sector: Knowledge and practices of drug sellers in rural Tanzania

PubMed Central

Hetzel, Manuel W; Dillip, Angel; Lengeler, Christian; Obrist, Brigit; Msechu, June J; Makemba, Ahmed M; Mshana, Christopher; Schulze, Alexander; Mshinda, Hassan

2008-01-01

Background Throughout Africa, the private retail sector has been recognised as an important source of antimalarial treatment, complementing formal health services. However, the quality of advice and treatment at private outlets is a widespread concern, especially with the introduction of artemisinin-based combination therapies (ACTs). As a result, ACTs are often deployed exclusively through public health facilities, potentially leading to poorer access among parts of the population. This research aimed at assessing the performance of the retail sector in rural Tanzania. Such information is urgently required to improve and broaden delivery channels for life-saving drugs. Methods During a comprehensive shop census in the districts of Kilombero and Ulanga, Tanzania, we interviewed 489 shopkeepers about their knowledge of malaria and malaria treatment. A complementary mystery shoppers study was conducted in 118 retail outlets in order to assess the vendors' drug selling practices. Both studies included drug stores as well as general shops. Results Shopkeepers in drug stores were able to name more malaria symptoms and were more knowledgeable about malaria treatment than their peers in general shops. In drug stores, 52% mentioned the correct child-dosage of sulphadoxine-pyrimethamine (SP) compared to only 3% in general shops. In drug stores, mystery shoppers were more likely to receive an appropriate treatment (OR = 9.6), but at an approximately seven times higher price. Overall, adults were more often sold an antimalarial than children (OR = 11.3). On the other hand, general shopkeepers were often ready to refer especially children to a higher level if they felt unable to manage the case. Conclusion The quality of malaria case-management in the retail sector is not satisfactory. Drug stores should be supported and empowered to provide correct malaria-treatment with drugs they are allowed to dispense. At the same time, the role of general shops as first contact points

Continuing professional development for medical, nursing, and midwifery cadres in Malawi, Tanzania and South Africa: A qualitative evaluation

PubMed Central

Pintye, Jillian; Jacob, Sheena; Chung, Michael H.; Middleton, Lyn; Iliffe, Jill; Kim, H. Nina

2017-01-01

Background As innovations in the prevention and treatment of HIV and TB advance, continuing professional development (CPD) of health care workers (HCWs) remains a high priority, particularly in sub-Saharan Africa where dual TB/HIV epidemics are compounded by severe HCW shortages. There is further need to examine CPD programs to identify challenges and effective solutions to strengthen HIV/TB-related CPD. Methods Qualitative evaluations in Malawi, Tanzania and South Africa (RSA) were conducted using key informant interviews (KIIs) and focus group discussions (FGDs) in each country to identify barriers and enablers of effective HIV/TB-related CPD. Key stakeholders represented CPD implementers, regulators, and developers. HCWs were purposively sampled from high disease burden districts; each HCW completed brief, semi-structured questionnaires and participated in a FGD. KII and FGD results were combined into key themes spanning across countries using a grounded theory approach. Results Fifty-two KIIs were conducted: 17 in Malawi, 19 in Tanzania and 16 in RSA. Eighty-nine HCWs (24 from Malawi, 38 from Tanzania and 27 from RSA) completed questionnaires and participated in FGDs. Primarily, lack of sustainable financial resources and limitations in coordination of CPD result in poor accountability for CPD oversight and reduce CPD quality assurance. Healthcare worker shortages limit CPD opportunities, creating disparities in CPD access. CPD irrelevance and imbalance between HCW-identified CPD needs and current programs reduce enthusiasm for CPD. Facility-level constraints, including poor infrastructure and weak supply chains, restrict implementation of CPD skills and knowledge. Challenges are more severe in rural settings. Conclusion To address identified gaps, sustainable funding, strong leadership and collaboration at every level are needed to strengthen CPD regulation and accreditation systems; increase CPD accessibility in the workplace; and create enabling environments

Genetic Diversity of Circulating Rotavirus Strains in Tanzania Prior to the Introduction of Vaccination

PubMed Central

Moyo, Sabrina J.; Blomberg, Bjørn; Hanevik, Kurt; Kommedal, Oyvind; Vainio, Kirsti; Maselle, Samuel Y.; Langeland, Nina

2014-01-01

Background Tanzania currently rolls out vaccination against rotavirus-diarrhea, a major cause of child illness and death. As the vaccine covers a limited number of rotavirus variants, this study describes the molecular epidemiology of rotavirus among children under two years in Dar es Salaam, Tanzania, prior to implementation of vaccination. Methods Stool specimens, demographic and clinical information, were collected from 690 children admitted to hospital due to diarrhea (cases) and 545 children without diarrhea (controls) during one year. Controls were inpatient or children attending child health clinics. Rotavirus antigen was detected using ELISA and positive samples were typed by multiplex semi-nested PCR and sequencing. Results The prevalence of rotavirus was higher in cases (32.5%) than in controls (7.7%, P<0.001). The most common G genotypes were G1 followed by G8, G12, and G4 in cases and G1, G12 and G8 in controls. The Tanzanian G1 variants displayed 94% similarity with the Rotarix vaccine G1 variant. The commonest P genotypes were P[8], P[4] and P[6], and the commonest G/P combination G1 P[8] (n = 123), G8 P[4] and G12 P[6]. Overall, rotavirus prevalence was higher in cool (23.9%) than hot months (17.1%) of the year (P = 0.012). We also observed significant seasonal variation of G genotypes. Rotavirus was most frequently found in the age group of four to six months. The prevalence of rotavirus in cases was lower in stunted children (28.9%) than in non-stunted children (40.1%, P = 0.003) and lower in HIV-infected (15.4%, 4/26) than in HIV-uninfected children (55.3%, 42/76, P<0.001). Conclusion This pre-vaccination study shows predominance of genotype G1 in Tanzania, which is phylogenetically distantly related to the vaccine strains. We confirm the emergence of genotype G8 and G12. Rotavirus infection and circulating genotypes showed seasonal variation. This study also suggests that rotavirus may not be an opportunistic pathogen in children

Accrediting retail drug shops to strengthen Tanzania's public health system: an ADDO case study.

PubMed

Rutta, Edmund; Liana, Jafary; Embrey, Martha; Johnson, Keith; Kimatta, Suleiman; Valimba, Richard; Lieber, Rachel; Shekalaghe, Elizabeth; Sillo, Hiiti

2015-01-01

Retail drug sellers are a major source of health care and medicines in many countries. In Tanzania, drug shops are widely used, particularly in rural and underserved areas. Previously, the shops were allowed to sell only over-the-counter medicines, but sellers who were untrained and unqualified often illegally sold prescription drugs of questionable quality. In 2003, we worked with Tanzania's Ministry of Health and Social Welfare to develop a public-private partnership based on a holistic approach that builds the capacity of owners, dispensers, and institutions that regulate, own, or work in retail drug shops. For shop owners and dispensers, this was achieved by combining training, business incentives, supervision, and regulatory enforcement with efforts to increase client demand for and expectations of quality products and services. The accredited drug dispensing outlet (ADDO) program's goal is to improve access to affordable, quality medicines and pharmaceutical services in retail drug outlets in rural or peri-urban areas with few or no registered pharmacies. The case study characterizes how the ADDO program achieved that goal based on the World Health Organization's health system strengthening building blocks: 1) service delivery, 2) health workforce, 3) health information systems, 4) access to essential medicines, 5) financing, and 6) leadership and governance. The ADDO program has proven to be scalable, sustainable, and transferable: Tanzania has rolled out the program nationwide; the ADDO program has been institutionalized as part of the country's health system; shops are profitable and meeting consumer demands; and the ADDO model has been adapted and implemented in Uganda and Liberia. The critical element that was essential to the ADDO program's success is stakeholder engagement-the successful buy-in and sustained commitment came directly from the effort, time, and resources spent to fully connect with vital stakeholders at all levels. Beyond improving the

Local production of pharmaceuticals in Africa and access to essential medicines: 'urban bias’ in access to imported medicines in Tanzania and its policy implications

PubMed Central

2014-01-01

Background International policy towards access to essential medicines in Africa has focused until recently on international procurement of large volumes of medicines, mainly from Indian manufacturers, and their import and distribution. This emphasis is now being challenged by renewed policy interest in the potential benefits of local pharmaceutical production and supply. However, there is a shortage of evidence on the role of locally produced medicines in African markets, and on potential benefits of local production for access to medicines. This article contributes to filling that gap. Methods This article uses WHO/HAI data from Tanzania for 2006 and 2009 on prices and sources of a set of tracer essential medicines. It employs innovative graphical methods of analysis alongside conventional statistical testing. Results Medicines produced in Tanzania were equally likely to be found in rural and in urban areas. Imported medicines, especially those imported from countries other than Kenya (mainly from India) displayed 'urban bias’: that is, they were significantly more likely to be available in urban than in rural areas. This finding holds across the range of sample medicines studied, and cannot be explained by price differences alone. While different private distribution networks for essential medicines may provide part of the explanation, this cannot explain why the urban bias in availability of imported medicines is also found in the public sector. Conclusions The findings suggest that enhanced local production may improve rural access to medicines. The potential benefits of local production and scope for their improvement are an important field for further research, and indicate a key policy area in which economic development and health care objectives may reinforce each other. PMID:24612518

Rationale and design of the Tanzania Vitamin and HIV Infection Trial.

PubMed

Fawzi, W W; Msamanga, G I; Spiegelman, D; Urassa, E J; Hunter, D J

1999-02-01

We present the rationale and design of a randomized, double-blind, placebo-controlled trial of vitamin supplements among HIV-positive pregnant women in Dar es Salaam, Tanzania. Higher levels of intake of vitamins A, B, C, and E may decrease the risk of vertical transmission and progression of HIV infection by enhancing maternal and infant immune function; by reducing viral load in the blood, breast milk, or lower genital tract secretions; and/or by strengthening the placental barrier to infection. Eligible pregnant women were randomized to receive vitamin A, multivitamins excluding A, vitamin A and multivitamins, or placebo. The main endpoints include vertical transmission of HIV infection, as assessed by examination of infection in infants using polymerase chain reaction (PCR), and progression of HIV disease as measured by the WHO clinical staging system. Over a period of 2 years, 13,876 women were tested for HIV infection, with appropriate pre- and posttest counseling, to enroll 1085 consenting HIV-positive women. The trial assesses women and their children once a month for a minimum of 18 months after delivery or up to the end of this 5-year study. We examine recruitment strategies and means of enhancing cohort retention in long-term follow-up. We assess compliance with the use of supplements by direct questioning, by counting pills, and biochemically by using serum beta-carotene and urine riboflavin levels. Briefly, we discuss ethical issues related to the conduct of AIDS prevention trials in this setting. In sub-Saharan Africa, most HIV-infected persons lack access to the relevant antiretroviral and prophylactic drugs, and the region urgently needs low-cost treatments and preventive strategies. The Tanzania trial should provide valuable data to address the effect of vitamin supplements in the transmission and progression of HIV infection.

Delivering at home or in a health facility? health-seeking behaviour of women and the role of traditional birth attendants in Tanzania

PubMed Central

2013-01-01

Background Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women’s health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system. Methods Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania. Results The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative. Conclusions Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive

Concentration and drug prices in the retail market for malaria treatment in rural Tanzania.

PubMed

Goodman, Catherine; Kachur, S Patrick; Abdulla, Salim; Bloland, Peter; Mills, Anne

2009-06-01

The impact of market concentration has been little studied in markets for ambulatory care in the developing world, where the retail sector often accounts for a high proportion of treatments. This study begins to address this gap through an analysis of the consumer market for malaria treatment in rural areas of three districts in Tanzania. We developed methods for investigating market definition, sales volumes and concentration, and used these to explore the relationship between antimalarial retail prices and competition.The market was strongly geographically segmented and highly concentrated in terms of antimalarial sales. Antimalarial prices were positively associated with market concentration. High antimalarial prices were likely to be an important factor in the low proportion of care-seekers obtaining appropriate treatment.Retail sector distribution of subsidised antimalarials has been proposed to increase the coverage of effective treatment, but this analysis indicates that local market power may prevent such subsidies from being passed on to rural customers. Policymakers should consider the potential to maintain lower retail prices by decreasing concentration among antimalarial providers and recommending retail price levels. Copyright (c) 2009 John Wiley & Sons, Ltd.

Mob justice in Tanzania: a medico-social problem.

PubMed

Ng'walali, Paul M; Kitinya, James N

2006-03-01

To investigate the magnitude of mob justice and associated factors. Mob justice is a social and public health problem that has grown in Tanzania in recent decades that has negative effects on social and health of the country, communities, and families. A four-year autopsy study was conducted at the Department of Pathology, MUCHS. Information on the cases was obtained from police, the relatives, friends and other witnesses if available. 1,249 persons were killed by mobs in Dar es Salaam during the period of 5 years (2000-2004). The alleged offense ranged from a serious crime like theft or murder to a mere violation of local customs or religious beliefs. The mode of the killings were mostly burning (48.11%) and stoning (49.96%). Other modes accounted for only 3.0% of the cases. The pattern of injuries ranged from skull and other skeletal fractures to viscera rupture. MJ is a social, legal and public health problem in Tanzania that needs immediate attention. Unemployment of youth and perceived economic inequalities should be addressed. As long as the judicial system doesn't work and corruption is not punished, people will continue to organize their own trials and judge their suspects in the street. These must be tackled in order to reduce the growing incidences of mob justice, hence saving life. It must be ensured that criminals do not violate the freedom, dignity and respect of each and every human or member of the society.

Pre-Service Teachers' Self-Efficacy Beliefs towards Educational Technologies Integration in Tanzania

ERIC Educational Resources Information Center

Raphael, Christina; Mtebe, Joel S.

2017-01-01

This study examines pre-service teachers' (N = 386) self-efficacy beliefs towards educational technologies integration in the classroom at the two colleges in Tanzania that prepare secondary education teachers. Using regression analysis, the study found out that the determinants of self-efficacy beliefs among pre-service teachers towards…

Prevalence of, and Factors Associated with, Unemployment among Graduates: Evidence from Tanzania

ERIC Educational Resources Information Center

Amani, Jaquiline

2017-01-01

Unemployment in Tanzania and many other sub-Saharan African countries has remained one of the daunting challenges in these nascent economies. Drawing on secondary sources, this article reviews and analyses the employment barriers Tanzanian graduates face, with a view to discussing possible counter-strategies. The article reveals barriers to…

Coteaching in Tanzania Benefits Both the School of St. Jude and Collegiate

ERIC Educational Resources Information Center

Independent School, 2016

2016-01-01

In 2012, Louisville Collegiate School (Kentucky) formed a partnership with The School of St. Jude in Arusha, Tanzania. As part of their professional development, six Collegiate faculty members travel each summer to spend two weeks coteaching and interacting with Tanzanian faculty and students. This professional development experience forces…

Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania

PubMed Central

Watson-Jones, Deborah; Lees, Shelley; Mwanga, Joseph; Neke, Nyasule; Changalucha, John; Broutet, Nathalie; Maduhu, Ibrahim; Kapiga, Saidi; Chandra-Mouli, Venkatraman; Bloem, Paul; Ross, David A

2016-01-01

Background: Human papillomavirus (HPV) vaccination offers an opportunity to strengthen provision of adolescent health interventions (AHI). We explored the feasibility of integrating other AHI with HPV vaccination in Tanzania. Methods: A desk review of 39 policy documents was preceded by a stakeholder meeting with 38 policy makers and partners. Eighteen key informant interviews (KIIs) with health and education policy makers and district officials were conducted to further explore perceptions of current programs, priorities and AHI that might be suitable for integration with HPV vaccination. Results: Fourteen school health interventions (SHI) or AHI are currently being implemented by the Government of Tanzania. Most are delivered as vertical programmes. Coverage of current programs is not universal, and is limited by financial, human resource and logistic constraints. Limited community engagement, rumours, and lack of strategic advocacy has affected uptake of some interventions, e.g. tetanus toxoid (TT) immunization. Stakeholder and KI perceptions and opinions were limited by a lack of experience with integrated delivery and AHI that were outside an individual’s area of expertise and experience. Deworming and educational sessions including reproductive health education were the most frequently mentioned interventions that respondents considered suitable for integrated delivery with HPV vaccine. Conclusions: Given programme constraints, limited experience with integrated delivery and concern about real or perceived side-effects being attributed to the vaccine, it will be very important to pilot-test integration of AHI/SHI with HPV vaccination. Selected interventions will need to be simple and quick to deliver since health workers are likely to face significant logistic and time constraints during vaccination visits. PMID:26768827

Setting research priorities across science, technology, and health sectors: the Tanzania experience.

PubMed

de Haan, Sylvia; Kingamkono, Rose; Tindamanyire, Neema; Mshinda, Hassan; Makandi, Harun; Tibazarwa, Flora; Kubata, Bruno; Montorzi, Gabriela

2015-03-12

Identifying research priorities is key to innovation and economic growth, since it informs decision makers on effectively targeting issues that have the greatest potential public benefit. As such, the process of setting research priorities is of pivotal importance for favouring the science, technology, and innovation (STI)-driven development of low- and middle-income countries. We report herein on a major cross-sectoral nationwide research priority setting effort recently carried out in Tanzania by the Tanzania Commission for Science and Technology (COSTECH) in partnership with the Council on Health Research for Development (COHRED) and the NEPAD Agency. The first of its type in the country, the process brought together stakeholders from 42 sub-sectors in science, technology, and health. The cross-sectoral research priority setting process consisted of a 'training-of-trainers' workshop, a demonstration workshop, and seven priority setting workshops delivered to representatives from public and private research and development institutions, universities, non-governmental organizations, and other agencies affiliated to COSTECH. The workshops resulted in ranked listings of research priorities for each sub-sector, totalling approximately 800 priorities. This large number was significantly reduced by an expert panel in order to build a manageable instrument aligned to national development plans that could be used to guide research investments. The Tanzania experience is an instructive example of the challenges and issues to be faced in when attempting to identify research priority areas and setting an STI research agenda in low- and middle-income countries. As countries increase their investment in research, it is essential to increase investment in research management and governance as well, a key and much needed capacity for countries to make proper use of research investments.

Method for providing a compliant cantilevered micromold

DOEpatents

Morales, Alfredo M.; Domeier, Linda A.; Gonzales, Marcela G.; Keifer, Patrick N.; Garino, Terry J.

2008-12-16

A compliant cantilevered three-dimensional micromold is provided. The compliant cantilevered micromold is suitable for use in the replication of cantilevered microparts and greatly simplifies the replication of such cantilevered parts. The compliant cantilevered micromold may be used to fabricate microparts using casting or electroforming techniques. When the compliant micromold is used to fabricate electroformed cantilevered parts, the micromold will also comprise an electrically conducting base formed by a porous metal substrate that is embedded within the compliant cantilevered micromold. Methods for fabricating the compliant cantilevered micromold as well as methods of replicating cantilevered microparts using the compliant cantilevered micromold are also provided.

Marine fisheries in Tanzania.

PubMed

Jiddawi, Narriman S; Ohman, Marcus C

2002-12-01

Fishery resources are a vital source of food and make valuable economic contributions to the local communities involved in fishery activities along the 850 km stretch of the Tanzania coastline and numerous islands. Small-scale artisanal fishery accounts for the majority of fish catch produced by more than 43 000 fishermen in the country, mainly operating in shallow waters within the continental shelf, using traditional fishing vessels including small boats, dhows, canoes, outrigger canoes and dinghys. Various fishing techniques are applied using uncomplicated passive fishing gears such as basket traps, fence traps, nets as well as different hook and line techniques. Species composition and size of the fish varies with gear type and location. More than 500 species of fish are utilized for food with reef fishes being the most important category including emperors, snappers, sweetlips, parrotfish, surgeonfish, rabbitfish, groupers and goatfish. Most of the fish products are used for subsistence purposes. However, some are exported. Destructive fishing methods such as drag nets and dynamite fishing pose a serious problem as they destroy important habitats for fish and other organisms, and there is a long-term trend of overharvested fishery resources. However, fishing pressure varies within the country as fishery resources are utilized in a sustainable manner in some areas. For this report more than 340 references about Tanzanian fishery and fish ecology were covered. There are many gaps in terms of information needed for successful fishery management regarding both basic and applied research. Most research results have been presented as grey literature (57%) with limited distribution; only one-fifth were scientific publications in international journals.

Assessing performance enhancing tools: experiences with the open performance review and appraisal system (OPRAS) and expectations towards payment for performance (P4P) in the public health sector in Tanzania

PubMed Central

2012-01-01

Background Health workers’ motivation is a key determinant of the quality of health services, and poor motivation has been found to be an obstacle to service delivery in many low-income countries. In order to increase the quality of service delivery in the public sector in Tanzania, the Open Performance Review and Appraisal System (OPRAS) has been implemented, and a new results-based payment system, Payment for performance (P4P) is introduced in the health sector. This article addresses health workers’ experiences with OPRAS, expectations towards P4P and how lessons learned from OPRAS can assist in the implementation of P4P. The broader aim is to generate knowledge on health workers’ motivation in low-income contexts. Methods A qualitative study design has been employed to elicit data on health worker motivation at a general level and in relation to OPRAS and P4P in particular. Focus group discussions (FGDs) and in-depth interviews (IDIs) have been conducted with nursing staff, clinicians and administrators in the public health sector in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in Tanzania. Results Health workers evaluated OPRAS and P4P in terms of the benefits experienced or expected from complying with the tools. The study found a general reluctance towards OPRAS as health workers did not see OPRAS as leading to financial gains nor did it provide feedback on performance. Great expectations were expressed towards P4P due to its prospects of topping up salaries, but the links between the two performance enhancing tools were unclear. Conclusions Health workers respond to performance enhancing tools based on whether the tools are found appropriate or yield any tangible benefits. The importance placed on salary and allowances forms the setting in which OPRAS operates. The expected addition to the salary through P4P has created a vigorous discourse among health workers attesting to the importance of

Decentralized health care priority-setting in Tanzania: evaluating against the accountability for reasonableness framework.

PubMed

Maluka, Stephen; Kamuzora, Peter; San Sebastiån, Miguel; Byskov, Jens; Olsen, Øystein E; Shayo, Elizabeth; Ndawi, Benedict; Hurtig, Anna-Karin

2010-08-01

Priority-setting has become one of the biggest challenges faced by health decision-makers worldwide. Fairness is a key goal of priority-setting and Accountability for Reasonableness has emerged as a guiding framework for fair priority-setting. This paper describes the processes of setting health care priorities in Mbarali district, Tanzania, and evaluates the descriptions against Accountability for Reasonableness. Key informant interviews were conducted with district health managers, local government officials and other stakeholders using a semi-structured interview guide. Relevant documents were also gathered and group priority-setting in the district was observed. The results indicate that, while Tanzania has a decentralized public health care system, the reality of the district level priority-setting process was that it was not nearly as participatory as the official guidelines suggest it should have been. Priority-setting usually occurred in the context of budget cycles and the process was driven by historical allocation. Stakeholders' involvement in the process was minimal. Decisions (but not the reasoning behind them) were publicized through circulars and notice boards, but there were no formal mechanisms in place to ensure that this information reached the public. There were neither formal mechanisms for challenging decisions nor an adequate enforcement mechanism to ensure that decisions were made in a fair and equitable manner. Therefore, priority-setting in Mbarali district did not satisfy all four conditions of Accountability for Reasonableness; namely relevance, publicity, appeals and revision, and enforcement. This paper aims to make two important contributions to this problematic situation. First, it provides empirical analysis of priority-setting at the district level in the contexts of low-income countries. Second, it provides guidance to decision-makers on how to improve fairness, legitimacy, and sustainability of the priority-setting process. (c

Occupational Health, Mercury Exposure, and Environmental Justice: Learning From Experiences in Tanzania

PubMed Central

2009-01-01

Mercury is a potent neurotoxin that is used by poverty-driven miners to extract gold in more than 50 countries. This article examines efforts of the United Nations to address occupational health and environmental justice amid these challenges, focusing on a 3-year campaign in one of the fastest-growing mining communities in Tanzania. By providing an integrative analysis of environmental health risks, labor practices, public health policies, and drivers of social inequity and marginalization, this study highlights the need for interdisciplinary public health approaches that support community development by strengthening local capacities. It illustrates why, to ensure that the needs of vulnerable populations are met, environmental justice and public health paradigms have to expand beyond the conventionally narrow attention paid to toxic exposure and emissions issues. PMID:19890157

An outbreak of East Coast Fever on the Comoros: a consequence of the import of immunised cattle from Tanzania?

PubMed

De Deken, R; Martin, V; Saido, A; Madder, M; Brandt, J; Geysen, D

2007-02-28

In 2003 and 2004, a severe epidemic decimated the cattle population on Grand Comore, the largest island of the Union of Comoros. Fatalities started soon after the import of cattle from Tanzania. Theileria parva and its vector, Rhipicephalus appendiculatus, could be identified as the main culprits of the epidemic. Characterisation by multilocus genotyping revealed that the T. parva parasites isolated on the Comoros were identical to the components of the Muguga cocktail vaccine used in Tanzania to immunise cattle. Therefore, it is believed that East Coast Fever reached the Comoros while some of the imported livestock got infected in Tanzania by ticks of which the immature stadia fed on Muguga cocktail vaccinated animals. Since the Comorian government neither has the financial means nor the competent staff to pursue an adequate epidemiosurveillance, the danger exists that without external assistance and in a context of continuing globalisation more transboundary diseases will affect the Comorian livestock sector in the future.

Field evaluation of the photo-induced electron transfer fluorogenic primers (PET) real-time PCR for the detection of Plasmodium falciparum in Tanzania.

PubMed

Talundzic, Eldin; Maganga, Mussa; Masanja, Irene M; Peterson, David S; Udhayakumar, Venkatachalam; Lucchi, Naomi W

2014-01-27

Accurate diagnosis of malaria infections remains challenging, especially in the identification of submicroscopic infections. New molecular diagnostic tools that are inexpensive, sensitive enough to detect low-level infections and suitable in laboratory settings of resource-limited countries are required for malaria control and elimination programmes. Here the diagnostic potential of a recently developed photo-induced electron transfer fluorogenic primer (PET) real-time polymerase chain reaction (PCR) called PET-PCR was investigated. This study aimed to (i) evaluate the use of this assay as a method for the detection of both Plasmodium falciparum and other Plasmodium species infections in a developing country's diagnostic laboratory; and, (ii) determine the assay's sensitivity and specificity compared to a nested 18S rRNA PCR. Samples used in this study were obtained from a previous study conducted in the region of Iringa, Tanzania. A total of 303 samples from eight health facilities in Tanzania were utilized for this evaluation. All samples were screened using the multiplex PET-PCR assay designed to detect Plasmodium genus and P. falciparum initially in laboratory in Tanzania and then repeated at a reference laboratory at the CDC in the USA. Microscopy data was available for all the 303 samples. A subset of the samples were tested in a blinded fashion to find the sensitivity and specificity of the PET-PCR compared to the nested 18S rRNA PCR. Compared to microscopy, the PET-PCR assay was 59% more sensitive in detecting P. falciparum infections. The observed sensitivity and specificity were 100% (95% confidence interval (CI0.95) = 94-100%) and (CI0.95 = 96-100%), respectively, for the PET-PCR assay when compared to nested 18S rRNA PCR. When compared to 18S rRNA PCR, microscopy had a low sensitivity of 40% (CI0.95 = 23-61%) and specificity of 100% (CI0.95 = 96-100%). The PET-PCR results performed in the field laboratory in Tanzania were in 100

Counselling on and women's awareness of pregnancy danger signs in selected rural health facilities in Burkina Faso, Ghana and Tanzania.

PubMed

Duysburgh, Els; Ye, Maurice; Williams, Afua; Massawe, Siriel; Sié, Ali; Williams, John; Mpembeni, Rose; Loukanova, Svetla; Temmerman, Marleen

2013-12-01

The aims of this study were to (i) assess healthcare workers' counselling practices concerning danger signs during antenatal consultations in rural primary healthcare (PHC) facilities in Burkina Faso, Ghana and Tanzania; to (ii) assess pregnant women's awareness of these danger signs; and (iii) to identify factors affecting counselling practices and women's awareness. Cross-sectional study in rural PHC facilities in Burkina Faso, Ghana and Tanzania. In each country, 12 facilities were randomly selected. WHO guidelines were used as standard for good counselling. We assessed providers' counselling practice on seven danger signs through direct observation study (35 observations/facility). Exit interviews (63 interviews/facility) were used to assess women's awareness of the same seven danger signs. We used negative binomial regression to assess associations with health services' and socio-demographic characteristics and to estimate per study site the average number of danger signs on which counselling was provided and the average number of danger signs mentioned by women. About one in three women was not informed of any danger sign. For most danger signs, fewer than half of the women were counselled. Vaginal bleeding and severe abdominal pain were the signs most counselled on (between 52% and 66%). At study facilities in Burkina Faso, 58% of the pregnant women were not able to mention a danger sign, in Ghana this was 22% and in Tanzania 30%. Fever, vaginal bleeding and severe abdominal pain were the danger signs most frequently mentioned. The type of health worker (depending on the training they received) was significantly associated with counselling practices. Depending on the study site, characteristics significantly associated with awareness of signs were women's age, gestational age, gravidity and educational level. Counselling practice is poor and not very efficient. A new approach of informing pregnant women on danger signs is needed. However, as effects of

Spectroscopy of red dravite from northern Tanzania

NASA Astrophysics Data System (ADS)

Taran, Michail N.; Dyar, M. Darby; Naumenko, Ievgen V.; Vyshnevsky, Olexij A.

2015-07-01

Low-Fe dravite with a formula of Na0.66Ca0.16Mg2.62Fe0.33Mn0.02Ti0.02Al5.95B3Si6.04O27(OH)4 is described from Engusero Sambu, northern Tanzania (On maps, Engusero Sambu may be found to be marked as belonging to Kenya, but in reality, it is located near the border in northern Tanzania). The sample has an unusual red color that is distinctly different from the red dravite from the Osarara, Narok district, in Kenya that was formerly studied by Mattson and Rossman (Phys Chem Miner 14:225-234, 1984) and Taran and Rossman (Am Mineral 87:1148-1153, 2002). This unique sample has been characterized by optical and Mössbauer spectral measurements to investigate underlying cause of the intense bands in absorption spectra that give rise to the red color. These features are shown to be caused by exchange-coupled Fe3+-Fe3+ interactions. Thermal annealing of the samples causes an increase in Fe3+ contents due to oxidation of [Y]Fe2+. However, heat treatment does not change the high-energy absorption edge, which is probably caused by intense ligand-to-Fe3+ charge-transfer UV bands. In fact, Mössbauer results show that high-temperature annealing initiates breakdown of the tourmaline into an Fe oxide and causes accompanying redistribution of Fe3+ within the structure. Because of the popularity of tourmaline as a gemstone, this work has implications for understanding the causes of color in tourmaline, facilitating recognition of the distinctions between naturally occurring and treated tourmalines in the gem industry and enabling heat treatments for color enhancement.

Evaluation of a family-oriented antenatal group educational program in rural Tanzania: a pre-test/post-test study.

PubMed

Shimpuku, Yoko; Madeni, Frida E; Horiuchi, Shigeko; Kubota, Kazumi; Leshabari, Sebalda C

2018-06-28

To increase births attended by skilled birth attendants in Tanzania, studies have identified the need for involvement of the whole family in pregnancy and childbirth education. This study aimed to develop, implement, and evaluate a family-oriented antenatal group educational program to promote healthy pregnancy and family involvement in rural Tanzania. This was a quasi-experimental 1 group pre-test/post-test study with antenatal education provided to pregnant women and their families in rural Tanzania. Before and after the educational program, the pre-test/post-test study was conducted using a 34-item Birth Preparedness Questionnaire. Acceptability of the educational program was qualitatively assessed. One-hundred and thirty-eight participants (42 pregnant women, 96 family members) attended the educational program, answered the questionnaire, and participated in the feasibility inquiry. The mean knowledge scores significantly increased between the pre-test and the post-test, 7.92 and 8.33, respectively (p = 0.001). For both pregnant women and family members, the educational program improved Family Support (p = 0.001 and p = 0.000) and Preparation of Money and Food (p = 0.000 and p = 0.000). For family members, the scores for Birth Preparedness (p = 0.006) and Avoidance of Medical Intervention (reversed item) (p = 0.002) significantly increased. Despite the educational program, the score for Home-based Value (reversed item) (p = 0.022) and References of SBA (p = 0.049) decreased in pregnant women. Through group discussions, favorable comments about the program and materials were received. The comments of the husbands reflected their better understanding and appreciation of their role in supporting their wives during the antenatal period. The family-oriented antenatal group educational program has potential to increase knowledge, birth preparedness, and awareness of the need for family support among pregnant women and their

Upper mantle Q and thermal structure beneath Tanzania, East Africa from teleseismic P wave spectra

NASA Astrophysics Data System (ADS)

Venkataraman, Anupama; Nyblade, Andrew A.; Ritsema, Jeroen

2004-08-01

We measure P wave spectral amplitude ratios from deep-focus earthquakes recorded at broadband seismic stations of the Tanzania network to estimate regional variation of sublithospheric mantle attenuation beneath the Tanzania craton and the eastern branch of the East African Rift. One-dimensional profiles of QP adequately explain the systematic variation of P wave attenuation in the sublithospheric upper mantle: QP ~ 175 beneath the cratonic lithosphere, while it is ~ 80 beneath the rifted lithosphere. By combining the QP values and a model of P wave velocity perturbations, we estimate that the temperature beneath the rifted lithosphere (100-400 km depth) is 140-280 K higher than ambient mantle temperatures, consistent with the observation that the 410 km discontinuity in this region is depressed by 30-40 km.

Peasants and Educators: A Study of the Literacy Environment in Rural Tanzania.

ERIC Educational Resources Information Center

Kadege, Nyasugara P.; And Others

A study mapped out the current provision of and needs for post-literacy facilities in Tanzania, in particular in the rural regions. Study activities included the following: literature review on post-literacy provision and participation; review of the Ministry of Education and Culture's (MEC's) official statistics on post-literacy provision and…

Torches in the Night. Educational Experiences in Tanzania and the Ivory Coast.

ERIC Educational Resources Information Center

Muncie, Peter C.

This booklet describes two educational projects financed by the World Bank in cooperation with UNESCO. Tanzania was the site of one project, where agricultural training at the intermediate and farmer levels was the focus. The second project was in the Ivory Coast and involved construction of technical, vocational, agricultural, teacher training…

"Drugs, Religion and Chemistry in Tanzania": An Interactive Seminar for Chemistry Students

ERIC Educational Resources Information Center

Buchanan, Malcolm S.

2015-01-01

Most Tanzanian Higher Education Institutes do not have the materials and technology to give students a significant practical experience in the sciences. In 2013 Tanzania was rated 159th out of 187 countries for "human development" (United Nations Development Program 2014 Report). In order to supplement their current, limited practical…

Climate Influence on Emerging Risk Areas for Rift Valley Fever Epidemics in Tanzania.

PubMed

Mweya, Clement N; Mboera, Leonard E G; Kimera, Sharadhuli I

2017-07-01

Rift Valley Fever (RVF) is a climate-related arboviral infection of animals and humans. Climate is thought to represent a threat toward emerging risk areas for RVF epidemics globally. The objective of this study was to evaluate influence of climate on distribution of suitable breeding habitats for Culex pipiens complex, potential mosquito vector responsible for transmission and distribution of disease epidemics risk areas in Tanzania. We used ecological niche models to estimate potential distribution of disease risk areas based on vectors and disease co-occurrence data approach. Climatic variables for the current and future scenarios were used as model inputs. Changes in mosquito vectors' habitat suitability in relation to disease risk areas were estimated. We used partial receiver operating characteristic and the area under the curves approach to evaluate model predictive performance and significance. Habitat suitability for Cx. pipiens complex indicated broad-scale potential for change and shift in the distribution of the vectors and disease for both 2020 and 2050 climatic scenarios. Risk areas indicated more intensification in the areas surrounding Lake Victoria and northeastern part of the country through 2050 climate scenario. Models show higher probability of emerging risk areas spreading toward the western parts of Tanzania from northeastern areas and decrease in the southern part of the country. Results presented here identified sites for consideration to guide surveillance and control interventions to reduce risk of RVF disease epidemics in Tanzania. A collaborative approach is recommended to develop and adapt climate-related disease control and prevention strategies.

A qualitative study of the determinants of HIV guidelines implementation in two south-eastern districts of Tanzania.

PubMed

Mwangome, Mary N; Geubbels, Eveline; Wringe, Alison; Todd, Jim; Klatser, Paul; Dieleman, Marjolein

2017-07-01

Current HIV policies in Tanzania have adopted the three long-term impact results of zero new infections, zero HIV deaths and zero stigma and discrimination. Strategies to reach these results include scaling-up HIV Testing and Counselling (HTC); Preventing Mother-To-Child Transmission (PMTCT); and strengthening Care and Treatment Clinic (CTC) services. Previous studies showed that HIV policy and guideline recommendations were not always implemented in rural South Tanzania. This study aims to identify the determinants of HIV guideline implementation. A qualitative study of 23 semi-structured interviews with facility in-charges; healthcare workers; district, regional and national HIV coordinators was conducted. Five health facilities were purposively selected by level, ownership and proximity to district headquarters. Interviews were analysed according to Fleuren's five determinants of innovation uptake related to: strategies used in guideline development and dissemination; guideline characteristics; the guideline implementing organization; guideline users; and the socio-cultural and regulatory context. None of the facilities had the HTC national guideline document. Non-involvement of providers in revisions and weak planning for guideline dissemination impeded their implementation. Lengthy guidelines and those written in English were under-used, and activities perceived to be complicated, like WHO-staging, were avoided. Availability of staff and lack of supplies like test kits and medication impeded implementation. Collaboration between facilities enhanced implementation, as did peer-support among providers. Provider characteristics including education level, knowledge of, and commitment to the guideline influenced implementation. According to providers, determinants of clients' service use included gender norms, stigma, trust and perceived benefits. The regulatory context prohibited private hospitals from buying HIV supplies. Being tools for bringing policies to

Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania – challenges in implementation

PubMed Central

2009-01-01

Background In the past decade there has been increasing visibility of malaria control efforts at the national and international levels. The factors that have enhanced this scenario are the availability of proven interventions such as artemisinin-based combination therapy, the wide scale use of insecticide-treated nets (ITNs) and a renewed emphasis in indoor residual house-spraying. Concurrently, there has been a window of opportunity of financial commitments from organizations such as the Global Fund for HIV/AIDS, Tuberculosis and Malaria (GFATM), the President's Malaria Initiative and the World Bank Booster programme. Methods The case study uses the health policy analysis framework to analyse the implementation of a public-private partnership approach embarked upon by the government of Tanzania in malaria control – 'The Tanzania National Voucher Scheme'- and in this synthesis, emphasis is on the challenges faced by the scheme during the pre-implementation (2001 – 2004) and implementation phases (2004 – 2005). Qualitative research tools used include: document review, interview with key informants, stakeholder's analysis, force-field analysis, time line of events, policy characteristic analysis and focus group discussions. The study is also complemented by a cross-sectional survey, which was conducted at the Rufiji Health Demographic Surveillance Site, where a cohort of women of child-bearing age were followed up regarding access and use of ITNs. Results The major challenges observed include: the re-introduction of taxes on mosquito nets and related products, procurement and tendering procedures in the implementation of the GFATM, and organizational arrangements and free delivery of mosquito nets through a Presidential initiative. Conclusion The lessons gleaned from this synthesis include: (a) the consistency of the stakeholders with a common vision, was an important strength in overcoming obstacles, (b) senior politicians often steered the policy agenda when

Equity in financing and use of health care in Ghana, South Africa, and Tanzania: implications for paths to universal coverage.

PubMed

Mills, Anne; Ataguba, John E; Akazili, James; Borghi, Jo; Garshong, Bertha; Makawia, Suzan; Mtei, Gemini; Harris, Bronwyn; Macha, Jane; Meheus, Filip; McIntyre, Di

2012-07-14

Universal coverage of health care is now receiving substantial worldwide and national attention, but debate continues on the best mix of financing mechanisms, especially to protect people outside the formal employment sector. Crucial issues are the equity implications of different financing mechanisms, and patterns of service use. We report a whole-system analysis--integrating both public and private sectors--of the equity of health-system financing and service use in Ghana, South Africa, and Tanzania. We used primary and secondary data to calculate the progressivity of each health-care financing mechanism, catastrophic spending on health care, and the distribution of health-care benefits. We collected qualitative data to inform interpretation. Overall health-care financing was progressive in all three countries, as were direct taxes. Indirect taxes were regressive in South Africa but progressive in Ghana and Tanzania. Out-of-pocket payments were regressive in all three countries. Health-insurance contributions by those outside the formal sector were regressive in both Ghana and Tanzania. The overall distribution of service benefits in all three countries favoured richer people, although the burden of illness was greater for lower-income groups. Access to needed, appropriate services was the biggest challenge to universal coverage in all three countries. Analyses of the equity of financing and service use provide guidance on which financing mechanisms to expand, and especially raise questions over the appropriate financing mechanism for the health care of people outside the formal sector. Physical and financial barriers to service access must be addressed if universal coverage is to become a reality. European Union and International Development Research Centre. Copyright © 2012 Elsevier Ltd. All rights reserved.

HIV-1 drug resistance in recently HIV-infected pregnant mother's naïve to antiretroviral therapy in Dodoma urban, Tanzania.

PubMed

Vairo, Francesco; Nicastri, Emanuele; Liuzzi, Giuseppina; Chaula, Zainab; Nguhuni, Boniface; Bevilacqua, Nazario; Forbici, Federica; Amendola, Alessandra; Fabeni, Lavinia; De Nardo, Pasquale; Perno, Carlo Federico; Cannas, Angela; Sakhoo, Calistus; Capobianchi, Maria Rosaria; Ippolito, Giuseppe

2013-09-21

HIV resistance affects virological response to therapy and efficacy of prophylaxis in mother-to-child-transmission. The study aims to assess the prevalence of HIV primary resistance in pregnant women naïve to antiretrovirals. Cross sectional baseline analysis of a cohort of HIV + pregnant women (HPW) enrolled in the study entitled Antiretroviral Management of Antenatal and Natal HIV Infection (AMANI, peace in Kiswahili language). The AMANI study began in May 2010 in Dodoma, Tanzania. In this observational cohort, antiretroviral treatment was provided to all women from the 28th week of gestation until the end of the breastfeeding period. Baseline CD4 cell count, viral load and HIV drug-resistance genotype were collected. Drug-resistance analysis was performed on 97 naïve infected-mothers. The prevalence of all primary drug resistance and primary non-nucleoside reverse-transcriptase inhibitors resistance was 11.9% and 7.5%, respectively. K103S was found in two women with no M184V detection. HIV-1 subtype A was the most commonly identified, with a high prevalence of subtype A1, followed by C, D, C/D recombinant, A/C recombinant and A/D recombinant. HIV drug- resistance mutations were detected in A1 and C subtypes. Our study reports an 11.9% prevalence rate of primary drug resistance in naïve HIV-infected pregnant women from a remote area of Tanzania. Considering that the non-nucleoside reverse-transcriptase inhibitors are part of the first-line antiretroviral regimen in Tanzania and all of Africa, resistance surveys should be prioritized in settings where antiretroviral therapy programs are scaled up.

A Nationwide Survey of the Quality of Antimalarials in Retail Outlets in Tanzania

PubMed Central

Kaur, Harparkash; Goodman, Catherine; Thompson, Eloise; Thompson, Katy-Anne; Masanja, Irene; Kachur, S. Patrick; Abdulla, Salim

2008-01-01

Introduction Retail pharmaceutical products are commonly used to treat fever and malaria in sub-Saharan African countries. Small scale studies have suggested that poor quality antimalarials are widespread throughout the region, but nationwide data are not available that could lead to generalizable conclusions about the extent to which poor quality drugs are available in African communities. This study aimed to assess the quality of antimalarials available from retail outlets across mainland Tanzania. Methods and Findings We systematically purchased samples of oral antimalarial tablets from retail outlets across 21 districts in mainland Tanzania in 2005. A total of 1080 antimalarial formulations were collected including 679 antifol antimalarial samples (394 sulfadoxine/pyrimethamine and 285 sulfamethoxypyrazine/pyrimethamine), 260 amodiaquine samples, 63 quinine samples, and 51 artemisinin derivative samples. A systematic subsample of 304 products was assessed for quality by laboratory based analysis to determine the amount of the active ingredient and dissolution profile by following the published United States Pharmacopoeia (USP) monogram for the particular tablet being tested. Products for which a published analytical monogram did not exist were assessed on amount of active ingredient alone. Overall 38 or 12.2% of the samples were found to be of poor quality. Of the antifolate antimalarial drugs tested 13.4% were found to be of poor quality by dissolution and content analysis using high-performance liquid chromatography (HPLC). Nearly one quarter (23.8%) of quinine tablets did not comply within the tolerance limits of the dissolution and quantification analysis. Quality of amodiaquine drugs was relatively better but still unacceptable as 7.5% did not comply within the tolerance limits of the dissolution analysis. Formulations of the artemisinin derivatives all contained the stated amount of active ingredient when analysed using HPLC alone. Conclusions Substandard

Unpacking Global Service-Learning in Developing Contexts: A Case Study from Rural Tanzania

ERIC Educational Resources Information Center

Oberhauser, Ann M.; Daniels, Rita

2017-01-01

This article examines intercultural aspects of global service learning (GSL) focused on gender and sustainable development in rural Tanzania. The discussion draws from critical development and postcolonial feminist approaches to examine how GSL addresses globalization, social histories, and political economies of development. The empirical…

Psychosocial, behavioural and health system barriers to delivery and uptake of intermittent preventive treatment of malaria in pregnancy in Tanzania – viewpoints of service providers in Mkuranga and Mufindi districts

PubMed Central

2014-01-01

Background Intermittent preventive treatment of malaria in pregnancy (IPTp) using sulphurdoxine-pyrimethamine (SP) is one of key malaria control strategies in Africa. Yet, IPTp coverage rates across Africa are still low due to several demand and supply constraints. Many countries implement the IPTp-SP strategy at antenatal care (ANC) clinics. This paper reports from a study on the knowledge and experience of health workers (HWs) at ANC clinics regarding psychosocial, behavioural and health system barriers to IPTp-SP delivery and uptake in Tanzania. Methods Data were collected through questionnaire-based interviews with 78 HWs at 28 ANC clinics supplemented with informal discussions with current and recent ANC users in Mkuranga and Mufindi districts. Qualitative data were analysed using a qualitative content analysis approach. Quantitative data derived from interviews with HWs were analysed using non-parametric statistical analysis. Results The majority of interviewed HWs were aware of the IPTp-SP strategy’s existence and of the recommended one month spacing of administration of SP doses. Some HWs were unsure of that it is not recommended to administer IPTp-SP and ferrous/folic acid concurrently. Others were administering three doses of SP per client following instruction from a non-governmental agency while believing that this was in conflict with national guidelines. About half of HWs did not find it appropriate for the government to recommend private ANC providers to provide IPTp-SP free of charge since doing so forces private providers to recover the costs elsewhere. HWs noted that pregnant women often register at clinics late and some do not comply with the regularity of appointments for revisits, hence miss IPTp and other ANC services. HWs also noted some amplified rumours among clients regarding health risks and treatment failures of SP used during pregnancy, and together with clients’ disappointment with waiting times and the sharing of cups at ANC

How do area-level socioeconomic status and gender norms affect partner violence against women? Evidence from Tanzania.

PubMed

Vyas, Seema; Heise, Lori

2016-11-01

To explore how area-level socioeconomic status and gender-related norms influence partner violence against women in Tanzania. We analysed data from the 2010 Tanzania Demographic and Health Survey and used multilevel logistic regression to estimate individual and community-level effects on women's risk of current partner violence. Prevalence of current partner violence was 36.1 %; however, variation in prevalence exists across communities. Twenty-nine percent of the variation in the logodds of partner violence is due to community-level influences. When adjusting for individual-level characteristics, this variation falls to 10 % and falls further to 8 % when adjusting for additional community-level factors. Higher levels of women's acceptance towards wife beating, male unemployment, and years of schooling among men were associated with higher risk of partner violence; however, higher levels of women in paid work were associated with lower risk. Area-level poverty and inequitable gender norms were associated with higher risk of partner violence. Empowerment strategies along with addressing social attitudes are likely to achieve reductions in rates of partner violence against women in Tanzania and in other similar low-income country settings.

Prevalence of and Factors Associated with Work Stress in Academia in Tanzania

ERIC Educational Resources Information Center

Mkumbo, Kitila

2014-01-01

Work stress has been identified as a common phenomenon in the teaching profession. However, little research has been done to examine the prevalence of and factors associated with work stress among employees in university context in Tanzania and sub-Saharan African countries in general. Using survey design within the quantitative approach, this…

Adolescent Hopefulness in Tanzania: Street Youth, Former Street Youth, and School Youth

ERIC Educational Resources Information Center

Nalkur, Priya G.

2009-01-01

This study compares hope in street youth, former street youth, and school youth (aged 12-18) in Tanzania. Responding to Snyder's hope theory, the author argues that not only personal agency but also the stability of living context (street, shelter, home) shapes hopefulness. Employing qualitative and quantitative analyses, the author presents a…

Quantifying Risk Factors for Human Brucellosis in Rural Northern Tanzania

PubMed Central

John, Kunda; Fitzpatrick, Julie; French, Nigel; Kazwala, Rudovick; Kambarage, Dominic; Mfinanga, Godfrey S.; MacMillan, Alastair; Cleaveland, Sarah

2010-01-01

Background Brucellosis is a zoonosis of veterinary, public health and economic significance in most developing countries. Human brucellosis is a severely debilitating disease that requires prolonged treatment with a combination of antibiotics. The disease can result in permanent and disabling sequel, and results in considerable medical expenses in addition to loss of income due to loss of working hours. A study was conducted in Northern Tanzania to determine the risk factors for transmission of brucellosis to humans in Tanzania. Methods This was a matched case-control study. Any patient with a positive result by a competitive ELISA (c-ELISA) test for brucellosis, and presenting to selected hospitals with at least two clinical features suggestive of brucellosis such as headache, recurrent or continuous fever, sweating, joint pain, joint swelling, general body malaise or backache, was defined as a case. For every case in a district, a corresponding control was traced and matched by sex using multistage cluster sampling. Other criteria for inclusion as a control included a negative c-ELISA test result and that the matched individual would present to hospital if falls sick. Results Multivariable analysis showed that brucellosis was associated with assisted parturition during abortion in cattle, sheep or goat. It was shown that individuals living in close proximity to other households had a higher risk of brucellosis. People who were of Christian religion were found to have a higher risk of brucellosis compared to other religions. The study concludes that assisting an aborting animal, proximity to neighborhoods, and Christianity were associated with brucellosis infection. There was no association between human brucellosis and Human Immunodeficiency Virus (HIV) serostatus. Protecting humans against contact with fluids and tissues during assisted parturition of livestock may be an important means of reducing the risk of transferring brucellosis from livestock to humans

"Ormilo disease" a disorder of zebu cattle in Tanzania: bovine cerebral theileriosis or new protozoan disease?

PubMed

Catalano, Deborah; Biasibetti, Elena; Lynen, Godelieve; Di Giulio, Giuseppe; De Meneghi, Daniele; Tomassone, Laura; Valenza, Federico; Capucchio, Maria Teresa

2015-06-01

"Ormilo" disease is a neurological disorder of cattle described by Maasai herders in Tanzania. It is attributed to infection by Theileria species, although no detailed data are available in the literature. The authors describe the macroscopical and histological changes observed in 30 brains of indigenous short-horn zebu cattle from Northern Tanzania, aged 2-9 years, with the characteristic neurological signs of "Ormilo". Moreover, the ultrastructural details observed in 14 selected brain samples were reported. Areas of congestion and hemorrhages, associated with the obstruction of the cerebral vessels with large numbers of parasitized lymphoid cells, were observed. Electron microscopy showed the presence of intralymphocytic parasites morphologically comparable to flagellated protozoa, not previously described in the lymphoid cells of cattle, but only reported during the sexual stages within the vector. Theileria taurotragi was detected by polymerase chain reaction (PCR) and reverse line blot (RLB) in nine samples. The authors hypothesize that the parasite detected by electron microscopy could be a strain of a Theileria endemic to this region till now not investigated, having an intralymphocytic phase and being associated with other Theileria spp. infestation. Further studies are needed to better understand the etiology of "Ormilo" disease and to characterize the morphology of the observed parasite, clarifying its role in the disease in Tanzania.

The Past, Present and Future of Domestic Equines in Tanzania

PubMed Central

WILSON, R. Trevor

2013-01-01

Equines are minor species in Tanzania’s array of domestic livestock. Attempts to use them for transport by early explorers from the mid-nineteenth century usually failed. Donkeys were used extensively as pack animals to complement human porters by both British and German forces in the First World War, but their advantages were often outweighed by slow progress and competition with troops and porters for water, and they died in huge numbers. The British had regular cavalry troops in their campaign and mules found limited use as individual mounts for officers. In modern times, there are very few horses in Tanzania but they find several uses. Exotic safaris are made on horseback, they are used as stock horses on ranches, there is a polo club in northern Tanzania and there are leisure riding activities around the capital city. Official census records for donkeys estimate numbers at under 300,000 with concentrations in the northern pastoral and agropastoral areas where they are used as pack animals with water being the main commodity transported. Elsewhere donkeys are used to a limited extent in transport and traction work. There is little interest in equines by the central and local governments or the general public and the status quo can be expected to continue. PMID:24834000

Mass distribution of free insecticide-treated nets do not interfere with continuous net distribution in Tanzania

PubMed Central

2014-01-01

Background To protect the most vulnerable groups from malaria (pregnant women and infants) the Tanzanian Government introduced a subsidy (voucher) scheme in 2004, on the basis of a public-private partnership. These vouchers are provided to pregnant women at their first antenatal care visit and mothers of infants at first vaccination. The vouchers are redeemed at registered retailers for a long-lasting insecticidal net against the payment of a modest top-up price. The present work analysed a large body of data from the Tanzanian National Voucher Scheme, focusing on interactions with concurrent mass distribution campaigns of free nets. Methods In an ecologic study involving all regions of Tanzania, voucher redemption data for the period 2007 2011, as well as data on potential determinants of voucher redemption were analysed. The four outcome variables were: pregnant woman and infant voucher redemption rates, use of treated bed nets by all household members and by under- five children. Each of the outcomes was regressed with selected determinants, using a generalized estimating equation model and accounting for regional data clustering. Results There was a consistent improvement in voucher redemption rates over the selected time period, with rates >80% in 2011. The major determinants of redemption rates were the top-up price paid by the voucher beneficiary, the retailer- clinic ratio, and socio-economic status. Improved redemption rates after 2009 were most likely due to reduced top-up prices (following a change in policy). Redemption rates were not affected by two major free net distribution campaigns. During this period, there was a consistent improvement in net use across all the regions, with rates of up to 75% in 2011. Conclusion The key components of the National Treated Nets Programme (NATNETS) seem to work harmoniously, leading to a high level of net use in the entire population. This calls for the continuation of this effort in Tanzania and for emulation by

Evaluation of collection methods for Culex quinquefasciatus, Aedes aegypti, and Aedes simpsoni in northeastern Tanzania.

PubMed

Thornton, Jonathan Harold; Batengana, Bernard Malongo; Eiras, Alvaro Eduardo; Irish, Seth Robert

2016-12-01

In East Africa, significant morbidity and mortality are caused by infections spread by Culex quinquefasciatus and Aedes aegypti. Sticky traps have been shown to be effective tools for sampling populations of Aedes mosquitoes and have been found to catch Cx. quinquefasciatus. Thus, they could potentially be used to sample populations of this species. This study compared Sticky ovitraps (SO) and MosquiTraps (MQT) with the CDC Gravid trap (CDC-GT) for collection of Culex and Aedes mosquito populations in Tanzania. A follow-up experiment was carried out using traps set for a 24-h period to accommodate the oviposition habits of Aedes aegypti and Ae. simpsoni s.l. mosquitoes. The results showed that the CDC-GT caught significantly more Cx. quinquefasciatus and Ae. aegypti than the SO or MQT, but there was no significant difference in the number of mosquitoes caught between the two sticky traps or of Ae. simpsoni s.l. caught among the three trap types. The results suggest that CDC-GTs are the most appropriate in sampling of Cx. quinquefasciatus. Although CDC-GTs collected more Ae. aegypti than the sticky traps, the simplicity and cost benefit of sticky traps facilitates large scale studies. All three trap types should be considered for monitoring Aedes mosquitoes. © 2016 The Society for Vector Ecology.

Globalisation, Language and Education: A Comparative Study of the United States and Tanzania

NASA Astrophysics Data System (ADS)

Roy-Campbell, Zaline M.

2001-07-01

Educational language choice has been one of the most provocative issues of the 20th century and continues to be a dominant issue at the turn of the new millennium. Efforts to naturalize English as the only suitable language for post primary school education persist in many African countries, including Tanzania. In the United States the campaign for "English only" in the schools is gaining momentum, despite the increasing multilingual population in the schools. Focusing on Tanzania and the United States, this article examines the fallacy of a monolingual, English only, policy in education. It examines the ethos surrounding the debate about the language of instruction, and considers some of the detrimental effects upon students of attempting to impose a monolingual policy. Finally, the paper suggests possible roles of educators and researchers in fostering international understanding of educational language issues as one aspect of the quest for global peace and social justice in the 21st century.

Built environment analysis for road traffic hotspot locations in Moshi, Tanzania.

PubMed

Waldon, Meredith; Ibingira, Treasure Joelson; de Andrade, Luciano; Mmbaga, Blandina T; Vissoci, João Ricardo N; Mvungi, Mark; Staton, Catherine A

2018-02-08

Road traffic injuries (RTIs) cause significant morbidity and mortality in low- and middle-income countries. Investigation of high risk areas for RTIs is needed to guide improvements. This study provides built environmental analysis of road traffic crash hotspots within Moshi, Tanzania. Spatial analysis of police data identified 36 hotspots. Qualitative comparative analysis revealed 40% of crash sites were on local roads without night lighting and increased motorcycle density. Paved narrow roads represented 26% of hotspots and 13% were unpaved roads with uneven roadsides. Roadside unevenness was more predominate in low risk [n = 19, (90.5%)] than high risk sites [n = 7 (46.7%)]. Both low [n = 6 (28.6%)] and high risk [n = 1 (6.7%)] sites had minimal signage. All sites had informal pedestrian pathways. Little variability between risk sites suggests hazardous conditions are widespread. Findings suggest improvement in municipal infrastructure, signage and enforcement is needed to reduce RTI burden.

Variability and validity of intimate partner violence reporting by couples in Tanzania

PubMed Central

Steven, Ester; Reich, Naomi; Badi, Lilian; Messersmith, Lisa

2018-01-01

In recent years, major global institutions have amplified their efforts to address intimate partner violence (IPV) against women—a global health and human rights violation affecting 15–71% of reproductive aged women over their lifetimes. Still, some scholars remain concerned about the validity of instruments used for IPV assessment in population-based studies. In this paper, we conducted two validation analyses using novel data from 450 women-men dyads across nine villages in Northern Tanzania. First, we examined the level of inter-partner agreement in reporting of men’s physical, sexual, emotional and economic IPV against women in the last three and twelve months prior to the survey, ever in the relationship, and during pregnancy. Second, we conducted a convergent validity analysis to compare the relative efficacy of men’s self-reports of perpetration and women’s of victimization as a valid indicator of IPV against Tanzanian women using logistic regression models with village-level clustered errors. We found that, for every violence type across the recall periods of the last three months, the last twelve months and ever in the relationship, at least one in three couples disagreed about IPV occurrences in the relationship. Couples’ agreement about physical, sexual and economic IPV during pregnancy was high with 86–93% of couples reporting concordantly. Also, men’s self-reported perpetration had statistically significant associations with at least as many validated risk factors as had women’s self-reported victimization. This finding suggests that men’s self-reports are at least as valid as women’s as an indicator of IPV against women in Northern Tanzania. We recommend more validation studies are conducted in low-income countries, and that data on relationship factors affecting IPV reports and reporting are made available along with data on IPV occurrences. Keywords: Intimate partner violence; measurement; validity; survey research; Tanzania

Strategies to reduce exposure of fumonisins from complementary foods in rural Tanzania.

PubMed

Kimanya, Martin E; De Meulenaer, Bruno; Van Camp, John; Baert, Katleen; Kolsteren, Patrick

2012-10-01

Feeding infants with maize can expose them to fumonisin mycotoxins. We assessed fumonisin exposure from complementary foods in rural Tanzania and determined strategies to reduce the exposure. We conducted a cross-sectional study in four villages of Tarakea division, Northern Tanzania. We used a repeat 24-hour dietary recall to collect data of maize consumption as complementary food for 254 infants aged 6-8 months. Fumonisin concentrations in the maize were also estimated. Fumonisin exposure was assessed using @risk analysis software. With the software, several maximum fumonisin contamination and maize consumption patterns were combined in order to determine effective strategies for minimizing fumonisin exposure. Of the infants, 89% consumed maize at amounts up to 158g/person/day (mean; 43g/person/day±28). The maize was contaminated with fumonisins at levels up to 3201µgkg(-1) . Risk of fumonisin intake above the provisional maximum tolerable daily limit of 2µgkg(-1) body weight was 15% (95% confidence interval; 10-19). The risk was minimized when the maximum contamination was set at 150µgkg(-1) . The risk was also minimized when the maximum consumption was set at 20g/child/day while keeping the maximum contamination at the European Union (EU) maximum tolerated limit (MTL) of 1000µgkg(-1) . Considering the economical and technological limitations of adopting good agricultural practices in rural Tanzania, it is practically difficult to reduce contamination in maize to 150µgkg(-1) . We suggest adoption of the EU MTL of 1000µgkg(-1) for fumonisins in maize and reduction, by replacement with another cereal, of the maize component in complementary foods to a maximum intake of 20g/child/day. © 2011 Blackwell Publishing Ltd.

Language Ideologies and Schooled Education in Rural Tanzania: The Case of Karagwe

ERIC Educational Resources Information Center

Wedin, Asa

2005-01-01

In this paper I argue that language policies for education have effects on pupils' educational possibilities. With the case of the Karagwe district in Tanzania the research suggests that the policy of "Swahili only" in primary school education favours the small minority of the children that live in a context where Swahili is used. This…

Suitable for Whom? The Case of System of Rice Intensification in Tanzania

ERIC Educational Resources Information Center

Tumusiime, Emmanuel

2017-01-01

Purpose: This study examines the suitability of the system of rice intensification (SRI) for diverse small-scale farmers in Tanzania by exploring if poor and non-poor farmers adopt the system to a similar extent. Originality: The suitability of low-external input technologies such as SRI for diverse African farmers is a contentious issue. Existing…

Cash versus food assistance to improve adherence to antiretroviral therapy among HIV-infected adults in Tanzania: a randomized trial

PubMed Central

McCOY, Sandra I.; NJAU, Prosper F.; FAHEY, Carolyn; KAPOLOGWE, Ntuli; KADIYALA, Suneetha; JEWELL, Nicholas P.; DOW, William H.; PADIAN, Nancy S.

2017-01-01

Objective We evaluated the effectiveness of short-term cash and food assistance to improve adherence to antiretroviral therapy (ART) and retention in care among people living with HIV (PLHIV) in Tanzania. Methods At three clinics, 805 participants were randomized to three groups in a 3:3:1 ratio, stratified by site: nutrition assessment and counseling (NAC) plus cash transfers (~$11/month, n=347), NAC plus food baskets (n=345), and NAC-only (comparison group, n=113, clinicaltrials.gov NCT01957917). Eligible PLHIV were: ≥18 years, initiated ART ≤90 days prior, and food insecure. Cash or food was provided for ≤6 consecutive months, conditional on visit attendance. The primary outcome was medication possession ratio (MPR) ≥95% at 6 months. Secondary outcomes were appointment attendance and loss to follow-up (LTFU) at 6 and 12 months. Results The primary intent-to-treat analysis included 800 participants. Achievement of MPR≥95% at 6 months was higher in the NAC+cash group compared to NAC-only (85.0% vs. 63.4%), a 21.6 percentage point difference (95% confidence interval (CI): 9.8, 33.4, p<0.01). MPR≥95% was also significantly higher in the NAC+food group versus NAC-only (difference=15.8, 95% CI: 3.8, 27.9, p<0.01). When directly compared, MPR≥95% was similar in the NAC+cash and NAC+food groups (difference=5.7, 95% CI: −1.2, 12.7, p=0.15). Compared to NAC-only, appointment attendance and LTFU were significantly higher in both the NAC+cash and NAC+food groups at 6 months. At 12 months, the effect of NAC+cash, but not NAC+food, on MPR≥95% and retention was sustained. Conclusions Short-term conditional cash and food assistance improves ART possession and appointment attendance and reduces LTFU among food-insecure ART initiates in Tanzania. PMID:28107221

Correlates of out-of-pocket and catastrophic health expenditures in Tanzania: results from a national household survey

PubMed Central

2014-01-01

Background Inequality in health services access and utilization are influenced by out-of-pocket health expenditures in many low and middle-income countries (LMICs). Various antecedents such as social factors, poor health and economic factors are proposed to direct the choice of health care service use and incurring out-of-pocket payments. We investigated the association of these factors with out-of-pocket health expenditures among the adult and older population in the United Republic of Tanzania. We also investigated the prevalence and associated determinants contributing to household catastrophic health expenditures. Methods We accessed the data of a multistage stratified random sample of 7279 adult participants, aged between 18 and 59 years, as well as 1018 participants aged above 60 years, from the first round of the Tanzania National Panel survey. We employed multiple generalized linear and logistic regression models to evaluate the correlates of out-of-pocket as well as catastrophic health expenditures, accounting for the complex sample design effects. Results Increasing age, female gender, obesity and functional disability increased the adults’ out-of-pocket health expenditures significantly, while functional disability and visits to traditional healers increased the out-of-pocket health expenditures in older participants. Adult participants, who lacked formal education or worked as manual laborers earned significantly less (p < 0.001) and spent less on health (p < 0.001), despite having higher levels of disability. Large household size, household head’s occupation as a manual laborer, household member with chronic illness, domestic violence against women and traditional healer’s visits were significantly associated with high catastrophic health expenditures. Conclusion We observed that the prevalence of inequalities in socioeconomic factors played a significant role in determining the nature of both out-of-pocket and catastrophic health

HIV type 1 subtypes among bar and hotel workers in Moshi, Tanzania.

PubMed

Kiwelu, Ireen E; Renjifo, Boris; Chaplin, Beth; Sam, Noel; Nkya, Watoky M M M; Shao, John; Kapiga, Saidi; Essex, Max

2003-01-01

The HIV-1 prevalence among bar and hotel workers in Tanzania suggests they are a high-risk group for HIV-1 infection. We determined the HIV-1 subtype of 3'-p24/5'-p7 gag and C2-C5 env sequences from 40 individuals representing this population in Moshi. Genetic patterns composed of A(gag)-A(env), C(gag)-C(env), and D(gag)-D(env) were found in 19 (48.0%), 8 (20.0%), and 3 (8.0%) samples, respectively. The remaining 10 samples (25%) had different subtypes in gag and env, indicative of intersubtype recombinants. Among these recombinants, two contained sequences from HIV-1 subsubtype A2, a new genetic variant in Tanzania. Five bar and hotel workers may have been infected with viruses from a common source, based on phylogenetic analysis. The information obtained by surveillance of HIV-1 subtypes in a high-risk population should be useful in the design and evaluation of behavioral, therapeutic, and vaccine trial interventions aimed at reducing HIV-1 transmission.

Evaluation of a reproductive health awareness program for adolescence in urban Tanzania-A quasi-experimental pre-test post-test research

PubMed Central

2011-01-01

Background Sub-Saharan Africa is among the countries where 10% of girls become mothers by the age of 16 years old. The United Republic of Tanzania located in Sub-Saharan Africa is one country where teenage pregnancy is a problem facing adolescent girls. Adolescent pregnancy has been identified as one of the reasons for girls dropping out from school. This study's purpose was to evaluate a reproductive health awareness program for the improvement of reproductive health for adolescents in urban Tanzania. Methods A quasi-experimental pre-test and post-test research design was conducted to evaluate adolescents' knowledge, attitude, and behavior about reproductive health before and after the program. Data were collected from students aged 11 to 16, at Ilala Municipal, Dar es Salaam, Tanzania. An anonymous 23-item questionnaire provided the data. The program was conducted using a picture drama, reproductive health materials and group discussion. Results In total, 313 questionnaires were distributed and 305 (97.4%) were useable for the final analysis. The mean age for girls was 12.5 years and 13.2 years for boys. A large minority of both girls (26.8%) and boys (41.4%) had experienced sex and among the girls who had experienced sex, 51.2% reported that it was by force. The girls' mean score in the knowledge pre-test was 5.9, and 6.8 in post-test, which increased significantly (t = 7.9, p = 0.000). The mean behavior pre-test score was 25.8 and post-test was 26.6, which showed a significant increase (t = 3.0, p = 0.003). The boys' mean score in the knowledge pre-test was 6.4 and 7.0 for the post-test, which increased significantly (t = 4.5, p = 0.000). The mean behavior pre-test score was 25.6 and 26.4 in post-test, which showed a significant increase (t = 2.4, p = 0.019). However, the pre-test and post-test attitude scores showed no statistically significant difference for either girls or boys. Conclusions Teenagers have sexual experiences including sexual violence. Both of

Physical partner violence, women’s economic status and help-seeking behaviour in Dar es Salaam and Mbeya, Tanzania

PubMed Central

Vyas, Seema; Mbwambo, Jessie

2017-01-01

ABSTRACT Background: Women’s responses to partner violence are influenced by a complex constellation of factors including: psychological attachment to the partner; context of the abuse; and structural factors, all of which shape available options for women outside of the relationship. Objective: To describe women’s responses to physical partner violence; and to understand the role of women’s economic resources on their responses. Methods: Cross-sectional data from Dar es Salaam and Mbeya, Tanzania. Multivariate logistic regression was used to explore the relationship between women’s economic resources and their responses to violence. Results: In both sites, among physically abused women, over one-half experienced severe violence; approximately two-thirds had disclosed the violence; and approximately 40% had sought help. Abused women were more likely to have sought help from health services, the police and religious leaders in Dar es Salaam, and from local leaders in Mbeya. Economic resources did not facilitate women’s ability to leave violent partners in Dar es Salaam. In Mbeya, women who jointly owned capital assets were less likely to have left. In both sites, women’s sole ownership of capital assets facilitated help-seeking. Conclusion: Although support services are being scaled-up in Tanzania, efforts are needed to increase the acceptability of accessing such services. PMID:28485667

A qualitative study of the determinants of HIV guidelines implementation in two south-eastern districts of Tanzania

PubMed Central

Geubbels, Eveline; Wringe, Alison; Todd, Jim; Klatser, Paul; Dieleman, Marjolein

2017-01-01

Abstract Current HIV policies in Tanzania have adopted the three long-term impact results of zero new infections, zero HIV deaths and zero stigma and discrimination. Strategies to reach these results include scaling-up HIV Testing and Counselling (HTC); Preventing Mother-To-Child Transmission (PMTCT); and strengthening Care and Treatment Clinic (CTC) services. Previous studies showed that HIV policy and guideline recommendations were not always implemented in rural South Tanzania. This study aims to identify the determinants of HIV guideline implementation. A qualitative study of 23 semi-structured interviews with facility in-charges; healthcare workers; district, regional and national HIV coordinators was conducted. Five health facilities were purposively selected by level, ownership and proximity to district headquarters. Interviews were analysed according to Fleuren’s five determinants of innovation uptake related to: strategies used in guideline development and dissemination; guideline characteristics; the guideline implementing organization; guideline users; and the socio-cultural and regulatory context. None of the facilities had the HTC national guideline document. Non-involvement of providers in revisions and weak planning for guideline dissemination impeded their implementation. Lengthy guidelines and those written in English were under-used, and activities perceived to be complicated, like WHO-staging, were avoided. Availability of staff and lack of supplies like test kits and medication impeded implementation. Collaboration between facilities enhanced implementation, as did peer-support among providers. Provider characteristics including education level, knowledge of, and commitment to the guideline influenced implementation. According to providers, determinants of clients’ service use included gender norms, stigma, trust and perceived benefits. The regulatory context prohibited private hospitals from buying HIV supplies. Being tools for bringing

Exploring Levels of Job Satisfaction among Teachers in Public Secondary Schools in Tanzania

ERIC Educational Resources Information Center

Msuya, Ombeni William

2016-01-01

A case study on the role of extrinsic factors (hygiene factors) and socio-demographic factors in determining job satisfaction among teachers in public secondary schools in Tanzania was undertaken. Biographical variables pertaining to teachers' age, sex, marital status and work experience were investigated to determine whether they had any…

Higher Education as an Instrument of Social Integration in Tanzania: Challenges and Prospects

ERIC Educational Resources Information Center

Mkude, Daniel

2011-01-01

In developing countries, higher education is a powerful instrument for social mobility and economic prosperity. An in-depth study of the relationship between higher education and certain equity issues has revealed that in Ghana and Tanzania there is inadequate effort to widen higher education participation to include traditionally disadvantaged…

Crater Highlands, Tanzania

NASA Technical Reports Server (NTRS)

2006-01-01

The Shuttle Radar Topography Mission (SRTM), flown aboard Space Shuttle Endeavour in February 2000, acquired elevation measurements for nearly all of Earth's landmass between 60oN and 56oS latitudes. For many areas of the world SRTM data provide the first detailed three-dimensional observation of landforms at regional scales. SRTM data were used to generate this view of the Crater Highlands along the East African Rift in Tanzania. Landforms are depicted with colored height and shaded relief, using a vertical exaggeration of 2X and a southwestwardly look direction.

Lake Eyasi is depicted in blue at the top of the image, and a smaller lake occurs in Ngorongoro Crater. Near the image center, elevations peak at 3648 meters (11,968 feet) at Mount Loolmalasin, which is south of Ela Naibori Crater. Kitumbeine (left) and Gelai (right) are the two broad mountains rising from the rift lowlands. Mount Longido is seen in the lower left, and the Meto Hills are in the right foreground.

Tectonics, volcanism, landslides, erosion and deposition -- and their interactions -- are all very evident in this view. The East African Rift is a zone of spreading between the African (on the west) and Somali (on the east) crustal plates. Two branches of the rift intersect here in Tanzania, resulting in distinctive and prominent landforms. One branch trends nearly parallel the view and includes Lake Eyasi and the very wide Ngorongoro Crater. The other branch is well defined by the lowlands that trend left-right across the image (below center, in green). Volcanoes are often associated with spreading zones where magma, rising to fill the gaps, reaches the surface and builds cones. Craters form if a volcano explodes or collapses. Later spreading can fracture the volcanoes, which is especially evident on Kitumbeine and Gelai Mountains (left and right, respectively, lower center).

The Crater Highlands rise far above the adjacent savannas, capture moisture from passing air masses

Internet Access and Usage by Secondary School Students in Morogoro Municipality, Tanzania

ERIC Educational Resources Information Center

Tarimo, Ronald; Kavishe, George

2017-01-01

The purpose of this paper was to report results of a study on the investigation of the Internet access and usage by secondary school students in Morogoro municipality in Tanzania. A simple random sampling technique was used to select 120 students from six schools. The data was collected through a questionnaire. A quantitative approach using the…

An analytical perspective of Global health initiatives in Tanzania and Zambia.

PubMed

Mwisongo, Aziza; Soumare, Alice Ntamwishimiro; Nabyonga-Orem, Juliet

2016-07-18

A number of Global health initiatives (GHIs) have been created to support low and middle income countries. Their support has been of different forms. The African Region has benefitted immensely from GHIs and continues to register an increase in health partnerships and initiatives. However, information on the functioning and operationalisation of GHIs in the countries is limited. This study involved two country case studies, one in Tanzania and the other one in Zambia. Data were collected using a semi-structured questionnaire. The aims were to understand and profile the GHIs supporting health development and to assess their governance and alignment with country priorities, harmonisation and alignment of their interventions and efforts, and contribution towards health systems strengthening. The respondents included senior officers from health stakeholder agencies at the national and sub-national levels. The qualitative data were analysed using thematic content analysis in MAXQDA software. Health systems in both Tanzania and Zambia are decentralised. They have benefitted from GHI support in fighting the common health problems of HIV/AIDS, tuberculosis, malaria and vaccine-preventable diseases. In both countries, no GHI adequately made use of the existing Sector-wide Approach (SWAp) mechanisms but they largely operate through their unique structures and committees. GHI efforts to improve general health governance have not been matched with similar efforts from the countries. Their support to health system strengthening has not been comprehensive but has involved the selection of a few areas some of which were disease-focused. On the positive side, however, in both Tanzania and Zambia improved alignment with the countries' priorities is noted in that most of the proposals submitted to the GHIs refer to the priorities, objectives and strategies in the national health development plans and, GHIs depend on the national health information systems. GHIs are important funders

Role of condom negotiation on condom use among women of reproductive age in three districts in Tanzania.

PubMed

Exavery, Amon; Kanté, Almamy M; Jackson, Elizabeth; Noronha, John; Sikustahili, Gloria; Tani, Kassimu; Mushi, Hildegalda P; Baynes, Colin; Ramsey, Kate; Hingora, Ahmed; Phillips, James F

2012-12-20

HIV/AIDS remains being a disease of great public health concern worldwide. In regions such as sub-Saharan Africa (SSA) where women are disproportionately infected with HIV, women are reportedly less likely capable of negotiating condom use. However, while knowledge of condom use for HIV prevention is extensive among men and women in many countries including Tanzania, evidence is limited about the role of condom negotiation on condom use among women in rural Tanzania. Data originate from a cross-sectional survey of random households conducted in 2011 in Rufiji, Kilombero and Ulanga districts in Tanzania. The survey assessed health-seeking behaviour among women and children using a structured interviewer-administered questionnaire. A total of 2,614 women who were sexually experienced and aged 15-49 years were extracted from the main database for the current analysis. Linkage between condom negotiation and condom use at the last sexual intercourse was assessed using multivariate logistic regression. Prevalence of condom use at the last sexual intercourse was 22.2% overall, ranging from12.2% among married women to 54.9% among unmarried (single) women. Majority of the women (73.4%) reported being confident to negotiate condom use, and these women were significantly more likely than those who were not confident to have used a condom at the last sexual intercourse (OR = 3.13, 95% CI 2.22-4.41). This effect was controlled for marital status, age, education, religion, number of sexual partners, household wealth and knowledge of HIV prevention by condom use. Confidence to negotiate condom use is a significant predictor of actual condom use among women in rural Tanzania. Women, especially unmarried ones, those in multiple partnerships or anyone needing protection should be empowered with condom negotiation skills for increased use of condoms in order to enhance their sexual and reproductive health outcomes.

Effects of an entertainment-education radio soap opera on family planning behavior in Tanzania.

PubMed

Rogers, E M; Vaughan, P W; Swalehe, R M; Rao, N; Svenkerud, P; Sood, S

1999-09-01

An entertainment-education radio soap opera introduced in Tanzania in 1993 was evaluated by means of a field experimental design in which the radio program was broadcast by seven mainland stations of Radio Tanzania. An eighth station broadcast alternative programming from 1993 to 1995, its listenership serving as a comparison area in which contemporaneous changes in family planning adoption were measured. The soap opera was subsequently broadcast nationwide from 1995 to 1997. Data about the effects of the radio soap opera were gathered in five annual surveys of about 2,750 households in the comparison and the treatment areas and from a sample of new family planning adopters in 79 health clinics. The soap opera had strong behavioral effects on family planning adoption; it increased listeners' self-efficacy regarding family planning adoption and influenced listeners to talk with their spouses and peers about contraception.

Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania

PubMed Central

Kamuhabwa, Appolinary AR; Gordian, Richard; Mutagonda, Ritah F

2016-01-01

Background In 2011, Tanzania adopted a policy for provision of daily co-trimoxazole prophylaxis to HIV-infected pregnant women for prevention of malaria and other opportunistic infections. As per the policy, HIV-infected pregnant women should not be given sulfadoxine-pyrimethamine (SP) for intermittent preventive therapy. The challenges associated with this policy change and the extent to which the new policy for prevention of malaria in pregnant women coinfected with HIV was implemented need to be assessed. Aim To assess the implementation of malaria-preventive therapy policy among HIV-infected pregnant women in the public health facilities in Dar es Salaam, Tanzania. Methodology The study was conducted in Kinondoni Municipality, Dar es Salaam, Tanzania, from January 2015 to July 2015. Three hundred and fifty-three HIV-infected pregnant women who were attending antenatal clinics (ANCs) and using co-trimoxazole for prevention of malaria were interviewed. Twenty-six health care workers working at the ANCs were also interviewed regarding provision of co-trimoxazole prophylaxis to pregnant women. A knowledge scale was used to grade the level of knowledge of health care providers. Focus group discussions were also conducted with 18 health care workers to assess the level of implementation of the policy and the challenges encountered. Results Twenty-three (6.5%) pregnant women with known HIV serostatus were using co-trimoxazole for prevention of opportunistic infections even before they became pregnant. Out of the 353 HIV-infected pregnant women, eight (2.5%) were coadministered with both SP and co-trimoxazole. Sixty (16.7%) pregnant women had poor adherence to co-trimoxazole prophylaxis. Out of the 26 interviewed health care providers, 20 had high level of knowledge regarding malaria-preventive therapy in HIV-infected pregnant women. Lack of adequate supply of co-trimoxazole in health facilities and inadequate training of health care providers were among the factors

Undernutrition among HIV-positive children in Dar es Salaam, Tanzania: antiretroviral therapy alone is not enough.

PubMed

Sunguya, Bruno F; Poudel, Krishna C; Otsuka, Keiko; Yasuoka, Junko; Mlunde, Linda B; Urassa, David P; Mkopi, Namala P; Jimba, Masamine

2011-11-16

The prevalence of HIV/AIDS has exacerbated the impact of childhood undernutrition in many developing countries, including Tanzania. Even with the provision of antiretroviral therapy, undernutrition among HIV-positive children remains a serious problem. Most studies to examine risk factors for undernutrition have been limited to the general population and ART-naive HIV-positive children, making it difficult to generalize findings to ART-treated HIV-positive children. The objectives of this study were thus to compare the proportions of undernutrition among ART-treated HIV-positive and HIV-negative children and to examine factors associated with undernutrition among ART-treated HIV-positive children in Dar es Salaam, Tanzania. From September to October 2010, we conducted a cross-sectional survey among 213 ART-treated HIV-positive and 202 HIV-negative children in Dar es Salaam, Tanzania. We measured the children's anthropometrics, socio-demographic factors, food security, dietary habits, diarrhea episodes, economic status, and HIV clinical stage. Data were analyzed using both univariate and multivariate methods. ART-treated HIV-positive children had higher rates of undernutrition than their HIV-negative counterparts. Among the ART-treated HIV-positive children, 78 (36.6%) were stunted, 47 (22.1%) were underweight, and 29 (13.6%) were wasted. Households of ART-treated HIV-positive children exhibited lower economic status, lower levels of education, and higher percentages of unmarried caregivers with higher unemployment rates. Food insecurity was prevalent in over half of ART-treated HIV-positive children's households. Furthermore, ART-treated HIV-positive children were more likely to be orphaned, to be fed less frequently, and to have lower body weight at birth compared to HIV-negative children.In the multivariate analysis, child's HIV-positive status was associated with being underweight (AOR = 4.61, 95% CI 1.38-15.36 P = 0.013) and wasting (AOR = 9.62, 95% CI 1

Antecedents of Continued Usage Intentions of Web-Based Learning Management System in Tanzania

ERIC Educational Resources Information Center

Lwoga, Edda Tandi; Komba, Mercy

2015-01-01

Purpose: The purpose of this paper is to examine factors that predict students' continued usage intention of web-based learning management systems (LMS) in Tanzania, with a specific focus on the School of Business of Mzumbe University. Specifically, the study investigated major predictors of actual usage and continued usage intentions of…

Sale of fluoroquinolones in northern Tanzania: a potential threat for fluoroquinolone use in tuberculosis treatment.

PubMed

van den Boogaard, Jossy; Semvua, Hadija H; Boeree, Martin J; Aarnoutse, Rob E; Kibiki, Gibson S

2010-01-01

Fluoroquinolones have a potential role in shortening tuberculosis (TB) treatment duration. They are currently used in the treatment of other infections. This has raised concerns about development of mycobacterial resistance. The current study evaluates the sale of fluoroquinolones (among other antibacterials) in Moshi, Tanzania, a country with one of the highest burdens of TB in the world. Trained pharmacy assistants registered the sale of fluoroquinolones during February and March 2009 to outpatients in Moshi in all 14 pharmacies that are authorized to sell antibacterials for systemic use. The sale of all antibacterials of the Anatomical Therapeutic Chemical (ATC) J01 class was expressed in defined daily doses (DDDs) per 1000 inhabitants per day (DID). The availability of fluoroquinolones in drug outlets that are not authorized to sell antibacterials for systemic use was assessed in 15 randomly selected outlets in Moshi. The sale of antibacterials to outpatients in Moshi by authorized pharmacies was 4.99 DID. The sale of fluoroquinolones was 0.62 DID (12% of total antibacterial sales). Ciprofloxacin was available in all 15 unauthorized drug outlets. The substantial sales of fluoroquinolones by authorized pharmacies and the wide availability of fluoroquinolones in unauthorized drug outlets in Moshi constitute a challenge to the use of fluoroquinolones in TB treatment in Tanzania. Control of antibacterial use in Tanzania requires the implementation of surveillance systems for antibacterial use and resistance, and adequate restriction of antibacterial sales to authorized pharmacies only.

An evaluation of a family planning mobile job aid for community health workers in Tanzania.

PubMed

Braun, Rebecca; Lasway, Christine; Agarwal, Smisha; L'Engle, Kelly; Layer, Erica; Silas, Lucy; Mwakibete, Anna; Kudrati, Mustafa

2016-07-01

The global rapid growth in mobile technology provides unique opportunities to support community health workers (CHWs) in providing family planning (FP) services. FHI 360, Pathfinder International and D-tree International developed an evidence-based mobile job aid to support CHW counseling, screening, service provision and referrals, with mobile forms for client and service data, and text-message reporting and reminders. The purpose of this study is to evaluate the acceptability and potential benefits to service quality from the perspective of CHWs and their clients. The mobile job aid was piloted in Dar es Salaam, Tanzania. Data collection tools included a demographic survey of all 25 CHWs trained to use the mobile job aid, in-depth interviews with 20 of the CHWs after 3 months and a survey of 176 clients who received FP services from a CHW using the mobile job aid after 6 months. Both CHWs and their clients reported that the mobile job aid was a highly acceptable FP support tool. CHWs perceived benefits to service quality, including timelier and more convenient care; better quality of information; increased method choice; and improved privacy, confidentiality and trust with clients. Most clients discussed multiple FP methods with CHWs; only 1 in 10 clients reported discussion of all 9 methods. This research suggests that mobile phones can be effective tools to support CHWs with FP counseling, screening and referrals, data collection and reporting, and communication. Challenges remain to support informed contraceptive choice. Future research should focus on implementation, including scale-up and sustainability. Mobile job aids can uniquely enhance FP service provision at the community level through adherence to standard protocols, real-time feedback and technical assistance, and provision of confidential care. This study can inform future efforts to support and expand the role of CHWs in increasing FP access and informed contraceptive choice. Copyright © 2016

From papers to practices: district level priority setting processes and criteria for family planning, maternal, newborn and child health interventions in Tanzania.

PubMed

Chitama, Dereck; Baltussen, Rob; Ketting, Evert; Kamazima, Switbert; Nswilla, Anna; Mujinja, Phares G M

2011-10-21

Successful priority setting is increasingly known to be an important aspect in achieving better family planning, maternal, newborn and child health (FMNCH) outcomes in developing countries. However, far too little attention has been paid to capturing and analysing the priority setting processes and criteria for FMNCH at district level. This paper seeks to capture and analyse the priority setting processes and criteria for FMNCH at district level in Tanzania. Specifically, we assess the FMNCH actor's engagement and understanding, the criteria used in decision making and the way criteria are identified, the information or evidence and tools used to prioritize FMNCH interventions at district level in Tanzania. We conducted an exploratory study mixing both qualitative and quantitative methods to capture and analyse the priority setting for FMNCH at district level, and identify the criteria for priority setting. We purposively sampled the participants to be included in the study. We collected the data using the nominal group technique (NGT), in-depth interviews (IDIs) with key informants and documentary review. We analysed the collected data using both content analysis for qualitative data and correlation analysis for quantitative data. We found a number of shortfalls in the district's priority setting processes and criteria which may lead to inefficient and unfair priority setting decisions in FMNCH. In addition, participants identified the priority setting criteria and established the perceived relative importance of the identified criteria. However, we noted differences exist in judging the relative importance attached to the criteria by different stakeholders in the districts. In Tanzania, FMNCH contents in both general development policies and sector policies are well articulated. However, the current priority setting process for FMNCH at district levels are wanting in several aspects rendering the priority setting process for FMNCH inefficient and unfair (or

Tanzania benefits from inter-organizational cooperation.

PubMed

1998-08-01

This article describes observations of a monitoring mission by JOICFP, the IPPF Regional Africa Office, and JICA in Tanzania, during June 7-13, 1998. The team visited the Morogoro region to review and assess the current major Integrated Program (IP) activities. The community-based distribution agents have been successful in gaining the trust of the community and contributing to social change. Agents are motivated to work and receive additional training, even though they do not receive a salary. Communities recognize the agents as their representatives. Training agents at the grass roots level has been cost effective. The visiting doctor scheme has been successful in maximizing use of health personnel. In one example, 92 patients from 3 villages were treated by a visiting doctor, who had an adequate supply of basic drugs. Service fees paid by patients cover the cost of medicine. Women receive reproductive health and sexually transmitted disease check-ups. The Income Generation Activities (IGA) program strengthens income generation and women's organizations. IGA also provides tools for masonry and carpentry to encourage male participation in the program. The IP has cooperative support from UMATI, the Ministry of Health, UNFPA, and the Japanese government. Essential drugs and equipment are procured by JICA, and delivered through the UMATI-JOICFP distribution channels to government health centers and dispensaries and UMATI's clinics. The experience has confirmed the ability of nongovernmental organizations to supply a multi-bilateral project. Grassroots staff are most appreciative.

Waiting for attention and care: birthing accounts of women in rural Tanzania who developed obstetric fistula as an outcome of labour.

PubMed

Mselle, Lilian T; Kohi, Thecla W; Mvungi, Abu; Evjen-Olsen, Bjørg; Moland, Karen Marie

2011-10-21

Obstetric fistula is a physically and socially disabling obstetric complication that affects about 3,000 women in Tanzania every year. The fistula, an opening that forms between the vagina and the bladder and/or the rectum, is most frequently caused by unattended prolonged labour, often associated with delays in seeking and receiving appropriate and adequate birth care. Using the availability, accessibility, acceptability and quality of care (AAAQ) concept and the three delays model, this article provides empirical knowledge on birth care experiences of women who developed fistula after prolonged labour. We used a mixed methods approach to explore the birthing experiences of women affected by fistula and the barriers to access adequate care during labour and delivery. Sixteen women were interviewed for the qualitative study and 151 women were included in the quantitative survey. All women were interviewed at the Comprehensive Community Based Rehabilitation Tanzania in Dar es Salaam and Bugando Medical Centre in Mwanza. Women experienced delays both before and after arriving at a health facility. Decisions on where to seek care were most often taken by husbands and mothers-in-law (60%). Access to health facilities providing emergency obstetric care was inadequate and transport was a major obstacle. About 20% reported that they had walked or were carried to the health facility. More than 50% had reported to a health facility after two or more days of labour at home. After arrival at a health facility women experienced lack of supportive care, neglect, poor assessment of labour and lack of supervision. Their birth accounts suggest unskilled birth care and poor referral routines. This study reveals major gaps in access to and provision of emergency obstetric care. It illustrates how poor quality of care at health facilities contributes to delays that lead to severe birth injuries, highlighting the need to ensure women's rights to accessible, acceptable and adequate

Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

PubMed Central

Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M. E.; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

2014-01-01

Background Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health

Pedagogical Practices in Early Childhood Education and Care in Tanzania: Policy and Practices

ERIC Educational Resources Information Center

Mligo, Ignasia; Mitchell, Linda; Bell, Beverley

2016-01-01

The purpose of this study was to examine current pedagogical practices in early childhood education and care in Tanzania, a reflection from policy and practices to the implementation of Learner-Centred Pedagogy and to put forward possible improvements for the future. In 2005 a new pre-school education curriculum introduced a learner-centred…

Adult Literacy in Africa--Nigeria, Rhodesia, South Africa, Sudan, Tanzania. Literacy Bibliographies 23.

ERIC Educational Resources Information Center

International Inst. for Adult Literacy Methods, Teheran (Iran).

Approximately 200 items are listed in this bibliography of materials pertaining to adult literacy in Nigeria, Rhodesia, South Africa, the Sudan, and Tanzania. The listed materials are categorized according to country and deal with a variety of topics, including the following: (1) adult education and adaptation to change in Nigeria; (2) adult…

A Bibliography on Rural Development in Tanzania. MSU Rural Development Paper No. 3.

ERIC Educational Resources Information Center

Kocher, James E.; Fleisher, Beverly

Rural development is understood to mean both the increased productivity of agriculture and other rural economic activities and the enhancement of the material well-being of the rural people (who comprise about 90% of Tanzania's 16 million population) through education, improved health, and better nutrition. Seven hundred and sixty-one books,…

Globalisation, Language and Education: A Comparative Study of the United States and Tanzania.

ERIC Educational Resources Information Center

Roy-Campbell, Zaline M.

2001-01-01

Focusing on Tanzania and the United States, this article examines the fallacy of a monolingual, English-only policy in education. It also examines the philosophy surrounding this debate and considers the detrimental effects upon students of attempting to impose a monolingual policy. Discusses the role of educational language in the quest for…

Marketing of Information in the Water Sector in Tanzania: A Strategy for MAJIDOC.

ERIC Educational Resources Information Center

Michael, Benedict P.

1992-01-01

Outlines a strategy for marketing the information products and services of the Water and Sanitation Information and Documentation Centre (MAJIDOC) of the Water Resources Institute in Dar es Salaam, Tanzania. Objectives of the marketing strategy are explained, ideas for internal and external promotion are described, and a budget plan is included.…

Risk and protective factors for relapse among individuals with schizophrenia: a qualitative study in Dar es Salaam, Tanzania.

PubMed

Sariah, Adellah E; Outwater, Anne H; Malima, Khadija I Y

2014-08-30

Relapse in people with schizophrenia is a major challenge for mental health service providers in Tanzania and other countries. Approximately 10% of people with schizophrenia are re-admitted due to relapse at Muhimbili National Hospital (MNH) Psychiatric Unit each month. Relapse brings about negative effects and it results in a huge burden to patients, their families, the mental health sector and the country's economy. So far no study has been done to address relapse in Tanzania. The purpose of the study was to explore perspectives on risk and protective factors influencing relapse of people with schizophrenia and their caregivers attending Muhimbili National Hospital Psychiatric Out-patient Department, Dar es Salaam, Tanzania. A qualitative study was conducted, involving in-depth interviews of seven people with schizophrenia who are out-patients and their seven family caregivers at MNH. Purposive sampling procedure was used to select participants for the study. Audio recorded in-depth interviews in Swahili language were conducted with all study participants. The recorded information was transcribed and analyzed using NVivo 9 computer assisted qualitative data analysis software. Personal risk and protective factors for relapse, environmental risk and protective factors for relapse and suggestions to reduce relapse were the main themes that emerged from this study. People with schizophrenia and their caregivers (all of whom were relatives) perceived non adherence to antipsychotic medication as a leading risk factor of relapse; other risks included poor family support, stressful life events and substance use. Family support, adherence to antipsychotic medication, employment and religion were viewed as protective factors. Participants suggested strengthening mental health psycho-education sessions and community home visits conducted by mental health nurses to help reduce relapse. Other suggestions included strengthening the nurse-patient therapeutic relationship in

East African and Kuunga Orogenies in Tanzania - South Kenya

NASA Astrophysics Data System (ADS)

Fritz, H.; Hauzenberger, C. A.; Tenczer, V.

2012-04-01

Tanzania and southern Kenya hold a key position for reconstructing Gondwana consolidation because here different orogen belts with different tectonic styles interfere. The older, ca. 650-620 Ma East African Orogeny resulted from the amalgamation of arc terranes in the northern Arabian-Nubian Shield (ANS) and continental collision between East African pieces and parts of the Azania terrane in the south (Collins and Pisarevsky, 2005). The change form arc suturing to continental collision settings is found in southern Kenya where southernmost arcs of the ANS conjoin with thickened continental margin suites of the Eastern Granulite Belt. The younger ca. 570-530 Ma Kuunga orogeny heads from the Damara - Zambesi - Irumide Belts (De Waele et al., 2006) over Tanzania - Mozambique to southern India and clashes with the East African orogen in southern-central Tanzania. Two transitional orogen settings may be defined, (1) that between island arcs and inverted passive continental margin within the East African Orogen and, (2) that between N-S trending East African and W-E trending Kuungan orogenies. The Neoproterozoic island arc suites of SE-Kenya are exposed as a narrow stripe between western Azania and the Eastern Granulite belt. This suture is a steep, NNW stretched belt that aligns roughly with the prominent southern ANS shear zones that converge at the southern tip of the ANS (Athi and Aswa shear zones). Oblique convergence resulted in low-vorticity sinstral shear during early phases of deformation. Syn-magmatic and syn-tectonic textures are compatible with deformation at granulite metamorphic conditions and rocks exhumed quickly during ongoing transcurrent motion. The belt is typified as wrench tectonic belt with horizontal northwards flow of rocks within deeper portions of an island arc. The adjacent Eastern Granulite Nappe experienced westward directed, subhorizontal, low-vorticity, high temperature flow at partly extreme metamorphic conditions (900°C, 1.2 to 1.4 GPa

'We call it the shaking illness': perceptions and experiences of Parkinson's disease in rural northern Tanzania

PubMed Central

2011-01-01

Background Parkinson disease (PD) causes physical disability that negatively affects the quality of life of the sufferer's and their families. There are no Parkinson's disease (PD) social science studies published from Africa. This paper presents findings from a qualitative research study on how PD is perceived and treated in a population of approximately 161,000 within a demographic surveillance site in rural Tanzania. Methods We conducted in-depth interviews with 28 PD sufferers, 28 carers, 4 health workers and 2 traditional healers. In addition, 6 focus group discussions were conducted in 3 villages to investigate wider community views of PD. Results PD sufferers expressed frustration with the physical, psychological, social and economic consequences of the illness. Feelings of a diminished quality of life characterised by dependency, stigma and social isolation were common. Additionally, a handful of male sufferers related their sexual incompetence to the illness. Carers complained of lost income opportunities and social isolation resulting from caring for sufferers. Misconceptions about the cause, symptoms and appropriated PD treatment were widespread. Only 2 PD sufferers had commenced western type treatment through outsourcing drugs from other parts of the country and outside of Tanzania. Conclusions This study highlights the urgent need for PD awareness and treatment interventions in such settings. Such interventions need to address the concerns and needs of sufferers, their carers and the wider community, including the health care system. PMID:21477284

The relationship of women's status and empowerment with skilled birth attendant use in Senegal and Tanzania.

PubMed

Shimamoto, Kyoko; Gipson, Jessica D

2015-07-24

Maternal mortality remains unacceptably high in sub-Saharan Africa with 179,000 deaths occurring each year, accounting for 2-thirds of maternal deaths worldwide. Progress in reducing maternal deaths and increasing Skilled Birth Attendant (SBA) use at childbirth has stagnated in Africa. Although several studies demonstrate the important influences of women's status and empowerment on SBA use, this evidence is limited, particularly in Africa. Furthermore, few studies empirically test the operationalization of women's empowerment and incorporate multidimensional measures to represent the potentially disparate influence of women's status and empowerment on SBA use across settings. This study examined the relationship of women's status and empowerment with SBA use in two African countries--Senegal and Tanzania--using the 2010 Demographic and Health Surveys (weighted births n = 10,688 in SN; 6748 in TZ). Factor analysis was first conducted to identify the structure and multiple dimensions of empowerment. Then, a multivariate regression analysis was conducted to examine associations between these empowerment dimensions and SBA use. Overall, women's status and empowerment were positively related to SBA use. Some sociodemographic characteristics showed similar effects across countries (e.g., age, wealth, residence, marital relationship, parity); however, women's status and empowerment influence SBA use differently by setting. Namely, women's education directly and positively influenced SBA use in Tanzania, but not in Senegal. Further, each of the dimensions of empowerment influenced SBA use in disparate ways. In Tanzania women's higher household decision-making power and employment were related to SBA use, while in Senegal more progressive perceptions of gender norms and older age at first marriage were related to SBA use. This study provides evidence of the disparate influences of women's status and empowerment on SBA use across settings. Results indicate that efforts to

Climate change induced risk analysis of Dar es Salaam city (Tanzania)

NASA Astrophysics Data System (ADS)

Topa, Maria Elena; Herslund, Lise; Cavan, Gina; Printz, Andreas; Simonis, Ingo; Bucchignani, Edoardo; Jean-Baptiste, Nathalie; Hellevik, Siri; Johns, Regina; Kibassa, Deusdedit; Kweka, Clara; Magina, Fredrick; Mangula, Alpha; Mbuya, Elinorata; Uhinga, Guido; Kassenga, Gabriel; Kyessi, Alphonce; Shemdoe, Riziki; Kombe, Wilbard

2013-04-01

CLUVA (CLimate change and Urban Vulnerability in Africa; http://www.cluva.eu/) is a 3 years project, funded by the European Commission in 2010. The main objective of CLUVA is to develop context-centered methods and knowledge to be applied to African cities to assess vulnerabilities and increase knowledge on managing climate related risks. The project estimates the impacts of climate changes in the next 40 years at urban scale and downscales IPCC climate projections to evaluate specific threats to selected African test cities. These are mainly from floods, sea-level rise, droughts, heat waves, and desertification. The project evaluates and links: social vulnerability; urban green structures and ecosystem services; urban-rural interfaces; vulnerability of urban built environment and lifelines; and related institutional and governance dimensions of adaptation. The multi-scale and multi-disciplinary qualitative, quantitative and probabilistic approach of CLUVA is currently being applied to selected African test cities (Addis Ababa - Ethiopia; Dar es Salaam - Tanzania; Douala - Cameroun; Ouagadougou - Burkina Faso; St. Louis - Senegal). In particular, the poster will present preliminary findings for the Dar es Salaam case study. Dar es Salaam, which is Tanzania's largest coastal city, is exposed to floods, coastal erosion, droughts and heat waves, and highly vulnerable to impacts as a result of ineffective urban planning (about 70% unplanned settlements), poverty and lack of basic infrastructure (e.g. lack of or poor quality storm water drainage systems). Climate change could exacerbate the current situation increasing hazard-exposure alongside the impacts of development pressures which act to increase urban vulnerability for example because of informal (unregulated) urbanization. The CLUVA research team - composed of climate and environmental scientists, risk management experts, urban planners and social scientists from both European and African institutions - has

Challenging HIV vulnerability discourse: the case of professional and entrepreneurial women in Dar Es Salaam, Tanzania.

PubMed

Jangu, Neema William; Tam, Ailie; Maticka-Tyndale, Eleanor

2017-05-01

A poverty-HIV narrative has dominated many HIV prevention strategies in Africa despite epidemiological data showing higher prevalence of infection among educated and wealthier women in several African countries. This paper examines the perspectives of professional and entrepreneurial women on HIV risk and vulnerability based on their knowledge and lived experiences, comparing this to the HIV discourse evident in five strategic documents that shape intervention in Tanzania. The purpose is to uncover the confluence and dissonance between the discourses of government and those of professional women themselves. Qualitative research methods included critical discourse analysis of five strategic documents and thematic analysis of 37 in-depth interviews with women. The findings challenge fixed representations of women and notions of vulnerability embedded in the poverty-HIV discourse. Women described using their sexuality and sexual agency as a means to elevate their position in ways that made them vulnerable to sexual harassment and coercion. This is explored through two intersecting themes: non-marital sexual exchanges to gain an education or employment, and marriage. The intersecting social positions and constructions of female sexuality and agency expressed by the women in this study provide insights into other avenues and forms of HIV vulnerability.

Women's perceptions of antenatal, delivery, and postpartum services in rural Tanzania

PubMed Central

Mahiti, Gladys Reuben; Mkoka, Dickson Ally; Kiwara, Angwara Dennis; Mbekenga, Columba Kokusiima; Hurtig, Anna-Karin; Goicolea, Isabel

2015-01-01

Background Maternal health care provision remains a major challenge in developing countries. There is agreement that the provision of quality clinical services is essential if high rates of maternal death are to be reduced. However, despite efforts to improve access to these services, a high number of women in Tanzania do not access them. The aim of this study is to explore women's views about the maternal health services (pregnancy, delivery, and postpartum period) that they received at health facilities in order to identify gaps in service provision that may lead to low-quality maternal care and increased risks associated with maternal morbidity and mortality in rural Tanzania. Design We gathered qualitative data from 15 focus group discussions with women attending a health facility after child birth and transcribed it verbatim. Qualitative content analysis was used for analysis. Results ‘Three categories emerged that reflected women's perceptions of maternal health care services: “mothers perceive that maternal health services are beneficial,” “barriers to accessing maternal health services” such as availability and use of traditional birth attendants (TBAs) and the long distances between some villages, and “ambivalence regarding the quality of maternal health services” reflecting that women had both positive and negative perceptions in relation to quality of health care services offered’. Conclusions Mothers perceived that maternal health care services are beneficial during pregnancy and delivery, but their awareness of postpartum complications and the role of medical services during that stage were poor. The study revealed an ambivalence regarding the perceived quality of health care services offered, partly due to shortages of material resources. Barriers to accessing maternal health care services, such as the cost of transport and the use of TBAs, were also shown. These findings call for improvement on the services provided. Improvements

Prevalence of Schistosomes and Soil-Transmitted Helminths and Morbidity Associated with Schistosomiasis among Adult Population in Lake Victoria Basin, Tanzania.

PubMed

Siza, Julius E; Kaatano, Godfrey M; Chai, Jong-Yil; Eom, Keeseon S; Rim, Han-Jong; Yong, Tai-Soon; Min, Duk-Young; Chang, Su Young; Ko, Yunsuk; Changalucha, John M

2015-10-01

The objective of this study was to carry out a community survey on schistosomiais and soil-transmitted helminth (STH) infections in order to suggest feasible and effective intervention strategies in Lake Victoria basin, Tanzania. A total of 37 communities selected from 23 districts of the 4 regions in the Lake Victoria basin of Tanzania were involved in the study. From each of the selected locality, 50 adult community members, 25 males and 25 females, were recruited for the study. Each study participant was requested to submit stool and urine specimens. From each stool specimen, duplicate Kato-Katz thick smears were prepared and microscopically examined for Schistosoma mansoni and STH eggs. Urine specimens were processed by the filtration technique and microscopically examined for Schistosoma haematobium eggs. Ultrasound examination for morbidity due to schistosomiasis was performed. Mass treatment was done using praziquantel and albendazole for schistosome and STHs infections, respectively. Out of 1,606 adults who provided stool specimens, 199 (12.4%) were positive for S. mansoni, 349 (21.7%) for hookworms, 133 (8.3%) for Ascaris lumbricoides, and 33 (2.0%) for Trichuris trichiura. Out of 1,400 participants who provided urine specimens, 25 (1.8%) were positive for S. haematobium eggs. Because of the co-endemicity of these afflictions and their impact on vulnerable population groups, the helminthiasis could be simultaneously treated with 2 drugs, praziquantel for schistosomiasis and albendazole for STHs.

A Continental Rifting Event in Tanzania Revealed by Envisat and ALOS InSAR Observations

NASA Astrophysics Data System (ADS)

Oyen, A. M.; Marinkovic, P. S.; Wauthier, C.; d'Oreye, N.; Hanssen, R. F.

2008-11-01

From July to September 2007 a series of moderate earthquakes struck the area South of the Gelai volcano, located on the Eastern branch of the East African Rift (North Tanzania). Most deformation patterns detected by InSAR in these period are very complex, impeding proper interpretation. To decrease the complexity of the models of the deformation, this study proposes two strategies of combining data from different tracks and sensors. In a first stage a method is proposed to correct unwrapping errors in C-band using the much more coherent L-band data. Furthermore, a modeling optimization method is explored, which aims at the decomposition of the deformation in smaller temporal baselines, by means of creating new, artificial interferograms and the use of models. Due to the higher coherence level and fewer phase cycles in L-band, the deformation interpretation is facilitated but model residual interpretation has become more difficult compared to C-band.

Hepatitis B Virus Infection in Tanzania: Current Status and Challenges

PubMed Central

Bakshi, Fatma A.; Jaka, Hyasinta

2018-01-01

Hepatitis B is one of the most common infectious diseases in the world with high prevalence in most of sub-Saharan Africa countries. The complexity in its diagnosis and treatment poses a significant management challenge in the resource-limited settings including Tanzania, where most of the tests and drugs are either unavailable or unaffordable. This mini review aims at demonstrating the current status of the disease in the country and discussing the concomitant challenges in diagnosis, treatment, and prevention. PMID:29666656

Chikungunya and dengue fever among hospitalized febrile patients in northern Tanzania.

PubMed

Hertz, Julian T; Munishi, O Michael; Ooi, Eng Eong; Howe, Shiqin; Lim, Wen Yan; Chow, Angelia; Morrissey, Anne B; Bartlett, John A; Onyango, Jecinta J; Maro, Venance P; Kinabo, Grace D; Saganda, Wilbrod; Gubler, Duane J; Crump, John A

2012-01-01

Consecutive febrile admissions were enrolled at two hospitals in Moshi, Tanzania. Confirmed acute Chikungunya virus (CHIKV), Dengue virus (DENV), and flavivirus infection were defined as a positive polymerase chain reaction (PCR) result. Presumptive acute DENV infection was defined as a positive anti-DENV immunoglobulin M (IgM) enzyme-linked immunsorbent assay (ELISA) result, and prior flavivirus exposure was defined as a positive anti-DENV IgG ELISA result. Among 870 participants, PCR testing was performed on 700 (80.5%). Of these, 55 (7.9%) had confirmed acute CHIKV infection, whereas no participants had confirmed acute DENV or flavivirus infection. Anti-DENV IgM serologic testing was performed for 747 (85.9%) participants, and of these 71 (9.5%) had presumptive acute DENV infection. Anti-DENV IgG serologic testing was performed for 751 (86.3%) participants, and of these 80 (10.7%) had prior flavivirus exposure. CHIKV infection was more common among infants and children than adults and adolescents (odds ratio [OR] 1.9, P = 0.026) and among HIV-infected patients with severe immunosuppression (OR 10.5, P = 0.007). CHIKV infection is an important but unrecognized cause of febrile illness in northern Tanzania. DENV or other closely related flaviviruses are likely also circulating.

Factors Influencing Teachers' Use of Multimedia Enhanced Content in Secondary Schools in Tanzania

ERIC Educational Resources Information Center

Mtebe, Joel S.; Mbwilo, Betty; Kissaka, Mussa M.

2016-01-01

Tanzania is faced with a severe shortage of qualified in-service school science and mathematics teachers. While science and mathematics account for 46% of the curriculum, only 28% of teachers are qualified to teach these subjects. In order to overcome this challenge, the Ministry of Education and Vocational Training (MoEVT) implemented a project…

Critical Success Factors for Adoption of Web-Based Learning Management Systems in Tanzania

ERIC Educational Resources Information Center

Lwoga, Edda Tandi

2014-01-01

This paper examines factors that predict students' continual usage intention of web-based learning content management systems in Tanzania, with a specific focus at Muhimbili University of Health and Allied Science (MUHAS). This study sent a questionnaire surveys to 408 first year undergraduate students, with a rate of return of 66.7. This study…

Durability of Olyset campaign nets distributed between 2009 and 2011 in eight districts of Tanzania.

PubMed

Massue, Dennis J; Moore, Sarah J; Mageni, Zawadi D; Moore, Jason D; Bradley, John; Pigeon, Olivier; Maziba, Erasto J; Mandike, Renata; Kramer, Karen; Kisinza, William N; Overgaard, Hans J; Lorenz, Lena M

2016-03-18

Long-lasting insecticidal nets (LLINs) are the first line choice for malaria vector control in sub-Saharan Africa, with most countries adopting universal coverage campaigns. However, there is only limited information on LLIN durability under user conditions. Therefore, this study aimed to assess the durability of Olyset(®) LLINs distributed during campaigns between 2009 and 2011 in Tanzania. A retrospective field survey was conducted in eight districts in Tanzania mainland to assess the durability of Olyset campaign nets. Household questionnaires were used to assess attrition, i.e. net loss. All nets remaining in households were collected. A sub-sample of 198 Olyset campaign nets was examined for bio-efficacy against Anopheles gambiae s.s. mosquitoes, permethrin content and physical integrity following standard World Health Organization (WHO) methods. Of 6067 campaign nets reported to have been received between 2009 and 2011, 35% (2145 nets) were no longer present. Most of those nets had been discarded (84%) mainly because they were too torn (94%). Of the 198 sub-sampled Olyset LLINs, 61% were still in serviceable physical condition sufficient to provide personal protection while 39% were in unserviceable physical condition according to WHO proportionate Hole Index (pHI). More than 96% (116/120) of nets in serviceable condition passed WHO bioefficacy criteria while all nets in unserviceable condition passed WHO bioefficacy criteria. Overall mean permethrin content was 16.5 g/kg (95% CI 16.2-16.9) with 78% of the sub-sampled nets retaining recommended permethrin content regardless of their age or physical condition. Nets aged 4 years and above had a mean permethrin content of 14 g/kg (95% CI 12.0-16.0). The only statistically significant predictor of reduced physical net integrity was rats in the house. Two-to-four years after a mass campaign, only 39% of distributed nets remain both present and in serviceable physical condition, a functional survival considerably

Prevalence and Antimicrobial Resistance of Campylobacter Isolated from Dressed Beef Carcasses and Raw Milk in Tanzania

PubMed Central

Kashoma, Isaac P.; Kassem, Issmat I.; John, Julius; Kessy, Beda M.; Gebreyes, Wondwossen; Kazwala, Rudovick R.

2016-01-01

Campylobacter species are commonly transmitted to humans through consumption of contaminated foods such as milk and meat. The aim of this study was to investigate the prevalence, antimicrobial resistance, and genetic determinants of resistance of Campylobacter isolated from raw milk and beef carcasses in Tanzania. The antimicrobial resistance genes tested included blaOXA-61 (ampicillin), aph-3-1 (aminoglycoside), tet(O) (tetracycline), and cmeB (multi-drug efflux pump). The prevalence of Campylobacter was 9.5% in beef carcasses and 13.4% in raw milk, respectively. Using multiplex-polymerase chain reaction (PCR), we identified 58.1% of the isolates as Campylobacter jejuni, 30.7% as Campylobacter coli, and 9.7% as other Campylobacter spp. One isolate (1.6%) was positive for both C. jejuni and C. coli specific PCR. Antimicrobial susceptibility testing using the disk diffusion assay and the broth microdilution method showed resistance to: ampicillin (63% and 94.1%), ciprofloxacin (9.3% and 11.8%), erythromycin (53.7% and 70.6%), gentamicin (0% and 15.7%), streptomycin (35.2% and 84.3%), and tetracycline (18.5% and 17.7%), respectively. Resistance to azithromycin (42.6%), nalidixic acid (64.8%), and chloramphenicol (13%) was determined using the disk diffusion assay only, while resistance to tylosin (90.2%) was quantified using the broth microdilution method. The blaOXA-61 (52.6% and 28.1%), cmeB (26.3% and 31.3%), tet(O) (26.3% and 31.3%), and aph-3-1 (5.3% and 3.0%) were detected in C. coli and C. jejuni. These findings highlight the extent of antimicrobial resistance in Campylobacter occurring in important foods in Tanzania. The potential risks to consumers emphasize the need for adequate control approaches, including the prudent use of antimicrobials to minimize the spread of antimicrobial-resistant Campylobacter. PMID:26153978

Prevalence and Antimicrobial Resistance of Campylobacter Isolated from Dressed Beef Carcasses and Raw Milk in Tanzania.

PubMed

Kashoma, Isaac P; Kassem, Issmat I; John, Julius; Kessy, Beda M; Gebreyes, Wondwossen; Kazwala, Rudovick R; Rajashekara, Gireesh

2016-01-01

Campylobacter species are commonly transmitted to humans through consumption of contaminated foods such as milk and meat. The aim of this study was to investigate the prevalence, antimicrobial resistance, and genetic determinants of resistance of Campylobacter isolated from raw milk and beef carcasses in Tanzania. The antimicrobial resistance genes tested included blaOXA-61 (ampicillin), aph-3-1 (aminoglycoside), tet(O) (tetracycline), and cmeB (multi-drug efflux pump). The prevalence of Campylobacter was 9.5% in beef carcasses and 13.4% in raw milk, respectively. Using multiplex-polymerase chain reaction (PCR), we identified 58.1% of the isolates as Campylobacter jejuni, 30.7% as Campylobacter coli, and 9.7% as other Campylobacter spp. One isolate (1.6%) was positive for both C. jejuni and C. coli specific PCR. Antimicrobial susceptibility testing using the disk diffusion assay and the broth microdilution method showed resistance to: ampicillin (63% and 94.1%), ciprofloxacin (9.3% and 11.8%), erythromycin (53.7% and 70.6%), gentamicin (0% and 15.7%), streptomycin (35.2% and 84.3%), and tetracycline (18.5% and 17.7%), respectively. Resistance to azithromycin (42.6%), nalidixic acid (64.8%), and chloramphenicol (13%) was determined using the disk diffusion assay only, while resistance to tylosin (90.2%) was quantified using the broth microdilution method. The blaOXA-61 (52.6% and 28.1%), cmeB (26.3% and 31.3%), tet(O) (26.3% and 31.3%), and aph-3-1 (5.3% and 3.0%) were detected in C. coli and C. jejuni. These findings highlight the extent of antimicrobial resistance in Campylobacter occurring in important foods in Tanzania. The potential risks to consumers emphasize the need for adequate control approaches, including the prudent use of antimicrobials to minimize the spread of antimicrobial-resistant Campylobacter.

Tetanus Immunity Gaps in Children 5–14 Years and Men ≥ 15 Years of Age Revealed by Integrated Disease Serosurveillance in Kenya, Tanzania, and Mozambique

PubMed Central

Scobie, Heather M.; Patel, Minal; Martin, Diana; Mkocha, Harran; Njenga, Sammy M.; Odiere, Maurice R.; Pelletreau, Sonia; Priest, Jeffrey W.; Thompson, Ricardo; Won, Kimberly Y.; Lammie, Patrick J.

2017-01-01

Recent tetanus cases associated with male circumcision in Eastern and Southern Africa (ESA) prompted an examination of tetanus immunity by age and sex using multiplex serologic data from community surveys in three ESA countries during 2012–2013. Tetanus seroprotection was lower among children 5–14 years versus 1–4 years of age in Kenya (66% versus 90%) and Tanzania (66% versus 89%), but not in Mozambique (91% versus 88%), where children receive two booster doses in school. Among males ≥ 15 years of age, tetanus seroprotection was lower than females in Kenya (45% versus 96%), Tanzania (28% versus 94%), and Mozambique (64% versus 90%). Tetanus immunity from infant vaccination doses wanes over time, and only women of reproductive age routinely receive booster doses. To prevent immunity gaps in older children, adolescents, and adult men, a life-course vaccination strategy is needed to provide the three recommended tetanus booster doses. PMID:27920395

Anaemia in Pregnancy: Prevalence, Risk Factors, and Adverse Perinatal Outcomes in Northern Tanzania.

PubMed

Stephen, Grace; Mgongo, Melina; Hussein Hashim, Tamara; Katanga, Johnson; Stray-Pedersen, Babill; Msuya, Sia Emmanueli

2018-01-01

Anaemia in pregnancy is a public health problem in developing countries. This study aimed to determine the prevalence, risk factors, and adverse perinatal outcomes of anaemia among pregnant women in Moshi Municipal, Northern Tanzania. This was a follow-up study conducted from October 2013 to June 2015. A total of 539 pregnant women were enrolled in this study. Interviews were conducted followed by determination of haemoglobin level. Women were followed up at delivery and at 7 days and 28 days after delivery. A total of 529 women were included in this analysis. Their mean age was 25.8 (SD 5.73). The prevalence of anaemia was 18.0% and 2% had severe anaemia. The clinic of recruitment and low education level of the women were the factors that were independently associated with anaemia during pregnancy. At delivery, there were 10 stillbirths, 16 low birth weight (LBW) newborns, and 2 preterm birth cases. No association was found between anaemia and LBW, preterm birth, or stillbirths. Anaemia in pregnancy was a mild public health problem in the study setting of Northern Tanzania.

Feasibility of nurse-led antidepressant medication management of depression in an HIV clinic in Tanzania.

PubMed

Adams, Julie L; Almond, Maria L G; Ringo, Edward J; Shangali, Wahida H; Sikkema, Kathleen J

2012-01-01

Sub-Saharan Africa has the highest HIV prevalence worldwide and depression is highly prevalent among those infected. The negative impact of depression on HIV outcomes highlights the need to identify and treat it in this population. A model for doing this in lower-resourced settings involves task-shifting depression treatment to primary care; however, HIV-infected individuals are often treated in a parallel HIV specialty setting. We adapted a model of task-shifting, measurement-based care (MBC), for an HIV clinic setting and tested its feasibility in Tanzania. MBC involves measuring depressive symptoms at meaningful intervals and adjusting antidepressant medication treatment based on the measure of illness. Twenty adults presenting for care at an outpatient HIV clinic in Tanzania were enrolled and followed by a nurse care manager who measured depressive symptoms at baseline and every 4 weeks for 12 weeks. An algorithm-based decision-support tool was utilized by the care manager to recommend individualized antidepressant medication doses to participants' HIV providers at each visit. Retention was high and fidelity of the care manager to the MBC protocol was exceptional. Follow through of antidepressant prescription dosing recommendations by the prescriber was low. Limited availability of antidepressants was also noted. Despite challenges, baseline depression scores decreased over the 12-week period. Overall, the model of algorithm-based nursing support of prescription decisions was feasible. Future studies should address implementation issues of medication supply and dosing. Further task-shifting to relatively more abundant and lower-skilled health workers, such as nurses' aides, warrants examination.

Effect of patient selection method on provider group performance estimates.

PubMed

Thorpe, Carolyn T; Flood, Grace E; Kraft, Sally A; Everett, Christine M; Smith, Maureen A

2011-08-01

Performance measurement at the provider group level is increasingly advocated, but different methods for selecting patients when calculating provider group performance have received little evaluation. We compared 2 currently used methods according to characteristics of the patients selected and impact on performance estimates. We analyzed Medicare claims data for fee-for-service beneficiaries with diabetes ever seen at an academic multispeciality physician group in 2003 to 2004. We examined sample size, sociodemographics, clinical characteristics, and receipt of recommended diabetes monitoring in 2004 for the groups of patients selected using 2 methods implemented in large-scale performance initiatives: the Plurality Provider Algorithm and the Diabetes Care Home method. We examined differences among discordantly assigned patients to determine evidence for differential selection regarding these measures. Fewer patients were selected under the Diabetes Care Home method (n=3558) than the Plurality Provider Algorithm (n=4859). Compared with the Plurality Provider Algorithm, the Diabetes Care Home method preferentially selected patients who were female, not entitled because of disability, older, more likely to have hypertension, and less likely to have kidney disease and peripheral vascular disease, and had lower levels of predicted utilization. Diabetes performance was higher under Diabetes Care Home method, with 67% versus 58% receiving >1 A1c tests, 70% versus 65% receiving ≥1 low-density lipoprotein (LDL) test, and 38% versus 37% receiving an eye examination. The method used to select patients when calculating provider group performance may affect patient case mix and estimated performance levels, and warrants careful consideration when comparing performance estimates.

Productive Activity in the Curriculum: Changing the Literate Bias of Secondary Schools in Tanzania.

ERIC Educational Resources Information Center

Saunders, Murray

1982-01-01

Analyzes Tanzania's efforts to modify the secondary curriculum by unifying academics and productive work. Teachers have not adopted the new approach. The author suggests that teachers' reactions are affected by the relationship between schools and the division of labor, difficulties of specifying what unity means, and problems of school…

The Occurrence and Prevalence of Giraffe Skin Disease in Protected Areas of Northern Tanzania.

PubMed

Lee, Derek E; Bond, Monica L

2016-07-01

Giraffe skin disease (GSD) is a disorder of undetermined etiology that causes lesions on the forelimbs of Masai giraffe ( Giraffa camelopardalis tippelskirchi). We estimated occurrence and prevalence of GSD in six wildlife conservation areas of Tanzania. The disjunct spatial pattern of occurrence implies that environmental factors may influence GSD.

Cost-effectiveness of dihydroartemisinin-piperaquine compared with artemether-lumefantrine for treating uncomplicated malaria in children at a district hospital in Tanzania.

PubMed

Mori, Amani T; Ngalesoni, Frida; Norheim, Ole F; Robberstad, Bjarne

2014-09-15

Dihydroartemisinin-piperaquine (DhP) is highly recommended for the treatment of uncomplicated malaria. This study aims to compare the costs, health benefits and cost-effectiveness of DhP and artemether-lumefantrine (AL) alongside "do-nothing" as a baseline comparator in order to consider the appropriateness of DhP as a first-line anti-malarial drug for children in Tanzania. A cost-effectiveness analysis was performed using a Markov decision model, from a provider's perspective. The study used cost data from Tanzania and secondary effectiveness data from a review of articles from sub-Saharan Africa. Probabilistic sensitivity analysis was used to incorporate uncertainties in the model parameters. In addition, sensitivity analyses were used to test plausible variations of key parameters and the key assumptions were tested in scenario analyses. The model predicts that DhP is more cost-effective than AL, with an incremental cost-effectiveness ratio (ICER) of US$ 12.40 per DALY averted. This result relies on the assumption that compliance to treatment with DhP is higher than that with AL due to its relatively simple once-a-day dosage regimen. When compliance was assumed to be identical for the two drugs, AL was more cost-effective than DhP with an ICER of US$ 12.54 per DALY averted. DhP is, however, slightly more likely to be cost-effective compared to a willingness-to-pay threshold of US$ 150 per DALY averted. Dihydroartemisinin-piperaquine is a very cost-effective anti-malarial drug. The findings support its use as an alternative first-line drug for treatment of uncomplicated malaria in children in Tanzania and other sub-Saharan African countries with similar healthcare infrastructures and epidemiology of malaria.

Depression and HIV risk among men who have sex with men in Tanzania.

PubMed

Ahaneku, Hycienth; Ross, Michael W; Nyoni, Joyce E; Selwyn, Beatrice; Troisi, Catherine; Mbwambo, Jessie; Adeboye, Adeniyi; McCurdy, Sheryl

2016-01-01

Studies have shown high rates of depression among men who have sex with men (MSM) in developed countries. Studies have also shown association between depression and HIV risk among MSM. However, very little research has been done on depression among African MSM. We assessed depression and HIV risk among a sample of MSM in Tanzania. We reviewed data on 205 MSM who were recruited from two Tanzanian cities using the respondent driven sampling method. Demographic and behavioral data were collected using a structured questionnaire. HIV and sexually transmitted infections data were determined from biological tests. Depression scores were assessed using the Patient Health Questionnaire (PHQ-9). For the analysis, depression scores were dichotomized as depressed (PHQ > 4) and not depressed (PHQ ≤ 4). Bivariate and multivariable Poisson regression analyses were conducted to assess factors associated with depression. The prevalence of depression in the sample was 46.3%. The mean (±SD) age of the sample was 25 (±5) years. In bivariate analysis, depression was associated with self-identifying as gay (p = .001), being HIV positive (p < .001: <8% of MSM knew they were HIV infected) and having a high number of sexual partners in the last 6 months (p = .001). Depression was also associated with sexual (p = .007), physical (p = .003) and verbal (p < .001) abuse. In the Poisson regression analysis, depression was associated with verbal abuse (APR = 1.91, CI = 1.30-2.81). Depression rates were high among MSM in Tanzania. It is also associated with abuse, HIV and HIV risk behaviors. Thus, reducing the risk of depression may be helpful in reducing the risk of HIV among MSM in Africa. We recommend the colocation of mental health and HIV preventive services as a cost-effective means of addressing both depression and HIV risk among MSM in Africa.

Post-stroke social networks, depressive symptoms, and disability in Tanzania: A prospective study.

PubMed

Saadi, Altaf; Okeng'o, Kigocha; Biseko, Maijo R; Shayo, Agness F; Mmbando, Theoflo N; Grundy, Sara J; Xu, Ai; Parker, Robert A; Wibecan, Leah; Iyer, Geetha; Onesmo, Peter M; Kapina, Boniphace N; Regenhardt, Robert W; Mateen, Farrah J

2018-01-01

Background Evidence suggests that social networks improve functional recovery after stroke, but this work has not been extended to low- and middle-income countries (LMICs). Post-stroke depression interferes with functional outcome but is understudied in LMICs. Aims To determine the relationships between social networks, disability, and depressive symptoms in patients surviving 90-days post-stroke in Dar es Salaam, Tanzania. Methods Participants ≥ 18 years, admitted ≤ 14 days of stroke onset, were enrolled. Disability was measured using the modified Rankin Scale, social networks by the Berkman-Syme social network index, and depressive symptoms by the Patient Health Questionnaire-9 (PHQ-9) by telephone interview at 90 days. A Kruskal-Wallis test or Spearman's correlation coefficient was used to assess the associations between social networks, depressive symptoms, and disability. Results Of 176 participants, 43% (n = 75) died, with an additional 11% (n = 20) lost to follow-up by 90 days. Among 81 survivors, 94% (n = 76, 57% male, average age 54 years) had complete information on all scales (mean and median follow-up time of 101 and 88 days). Thirty percent (n = 23, 41.9%, 95% confidence interval 20.2) had at least mild depressive symptoms (PHQ-9 ≥ 5 points). Nearly two-thirds (n = 46, 61%) reported ≥ 3 close friends. A higher social network index score was associated with fewer depressive symptoms (p < 0.0001) and showed a trend towards significance with lower disability (p = 0.061). Higher depressive symptom burden was correlated with higher disability (r = 0.52, p < 0.0001). Conclusion Post-stroke social isolation is associated with more depressive symptoms in Tanzania. Understanding social networks and the associated mechanisms of recovery in stroke is especially relevant in the context of limited resources.

Costing maternal health services in South Tanzania: a case study from Mtwara Urban District.

PubMed

von Both, Claudia; Jahn, Albrecht; Fleba, Steffen

2008-05-01

The following paper presents the methodology and results of a costing exercise of maternal health services in Tanzania. The main objective of this study was to determine the actual costs of antenatal and obstetric care in different health institutions in a district in Tanzania as a basis of more efficient resource allocation. A costing tool was developed that allows the calculation of costs of service units, such as deliveries and antenatal care, and separates these costs from the costs of other services. Time consumed by each activity was used as an allocation key. For that purpose, we recorded the personnel consumption with different time-study methodologies. This approach was tested and implemented in Mtwara Urban District, South Tanzania. The results were analyzed by a spreadsheet program. The paper presents average costs for different costing units of maternal care. Among other findings, we found that the cost of a normal vaginal delivery is US $12.30 in a dispensary and US $6.30 in the hospital--a result that needs explanation, as usually one would expect that hospitals are more cost-intensive than first-line facilities. However, dispensaries are grossly underutilized so that the costs per service unit are rather high. The cost for surgical delivery (only in hospitals) was found to be US $69.26 and the average cost per antenatal care consultation (only at dispensaries) was US $2.50. We conclude that improved planning of elective services is a prerequisite for more effective and efficient use of personnel resources. In addition, the definition of medically and economically sound standards, in particular staffing standards, is critical to make cost analysis an effective management tool to guide rational resource allocation.

From nature tourism to ecotourism? The case of the Ngorongoro Conservation Area, Tanzania.

Treesearch

Susan Charnley

2005-01-01

This paper examines what is needed to transform nature tourism to protected areas into ecotourism, having genuine social benefits and serving as a tool for sustainable community development. It draws on the case of the Ngorongoro Conservation Area, Tanzania's most visited protected area, and a multiple land use zone inhabited by the pastoral Maasai peoples. I...

A cross-sectional survey on knowledge and perceptions of health risks associated with arsenic and mercury contamination from artisanal gold mining in Tanzania

PubMed Central

2013-01-01

Background An estimated 0.5 to 1.5 million informal miners, of whom 30-50% are women, rely on artisanal mining for their livelihood in Tanzania. Mercury, used in the processing gold ore, and arsenic, which is a constituent of some ores, are common occupational exposures that frequently result in widespread environmental contamination. Frequently, the mining activities are conducted haphazardly without regard for environmental, occupational, or community exposure. The primary objective of this study was to assess community risk knowledge and perception of potential mercury and arsenic toxicity and/or exposure from artisanal gold mining in Rwamagasa in northwestern Tanzania. Methods A cross-sectional survey of respondents in five sub-villages in the Rwamagasa Village located in Geita District in northwestern Tanzania near Lake Victoria was conducted. This area has a history of artisanal gold mining and many of the population continue to work as miners. Using a clustered random selection approach for recruitment, a total of 160 individuals over 18 years of age completed a structured interview. Results The interviews revealed wide variations in knowledge and risk perceptions concerning mercury and arsenic exposure, with 40.6% (n=65) and 89.4% (n=143) not aware of the health effects of mercury and arsenic exposure respectively. Males were significantly more knowledgeable (n=59, 36.9%) than females (n=36, 22.5%) with regard to mercury (x2=3.99, p<0.05). An individual’s occupation category was associated with level of knowledge (x2=22.82, p=<0.001). Individuals involved in mining (n=63, 73.2%) were more knowledgeable about the negative health effects of mercury than individuals in other occupations. Of the few individuals (n=17, 10.6%) who knew about arsenic toxicity, the majority (n=10, 58.8%) were miners. Conclusions The knowledge of individuals living in Rwamagasa, Tanzania, an area with a history of artisanal gold mining, varied widely with regard to the health

Animal research ethics in Africa: is Tanzania making progress?

PubMed

Seth, Misago; Saguti, Fredy

2013-12-01

The significance of animals in research cannot be over-emphasized. The use of animals for research and training in research centres, hospitals and schools is progressively increasing. Advances in biotechnology to improve animal productivity require animal research. Drugs being developed and new interventions or therapies being invented for cure and palliation of all sorts of animal diseases and conditions need to be tested in animals for their safety and efficacy at some stages of their development. Drugs and interventions for human use pass through a similar development process and must be tested pre-clinically in laboratory animals before clinical trials in humans can be conducted. Therefore, animals are important players in research processes which directly and indirectly benefit animals and humans. However, questions remain as to whether these uses of animals consider the best interests of animals themselves. Various research and training institutions in Tanzania have established some guidelines on animal use, including establishing animal ethics committees. However, most institutions have not established oversight committees. In institutions where there may be guidelines and policies, there are no responsible committees or units to directly oversee if and how these guidelines and policies are enforced; thus, implementation becomes difficult or impossible. This paper endeavours to raise some issues associated with the responsible use of animals in research and training in Tanzania and highlights suggestions for improvement of deficiencies that exist in order to bridge the gap between what ought to be practised and what is practised. © 2012 John Wiley & Sons Ltd.

Ethnobotanical study of some of mosquito repellent plants in north-eastern Tanzania

PubMed Central

Kweka, Eliningaya J; Mosha, Franklin; Lowassa, Asanterabi; Mahande, Aneth M; Kitau, Jovin; Matowo, Johnson; Mahande, Michael J; Massenga, Charles P; Tenu, Filemoni; Feston, Emmanuel; Lyatuu, Ester E; Mboya, Michael A; Mndeme, Rajabu; Chuwa, Grace; Temu, Emmanuel A

2008-01-01

Background The use of plant repellents against nuisance biting insects is common and its potential for malaria vector control requires evaluation in areas with different level of malaria endemicity. The essential oils of Ocimum suave and Ocimum kilimandscharicum were evaluated against malaria vectors in north-eastern Tanzania. Methodology An ethnobotanical study was conducted at Moshi in Kilimanjaro region north-eastern Tanzania, through interviews, to investigate the range of species of plants used as insect repellents. Also, bioassays were used to evaluate the protective potential of selected plants extracts against mosquitoes. Results The plant species mostly used as repellent at night are: fresh or smoke of the leaves of O. suave and O. kilimandscharicum (Lamiaceae), Azadirachta indica (Meliaceae), Eucalyptus globules (Myrtaceae) and Lantana camara (Verbenaceae). The most popular repellents were O. kilimandscharicum (OK) and O. suave (OS) used by 67% out of 120 households interviewed. Bioassay of essential oils of the two Ocimum plants was compared with citronella and DEET to study the repellence and feeding inhibition of untreated and treated arms of volunteers. Using filter papers impregnated with Ocimum extracts, knockdown effects and mortality was investigated on malaria mosquito Anopheles arabiensis and Anopheles gambiae, including a nuisance mosquito, Culex quinquefasciatus. High biting protection (83% to 91%) and feeding inhibition (71.2% to 92.5%) was observed against three species of mosquitoes. Likewise the extracts of Ocimum plants induced KD90 of longer time in mosquitoes than citronella, a standard botanical repellent. Mortality induced by standard dosage of 30 mg/m2 on filter papers, scored after 24 hours was 47.3% for OK and 57% for OS, compared with 67.7% for citronella. Conclusion The use of whole plants and their products as insect repellents is common among village communities of north-eastern Tanzania and the results indicate that the use of

The Successful Education Sector Development in Tanzania--Comment on Gender Balance and Inclusive Education

ERIC Educational Resources Information Center

Okkolin, Mari-Anne; Lehtomaki, Elina; Bhalalusesa, Eustella

2010-01-01

In this paper we discuss to what extent the international and national equality goals regarding gender balance and inclusive education have been reached in the education sector development in Tanzania. According to recent reports, the development trend has been generally positive, and the country is close to achieving its primary education…

Sibling Negotiations and the Construction of Literacy Events in an Urban Area of Tanzania

ERIC Educational Resources Information Center

Frankenberg, Sofia Johnson; Holmqvist, Rolf; Rubenson, Birgitta; Rindstedt, Camilla

2012-01-01

This study presents findings from analyses of naturally occurring literacy events, where children jointly focus on reading and writing letters of the alphabet, illustrating social constructions of learning created through language and embodied action. Video recorded data from two different families living in an urban low-income area in Tanzania is…

Population growth, agrarian peasant economy and environmental degradation in Tanzania.

PubMed

Madulu, N F

1995-03-01

Population strategies to relieve the density pressures on land and resources in Tanzania have not considered the basic causes of population growth. Resettlement results in the same environmental degradation as in the original settlement. There should be a reduction in the population growth and planning of proper land use and resource exploitation before resettlement. Rural development must include a decline in the dependency on subsistence agriculture. Population in Tanzania increased by 213% during 1948-88. An absolute increase in population size during 1978-88 is recorded despite a slight decline in the rate of growth. Death rates declined, but birth rates were relatively stable at around 50 per 1000 population. Regions with the highest growth rates were Dar es Salaam (4.8%), Rukwa (4.3%), Arusha (3.8%), Mbeya (3.1%), and Ruvuma (3.2%). The regions with the lowest rates were Tanga and Kilimanjaro (2.1%), Coast (2.1%), Lindi (2%), and Mtwara (1.4%). Low growth rates are attributed to low fertility and high infertility. Other factors affecting high growth rates are culture, rates of natural increase, intensity of internal and international migration, climatic conditions, and availability of resources. In 1988 46% of the population was under 15 years old. Per capita land availability declined from 11.8 hectares in 1948 to 3.8 hectares in 1988. The number of landless peasants increased. Productivity declined, and distances to farms increased. The total fertility rate was 6.5 children per woman in 1988 and 6.1 during 1991-92. Slight declines were apparent in the crude birth rate also. High fertility was a response to universal marriage, low contraceptive use (7% using modern methods during 1991-92), declining lactation periods, high mortality rates, and old traditions favoring large families. Children were used extensively in time-consuming and labor-intensive activities, such as fetching water. The mean number of children ever born was higher among women with 1

Why give birth in health facility? Users’ and providers’ accounts of poor quality of birth care in Tanzania

PubMed Central

2013-01-01

Background In Tanzania, half of all pregnant women access a health facility for delivery. The proportion receiving skilled care at birth is even lower. In order to reduce maternal mortality and morbidity, the government has set out to increase health facility deliveries by skilled care. The aim of this study was to describe the weaknesses in the provision of acceptable and adequate quality care through the accounts of women who have suffered obstetric fistula, nurse-midwives at both BEmOC and CEmOC health facilities and local community members. Methods Semi-structured interviews involving 16 women affected by obstetric fistula and five nurse-midwives at maternity wards at both BEmOC and CEmOC health facilities, and Focus Group Discussions with husbands and community members were conducted between October 2008 and February 2010 at Comprehensive Community Based Rehabilitation in Tanzania and Temeke hospitals in Dar es Salaam, and Mpwapwa district in Dodoma region. Results Health care users and health providers experienced poor quality caring and working environments in the health facilities. Women in labour lacked support, experienced neglect, as well as physical and verbal abuse. Nurse-midwives lacked supportive supervision, supplies and also seemed to lack motivation. Conclusions There was a consensus among women who have suffered serious birth injuries and nurse midwives staffing both BEmOC and CEmOC maternity wards that the quality of care offered to women in birth was inadequate. While the birth accounts of women pointed to failure of care, the nurses described a situation of disempowerment. The bad birth care experiences of women undermine the reputation of the health care system, lower community expectations of facility birth, and sustain high rates of home deliveries. The only way to increase the rate of skilled attendance at birth in the current Tanzanian context is to make facility birth a safer alternative than home birth. The findings from this study

Challenges to fair decision-making processes in the context of health care services: a qualitative assessment from Tanzania

PubMed Central

2012-01-01

Background Fair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people’s needs. In Tanzania, the policy of decentralization and the health sector reform place an emphasis on community participation in making decisions in health care. However, aspects that can influence an individual’s opportunity to be listened to and to contribute to discussion have been researched to a very limited extent in low-income settings. The objective of this study was to explore challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory. Methods The study was carried out in the Mbarali District of Tanzania. A qualitative study design was used. In-depth interviews and focus group discussion were conducted among members of the district health team, local government officials, health care providers and community members. Informal discussion on the topics was also of substantial value. Results The study findings indicate a substantial influence of gender, wealth, ethnicity and education on health care decision-making processes. Men, wealthy individuals, members of strong ethnic groups and highly educated individuals had greater influence. Opinions varied among the study informants as to whether such differences should be considered fair. The differences in levels of influence emerged most clearly at the community level, and were largely perceived as legitimate. Conclusions Existing challenges related to individuals’ influence of decision making processes in health care need to be addressed if greater participation is desired. There is a need for increased advocacy and a strengthening of responsive practices with an emphasis on the right of all individuals to participate in

Early Language Learning: Complexity and Mixed Methods

ERIC Educational Resources Information Center

Enever, Janet, Ed.; Lindgren, Eva, Ed.

2017-01-01

This is the first collection of research studies to explore the potential for mixed methods to shed light on foreign or second language learning by young learners in instructed contexts. It brings together recent studies undertaken in Cameroon, China, Croatia, Ethiopia, France, Germany, Italy, Kenya, Mexico, Slovenia, Spain, Sweden, Tanzania and…

Knowledge and attitude towards zoonoses among animal health workers and livestock keepers in Arusha and Tanga, Tanzania.

PubMed

Swai, Emanuel S; Schoonman, Luuk; Daborn, Chris J

2010-10-01

Zoonoses are infections naturally transmitted between vertebrate animals and humans. An exploratory questionnaire-based survey of animal health workers(n=36) and livestock keepers(n=43) was carried out from April 2001 to March 2002 in Tanga and Arusha regions, northern Tanzania, to assess local knowledge, attitudes and public awareness for animal zoonoses. A combination of closed and open-ended questions, focus group discussions and ranking techniques were employed to gather information on perceptions concerning the type of zoonotic diseases prevalent in the study area, level of risk, mode of transmission and methods of preventing disease transmission from animals to humans. The results demonstrated that rabies, tuberculosis and anthrax were considered the three most common zoonotic diseases. Sharing living accommodation with animals, consumption of un-treated livestock products (i.e. milk, meat or eggs) and attending to parturition were perceived as routes of transmission. Knowledge about zoonosis was higher in smallholder dairy (92%; 33/36) than traditional livestock keepers (P<0.05). On the contrary, the perceived risk of contracting a zoonosis was significantly higher in traditional livestock (86%; 6/7) than smallholder dairy keepers (P<0.05). Stratification of the risk of zoonosis by farm location revealed that rural farms (85%; 7/8) were considered significantly at a higher risk when compared to peri or urban located farms (P<0.05). Most of the respondents stated cooking of meat or boiling of milk as a way to prevent transmission. However, there was a significant difference in the perception of the risk posed by contact with potentially infected animals /or animal products with animal health workers having a much higher level of perception compared to livestock keepers. These results suggest that in the Tanga and Arusha, Tanzania, patchy awareness and knowledge of zoonoses, combined with food consumption habits and poor animal husbandry are likely to expose

Experience on healthcare utilization in seven administrative regions of Tanzania

PubMed Central

2012-01-01

Health care utilization in many developing countries, Tanzania included, is mainly through the use of traditional medicine (TRM) and its practitioners despite the presence of the conventional medicine. This article presents findings on the study that aimed to get an experience of health care utilization from both urban and rural areas of seven administrative regions in Tanzania. A total of 33 health facility managers were interviewed on health care provision and availability of supplies including drugs, in their respective areas. The findings revealed that the health facilities were overburden with higher population to serve than it was planned. Consequently essential drugs and other health supplies were available only in the first two weeks of the month. Conventional health practitioners considered traditional health practitioners to be more competent in mental health management, and overall, they were considered to handle more HIV/AIDS cases knowingly or unknowingly due to shear need of healthcare by this group. In general conventional health practitioners were positive towards traditional medicine utilization; and some of them admitted using traditional medicines. Traditional medicines like other medical health systems worldwide have side effects and some contentious ethical issues that need serious consideration and policy direction. Since many people will continue using traditional/alternative medicine, there is an urgent need to collaborate with traditional/alternative health practitioners through the institutionalization of basic training including hygiene in order to improved healthcare in the community and attain the Millennium Development Goals by 2015. PMID:22284539

Systems and Methods for Providing Insulation

NASA Technical Reports Server (NTRS)

Golden, Johnny L. (Inventor)

2015-01-01

Systems and methods provide a multi-layer insulation (MLI) that includes a plurality of sealed metalized volumes in a stacked arrangement, wherein the plurality of sealed metalized volumes encapsulate a gas therein, with the gas having one of a thermal insulating property, an acoustic insulating property, or a combination insulating property thereof. The MLI also includes at least one spacer between adjacent sealed metalized volumes of the plurality of sealed metalized volumes and a protective cover surrounding the plurality of sealed metalized volumes.

Microbial Efficacy of Waterless Hand Hygiene in Dar es Salaam, Tanzania

NASA Astrophysics Data System (ADS)

Pickering, A.; Boehm, A.; Davis, J.

2008-12-01

Millions of people die from diarrheal and respiratory diseases every year due to lack of proper sanitation, hygiene, and access to clean water. The act of handwashing with soap has been found to effectively reduce both diarrheal and respiratory illness, however, handwashing at critical times (i.e. after using the toilet, before preparing food) remains infrequent around the world. This research investigates the potential for alcohol- based hand sanitizer (ABHS) to be an effective and appropriate hand hygiene option in developing countries. A study was conducted to assess the microbiological effectiveness of ABHS, as compared to handwashing with soap and water, in field conditions in Dar es Salaam, Tanzania. A total of 205 participants, including mothers, nurses, students, and teachers, were introduced to ABHS, given a standardized amount (2ml) of product, and instructed on how to use the product correctly. Hand samples were obtained using the hand rinse method before and after the use of ABHS from 152 participants. The other 53 participants were hand sampled before and after handwashing with a non-antimicrobial liquid soap and clean water (prior to using ABHS). Visual inspections of the hands were performed before hand sampling to record the level of dirt on the hands. All hand samples were processed and analyzed by membrane filtration for concentrations of two microbial indicators, enterococci and E. coli. User perceptions of the product and willingness to pay are also documented. The results of this study provide valuable insight on the prospective of promoting ABHS in developing countries and water scarce areas.

Epidemiologic and clinical aspects of a Rift Valley fever outbreak in humans in Tanzania, 2007.

PubMed

Mohamed, Mohamed; Mosha, Fausta; Mghamba, Janeth; Zaki, Sherif R; Shieh, Wun-Ju; Paweska, Janusz; Omulo, Sylvia; Gikundi, Solomon; Mmbuji, Peter; Bloland, Peter; Zeidner, Nordin; Kalinga, Raphael; Breiman, Robert F; Njenga, M Kariuki

2010-08-01

In January 2007, an outbreak of Rift Valley fever (RVF) was detected among humans in northern Tanzania districts. By the end of the outbreak in June, 2007, 511 suspect RVF cases had been recorded from 10 of the 21 regions of Tanzania, with laboratory confirmation of 186 cases and another 123 probable cases. All confirmed RVF cases were located in the north-central and southern regions of the country, with an eventual fatality rate of 28.2% (N = 144). All suspected cases had fever; 89% had encephalopathy, 10% hemorrhage, and 3% retinopathy. A total of 169 (55%) of the 309 confirmed or probable cases were also positive for malaria as detected by peripheral blood smear. In a cohort of 20 RVF cases with known outcome that were also positive for human immunodeficiency virus, 15 (75%) died. Contact with sick animals and animal products, including blood, meat, and milk, were identified as major risk factors of acquiring RVF.

Epidemiologic and Clinical Aspects of a Rift Valley Fever Outbreak in Humans in Tanzania, 2007

PubMed Central

Mohamed, Mohamed; Mosha, Fausta; Mghamba, Janeth; Zaki, Sherif R.; Shieh, Wun-Ju; Paweska, Janusz; Omulo, Sylvia; Gikundi, Solomon; Mmbuji, Peter; Bloland, Peter; Zeidner, Nordin; Kalinga, Raphael; Breiman, Robert F.; Njenga, M. Kariuki

2010-01-01

In January 2007, an outbreak of Rift Valley fever (RVF) was detected among humans in northern Tanzania districts. By the end of the outbreak in June, 2007, 511 suspect RVF cases had been recorded from 10 of the 21 regions of Tanzania, with laboratory confirmation of 186 cases and another 123 probable cases. All confirmed RVF cases were located in the north-central and southern regions of the country, with an eventual fatality rate of 28.2% (N = 144). All suspected cases had fever; 89% had encephalopathy, 10% hemorrhage, and 3% retinopathy. A total of 169 (55%) of the 309 confirmed or probable cases were also positive for malaria as detected by peripheral blood smear. In a cohort of 20 RVF cases with known outcome that were also positive for human immunodeficiency virus, 15 (75%) died. Contact with sick animals and animal products, including blood, meat, and milk, were identified as major risk factors of acquiring RVF. PMID:20682902