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Sample records for rural tanzania method

  1. Verbal Autopsies in Rural Tanzania

    African Journals Online (AJOL)

    Maternal mortality rates in rural Tanzania are high. In preparation for the introduction of an intervention to reduce maternal deaths by distribution of misoprostol and erythromycin to women living in rural Rorya District, Mara Region, Tanzania, we conducted a limited verbal autopsy by surveying family members of women ...

  2. Bioenergy options. Multidisciplinary participatory method for assessing bioenergy options for rural villages in Tanzania

    Energy Technology Data Exchange (ETDEWEB)

    Kauzeni, A S; Masao, H P; Sawe, E N; Shechambo, F C [Dar Es Salaam Univ. (Tanzania). Inst. of Resource Assessment; Ellegaard, A [Stockholm Environment Inst. (Sweden)

    1999-12-31

    In Tanzania, like in many other developing countries in Southern and Eastern Africa, bioenergy planning has received relatively little attention, compared to planning for `modern` energy sources, although it accounts for about 90% of the country`s energy supply. As a result there is less understanding of the complexity and diversity of bioenergy systems. There is a lack of reliable data and information on bio-resources, their consumption and interaction with social, economic, institutional and environmental factors. This is largely due to lack of adequately developed and easily understood methods of data and information development, analysis and methods of evaluating available bioenergy options. In order to address the above constraints a project was initiated where the general objective was to develop and test a multi-disciplinary research method for identifying bioenergy options that can contribute to satisfying the energy needs of the rural household, agricultural and small scale industrial sectors, promote growth and facilitate sustainable development. The decision on the development and testing of a multidisciplinary research method was based on the fact that in Tanzania several bioenergy programmes have been introduced e.g. tree planting, improved cookstoves, biogas, improved charcoal making kilns etc. for various purposes including combating deforestation; promoting economic growth, substitution of imported petroleum fuels, health improvement, and raising standards of living. However efforts made in introducing these programmes or interventions have met with limited success. This situation prevails because developed bioenergy technologies are not being adopted in adequate numbers by the target groups. There are some indications from the study that some of the real barriers to effective bioenergy interventions or adoption of bioenergy technologies lie at the policy level and not at the project level. After the development and testing of the methodology

  3. Bioenergy options. Multidisciplinary participatory method for assessing bioenergy options for rural villages in Tanzania

    Energy Technology Data Exchange (ETDEWEB)

    Kauzeni, A.S.; Masao, H.P.; Sawe, E.N.; Shechambo, F.C. [Dar Es Salaam Univ. (Tanzania). Inst. of Resource Assessment; Ellegaard, A. [Stockholm Environment Inst. (Sweden)

    1998-12-31

    In Tanzania, like in many other developing countries in Southern and Eastern Africa, bioenergy planning has received relatively little attention, compared to planning for `modern` energy sources, although it accounts for about 90% of the country`s energy supply. As a result there is less understanding of the complexity and diversity of bioenergy systems. There is a lack of reliable data and information on bio-resources, their consumption and interaction with social, economic, institutional and environmental factors. This is largely due to lack of adequately developed and easily understood methods of data and information development, analysis and methods of evaluating available bioenergy options. In order to address the above constraints a project was initiated where the general objective was to develop and test a multi-disciplinary research method for identifying bioenergy options that can contribute to satisfying the energy needs of the rural household, agricultural and small scale industrial sectors, promote growth and facilitate sustainable development. The decision on the development and testing of a multidisciplinary research method was based on the fact that in Tanzania several bioenergy programmes have been introduced e.g. tree planting, improved cookstoves, biogas, improved charcoal making kilns etc. for various purposes including combating deforestation; promoting economic growth, substitution of imported petroleum fuels, health improvement, and raising standards of living. However efforts made in introducing these programmes or interventions have met with limited success. This situation prevails because developed bioenergy technologies are not being adopted in adequate numbers by the target groups. There are some indications from the study that some of the real barriers to effective bioenergy interventions or adoption of bioenergy technologies lie at the policy level and not at the project level. After the development and testing of the methodology

  4. Unsafe abortion in urban and rural Tanzania: method, provider and consequences

    DEFF Research Database (Denmark)

    Rasch, Vibeke; Kipingili, Rose

    2009-01-01

    OBJECTIVE: To describe unsafe abortion methods and associated health consequences in Tanzania, where induced abortion is restricted by law but common and known to account for a disproportionate share of hospital admissions. METHOD: Cross-sectional study of women admitted with alleged miscarriage...

  5. Scaling up postabortion contraceptive service--results from a study conducted among women having unwanted pregnancies in urban and rural Tanzania

    DEFF Research Database (Denmark)

    Rasch, Vibeke; Yambesi, Fortunata; Kipingili, Rose

    2005-01-01

    Tanzania and 42% in rural Tanzania stated that their pregnancy was unwanted. Contraceptive acceptance among women with unwanted pregnancies was high; 93% in urban Tanzania and 71% in rural Tanzania left with a contraceptive method. CONCLUSION: The high proportion of women with unwanted pregnancies in urban...... and rural Tanzania underlines the need of scaling up postabortion contraceptive service....

  6. Performance and self-perceived competencies of enrolled nurse/midwives: a mixed methods study from rural Tanzania.

    Science.gov (United States)

    Tarimo, Edith A M; Moyo, Gustav; Masenga, Happy; Magesa, Paul; Mzava, Dafroza

    2018-04-11

    Tanzania is experiencing a severe shortage of human resources for health, which poses a serious threat to the quality of health care services particularly in rural areas. Task shifting has been considered a way to address this problem. However, since a large percentage of health care providers in rural setting is comprised of Enrolled Nurse/Midwives (ENMs), most of the health care tasks are shifted to them. This article analyzes the performance and self-perceived competencies of ENMs at the dispensary level; the lowest health facility in Tanzania. Performance refers to routine duties performed by ENMs, and self-perceived competence means self-perceived proficiency in performing nursing/midwifery and medical duties. This was a mixed methods study conducted in rural Tanzania. A purposeful sample of twelve (12) informants (six ENMs; two Community Leaders [CLs] and four Dispensary In-charges [DIs]) was recruited for semi-structured interviews. The interviews were supplemented with quantitative data from 59 ENMs. Both thematic and descriptive analysis approaches were used. Three themes emerged: (1) 'Approval of the performances of ENMs in meeting community health needs' underscores important services the community members got from ENMs at dispensaries. (2) 'Experienced difficulties of meeting community health needs' indicate the problems ENMs encountered while providing services to the community. In striving to serve a large number of demanding clients without adequate medical equipment and supplies, sometimes the ENMs ended up with prescription errors (3) 'Appreciating the performances and competencies of ENMs' shows the acknowledgement of community members towards ENMs' performance and competencies within and beyond their scope of practice. The community members as well as ENMs and their supervisors knew that ENMs must sometimes provide care that is outside their scope of training and competency. Overall, the performance among ENMs above 38 years of age (P

  7. Socio-economic Status and Women Empowerment in Rural Tanzania

    African Journals Online (AJOL)

    Socio-economic Status and Women Empowerment in Rural Tanzania: A Case of Onion ... Tanzania Journal of Development Studies ... Therefore the government, nongovernmental organisations and development programmes espousing to ...

  8. Planning a Family: Priorities and Concerns in Rural Tanzania ...

    African Journals Online (AJOL)

    Planning a Family: Priorities and Concerns in Rural Tanzania. T Marchant, AK Mushi, R Nathan, O Mukasa, S Abdulla, C Lengeler, JRM Armstrong Schellenberg. Abstract. A fertility survey using qualitative and quantitative techniques described a high fertility setting (TFR 5.8) in southern Tanzania where family planning use ...

  9. Cost of microbial larviciding for malaria control in rural Tanzania.

    Science.gov (United States)

    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.

  10. School Proximity and Child Labor: Evidence from Rural Tanzania

    Science.gov (United States)

    Kondylis, Florence; Manacorda, Marco

    2012-01-01

    Is improved school accessibility an effective policy tool for reducing child labor in developing countries? We address this question using microdata from rural Tanzania and a regression strategy that attempts to control for nonrandom location of households around schools as well as classical and nonclassical measurement error in self-reported…

  11. Users' perspectives on decentralized rural water services in Tanzania

    NARCIS (Netherlands)

    Masanyiwa, Z.S.; Niehof, A.; Termeer, C.J.A.M.

    2015-01-01

    This article examines the impact of decentralization reforms on improving access to domestic water supply in the rural districts of Kondoa and Kongwa, Tanzania, using a users' and a gender perspective. The article addresses the question whether and to what extent the delivery of gender-sensitive

  12. Rural Transformation and the Emergence of Urban Centres in Tanzania

    DEFF Research Database (Denmark)

    Lazaro, Evelyne; Agergaard, Jytte; Larsen, Marianne Nylandsted

    as market places for sale of a dominant crop. In all four cases, new employment opportunities have been created in the value chain sequence of economic activities and the influx of migrant works have increased significantly. 3) How do migration and investments contribute to the consolidation of EUCs...... that have been stimulated by Tanzanian market liberalizations and its long term effects on private enterprise. The paper is based on a study of four EUCs in Tanzania (Ilula, Igowole, Madizini and Kibaigwa) and seeks to answer three major research questions: 1) What economic and spatial trends, including......Urbanization and rural transformation in the Global South can be conceptualized and explored as integrated processes. Recent academic debates have discussed how rural places are changing in close relation to economic and social processes where the distinction between rural and urban livelihoods...

  13. Unsafe abortion in rural Tanzania ¿ the use of traditional medicine from a patient and a provider perspective

    DEFF Research Database (Denmark)

    Rasch, Vibeke; Sørensen, Pernille H; Wang, Anna R

    2014-01-01

    BackgroundThe circumstances under which women obtain unsafe abortion vary and depend on the traditional methods known and the type of providers present. In rural Tanzania women often resort to traditional providers who use plant species as abortion remedies. Little is known about how these plants...

  14. How long-distance truck drivers and villagers in rural southeastern Tanzania think about heterosexual anal sex: a qualitative study

    NARCIS (Netherlands)

    Mtenga, S.; Shamba, D.; Wamoyi, J.; Kakoko, D.; Haafkens, J.; Mongi, A.; Kapiga, S.; Geubbels, E.

    2015-01-01

    Objective: To explore ideas of truck drivers and villagers from rural Tanzania about heterosexual anal sex (HAS) and the associated health risks. Methods: Qualitative study using 8 in-depth interviews (IDIs) and 2 focus group discussions (FGDs) with truck drivers and 16 IDIs and 4 FGDs with

  15. Feeding and management strategies for rural poultry production in Central Tanzania

    NARCIS (Netherlands)

    Goromela, E.H.

    2009-01-01

    Keywords: Central Tanzania, rural poultry, scavengeable feed resources, nutrient composition, crop
    contents, season, farming system, chemical composition, supplementary feeding, weaning, egg production,
    growth rate, survival rate, laying management, indigenous chickens

    The

  16. Ending Open Defecation in Rural Tanzania: Which Factors Facilitate Latrine Adoption?

    Directory of Open Access Journals (Sweden)

    Stephen Sara

    2014-09-01

    Full Text Available Diarrheal diseases account for 7% of deaths in children under five years of age in Tanzania. Improving sanitation is an essential step towards reducing these deaths. This secondary analysis examined rural Tanzanian households’ sanitation behaviors and attitudes in order to identify barriers and drivers to latrine adoption. The analysis was conducted using results from a cross-sectional study of 1000 households in five rural districts of Tanzania. Motivating factors, perceptions, and constraints surrounding open defecation and latrine adoption were assessed using behavioral change theory. Results showed a significant association between use of improved sanitation and satisfaction with current sanitation facility (OR: 5.91; CI: 2.95–11.85; p = 0.008. Livestock-keeping was strongly associated with practicing open defecation (OR: 0.22; CI 0.063–0.75; p < 0.001. Of the 93 total households that practiced open defecation, 79 (85% were dissatisfied with the practice, 62 (67% had plans to build a latrine and 17 (18% had started saving for a latrine. Among households that planned to build a latrine, health was the primary reason stated (60%. The inability to pay for upgrading sanitation infrastructure was commonly reported among the households. Future efforts should consider methods to reduce costs and ease payments for households to upgrade sanitation infrastructure. Messages to increase demand for latrine adoption in rural Tanzania should integrate themes of privacy, safety, prestige and health. Findings indicate a need for lower cost sanitation options and financing strategies to increase household ability to adopt sanitation facilities.

  17. Dissatisfaction with traditional birth attendants in rural Tanzania.

    Science.gov (United States)

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

    2009-10-01

    To assess women's satisfaction with traditional birth attendants (TBAs) in rural Tanzania. A population-representative sample of households in Kasulu district was used to collect data on demographics, childbirth history, and perception of TBAs and doctors/nurses from women who had recently had a child and from their partners. Two-thirds of women who gave birth in a health facility reported being very satisfied with the experience, compared with 21.2% of women who delivered at home with TBAs. A sizeable proportion of women felt that TBAs had poor medical skills (23.1%), while only 0.3% of women felt the same about doctors' and nurses' skills. Of women who delivered with a TBA, 16.0% reported that TBAs had poor medical skills whereas 0.5% stated the same for doctors and nurses. Although many women delivered at home in this rural study district, women and their partners reported higher confidence in doctors and nurses than in TBAs. Policymakers and program managers should not assume that women prefer TBAs to trained professionals for delivery but should consider system barriers to facility delivery in interventions aimed at reducing maternal mortality.

  18. Health-seeking behaviour of human brucellosis cases in rural Tanzania

    Directory of Open Access Journals (Sweden)

    MacMillan Alastair

    2007-11-01

    Full Text Available Abstract Background Brucellosis is known to cause debilitating conditions if not promptly treated. In some rural areas of Tanzania however, practitioners give evidence of seeing brucellosis cases with symptoms of long duration. The purpose of this study was to establish health-seeking behaviour of human brucellosis cases in rural Tanzania and explore the most feasible ways to improve it. Methods This was designed as a longitudinal study. Socio-demographic, clinical and laboratory data were collected from patients who reported to selected hospitals in rural northern Tanzania between June 2002 and April 2003. All patients with conditions suspicious of brucellosis on the basis of preliminary clinical examination and history were enrolled into the study as brucellosis suspects. Blood samples were taken and tested for brucellosis using the Rose-Bengal Plate Test (RBPT and other agglutination tests available at the health facilities and the competitive ELISA (c-ELISA test at the Veterinary Laboratory Agencies (VLA in the UK. All suspects who tested positive with the c-ELISA test were regarded as brucellosis cases. A follow-up of 49 cases was made to collect data on health-seeking behaviour of human brucellosis cases. Results The majority of cases 87.7% gave a history of going to hospital as the first point of care, 10.2% purchased drugs from a nearby drug shop before going to hospital and 2% went to a local traditional healer first. Brucellosis cases delayed going to hospital with a median delay time of 90 days, and with 20% of the cases presenting to hospitals more than a year after the onset of symptoms. Distance to the hospital, keeping animals and knowledge of brucellosis were significantly associated with patient delay to present to hospital. Conclusion More efforts need to be put on improving the accessibility of health facilities to the rural poor people who succumb to most of the diseases including zoonoses. Health education on brucellosis in

  19. Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey

    Directory of Open Access Journals (Sweden)

    Setel Philip

    2005-01-01

    Full Text Available Abstract Background Injuries are becoming a major health problem in developing countries. Few population based studies have been carried out in African countries. We examined the pattern of nonfatal injuries and associated risk factors in an urban and rural setting of Tanzania. Methods A population-based household survey was conducted in 2002. Participants were selected by cluster sampling. A total of 8,188 urban and 7,035 rural residents of all ages participated in the survey. All injuries reported among all household members in the year preceding the interview and resulting in one or more days of restricted activity were included in the analyis. Results A total of 206 (2.5% and 303 (4.3% persons reported to have been injured in the urban and rural area respectively. Although the overall incidence was higher in the rural area, the incidence of major injuries (≥ 30 disability days was similar in both areas. Males were at a higher risk of having an injury than females. Rural residents were more likely to experience injuries due to falls (OR = 1.6; 95% CI = 1.1 – 2.3 and cuts (OR = 4.3; 95% CI = 3.0 – 6.2 but had a lower risk of transport injuries. The most common causes of injury in the urban area were transport injuries and falls. In the rural area, cuts and stabs, of which two thirds were related to agriculture, formed the most common cause. Age was an important risk factor for certain types of injuries. Poverty levels were not significantly associated with experiencing a nonfatal injury. Conclusion The patterns of injury differ in urban and rural areas partly as a reflection of livelihoods and infrastructure. Rural residents are at a higher overall injury risk than urban residents. This may be important in the development of injury prevention strategies.

  20. Preparing investigation of methods for surveying tree seed demands among farmers in Tanzania

    DEFF Research Database (Denmark)

    Aabæk, Anders

    Insufficient seed supplies is often a major constraint on tree planting activities in developing countries. A central problem is to assess the actual demands for tree seed. This report shall, as a part of a PhD-study, prepare an investigation of different methods for surveying tree seed demands...... and preferences among private farmers in Tanzania. A framework for investigating seed demand and supply is outlined. The role of a national tree seed project in a seed supply sector is discussed and data requirements for strategy on seed procurement and tree improvement are outlined. Earlier surveys on seed...... demand pattern in Tanzania, Uganda and Nicaragua are discussed and a choice of strategy for an extensive survey of seed demand and supply in Tanzania is made. Different data collection methods and tools, e.g. quantitative and qualitative surveys and rapid rural appraisals, are described in detail...

  1. Risk distribution across multiple health insurance funds in rural Tanzania

    DEFF Research Database (Denmark)

    Chomi, Eunice Nahyuha; Mujinja, Phares Gamba; Enemark, Ulrika

    2014-01-01

    cross-subsidisation across the funds. This paper analyses whether the risk distribution varies across the Community Health Fund (CHF) and National Health Insurance Fund (NHIF) in two districts in Tanzania. Specifically we aim to 1) identify risk factors associated with increased utilisation of health...... services and 2) compare the distribution of identified risk factors among the CHF, NHIF and non-member households. METHODS: Data was collected from a survey of 695 households. A multivariate logisitic regression model was used to identify risk factors for increased health care utilisation. Chi-square tests...... were performed to test whether the distribution of identified risk factors varied across the CHF, NHIF and non-member households. RESULTS: There was a higher concentration of identified risk factors among CHF households compared to those of the NHIF. Non-member households have a similar wealth status...

  2. Tanzania.

    Science.gov (United States)

    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

  3. Determinants of early child development in rural Tanzania.

    Science.gov (United States)

    Ribe, Ingeborg G; Svensen, Erling; Lyngmo, Britt A; Mduma, Estomih; Hinderaker, Sven G

    2018-01-01

    It has been estimated that more than 200 million children under the age of five do not reach their full potential in cognitive development. Much of what we know about brain development is based on research from high-income countries. There is limited evidence on the determinants of early child development in low-income countries, especially rural sub-Saharan Africa. The present study aimed to identify the determinants of cognitive development in children living in villages surrounding Haydom, a rural area in north-central Tanzania. This cohort study is part of the MAL-ED (The Interactions of Malnutrition & Enteric Infections: Consequences for Child Health and Development) multi-country consortium studying risk factors for ill health and poor development in children. Descriptive analysis and linear regression analyses were performed. Associations between nutritional status, socio-economic status, and home environment at 6 months of age and cognitive outcomes at 15 months of age were studied. The third edition of the Bayley Scales for Infant and Toddler Development was used to assess cognitive, language and motor development. There were 262 children enrolled into the study, and this present analysis included the 137 children with data for 15-month Bayley scores. Univariate regression analysis, weight-for-age and weight-for-length z-scores at 6 months were significantly associated with 15-month Bayley gross motor score, but not with other 15-month Bayley scores. Length-for-age z-scores at 6 months were not significantly associated with 15-month Bayley scores. The socio-economic status, measured by a set of assets and monthly income was significantly associated with 15-month Bayley cognitive score, but not with language, motor, nor total 15-month Bayley scores. Other socio-economic variables were not significantly associated with 15-month Bayley scores. No significant associations were found between the home environment and 15-month Bayley scores. In multivariate

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

    Science.gov (United States)

    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 ...

  5. Wood fuel use in Tanzania rural-based industries. Brick kiln studies in Tanzania

    Energy Technology Data Exchange (ETDEWEB)

    Kiwele, P.M.; Mbise, H.A.; Mwihava, N.C.X.; Svenningsson, P.J.

    1999-07-01

    About 90% of the annual total energy consumed in Tanzania is biomass-based, mainly in the form of wood fuel. Small-scale brick-making is one of the major consumers of wood fuel, with Arusha, Iringa and Mbeya being the main areas where brick-making activities take place. In 1993, the Stockholm Environment Institute (SEI) in collaboration with the Ministry of Energy and Minerals (MEM) proposed a project to undertake studies on fuelwood in small rural industries of Tanzania, particularly brick-making. The study on wood fuel utilisation involved field measurements and analyses with the aim of establishing major sources of energy losses and to recommend measures regarding fuel switching, kiln thermal efficiency improvements, and the yield and quality of bricks. The positive feedback would mean reduced demand for fuelwood and hence reduced deforestation rate and therefore environmental protection. The implementation of the project, which commenced in 1994, involved field measurements in order to establish kiln performances as well as laboratory tests to determine the qualities of the fired bricks. At a later stage of implementation, efforts were made to consider other potential fuels (sawdust and coal) for firing the kilns. The main indicators of kiln performance include thermal efficiency, specific energy consumption (SEC), which is sometimes referred to as specific fuel consumption (SFC; yield; and quality. The average SEC for Mbeya region was found to vary from 1.11 to 1.54 while for Iringa region the range was from 1.21 to 1.84 MJ/kg fired brick. The data for Arusha was in the range of 0.76 to 3.3 MJ/kg of fired brick. The low SEC may not necessarily give a reasonable indication of the kiln performance because kiln operators in Mbeya mould larger size bricks which are unloaded from incomplete firing conditions. The fired bricks at Babati (Arusha), though of work-size, are of low quality and consume very little wood fuel. Findings obtained under the SADC project four

  6. Panic disorder in rural Tanzania: an explorative study | Nordgreen ...

    African Journals Online (AJOL)

    This article examines cultural based interpretations of the diagnosis of panic disorder (PD) in a rural Tanzanian hospital setting through clinical work. It also examines how to adapt and apply brief cognitive behaviour therapy (CBT) interventions to this setting. Method: A qualitative analysis of clinical data from ten participants ...

  7. 'We call it the shaking illness': perceptions and experiences of Parkinson's disease in rural northern Tanzania

    Directory of Open Access Journals (Sweden)

    Dotchin Catherine L

    2011-04-01

    Full Text Available Abstract 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.

  8. Local management of rural power supply. A new approach in Tanzania

    Energy Technology Data Exchange (ETDEWEB)

    Gullberg, Monica; Katyega, Maneno; Kjellstroem, Bjoern

    1999-07-01

    The rural electrification program in Tanzania has been on going since independence in 1961, with the national utility, Tanzania Electric Supply Company Ltd. (TANESCO) being responsible for its implementation. By 1992, 14 townships and 37 villages had been electrified as a result of this program. This covers only a small fraction of rural Tanzania. It is estimated that in 1998, less than 1% of the rural households in Tanzania had access to electricity. Electricity constitutes only 1% of Tanzania's final energy consumption. Except for the few latest years, electricity generation and distribution in Tanzania has been the full responsibility of TANESCO. The national electricity grid is mainly supplied by large-scale hydro power plants (391 MW), and thermal power plants (148 MW). Rural areas are supplied either by a transmission line from the national grid or by diesel generator sets. The isolated branches run by TANESCO have an installed capacity amounting to a total of 23 MW. Electric lighting is the dominating use of electricity in rural areas. Industrial use in these areas is marginal. Very few rural households use electricity for cooking. Cooking is made with fuelwood and to some extent charcoal and kerosene. Where electricity is not available, kerosene in simple wick lamps is used for lighting. As part of the research co-operation between TANESCO and the Stockholm Environment Institute, SEI, an extensive evaluation of the experiences from the rural electrification program in Tanzania was carried out in 1989 - 1991. The four main conclusions from this evaluation were in summary: The rural people appreciate electrification. Rural electrification is a large financial burden on TANESCO. The quality of the service, in particular the supply reliability, is low in rural areas. Many of the perceived benefits of rural electrification, like the creation of small scale industries or reduced use of fuel wood for cooking, have not materialised to a significant degree. As

  9. Private Capital, Public Goods: Forest Plantations' Investment in Local Infrastructure and Social Services in Rural Tanzania

    NARCIS (Netherlands)

    Degnet, M.B.; Werf, van der E.; Ingram, V.J.; Wesseler, Justus

    2017-01-01

    With the rapid expansion of private forest plantations worldwide, their impacts on local development are under scrutiny by NGOs and researchers alike. This study investigates the impacts of private forest plantations on local infrastructure and social services in rural Tanzania. We take a

  10. Identification, characterisation and composition of scavengeable feed resources for rural poultry production in Central Tanzania

    NARCIS (Netherlands)

    Goromela, E.H.; Kwakkel, R.P.; Verstegen, M.W.A.; Katule, A.M.

    2007-01-01

    A participatory study was carried out in four villages of central Tanzania to appraise existing and potential scavengeable feed resources available for rural poultry. In addition, proximate analysis of selected scavengeable feed resources including chicken crop and gizzards contents was carried out

  11. Impacts of Electricity Access to Rural Enterprises in Bolivia, Tanzania and Vietnam

    NARCIS (Netherlands)

    van Dijk, Annemarije; Clancy, Joy S.

    2010-01-01

    There is little empirical evidence to underpin strategies of poverty reduction through income generation in small scale rural enterprises through supplying energy. This paper reports on research findings from a three country study in Bolivia, Tanzania and Vietnam which aimed to provide insights into

  12. Unpacking Global Service-Learning in Developing Contexts: A Case Study from Rural Tanzania

    Science.gov (United States)

    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…

  13. Potential use of birthweight indicators in rural Tanzania for monitoring malaria control in pregnancy

    NARCIS (Netherlands)

    Uddenfeldt Wort, Ulrika; Warsame, Marian; Brabin, Bernard J.

    2008-01-01

    Objective: Birthweight outcomes in rural Tanzania were determined in relation to place of delivery (hospital, dispensary or home), parity and maternal age (adolescent or non-adolescent) in order to evaluate the usefulness of birthweight data for monitoring malaria control in pregnancy. Study design:

  14. What policy says and practice does : gender, household and community in rural water provision in Tanzania

    NARCIS (Netherlands)

    Mandara, C.G.

    2014-01-01

    Summary

    Since 1945 to date the governance of the rural water sector in Tanzania has passed through multiple phases, from the colonial era to the times characterized by liberalization, decentralisation and privatization.

  15. Cooperation and trust in the context of decentralization reforms in rural Tanzania

    NARCIS (Netherlands)

    Masanyiwa, Z.S.; Niehof, A.; Termeer, C.J.A.M.

    2014-01-01

    This paper investigates the impact of decentralization reforms on cooperation and trust at the village level in Tanzania, using a gender perspective. The paper draws on survey and qualitative data from ten villages in two rural districts. The findings show that the reforms have revitalized 'formal’

  16. Standardized small diesel power plants for rural electrification in Tanzania

    International Nuclear Information System (INIS)

    Holmqvist, A.; Soerman, J.; Gullberg, M.; Kjellstroem, B.

    1993-01-01

    This study focuses on small townships where the forecasted power demand stays below 500 kW during the ten first years. Case study calculations were made where two hypothetical load centres form the base. Each load centre is assumed to be supplied by two alternative standardized diesel power plants. One option is a power plant consisting of two medium speed (750 rpm) generator sets, one always on stand-by. Alternatively, a power plant consisting of three high speed (1500 rpm) generator sets is evaluated for each hypothetical load centre. The calculations clearly show that the high speed, three unit option comes out cheaper than the two unit, medium speed option in all the considered cases. The fuel costs per kWh generated are almost the same in all the cases studied, i.e. between 6 and 7 US cents. The medium speed engine tends to consume more fuel per kWh generated than the high speed, as it runs more often on part load. Consequently, the fuel costs will be slightly higher for this option. It is also of interest to compare the plant failure rate of the two options. In this study no proper probability evaluation has been made, but some general reflections can be worth considering. The availability of spare parts in Tanzania is doubtful. Many small diesel power plants presently operating have to wait indefinitely, when a failure appears that requires spare parts. As long as the individual sets have the same, or nearly the same failure rate, a three unit plant has lower probability for total loss of generating capacity than a two unit plant. The main conclusion of this evaluation is that for electricity generation in rural Tanzanian villages, power plants with three small, high speed generator sets are preferable to plants with two, medium speed generator sets. A power plant made out of small sets requires less capital, consumes less fuel and is not as likely to loose its generating capacity totally. 16 refs, 10 figs, 21 tabs

  17. 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.

    Science.gov (United States)

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

    2014-10-16

    Strategies to improve infant and young child nutrition in low- and middle- income countries need to be implemented at scale. We contextualised and packaged successful strategies into a feasible intervention for implementation in rural Tanzania. Opportunities that can optimise delivery of the intervention and encourage behaviour change include mothers willingness to modifying practices; support of family members; seasonal availability and accessibility of foods; established set-up of village peers and functioning health system. The primary objective of the study is to evaluate the effectiveness of a nutrition education package in improving feeding practices, dietary adequacy and growth as compared to routine health education. A parallel cluster randomised controlled trial will be conducted in rural central Tanzania in 9 intervention and 9 control villages. The control group will receive routine health education offered monthly by health staff at health facilities. The intervention group will receive a nutrition education package in addition to the routine health education. The education package is comprised of four components: 1) education and counselling of mothers, 2) training community-based nutrition counsellors and monthly home visits, 3) sensitisation meetings with health staff and family members, and 4) supervision of community-based nutrition counsellors. The duration of the intervention is 9 months and infants will be recruited at 6 months of age. Primary outcome (linear growth as length-for-age Z-scores) and secondary outcomes (changes in weight-for-length Z-scores; mean intake of energy, fat, iron and zinc from complementary foods; proportion of children consuming 4 or more food groups and recommended number of semi-solid/soft meals and snacks per day; maternal level of knowledge and performance of recommended practices) will be assessed at baseline and ages 9, 12 and 15 months. Process evaluation will document reach, dose and fidelity of the

  18. Gender, cooperative organisation and participatory intervention in rural Tanzania : a case study of different types of cooperatives and Moshi University College’s support to rural women

    NARCIS (Netherlands)

    Msonganzila, M.

    2013-01-01

    The thesis examines cooperation and participation as modes of institutional action to address women’ social and economic problems and needs in the context of rural Tanzania. It does so against the background of the history of cooperatives in Tanzania and development cooperation. The thesis takes

  19. Disclosure of HIV Status in Rural Tanzania: Practices, Facilitators ...

    African Journals Online (AJOL)

    In Tanzania, HIV counselling and testing practices are now widely accepted as the cornerstone of HIV prevention programmes. Within HIV testing and counselling, emphasis is placed on the importance of individuals to disclose their HIV status. Despite increasing focus on disclosure of HIV status, relatively little is known ...

  20. Rural to urban migration and changes in cardiovascular risk factors in Tanzania: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Tamin Bushiri

    2010-05-01

    Full Text Available Abstract Background High levels of rural to urban migration are a feature of most African countries. Our aim was to investigate changes, and their determinants, in cardiovascular risk factors on rural to urban migration in Tanzania. Methods Men and women (15 to 59 years intending to migrate from Morogoro rural region to Dar es Salaam for at least 6 months were identified. Measurements were made at least one week but no more than one month prior to migration, and 1 to 3 monthly after migration. Outcome measures included body mass index, blood pressure, fasting lipids, and self reported physical activity and diet. Results One hundred and three men, 106 women, mean age 29 years, were recruited and 132 (63.2% followed to 12 months. All the figures presented here refer to the difference between baseline and 12 months in these 132 individuals. Vigorous physical activity declined (79.4% to 26.5% in men, 37.8% to 15.6% in women, p -1 respectively, p -1, p = 0.01, and triglycerides fell (0.31 mmoll-1, p = 0.034. Blood pressure appeared to fall in both men and women. For example, in men systolic blood pressure fell by 5.4 mmHg, p = 0.007, and in women by 8.6 mmHg, p = 0.001. Conclusion The lower level of physical activity and increasing weight will increase the risk of diabetes and cardiovascular disease. However, changes in diet were mixed, and may have contributed to mixed changes in lipid profiles and a lack of rise in blood pressure. A better understanding of the changes occurring on rural to urban migration is needed to guide preventive measures.

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

    Directory of Open Access Journals (Sweden)

    Montgomery Scott M

    2008-10-01

    Full Text Available Abstract 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

  2. Concentration and drug prices in the retail market for malaria treatment in rural Tanzania.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  4. Markets, voucher subsidies and free nets combine to achieve high bed net coverage in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Gerrets Rene PM

    2008-06-01

    Full Text Available Abstract Background Tanzania has a well-developed network of commercial ITN retailers. In 2004, the government introduced a voucher subsidy for pregnant women and, in mid 2005, helped distribute free nets to under-fives in small number of districts, including Rufiji on the southern coast, during a child health campaign. Contributions of these multiple insecticide-treated net delivery strategies existing at the same time and place to coverage in a poor rural community were assessed. Methods Cross-sectional household survey in 6,331 members of randomly selected 1,752 households of 31 rural villages of Demographic Surveillance System in Rufiji district, Southern Tanzania was conducted in 2006. A questionnaire was administered to every consenting respondent about net use, treatment status and delivery mechanism. Findings Net use was 62.7% overall, 87.2% amongst infants (0 to1 year, 81.8% amongst young children (>1 to 5 years, 54.5% amongst older children (6 to 15 years and 59.6% amongst adults (>15 years. 30.2% of all nets had been treated six months prior to interview. The biggest source of nets used by infants was purchase from the private sector with a voucher subsidy (41.8%. Half of nets used by young children (50.0% and over a third of those used by older children (37.2% were obtained free of charge through the vaccination campaign. The largest source of nets amongst the population overall was commercial purchase (45.1% use and was the primary means for protecting adults (60.2% use. All delivery mechanisms, especially sale of nets at full market price, under-served the poorest but no difference in equity was observed between voucher-subsidized and freely distributed nets. Conclusion All three delivery strategies enabled a poor rural community to achieve net coverage high enough to yield both personal and community level protection for the entire population. Each of them reached their relevant target group and free nets only temporarily

  5. The determinants of traditional medicine use in Northern Tanzania: a mixed-methods study.

    Directory of Open Access Journals (Sweden)

    John W Stanifer

    Full Text Available Traditional medicines are an important part of healthcare in sub-Saharan Africa, and building successful disease treatment programs that are sensitive to traditional medicine practices will require an understanding of their current use and roles, including from a biomedical perspective. Therefore, we conducted a mixed-method study in Northern Tanzania in order to characterize the extent of and reasons for the use of traditional medicines among the general population so that we can better inform public health efforts in the region.Between December 2013 and June 2014 in Kilimanjaro, Tanzania, we conducted 5 focus group discussions and 27 in-depth interviews of key informants. The data from these sessions were analyzed using an inductive framework method with cultural insider-outsider coding. From these results, we developed a structured survey designed to test different aspects of traditional medicine use and administered it to a random sample of 655 adults from the community. The results were triangulated to explore converging and diverging themes.Most structured survey participants (68% reported knowing someone who frequently used traditional medicines, and the majority (56% reported using them themselves in the previous year. The most common uses were for symptomatic ailments (42%, chronic diseases (15%, reproductive problems (11%, and malaria/febrile illnesses (11%. We identified five major determinants for traditional medicine use in Northern Tanzania: biomedical healthcare delivery, credibility of traditional practices, strong cultural identities, individual health status, and disease understanding.In order to better formulate effective local disease management programs that are sensitive to TM practices, we described the determinants of TM use. Additionally, we found TM use to be high in Northern Tanzania and that its use is not limited to lower-income areas or rural settings. After symptomatic ailments, chronic diseases were reported as

  6. Access and utilisation of healthcare services in rural Tanzania

    DEFF Research Database (Denmark)

    Shayo, Elizabeth H.; Senkoro, Kesheni P.; Momburi, Romanus

    2016-01-01

    was also found in the provider–client relationship satisfaction level between non-public (89.1%) and public facilities (74.7%) (OR = 2.8, CI: 1.5–5.0), indicating a level of lower trust in the later. Revised strategies are needed to ensure availability of medicines in public facilities, which are used......This study compared the access and utilisation of health services in public and non-public health facilities in terms of quality, equity and trust in the Mbarali district, Tanzania. Interviews, focus group discussions, and informal discussions were used to generate data. Of the 1836 respondents...

  7. 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.

    Science.gov (United States)

    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

  8. Rural and Micro-Enterprise Financing in Tanzania: Lessons from ...

    African Journals Online (AJOL)

    Evidence shows that little progress has so far been made in financing rural and micro-enterprise activities despite the inception of financial sector reforms in 1991. This little progress could be attributed to, among other things, the failure by the reforms to include comprehensive and complementing policies on rural and ...

  9. Panic disorder in rural Tanzania: an explorative study | Nordgreen ...

    African Journals Online (AJOL)

    ... patients as especially useful. Conclusion: A manual for brief interventions for PD may be adapted to a rural Tanzanian setting, also taking into consideration the limited financial and human resources in a rural low-income country setting. Keywords: Panic disorder; Culture; Cognitive behaviour therapy; Low-income country ...

  10. Associations of land, cattle and food security with infant feeding practices among a rural population living in Manyara, Tanzania.

    Science.gov (United States)

    Hanselman, Bailey; Ambikapathi, Ramya; Mduma, Estomih; Svensen, Erling; Caulfield, Laura E; Patil, Crystal L

    2018-01-19

    Livelihoods strategies and food security experiences can positively and negatively affect infant and young child feeding (IYCF) practices. This study contributes to this literature by exploring how variation in household economics among rural farmers in Tanzania relates to IYCF patterns over the first 8 months of an infant's life. These data were produced from a longitudinal study in which a cohort of mother-infant dyads was followed from birth to 24 months. In addition to baseline maternal, infant, and household characteristics, mothers were queried twice weekly and monthly about infant feeding practices and diet. Weekly and monthly datasets were merged and analyzed to assess infant feeding patterns through the first 8 months. Standard statistical methods including survival and logistic regression analyses were used. Aside from breastfeeding initiation, all other IYCF practices were suboptimal in this cohort. Land and cattle ownership were associated with the early introduction of non-breastmilk food items. Food insecurity also played a role in patterning and inadequate complementary feeding was commonplace. Health promotion programs are needed to delay the introduction of animal milks and grain-based porridge, and to achieve a minimum acceptable diet after 6 months of age among smallholder farmers in rural Tanzania. Results highlight that livelihoods-based health promotion interventions, built from a flexible and integrated design, may be an important strategy to address community-level variation in infant feeding practices and promote optimal IYCF practices.

  11. Participatory science and innovation for improved sanitation and hygiene: process and outcome evaluation of project SHINE, a school-based intervention in Rural Tanzania

    OpenAIRE

    Hetherington, Erin; Eggers, Matthijs; Wamoyi, Joyce; Hatfield, Jennifer; Manyama, Mange; Kutz, Susan; Bastien, Sheri

    2017-01-01

    Abstract Background Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education) is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene. Methods Based in rural and remote Tanzania, this pilot study engaged...

  12. Teachers? Attitudes towards and Comfort about Teaching School-Based Sexuality Education in Urban and Rural Tanzania

    OpenAIRE

    Mkumbo, Kitila Alexander

    2012-01-01

    Teachers? attitudes towards sexuality education are among the important predictors of their willingness to teach sexuality education programmes in schools. While there is a plethora of studies on teachers? attitudes towards sexuality in developed countries, there is a paucity of such studies in sub-Saharan Africa in general and Tanzania in particular. This study examined teachers? attitudes towards and comfort in teaching sexuality education in rural and urban Tanzania. The results show that ...

  13. Panic disorder in rural Tanzania: an explorative study

    African Journals Online (AJOL)

    research from low-income countries on the relevance of diagnoses ... study examines cultural based interpretations of the PD diagnose ... for PD may be adapted to a rural Tanzanian setting, also taking into consideration the limited financial ...

  14. Quantifying risk factors for human brucellosis in rural northern Tanzania.

    Science.gov (United States)

    John, Kunda; Fitzpatrick, Julie; French, Nigel; Kazwala, Rudovick; Kambarage, Dominic; Mfinanga, Godfrey S; MacMillan, Alastair; Cleaveland, Sarah

    2010-04-01

    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. 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. 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. These can be achieved

  15. Quantifying risk factors for human brucellosis in rural northern Tanzania.

    Directory of Open Access Journals (Sweden)

    Kunda John

    2010-04-01

    Full Text Available 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.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.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. These can be

  16. Rural energy finance in Tanzania: Thinking outside the box

    International Nuclear Information System (INIS)

    Persson, Therese Hindman; Anderson, Ryan

    2006-01-01

    Conventional financing approaches have proven inadequate in the drive to provide rural communities with modern energy. A recent study by ECON found a critical need for initiatives aimed at improving consumer's access to financing. In addition, demonstration projects are needed to prove the financial viability of investments in rural energy. ECON's recommendations are focused on strengthening the demand side of the financial supply chain and, in particular, consumers' access to credit

  17. Gender, cooperative organisation and participatory intervention in rural Tanzania : a case study of different types of cooperatives and Moshi University College’s support to rural women

    OpenAIRE

    Msonganzila, M.

    2013-01-01

    The thesis examines cooperation and participation as modes of institutional action to address women’ social and economic problems and needs in the context of rural Tanzania. It does so against the background of the history of cooperatives in Tanzania and development cooperation. The thesis takes cooperation in a broad sense as the act or process of people working together; cooperative groups and cooperatives thereby become synonyms in this study. In contrast to literature that only recognise...

  18. The role of credit facilities and Investment practices in rural Tanzania

    DEFF Research Database (Denmark)

    Larsen, Marianne Nylandsted; Birch-Thomsen, Torben

    2015-01-01

    Small urban settlements or small towns in rural areas represent the fastest urban growth in most of the African continent. Along with a renewed political interest in African agriculture, the role of urban settlements has gained a prominent position in poverty reduction in rural areas...... and as an alternative to out-migration. Based on data collected between 2010 and 2012 covering more than 60 business operators in two emerging urban centres (EUCs) and their rural hinterlands, the article explores development trajectories in two EUCs in Tanzania, both of which have experienced rapid population growth...... and attracted new investments in business by both migrants and the indigenous population in an effort to exploit new opportunities in the centres. The initial urbanization has not been driven by the state or by new institutional interventions such as microfinance but rather by ‘the market’. This paper argues...

  19. Community management and sustainability of rural water facilities in Tanzania

    NARCIS (Netherlands)

    Mandara, C.G.; Butijn, C.A.A.; Niehof, Anke

    2013-01-01

    This paper addresses the question of whether community management in water service delivery affects the sustainability of rural water facilities (RWFs) at village level, in terms of their technical and managerial aspects, and what role capacity building of users and providers plays in this process.

  20. Malaria treatment in the retail sector: Knowledge and practices of drug sellers in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Makemba Ahmed M

    2008-05-01

    Full Text Available Abstract 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

  1. Community perceptions of rape and child sexual abuse: a qualitative study in rural Tanzania.

    Science.gov (United States)

    Abeid, Muzdalifat; Muganyizi, Projestine; Olsson, Pia; Darj, Elisabeth; Axemo, Pia

    2014-08-18

    Rape of women and children is recognized as a health and human rights issue in Tanzania and internationally. Exploration of the prevailing perceptions in rural areas is needed in order to expand the understanding of sexual violence in the diversity of Tanzania's contexts. The aim of this study therefore was to explore and understand perceptions of rape of women and children at the community level in a rural district in Tanzania with the added objective of exploring those perceptions that may contribute to perpetuating and/or hindering the disclosure of rape incidences. A qualitative design was employed using focus group discussions with male and female community members including religious leaders, professionals, and other community members. The discussions centered on causes of rape, survivors of rape, help-seeking and reporting, and gathered suggestions on measures for improvement. Six focus group discussions (four of single gender and two of mixed gender) were conducted. The focus group discussions were recorded, transcribed verbatim, and analyzed using manifest qualitative content analysis. The participants perceived rape of women and children to be a frequent and hidden phenomenon. A number of factors were singled out as contributing to rape, such as erosion of social norms, globalization, poverty, vulnerability of children, alcohol/drug abuse and poor parental care. Participants perceived the need for educating the community to raise their knowledge of sexual violence and its consequences, and their roles as preventive agents. In this rural context, social norms reinforce sexual violence against women and children, and hinder them from seeking help from support services. Addressing the identified challenges may promote help-seeking behavior and improve care of survivors of sexual violence, while changes in social and cultural norms are needed for the prevention of sexual violence.

  2. Scepticism towards insecticide treated mosquito nets for malaria control in a rural community in northwestern Tanzania

    DEFF Research Database (Denmark)

    Nnko, Soori; Whyte, Susan Reynolds; Geissler, Wenzel

    2012-01-01

    in Mwanza region, North-Western Tanzania. The study explores reasons for scepticism and low uptake of insecticide treated mosquito nets (ITNs) that were promoted through social marketing strategy for malaria control prior to the introduction of long lasting nets (LLN). The paper breaks from traditional...... attendances. In terms of mortality, malaria is known to be responsible for more than one third of deaths among children of age below 5 years and also contributes for up to one fifth of deaths among pregnant women. This paper is based on a study conducted in a rural community along the shores of Lake Victoria...

  3. Alcohol consumption in the rural population of Misungwi subdistrict in Mwanza Region, Tanzania

    NARCIS (Netherlands)

    Rijken, T; Velema, JP; Dijkstra, R

    Objective: This study was undertaken to investigate the frequency and quantity of alcohol consumption in four villages on the southern shores of Lake Victoria, Tanzania. Method: Study participants were 148 men and 162 women selected by cluster sampling from the population (N = 9,243) of four

  4. A telemedicine network to support paediatric care in small hospitals in rural Tanzania.

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    Krüger, Carsten; Niemi, Mauri

    2012-01-01

    We reviewed our experience with the Tanzanian Telemedicine Network in supporting paediatric care at 40 small, rural hospitals in the country. The network began operating in 2008. Store and forward telemedicine was provided via the open source software iPath. The 33 volunteer consultants were based in several countries, although most of them had practical experience in Tanzania. During the first three years of network operation there were 533 referrals. There were 159 paediatric cases (median age five years). Three paediatric specialists provided most consultations (64%), but other specialists provided recommendations when required. The response time was usually less than two days (median 6 h; inter-quartile range 2-24 h). A precise recommendation was not always provided, but since all consultants had an intimate knowledge of the state of health services in Tanzania, their advice was usually well adapted to the local circumstances of the hospitals. Referral to a higher level of care was recommended in 26 cases (16%). A simple web-based telemedicine system combined with email alerts is feasible in remote locations in Tanzania, even where fast Internet connections are not available. Copyright © 2012 by the Royal Society of Medicine Press Ltd

  5. Strategies to reduce exposure of fumonisins from complementary foods in rural Tanzania.

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    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.

  6. Health status and quality of life among older adults in rural Tanzania

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    Mathew A. Mwanyangala

    2010-09-01

    Full Text Available Background: Increasingly, human populations throughout the world are living longer and this trend is developing in sub-Saharan Africa. In developing African countries such as Tanzania, this demographic phenomenon is taking place against a background of poverty and poor health conditions. There has been limited research on how this process of ageing impacts upon the health of older people within such low-income settings. Objective: The objective of this study is to describe the impacts of ageing on the health status, quality of life and well-being of older people in a rural population of Tanzania. Design: A short version of the WHO Survey on Adult Health and Global Ageing questionnaire was used to collect information on the health status, quality of life and well-being of older adults living in Ifakara Health and Demographic Surveillance System, Tanzania, during early 2007. Questionnaires were administered through this framework to 8,206 people aged 50 and over. Results: Among people aged 50 and over, having good quality of life and health status was significantly associated with being male, married and not being among the oldest old. Functional ability assessment was associated with age, with people reporting more difficulty in performing routine activities as age increased, particularly among women. Reports of good quality of life and well-being decreased with increasing age. Women were significantly more likely to report poor quality of life (odds ratio 1.31; p<0.001, 95% CI 1.15–1.50. Conclusions: Older people within this rural Tanzanian setting reported that the ageing process had significant impacts on their health status, quality of life and physical ability. Poor quality of life and well-being, and poor health status in older people were significantly associated with marital status, sex, age and level of education. The process of ageing in this setting is challenging and raises public health concerns.

  7. Desirability for a typhoid fever vaccine among rural residents, Pemba Island, Tanzania.

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    Kaljee, Linda M; Pach, Alfred; Thriemer, Kamala; Ley, Benedikt; Jiddawi, Mohamed; Puri, Mahesh; Ochiai, Leon; Wierzba, Thomas; Clemens, John; Ali, Said M

    2013-06-24

    Surveillance data indicate that Salmonella enterica serotype Typhi (S. Typhi) is a significant cause of morbidity and mortality in Africa. With limited anticipated short-term improvements in sanitation and water infrastructure, targeted vaccination campaigns may be an important prevention tool for typhoid fever. A cross-sectional survey was conducted with 435 randomly selected households in four rural villages on Pemba Island, Tanzania. A dichotomous 'readiness to pay' variable was created to assess vaccine desirability. Data analyses included univariate and bivariate descriptive statistics and binary logistic regression. Bivariate outcomes (ANOVA, t-tests, and chi-square) and odds ratios with 95% confidence intervals are reported. A total of 66% respondents stated that they would pay for a typhoid fever vaccine in the future. Readiness to pay was not significantly associated with household expenditures. Readiness to pay was associated with use of local Primary Health Care Units (PHCUs) compared to use of cottage or district hospitals (OR 1.8 [95% CI, 1.2-2.7]: p=.007) and with knowledge of someone being sick from typhoid fever (OR 2.2 [95% CI, 1.0-4.5]: p=.039). Respondents perceiving prevention measures as more effective (OR 1.0 [95% CI, 1.0-1.2]: p=.009) were also more likely ready to pay. Preferred methods of communication of information about a typhoid fever vaccine included broadcasting via microphone ('miking'), radio, and door-to-door visits. With rapid increase in numbers of licensed and promising vaccines, policy makers and health administrators are faced with decisions regarding allocation of scarce health resources for competing interventions. Community residents need to be informed about diseases which may not be readily recognized, diagnosed, and treated. Perceived vulnerability to the disease may increase likelihood of vaccine desirability. A better local understanding of typhoid fever is needed for general prevention measures, increasing treatment

  8. Using classification tree modelling to investigate drug prescription practices at health facilities in rural Tanzania

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    Kajungu Dan K

    2012-09-01

    Full Text Available Abstract Background Drug prescription practices depend on several factors related to the patient, health worker and health facilities. A better understanding of the factors influencing prescription patterns is essential to develop strategies to mitigate the negative consequences associated with poor practices in both the public and private sectors. Methods A cross-sectional study was conducted in rural Tanzania among patients attending health facilities, and health workers. Patients, health workers and health facilities-related factors with the potential to influence drug prescription patterns were used to build a model of key predictors. Standard data mining methodology of classification tree analysis was used to define the importance of the different factors on prescription patterns. Results This analysis included 1,470 patients and 71 health workers practicing in 30 health facilities. Patients were mostly treated in dispensaries. Twenty two variables were used to construct two classification tree models: one for polypharmacy (prescription of ≥3 drugs on a single clinic visit and one for co-prescription of artemether-lumefantrine (AL with antibiotics. The most important predictor of polypharmacy was the diagnosis of several illnesses. Polypharmacy was also associated with little or no supervision of the health workers, administration of AL and private facilities. Co-prescription of AL with antibiotics was more frequent in children under five years of age and the other important predictors were transmission season, mode of diagnosis and the location of the health facility. Conclusion Standard data mining methodology is an easy-to-implement analytical approach that can be useful for decision-making. Polypharmacy is mainly due to the diagnosis of multiple illnesses.

  9. How long-distance truck drivers and villagers in rural southeastern Tanzania think about heterosexual anal sex: a qualitative study

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    Mtenga, S.; Shamba, D.; Wamoyi, J.; Kakoko, D.; Haafkens, J.; Mongi, A.; Kapiga, S.; Geubbels, E.

    2015-01-01

    To explore ideas of truck drivers and villagers from rural Tanzania about heterosexual anal sex (HAS) and the associated health risks. Qualitative study using 8 in-depth interviews (IDIs) and 2 focus group discussions (FGDs) with truck drivers and 16 IDIs and 4 FGDs with villagers from the Morogoro

  10. Determining and addressing obstacles to the effective use of long-lasting insecticide-impregnated nets in rural Tanzania

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    Benziger Peter W

    2009-12-01

    Full Text Available Abstract Background The objective of this project was to achieve high, sustainable levels of net coverage in a village in rural Tanzania by combining free distribution of long-lasting insecticide-impregnated nets (LLINs with community-tailored education. In Tanzania, malaria is the leading cause of morbidity and mortality. Although malaria bed nets have a well-established role in reducing disease burden, few rural households have access to nets, and effective use depends on personal practices and attitudes. Methods Five practices and attitudes inconsistent with effective LLIN use were identified from household interviews (n = 10. A randomized survey of villagers (n = 132 verified local prevalence of these practices and attitudes. Community leaders held an educational session for two members of every household addressing these practice and attitudes, demonstrating proper LLIN use, and emphasizing behaviour modification. Attendees received one or two LLINs per household. Surveys distributed three weeks (n = 104 and 15 months (n = 104 post-intervention assessed corrected practices and attitudes. Project efficacy was defined by correction of baseline practices and attitudes as well as high rates of reported daily net use, with statistical significance determined by chi-square test. Results Baseline interviews and surveys revealed incorrect practices and attitudes regarding 1 use of nets in dry season, 2 need to retreat LLINs, 3 children napping under nets, 4 need to repair nets, and 5 net procurement as a priority, with 53- 88.6% incorrect responses (11.4-47% correct responses. A three-week follow-up demonstrated 83-95% correct responses. Fifteen-month follow-up showed statistically significant (p Conclusions Results suggest that addressing community-specific practices and attitudes prior to LLIN distribution promotes consistent and correct use, and helps change attitudes towards bed nets as a preventative health measure. Future LLIN distributions

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

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    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

  12. How Can Childbirth Care for the Rural Poor Be Improved? A Contribution from Spatial Modelling in Rural Tanzania.

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    Piera Fogliati

    Full Text Available Maternal and perinatal mortality remain a challenge in resource-limited countries, particularly among the rural poor. To save lives at birth health facility delivery is recommended. However, increasing coverage of institutional deliveries may not translate into mortality reduction if shortage of qualified staff and lack of enabling working conditions affect quality of services. In Tanzania childbirth care is available in all facilities; yet maternal and newborn mortality are high. The study aimed to assess in a high facility density rural context whether a health system organization with fewer delivery sites is feasible in terms of population access.Data on health facilities' location, staffing and delivery caseload were examined in Ludewa and Iringa Districts, Southern Tanzania. Geospatial raster and network analysis were performed to estimate access to obstetric services in walking time. The present geographical accessibility was compared to a theoretical scenario with a 40% reduction of delivery sites.About half of first-line health facilities had insufficient staff to offer full-time obstetric services (45.7% in Iringa and 78.8% in Ludewa District. Yearly delivery caseload at first-line health facilities was low, with less than 100 deliveries in 48/70 and 43/52 facilities in Iringa and Ludewa District respectively. Wide geographical overlaps of facility catchment areas were observed. In Iringa 54% of the population was within 1-hour walking distance from the nearest facility and 87.8% within 2 hours, in Ludewa, the percentages were 39.9% and 82.3%. With a 40% reduction of delivery sites, approximately 80% of population will still be within 2 hours' walking time.Our findings from spatial modelling in a high facility density context indicate that reducing delivery sites by 40% will decrease population access within 2 hours by 7%. Focused efforts on fewer delivery sites might assist strengthening delivery services in resource-limited settings.

  13. Is Sustainable Intensification Pro-Poor? Evidence from Small-Scale Farmers in Rural Tanzania

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    Kathleen Brüssow

    2017-09-01

    Full Text Available The transition of farming systems to higher levels of productivity without overusing natural resources is of rising interest especially in African countries, where population growth has often been larger than past productivity increases. This paper aims to contribute to the debate on whether environmentally friendly agricultural practices are compatible with economic interests. In the context of small-scale farm households in Tanzania, the analysis focuses on Conservation Agriculture (CA at different levels of agricultural output, as CA is a promising toolbox for sustainable intensification. The results are based on a household survey conducted in 2014 with 900 randomly selected small-scale farmers in rural Tanzania, i.e., in semi-arid Dodoma and in semi-humid Morogoro region. We find that mulching is most frequently applied, followed by crop rotation, fallowing, intercropping and tree planting. Logit regressions show that CA adoption is influenced by socio-economic factors, farm characteristics and the regional context. Quantile regressions explain different levels of agricultural output through variables related to the extent of using CA. They indicate that marginalized farmers have the strongest crop income effect from an increased use of mulching. With increasing levels of agricultural output, the use of mulching remains beneficial for farmers, but the effect appears less pronounced.

  14. Economic burden of malaria in rural Tanzania: variations by socioeconomic status and season.

    Science.gov (United States)

    Somi, Masha F; Butler, James R G; Vahid, Farshid; Njau, Joseph D; Kachur, S Patrick; Abdulla, Salim

    2007-10-01

    To determine the economic burden of malaria in a rural Tanzanian setting and identify any differences by socioeconomic status and season. Interviews of 557 households in south eastern Tanzania between May and December 2004, on consumption and malaria-related costs. Malaria-related expenses were significantly higher in the dry, non-malarious season than in the rainy season. Households sought treatment more frequently and from more expensive service providers in the dry season, when they have more money. Malaria expenses did not vary significantly across socioeconomic status quintiles, but poorer households spent a higher proportion of their consumption in both seasons. Poorer households bear a greater economic burden from malaria relative to their consumption than better-off households. Households are particularly vulnerable to malaria in the rainy season, when malaria prevalence is highest but liquidity is lower. Alternative strategies to assist households to cope with seasonal liquidity issues, including insurance, should be investigated.

  15. COOPERATION AND TRUST IN THE CONTEXT OF DECENTRALIZATION REFORMS IN RURAL TANZANIA

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    Zacharia S. Masanyiwa

    2014-01-01

    Full Text Available This paper investigates the impact of decentralization reforms on cooperation andtrust at the village level in Tanzania, using a gender perspective. The paper drawson survey and qualitative data from ten villages intwo rural districts. The findingsshow that the reforms have revitalized 'formal’ cooperative efforts and socialnetworks and groups aimed at improving public services and poverty reduction.Citizen’s participation in decision-making processes and users’ satisfaction withpublic services are significantly related to socialand political trust, in whichgender plays a role as well. There is a two-way interface between trust and decent-ralization reforms. ‘Good’ decentralization outcomes generate trust while ‘bad’outcomes decrease trust.

  16. Road traffic injury on rural roads in Tanzania: measuring the effectiveness of a road safety program.

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    Zimmerman, Karen; Jinadasa, Deepani; Maegga, Bertha; Guerrero, Alejandro

    2015-01-01

    Road traffic injuries (RTIs) are a major public health burden, especially in low- and middle-income countries. There is limited data on RTIs in low-volume, rural African settings. This study attempted to survey all individuals living in households within 200 m of two low-volume rural roads in Tanzania and to collect data on RTIs. Local communities and users of the Bago to Talawanda road (intervention site) and Kikaro to Mihuga road (control site) were targeted and received an intensive program of road safety measures tailored using the crash characteristics of the baseline sample. Demographic data on all household members were collected, and those individuals who suffered an RTI in the previous 3 months had comprehensive information collected about the crash characteristics and the socioeconomic impact. The follow-up data collection occurred nine months after the baseline data were collected. The majority of crashes that caused an RTI involved a motorcycle (71%) and the majority of victims were male (82%) with an average age of 27. Injuries to the legs (55%) were most common and the average length of time away from normal activity was 27 (±33) days. RTI incidence at the intervention site increased during the course of the study (incidence before vs. incidence after) and was unchanged in the community control (incidence before vs. incidence after). The incidence of RTIs in the low-volume rural setting is unacceptably high and most commonly associated with motorcycles. The change in incidence is unreliable due to logistic restraints of the project and more research is needed to quantify the impact of various RTI prevention strategies in this setting. This study provides insight into road traffic injuries on low-volume rural roads, areas where very little research has been captured. Additionally, it provides a replicable study design for those interested in collecting similar data on low-volume rural roads.

  17. Viral hepatitis and rapid diagnostic test based screening for HBsAg in HIV-infected patients in rural Tanzania.

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    Fabian C Franzeck

    Full Text Available BACKGROUND: Co-infection with hepatitis B virus (HBV is highly prevalent in people living with HIV in Sub-Saharan Africa. Screening for HBV surface antigen (HBsAg before initiation of combination antiretroviral therapy (cART is recommended. However, it is not part of diagnostic routines in HIV programs in many resource-limited countries although patients could benefit from optimized antiretroviral therapy covering both infections. Screening could be facilitated by rapid diagnostic tests for HBsAg. Operating experience with these point of care devices in HIV-positive patients in Sub-Saharan Africa is largely lacking. We determined the prevalence of HBV and Hepatitis C virus (HCV infection as well as the diagnostic accuracy of the rapid test device Determine HBsAg in an HIV cohort in rural Tanzania. METHODS: Prospectively collected blood samples from adult, HIV-1 positive and antiretroviral treatment-naïve patients in the Kilombero and Ulanga antiretroviral cohort (KIULARCO in rural Tanzania were analyzed at the point of care with Determine HBsAg, a reference HBsAg EIA and an anti-HCV EIA. RESULTS: Samples of 272 patients were included. Median age was 38 years (interquartile range [IQR] 32-47, 169/272 (63% subjects were females and median CD4+ count was 250 cells/µL (IQR 97-439. HBsAg was detected in 25/272 (9.2%, 95% confidence interval [CI] 6.2-13.0% subjects. Of these, 7/25 (28% were positive for HBeAg. Sensitivity of Determine HBsAg was rated at 96% (95% CI 82.8-99.6% and specificity at 100% (95% CI, 98.9-100%. Antibodies to HCV (anti-HCV were found in 10/272 (3.7%, 95% CI 2.0-6.4% of patients. CONCLUSION: This study reports a high prevalence of HBV in HIV-positive patients in a rural Tanzanian setting. The rapid diagnostic test Determine HBsAg is an accurate assay for screening for HBsAg in HIV-1 infected patients at the point of care and may further help to guide cART in Sub-Saharan Africa.

  18. Cost-effectiveness of canine vaccination to prevent human rabies in rural Tanzania.

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    Fitzpatrick, Meagan C; Hampson, Katie; Cleaveland, Sarah; Mzimbiri, Imam; Lankester, Felix; Lembo, Tiziana; Meyers, Lauren A; Paltiel, A David; Galvani, Alison P

    2014-01-21

    The annual mortality rate of human rabies in rural Africa is 3.6 deaths per 100 000 persons. Rabies can be prevented with prompt postexposure prophylaxis, but this is costly and often inaccessible in rural Africa. Because 99% of human exposures occur through rabid dogs, canine vaccination also prevents transmission of rabies to humans. To evaluate the cost-effectiveness of rabies control through annual canine vaccination campaigns in rural sub-Saharan Africa. We model transmission dynamics in dogs and wildlife and assess empirical uncertainty in the biological variables to make probability-based evaluations of cost-effectiveness. Epidemiologic variables from a contact-tracing study and literature and cost data from ongoing vaccination campaigns. Two districts of rural Tanzania: Ngorongoro and Serengeti. 10 years. Health policymaker. Vaccination coverage ranging from 0% to 95% in increments of 5%. Life-years for health outcomes and 2010 U.S. dollars for economic outcomes. Annual canine vaccination campaigns were very cost-effective in both districts compared with no canine vaccination. In Serengeti, annual campaigns with as much as 70% coverage were cost-saving. Across a wide range of variable assumptions and levels of societal willingness to pay for life-years, the optimal vaccination coverage for Serengeti was 70%. In Ngorongoro, although optimal coverage depended on willingness to pay, vaccination campaigns were always cost-effective and lifesaving and therefore preferred. Canine vaccination was very cost-effective in both districts, but there was greater uncertainty about the optimal coverage in Ngorongoro. Annual canine rabies vaccination campaigns conferred extraordinary value and dramatically reduced the health burden of rabies. National Institutes of Health.

  19. Wild mushroom--an underutilized healthy food resource and income generator: experience from Tanzania rural areas.

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    Tibuhwa, Donatha D

    2013-07-10

    This study documents the use of a wild edible mushroom (WEM) in Tanzania rural areas and assesses its significance as a source of healthy food and income for the disadvantaged rural dwellers. The data was gathered through local market surveys in order to conventionally identify different common WEM taxa using a semi-structured interview and it involved 160 people comprised of WEM hunters, traders and consumers. The collected data covered the information on where, how, when and who was the principal transmitter of the mycological knowledge learned and the general information on their market and values. Results show that mushroom gathering is gender oriented, dominated by women (76.25%) whereas men account for 23.75%. Women possess vast knowledge of mushroom folk taxonomy, biology and ecology and are therefore the principal knowledge transmitters. It was also found that learning about WEM began at an early age and is family tradition based. The knowledge is acquired and imparted by practices and is mostly transmitted vertically through family dissemination. The results also revealed that 75 WEM species belong to 14 families sold in fresh or dry form. The common sold species belonged to the family Cantharellaceae (19) followed by Rusullaceae (16) and Lyophyllaceae (13), respectively. Collectors residing near miombo woodland may harvest 20-30 buckets (capacity 20 liters) and the business may earn a person about $400-900 annually. This finding envisages the purposeful strengthening of WEM exploitation, which would contribute significantly in boosting the rural income/economy and reduce conflicts between community and forest conservers. The activity would also provide alternative employment, improve food security to rural disadvantaged groups especially women and old people hence improve their livelihood.

  20. Cost-effectiveness of the "helping babies breathe" program in a missionary hospital in rural Tanzania.

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    Vossius, Corinna; Lotto, Editha; Lyanga, Sara; Mduma, Estomih; Msemo, Georgina; Perlman, Jeffrey; Ersdal, Hege L

    2014-01-01

    The Helping Babies Breathe" (HBB) program is an evidence-based curriculum in basic neonatal care and resuscitation, utilizing simulation-based training to educate large numbers of birth attendants in low-resource countries. We analyzed its cost-effectiveness at a faith-based Haydom Lutheran Hospital (HLH) in rural Tanzania. Data about early neonatal mortality and fresh stillbirth rates were drawn from a linked observational study during one year before and one year after full implementation of the HBB program. Cost data were provided by the Tanzanian Ministry of Health and Social Welfare (MOHSW), the research department at HLH, and the manufacturer of the training material Lærdal Global Health. Costs per life saved were USD 233, while they were USD 4.21 per life year gained. Costs for maintaining the program were USD 80 per life saved and USD 1.44 per life year gained. Costs per disease adjusted life year (DALY) averted ranged from International Dollars (ID; a virtual valuta corrected for purchasing power world-wide) 12 to 23, according to how DALYs were calculated. The HBB program is a low-cost intervention. Implementation in a very rural faith-based hospital like HLH has been highly cost-effective. To facilitate further global implementation of HBB a cost-effectiveness analysis including government owned institutions, urban hospitals and district facilities is desirable for a more diverse analysis to explore cost-driving factors and predictors of enhanced cost-effectiveness.

  1. Supply and Demand for Improved Sanitation: Results from Randomized Pricing Experiments in Rural Tanzania.

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    Peletz, Rachel; Cock-Esteb, Alicea; Ysenburg, Dorothea; Haji, Salim; Khush, Ranjiv; Dupas, Pascaline

    2017-06-20

    Improving access to sanitation is a global public health priority. Sufficient consumer demand is required for sanitation coverage to expand through private provision. To measure consumer demand for hygienic latrine platform products in rural Tanzania, we conducted a randomized, voucher-based real-money sales trial with 1638 households with unimproved latrines. We also evaluated multiple supply chain options to determine the costs of supplying latrine platform products to rural households. For concrete latrine SanPlats, 60% of households were willing to pay US$0.48 and 10% of households were willing to pay US$4.05, yet the average cost of supplying the SanPlat to households was US$7.51. Similarly, for plastic sanitary platforms, willingness-to-pay (WTP) dropped from almost 60% at a price of US$1.43 to 5% at a price of US$12.29, compared to an average supply cost of US$23.28. WTP was not significantly different between villages that had participated in the National Sanitation Campaign and those that had not. Randomized informational interventions, including hygiene data-sharing and peer-based exposure to latrine platform products, had minimal effects on WTP. In conclusion, current household demand for latrine platform products is too low to achieve national goals for improved sanitation coverage through fully commercial distribution.

  2. Women's perceptions of antenatal, delivery, and postpartum services in rural Tanzania

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    Gladys Reuben Mahiti

    2015-10-01

    Full Text Available 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

  3. Sociodemographic drivers of multiple sexual partnerships among women in three rural districts of Tanzania

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    Exavery A

    2015-04-01

    Full Text Available Amon Exavery,1 Almamy Malick Kanté,1–3 Kassimu Tani,1 Ahmed Hingora,1 James F Phillips2 1Ifakara Health Institute, Dar es Salaam, Tanzania; 2Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA; 3Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland Background: This study examines prevalence and correlates of multiple sexual partnerships (MSP among women aged 15+ years in Rufiji, Kilombero, and Ulanga districts of Tanzania. Materials and methods: Data were collected in a cross-sectional household survey in Rufiji, Kilombero, and Ulanga districts in Tanzania in 2011. From the survey, a total of 2,643 sexually active women ages 15+ years were selected for this analysis. While the chi-square test was used for testing association between MSP and each of the independent variables, logistic regression was used for multivariate analysis. Results: Number of sexual partners reported ranged from 1 to 7, with 7.8% of the women reporting multiple sexual partners (2+ in the past year. MSP was more likely among both ever married women (adjusted odds ratio [AOR] =3.83, 95% confidence interval [CI] 1.40–10.49 and single women (AOR =6.13, 95% CI 2.45–15.34 than currently married women. There was an interaction between marital status and education, whereby MSP was 85% less likely among single women with secondary or higher education compared to married women with no education (AOR =0.15, 95% CI 0.03–0.61. Furthermore, women aged 40+ years were 56% less likely compared to the youngest women (<20 years to report MSP (AOR =0.44, 95% CI 0.24–0.80. The odds of MSP among Muslim women was 1.56 times as high as that for Christians women (AOR =1.56, 95% CI 1.11–2.21. Ndengereko women were 67% less likely to report MSP compared to Pogoro women (AOR =0.33, 95% CI 0.18–0.59. Conclusion: Eight percent of the women aged 15+ in Rufiji, Kilombero, and Ulanga

  4. How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania

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    Cousens Simon

    2011-09-01

    Full Text Available Abstract Background Many women in Sub-Saharan African countries do not receive key recommended interventions during routine antenatal care (ANC including information on pregnancy, related complications, and importance of skilled delivery attendance. We undertook a process evaluation of a successful cluster randomized trial testing the effectiveness of birth plans in increasing utilization of skilled delivery and postnatal care in Ngorongoro district, rural Tanzania, to document the time spent by health care providers on providing the recommended components of ANC. Methods The study was conducted in 16 health units (eight units in each arm of the trial. We observed, timed, and audio-recorded ANC consultations to assess the total time providers spent with each woman and the time spent for the delivery of each component of care. T-test statistics were used to compare the total time and time spent for the various components of ANC in the two arms of the trial. We also identified the topics discussed during the counselling and health education sessions, and examined the quality of the provider-woman interaction. Results The mean total duration for initial ANC consultations was 40.1 minutes (range 33-47 in the intervention arm versus 19.9 (range 12-32 in the control arm p Conclusion Although the implementation of birth plans in the intervention health units improved provider-women dialogue on skilled delivery attendance, most recommended topics critical to improving maternal and newborn survival were rarely covered.

  5. How to make rural jobs more attractive to health workers. Findings from a discrete choice experiment in Tanzania.

    Science.gov (United States)

    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.

  6. Contradictory sexual norms and expectations for young people in rural Northern Tanzania.

    Science.gov (United States)

    Wight, Daniel; Plummer, Mary L; Mshana, Gerry; Wamoyi, Joyce; Shigongo, Zachayo S; Ross, David A

    2006-02-01

    There has been a long-running debate as to whether sexual cultures in sub-Saharan Africa are permissive or characterised by restrictive rules, rituals and self-restraint. This paper, based on participant observation data, outlines the main features of sexual culture in rural northern Tanzania and highlights both permissive and restrictive norms and expectations for young people. It also illustrates how sexual beliefs are socially constructed and subject to social change. Sexual activity is constrained by clear norms of school pupil abstinence, female sexual respectability and taboos around the discussion of sex. However, these norms are incompatible with several widely held expectations: that sexual activity is inevitable unless prevented, sex is a female resource to be exploited, restrictions on sexual activity are relaxed at festivals, and masculine esteem is boosted through sexual experience. Differential commitment to these norms and expectations reflects conflicts between generations and genders. Young people appear to manage the contradictions in these norms by concealing their sexual relationships. This almost certainly contributes to their short duration and the high levels of partner change, since relationships are not reinforced through social recognition and there is little scope to develop intimacy through non-sexual contacts.

  7. Challenges Addressing Unmet Need for Contraception: Voices of Family Planning Service Providers in Rural Tanzania.

    Science.gov (United States)

    Baraka, Jitihada; Rusibamayila, Asinath; Kalolella, Admirabilis; Baynes, Colin

    2015-12-01

    Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers' efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors--such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively--also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.

  8. Enhancing the routine health information system in rural southern Tanzania: successes, challenges and lessons learned.

    Science.gov (United States)

    Maokola, W; Willey, B A; Shirima, K; Chemba, M; Armstrong Schellenberg, J R M; Mshinda, H; Alonso, P; Tanner, M; Schellenberg, D

    2011-06-01

    To describe and evaluate the use of handheld computers for the management of Health Management Information System data. Electronic data capture took place in 11 sentinel health centres in rural southern Tanzania. Information from children attending the outpatient department (OPD) and the Expanded Program on Immunization vaccination clinic was captured by trained local school-leavers, supported by monthly supervision visits. Clinical data included malaria blood slides and haemoglobin colour scale results. Quality of captured data was assessed using double data entry. Malaria blood slide results from health centre laboratories were compared to those from the study's quality control laboratory. The system took 5 months to implement, and few staffings or logistical problems were encountered. Over the following 12 months (April 2006-March 2007), 7056 attendances were recorded in 9880 infants aged 2-11 months, 50% with clinical malaria. Monthly supervision visits highlighted incomplete recording of information between OPD and laboratory records, where on average 40% of laboratory visits were missing the record of their corresponding OPD visit. Quality of microscopy from health facility laboratories was lower overall than that from the quality assurance laboratory. Electronic capture of HMIS data was rapidly and successfully implemented in this resource-poor setting. Electronic capture alone did not resolve issues of data completeness, accuracy and reliability, which are essential for management, monitoring and evaluation; suggestions to monitor and improve data quality are made. © 2011 Blackwell Publishing Ltd.

  9. User preferences and willingness to pay for safe drinking water: Experimental evidence from rural Tanzania.

    Science.gov (United States)

    Burt, Zachary; Njee, Robert M; Mbatia, Yolanda; Msimbe, Veritas; Brown, Joe; Clasen, Thomas F; Malebo, Hamisi M; Ray, Isha

    2017-01-01

    Almost half of all deaths from drinking microbiologically unsafe water occur in Sub-Saharan Africa. Household water treatment and safe storage (HWTS) systems, when consistently used, can provide safer drinking water and improve health. Social marketing to increase adoption and use of HWTS depends both on the prices of and preferences for these systems. This study included 556 households from rural Tanzania across two low-income districts with low-quality water sources. Over 9 months in 2012 and 2013, we experimentally evaluated consumer preferences for six "low-cost" HWTS options, including boiling, through an ordinal ranking protocol. We estimated consumers' willingness to pay (WTP) for these options, using a modified auction. We allowed respondents to pay for the durable HWTS systems with cash, chickens or mobile money; a significant minority chose chickens as payment. Overall, our participants favored boiling, the ceramic pot filter and, where water was turbid, PuR™ (a combined flocculant-disinfectant). The revealed WTP for all products was far below retail prices, indicating that significant scale-up may need significant subsidies. Our work will inform programs and policies aimed at scaling up HWTS to improve the health of resource-constrained communities that must rely on poor-quality, and sometimes turbid, drinking water sources. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Prevalence and Evolution of Renal Impairment in People Living With HIV in Rural Tanzania.

    Science.gov (United States)

    Mapesi, Herry; Kalinjuma, Aneth V; Ngerecha, Alphonce; Franzeck, Fabian; Hatz, Christoph; Tanner, Marcel; Mayr, Michael; Furrer, Hansjakob; Battegay, Manuel; Letang, Emilio; Weisser, Maja; Glass, Tracy R

    2018-04-01

    We assessed the prevalence, incidence, and predictors of renal impairment among people living with HIV (PLWHIV) in rural Tanzania. In a cohort of PLWHIV aged ≥15 years enrolled from January 2013 to June 2016, we assessed the association between renal impairment (estimated glomerural filtration rate impairment at enrollment. Of 921 patients with normal renal function at baseline, 117 (12.7%) developed renal impairment during a median follow-up (interquartile range) of 6.2 (0.4-14.7) months. The incidence of renal impairment was 110 cases per 1000 person-years (95% confidence interval [CI], 92-132). At enrollment, logistic regression identified older age (adjusted odds ratio [aOR], 1.79; 95% CI, 1.52-2.11), hypertension (aOR, 1.84; 95% CI, 1.08-3.15), CD4 count impairment. Cox regression model confirmed older age (adjusted hazard ratio [aHR], 1.85; 95% CI, 1.56-2.20) and CD4 count impairment. Our study found a low prevalence of renal impairment among PLWHIV despite high usage of tenofovir and its association with age, hypertension, low CD4 count, and advanced WHO stage. These important and reassuring safety data stress the significance of noncommunicable disease surveillance in aging HIV populations in sub-Saharan Africa.

  11. Criteria-based audit of caesarean section in a referral hospital in rural Tanzania.

    Science.gov (United States)

    Heemelaar, S; Nelissen, E; Mdoe, P; Kidanto, H; van Roosmalen, J; Stekelenburg, J

    2016-04-01

    WHO uses the Caesarean section (CS) rate to monitor implementation of emergency obstetric care (EmOC). Although CS rates are rising in sub-Saharan Africa, maternal outcome has not improved. We audited indications for CS and related complications among women with severe maternal morbidity and mortality in a referral hospital in rural Tanzania. Cross-sectional study was from November 2009 to November 2011. Women with severe maternal morbidity and mortality were identified and those with CS were included in this audit. Audit criteria were developed based on the literature review and (inter)national guidelines. Tanzanian and Dutch doctors reviewed hospital notes. The main outcome measured was prevalence of substandard quality of care leading to unnecessary CS and delay in performing interventions to prevent CS. A total of 216 maternal near misses and 32 pregnancy-related deaths were identified, of which 82 (33.1%) had a CS. Indication for CS was in accordance with audit criteria for 36 of 82 (44.0%) cases without delay. In 20 of 82 (24.4%) cases, the indication was correct; however, there was significant delay in providing standard obstetric care. In 16 of 82 (19.5%) cases, the indication for CS was not in accordance with audit criteria. During office hours, CS was more often correctly indicated than outside office hours (60.0% vs. 36.0%, P audit. © 2016 John Wiley & Sons Ltd.

  12. Cost-effectiveness of the "helping babies breathe" program in a missionary hospital in rural Tanzania.

    Directory of Open Access Journals (Sweden)

    Corinna Vossius

    Full Text Available The Helping Babies Breathe" (HBB program is an evidence-based curriculum in basic neonatal care and resuscitation, utilizing simulation-based training to educate large numbers of birth attendants in low-resource countries. We analyzed its cost-effectiveness at a faith-based Haydom Lutheran Hospital (HLH in rural Tanzania.Data about early neonatal mortality and fresh stillbirth rates were drawn from a linked observational study during one year before and one year after full implementation of the HBB program. Cost data were provided by the Tanzanian Ministry of Health and Social Welfare (MOHSW, the research department at HLH, and the manufacturer of the training material Lærdal Global Health.Costs per life saved were USD 233, while they were USD 4.21 per life year gained. Costs for maintaining the program were USD 80 per life saved and USD 1.44 per life year gained. Costs per disease adjusted life year (DALY averted ranged from International Dollars (ID; a virtual valuta corrected for purchasing power world-wide 12 to 23, according to how DALYs were calculated.The HBB program is a low-cost intervention. Implementation in a very rural faith-based hospital like HLH has been highly cost-effective. To facilitate further global implementation of HBB a cost-effectiveness analysis including government owned institutions, urban hospitals and district facilities is desirable for a more diverse analysis to explore cost-driving factors and predictors of enhanced cost-effectiveness.

  13. SMS for Life: a pilot project to improve anti-malarial drug supply management in rural Tanzania using standard technology

    Directory of Open Access Journals (Sweden)

    Mwafongo Winfred

    2010-10-01

    Full Text Available Abstract Background Maintaining adequate supplies of anti-malarial medicines at the health facility level in rural sub-Saharan Africa is a major barrier to effective management of the disease. Lack of visibility of anti-malarial stock levels at the health facility level is an important contributor to this problem. Methods A 21-week pilot study, 'SMS for Life', was undertaken during 2009-2010 in three districts of rural Tanzania, involving 129 health facilities. Undertaken through a collaborative partnership of public and private institutions, SMS for Life used mobile telephones, SMS messages and electronic mapping technology to facilitate provision of comprehensive and accurate stock counts from all health facilities to each district management team on a weekly basis. The system covered stocks of the four different dosage packs of artemether-lumefantrine (AL and quinine injectable. Results Stock count data was provided in 95% of cases, on average. A high response rate (≥ 93% was maintained throughout the pilot. The error rate for composition of SMS responses averaged 7.5% throughout the study; almost all errors were corrected and messages re-sent. Data accuracy, based on surveillance visits to health facilities, was 94%. District stock reports were accessed on average once a day. The proportion of health facilities with no stock of one or more anti-malarial medicine (i.e. any of the four dosages of AL or quinine injectable fell from 78% at week 1 to 26% at week 21. In Lindi Rural district, stock-outs were eliminated by week 8 with virtually no stock-outs thereafter. During the study, AL stocks increased by 64% and quinine stock increased 36% across the three districts. Conclusions The SMS for Life pilot provided visibility of anti-malarial stock levels to support more efficient stock management using simple and widely available SMS technology, via a public-private partnership model that worked highly effectively. The SMS for Life system has

  14. SMS for Life: a pilot project to improve anti-malarial drug supply management in rural Tanzania using standard technology

    Science.gov (United States)

    2010-01-01

    Background Maintaining adequate supplies of anti-malarial medicines at the health facility level in rural sub-Saharan Africa is a major barrier to effective management of the disease. Lack of visibility of anti-malarial stock levels at the health facility level is an important contributor to this problem. Methods A 21-week pilot study, 'SMS for Life', was undertaken during 2009-2010 in three districts of rural Tanzania, involving 129 health facilities. Undertaken through a collaborative partnership of public and private institutions, SMS for Life used mobile telephones, SMS messages and electronic mapping technology to facilitate provision of comprehensive and accurate stock counts from all health facilities to each district management team on a weekly basis. The system covered stocks of the four different dosage packs of artemether-lumefantrine (AL) and quinine injectable. Results Stock count data was provided in 95% of cases, on average. A high response rate (≥ 93%) was maintained throughout the pilot. The error rate for composition of SMS responses averaged 7.5% throughout the study; almost all errors were corrected and messages re-sent. Data accuracy, based on surveillance visits to health facilities, was 94%. District stock reports were accessed on average once a day. The proportion of health facilities with no stock of one or more anti-malarial medicine (i.e. any of the four dosages of AL or quinine injectable) fell from 78% at week 1 to 26% at week 21. In Lindi Rural district, stock-outs were eliminated by week 8 with virtually no stock-outs thereafter. During the study, AL stocks increased by 64% and quinine stock increased 36% across the three districts. Conclusions The SMS for Life pilot provided visibility of anti-malarial stock levels to support more efficient stock management using simple and widely available SMS technology, via a public-private partnership model that worked highly effectively. The SMS for Life system has the potential to alleviate

  15. Distinct clinical characteristics and helminth co-infections in adult tuberculosis patients from urban compared to rural Tanzania.

    Science.gov (United States)

    Sikalengo, George; Hella, Jerry; Mhimbira, Francis; Rutaihwa, Liliana K; Bani, Farida; Ndege, Robert; Sasamalo, Mohamed; Kamwela, Lujeko; Said, Khadija; Mhalu, Grace; Mlacha, Yeromin; Hatz, Christoph; Knopp, Stefanie; Gagneux, Sébastien; Reither, Klaus; Utzinger, Jürg; Tanner, Marcel; Letang, Emilio; Weisser, Maja; Fenner, Lukas

    2018-03-24

    Differences in rural and urban settings could account for distinct characteristics in the epidemiology of tuberculosis (TB). We comparatively studied epidemiological features of TB and helminth co-infections in adult patients from rural and urban settings of Tanzania. Adult patients (≥ 18 years) with microbiologically confirmed pulmonary TB were consecutively enrolled into two cohorts in Dar es Salaam, with ~ 4.4 million inhabitants (urban), and Ifakara in the sparsely populated Kilombero District with ~ 400 000 inhabitants (rural). Clinical data were obtained at recruitment. Stool and urine samples were subjected to diagnose helminthiases using Kato-Katz, Baermann, urine filtration, and circulating cathodic antigen tests. Differences between groups were assessed by χ 2 , Fisher's exact, and Wilcoxon rank sum tests. Logistic regression models were used to determine associations. Between August 2015 and February 2017, 668 patients were enrolled, 460 (68.9%) at the urban and 208 (31.1%) at the rural site. Median patient age was 35 years (interquartile range [IQR]: 27-41.5 years), and 454 (68%) were males. Patients from the rural setting were older (median age 37 years vs. 34 years, P = 0.003), had a lower median body mass index (17.5 kg/m 2 vs. 18.5 kg/m 2 , P urban Tanzania. There was no significant difference in frequencies of HIV infection, diabetes mellitus, and haemoglobin concentration levels between the two settings. The overall prevalence of helminth co-infections was 22.9% (95% confidence interval [CI]: 20.4-27.0%). The significantly higher prevalence of helminth infections at the urban site (25.7% vs. 17.3%, P = 0.018) was predominantly driven by Strongyloides stercoralis (17.0% vs. 4.8%, P rural setting (adjusted odds ratio [aOR]: 3.97, 95% CI: 1.16-13.67) and increasing age (aOR: 1.06, 95% CI: 1.02-1.10). Clinical characteristics and helminth co-infections pattern differ in TB patients in urban and rural Tanzania. The

  16. Access to and Usage of Information among Rural Communities: a Case Study of Kilosa District Morogoro Region in Tanzania

    Directory of Open Access Journals (Sweden)

    Wulystan Pius Mtega

    2012-05-01

    Full Text Available The study investigated how rural communities in Kilosa District of Morogoro region in Tanzania accessed and used information. Specifically the study identified the information needs of rural people; determined the factors influencing the choice of information sources; and the appropriateness of the information sources basing on usefulness and preference. Three divisions were involved in the study area, choice of the study area was based on the availability of multiple information sources/channels information seekers could consulted. Simple random sampling technique was employed in selecting villages to be investigated and respondents to be interviewed. Findings showed that almost all people needed information of all types. Most of the information needed related to day to day problems. Information was accessed mainly through radio, television sets, newspapers and magazines, and also through cell phones and face to face communication. Choice of information sources was influenced by the respondents’ level of education, income, sex, age, occupation and distance from the information seeker’s residence to the information sources. Findings showed further that people accessed and used information for solving day to day problems and for leisure purposes. The study recommends that it is important to have frequent rural information needs assessments before providing information services to rural areas. Information providers should repackage information in appropriate forms suitable for rural communities. Moreover, radio and television stations should have enough rural related programmes which should be broadcasted during appropriate time.

  17. Birth preparedness and complication readiness – a qualitative study among community members in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Furaha August

    2015-06-01

    Full Text Available Background: Birth preparedness and complication readiness (BP/CR strategies are aimed at reducing delays in seeking, reaching, and receiving care. Counselling on birth preparedness is provided during antenatal care visits. However, it is not clear why birth preparedness messages do not translate to utilisation of facility delivery. This study explores the perceptions, experiences, and challenges the community faces on BP/CR. Design: A qualitative study design using Focused Group Discussions was conducted. Twelve focus group discussions were held with four separate groups: young men and women and older men and women in a rural community in Tanzania. Qualitative content analysis was used to analyse the data. Results: The community members expressed a perceived need to prepare for childbirth. They were aware of the importance to attend the antenatal clinics, relied on family support for practical and financial preparations such as saving money for costs related to delivery, moving closer to the nearest hospital, and also to use traditional herbs, in favour of a positive outcome. Community recognised that pregnancy and childbirth complications are preferably treated at hospital. Facility delivery was preferred; however, certain factors including stigma on unmarried women and transportation were identified as hindering birth preparedness and hence utilisation of skilled care. Challenges were related to the consequences of poverty, though the maternal health care should be free, they perceived difficulties due to informal user fees. Conclusions: This study revealed community perceptions that were in favour of using skilled care in BP/CR. However, issues related to inability to prepare in advance hinder the realisation of the intention to use skilled care. It is important to innovate how the community reinforces BP/CR, such as using insurance schemes, using community health funds, and providing information on other birth preparedness messages via

  18. Birth preparedness and complication readiness – a qualitative study among community members in rural Tanzania

    Science.gov (United States)

    August, Furaha; Pembe, Andrea B.; Kayombo, Edmund; Mbekenga, Columba; Axemo, Pia; Darj, Elisabeth

    2015-01-01

    Background Birth preparedness and complication readiness (BP/CR) strategies are aimed at reducing delays in seeking, reaching, and receiving care. Counselling on birth preparedness is provided during antenatal care visits. However, it is not clear why birth preparedness messages do not translate to utilisation of facility delivery. This study explores the perceptions, experiences, and challenges the community faces on BP/CR. Design A qualitative study design using Focused Group Discussions was conducted. Twelve focus group discussions were held with four separate groups: young men and women and older men and women in a rural community in Tanzania. Qualitative content analysis was used to analyse the data. Results The community members expressed a perceived need to prepare for childbirth. They were aware of the importance to attend the antenatal clinics, relied on family support for practical and financial preparations such as saving money for costs related to delivery, moving closer to the nearest hospital, and also to use traditional herbs, in favour of a positive outcome. Community recognised that pregnancy and childbirth complications are preferably treated at hospital. Facility delivery was preferred; however, certain factors including stigma on unmarried women and transportation were identified as hindering birth preparedness and hence utilisation of skilled care. Challenges were related to the consequences of poverty, though the maternal health care should be free, they perceived difficulties due to informal user fees. Conclusions This study revealed community perceptions that were in favour of using skilled care in BP/CR. However, issues related to inability to prepare in advance hinder the realisation of the intention to use skilled care. It is important to innovate how the community reinforces BP/CR, such as using insurance schemes, using community health funds, and providing information on other birth preparedness messages via community health workers

  19. Birth preparedness and complication readiness - a qualitative study among community members in rural Tanzania.

    Science.gov (United States)

    August, Furaha; Pembe, Andrea B; Kayombo, Edmund; Mbekenga, Columba; Axemo, Pia; Darj, Elisabeth

    2015-01-01

    Birth preparedness and complication readiness (BP/CR) strategies are aimed at reducing delays in seeking, reaching, and receiving care. Counselling on birth preparedness is provided during antenatal care visits. However, it is not clear why birth preparedness messages do not translate to utilisation of facility delivery. This study explores the perceptions, experiences, and challenges the community faces on BP/CR. A qualitative study design using Focused Group Discussions was conducted. Twelve focus group discussions were held with four separate groups: young men and women and older men and women in a rural community in Tanzania. Qualitative content analysis was used to analyse the data. The community members expressed a perceived need to prepare for childbirth. They were aware of the importance to attend the antenatal clinics, relied on family support for practical and financial preparations such as saving money for costs related to delivery, moving closer to the nearest hospital, and also to use traditional herbs, in favour of a positive outcome. Community recognised that pregnancy and childbirth complications are preferably treated at hospital. Facility delivery was preferred; however, certain factors including stigma on unmarried women and transportation were identified as hindering birth preparedness and hence utilisation of skilled care. Challenges were related to the consequences of poverty, though the maternal health care should be free, they perceived difficulties due to informal user fees. This study revealed community perceptions that were in favour of using skilled care in BP/CR. However, issues related to inability to prepare in advance hinder the realisation of the intention to use skilled care. It is important to innovate how the community reinforces BP/CR, such as using insurance schemes, using community health funds, and providing information on other birth preparedness messages via community health workers.

  20. Community violence in Dar es Salaam, Tanzania: A mixed methods ...

    African Journals Online (AJOL)

    Most homicide deaths in Dar es Salaam, Tanzania (DSM) are a result of violence arising from within the community. This type of violence is commonly called, by perpetrators and victims, “mob justice”. Unilateral non-state collective violence can take four forms: lynching, vigilantism, rioting, and terrorism. The purpose of this ...

  1. Attitudes towards African traditional medicine and Christian spiritual healing regarding treatment of epilepsy in a rural community of northern Tanzania.

    Science.gov (United States)

    Winkler, Andrea Sylvia; Mayer, Michael; Ombay, Michael; Mathias, Bartholomayo; Schmutzhard, Erich; Jilek-Aall, Louise

    2009-12-30

    Most people with epilepsy (PWE) live in developing countries with limited access to health care facilities. In sub-Saharan Africa with approximately 12 million PWE, 90% do not receive adequate medical treatment. In this context, traditional medicine, being easily accessible, plays an important role. However, in sub- Saharan Africa, studies on the attitude of people (both affected and not affected by epilepsy) towards traditional medicine for treatment of epilepsy are scarce. In this study, 167 people (59 PWE, 62 relatives, 46 villagers) were interviewed at the hospital and in the community with a semi-structured validated questionnaire regarding the prevailing attitude towards traditional medicine for treatment of epilepsy in a rural area of northern Tanzania. Various traditional healing methods (THM) could be ascertained, i.e. traditional herbal medicine, spiritual healing, scarifications and spitting. 44.3% (n=74/167) of the interviewed people were convinced that epilepsy could be treated successfully with THM. Interestingly, 34.1% (n=57/167) thought that Christian prayers could cure the cause and/or treat symptoms of epilepsy. Significantly more PWE and their relatives were in favour of THM compared to villagers not knowing about epilepsy or not being immediately affected by epilepsy (χ(2)-test, p=0.004). Further factors influencing people's attitudes towards THM were gender, tribe, religion and urbanity of people's dwellings. Our study demonstrates that not only THM but also prayers in the Christian sense seem to play an important role in people's beliefs regarding successful treatment of epilepsy. Factors influencing this belief system have been identified and are discussed.

  2. Scaling up stigma? The effects of antiretroviral roll-out on stigma and HIV testing. Early evidence from rural Tanzania

    Science.gov (United States)

    Roura, M; Urassa, M; Busza, J; Mbata, D; Wringe, A; Zaba, B

    2009-01-01

    Objective: To investigate the interplay between antiretroviral therapy (ART) scale-up, different types of stigma and Voluntary Counselling and Testing (VCT) uptake 2 years after the introduction of free ART in a rural ward of Tanzania. Methods: Qualitative study using in-depth interviews and group activities with a purposive sample of 91 community leaders, 77 ART clients and 16 health providers. Data were analysed for recurrent themes using NVIVO-7 software. Results: The complex interplay between ART, stigma and VCT in this setting is characterised by two powerful but opposing dynamics. The availability of effective treatment has transformed HIV into a manageable condition which is contributing to a reduction in self-stigma and is stimulating VCT uptake. However, this is counterbalanced by the persistence of blaming attitudes and emergence of new sources of stigma associated with ART provision. The general perception among community leaders was that as ART users regained health, they increasingly engaged in sexual relations and “spread the disease.” Fears were exacerbated because they were perceived to be very mobile and difficult to identify physically. Some leaders suggested giving ART recipients drugs “for impotence,” marking them “with a sign” and putting them “in isolation camps.” In this context, traditional beliefs about disease aetiology provided a less stigmatised explanation for HIV symptoms contributing to a situation of collective denial. Conclusion: Where anticipated stigma prevails, provision of antiretroviral drugs alone is unlikely to have sufficient impact on VCT uptake. Achieving widespread public health benefits of ART roll-out requires community-level interventions to ensure local acceptability of antiretroviral drugs. PMID:19036776

  3. Factors influencing drug uptake during mass drug administration for control of lymphatic filariasis in rural and urban Tanzania.

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    William J Kisoka

    Full Text Available BACKGROUND: In most countries of Sub-Saharan Africa, control of lymphatic filariasis (LF is based on annual mass drug administration (MDA with a combination of ivermectin and albendazole. Treatment coverages are however often suboptimal for programmes to reach the goal of transmission interruption within reasonable time. The present study aimed to identify predictors and barriers to individual drug uptake during MDA implementation by the National LF Elimination Programme in Tanzania. METHODS: A questionnaire based cross sectional household survey was carried out in two rural and two urban districts in Lindi and Morogoro regions shortly after the 2011 MDA. 3279 adults (≥15 years were interviewed about personal characteristics, socio-economic status, MDA drug uptake among themselves and their children, reasons for taking/not taking drugs, and participation in previous MDA activities for LF control. FINDINGS: The overall drug uptake rate was 55.1% (range of 44.5-75.6% between districts. There was no overall major difference between children (54.8% and adults (55.2% or between females (54.9% and males (55.8%, but the role of these and other predictors varied to some extent between study sites. Major overall predictors of drug uptake among the interviewed adults were increasing age and history of previous drug uptake. Being absent from home during drug distribution was the main reason for not taking the drugs (50.2% followed by clinical contraindications to treatment (10.8%, missing household visits of drug distributors (10.6%, and households not being informed about the distribution (9.0%. CONCLUSION: Drug uptake relied more on easily modifiable provider-related factors than on individual perceptions and practices in the target population. Limited investments in appropriate timing, dissemination of accurate timing information to recipients and motivation of drug distributors to visit all households (repeatedly when residents are absent are likely

  4. Compliance with focused antenatal care services: do health workers in rural Burkina Faso, Uganda and Tanzania perform all ANC procedures?

    Science.gov (United States)

    Conrad, Paul; Schmid, Gerhrd; Tientrebeogo, Justin; Moses, Arinaitwe; Kirenga, Silvia; Neuhann, Florian; Müller, Olaf; Sarker, Malabika

    2012-03-01

    To assess health workers' compliance with the procedures set in the focused antenatal care (ANC) guidelines in rural Uganda, Tanzania and Burkina Faso; to compare the compliance within and among the three study sites; and to appraise the logistic and supply of the respective health facilities (HF). The cross-sectional study was conducted in the rural HF in three African countries. This descriptive observational study took place in HF in Nouna, Burkina Faso (5), Iganga, Uganda (6) and Rufiji, Tanzania (7). In total, 788 ANC sessions and service provisions were observed, the duration of each ANC service provision was calculated, and the infrastructures of the respective HF were assessed. Health workers in all HF performed most of the procedures but also omitted certain practices stipulated in the focused ANC guidelines. There was a substantial variation in provision of ANC services among HF within and among the country sites. The findings also revealed that the duration of first visits was ANC guidelines were often out of stock in most facilities. Health workers in all three country sites failed to perform all procedures stipulated in the focused ANC guideline; this could not be always explained by the lack of supplies. It is crucial to point out the necessity of the core procedures of ANC repeatedly. © 2011 Blackwell Publishing Ltd.

  5. Using art and story to explore how primary school students in rural Tanzania understand planetary health: a qualitative analysis

    Directory of Open Access Journals (Sweden)

    Elizabeth VanWormer, PhD

    2018-05-01

    Full Text Available Background: The global planetary health community increasingly recognises the need to prepare students to investigate and address connections between environmental change and human health. As we strive to support education on planetary health themes for students of all ages, understanding students' concepts of linkages between the health of people and animals, and their shared environments might advance educational approaches. Children living in villages bordering Ruaha National Park in Iringa Region, Tanzania, have direct experience of these connections as they share a water-stressed but biodiverse environment with domestic animals and wildlife. Livelihoods in these villages depend predominantly on crop and livestock production, including extensive pastoralist livestock keeping. Through qualitative research, we aim to explore and describe Tanzanian primary school students' understanding of connections between human health and the environment. Methods: Working with 26 village primary schools in Iringa Rural District, Tanzania, we adapted an art and story outreach activity to explore student perceptions of planetary health concepts. Following a standardised training session, a lead teacher at each primary school helped students aged 12–15 years form small teams to independently develop and illustrate a story centred on themes of how human health depends on water sources, wildlife, livestock, climate, and forest or grassland resources. Students were encouraged to discuss these themes with their teachers, peers, and families while developing their stories to gain broader as well as historical perspectives. The students generated stories that incorporated solutions to challenges within these themes. Written materials and illustrations were collected from each school along with data on sex and tribe of the group members. We translated all stories from Swahili to English for analysis. The primary outcomes of interest in analysing the students

  6. Affordable house designs to improve health in rural Africa: a field study from northeastern Tanzania.

    Science.gov (United States)

    von Seidlein, Lorenz; Ikonomidis, Konstantin; Mshamu, Salum; Nkya, Theresia E; Mukaka, Mavuto; Pell, Christopher; Lindsay, Steven W; Deen, Jacqueline L; Kisinza, William N; Knudsen, Jakob B

    2017-08-01

    The population of sub-Saharan Africa is currently estimated to be 1245 million and is expected to quadruple by the end of the century, necessitating the building of millions of homes. Malaria remains a substantial problem in this region and efforts to minimise transmission should be considered in future house planning. We studied how building elements, which have been successfully employed in southeast Asia to prevent mosquitos from entering and cooling the house, could be integrated in a more sustainable house design in rural northeastern Tanzania, Africa, to decrease mosquito density and regulate indoor climate. In this field study, six prototype houses of southeast Asian design were built in in the village of Magoda in Muheza District, Tanga Region, Tanzania, and compared with modified and unmodified, traditional, sub-Saharan African houses. Prototype houses were built with walls made of lightweight permeable materials (bamboo, shade net, or timber) with bedrooms elevated from the ground and with screened windows. Modified and unmodified traditional African houses, wattle-daub or mud-block constructions, built on the ground with poor ventilation served as controls. In the modified houses, major structural problems such as leaking roofs were repaired, windows screened, open eaves blocked with bricks and mortar, cement floors repaired or constructed, and rain gutters and a tank for water storage added. Prototype houses were randomly allocated to village households through a free, fair, and transparent lottery. The lottery tickets were deposited in a bucket made of transparent plastic. Each participant could draw one ticket. Hourly measurements of indoor temperature and humidity were recorded in all study houses with data loggers and mosquitoes were collected indoors and outdoors using Furvela tent traps and were identified with standard taxonomic keys. Mosquitoes of the Anopheles gambiae complex were identified to species using PCR. Attitudes towards the new house

  7. Microbiological effectiveness of household water treatment technologies under field use conditions in rural Tanzania.

    Science.gov (United States)

    Mohamed, Hussein; Clasen, Thomas; Njee, Robert Mussa; Malebo, Hamisi M; Mbuligwe, Stephen; Brown, Joe

    2016-01-01

    To assess the microbiological effectiveness of several household water treatment and safe storage (HWTS) options in situ in Tanzania, before consideration for national scale-up of HWTS. Participating households received supplies and instructions for practicing six HWTS methods on a rotating 5-week basis. We analysed 1202 paired samples (source and treated) of drinking water from 390 households, across all technologies. Samples were analysed for thermotolerant (TTC) coliforms, an indicator of faecal contamination, to measure effectiveness of treatment in situ. All HWTS methods improved microbial water quality, with reductions in TTC of 99.3% for boiling, 99.4% for Waterguard ™ brand sodium hypochlorite solution, 99.5% for a ceramic pot filter, 99.5% for Aquatab ® sodium dichloroisocyanurate (NaDCC) tablets, 99.6% for P&G Purifier of Water ™ flocculent/disinfectant sachets, and 99.7% for a ceramic siphon filter. Microbiological performance was relatively high compared with other field studies and differences in microbial reductions between technologies were not statistically significant. Given that microbiological performance across technologies was comparable, decisions regarding scale-up should be based on other factors, including uptake in the target population and correct, consistent, and sustained use over time. © 2015 John Wiley & Sons Ltd.

  8. Prevalence and risk factors for HIV-1 infection in rural Kilimanjaro region of Tanzania: Implications for prevention and treatment

    Directory of Open Access Journals (Sweden)

    Leyna Germana H

    2007-04-01

    Full Text Available Abstract Background Variability in stages of the HIV-1 epidemic and hence HIV-1 prevalence exists in different areas in sub-Saharan Africa. The purpose of this study was to investigate the magnitude of HIV-1 infection and identify HIV-1 risk factors that may help to develop preventive strategies in rural Kilimanjaro, Tanzania. Methods A cross-sectional study was conducted between March and May of 2005 involving all individuals aged between 15–44 years having an address in Oria Village. All eligible individuals were registered and invited to participate. Participants were interviewed regarding their demographic characteristics, sexual behaviors, and medical history. Following a pre-test counseling, participants were offered an HIV test. Results Of the 2 093 eligible individuals, 1 528 (73.0% participated. The overall age and sex adjusted HIV-1 prevalence was 5.6%. Women had 2.5 times higher prevalence (8.0% vs. 3.2% as compared to men. The age group 25–44 years, marriage, separation and low education were associated with higher risk of HIV-1 infection for both sexes. HIV-1 infection was significantly associated with >2 sexual partners in the past 12 months (women: Adjusted odds ratio [AOR], 2.5 (95%CI: 1.3–4.7, and past 5 years, [(men: AOR, 2.2 (95%CI:1.2–5.6; women: AOR, 2.5 (95%CI: 1.4–4.0], unprotected casual sex (men: AOR,1.8 95%CI: 1.2–5.8, bottled alcohol (Men: AOR, 5.9 (95%CI:1.7–20.1 and local brew (men: AOR, 3.7 (95%CI: 1.5–9.2. Other factors included treatment for genital ulcers and genital discharge in the past 1 month. Health-related complaints were more common among HIV-1 seropositive as compared to seronegative participants and predicted the presence of HIV-1 infection. Conclusion HIV-1 infection was highly prevalent in this population. As compared to our previous findings, a shift of the epidemic from a younger to an older age group and from educated to uneducated individuals was observed. Women and married or

  9. HIV-1, HSV-2 and syphilis among pregnant women in a rural area of Tanzania: Prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Evjen-Olsen Bjørg

    2008-06-01

    Full Text Available Abstract Background Evidence suggests that a substantial proportion of new HIV infections in African countries are associated with herpes simplex virus type 2 (HSV-2. Thus, the magnitude of HSV-2 infection in an area may suggest the expected course of the HIV epidemic. We determined prevalence of genital herpes, syphilis and associated factors among pregnant women from a remote rural Tanzanian community that has a low but increasing HIV prevalence. Methods We analysed 1296 sera and responses to a standard structured questionnaire collected from pregnant women aged between 15–49 years, attending six different antenatal clinics within rural Manyara and Singida regions in Tanzania. Linked anonymous testing (with informed consent of the serum for specific antibodies against HSV-2 was done using a non-commercial peptide- 55 ELISA. Antibodies against syphilis were screened by using rapid plasma reagin (RPR and reactive samples confirmed by Treponema pallidum haemagglutination assay (TPHA. Results Previous analysis of the collected sera had shown the prevalence of HIV antibodies to be 2%. In the present study the prevalence of genital herpes and syphilis was 20.7% (95% CI: 18.53–23.00 and 1.6% (95% CI: 1.03–2.51, respectively. The presence of HSV-2 antibodies was associated with polygamy (OR 2.2, 95% CI: 1.62 – 3.01 and the use of contraceptives other than condoms (OR 1.7, 95% CI: 1.21 – 2.41. Syphilis was associated with reporting more than one lifetime sexual partner (OR 5.4, 95% CI: 1.88 – 15.76 and previous spontaneous abortion (OR 4.3, 95% CI: 1.52–12.02. Conclusion The low prevalence of HIV infection offers a unique opportunity for strengthening HIV prevention in a cost-effective manner. The identification and control of other prevalent curable STIs other than syphilis and specific intervention of HSV-2 in specific populations like pregnant women would be one among approaches towards preventing incident HIV infections.

  10. Caesarean section audit to improve quality of care in a rural referral hospital in Tanzania.

    Science.gov (United States)

    Dekker, Luuk; Houtzager, Tessa; Kilume, Omary; Horogo, John; van Roosmalen, Jos; Nyamtema, Angelo Sadock

    2018-05-15

    Caesarean section (CS) is often a life-saving procedure, but can also lead to serious complications, even more so in low-resource settings. Therefore unnecessary CS should be avoided and optimal circumstances for vaginal delivery should be created. In this study, we aim to audit indications for Caesarean sections and improve decision-making and obstetric management. Audit of all cases of CS performed from January to August 2013 was performed in a rural referral hospital in Tanzania. The study period was divided in three audit blocks; retrospective (before auditing), prospective 1 and prospective 2. A local audit panel (LP) and an external auditor (EA) judged if obstetric management was adequate and indications were appropriate or if CS could have been prevented and yet retain good pregnancy outcome. Furthermore, changes in modes of deliveries, overall pregnancy outcome and decision-to-delivery interval were monitored. During the study period there were 1868 deliveries. Of these, 403 (21.6%) were Caesarean sections. The proportions of unjustified CS prior to introduction of audit were as high as 34 and 75%, according to the respective judgments of LP and EA. Following introduction of audit, the proportions of unjustified CS decreased to 23% (p = 0.29) and 52% (p = 0.01) according to LP and EA respectively. However, CS rate did not change (20.2 to 21.7%), assisted vacuum delivery rate did not increase (3.9 to 1.8%) and median decision-to-delivery interval was 83 min (range 10 - 390 min). Although this is a single center study, these findings suggest that unnecessary Caesarean sections exist at an alarming rate even in referral hospitals and suggest that a vast number can be averted by introducing a focused CS audit system. Our findings indicate that CS audit is a useful tool and, if well implemented, can enhance rational use of resources, improve decision-making and harmonise practice among care providers.

  11. Decision making under the tree: gender perspectives on decentralization reforms in service delivery in rural Tanzania

    NARCIS (Netherlands)

    Masanyiwa, Z.S.

    2014-01-01

    In recent decades, decentralization has been upheld by governments, donors and policy makers in many developing countries as a means of improving people’s participation and public services delivery. In 1996, the government of Tanzania embarked on major local government reforms reflecting the

  12. Gender perspectives on decentralisation and service users’ participation in rural Tanzania

    NARCIS (Netherlands)

    Masanyiwa, Z.S.; Niehof, A.; Termeer, C.J.A.M.

    2014-01-01

    Increasing participation in decision-making processes by service users is one of the objectives of decentralisation reforms in Tanzania. The argument is that decentralisation enhances participation by all sections of the community, and by women in particular, and results in decisions that better

  13. Clean home-delivery in rural Southern Tanzania: barriers, influencers, and facilitators.

    Science.gov (United States)

    Shamba, Donat D; Schellenberg, Joanna; Penfold, Suzanne C; Mashasi, Irene; Mrisho, Mwifadhi; Manzi, Fatuma; Marchant, Tanya; Tanner, Marcel; Mshinda, Hassan; Schellenberg, David; Hill, Zelee

    2013-03-01

    The study explored the childbirth-related hygiene and newborn care practices in home-deliveries in Southern Tanzania and barriers to and facilitators of behaviour change. Eleven home-birth narratives and six focus group discussions were conducted with recently-delivering women; two focus group discussions were conducted with birth attendants. The use of clean cloth for delivery was reported as common in the birth narratives; however, respondents did not link its use to newborn's health. Handwashing and wearing of gloves by birth attendants varied and were not discussed in terms of being important for newborn's health, with few women giving reasons for this behaviour. The lack of handwashing and wearing of gloves was most commonly linked to the lack of water, gloves, and awareness. A common practice was the insertion of any family member's hands into the vagina of delivering woman to check labour progress before calling the birth attendant. The use of a new razor blade to cut the cord was near-universal; however, the cord was usually tied with a used thread due to the lack of knowledge and the low availability of clean thread. Applying something to the cord was near-universal and was considered essential for newborn's health. Three hygiene practices were identified as needing improvement: family members inserting a hand into the vagina of delivering woman before calling the birth attendant, the use of unclean thread, and putting substances on the cord. Little is known about families conducting internal checks of women in labour, and more research is needed before this behaviour is targeted in interventions. The use of clean thread as cord-tie appears acceptable and can be addressed, using the same channels and methods that were used for successfully encouraging the use of new razor blade.

  14. Managing the double burden: Effects of pregnancy on labor-intensive time use in rural China, Mexico and Tanzania

    Science.gov (United States)

    Peterman, Amber; Ng, Shu Wen; Palermo, Tia; Lee, I-Heng Emma

    2014-01-01

    Labor-intensive work is often a way of life for women in rural areas of developing countries. However, physical exertion may result in poor health outcomes for mother and infant if continued through pregnancy. Using longitudinal data from China, Mexico and Tanzania, we examine the relationship between pregnancy and four time use outcomes, measured as hours spent in the last week on: 1) housework, 2) care giving, 3) agricultural work, and 4) self-employed or non-agricultural work outside the home. An individual fixed effects approach is adopted to overcome potential time invariant woman-level endogeneity of pregnancy status. With a few exceptions, we do not find significantly different time use patterns between pregnant and non-pregnant women. The assumption that women decrease labor intensive work in developing countries during pregnancy needs revisiting, and may have implications for both women’s livelihood programming and assistance during childbearing periods. PMID:24323660

  15. Managing the double burden: pregnancy and labor-intensive time use in rural China, Mexico, and Tanzania.

    Science.gov (United States)

    Peterman, Amber; Ng, Shu Wen; Palermo, Tia; Lee, I-Heng Emma

    2013-12-01

    Labor-intensive work is often a way of life for women living in rural areas of developing countries. The physical exertion involved in such work may result in poor health outcomes for mothers and infants when continued through pregnancy. Using longitudinal data from China, Mexico, and Tanzania, we examine the relationship between pregnancy and four time-use outcomes, measured as hours spent in the past week on: (1) housework, (2) caregiving, (3) agricultural work, and (4) self-employment or nonagricultural work outside the home. An individual fixed-effects approach is adopted to overcome the potential time-invariant woman-level endogeneity of pregnancy status. With few exceptions, we do not find significantly different time-use patterns between pregnant and nonpregnant women. The assumption that women decrease labor-intensive work in developing countries during pregnancy needs revisiting and may have implications for both women's livelihood programming and assistance during childbearing periods. © 2013 The Population Council, Inc.

  16. Scepticism towards insecticide treated mosquito nets for malaria control in rural community in north-western Tanzania.

    Science.gov (United States)

    Nnko, Soori E; Whyte, Susan R; Geissler, Wenzel P; Aagaard-Hansen, Jens

    2012-04-01

    Despite existence of effective tools for malaria control, malaria continues to be one of the leading killer diseases especially among under-five year children and pregnant women in poor rural populations of Sub Saharan Africa. In Tanzania Mainland the disease contributes to 39.4% of the total OPD attendances. In terms of mortality, malaria is known to be responsible for more than one third of deaths among children of age below 5 years and also contributes for up to one fifth of deaths among pregnant women. This paper is based on a study conducted in a rural community along the shores of Lake Victoria in Mwanza region, North-Western Tanzania. The study explores reasons for scepticism and low uptake of insecticide treated mosquito nets (ITNs) that were promoted through social marketing strategy for malaria control prior to the introduction of long lasting nets (LLN). The paper breaks from traditional approach that tend to study low uptake of health interventions in terms of structural practical constraints--cost, accessibility, everyday priorities--or in terms of cognition--insufficient knowledge of benefits e.g. ignorance of public health messages. This paper has shown that, the majority of people who could afford the prices of ITNs and who knew where to obtain the insecticides did not necessarily buy them. This suggests that, although people tend to report cost-related factors as a barrier against the use of ITNs, there are other critical concerns at work. Without underestimating the practical factors, our study have recommended to consider critical examinations of those other concerns that hinder optimal utilization of ITN for malaria control, and the basis for those concerns.

  17. Simulation of a hot air engine for a generation of electricity using biogas for Tanzania rural application

    International Nuclear Information System (INIS)

    Mkiramweni, L.L.N.; Msaki, P.; Mshoro, I.B.

    2007-01-01

    At the moment, about 80% of the rural population in Tanzania lacks grid electricity. As a result, up to 90% of energy requirements in rural areas are met by firewood and hence causing deforestation. In the present paper, the authors are advocating the application of biogas to generate electricity in rural areas to minimise deforestation. Preliminary study conducted has shown that the power required in rural areas is about 10kW for household and small economic activities. As such, the authors have investigated the possibility of applying a hot air engine using biogas as a source of energy to generate electricity. The study involved simulation of hot air engine using a Stirling Numerical Analysis Program (SNAP) with use modifiable code. In the exercise, the performance of the simulated engine was assessed with helium, hydrogen and air as working media. Reheat loss and pressure losses were also assessed for varies range of engine power and efficiency. It has been observed that with helium and hydrogen as working gas, the power output could easily reach 10kW, which is sufficient for rural household application. However, with air the engine could realise only 4kW under similar conditions. It has further been observed that air has bigger and more viscous molecular with lower thermal conductivity and heat capacity, which results in higher losses. This implies that a relatively bigger engine need be employed for running with air. However, high initial cost will be offset by the reduction in operating cost, since air is freely available. For proper operation of the engine heater temperature should be maintained above 630(deg)C, which is realizable with biogas having a flame temperature of about 870(deg)C. (author)

  18. Impact of Rotavirus Vaccine Introduction and Postintroduction Etiology of Diarrhea Requiring Hospital Admission in Haydom, Tanzania, a Rural African Setting

    Science.gov (United States)

    Platts-Mills, James A.; Amour, Caroline; Gratz, Jean; Nshama, Rosemary; Walongo, Thomas; Mujaga, Buliga; Maro, Athanasia; McMurry, Timothy L; Liu, Jie; Mduma, Estomih; Houpt, Eric R

    2017-01-01

    Abstract Background No data are available on the etiology of diarrhea requiring hospitalization after rotavirus vaccine introduction in Africa. The monovalent rotavirus vaccine was introduced in Tanzania on 1 January 2013. We performed a vaccine impact and effectiveness study as well as a quantitative polymerase chain reaction (qPCR)–based etiology study at a rural Tanzanian hospital. Methods We obtained data on admissions among children <5 years to Haydom Lutheran Hospital between 1 January 2010 and 31 December 2015 and estimated the impact of vaccine introduction on all-cause diarrhea admissions. We then performed a vaccine effectiveness study using the test-negative design. Finally, we tested diarrheal specimens during 2015 by qPCR for a broad range of enteropathogens and calculated pathogen-specific attributable fractions (AFs). Results Vaccine introduction was associated with a 44.9% (95% confidence interval [CI], 17.6%–97.4%) reduction in diarrhea admissions in 2015, as well as delay of the rotavirus season. The effectiveness of 2 doses of vaccine was 74.8% (95% CI, –8.2% to 94.1%) using an enzyme immunoassay–based case definition and 85.1% (95% CI, 26.5%–97.0%) using a qPCR-based case definition. Among 146 children enrolled in 2015, rotavirus remained the leading etiology of diarrhea requiring hospitalization (AF, 25.8% [95% CI, 24.4%–26.7%]), followed by heat-stable enterotoxin-producing Escherichia coli (AF, 18.4% [95% CI, 12.9%–21.9%]), Shigella/enteroinvasive E. coli (AF, 14.5% [95% CI, 10.2%–22.8%]), and Cryptosporidium (AF, 7.9% [95% CI, 6.2%–9.3%]). Conclusions Despite the clear impact of vaccine introduction in this setting, rotavirus remained the leading etiology of diarrhea requiring hospitalization. Further efforts to maximize vaccine coverage and improve vaccine performance in these settings are warranted. PMID:28575304

  19. Parent-child communication about sexual and reproductive health in rural Tanzania: Implications for young people's sexual health interventions

    Directory of Open Access Journals (Sweden)

    Urassa Mark

    2010-05-01

    Full Text Available Abstract Background Many programmes on young people and HIV/AIDS prevention have focused on the in-school and channeled sexual and reproductive health messages through schools with limited activities for the young people's families. The assumption has been that parents in African families do not talk about sexual and reproductive health (SRH with their children. These approach has had limited success because of failure to factor in the young person's family context, and the influence of parents. This paper explores parent-child communication about SRH in families, content, timing and reasons for their communication with their children aged 14-24 years in rural Tanzania. Methods This study employed an ethnographic research design. Data collection involved eight weeks of participant observation, 17 focus group discussions and 46 in-depth interviews conducted with young people aged 14-24 years and parents of young people in this age group. Thematic analysis was conducted with the aid of NVIVO 7 software. Results Parent-child communication about SRH happened in most families. The communication was mainly on same sex basis (mother-daughter and rarely father-son or father-daughter and took the form of warnings, threats and physical discipline. Communication was triggered by seeing or hearing something a parent perceived negative and would not like their child to experience (such as a death attributable to HIV and unmarried young person's pregnancy. Although most young people were relaxed with their mothers than fathers, there is lack of trust as to what they can tell their parents for fear of punishment. Parents were limited as to what they could communicate about SRH because of lack of appropriate knowledge and cultural norms that restricted interactions between opposite sex. Conclusions Due to the consequences of the HIV pandemic, parents are making attempts to communicate with their children about SRH. They are however, limited by cultural barriers

  20. Genetic distinction between contiguous urban and rural multimammate mice in Tanzania despite gene flow

    Czech Academy of Sciences Publication Activity Database

    Gryseels, S.; Goüy de Bellocq, Joëlle; Makundi, R.; Vanmechelen, K.; Broeckhove, J.; Mazoch, V.; Šumbera, R.; Zima Jr., Jan; Leirs, H.; Baird, Stuart J. E.

    2016-01-01

    Roč. 29, č. 10 (2016), s. 1952-1967 ISSN 1010-061X R&D Projects: GA ČR GCP502/11/J070; GA ČR GAP506/10/0983; GA MŠk EE2.3.20.0303 Institutional support: RVO:68081766 Keywords : Mastomys natalensis * urbanisation * synanthropy * population genetics * IMa2 * spatial genetics * Tanzania Subject RIV: EG - Zoology Impact factor: 2.792, year: 2016

  1. Effectiveness of community based safe motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania

    Directory of Open Access Journals (Sweden)

    Jahn Albrecht

    2010-04-01

    Full Text Available Abstract Background In Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%, only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania. Method This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs. Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues. Results Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (ρ Conclusion The study has demonstrated the effectiveness of community-based safe motherhood intervention in promoting the utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

  2. Women and Land Ownership Rights in Kilimanjaro: A Tension between Women Land Ownership Rights and Culture: A case of Moshi Rural District Tanzania

    OpenAIRE

    Asantemungu, Raphael Ernest

    2011-01-01

    Despite the efforts and strategies geared towards women in realizing property rights in terms of empowerment, participation and decision making in the global context today many African societies are still characterized by social economic and political inequalities between men and women. This situation is worse in Tanzania rural areas where women land rights are violated as result of culture being regarded as a daily routine that provide the basis and ways in which land is owned and distribute...

  3. "Every method seems to have its problems"- Perspectives on side effects of hormonal contraceptives in Morogoro Region, Tanzania.

    Science.gov (United States)

    Chebet, Joy J; McMahon, Shannon A; Greenspan, Jesse A; Mosha, Idda H; Callaghan-Koru, Jennifer A; Killewo, Japhet; Baqui, Abdullah H; Winch, Peter J

    2015-11-03

    Family planning has been shown to be an effective intervention for promoting maternal, newborn and child health. Despite family planning's multiple benefits, women's experiences of - or concerns related to - side effects present a formidable barrier to the sustained use of contraceptives, particularly in the postpartum period. This paper presents perspectives of postpartum, rural, Tanzanian women, their partners, public opinion leaders and community and health facility providers related to side effects associated with contraceptive use. Qualitative interviews were conducted with postpartum women (n = 34), their partners (n = 23), community leaders (n = 12) and health providers based in both facilities (n = 12) and communities (n = 19) across Morogoro Region, Tanzania. Following data collection, digitally recorded data were transcribed, translated and coded using thematic analysis. Respondents described family planning positively due to the health and economic benefits associated with limiting and spacing births. However, side effects were consistently cited as a reason that women and their partners choose to forgo family planning altogether, discontinue methods, switch methods or use methods in an intermittent (and ineffective) manner. Respondents detailed side effects including excessive menstrual bleeding, missed menses, weight gain and fatigue. Women, their partners and community leaders also described concerns that contraceptives could induce sterility in women, or harm breastfeeding children via contamination of breast milk. Use of family planning during the postpartum period was viewed as particularly detrimental to a newborn's health in the first months of life. To meet Tanzania's national target of increasing contraceptive use from 34 to 60 % by 2015, appropriate counseling and dialogue on contraceptive side effects that speaks to pressing concerns outlined by women, their partners, communities and service providers are needed.

  4. Demographic, knowledge, attitudinal, and accessibility factors associated with uptake of cervical cancer screening among women in a rural district of Tanzania: Three public policy implications

    Directory of Open Access Journals (Sweden)

    Lyimo Frida S

    2012-01-01

    Full Text Available Abstract Background Cervical cancer is an important public health problem worldwide, which comprises approximately 12% of all cancers in women. In Tanzania, the estimated incidence rate is 30 to 40 per 100,000 women, indicating a high disease burden. Cervical cancer screening is acknowledged as currently the most effective approach for cervical cancer control, and it is associated with reduced incidence and mortality from the disease. The aim of the study was to identify the most important factors related to the uptake of cervical cancer screening among women in a rural district of Tanzania. Methods A cross sectional study was conducted with a sample of 354 women aged 18 to 69 years residing in Moshi Rural District. A multistage sampling technique was used to randomly select eligible women. A one-hour interview was conducted with each woman in her home. The 17 questions were modified from similar questions used in previous research. Results Less than one quarter (22.6% of the participants had obtained cervical cancer screening. The following characteristics, when examined separately in relation to the uptake of cervical cancer screening service, were significant: husband approval of cervical cancer screening, women's level of education, women's knowledge of cervical cancer and its prevention, women's concerns about embarrassment and pain of screening, women's preference for the sex of health provider, and women's awareness of and distance to cervical cancer screening services. When examined simultaneously in a logistic regression, we found that only knowledge of cervical cancer and its prevention (OR = 8.90, 95%CI = 2.14-16.03 and distance to the facility which provides cervical cancer screening (OR = 3.98, 95%CI = 0.18-5.10 were significantly associated with screening uptake. Conclusions Based on the study findings, three recommendations are made. First, information about cervical cancer must be presented to women. Second, public education of

  5. Has the HIV epidemic in rural Mwanza, Tanzania reached a plateau?

    African Journals Online (AJOL)

    migration of HIV positive people out of the communities or when ... rural Mwanza may be responsible for changes in risky sexual behaviour and have successfully impeded the spread ... 20 clusters and cluster sampling was used to select 7-9.

  6. 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

    Science.gov (United States)

    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,…

  7. Gender and willingness to pay for insecticides treated bed nets in a poor rural area in Tanzania.

    Science.gov (United States)

    Mujinja, P G M; Makwaya, C K; Sauerborn, R

    2004-12-01

    To examine socio-economic and malaria related differences between males and females that may cause gender differences in willingness to pay (WTP) for insecticide treated bed nets in a poor rural area. A two-week-interval (test re-test) cross-sectional study. Kisarawe District in coastal Tanzania. Two hundred and fifty one males and two hundred dollars females were interviewed. Females had about 50% of the males' income. The monthly average income was about US dollars 10.50 for females and US dollars 20.20 for males. The proportion of respondents willing to pay for an ITN, for both males and females, declined as the ITN prices increased (Pdifference between men and women, between both rounds were not statistically significant (p>0.05). Male respondents reported a higher mean number of own underfives living in the household compared to women, the difference was not statistically significant (P>0.8). Willingness to pay for ITN was found to be independent of having an under five child with recent history of malaria. Among both males and females, there was an association between a recent experience with malaria episode and WTP, p=0.05 and p=0.02 respectively. Among females, the proportion of those willing to pay for another person, at the lowest ITN price, was significantly higher in those with under five children in their households than in those with no underfives. This was not the case among the male respondents as the association was not statistically significant. Contrary to expectations were was no statistically significant difference in WTP for an ITN between females and males. Further studies that link willingness and ability to pay are required in rural poor population, such studies may be valuable inputs to government policy on and planning of ITN interventions in the public and private sector.

  8. Ecology and Demography of Free-Roaming Domestic Dogs in Rural Villages near Serengeti National Park in Tanzania.

    Science.gov (United States)

    Czupryna, Anna M; Brown, Joel S; Bigambo, Machunde A; Whelan, Christopher J; Mehta, Supriya D; Santymire, Rachel M; Lankester, Felix J; Faust, Lisa J

    2016-01-01

    Free-roaming dogs (Canis lupus familiaris) are of public health and conservation concern because of their potential to transmit diseases, such as rabies, to both people and wildlife. Understanding domestic dog population dynamics and how they could potentially be impacted by interventions, such as rabies vaccination, is vital for such disease control efforts. For four years, we measured demographic data on 2,649 free-roaming domestic dogs in four rural villages in Tanzania: two villages with and two without a rabies vaccination campaign. We examined the effects of body condition, sex, age and village on survivorship and reproduction. Furthermore, we compared sources of mortality among villages. We found that adult dogs (>12mos) had higher survival than puppies in all villages. We observed a male-biased sex ratio across all age classes. Overall survival in one non-vaccination village was lower than in the other three villages, all of which had similar survival probabilities. In all villages, dogs in poor body condition had lower survival than dogs in ideal body condition. Sickness and spotted hyena (Crocuta crocuta) predation were the two main causes of dog death. Within vaccination villages, vaccinated dogs had higher survivorship than unvaccinated dogs. Dog population growth, however, was similar in all the villages suggesting village characteristics and ownership practices likely have a greater impact on overall dog population dynamics than vaccination. Free-roaming domestic dogs in rural communities exist in the context of their human owners as well as the surrounding wildlife. Our results did not reveal a clear effect of vaccination programs on domestic dog population dynamics. An investigation of the role of dogs and their care within these communities could provide additional insight for planning and implementing rabies control measures such as mass dog vaccination.

  9. A cross-sectional study of quality of life in incident stroke survivors in rural northern Tanzania.

    Science.gov (United States)

    Howitt, Suzanne C; Jones, Matthew P; Jusabani, Ahmed; Gray, William K; Aris, Eric; Mugusi, Ferdinand; Swai, Mark; Walker, Richard W

    2011-08-01

    The aim of this study was to evaluate changes to, and predictors of, quality of life (QOL) in a community-based cohort of stroke survivors from an earlier stroke incidence study in rural northern Tanzania. Patients were assessed 1-5 years after their incident stroke. The study cohort was compared with an age- and sex-matched control group from the same rural district within a cross-sectional design. Patients and controls were asked a series of questions relating to their QOL [World Health Organization quality of life, abbreviated version (WHOQOL-BREF)], levels of anxiety and depression [hospital anxiety and depression (HAD) scale], cognitive function [community screening instrument for dementia (CSI-D) screening tool], socioeconomic status and demographic characteristics (e.g. age, sex, education and abode). Patients were further assessed for functional outcome and disability (Barthel index, modified Rankin scale), post-stroke care and psychosocial functioning. Patients (n = 58) were found to have significantly lower QOL than controls (n = 58) in all six domains of the WHOQOL-BREF. Gender, socioeconomic status, cognitive function and time elapsed since stroke were not associated with QOL. Older patients and those with more impaired motor function and disability (Barthel index, modified Rankin score) had significantly poorer physical health-related QOL. Greater anxiety and depression, reduced muscle power and less involvement in social events were significantly correlated with lower physical and psychological health-related QOL. To our knowledge, this is the first long-term study of QOL in survivors of incident stroke in Sub-Saharan Africa (SSA). Poorer QOL was associated with greater levels of physical disability, anxiety and depression and reduced social interaction. Demographic factors appear to be much less significant. Modifying these QOL predictors could be important in planning effective post-stroke care within a stretched healthcare system.

  10. Dietary patterns and household food insecurity in rural populations of Kilosa district, Tanzania.

    Directory of Open Access Journals (Sweden)

    Julius Edward Ntwenya

    Full Text Available Few studies have investigated the relationship between dietary pattern and household food insecurity. The objective of the present analysis was to describe the food consumption patterns and to relate these with the prevalence of food insecurity in the context of a rural community.Three hundred and seven (307 randomly selected households in Kilosa district participated in the study. Data were collected during the rainy season (February-May and post harvest season (September-October in the year 2011. Food consumption pattern was determined using a 24-h dietary recall method. Food insecurity data were based on the 30 day recall experience to food insecurity in the household. Factor analysis method using Principal Components extraction function was used to derive the dietary patterns and correlation analysis was used to establish the existing relationship between household food insecurity and dietary patterns factor score.Four food consumption patterns namely (I Meat and milk; (II Pulses, legumes, nuts and cooking oils; (III fish (and other sea foods, roots and tubers; (IV Cereals, vegetables and fruits consumption patterns were identified during harvest season. Dietary patterns identified during the rainy season were as follows: (I Fruits, cooking oils, fats, roots and tubers (II Eggs, meat, milk and milk products (III Fish, other sea foods, vegetables, roots and tubers and (IV Pulses, legumes, nuts, cereals and vegetables. Household food insecurity was 80% and 69% during rainy and harvest-seasons, respectively (P = 0.01. Household food insecurity access scale score was negatively correlated with the factor scores on household dietary diversity.Food consumption patterns and food insecurity varied by seasons with worst scenarios most prevalent during the rainy season. The risk for inadequate dietary diversity was higher among food insecure households compared to food secure households. Effort geared at alleviating household food insecurity could

  11. The effectiveness of non-pyrethroid insecticide-treated durable wall lining to control malaria in rural Tanzania: study protocol for a two-armed cluster randomized trial

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    George Mtove

    2016-07-01

    Full Text Available Abstract Background Despite considerable reductions in malaria achieved by scaling-up long-lasting insecticidal nets (LLINs and indoor residual spraying (IRS, maintaining sustained community protection remains operationally challenging. Increasing insecticide resistance also threatens to jeopardize the future of both strategies. Non-pyrethroid insecticide­treated wall lining (ITWL may represent an alternate or complementary control method and a potential tool to manage insecticide resistance. To date no study has demonstrated whether ITWL can reduce malaria transmission nor provide additional protection beyond the current best practice of universal coverage (UC of LLINs and prompt case management. Methods/design A two-arm cluster randomized controlled trial will be conducted in rural Tanzania to assess whether non-pyrethroid ITWL and UC of LLINs provide added protection against malaria infection in children, compared to UC of LLINs alone. Stratified randomization based on malaria prevalence will be used to select 22 village clusters per arm. All 44 clusters will receive LLINs and half will also have ITWL installed on interior house walls. Study children, aged 6 months to 11 years old, will be enrolled from each cluster and followed monthly to estimate cumulative incidence of malaria parasitaemia (primary endpoint, time to first malaria episode and prevalence of anaemia before and after intervention. Entomological inoculation rate will be estimated using indoor CDC light traps and outdoor tent traps followed by detection of Anopheles gambiae species, sporozoite infection, insecticide resistance and blood meal source. ITWL bioefficacy and durability will be monitored using WHO cone bioassays and household surveys, respectively. Social and cultural factors influencing community and household ITWL acceptability will be explored through focus-group discussions and in-depth interviews. Cost-effectiveness, compared between study arms, will be

  12. Mosquito abundance, bed net coverage and other factors associated with variations in sporozoite infectivity rates in four villages of rural Tanzania

    DEFF Research Database (Denmark)

    Kweka, Eliningaya J; Nkya, Watoky M M; Mahande, Aneth M

    2008-01-01

    . Sporozoite infectivity rates, mosquito host blood meal source, bed net coverage and mosquito abundance were assessed in this study. METHODOLOGY: A longitudinal survey was conducted in four villages in two regions of Tanzania. Malaria vectors were sampled using the CDC light trap and pyrethrum spray catch...... methods. In each village, ten paired houses were selected for mosquitoes sampling. Sampling was done in fortnight case and study was undertaken for six months in both Kilimanjaro (Northern Tanzania) and Dodoma (Central Tanzania) regions. RESULTS: A total of 6,883 mosquitoes were collected including: 5......,628 (81.8%) Anopheles arabiensis, 1,100 (15.9%) Culex quinquefasciatus, 89 (1.4%) Anopheles funestus, and 66 (0.9%) Anopheles gambiae s.s. Of the total mosquitoes collected 3,861 were captured by CDC light trap and 3,022 by the pyrethrum spray catch method. The overall light trap: spray catch ratio was 1...

  13. Nutrient status of crop contents of rural scavenging local chickens in Tanzania.

    Science.gov (United States)

    Mwalusanya, N A; Katule, A M; Mutayoba, S K; Minga, U M; Mtambo, M M A; Olsen, J E

    2002-03-01

    1. A total of 144 chickens purchased from peasants in Morogoro, Tanzania were slaughtered, their crops dissected and the contents analysed. The birds consisted of 48 chickens from each of three climatic zones (warm and wet, warm and dry, cool and wet). Seventy-two chickens were slaughtered in each season, that is short rainy and long rainy season. 2. Cereal grains, bran, green forages, insects/worms and kitchen food wastes were the main crop contents and their composition varied significantly with season and climate. 3. The overall mean chemical compositions (g/kg) of the crop contents were: 430.8 +/- 107.78 dry matter (DM), 104.4 +/- 43.47 crude protein (CP), 61.2 +/- 36.48 ether extract (EE), 58.2 +/- 26.29 crude fibre (CF), 125.4 +/- 58-27 ash, 6.3 +/- 5.19 calcium (Ca) and 3.6 +/- 2.41 phosphorus (P). 4. CP, EE, ash and P contents varied significantly (Pnutritional requirements and varied with season, climate and age of birds.

  14. The costs of introducing artemisinin-based combination therapy: evidence from district-wide implementation in rural Tanzania

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    Abdulla Salim

    2008-01-01

    Full Text Available Abstract Background The development of antimalarial drug resistance has led to increasing calls for the introduction of artemisinin-based combination therapy (ACT. However, little evidence is available on the full costs associated with changing national malaria treatment policy. This paper presents findings on the actual drug and non-drug costs associated with deploying ACT in one district in Tanzania, and uses these data to estimate the nationwide costs of implementation in a setting where identification of malaria cases is primarily dependant on clinical diagnosis. Methods Detailed data were collected over a three year period on the financial costs of providing ACT in Rufiji District as part of a large scale effectiveness evaluation, including costs of drugs, distribution, training, treatment guidelines and other information, education and communication (IEC materials and publicity. The district-level costs were scaled up to estimate the costs of nationwide implementation, using four scenarios to extrapolate variable costs. Results The total district costs of implementing ACT over the three year period were slightly over one million USD, with drug purchases accounting for 72.8% of this total. The composite (best estimate of nationwide costs for the first three years of ACT implementation was 48.3 million USD (1.29 USD per capita, which varied between 21 and 67.1 million USD in the sensitivity analysis (2003 USD. In all estimates drug costs constituted the majority of total costs. However, non-drug costs such as IEC materials, drug distribution, communication, and health worker training were also substantial, accounting for 31.4% of overall ACT implementation costs in the best estimate scenario. Annual implementation costs are equivalent to 9.5% of Tanzania's recurrent health sector budget, and 28.7% of annual expenditure on medical supplies, implying a 6-fold increase in the national budget for malaria treatment. Conclusion The costs of

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

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    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

  16. Inpatient child mortality by travel time to hospital in a rural area of Tanzania.

    Science.gov (United States)

    Manongi, Rachel; Mtei, Frank; Mtove, George; Nadjm, Behzad; Muro, Florida; Alegana, Victor; Noor, Abdisalan M; Todd, Jim; Reyburn, Hugh

    2014-05-01

    To investigate the association, if any, between child mortality and distance to the nearest hospital. The study was based on data from a 1-year study of the cause of illness in febrile paediatric admissions to a district hospital in north-east Tanzania. All villages in the catchment population were geolocated, and travel times were estimated from availability of local transport. Using bands of travel time to hospital, we compared admission rates, inpatient case fatality rates and child mortality rates in the catchment population using inpatient deaths as the numerator. Three thousand hundred and eleven children under the age of 5 years were included of whom 4.6% died; 2307 were admitted from time between admission and death. Assuming uniform mortality in the catchment population, the predicted number of deaths not benefiting from hospital admission prior to death increased by 21.4% per hour of travel time to hospital. If the same admission and death rates that were found at <3 h from the hospital applied to the whole catchment population and if hospital care conferred a 30% survival benefit compared to home care, then 10.3% of childhood deaths due to febrile illness in the catchment population would have been averted. The mortality impact of poor access to hospital care in areas of high paediatric mortality is likely to be substantial although uncertainty over the mortality benefit of inpatient care is the largest constraint in making an accurate estimate. © 2014 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  17. A feasibility study of an educational program on obstetric danger signs among pregnant adolescents in Tanzania: A mixed-methods study

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    Beatrice Mwilike

    Full Text Available Background: In Tanzania, adolescents have a high lifetime risk of dying from pregnancy and childbirth complications. Objective: To determine the feasibility of an education program in improving knowledge of obstetric danger signs and promoting appropriate healthcare-seeking behavior, as well as encouraging the development of a peer network support group. Methods: An embedded mixed-methods design was used. This research was a pilot study conducted in a health facility in rural Tanzania. Quantitative data was collected before and after the education program using questionnaires. Focus group discussion was used to collect qualitative data. Results: 15 pregnant adolescents between 15 and 19 years of age participated. Their median age was 18.0 years (SD ± 1.19, and 66.7% were ≤18 years. There was a significant increase in the scores of knowledge of danger signs during pregnancy between the pre-test (M = 7.20, SD = 2.83 and the post-test (M = 9.07, SD = 1.67; t = 2.168, p = 0.048. There was a significant strong positive correlation between the healthcare-seeking behavior score and social support score variables [r = 0.654, p = 0.008]. The education program was feasible in terms of implementation, acceptability, and demand as indicated by its >84% score. Four categories were identified from the qualitative data: “supportive family”, “rejection and abortion”, “support from peers”, and “potential barriers to seek care”. Conclusion: The development of an education program particularly on obstetric danger signs was feasible and helpful for pregnant adolescents in Tanzania. Keywords: Pregnancy, Adolescent, Obstetric danger signs, Social support, Healthcare-seeking behavior, Antenatal care

  18. How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania.

    Science.gov (United States)

    Magoma, Moke; Requejo, Jennifer; Merialdi, Mario; Campbell, Oona M R; Cousens, Simon; Filippi, Veronique

    2011-09-24

    Many women in Sub-Saharan African countries do not receive key recommended interventions during routine antenatal care (ANC) including information on pregnancy, related complications, and importance of skilled delivery attendance. We undertook a process evaluation of a successful cluster randomized trial testing the effectiveness of birth plans in increasing utilization of skilled delivery and postnatal care in Ngorongoro district, rural Tanzania, to document the time spent by health care providers on providing the recommended components of ANC. The study was conducted in 16 health units (eight units in each arm of the trial). We observed, timed, and audio-recorded ANC consultations to assess the total time providers spent with each woman and the time spent for the delivery of each component of care. T-test statistics were used to compare the total time and time spent for the various components of ANC in the two arms of the trial. We also identified the topics discussed during the counselling and health education sessions, and examined the quality of the provider-woman interaction. The mean total duration for initial ANC consultations was 40.1 minutes (range 33-47) in the intervention arm versus 19.9 (range 12-32) in the control arm p < 0.0001. Except for drug administration, which was the same in both arms of the trial, the time spent on each component of care was also greater in the intervention health units. Similar trends were observed for subsequent ANC consultations. Birth plans were always discussed in the intervention health units. Counselling on HIV/AIDS was also prioritized, especially in the control health units. Most other recommended topics (e.g. danger signs during pregnancy) were rarely discussed. Although the implementation of birth plans in the intervention health units improved provider-women dialogue on skilled delivery attendance, most recommended topics critical to improving maternal and newborn survival were rarely covered.

  19. Who is left behind on the road to universal facility delivery? A cross-sectional multilevel analysis in rural Tanzania.

    Science.gov (United States)

    Kruk, Margaret E; Hermosilla, Sabrina; Larson, Elysia; Vail, Daniel; Chen, Qixuan; Mazuguni, Festo; Byalugaba, Beatrice; Mbaruku, Godfrey

    2015-08-01

    To examine factors associated with home delivery among women in Pwani Region, Tanzania, which has experienced a rapid rise in facility delivery coverage. Cross-sectional data from a population-based survey of women residing in rural areas of Pwani Region were linked to health facility locations. We fitted multilevel logistic models to examine individual and community factors associated with home delivery. A total of 752 (27.95%) of the 2691 women who completed the survey delivered their last child at home. Women were less likely to deliver at home if they had any primary education [odds ratio (OR) 0.62; 95% confidence interval (CI): 0.50, 0.79], were primiparous (OR: 0.52; 95% CI: 0.37, 0.73), had more exposure to media (OR: 0.80; 95% CI: 0.66, 0.96) or had received more (OR: 0.78; 95% CI: 0.63, 0.96) or better quality antenatal care (ANC) services (OR: 0.48; 95% CI: 0.34, 0.67). Increased wealth was strongly associated with lower odds of home delivery (OR: 0.27; 95% CI: 0.18, 0.39), as was living in a village that grew cash crops (OR: 0.56; 95% CI: 0.35, 0.88). Farther distance to hospital, but not to lower level facilities, was associated with higher likelihood of home delivery (OR 2.49; 95% CI: 1.60, 3.88). Poverty, multiparity, weak ANC and distance to hospital were associated with persistence of home delivery in a region with high coverage of facility delivery. A pro-poor path to universal coverage of safe delivery requires a greater focus on quality of care and more intensive outreach to poor and multiparous women. © 2015 John Wiley & Sons Ltd.

  20. A longitudinal cohort study of malaria exposure and changing serostatus in a malaria endemic area of rural Tanzania.

    Science.gov (United States)

    Simmons, Ryan A; Mboera, Leonard; Miranda, Marie Lynn; Morris, Alison; Stresman, Gillian; Turner, Elizabeth L; Kramer, Randall; Drakeley, Chris; O'Meara, Wendy P

    2017-08-02

    Measurements of anti-malarial antibodies are increasingly used as a proxy of transmission intensity. Most serological surveys are based on the use of cross-sectional data that, when age-stratified, approximates historical patterns of transmission within a population. Comparatively few studies leverage longitudinal data to explicitly relate individual infection events with subsequent antibody responses. The occurrence of seroconversion and seroreversion events for two Plasmodium falciparum asexual stage antigens (MSP-1 and AMA-1) was examined using three annual measurements of 691 individuals from a cohort of individuals in a malaria-endemic area of rural east-central Tanzania. Mixed-effect logistic regression models were employed to determine factors associated with changes in serostatus over time. While the expected population-level relationship between seroprevalence and disease incidence was observed, on an individual level the relationship between individual infections and the antibody response was complex. MSP-1 antibody responses were more dynamic in response to the occurrence and resolution of infection events than AMA-1, while the latter was more correlated with consecutive infections. The MSP-1 antibody response to an observed infection seemed to decay faster over time than the corresponding AMA-1 response. Surprisingly, there was no evidence of an age effect on the occurrence of a conversion or reversion event. While the population-level results concur with previously published sero-epidemiological surveys, the individual-level results highlight the more complex relationship between detected infections and antibody dynamics than can be analysed using cross-sectional data. The longitudinal analysis of serological data may provide a powerful tool for teasing apart the complex relationship between infection events and the corresponding immune response, thereby improving the ability to rapidly assess the success or failure of malaria control programmes.

  1. Prevalence and risk factors for HIV-1 infection in rural Kilimanjaro region of Tanzania: implications for prevention and treatment.

    Science.gov (United States)

    Mmbaga, Elia J; Hussain, Akhtar; Leyna, Germana H; Mnyika, Kagoma S; Sam, Noel E; Klepp, Knut-Inge

    2007-04-19

    Variability in stages of the HIV-1 epidemic and hence HIV-1 prevalence exists in different areas in sub-Saharan Africa. The purpose of this study was to investigate the magnitude of HIV-1 infection and identify HIV-1 risk factors that may help to develop preventive strategies in rural Kilimanjaro, Tanzania. A cross-sectional study was conducted between March and May of 2005 involving all individuals aged between 15-44 years having an address in Oria Village. All eligible individuals were registered and invited to participate. Participants were interviewed regarding their demographic characteristics, sexual behaviors, and medical history. Following a pre-test counseling, participants were offered an HIV test. Of the 2 093 eligible individuals, 1 528 (73.0%) participated. The overall age and sex adjusted HIV-1 prevalence was 5.6%. Women had 2.5 times higher prevalence (8.0% vs. 3.2%) as compared to men. The age group 25-44 years, marriage, separation and low education were associated with higher risk of HIV-1 infection for both sexes. HIV-1 infection was significantly associated with >2 sexual partners in the past 12 months (women: Adjusted odds ratio [AOR], 2.5 (95%CI: 1.3-4.7), and past 5 years, [(men: AOR, 2.2 (95%CI:1.2-5.6); women: AOR, 2.5 (95%CI: 1.4-4.0)], unprotected casual sex (men: AOR,1.8 95%CI: 1.2-5.8), bottled alcohol (Men: AOR, 5.9 (95%CI:1.7-20.1) and local brew (men: AOR, 3.7 (95%CI: 1.5-9.2). Other factors included treatment for genital ulcers and genital discharge in the past 1 month. Health-related complaints were more common among HIV-1 seropositive as compared to seronegative participants and predicted the presence of HIV-1 infection. HIV-1 infection was highly prevalent in this population. As compared to our previous findings, a shift of the epidemic from a younger to an older age group and from educated to uneducated individuals was observed. Women and married or separated individuals remained at higher risk of infection. To prevent further

  2. Coming home to die? The association between migration and mortality in rural Tanzania before and after ART scale-up.

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    Levira, Francis; Todd, Jim; Masanja, Honorati

    2014-01-01

    Prior to the scale-up of antiretroviral therapy (ART), demographic surveillance cohort studies showed higher mortality among migrants than residents in many rural areas. This study quantifies the overall and AIDS-specific mortality between migrants and residents prior to ART, during ART scale-up, and after widespread availability of ART in Rufiji district in Tanzania. In Health and Demographic Surveillance System (HDSS), the follow-up of individuals aged 15-59 years was categorized into three periods: before ART (1998-2003), during ART scale-up (2004-2007), and after widespread availability of ART (2008-2011). Residents were those who never migrated within and beyond HDSS, internal migrants were those who moved within the HDSS, and external migrants were those who moved into the HDSS from outside. Mortality rates were estimated from deaths and person-years of observations calculated in each time period. Hazard ratios were estimated to compare mortality between migrants and residents. AIDS deaths were identified from verbal autopsy, and the odds ratio of dying from AIDS between migrants and residents was estimated using the multivariate logistic regression model. Internal and external migrants experienced higher overall mortality than residents before the introduction of ART. After widespread availability of ART overall mortality were similar for internal and external migrants. These overall mortality experiences observed were similar for males and females. In the multivariate logistic regression model, adjusting for age, sex, education, and social economic status, internal migrants had similar likelihood of dying from AIDS as residents (adjusted odds ratio [AOR]=1.14, 95% confidence interval [CI]: 0.70-1.87) while external migrants were 70% more likely to die from AIDS compared to residents prior to the introduction of ART (AOR=1.70, 95% CI: 1.06-2.73). After widespread availability of ART with the same adjustment factors, the odds of dying from AIDS were similar

  3. Unpredictability dictates quality of maternal and newborn care provision in rural Tanzania-A qualitative study of health workers' perspectives.

    Science.gov (United States)

    Baker, Ulrika; Hassan, Farida; Hanson, Claudia; Manzi, Fatuma; Marchant, Tanya; Swartling Peterson, Stefan; Hylander, Ingrid

    2017-02-06

    Health workers are the key to realising the potential of improved quality of care for mothers and newborns in the weak health systems of Sub Saharan Africa. Their perspectives are fundamental to understand the effectiveness of existing improvement programs and to identify ways to strengthen future initiatives. The objective of this study was therefore to examine health worker perspectives of the conditions for maternal and newborn care provision and their perceptions of what constitutes good quality of care in rural Tanzanian health facilities. In February 2014, we conducted 17 in-depth interviews with different cadres of health workers providing maternal and newborn care in 14 rural health facilities in Tandahimba district, south-eastern Tanzania. These facilities included one district hospital, three health centres and ten dispensaries. Interviews were conducted in Swahili, transcribed verbatim and translated into English. A grounded theory approach was used to guide the analysis, the output of which was one core category, four main categories and several sub-categories. 'It is like rain' was identified as the core category, delineating unpredictability as the common denominator for all aspects of maternal and newborn care provision. It implies that conditions such as mothers' access to and utilisation of health care are unreliable; that availability of resources is uncertain and that health workers have to help and try to balance the situation. Quality of care was perceived to vary as a consequence of these conditions. Health workers stressed the importance of predictability, of 'things going as intended', as a sign of good quality care. Unpredictability emerged as a fundamental condition for maternal and newborn care provision, an important determinant and characteristic of quality in this study. We believe that this finding is also relevant for other areas of care in the same setting and may be an important defining factor of a weak health system. Increasing

  4. Motivation of human resources for health: a case study at rural district level in Tanzania.

    Science.gov (United States)

    Zinnen, Véronique; Paul, Elisabeth; Mwisongo, Aziza; Nyato, Daniel; Robert, Annie

    2012-01-01

    An increasing number of studies explore the association between financial and non-financial incentives and the retention of health workers in developing countries. This study aims to contribute to empirical evidence on human resource for health motivation factors to assist policy makers in promoting effective and realistic interventions. A cross-sectional survey was conducted in four rural Tanzanian districts to explore staff stability and health workers' motivation. Data were collected using qualitative and quantitative techniques, covering all levels and types of health facilities. Stability of staff was found to be quite high. Public institutions remained very attractive with better job security, salary and retirement benefits. Satisfaction over working conditions was very low owing to inadequate working equipment, work overload, lack of services, difficult environment, favouritism and 'empty promotions'. Positive incentives mentioned were support for career development and supportive supervision. Attracting new staff in rural areas appeared to be more difficult than retaining staff in place. The study concluded that strategies to better motivate health personnel should focus on adequate remuneration, positive working and living environment and supportive management. However, by multiplying health facilities, the latest Tanzanian human resource for health plan could jeopardize current positive results. Copyright © 2012 John Wiley & Sons, Ltd.

  5. Experience of safety monitoring in the context of a prospective observational study of artemether-lumefantrine in rural Tanzania: lessons learned for pharmacovigilance reporting

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    Kabanywanyi Abdunoor M

    2010-07-01

    Full Text Available Abstract Objectives To identify and implement strategies that help meet safety monitoring requirements in the context of an observational study for artemether-lumefantrine (AL administered as first-line treatment for uncomplicated malaria in rural Tanzania. Methods Pharmacovigilance procedures were developed through collaboration between the investigating bodies, the relevant regulatory authority and the manufacturer of AL. Training and refresher sessions on the pharmacovigilance system were provided for healthcare workers from local health facilities and field recorders of the Ifakara Health Demographic Surveillance System (IHDSS. Three distinct channels for identification of adverse events (AEs and serious adverse events (SAEs were identified and implemented. Passive reporting took place through IHDSS and health care facilities, starting in October 2007. The third channel was through solicited reporting that was included in the context of a survey on AL as part of the ALIVE (Artemether-Lumefantrine In Vulnerable patients: Exploring health impact study (conducted only in March-April 2008. Results Training was provided for 40 healthcare providers (with refresher training 18 months later and for six field recorders. During the period 1st September 2007 to 31st March 2010, 67 AEs were reported including 52 under AL, five under sulphadoxine-pyrimethamine, one under metakelfin, two after antibiotics; the remaining seven were due to anti-pyretic or anti-parasite medications. Twenty patients experienced SAEs; in 16 cases, a relation to AL was suspected. Six of the 20 cases were reported within 24 hours of occurrence. Discussion Safety monitoring and reporting is possible even in settings with weak health infrastructure. Reporting can be enhanced by regular and appropriate training of healthcare providers. SMS text alerts provide a practical solution to communication challenges. Conclusion Experience gained in this setting could help to improve

  6. A Novel Off-Grid Optimal Hybrid Energy System for Rural Electrification of Tanzania Using a Closed Loop Cooled Solar System

    Directory of Open Access Journals (Sweden)

    Muhammad Adil Khan

    2018-04-01

    Full Text Available A large proportion of the world’s populations live in developing countries. Rural areas in many of these countries are isolated geographically from grid connections and they have a very low rate of electrification. The uninterrupted power supply (UPS in these regions is a considerable challenge. The use of renewable energy resources (RER in an off-grid hybrid energy system can be a pathway to solving this problem. Tanzania has a very low electrification rate (rural 16.9%, urban 65.3%. This paper discussed, described, designed a novel uninterruptible, and environmental friendly solar-wind hybrid energy system (HES for remote area of Tanzania having closed loop cooled-solar system (CLC-SS. An optimized configuration for the proposed HES was obtained by Hybrid Optimization Model for Electric Renewable (HOMER analysis software using local solar and wind resources. The designed CLC-SS improved the efficiency of the hybrid solar-wind systems by extracting more power from the solar modules. An evaluation of CLC-SS revealed a 10.23% increase in power output from conventional solar PV modules. The results validate that the optimized system’s energy cost (COE is 0.26 $/kWh and the net present cost (NPC of the system is $7110.53. The enhanced output solar wind hybrid system, designed in this paper is cost-effective and can be applied easily to other regions of the world with similar climate conditions.

  7. Parent-child communication about sexual and reproductive health in rural Tanzania: Implications for young people's sexual health interventions.

    Science.gov (United States)

    Wamoyi, Joyce; Fenwick, Angela; Urassa, Mark; Zaba, Basia; Stones, William

    2010-05-12

    Many programmes on young people and HIV/AIDS prevention have focused on the in-school and channeled sexual and reproductive health messages through schools with limited activities for the young people's families. The assumption has been that parents in African families do not talk about sexual and reproductive health (SRH) with their children. These approach has had limited success because of failure to factor in the young person's family context, and the influence of parents. This paper explores parent-child communication about SRH in families, content, timing and reasons for their communication with their children aged 14-24 years in rural Tanzania. This study employed an ethnographic research design. Data collection involved eight weeks of participant observation, 17 focus group discussions and 46 in-depth interviews conducted with young people aged 14-24 years and parents of young people in this age group. Thematic analysis was conducted with the aid of NVIVO 7 software. Parent-child communication about SRH happened in most families. The communication was mainly on same sex basis (mother-daughter and rarely father-son or father-daughter) and took the form of warnings, threats and physical discipline. Communication was triggered by seeing or hearing something a parent perceived negative and would not like their child to experience (such as a death attributable to HIV and unmarried young person's pregnancy). Although most young people were relaxed with their mothers than fathers, there is lack of trust as to what they can tell their parents for fear of punishment. Parents were limited as to what they could communicate about SRH because of lack of appropriate knowledge and cultural norms that restricted interactions between opposite sex. Due to the consequences of the HIV pandemic, parents are making attempts to communicate with their children about SRH. They are however, limited by cultural barriers, and lack of appropriate knowledge. With some skills training on

  8. Linking poverty levels to water resource use and conflicts in rural Tanzania

    Science.gov (United States)

    Madulu, Ndalahwa F.

    Water scarcity is an important environmental constraint to development. Water availability is closely linked to human welfare and health by affecting nutrition status and quantity of drinking water especially for the poor. It has impacts on household labour because of the time and energy spent in obtaining it. These problems are more keenly felt among the poor households and in the agricultural subsistence economy. In many areas, the demand for water has been increasing due to rapid population growth, economic development, and climatic change. Water scarcity also stimulates social conflicts between various water users: individuals, communities, industries, livestock, wildlife, agriculture etc. Consequently, local communities have evolved strategies for coping with water stress and drought. These strategies include use of various sources of water, inaction to strict bye-laws regarding the use of water, crop diversification, wage labour, and possibly seasonal migration. The available strategies are likely to vary from one area to another. Some of these actions have measurable longterm demographic consequences, particularly if water stress is severe or repetitive. Although most governments and donor organizations often put much emphasis on the provision of water for drinking purposes, there is clear evidence that the supply of water for other uses has equal importance especially among rural communities. This observation suggests that putting too much emphasis on drinking water needs, addresses a rather insignificant part of the problem of water resources and biases the range of solutions which are likely to be proposed for perceived shortages. The presence of other water uses necessitates the provision of multi-purpose water sources that can serve a number of contrasting functions. This demand-responsive approach can enable the local communities and the poor households to choose the type of services they require on the basis of perceived needs and their ability to

  9. Quantifying behavioural interactions between humans and mosquitoes: Evaluating the protective efficacy of insecticidal nets against malaria transmission in rural Tanzania

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    Mathenge Evan

    2006-11-01

    Full Text Available Abstract Background African malaria vectors bite predominantly indoors at night so sleeping under an Insecticide-Treated Net (ITN can greatly reduce malaria risk. Behavioural adaptation by mosquitoes to increasing ITN coverage could allow vector mosquitoes to bite outside of peak sleeping hours and undermine efficacy of this key malaria prevention measure. Methods High coverage with largely untreated nets has been achieved in the Kilombero Valley, southern Tanzania through social marketing programmes. Direct surveys of nightly biting activity by An. gambiae Giles were conducted in the area before (1997 and after (2004 implementation of ITN promotion. A novel analytical model was applied to estimate the effective protection provided by an ITN, based on published experimental hut trials combined with questionnaire surveys of human sleeping behaviour and recorded mosquito biting patterns. Results An. gambiae was predominantly endophagic and nocturnal in both surveys: Approximately 90% and 80% of exposure occurred indoors and during peak sleeping hours, respectively. ITNs consistently conferred >70% protection against exposure to malaria transmission for users relative to non-users. Conclusion As ITN coverage increases, behavioural adaptation by mosquitoes remains a future possibility. The approach described allows comparison of mosquito biting patterns and ITN efficacy at multiple study sites and times. Initial results indicate ITNs remain highly effective and should remain a top-priority intervention. Combined with recently developed transmission models, this approach allows rapid, informative and cost-effective preliminary comparison of diverse control strategies in terms of protection against exposure before more costly and intensive clinical trials.

  10. Why do women not adhere to advice on maternal referral in rural Tanzania? Narratives of women and their family members

    OpenAIRE

    Pembe, Andrea B.; Mbekenga, Columba K.; Olsson, Pia; Darj, Elisabeth

    2017-01-01

    ABSTRACT Background: In most low-income countries, many women with high-risk pregnancies and complications do not reach the referral hospitals despite the provision of referral advice. Objective: To explore how antenatal maternal referral advice is understood and handled in a rural Tanzanian community. Methods: Individual in-depth interviews were conducted with six women who did not go to hospital and 13 people who were involved in the referral advice. Narrative analysis was used to describe ...

  11. A comparison of stigma among patients with leprosy in rural Tanzania and urban United States: a role for public health in dermatology.

    Science.gov (United States)

    Roosta, Neda; Black, David S; Rea, Thomas H

    2013-04-01

      Leprosy is a chronic infection of the skin and peripheral nerves caused by the bacterium Mycobacterium leprae, which causes peripheral insensitivity and disfigurements of the skin, limbs, and digits. Social stigma is a common consequence of leprosy and may differ according to level of physical disfigurement and geographic location. The objective of this study was to assess social stigma encountered by patients with leprosy in clinical settings located in rural Tanzania and urban USA and to compare the social stigma reported in these regions.   A total of 56 respondents were recruited from one leprosy inpatient facility in Shirati, Tanzania (n = 28), and one outpatient clinic in Los Angeles, USA (n = 28). Cross-sectional data were obtained from face-to-face interviews, which were conducted with respondents at each clinic location. Measures of perceived stigma were assessed in family relationship, vocational, social interaction, and interpersonal contexts.   Patients in Tanzania, as compared with those in the USA, reported significantly higher levels of stigma in family relationship and vocational contexts. Tanzanian patients also reported higher levels of stigma in social interaction and self-esteem contexts, but these differences were marginally significant and may reflect the small sample size.   Leprosy-related social stigma is a major problem in regions of both developed and developing countries; however, patients with leprosy in developing countries reported higher levels of stigma in four social contexts. A public health role in dermatology is discussed as an agent of early diagnosis, control, and education in order to reduce social stigma and promote social rehabilitation. © 2013 The International Society of Dermatology.

  12. The quality of antenatal care in rural Tanzania: what is behind the number of visits?

    NARCIS (Netherlands)

    Nyamtema, A.S.; de Jong, A.; Urassa, D.P.; Hagen, J.P.; van Roosmalen, J.

    2012-01-01

    Background: Antenatal care (ANC) provides an important opportunity for pregnant women with a wide range of interventions and is considered as an important basic component of reproductive health care.Methods: In 2008, severe maternal morbidity audit was established at Saint Francis Designated

  13. Acceptance and use of the female condom among women with incomplete abortion in rural Tanzania

    DEFF Research Database (Denmark)

    Rasch, Vibeke; Yambesi, Fortunata; Kipingili, Rose

    2006-01-01

    BACKGROUND: This study describes the outcome of a postabortion care intervention aimed at introducing the female condom as a means of preventing women from having unwanted pregnancies and sexually transmitted infections (STIs)/HIV. METHODS: Postabortion contraceptive counseling and services were...... intended to use it again. CONCLUSION: Postabortion care programs provide an excellent entry point for introducing the female condom as a contraceptive method for the prevention of both repeat unwanted pregnancies and STI/HIV infection....... offered to 548 women admitted to the Kagera Regional Hospital for incomplete abortion. The counseling included information about STI/HIV and the use male or female condom. In total, 521 (95%) women accepted contraception. RESULTS: Contraceptive use was assessed 3 months after abortion among 475 (91...

  14. Effectiveness of community based Safe Motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania.

    Science.gov (United States)

    Mushi, Declare; Mpembeni, Rose; Jahn, Albrecht

    2010-04-01

    In Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%), only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania. This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs). Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues. Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (rho utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

  15. Participatory science and innovation for improved sanitation and hygiene: process and outcome evaluation of project SHINE, a school-based intervention in Rural Tanzania

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    Erin Hetherington

    2017-02-01

    Full Text Available Abstract Background Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene. Methods Based in rural and remote Tanzania, this pilot study engaged pastoralist high-school students and communities in the development and evaluation of culturally and contextually relevant strategies to improve sanitation and hygiene. Using a train-the-trainer approach, key activities included teacher workshops, school-based lessons, extra-curricular activities, community events and a One Health sanitation science fair which showcased projects related to water, sanitation and hygiene in relation to human and animal health. The process and outcome of the study were evaluated through qualitative interviews and focus group discussions with diverse project participants, as well as pre- and post- questionnaires completed by students on knowledge, attitudes and practices concerning sanitation and hygiene. Results The questionnaire results at baseline and follow-up showed statistically significant improvements on key measures including a decrease in unhygienic behaviors, an increase in the perceived importance of handwashing and intention to use the toilet, and increased communication in the social network about the importance of clean water and improved sanitation and hygiene practices, however there were no significant changes in sanitation related knowledge. Qualitative data highlighted strong leadership emerging from youth and enthusiasm from teachers and students concerning the overall approach in the project, including the use of participatory methods. There was a high degree of community engagement with hundreds of

  16. Effectiveness of an integrated intervention in the control of endo- and ectoparasites of pigs kept by smallholder farmers in Mbeya rural and Mbozi districts, Tanzania

    DEFF Research Database (Denmark)

    Kabululu, Mwemezi Lutakyawa; Ngowi, Helena Aminiel; Kimera, Sharadhuli Iddi

    2018-01-01

    This study was conducted to evaluate effectiveness of an integrated management intervention in the control of endo- and ectoparasites of pigs kept by smallholder farmers in Mbeya Rural and Mbozi districts of southern highlands of Tanzania. A repeated cross-sectional group randomization design...... and ectoparasites, but no effect on sero-prevalence of PC. The reported ineffectiveness of the intervention against PC is probably an underestimation because serology is not able to provide quantitative data. It may also be a result of reduced compliance as this was a field study. Nevertheless, further studies...... was used to measure intervention effect by comparing changes from baseline values of prevalence and faecal egg counts between the two groups. No significant difference (p > 0.05) was observed between the two groups, in changes from baseline of sero-prevalence of PC. The intervention significantly reduced...

  17. "Hoping for a normal life again": reintegration after fistula repair in rural Tanzania.

    Science.gov (United States)

    Teddy Mselle, Lilian; Evjen-Olsen, Bjørg; Marie Moland, Karen; Mvungi, Abu; Wankuru Kohi, Thecla

    2012-10-01

    To explore women's expectations, worries, and hopes related to returning to their family and community after fistula repair. We used a concurrent mixed methods design with a hospital survey and qualitative interviews. One hundred fifty-one women completed a questionnaire, eight were interviewed in hospital after fistula repair, and one woman was followed up at home for six months during the reintegration phase. Women were concerned about where they could live and about not being accepted by their husbands and in-laws. While 51% feared that their husbands would not accept them despite full recovery, 53% said their parents would accept them. In the qualitative study women wished to live with their parents, whereas almost one half (49.7%) of the women in the quantitative study, who had lived with fistula for a shorter time, wished to live with their husbands. All women hoped to have children in the future, although many women, especially those with no children, were worried about whether they could bear children in the future. Despite fears related to economic survival and social acceptance, women were optimistic about regaining a normal social life. Women's expectations of going home after fistula repair are linked to their history of living with obstetric fistula. For women who have lived with a fistula for many years, reintegration involves re-establishing an identity that is clean and respected. To facilitate this transition, fistula repair needs to be accompanied by psychological and social rehabilitation and assistance in returning to reproductive capabilities.

  18. Cost of installing and operating an electronic clinical decision support system for maternal health care: case of Tanzania rural primary health centres.

    Science.gov (United States)

    Saronga, Happiness Pius; Dalaba, Maxwell Ayindenaba; Dong, Hengjin; Leshabari, Melkizedeck; Sauerborn, Rainer; Sukums, Felix; Blank, Antje; Kaltschmidt, Jens; Loukanova, Svetla

    2015-04-02

    Poor quality of care is among the causes of high maternal and newborn disease burden in Tanzania. Potential reason for poor quality of care is the existence of a "know-do gap" where by health workers do not perform to the best of their knowledge. An electronic clinical decision support system (CDSS) for maternal health care was piloted in six rural primary health centers of Tanzania to improve performance of health workers by facilitating adherence to World Health Organization (WHO) guidelines and ultimately improve quality of maternal health care. This study aimed at assessing the cost of installing and operating the system in the health centers. This retrospective study was conducted in Lindi, Tanzania. Costs incurred by the project were analyzed using Ingredients approach. These costs broadly included vehicle, computers, furniture, facility, CDSS software, transport, personnel, training, supplies and communication. These were grouped into installation and operation cost; recurrent and capital cost; and fixed and variable cost. We assessed the CDSS in terms of its financial and economic cost implications. We also conducted a sensitivity analysis on the estimations. Total financial cost of CDSS intervention amounted to 185,927.78 USD. 77% of these costs were incurred in the installation phase and included all the activities in preparation for the actual operation of the system for client care. Generally, training made the largest share of costs (33% of total cost and more than half of the recurrent cost) followed by CDSS software- 32% of total cost. There was a difference of 31.4% between the economic and financial costs. 92.5% of economic costs were fixed costs consisting of inputs whose costs do not vary with the volume of activity within a given range. Economic cost per CDSS contact was 52.7 USD but sensitive to discount rate, asset useful life and input cost variations. Our study presents financial and economic cost estimates of installing and operating an

  19. The influence of perceived behaviour control, attitude and empowerment on reported condom use and intention to use condoms among adolescents in rural Tanzania.

    Science.gov (United States)

    Kalolo, Albino; Kibusi, Stephen Matthew

    2015-11-13

    Despite the declining trends of Human immunodeficiency virus (HIV) infection in Sub-Saharan Africa (SSA), unsafe sexual behaviours among adolescents still represent a public health challenge. It is important to understand factors acting at different levels to influence sexual behaviour among adolescents. This study examined the influence of perceived behaviour control, subjective norms, attitudes and empowerment on intention to use condoms and reported use of condoms among adolescents in rural Tanzania. We used a questionnaire to collect data from 403 adolescents aged 14 through 19 years from nine randomly selected secondary schools in the Newala district located in the Southern part of Tanzania. The self-administered questionnaire collected information on sexual practices and factors such as attitudes, subjective norms, perceived behaviour control and empowerment. Binary logistic regression was performed to identify factors associated with intention to use and reported use of condoms. Sexually active adolescents constituted 40.6 % of the sample, among them 49.7 % did not use a condom at last sexual intercourse and 49.8 % had multiple sex partners. Many (85 %) of sexually active respondents had their sexual debut between the ages of 14 to 17 years. Girls became sexually active earlier than boys. Perceived behaviour control predicted intentions to use condoms (AOR = 3.059, 95 % CI 1.324-7.065), thus demonstrating its importance in the decision to use a condom. Empowerment (odds ratio = 3.694, 95 % CI 1.295-10.535) and a positive attitude (AOR = 3.484, 95 % CI 1.132-10.72) predicted reported condom use, thus turning the decision to actions. Subjective norms had only indirect effects on intention and reported use of condoms. The findings suggest that unsafe sex practices are prevalent among school adolescents in rural areas of Tanzania. Perceived behaviour control and positive attitudes predict intensions to use condoms whereas empowerment

  20. Increased proportions of outdoor feeding among residual malaria vector populations following increased use of insecticide-treated nets in rural Tanzania

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    Azizi Salum

    2011-04-01

    Full Text Available Abstract Background Insecticide-treated nets (ITNs and indoor residual spraying (IRS represent the front-line tools for malaria vector control globally, but are optimally effective where the majority of baseline transmission occurs indoors. In the surveyed area of rural southern Tanzania, bed net use steadily increased over the last decade, reducing malaria transmission intensity by 94%. Methods Starting before bed nets were introduced (1997, and then after two milestones of net use had been reached-75% community-wide use of untreated nets (2004 and then 47% use of ITNs (2009-hourly biting rates of malaria vectors from the Anopheles gambiae complex and Anopheles funestus group were surveyed. Results In 1997, An. gambiae s.l. and An. funestus mosquitoes exhibited a tendency to bite humans inside houses late at night. For An. gambiae s.l., by 2009, nocturnal activity was less (p = 0.0018. At this time, the sibling species composition of the complex had shifted from predominantly An. gambiae s.s. to predominantly An. arabiensis. For An. funestus, by 2009, nocturnal activity was less (p = 0.0054 as well as the proportion biting indoors (p An. funestus s.s. remained the predominant species within this group. As a consequence of these altered feeding patterns, the proportion (mean ± standard error of human contact with mosquitoes (bites per person per night occurring indoors dropped from 0.99 ± 0.002 in 1997 to 0.82 ± 0.008 in 2009 for the An. gambiae complex (p = 0.0143 and from 1.00 ± An. funestus complex (p = 0.0004 over the same time period. Conclusions High usage of ITNs can dramatically alter African vector populations so that intense, predominantly indoor transmission is replaced by greatly lowered residual transmission, a greater proportion of which occurs outdoors. Regardless of the underlying mechanism, the residual, self-sustaining transmission will respond poorly to further insecticidal measures within houses. Additional vector control

  1. Parental control and monitoring of young people's sexual behaviour in rural North-Western Tanzania: Implications for sexual and reproductive health interventions

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    Urassa Mark

    2011-02-01

    Full Text Available Abstract Background Parenting through control and monitoring has been found to have an effect on young people's sexual behaviour. There is a dearth of literature from sub-Saharan Africa on this subject. This paper examines parental control and monitoring and the implications of this on young people's sexual decision making in a rural setting in North-Western Tanzania. Methods This study employed an ethnographic research design. Data collection involved 17 focus group discussions and 46 in-depth interviews conducted with young people aged 14-24 years and parents/carers of young people within this age-group. Thematic analysis was conducted with the aid of NVIVO 7 software. Results Parents were motivated to control and monitor their children's behaviour for reasons such as social respectability and protecting them from undesirable sexual and reproductive health (SRH outcomes. Parental control and monitoring varied by family structure, gender, schooling status, a young person's contribution to the economic running of the family and previous experience of a SRH outcome such as unplanned pregnancy. Children from single parent families reported that they received less control compared to those from both parent families. While a father's presence in the family seemed important in controlling the activities of young people, a mother's did not have a similar effect. Girls especially those still schooling received more supervision compared to boys. Young women who had already had unplanned pregnancy were not supervised as closely as those who hadn't. Parents employed various techniques to control and monitor their children's sexual activities. Conclusions Despite parents making efforts to control and monitor their young people's sexual behaviour, they are faced with several challenges (e.g. little time spent with their children which make it difficult for them to effectively monitor them. There is a need for interventions such as parenting skills building

  2. Participatory science and innovation for improved sanitation and hygiene: process and outcome evaluation of project SHINE, a school-based intervention in Rural Tanzania.

    Science.gov (United States)

    Hetherington, Erin; Eggers, Matthijs; Wamoyi, Joyce; Hatfield, Jennifer; Manyama, Mange; Kutz, Susan; Bastien, Sheri

    2017-02-07

    Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education) is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene. Based in rural and remote Tanzania, this pilot study engaged pastoralist high-school students and communities in the development and evaluation of culturally and contextually relevant strategies to improve sanitation and hygiene. Using a train-the-trainer approach, key activities included teacher workshops, school-based lessons, extra-curricular activities, community events and a One Health sanitation science fair which showcased projects related to water, sanitation and hygiene in relation to human and animal health. The process and outcome of the study were evaluated through qualitative interviews and focus group discussions with diverse project participants, as well as pre- and post- questionnaires completed by students on knowledge, attitudes and practices concerning sanitation and hygiene. The questionnaire results at baseline and follow-up showed statistically significant improvements on key measures including a decrease in unhygienic behaviors, an increase in the perceived importance of handwashing and intention to use the toilet, and increased communication in the social network about the importance of clean water and improved sanitation and hygiene practices, however there were no significant changes in sanitation related knowledge. Qualitative data highlighted strong leadership emerging from youth and enthusiasm from teachers and students concerning the overall approach in the project, including the use of participatory methods. There was a high degree of community engagement with hundreds of community members participating in school-based events

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

    Science.gov (United States)

    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

  4. Tanzania | Page 22 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Language French. Read more about Quality Improvement for Maternal and Newborn Health in Mtwara Region, Tanzania (IMCHA). Language English. Read more about Building an Enhanced Cadre of Community Health Workers to Improve Maternal and Newborn Health in Rural Tanzania (IMCHA). Language English.

  5. Development of a Geographical Information System for the monitoring of the health infrastructure in rural areas in Tanzania

    Directory of Open Access Journals (Sweden)

    Jürgen Schweikart

    2008-12-01

    Full Text Available

    Background: Setting up Geographical Information Systems (GIS on the existing health infrastructure and ongoing and planned interventions in public health in Tanzania is still in its infancy. While there are several activities on gathering information and attempts of documentation there does not exist an overall systematic approach of generally capturing all health related facts and bringing them together into a unique information system yet. In order to strengthen the information system in the health sector in general, and to assist Ministry of Health and Social Welfare (MoHSW in better receiving an overview of health related infrastructure and intervention data for management purpose, a first-pilot GIS was built up in the Mbeya Region in cooperation with Tanzanian German Programme to Support Health (TGPSH/Gesellschaft für technische Zusammenarbeit (GTZ.

    Methods: The Health-GIS contains information on all health facilities (HF in the region and their infrastructure. Therefore, personal interviews were conducted in selected HF based on a comprehensive questionnaire. The spatial coordinates of the HF were taken with a Global Positioning System (GPS. In a relational database, the newly coded HF are linked to the gathered information pertaining to them and in a second step are analysed and visualised with help of GIS. Results: First results show newly collected geometry and attribute data for a considerable number of HFs in Mbeya Region, which are then supplemented by information on the street network lately surveyed during the fieldtrip. With the help of a database management system (DBMS all information are stored and maintained within one health database. By their spatial relation, data may be analysed and mapped with a Health-GIS. Because of the targeted cooperation with people and institutions from the local health sector, the way for integrating the Health-GIS into the health

  6. Out-of-pocket costs and other determinants of access to healthcare for children with febrile illnesses: a case-control study in rural Tanzania.

    Directory of Open Access Journals (Sweden)

    Joëlle Castellani

    Full Text Available To study private costs and other determinants of access to healthcare for childhood fevers in rural Tanzania.A case-control study was conducted in Tanzania to establish factors that determine access to a health facility in acute febrile illnesses in children less than 5 years of age. Carers of eligible children were interviewed in the community; cases were represented by patients who went to a facility and controls by those who did not. A Household Wealth Index was estimated using principal components analysis. A multivariable logistic regression analysis was performed to understand the factors which influenced attendance of healthcare facility including severity of the illness and household wealth/socio-demographic indicators. To complement the data on costs from community interviews, a hospital-based study obtained details of private expenditures for hospitalised children under the age of 5.Severe febrile illness is strongly associated with health facility attendance (OR: 35.76, 95%CI: 3.68-347.43, p = 0.002 compared with less severe febrile illness. Overall, the private costs of an illness for patients who went to a hospital were six times larger than private costs of controls ($5.68 vs. $0.90, p<0.0001. Household wealth was not significantly correlated with total costs incurred. The separate hospital based cost study indicated that private costs were three times greater for admissions at the mission versus public hospital: $13.68 mission vs. $4.47 public hospital (difference $ 9.21 (95% CI: 7.89 -10.52, p<0.0001. In both locations, approximately 50% of the cost was determined by the duration of admission, with each day in hospital increasing private costs by about 12% (95% CI: 5% - 21%.The more severely ill a child, the higher the probability of attending hospital. We did not find association between household wealth and attending a health facility; nor was there an association between household wealth and private cost.

  7. ‘It is just the way it was in the past before I went to test’: a qualitative study to explore responses to HIV prevention counselling in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Caoimhe Cawley

    2016-06-01

    Full Text Available Abstract Background Voluntary counselling and testing (VCT for HIV first evolved in Western settings, with one aim being to promote behaviours which lower the risk of onward transmission or acquisition of HIV. However, although quantitative studies have shown that the impact of VCT on sexual behaviour change has been limited in African settings, there is a lack of qualitative research exploring perceptions of HIV prevention counselling messages, particularly among clients testing HIV-negative. We conducted a qualitative study to explore healthcare worker, community and both HIV-negative and HIV-positive clients’ perceptions of HIV prevention counselling messages in rural Tanzania. Methods This study was carried out within the context of an ongoing community HIV cohort study in Kisesa, northwest Tanzania. Nine group sessions incorporating participatory learning and action (PLA activities were conducted in order to gain general community perspectives of HIV testing and counselling (HTC services. Thirty in-depth interviews (IDIs with HIV-negative and HIV-positive service users explored individual perceptions of HIV prevention counselling messages, while five IDIs were carried out with nurses or counsellors offering HTC in order to explore provider perspectives. Results Two key themes revolving around socio-cultural and contextual factors emerged in understanding responses to HIV prevention counselling messages. The first included constraints to client-counsellor interactions, which were impeded as a result of difficulties discussing private sexual behaviours during counselling sessions, a hierarchical relationship between healthcare providers and clients, insufficient levels of training and support for counsellors, and client concerns about confidentiality. The second theme related to imbalanced gender-power dynamics, which constrained the extent to which women felt able to control their HIV-related risk. Conclusion Within the broader social

  8. Verbal autopsy completion rate and factors associated with undetermined cause of death in a rural resource-poor setting of Tanzania

    Directory of Open Access Journals (Sweden)

    Maliti Deodatus V

    2011-08-01

    Full Text Available Abstract Background Verbal autopsy (VA is a widely used tool to assign probable cause of death in areas with inadequate vital registration systems. Its uses in priority setting and health planning are well documented in sub-Saharan Africa (SSA and Asia. However, there is a lack of data related to VA processing and completion rates in assigning causes of death in a community. There is also a lack of data on factors associated with undetermined causes of death documented in SSA. There is a need for such information for understanding the gaps in VA processing and better estimating disease burden. Objective The study's intent was to determine the completion rate of VA and factors associated with assigning undetermined causes of death in rural Tanzania. Methods A database of deaths reported from the Ifakara Health and Demographic Surveillance System from 2002 to 2007 was used. Completion rates were determined at the following stages of processing: 1 death identified; 2 VA interviews conducted; 3 VA forms submitted to physicians; 4 coding and assigning of cause of death. Logistic regression was used to determine factors associated with deaths coded as "undetermined." Results The completion rate of VA after identification of death and the VA interview ranged from 83% in 2002 and 89% in 2007. Ninety-four percent of deaths submitted to physicians were assigned a specific cause, with 31% of the causes coded as undetermined. Neonates and child deaths that occurred outside health facilities were associated with a high rate of undetermined classification (33%, odds ratio [OR] = 1.33, 95% confidence interval [CI] (1.05, 1.67, p = 0.016. Respondents reporting high education levels were less likely to be associated with deaths that were classified as undetermined (24%, OR = 0.76, 95% CI (0.60, -0.96, p = 0.023. Being a child of the deceased compared to a partner (husband or wife was more likely to be associated with undetermined cause of death classification

  9. Demographic, knowledge, attitudinal, and accessibility factors associated with uptake of cervical cancer screening among women in a rural district of Tanzania: three public policy implications.

    Science.gov (United States)

    Lyimo, Frida S; Beran, Tanya N

    2012-01-10

    Cervical cancer is an important public health problem worldwide, which comprises approximately 12% of all cancers in women. In Tanzania, the estimated incidence rate is 30 to 40 per 100,000 women, indicating a high disease burden. Cervical cancer screening is acknowledged as currently the most effective approach for cervical cancer control, and it is associated with reduced incidence and mortality from the disease. The aim of the study was to identify the most important factors related to the uptake of cervical cancer screening among women in a rural district of Tanzania. A cross sectional study was conducted with a sample of 354 women aged 18 to 69 years residing in Moshi Rural District. A multistage sampling technique was used to randomly select eligible women. A one-hour interview was conducted with each woman in her home. The 17 questions were modified from similar questions used in previous research. Less than one quarter (22.6%) of the participants had obtained cervical cancer screening. The following characteristics, when examined separately in relation to the uptake of cervical cancer screening service, were significant: husband approval of cervical cancer screening, women's level of education, women's knowledge of cervical cancer and its prevention, women's concerns about embarrassment and pain of screening, women's preference for the sex of health provider, and women's awareness of and distance to cervical cancer screening services. When examined simultaneously in a logistic regression, we found that only knowledge of cervical cancer and its prevention (OR = 8.90, 95%CI = 2.14-16.03) and distance to the facility which provides cervical cancer screening (OR = 3.98, 95%CI = 0.18-5.10) were significantly associated with screening uptake. Based on the study findings, three recommendations are made. First, information about cervical cancer must be presented to women. Second, public education of the disease must include specific information on how to prevent it

  10. Potential use of mobile phones in improving animal health service delivery in underserved rural areas: experience from Kilosa and Gairo districts in Tanzania.

    Science.gov (United States)

    Karimuribo, Esron D; Batamuzi, Emmanuel K; Massawe, Lucas B; Silayo, Richard S; Mgongo, Frederick O K; Kimbita, Elikira; Wambura, Raphael M

    2016-10-07

    Sub-optimal performance of the animal health delivery system in rural areas is common in developing countries including Tanzania. However, penetration of mobile phones and availability of good road network and public transport systems offer opportunities for improving the access of rural communities to diagnostic and advisory services from facilities and expertise located in urban areas. A questionnaire survey on possession and use of mobile phones by pastoral and agro-pastoral communities in Kilosa and Gairo districts was carried out between November and December 2015. A total number of 138 livestock keepers from three villages of Chakwale (54), Mvumi (41) and Parakuyo (43) participated in the study. An e-based system was designed and tested to link rural communities with urban diagnostic facilities. It was observed that the average number of phones possessed by individuals interviewed and household families was 1.1 ± 0.26 (1-2) and 3.5 ± 2.23 (1-10), respectively. It was further observed that out of 138 livestock keepers interviewed, 133 (96.4 %) had feature phones while 10 (7.2 %) of them possessed smartphones. Mobile phone is currently used to support livestock production by communicating on animal health in Parakuyo (18, 41.9 %), Mvumi (18, 43.9 %) and Chakwale (14, 25.9 %). Other contributions of mobile phones in livestock and crop agriculture observed in the study area include: exchange of livestock price information, crop price information, communicating on plant health/diseases, livestock extension and advisory services as well as crop farming extension and advisory services. We also designed and tested an e-based SUAVetDiag® system to support timely diagnosis of infectious disease conditions and prompt advice on case management in veterinary underserved areas. Availability of mobile phones in rural areas, in combination with supporting infrastructure and facilities in urban areas, has potential to stimulate local development and improving

  11. The costs of introducing artemisinin-based combination therapy: evidence from district-wide implementation in rural Tanzania.

    Science.gov (United States)

    Njau, Joseph D; Goodman, Catherine A; Kachur, S Patrick; Mulligan, Jo; Munkondya, John S; McHomvu, Naiman; Abdulla, Salim; Bloland, Peter; Mills, Anne

    2008-01-07

    The development of antimalarial drug resistance has led to increasing calls for the introduction of artemisinin-based combination therapy (ACT). However, little evidence is available on the full costs associated with changing national malaria treatment policy. This paper presents findings on the actual drug and non-drug costs associated with deploying ACT in one district in Tanzania, and uses these data to estimate the nationwide costs of implementation in a setting where identification of malaria cases is primarily dependant on clinical diagnosis. Detailed data were collected over a three year period on the financial costs of providing ACT in Rufiji District as part of a large scale effectiveness evaluation, including costs of drugs, distribution, training, treatment guidelines and other information, education and communication (IEC) materials and publicity. The district-level costs were scaled up to estimate the costs of nationwide implementation, using four scenarios to extrapolate variable costs. The total district costs of implementing ACT over the three year period were slightly over one million USD, with drug purchases accounting for 72.8% of this total. The composite (best) estimate of nationwide costs for the first three years of ACT implementation was 48.3 million USD (1.29 USD per capita), which varied between 21 and 67.1 million USD in the sensitivity analysis (2003 USD). In all estimates drug costs constituted the majority of total costs. However, non-drug costs such as IEC materials, drug distribution, communication, and health worker training were also substantial, accounting for 31.4% of overall ACT implementation costs in the best estimate scenario. Annual implementation costs are equivalent to 9.5% of Tanzania's recurrent health sector budget, and 28.7% of annual expenditure on medical supplies, implying a 6-fold increase in the national budget for malaria treatment. The costs of implementing ACT are substantial. Although drug purchases

  12. Use of Modern Birth Control Methods Among Rural Communities in ...

    African Journals Online (AJOL)

    elearning

    ABSTRACT. This paper studied the extent of utilization of Modern Birth Control Methods (MBCM) among rural dwellers in ... respondents used MBCM while 57% of them used the traditional birth control methods. ..... School of Public Health.

  13. Estimating the prevalence and intensity of Schistosoma mansoni infection among rural communities in Western Tanzania

    DEFF Research Database (Denmark)

    Bakuza, Jared S.; Denwood, Matthew J.; Nkwengulila, Gamba

    2017-01-01

    with sex or age. Conclusions/Significance Overall, our data suggest a more widespread distribution of S. mansoni in this part of Tanzania than was previously thought. The apparent prevalence estimates substantially under-estimated the true prevalence as determined by the ZINB models, and the two types......) models with explanatory variables of site, sex, and age. The ZINB models indicated that a substantial proportion of the observed zero FWEC reflected a failure to detect eggs in truly infected individuals, meaning that the estimated true prevalence was much higher than the apparent prevalence...... of sampling strategies also resulted in differing conclusions regarding prevalence of infection. We therefore recommend that future surveillance programmes designed to assess risk factors should use active sampling whenever possible, in order to avoid the self-selection bias associated with passive sampling....

  14. Are schools a good setting for adolescent sexual health promotion in rural Africa? A qualitative assessment from Tanzania.

    Science.gov (United States)

    Plummer, Mary L; Wight, D; Wamoyi, J; Nyalali, K; Ingall, T; Mshana, G; Shigongo, Z S; Obasi, A I N; Ross, D A

    2007-08-01

    African adolescents are at high risk of poor sexual health. School-based interventions could reach many adolescents in a sustainable and replicable way, if enrolment, funding and infrastructure are adequate. This study examined pupils', recent school leavers', parents' and teachers' views and experiences of rural Tanzanian primary schools, focusing on the implications for potential sexual health programmes. From 1999 to 2002, participant observation was conducted in nine villages for 158 person-weeks. Half of Year 7 pupils were 15-17 years old, and few went on to secondary school, suggesting that primary schools may be a good venue for such programmes. However, serious challenges include low enrolment and attendance rates, limited teacher training, little access to teaching resources and official and unofficial practices that may alienate pupils and their parents, e.g. corporal punishment, pupils being made to do unpaid work, forced pregnancy examinations, and some teachers' alcohol or sexual abuse. At a national level, improved teacher training and supervision are critical, as well as policies that better prevent, identify and correct undesired practices. At a programme level, intervention developers need to simplify the subject matter, introduce alternative teaching methods, help improve teacher-pupil and teacher-community relationships, and closely supervise and appropriately respond to undesired practices.

  15. A random spatial sampling method in a rural developing nation

    Science.gov (United States)

    Michelle C. Kondo; Kent D.W. Bream; Frances K. Barg; Charles C. Branas

    2014-01-01

    Nonrandom sampling of populations in developing nations has limitations and can inaccurately estimate health phenomena, especially among hard-to-reach populations such as rural residents. However, random sampling of rural populations in developing nations can be challenged by incomplete enumeration of the base population. We describe a stratified random sampling method...

  16. Tracing Improving Livelihoods in Rural Africa Using Local Measures of Wealth: A Case Study from Central Tanzania, 1991–2016

    Directory of Open Access Journals (Sweden)

    Wilhelm Östberg

    2018-04-01

    Full Text Available We studied livelihood changes and poverty dynamics over a 25-year period in two villages in central Tanzania. The villages were, from the early 1990s and 2000s, strikingly poor with between 50% and 55% of families in the poorest wealth groups. 25 years later much has changed: people have become substantially wealthier, with 64% and 71% in the middle wealth groups. The new wealth had been generated locally, from farming, particularly of sunflowers as a cash crop. This goes against a conventional view of small-scale farming in Tanzania as being stagnant or unproductive. The area of land farmed per family has increased, almost doubling in one village. People have made money, which they invest in mechanised farming, improved housing, education of their children, livestock, and consumer goods. Improved infrastructure and local entrepreneurs have played key roles in the area’s transformation. Locally identified wealth rankings showed that most villagers, those in the middle wealth groups and above, can now support themselves from their land, which is a notable change to a time when 71% and 82% in each village respectively depended on casual labour for their survival. This change has come at a cost to the environment. By 2016, the village forests have largely gone and been replaced by farms. Farmers were concerned that the climate was turning drier because of deforestation. Studying the mundane—the material used in roofs, the size of farms, and so on made it possible to trace and understand the radical transition the area has experienced.

  17. Understanding the Challenges of Improving Sanitation and Hygiene Outcomes in a Community Based Intervention: A Cross-Sectional Study in Rural Tanzania.

    Science.gov (United States)

    Kamara, Joseph Kihika; Galukande, Moses; Maeda, Florence; Luboga, Sam; Renzaho, Andre M N

    2017-06-05

    Good sanitation and clean water are basic human rights yet they remain elusive to many rural communities in Sub-Saharan Africa (SSA). We carried out a cross sectional study to examine the impact of a four-year intervention aimed at improving access to water and sanitation and reducing waterborne disease, especially diarrhea in children under five years old. The study was carried out in April and May 2015 in Busangi, Chela and Ntobo wards of Kahama District of Tanzania. The interventions included education campaigns and improved water supply, and sanitation. The percentage of households (HHs) with access to water within 30 min increased from 19.2 to 48.9 and 17.6 to 27.3 in the wet and dry seasons, respectively. The percentage of HHs with hand washing facilities at the latrine increased from 0% to 13.2%. However, the incidence of diarrhea among children under five years increased over the intervention period, RR 2.91 95% CI 2.71-3.11, p < 0.0001. Availability of water alone may not influence the incidence of waterborne diseases. Factors such as water storage and usage, safe excreta disposal and other hygiene practices are critical for interventions negating the spread of water borne diseases. A model that articulates the extent to which these factors are helpful for such interventions should be explored.

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

    Directory of Open Access Journals (Sweden)

    Helen Prytherch

    2012-10-01

    Full Text Available 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

  19. Understanding the uneven spread of HIV within Africa: comparative study of biologic, behavioral, and contextual factors in rural populations in Tanzania and Zimbabwe.

    Science.gov (United States)

    Boerma, J Ties; Gregson, Simon; Nyamukapa, Constance; Urassa, Mark

    2003-10-01

    Large differences in the spread of HIV have been observed within sub-Saharan Africa. The goal was to identify factors that could explain differences in the spread of HIV within sub-Saharan African populations. Ecologic comparison of data from population-based surveys in high and relatively low HIV prevalence rural areas in Zimbabwe, Manicaland, and Tanzania, Kisesa. HIV prevalence in Manicaland and Kisesa was 15.4% and 5.3% in men aged 17-44 years and 21.1% and 8.0% in women aged 15-44 years (odds ratios, 3.3 and 3.1, respectively). Marriage is later, spatial mobility more common, cohabitation with marital partners less frequent, education levels are higher, and male circumcision is less common in Manicaland. However, adjustment for differences in these factors increased the odds ratios for HIV infection in Manicaland versus Kisesa to 6.9 and 4.8 for men and women, respectively. Sexually transmitted infection levels were similar, but syphilis was only common in Kisesa. Respondents in Kisesa started sex earlier and reported more sexual partners. Age differences between partners were similar in the 2 locations. Substantial differences exist between the contemporary sociodemographic profiles of rural Manicaland and Kisesa. However, these differences did not translate into measurable differences in the biologic or behavioral factors for which data were available and did not explain the much higher HIV prevalence found in Manicaland. These findings might reflect more extensive AIDS-selective mortality and behavior change or greater bias in reporting of sexual behavior in Zimbabwe.

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

    Science.gov (United States)

    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

  1. USING ANALYTIC HIERARCHY PROCESS (AHP METHOD IN RURAL DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Tülay Cengiz

    2003-04-01

    Full Text Available Rural development is a body of economical and social policies towards improving living conditions in rural areas through enabling rural population to utilize economical, social, cultural and technological blessing of city life in place, without migrating. As it is understood from this description, rural development is a very broad concept. Therefore, in development efforts problem should be stated clearly, analyzed and many criterias should be evaluated by experts. Analytic Hierarchy Process (AHP method can be utilized at there stages of development efforts. AHP methods is one of multi-criteria decision method. After degrading a problem in smaller pieces, relative importance and level of importance of two compared elements are determined. It allows evaluation of quality and quantity factors. At the same time, it permits utilization of ideas of many experts and use them in decision process. Because mentioned features of AHP method, it could be used in rural development works. In this article, cultural factors, one of the important components of rural development is often ignored in many studies, were evaluated as an example. As a result of these applications and evaluations, it is concluded that AHP method could be helpful in rural development efforts.

  2. Evaluating the impact of continuous quality improvement methods at hospitals in Tanzania: a cluster-randomized trial.

    Science.gov (United States)

    Kamiya, Yusuke; Ishijma, Hisahiro; Hagiwara, Akiko; Takahashi, Shizu; Ngonyani, Henook A M; Samky, Eleuter

    2017-02-01

    To evaluate the impact of implementing continuous quality improvement (CQI) methods on patient's experiences and satisfaction in Tanzania. Cluster-randomized trial, which randomly allocated district-level hospitals into treatment group and control group, was conducted. Sixteen district-level hospitals in Kilimanjaro and Manyara regions of Tanzania. Outpatient exit surveys targeting totally 3292 individuals, 1688 in the treatment and 1604 in the control group, from 3 time-points between September 2011 and September 2012. Implementation of the 5S (Sort, Set, Shine, Standardize, Sustain) approach as a CQI method at outpatient departments over 12 months. Cleanliness, waiting time, patient's experience, patient's satisfaction. The 5S increased cleanliness in the outpatient department, patients' subjective waiting time and overall satisfaction. However, negligible effects were confirmed for patient's experiences on hospital staff behaviours. The 5S as a CQI method is effective in enhancing hospital environment and service delivery; that are subjectively assessed by outpatients even during the short intervention period. Nevertheless, continuous efforts will be needed to connect CQI practices with the further improvement in the delivery of quality health care. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  3. Effect of National Schistosomiasis Control Programme on Taenia solium taeniosis and porcine cysticercosis in rural communities of Tanzania

    Directory of Open Access Journals (Sweden)

    Uffe Christian Braae

    2016-09-01

    Full Text Available Taenia solium is found throughout sub-Saharan Africa and co-endemic with schistosomiasis in many regions. Taenia solium leads to taeniosis and neurocysticercosis - the leading cause of preventable epilepsy globally. This study aimed to assess the effects of the National Schistosomiasis Control Programme on prevalence of taeniosis and porcine cysticercosis over a four year period in Tanzania. School-based mass drug administration (MDA of praziquantel was carried out based on schistosomiasis endemicity. Four human and five porcine cross-sectional surveys were carried out from 2012 to 2015 in Mbozi and Mbeya district in Tanzania. Three rounds of school-based MDA of praziquantel were delivered in Mbozi and two in Mbeya. The prevalence of taeniosis and porcine cysticercosis was estimated annually. Stool samples were collected from humans and prevalence of taeniosis estimated by copro-Ag-ELISA. Blood samples from pigs were collected to estimate cysticercosis prevalence by Ag-ELISA. “Track-and-treat” of taeniosis cases was carried out after each survey. In total 12082 stool samples and 4579 porcine serum samples were collected. Significantly fewer children (≤15 from Mbozi were infected throughout the study than children from Mbeya who showed a significant decrease in copro-Ag prevalence after the first treatment only. During the final survey in Mbozi the prevalence of taeniosis in adults (1.8% was significantly lower (p = 0.031, OR 0.40, CI: 0.17–0.89, compared to baseline (4.1%. The prevalence of porcine cysticercosis (8% had also dropped significantly (p = 0.002, OR 0.49, CI: 0.32–0.76 in this district compared to baseline (13%, whereas no significant difference was seen in Mbeya compared to baseline. The study suggests that three rounds of MDA targeting schistosomiasis in school-aged children combined with ‘track-and-treat’ contributed to a reduction in prevalence of T. solium in this population, and also had a spillover effect on

  4. Effect of National Schistosomiasis Control Programme on Taenia solium taeniosis and porcine cysticercosis in rural communities of Tanzania.

    Science.gov (United States)

    Braae, Uffe Christian; Magnussen, Pascal; Harrison, Wendy; Ndawi, Benedict; Lekule, Faustin; Johansen, Maria Vang

    2016-09-01

    Taenia solium is found throughout sub-Saharan Africa and co-endemic with schistosomiasis in many regions. Taenia solium leads to taeniosis and neurocysticercosis - the leading cause of preventable epilepsy globally. This study aimed to assess the effects of the National Schistosomiasis Control Programme on prevalence of taeniosis and porcine cysticercosis over a four year period in Tanzania. School-based mass drug administration (MDA) of praziquantel was carried out based on schistosomiasis endemicity. Four human and five porcine cross-sectional surveys were carried out from 2012 to 2015 in Mbozi and Mbeya district in Tanzania. Three rounds of school-based MDA of praziquantel were delivered in Mbozi and two in Mbeya. The prevalence of taeniosis and porcine cysticercosis was estimated annually. Stool samples were collected from humans and prevalence of taeniosis estimated by copro-Ag-ELISA. Blood samples from pigs were collected to estimate cysticercosis prevalence by Ag-ELISA. "Track-and-treat" of taeniosis cases was carried out after each survey. In total 12082 stool samples and 4579 porcine serum samples were collected. Significantly fewer children (≤ 15) from Mbozi were infected throughout the study than children from Mbeya who showed a significant decrease in copro-Ag prevalence after the first treatment only. During the final survey in Mbozi the prevalence of taeniosis in adults (1.8%) was significantly lower (p = 0.031, OR 0.40, CI: 0.17-0.89), compared to baseline (4.1%). The prevalence of porcine cysticercosis (8%) had also dropped significantly (p = 0.002, OR 0.49, CI: 0.32-0.76) in this district compared to baseline (13%), whereas no significant difference was seen in Mbeya compared to baseline. The study suggests that three rounds of MDA targeting schistosomiasis in school-aged children combined with 'track-and-treat' contributed to a reduction in prevalence of T. solium in this population, and also had a spillover effect on adults in treated

  5. Involving traditional birth attendants in emergency obstetric care in Tanzania: policy implications of a study of their knowledge and practices in Kigoma Rural District.

    Science.gov (United States)

    Vyagusa, Dismas B; Mubyazi, Godfrey M; Masatu, Melchiory

    2013-10-14

    Access to quality maternal health services mainly depends on existing policies, regulations, skills, knowledge, perceptions, and economic power and motivation of service givers and target users. Critics question policy recommending involvement of traditional birth attendants (TBAs) in emergency obstetric care (EmoC) services in developing countries. This paper reports about knowledge and practices of TBAs on EmoC in Kigoma Rural District, Tanzania and discusses policy implications on involving TBAs in maternal health services. 157 TBAs were identified from several villages in 2005, interviewed and observed on their knowledge and practice in relation to EmoC. Quantitative and qualitative techniques were used for data collection and analysis depending on the nature of the information required. Among all 157 TBAs approached, 57.3% were aged 50+ years while 50% had no formal education. Assisting mothers to deliver without taking their full pregnancy history was confessed by 11% of all respondents. Having been attending pregnant women with complications was experienced by 71.2% of all respondents. Only 58% expressed adequate knowledge on symptoms and signs of pregnancy complications. Lack of knowledge on possible risk of HIV infections while assisting childbirth without taking protective gears was claimed by 5.7% of the respondents. Sharing the same pair of gloves between successful deliveries was reported to be a common practice by 21.1% of the respondents. Use of unsafe delivery materials including local herbs and pieces of cloth for protecting themselves against HIV infections was reported as being commonly practiced among 27.6% of the respondents. Vaginal examination before and during delivery was done by only a few respondents. TBAs in Tanzania are still consulted by people living in underserved areas. Unfortunately, TBAs' inadequate knowledge on EmOC issues seems to have contributed to the rising concerns about their competence to deliver the recommended maternal

  6. A Randomized Longitudinal Factorial Design to Assess Malaria Vector Control and Disease Management Interventions in Rural Tanzania

    Directory of Open Access Journals (Sweden)

    Randall A. Kramer

    2014-05-01

    Full Text Available The optimization of malaria control strategies is complicated by constraints posed by local health systems, infrastructure, limited resources, and the complex interactions between infection, disease, and treatment. The purpose of this paper is to describe the protocol of a randomized factorial study designed to address this research gap. This project will evaluate two malaria control interventions in Mvomero District, Tanzania: (1 a disease management strategy involving early detection and treatment by community health workers using rapid diagnostic technology; and (2 vector control through community-supported larviciding. Six study villages were assigned to each of four groups (control, early detection and treatment, larviciding, and early detection and treatment plus larviciding. The primary endpoint of interest was change in malaria infection prevalence across the intervention groups measured during annual longitudinal cross-sectional surveys. Recurring entomological surveying, household surveying, and focus group discussions will provide additional valuable insights. At baseline, 962 households across all 24 villages participated in a household survey; 2,884 members from 720 of these households participated in subsequent malariometric surveying. The study design will allow us to estimate the effect sizes of different intervention mixtures. Careful documentation of our study protocol may also serve other researchers designing field-based intervention trials.

  7. A randomized longitudinal factorial design to assess malaria vector control and disease management interventions in rural Tanzania.

    Science.gov (United States)

    Kramer, Randall A; Mboera, Leonard E G; Senkoro, Kesheni; Lesser, Adriane; Shayo, Elizabeth H; Paul, Christopher J; Miranda, Marie Lynn

    2014-05-16

    The optimization of malaria control strategies is complicated by constraints posed by local health systems, infrastructure, limited resources, and the complex interactions between infection, disease, and treatment. The purpose of this paper is to describe the protocol of a randomized factorial study designed to address this research gap. This project will evaluate two malaria control interventions in Mvomero District, Tanzania: (1) a disease management strategy involving early detection and treatment by community health workers using rapid diagnostic technology; and (2) vector control through community-supported larviciding. Six study villages were assigned to each of four groups (control, early detection and treatment, larviciding, and early detection and treatment plus larviciding). The primary endpoint of interest was change in malaria infection prevalence across the intervention groups measured during annual longitudinal cross-sectional surveys. Recurring entomological surveying, household surveying, and focus group discussions will provide additional valuable insights. At baseline, 962 households across all 24 villages participated in a household survey; 2,884 members from 720 of these households participated in subsequent malariometric surveying. The study design will allow us to estimate the effect sizes of different intervention mixtures. Careful documentation of our study protocol may also serve other researchers designing field-based intervention trials.

  8. Electricity's effect on gender equality in rural Zanzibar, Tanzania : case study for Gender and Energy World Development Report Background Paper

    NARCIS (Netherlands)

    Winther, Tanja

    2012-01-01

    This anthropological case study on the introduction of electricity in rural Zanzibar around 1990 discusses to what extent and how women became empowered in the process. What factors contributed to increased gender equality during the uptake of electricity and related appliances – and what were the

  9. Where do the rural poor deliver when high coverage of health facility delivery is achieved? Findings from a community and hospital survey in Tanzania.

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    Manuela Straneo

    Full Text Available As part of maternal mortality reducing strategies, coverage of delivery care among sub-Saharan African rural poor will improve, with a range of facilities providing services. Whether high coverage will benefit all socio-economic groups is unknown. Iringa rural District, Southern Tanzania, with high facility delivery coverage, offers a paradigm to address this question. Delivery services are available in first-line facilities (dispensaries, health centres and one hospital. We assessed whether all socio-economic groups access the only comprehensive emergency obstetric care facility equally, and surveyed existing delivery services.District population characteristics were obtained from a household community survey (n = 463. A Hospital survey collected data on women who delivered in this facility (n = 1072. Principal component analysis on household assets was used to assess socio-economic status. Hospital population socio-demographic characteristics were compared to District population using multivariable logistic regression. Deliveries' distribution in District facilities and staffing were analysed using routine data.Women from the hospital compared to the District population were more likely to be wealthier. Adjusted odds ratio of hospital delivery increased progressively across socio-economic groups, from 1.73 for the poorer (p = 0.0031 to 4.53 (p<0.0001 for the richest. Remarkable dispersion of deliveries and poor staffing were found. In 2012, 5505/7645 (72% institutional deliveries took place in 68 first-line facilities, the remaining in the hospital. 56/68 (67.6% first-line facilities reported ≤100 deliveries/year, attending 33% of deliveries. Insufficient numbers of skilled birth attendants were found in 42.9% of facilities.Poorer women remain disadvantaged in high coverage, as they access lower level facilities and are under-represented where life-saving transfusions and caesarean sections are available. Tackling the challenges

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

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    Mselle Lilian T

    2011-10-01

    Full Text Available Abstract 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

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

    Science.gov (United States)

    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

  12. Obstacles to prompt and effective malaria treatment lead to low community-coverage in two rural districts of Tanzania

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    Dillip Angel

    2008-09-01

    Full Text Available Abstract Background Malaria is still a leading child killer in sub-Saharan Africa. Yet, access to prompt and effective malaria treatment, a mainstay of any malaria control strategy, is sub-optimal in many settings. Little is known about obstacles to treatment and community-effectiveness of case-management strategies. This research quantified treatment seeking behaviour and access to treatment in a highly endemic rural Tanzanian community. The aim was to provide a better understanding of obstacles to treatment access in order to develop practical and cost-effective interventions. Methods We conducted community-based treatment-seeking surveys including 226 recent fever episodes in 2004 and 2005. The local Demographic Surveillance System provided additional household information. A census of drug retailers and health facilities provided data on availability and location of treatment sources. Results After intensive health education, the biomedical concept of malaria has largely been adopted by the community. 87.5% (78.2–93.8 of the fever cases in children and 80.7% (68.1–90.0 in adults were treated with one of the recommended antimalarials (at the time SP, amodiaquine or quinine. However, only 22.5% (13.9–33.2 of the children and 10.5% (4.0–21.5 of the adults received prompt and appropriate antimalarial treatment. Health facility attendance increased the odds of receiving an antimalarial (OR = 7.7 but did not have an influence on correct dosage. The exemption system for under-fives in public health facilities was not functioning and drug expenditures for children were as high in health facilities as with private retailers. Conclusion A clear preference for modern medicine was reflected in the frequent use of antimalarials. Yet, quality of case-management was far from satisfactory as was the functioning of the exemption mechanism for the main risk group. Private drug retailers played a central role by complementing existing formal health

  13. Tanzania | Page 29 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Corn, cassava and pulses are the main food sources in rural Tanzania. Meat is scarce for rural populations, and don't expect to find carrots, kale or squash at the local market! Animal products – particularly offal –, green vegetables and orange fruits and vegetables are the best sources of vitamin A. As a result, Tanzanians ...

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

  16. Effectiveness of a Home-Based Counselling Strategy on Neonatal Care and Survival: A Cluster-Randomised Trial in Six Districts of Rural Southern Tanzania.

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    Claudia Hanson

    2015-09-01

    Full Text Available We report a cluster-randomised trial of a home-based counselling strategy, designed for large-scale implementation, in a population of 1.2 million people in rural southern Tanzania. We hypothesised that the strategy would improve neonatal survival by around 15%.In 2010 we trained 824 female volunteers to make three home visits to women and their families during pregnancy and two visits to them in the first few days of the infant's life in 65 wards, selected randomly from all 132 wards in six districts in Mtwara and Lindi regions, constituting typical rural areas in Southern Tanzania. The remaining wards were comparison areas. Participants were not blinded to the intervention. The primary analysis was an intention-to-treat analysis comparing the neonatal mortality (day 0-27 per 1,000 live births in intervention and comparison wards based on a representative survey in 185,000 households in 2013 with a response rate of 90%. We included 24,381 and 23,307 live births between July 2010 and June 2013 and 7,823 and 7,555 live births in the last year in intervention and comparison wards, respectively. We also compared changes in neonatal mortality and newborn care practices in intervention and comparison wards using baseline census data from 2007 including 225,000 households and 22,243 births in five of the six intervention districts. Amongst the 7,823 women with a live birth in the year prior to survey in intervention wards, 59% and 41% received at least one volunteer visit during pregnancy and postpartum, respectively. Neonatal mortality reduced from 35.0 to 30.5 deaths per 1,000 live births between 2007 and 2013 in the five districts, respectively. There was no evidence of an impact of the intervention on neonatal survival (odds ratio [OR] 1.1, 95% confidence interval [CI] 0.9-1.2, p = 0.339. Newborn care practices reported by mothers were better in intervention than in comparison wards, including immediate breastfeeding (42% of 7,287 versus 35% of 7

  17. The potential role of mother-in-law in prevention of mother-to-child transmission of HIV: a mixed methods study from the Kilimanjaro region, northern Tanzania

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    Leshabari Sebalda

    2011-07-01

    Full Text Available Abstract Background In the Kilimanjaro region the mother-in-law has traditionally had an important role in matters related to reproduction and childcare. The aim of this study was to explore the role of the mothers-in-law in prevention of mother-to-child transmission (PMTCT service utilization and adherence to infant feeding guidelines. Methods The study was conducted during 2007-2008 in rural and urban areas of Moshi district in the Kilimanjaro region of Tanzania. Mixed methods were used and included focus group discussions with mothers-in-law, mothers and fathers; in-depth interviews with mothers-in-law, mothers, fathers and HIV-infected mothers, and a survey of 446 mothers bringing their four-week-old infants for immunisation at five reproductive and child health clinics. Results The study demonstrated that the mother-in-law saw herself as responsible for family health issues in general and child care in particular. However she received limited trust, and couples, in particular couples living in urban areas, tended to exclude her from decisions related to childbearing and infant feeding. Mothers-in-law expected their daughters-in-law to breastfeed in a customary manner and were generally negative towards the infant feeding methods recommended for HIV-infected mothers; exclusive replacement feeding and exclusive breastfeeding. Conclusions Decreasing influence of the mother-in-law and increasing prominence of the conjugal couples in issues related to reproduction and child care, reinforce the importance of continued efforts to include male partners in the PMTCT programme. The potential for involving mothers-in-law in the infant feeding component, where she still has influence in some areas, should be further explored.

  18. Impact of rotavirus vaccine introduction and post-introduction etiology of diarrhea requiring hospital admission in Haydom, Tanzania, a rural African setting.

    Science.gov (United States)

    Platts-Mills, James A; Amour, Caroline; Gratz, Jean; Nshama, Rosemary; Walongo, Thomas; Mujaga, Buliga; Maro, Athanasia; McMurry, Timothy L; Liu, Jie; Mduma, Estomih; Houpt, Eric R

    2017-05-29

    No data are available on the etiology of diarrhea requiring hospitalization after rotavirus vaccine introduction in Africa. The monovalent rotavirus vaccine was introduced in Tanzania on January 1, 2013. We performed a vaccine impact and effectiveness study as well as a qPCR-based etiology study at a rural Tanzanian hospital. We obtained data on admissions among children under 5 years to Haydom Lutheran Hospital between January 1, 2010 and December 31, 2015, and estimated the impact of vaccine introduction on all-cause diarrhea admissions. We then performed a vaccine effectiveness study using the test-negative design. Finally, we tested diarrheal specimens during 2015 by qPCR for a broad range of enteropathogens and calculated pathogen-specific attributable fractions. Vaccine introduction was associated with a 44.9% (95% CI 17.6 - 97.4) reduction in diarrhea admissions in 2015, as well as delay of the rotavirus season. The effectiveness of two doses of vaccine was 74.8% (-8.2 - 94.1) using an enzyme immunoassay-based case definition and 85.1% (26.5 - 97.0) using a qPCR-based case definition. Among 146 children enrolled in 2015, rotavirus remained the leading etiology of diarrhea requiring hospitalization (AF 25.8%, 95% CI: 24.4 - 26.7), followed by heat-stabile enterotoxin-producing E. coli (18.4%, 12.9 - 21.9), Shigella/enteroinvasive E. coli (14.5%, 10.2 - 22.8), and Cryptosporidium (7.9%, 6.2 - 9.3). Despite the clear impact of vaccine introduction in this setting, rotavirus remained the leading etiology of diarrhea requiring hospitalization. Further efforts to maximize vaccine coverage and improve vaccine performance in these settings are warranted. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  19. "We have been working overnight without sleeping": traditional birth attendants' practices and perceptions of post-partum care services in rural Tanzania.

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    Mahiti, Gladys R; Kiwara, Angwara D; Mbekenga, Columba K; Hurtig, Anna-Karin; Goicolea, Isabel

    2015-02-03

    In many low-income countries, formal post-partum care utilization is much lower than that of skilled delivery and antenatal care. While Traditional Birth Attendants (TBAs) might play a role in post-partum care, research exploring their attitudes and practices during this period is scarce. Therefore, the aim of this study was to explore TBAs' practices and perceptions in post-partum care in rural Tanzania. Qualitative in-depth interview data were collected from eight untrained and three trained TBAs. Additionally, five multiparous women who were clients of untrained TBAs were also interviewed. Interviews were conducted in February 2013. Data were digitally recorded and transcribed verbatim. Qualitative content analysis was used to analyze data. Our study found that TBAs take care of women during post-partum with rituals appreciated by women. They report lacking formal post-partum care training, which makes them ill-equipped to detect and handle post-partum complications. Despite their lack of preparation, they try to provide care for some post-partum complications which could put the health of the woman at risk. TBAs perceive that utilization of hospital-based post-partum services among women was only important for the baby and for managing complications which they cannot handle. They are poorly linked with the health system. This study found that the TBAs conducted close follow-ups and some of their practices were appreciated by women. However, the fact that they were trying to manage certain post-partum complications can put women at risk. These findings point out the need to enhance the communication between TBAs and the formal health system and to increase the quality of the TBA services, especially in terms of prompt referral, through provision of training, mentoring, monitoring and supervision of the TBA services.

  20. The effectiveness of birth plans in increasing use of skilled care at delivery and postnatal care in rural Tanzania: a cluster randomised trial.

    Science.gov (United States)

    Magoma, Moke; Requejo, Jennifer; Campbell, Oona; Cousens, Simon; Merialdi, Mario; Filippi, Veronique

    2013-04-01

    To determine the effectiveness of birth plans in increasing use of skilled care at delivery and in the postnatal period among antenatal care (ANC) attendees in a rural district with low occupancy of health units for delivery but high antenatal care uptake in northern Tanzania. Cluster randomised trial in Ngorongoro district, Arusha region, involving 16 health units (8 per arm). Nine hundred and five pregnant women at 24 weeks of gestation and above (404 in the intervention arm) were recruited and followed up to at least 1 month postpartum. Skilled delivery care uptake was 16.8% higher in the intervention units than in the control [95% CI 2.6-31.0; P = 0.02]. Postnatal care utilisation in the first month of delivery was higher (difference in proportions: 30.0% [95% CI 1.3-47.7; P < 0.01]) and also initiated earlier (mean duration 6.6 ± 1.7 days vs. 20.9 ± 4.4 days, P < 0.01) in the intervention than in the control arm. Women's and providers' reports of care satisfaction (received or provided) did not differ greatly between the two arms of the study (difference in proportion: 12.1% [95% CI -6.3-30.5] P = 0.17 and 6.9% [95% CI -3.2-17.1] P = 0.15, respectively). Implementation of birth plans during ANC can increase the uptake of skilled delivery and post delivery care in the study district without negatively affecting women's and providers' satisfaction with available ANC services. Birth plans should be considered along with the range of other recommended interventions as a strategy to improve the uptake of maternal health services. © 2013 Blackwell Publishing Ltd.

  1. The chicken or the egg? Exploring bi-directional associations between Newcastle disease vaccination and village chicken flock size in rural Tanzania.

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    Julia de Bruyn

    Full Text Available Newcastle disease (ND is a viral disease of poultry with global importance, responsible for the loss of a potential source of household nutrition and economic livelihood in many low-income food-deficit countries. Periodic outbreaks of this endemic disease result in high mortality amongst free-ranging chicken flocks and may serve as a disincentive for rural households to invest time or resources in poultry-keeping. Sustainable ND control can be achieved through vaccination using a thermotolerant vaccine administered via eyedrop by trained "community vaccinators". This article evaluates the uptake and outcomes of fee-for-service ND vaccination programs in eight rural villages in the semi-arid central zone of Tanzania. It represents part of an interdisciplinary program seeking to address chronic undernutrition in children through improvements to existing poultry and crop systems. Newcastle disease vaccination uptake was found to vary substantially across communities and seasons, with a significantly higher level of vaccination amongst households participating in a longitudinal study of children's growth compared with non-participating households (p = 0.009. Two multivariable model analyses were used to explore associations between vaccination and chicken numbers, allowing for clustered data and socioeconomic and cultural variation amongst the population. Results demonstrated that both (a households that undertook ND vaccination had a significantly larger chicken flock size in the period between that vaccination campaign and the next compared with those that did not vaccinate (p = 0.018; and (b households with larger chicken flocks at the time of vaccination were significantly more likely to participate in vaccination programs (p < 0.001. Additionally, households vaccinating in all three vaccination campaigns held over 12 months were identified to have significantly larger chicken flocks at the end of this period (p < 0.001. Opportunities to

  2. All projects related to tanzania | Page 2 | IDRC - International ...

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    In Tanzania, the maternal mortality rate of 454 deaths per 100,000 live births means that ... and employment options in poor rural communities in Rwanda and Tanzania. ... of fruit results in post-harvest losses of nearly 40% in tropical countries.

  3. Why do women not adhere to advice on maternal referral in rural Tanzania? Narratives of women and their family members.

    Science.gov (United States)

    Pembe, Andrea B; Mbekenga, Columba K; Olsson, Pia; Darj, Elisabeth

    2017-01-01

    In most low-income countries, many women with high-risk pregnancies and complications do not reach the referral hospitals despite the provision of referral advice. To explore how antenatal maternal referral advice is understood and handled in a rural Tanzanian community. Individual in-depth interviews were conducted with six women who did not go to hospital and 13 people who were involved in the referral advice. Narrative analysis was used to describe and create meanings out of the decision-making process. In all interviews, not following the referral advice was greatly influenced by close family members. Three main traits of how referral advice was understood emerged: convinced referral is not necessary, accepting referral advice but delayed by others, and passive and moving with the wind. The main reasons given for declining the referral advice included discrediting midwives' advice, citing previous successful deliveries despite referral advice; being afraid of undergoing surgery; lack of support for care of siblings at home; and high costs incurred during referral. Declining maternal referral advice centred around the pregnant women's position and their dependence on the family members around them, with a decreased ability to show autonomy. If they were socially and economically empowered, women could positively influence decision making during maternal referrals.

  4. Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme.

    Science.gov (United States)

    Hetzel, Manuel W; Iteba, Nelly; Makemba, Ahmed; Mshana, Christopher; Lengeler, Christian; Obrist, Brigit; Schulze, Alexander; Nathan, Rose; Dillip, Angel; Alba, Sandra; Mayumana, Iddy; Khatib, Rashid A; Njau, Joseph D; Mshinda, Hassan

    2007-06-29

    Prompt access to effective treatment is central in the fight against malaria. However, a variety of interlinked factors at household and health system level influence access to timely and appropriate treatment and care. Furthermore, access may be influenced by global and national health policies. As a consequence, many malaria episodes in highly endemic countries are not treated appropriately. The ACCESS Programme aims at understanding and improving access to prompt and effective malaria treatment and care in a rural Tanzanian setting. The programme's strategy is based on a set of integrated interventions, including social marketing for improved care seeking at community level as well as strengthening of quality of care at health facilities. This is complemented by a project that aims to improve the performance of drug stores. The interventions are accompanied by a comprehensive set of monitoring and evaluation activities measuring the programme's performance and (health) impact. Baseline data demonstrated heterogeneity in the availability of malaria treatment, unavailability of medicines and treatment providers in certain areas as well as quality problems with regard to drugs and services. The ACCESS Programme is a combination of multiple complementary interventions with a strong evaluation component. With this approach, ACCESS aims to contribute to the development of a more comprehensive access framework and to inform and support public health professionals and policy-makers in the delivery of improved health services.

  5. Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme

    Directory of Open Access Journals (Sweden)

    Alba Sandra

    2007-06-01

    Full Text Available Abstract Background Prompt access to effective treatment is central in the fight against malaria. However, a variety of interlinked factors at household and health system level influence access to timely and appropriate treatment and care. Furthermore, access may be influenced by global and national health policies. As a consequence, many malaria episodes in highly endemic countries are not treated appropriately. Project The ACCESS Programme aims at understanding and improving access to prompt and effective malaria treatment and care in a rural Tanzanian setting. The programme's strategy is based on a set of integrated interventions, including social marketing for improved care seeking at community level as well as strengthening of quality of care at health facilities. This is complemented by a project that aims to improve the performance of drug stores. The interventions are accompanied by a comprehensive set of monitoring and evaluation activities measuring the programme's performance and (health impact. Baseline data demonstrated heterogeneity in the availability of malaria treatment, unavailability of medicines and treatment providers in certain areas as well as quality problems with regard to drugs and services. Conclusion The ACCESS Programme is a combination of multiple complementary interventions with a strong evaluation component. With this approach, ACCESS aims to contribute to the development of a more comprehensive access framework and to inform and support public health professionals and policy-makers in the delivery of improved health services.

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

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    Mubyazi Godfrey M

    2012-02-01

    Full Text Available Abstract 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

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

    Science.gov (United States)

    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

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    Leveraging Indigenous Knowledge to Create Jobs for Women in Rural Areas ... Region: India, Kenya, Sri Lanka, Tanzania, Trinidad and Tobago, West Indies, Canada ... growth rates in East Africa, the effects of growth on poverty reduction and ...

  9. Cognitive stimulation therapy as a low-resource intervention for dementia in sub-Saharan Africa (CST-SSA): Adaptation for rural Tanzania and Nigeria.

    Science.gov (United States)

    Mkenda, Sarah; Olakehinde, Olaide; Mbowe, Godfrey; Siwoku, Akeem; Kisoli, Aloyce; Paddick, Stella-Maria; Adediran, Babatunde; Gray, William K; Dotchin, Catherine L; Adebiyi, Akinpelumi; Walker, Richard W; Mushi, Declare; Ogunniyi, Adesola

    2016-06-21

    Cognitive stimulation therapy is a non-pharmacological intervention for people with dementia. Its use has been associated with substantial improvements in cognition and quality of life in studies from high-income countries, equivalent to those achieved by pharmacological treatments. Cognitive stimulation therapy may be particularly suited to low resource settings, such as sub-Saharan Africa, because it requires little specialist equipment and can be delivered by non-specialist health workers. The aim of this study was to adapt cognitive stimulation therapy for use in sub-Saharan Africa taking into account socio-cultural differences and resource implications. Cognitive stimulation therapy is a structured programme, originally developed in the United Kingdom. Substantial adaptations were required for use in sub-Saharan Africa. The formative method for adapting psychotherapy was used as a framework for the adaption process. The feasibility of using the adapted cognitive stimulation therapy programme to manage dementia was assessed in Tanzania and Nigeria in November 2013. Further adaptations were made following critical appraisal of feasibility. The adapted cognitive stimulation therapy intervention appeared feasible and acceptable to participants and carers. Key adaptations included identification of suitable treatment settings, task adaptation to accommodate illiteracy and uncorrected sensory impairment, awareness of cultural differences and usage of locally available materials and equipment to ensure sustainability. Cognitive stimulation therapy was successfully adapted for use in sub-Saharan Africa. Future work will focus on a trial of cognitive stimulation therapy in each setting. © The Author(s) 2016.

  10. Prevention of mother-to-child transmission of HIV Option B+ cascade in rural Tanzania: The One Stop Clinic model.

    Directory of Open Access Journals (Sweden)

    Anna Gamell

    Full Text Available Strategies to improve the uptake of Prevention of Mother-To-Child Transmission of HIV (PMTCT are needed. We integrated HIV and maternal, newborn and child health services in a One Stop Clinic to improve the PMTCT cascade in a rural Tanzanian setting.The One Stop Clinic of Ifakara offers integral care to HIV-infected pregnant women and their families at one single place and time. All pregnant women and HIV-exposed infants attended during the first year of Option B+ implementation (04/2014-03/2015 were included. PMTCT was assessed at the antenatal clinic (ANC, HIV care and labour ward, and compared with the pre-B+ period. We also characterised HIV-infected pregnant women and evaluated the MTCT rate.1,579 women attended the ANC. Seven (0.4% were known to be HIV-infected. Of the remainder, 98.5% (1,548/1,572 were offered an HIV test, 94% (1,456/1,548 accepted and 38 (2.6% tested HIV-positive. 51 were re-screened for HIV during late pregnancy and one had seroconverted. The HIV prevalence at the ANC was 3.1% (46/1,463. Of the 39 newly diagnosed women, 35 (90% were linked to care. HIV test was offered to >98% of ANC clients during both the pre- and post-B+ periods. During the post-B+ period, test acceptance (94% versus 90.5%, p<0.0001 and linkage to care (90% versus 26%, p<0.0001 increased. Ten additional women diagnosed outside the ANC were linked to care. 82% (37/45 of these newly-enrolled women started antiretroviral treatment (ART. After a median time of 17 months, 27% (12/45 were lost to follow-up. 79 women under HIV care became pregnant and all received ART. After a median follow-up time of 19 months, 6% (5/79 had been lost. 5,727 women delivered at the hospital, 20% (1,155/5,727 had unknown HIV serostatus. Of these, 30% (345/1,155 were tested for HIV, and 18/345 (5.2% were HIV-positive. Compared to the pre-B+ period more women were tested during labour (30% versus 2.4%, p<0.0001. During the study, the MTCT rate was 2.2%.The implementation of

  11. The use of nominal group technique in identifying community health priorities in Moshi rural district, northern Tanzania

    DEFF Research Database (Denmark)

    Makundi, E A; Manongi, R; Mushi, A K

    2005-01-01

    in the list implying that priorities should not only be focused on diseases, but should also include health services and social cultural issues. Indeed, methods which are easily understood and applied thus able to give results close to those provided by the burden of disease approaches should be adopted....... The patients/caregivers, women's group representatives, youth leaders, religious leaders and community leaders/elders constituted the principal subjects. Emphasis was on providing qualitative data, which are of vital consideration in multi-disciplinary oriented studies, and not on quantitative information from....... It is the provision of ownership of the derived health priorities to partners including the community that enhances research utilization of the end results. In addition to disease-based methods, the Nominal Group Technique is being proposed as an important research tool for involving the non-experts in priority...

  12. Effect of national schistosomiasis control programme on Taenia solium taeniosis and porcine cysticercosis in rural communities of Tanzania

    DEFF Research Database (Denmark)

    Braae, Uffe Christian; Magnussen, Pascal; Harrison, Wendy

    2016-01-01

    and Mbeya district in Tanzania. Three rounds of school-based MDA of praziquantel were delivered in Mbozi and two in Mbeya. The prevalence of taeniosis and porcine cysticercosis was estimated annually. Stool samples were collected from humans and prevalence of taeniosis estimated by copro-Ag-ELISA. Blood...

  13. Identification of rural landscape classes through a GIS clustering method

    Directory of Open Access Journals (Sweden)

    Irene Diti

    2013-09-01

    Full Text Available The paper presents a methodology aimed at supporting the rural planning process. The analysis of the state of the art of local and regional policies focused on rural and suburban areas, and the study of the scientific literature in the field of spatial analysis methodologies, have allowed the definition of the basic concept of the research. The proposed method, developed in a GIS, is based on spatial metrics selected and defined to cover various agricultural, environmental, and socio-economic components. The specific goal of the proposed methodology is to identify homogeneous extra-urban areas through their objective characterization at different scales. Once areas with intermediate urban-rural characters have been identified, the analysis is then focused on the more detailed definition of periurban agricultural areas. The synthesis of the results of the analysis of the various landscape components is achieved through an original interpretative key which aims to quantify the potential impacts of rural areas on the urban system. This paper presents the general framework of the methodology and some of the main results of its first implementation through an Italian case study.

  14. Changes in oral health related knowledge, attitudes and behaviours following school based oral health education and atraumatic restorative treatment in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Anne Nordrehaug Åstrøm

    2012-05-01

    Full Text Available Objectives: The following questions were addressed; to what extent is sugar consumption, tooth brushing, and oral health related attitudes and knowledge subject to change following a combined atraumatic restorative treatment (ART /oral health education (OHE program? Are changes in intended sugar avoidance associated with changes in cognitions as specified by the Theory of Planned Behaviour (TPB? Are changes in oral health related knowledge associated with changes in attitudes and oral health behaviour?Method: A total of 1306 (follow-up prevalence 73.8% primary school students in Kilwa, Tanzania completed interviews before and after a combined ART/OHE program. Post intervention at 6 months follow-up assessed changes in oral health related knowledge, attitudes, and behaviours. Complete baseline and follow-up interviews were obtained from 221 and 1085 students who received ART/OHE and OHE only at schools, respectively.Results: Improvement was obtained with attitudes towards sugar avoidance, knowledge, and tooth brushing (effect sizes in the range 0.1-0.3. Within individual changes did not differ significantly between students receiving ART/ OHE and OHE only. Change scores of intended sugar avoidance associated in the expected direction with changes in sugar consumption. Attitudes and norms with respect to sugar avoidance deteriorated and improved among subjects who respectively decreased and increased intended sugar avoidance. Tooth brushing increased in students who improved oral knowledge.Conclusion: School based ART/OHE improved pupils’ tooth brushing, knowledge, and attitudes, but had no effect on sugar consumption. This study provided support for the validity of the TPB in predicting changes in intended sugar avoidance and reported sugar intake.

  15. Tanzania | Page 19 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Language English. Read more about Bourses de recherche pour la lutte antitabac en Afrique. Language French. Read more about Tobacco Control Research Scholarships in Africa. Language English. Read more about Leveraging Indigenous Knowledge to Create Jobs for Women in Rural Areas of Tanzania and Rwanda.

  16. CHECKLIST OF THE MILLIPEDES (DIPLOPODA) OF TANZANIA

    African Journals Online (AJOL)

    However, these many-legged animals are not insects (which have three .... Simon Stuart, who was carrying out studies on birds, contributed many specimens ... Diversity Project of November 1994 provided a series of millipede specimens. ... Tanzania records: Morogoro Region, Morogoro Rural Distr., Uluguru Mts, Lupanga.

  17. Lymphatic filariasis control in Tanga Region, Tanzania

    DEFF Research Database (Denmark)

    Simonsen, Paul Erik; Derua, Yahya A.; Magesa, Stephen M.

    2014-01-01

    BackgroundLymphatic filariasis (LF) control started in Tanga Region of Tanzania in 2004, with annual ivermectin/albendazole mass drug administration (MDA). Since then, the current project has monitored the effect in communities and schools in rural areas of Tanga District. In 2013, after 8 rounds...

  18. Tanzania : Productive Jobs Wanted

    OpenAIRE

    World Bank Group

    2014-01-01

    Over the past 18 months, the World Bank has been working on a comprehensive plan to address the challenge of productive jobs in Tanzania. This study represents a step towards a better understanding of how to promote job creation in Tanzania. Indeed, the growth of productive jobs is vital for alleviating poverty and promoting shared prosperity - two important goals of Tanzania's economic st...

  19. Migration from rural to urban habitat in Tropical Africa (1970-2000).

    Science.gov (United States)

    Ankerl, G G

    1982-01-01

    Problems associated with rural-urban migration in Tropical Africa are examined, with particular reference to the experience of Ghana, Kenya, Nigeria, Tanzania, and Zaire. The problems examined include overurbanization, maldistribution of population, poor urban living conditions, population density, and traditional methods of construction.

  20. On the way to universal coverage of maternal services in Iringa rural ...

    African Journals Online (AJOL)

    Methods: Data was collected through a household survey of 464 women with a recent delivery. Primary .... both in bivariate and multivariate analysis to account for clustered design. ... applied by Bernard et al17 in rural Tanzania, a context very similar to that of the ..... reflected a lack of statistical power, though large effects.

  1. Individual Local Farmers’ Perceptions of Environmental Change in Tanzania

    Directory of Open Access Journals (Sweden)

    Lina Röschel

    2018-04-01

    Full Text Available Climatic and environmental changes are expected to affect in particular those regions where the economy is primarily based on the agricultural sector and where the dependency on water availability is high. This study examines how smallholder farmers in rural Tanzania perceived climatic and environmental changes over the past 20 years and the resulting effects on water availability and food security. The study is based on a household survey of 899 farmers in a semi-arid and a sub-humid region in Tanzania. It was found that (a significant differences in perceptions of the environment by farmers can be attributed to agro-climatic location, while the distance to a water source has less impact on individual perception; (b differently perceived changes affect individual water availability and food security; and (c the farm level adaptation methods applied are linked to vulnerability to changes and the household dependence on the immediate environment. The authors conclude that the specific environmental surroundings paired with socio-economic factors can severely compound the negative effects of water scarcity on rural farmers.

  2. Exploring Foreign Tourists’ Image of Tanzania

    DEFF Research Database (Denmark)

    Nandonde, Felix Adamu

    2015-01-01

    In the last decade, the economy of African continent and Tanzania in particular has witnessed a business boom of the tourism sector. While the sector has continued to grow and become a dependable source of direct and indirect employment to youths in urban and rural areas, the sector has been awash...... with challenges. These challenges include terrorism attacks, energy crises and poor infrastructure. However, the impact of these challenges on the image of Tanzania as a tourist destination has not received the deserved attention. This study explores the perception of visitors towards Tanzania as a tourist....... Front line employees, various tourist sites and access to services emerged to be strong tourist destination image factors. This implies that the efforts of marketing tourism destination should focus on promoting all the sites the country has....

  3. Utilising a collective case study system theory mixed methods approach: a rural health example.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2014-07-28

    Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services

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

    Science.gov (United States)

    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.

  5. Developing a Pictorial Sisterhood Method in collaboration with illiterate Maasai traditional birth attendants in northern Tanzania

    NARCIS (Netherlands)

    Roggeveen, Yadira; Schreuder, Renske; Zweekhorst, Marjolein; Manyama, Mange; Hatfield, Jennifer; Scheele, Fedde; van Roosmalen, Jos

    2016-01-01

    Objective To study whether data on maternal mortality can be gathered while maintaining local ownership of data in a pastoralist setting where a scarcity of data sources and a culture of silence around maternal death amplifies limited awareness of the magnitude of maternal mortality. Methods As part

  6. Developing a Pictorial Sisterhood Method in collaboration with illiterate Maasai traditional birth attendants in northern Tanzania.

    Science.gov (United States)

    Roggeveen, Yadira; Schreuder, Renske; Zweekhorst, Marjolein; Manyama, Mange; Hatfield, Jennifer; Scheele, Fedde; van Roosmalen, Jos

    2016-10-01

    To study whether data on maternal mortality can be gathered while maintaining local ownership of data in a pastoralist setting where a scarcity of data sources and a culture of silence around maternal death amplifies limited awareness of the magnitude of maternal mortality. As part of a participatory action research project, investigators and illiterate traditional birth attendants (TBAs) collaboratively developed a quantitative participatory tool-the Pictorial Sisterhood Method-that was pilot-tested between March 12 and May 30, 2011, by researchers and TBAs in a cross-sectional study. Fourteen TBAs interviewed 496 women (sample), which led to 2241 sister units of risk and a maternal mortality ratio of 689 deaths per 100000 live births (95% confidence interval 419-959). Researchers interviewed 474 women (sample), leading to 1487 sister units of risk and a maternal mortality ratio of 484 (95% confidence interval 172-795). The Pictorial Sisterhood Method is an innovative application that might increase the participation of illiterate individuals in maternal health research and advocacy. It offers interesting opportunities to increase maternal mortality data ownership and awareness, and warrants further study and validation. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Temperature Changes, Household Consumption and Internal Migration: Evidence from Tanzania

    OpenAIRE

    Kalle Hirvonen

    2015-01-01

    Large rural-urban wage gaps observed in many developing countries are suggestive of barriers to migration that keep potential migrants in the rural areas. Using long panel data spanning nearly two decades, I study the extent to which migration rates are constrained by liquidity constraints in rural Tanzania. The analysis begins by quantifying the impact of weather variation on household welfare. The results show how household consumption co-moves with temperature rendering households vulnerab...

  8. Prioritization of intervention methods for prevention of communicable diseases in Tanzania

    Science.gov (United States)

    Mayo, A. W.

    Water, sanitation, housing and hygienic behavior plays dominant role in the transmission and intensification of diseases. To effectively utilize limited financial resources, it is important to prioritize disease intervention methods in order to minimize mortality and morbidity cases. Realization of the environmental health components that respond to the practical effects of their contribution to transmission of diseases has greater chances of effectively enhancing health. Data of frequency of diseases and mortality rate were collected from four municipal hospitals from districts of Ilala, Kinondoni, Temeke and Kibaha in Dar es Salaam and Coast Regions. The populations at risk were sub-categorized in relation to age; below five years and above five years. The age parameter assists on envisaging the major causes to be either in-house or in public domain. Data were analyzed to assess the role of water quality, water quantity, excreta disposal, waste disposal and hygiene education on spreading the diseases in order to come up with scientifically evaluated information. Scores were given to each intervention method depending on its importance in controlling a particular disease. The results indicate that incidences of malaria, skin and eye infections, pneumonia and diarrhea are frequent in these districts. Children under 5 years are particularly affected by pneumonia and diarrhea more than adults. Malaria, tuberculosis and pneumonia are the major causes of mortality rates in these districts. Fatality cases are caused largely by malaria, pneumonia and diarrhea for children less than 5 years, but malaria, tuberculosis and pneumonia are responsible for mortality rates in adults and children over 5 years. Statistical analysis revealed that in all districts, hygiene education is the major factor responsible for transmission of diseases accounting for 32-39%. Other factors, which are the major contributors to the incidences of diseases, are inadequacy of water (15.6-22.5%) and

  9. Sexual practices among unmarried adolescents in Tanzania

    OpenAIRE

    Kazaura, Method R; Masatu, Melkiory C

    2009-01-01

    Abstract 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 question...

  10. Socio-economic comparison between traditional and improved cultivation methods in agroforestry systems, East Usambara Mountains, Tanzania.

    Science.gov (United States)

    Reyes, Teija; Quiroz, Roberto; Msikula, Shija

    2005-11-01

    The East Usambara Mountains, recognized as one of the 25 most important biodiversity hot spots in the world, have a high degree of species diversity and endemism that is threatened by increasing human pressure on resources. Traditional slash and burn cultivation in the area is no longer sustainable. However, it is possible to maintain land productivity, decrease land degradation, and improve rural people's livelihood by ameliorating cultivation methods. Improved agroforestry seems to be a very convincing and suitable method for buffer zones of conservation areas. Farmers could receive a reasonable net income from their farm with little investment in terms of time, capital, and labor. By increasing the diversity and production of already existing cultivations, the pressure on natural forests can be diminished. The present study shows a significant gap between traditional cultivation methods and improved agroforestry systems in socio-economic terms. Improved agroforestry systems provide approximately double income per capita in comparison to traditional methods. More intensified cash crop cultivation in the highlands of the East Usambara also results in double income compared to that in the lowlands. However, people are sensitive to risks of changing farming practices. Encouraging farmers to apply better land management and practice sustainable cultivation of cash crops in combination with multipurpose trees would be relevant in improving their economic situation in the relatively short term. The markets of most cash crops are already available. Improved agroforestry methods could ameliorate the living conditions of the local population and protect the natural reserves from human disturbance.

  11. Mixed Methods Survey of Zoonotic Disease Awareness and Practice among Animal and Human Healthcare Providers in Moshi, Tanzania.

    Directory of Open Access Journals (Sweden)

    Helen L Zhang

    2016-03-01

    Full Text Available Zoonoses are common causes of human and livestock illness in Tanzania. Previous studies have shown that brucellosis, leptospirosis, and Q fever account for a large proportion of human febrile illness in northern Tanzania, yet they are infrequently diagnosed. We conducted this study to assess awareness and knowledge regarding selected zoonoses among healthcare providers in Moshi, Tanzania; to determine what diagnostic and treatment protocols are utilized; and obtain insights into contextual factors contributing to the apparent under-diagnosis of zoonoses.We conducted a questionnaire about zoonoses knowledge, case reporting, and testing with 52 human health practitioners and 10 livestock health providers. Immediately following questionnaire administration, we conducted semi-structured interviews with 60 of these respondents, using the findings of a previous fever etiology study to prompt conversation. Sixty respondents (97% had heard of brucellosis, 26 (42% leptospirosis, and 20 (32% Q fever. Animal sector respondents reported seeing cases of animal brucellosis (4, rabies (4, and anthrax (3 in the previous 12 months. Human sector respondents reported cases of human brucellosis (15, 29%, rabies (9, 18% and anthrax (6, 12%. None reported leptospirosis or Q fever cases. Nineteen respondents were aware of a local diagnostic test for human brucellosis. Reports of tests for human leptospirosis or Q fever, or for any of the study pathogens in animals, were rare. Many respondents expressed awareness of malaria over-diagnosis and zoonoses under-diagnosis, and many identified low knowledge and testing capacity as reasons for zoonoses under-diagnosis.This study revealed differences in knowledge of different zoonoses and low case report frequencies of brucellosis, leptospirosis, and Q fever. There was a lack of known diagnostic services for leptospirosis and Q fever. These findings emphasize a need for improved diagnostic capacity alongside healthcare

  12. Poverty, partner discord, and divergent accounts; a mixed methods account of births before arrival to health facilities in Morogoro Region, Tanzania.

    Science.gov (United States)

    McMahon, Shannon A; Chase, Rachel P; Winch, Peter J; Chebet, Joy J; Besana, Giulia V R; Mosha, Idda; Sheweji, Zaina; Kennedy, Caitlin E

    2016-09-27

    Births before arrival (BBA) to health care facilities are associated with higher rates of perinatal morbidity and mortality compared to facility deliveries or planned home births. Research on such births has been conducted in several high-income countries, but there are almost no studies from low-income settings where a majority of maternal and newborn deaths occur. Drawing on a household survey of women and in-depth interviews with women and their partners, we examined the experience of BBA in rural districts of Morogoro Region, Tanzania. Among survey respondents, 59 births (4 %) were classified as BBAs. Most of these births occurred in the presence of a family member (47 %) or traditional birth attendant (24 %). Low socioeconomic status was the strongest predictor of BBA. After controlling for wealth via matching, high parity and a low number of antenatal care (ANC) visits retained statistical significance. While these variables are useful indicators of which women are at greater risk of BBA, their predictive power is limited in a context where many women are poor, multiparous, and make multiple ANC visits. In qualitative interviews, stories of BBAs included themes of partner disagreement regarding when to depart for facilities and financial or logistical constraints that underpinned departure delays. Women described wanting to depart earlier to facilities than partners. As efforts continue to promote facility birth, we highlight the financial demands associated with facility delivery and the potential for these demands to place women at a heightened risk for BBAs.

  13. Comparison of Overnight Pooled and Standard Sputum Collection Method for Patients with Suspected Pulmonary Tuberculosis in Northern Tanzania

    Directory of Open Access Journals (Sweden)

    Stellah G. Mpagama

    2012-01-01

    Full Text Available In Tanzania sputum culture for tuberculosis (TB is resource intensive and available only at zonal facilities. In this study overnight pooled sputum collection technique was compared with standard spot morning collection among pulmonary TB suspects at Kibong’oto National TB Hospital in Tanzania. A spot sputum specimen performed at enrollment, an overnight pooled sputum, and single morning specimen were collected from 50 subjects and analyzed for quality, quantity, and time to detection in Bactec MGIT system. Forty-six (92% subjects’ overnight pooled specimens had a volume ≥5 mls compared to 37 (37% for the combination of spot and single morning specimens (P<0.001. Median time to detection was 96 hours (IQR 87–131 for the overnight pooled specimens compared to 110.5 hours (IQR is 137 right 137–180 for the combination of both spot and single morning specimens (P=0.001. In our setting of limited TB culture capacity, we recommend a single pooled sputum to maximize yield and speed time to diagnosis.

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

    Science.gov (United States)

    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

  15. Women's access needs in maternity care in rural Tasmania, Australia: a mixed methods study.

    Science.gov (United States)

    Hoang, Ha; Le, Quynh; Terry, Daniel

    2014-03-01

    This study investigates (i) maternity care access issues in rural Tasmania, (ii) rural women's challenges in accessing maternity services and (iii) rural women's access needs in maternity services. A mixed-method approach using a survey and semi-structured interviews was conducted. The survey explored women's views of rural maternity services from antenatal to postnatal care, while interviews reinforced the survey results and provided insights into the access issues and needs of women in maternity care. The survey was completed by n=210 women, with a response rate of 35%, with n=22 follow-up interviews being conducted. The survey indicated the majority of rural women believed antenatal education and check-ups and postnatal check-ups should be provided locally. The majority of women surveyed also believed in the importance of having a maternity unit in the local hospital, which was further iterated and clarified within the interviews. Three main themes emerged from the interview data, namely (i) lack of access to maternity services, (ii) difficulties in accessing maternity services, and (iii) rural women's access needs. The study suggested that women's access needs are not fully met in some rural areas of Tasmania. Rural women face many challenges when accessing maternity services, including financial burden and risk of labouring en route. The study supports the claim that the closure of rural maternity units shifts cost and risk from the health care system to rural women and their families. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  16. Crowdsourcing Vector Surveillance: Using Community Knowledge and Experiences to Predict Densities and Distribution of Outdoor-Biting Mosquitoes in Rural Tanzania.

    Directory of Open Access Journals (Sweden)

    Stephen Peter Mwangungulu

    Full Text Available Lack of reliable techniques for large-scale monitoring of disease-transmitting mosquitoes is a major public health challenge, especially where advanced geo-information systems are not regularly applicable. We tested an innovative crowd-sourcing approach, which relies simply on knowledge and experiences of residents to rapidly predict areas where disease-transmitting mosquitoes are most abundant. Guided by community-based resource persons, we mapped boundaries and major physical features in three rural Tanzanian villages. We then selected 60 community members, taught them basic map-reading skills, and offered them gridded maps of their own villages (grid size: 200m×200m so they could identify locations where they believed mosquitoes were most abundant, by ranking the grids from one (highest density to five (lowest density. The ranks were interpolated in ArcGIS-10 (ESRI-USA using inverse distance weighting (IDW method, and re-classified to depict areas people believed had high, medium and low mosquito densities. Finally, we used odor-baited mosquito traps to compare and verify actual outdoor mosquito densities in the same areas. We repeated this process for 12 months, each time with a different group of 60 residents. All entomological surveys depicted similar geographical stratification of mosquito densities in areas classified by community members as having high, medium and low vector abundance. These similarities were observed when all mosquito species were combined, and also when only malaria vectors were considered. Of the 12,412 mosquitoes caught, 60.9% (7,555 were from areas considered by community members as having high mosquito densities, 28% (3,470 from medium density areas, and 11.2% (1,387 from low density areas. This study provides evidence that we can rely on community knowledge and experiences to identify areas where mosquitoes are most abundant or least abundant, even without entomological surveys. This crowd-sourcing method could

  17. Evaluation of a Smartphone-Based Training Strategy Among Health Care Workers Screening for Cervical Cancer in Northern Tanzania: The Kilimanjaro Method

    Science.gov (United States)

    Sleeth, Jessica; Hopman, Wilma; Ginsburg, Ophira; Heus, Katharine; Andrews, Linda; Giattas, Mary Rose; Yuma, Safina; Macheku, Godwin; Msuya, Aziz; Oneko, Olola

    2016-01-01

    Purpose Almost nine of 10 deaths resulting from cervical cancer occur in low-income countries. Visual inspection under acetic acid (VIA) is an evidence-based, cost-effective approach to cervical cancer screening (CCS), but challenges to effective implementation include health provider training costs, provider turnover, and skills retention. We hypothesized that a smartphone camera and use of cervical image transfer for real-time mentorship by experts located distantly across a closed user group through a commercially available smartphone application would be both feasible and effective in enhancing VIA skills among CCS providers in Tanzania. Methods We trained five nonphysician providers in semirural Tanzania to perform VIA enhanced by smartphone cervicography with real-time trainee support from regional experts. Deidentified images were sent through a free smartphone application on the available mobile telephone networks. Our primary outcomes were feasibility of using a smartphone camera to perform smartphone-enhanced VIA and level of agreement in diagnosis between the trainee and expert reviewer over time. Results Trainees screened 1,072 eligible women using our methodology. Within 1 month of training, the agreement rate between trainees and expert reviewers was 96.8%. Providers received a response from expert reviewers within 1 to 5 minutes 48.4% of the time, and more than 60% of the time, feedback was provided by regional expert reviewers in less than 10 minutes. Conclusion Our method was found to be feasible and effective in increasing health care workers’ skills and accuracy. This method holds promise for improved quality of VIA-based CCS programs among health care providers in low-income countries. PMID:28717721

  18. Cost/benefit analysis of biomass energy supply options for rural smallholders in the semi-arid eastern part of Shinyanga Region in Tanzania

    Energy Technology Data Exchange (ETDEWEB)

    Wiskerke, W.T.; Dornburg, V.; Faaij, A.P.C. [Department of Science, Technology and Society, Utrecht University, Heidelberglaan 2, 3584 CS, Utrecht (Netherlands); Rubanza, C.D.K. [Tanzania Forestry Research Institute (TAFORI)/National Forest Resource Management and Agroforestry Centre (NACRAF), P.O. Box 1257, Shinyanga (Tanzania); Malimbwi, R.E. [Faculty of Forestry and Natural Resources, Sokoine University, P.O. Box 3010, Morogoro (Tanzania)

    2010-01-15

    This study analyzes the economic feasibility of sustainable smallholder bio-energy production under semi-arid conditions. The eastern part of Shinyanga region in Tanzania was chosen as a case study area. Three different sustainable biomass energy supply systems were compared by means of cost/benefit analysis: a small-scale forestation project for carbon sequestration, a short rotation woodlot and a Jatropha plantation, thereby using the produced Jatropha oil as a substitute for fuelwood or diesel. Rotational woodlots are most profitable with a Net Present Value of up to US${sub 2007} 1165/ha, a return on labour of up to US${sub 2007} 6.69/man-day and a fuelwood production cost of US${sub 2007} 0.53/GJ, compared to a local market price of US${sub 2007} 1.95/GJ. With a production cost of US${sub 2007} 19.60/GJ, Jatropha oil is too expensive to be used as an alternative for fuelwood. Instead it can be utilized economically as a diesel substitute, at an observed diesel cost of US${sub 2007} 1.49/l. The mean annual biomass increment (MAI) in semi-arid East Shinyanga is too low to collect sufficient benefits from trading forestation carbon credits under the Clean Development Mechanism (CDM) to cover the costs of forestation and forest management. (author)

  19. Use of Modern Birth Control Methods Among Rural Communities in ...

    African Journals Online (AJOL)

    MBCM) among rural dwellers in Imo State Nigeria. Three hundred and sixty households were randomly selected and data were obtained from them with the use of questionnaires and Focus Group Discussion. The results showed that only 30% of ...

  20. Exploration on Planning Methods for Rural Communities in the Local Economic and Institutional Contexts

    Institute of Scientific and Technical Information of China (English)

    Ying; WANG; Xin; PAN; Zhilun; XIAO; Xiangwei; CHENG; Caige; LI

    2014-01-01

    This paper reviews the wave of rural community construction, compares the urban and rural areas on the aspects of land property right, financing channels, construction management procedures, and the user-builder difference, and examines the unique characteristics of rural communities. On the basis of that, it proposes some planning methods for the rural community planning and construction, such as encouraging public participation, conducting public facility-oriented planning, and providing house-design menu, and further puts forward some supporting measures and policies.

  1. Workers' Education Methods and Techniques for Rural Workers and Their Organisations: Summary of Views Expressed

    Science.gov (United States)

    Labour Education, 1975

    1975-01-01

    Several issues concerning rural workers' organizations and workers' education are discussed: motivation for self-organization, workers' education needs of rural workers, workers' education methods and techniques, training institutions and training personnel, financial resources, and the role of the International Labor Organization workers'…

  2. Mixed-Methods Analysis of Rural Special Educators' Role Stressors, Behavior Management, and Burnout

    Science.gov (United States)

    Garwood, Justin D.; Werts, Margaret G.; Varghese, Cheryl; Gosey, Leanne

    2018-01-01

    The researchers of this study used a mixed-methods approach to understand issues of rural special education teacher burnout. Results of survey responses (n = 64) and follow-up focus group interviews (n = 12) from rural special education teachers indicated several factors contributing to stress and burnout. Teachers noted that lack of clarity in…

  3. Multicriteria method to evaluate the operation of technologies of renewable energy in rural areas

    International Nuclear Information System (INIS)

    Cherni, Judilh

    2003-01-01

    This paper evaluates the problem of the selection of renewable energy alternatives in rural regions in the developing world. We discuss a multicriteria method, map result, for assessing the effectiveness and sustainability of the energy systems that have been installed in rural areas. The purpose is to improve the effectiveness of energization policies

  4. 24 STATUS OF LIBRARY AUTOMATION IN TANZANIA'S PUBLIC ...

    African Journals Online (AJOL)

    Dr A.S. Samzugi

    universities. Kasulwa's (2008) report has mentioned the automation efforts in Tanzania, ... System (EMIS) and E-Library system for All Higher Education and Research Institutions in. Tanzania. ... Both telephone and face-to-face methods were used. ... Qualitative data collected from interviews with directors of libraries, on the.

  5. Sixty Years of Special Needs Education in Tanzania: Celebrating ...

    African Journals Online (AJOL)

    This study traces the development of special needs education in Tanzania from 1950, and discusses the achievements and the persistent challenges that Tanzania is facing as we celebrate 60 years since the first special education school was started. Both documentation and interview methods were used to collect ...

  6. Biofuel investment in Tanzania: Omissions in implementation

    International Nuclear Information System (INIS)

    Habib-Mintz, Nazia

    2010-01-01

    Increasing demand for biofuels as a component of climate change mitigation, energy security, and a fossil fuel alternative attracts investors to developing countries like Tanzania. Ample unused land is critical for first generation biofuels production and an important feature to attract foreign direct investments that can contribute towards agricultural modernization and poverty reduction initiatives. Despite the economic justifications, the existing institutional and infrastructural capacities dictate the impacts of biofuels market penetrations. Furthermore, exogenous factors like global recessionary pressure depressed oil prices below the level at which biofuel production were profitable in 2007, making Tanzania's competitiveness and potential benefits questionable. This paper investigates the extent that first generation, jatropha-based biofuels industry development in Tanzania observed during fieldwork in Kisarawe and Bahi may fulfill policy objectives. This paper argues that without strong regulatory frameworks for land, investment management, and rural development, biofuel industrialization could further exacerbate poverty and food insecurity in Tanzania. The paper concludes with policy recommendations for first generation biofuel development while keeping in mind implications of second generation production. Since the topic is broad and multifaceted, a multidisciplinary approach is used that includes political, institutional, and agricultural economics to analyze and conceptualize biofuel industry development and food security.

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

    Science.gov (United States)

    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.

  8. Effectiveness of the Home Based Life Saving Skills training by community health workers on knowledge of danger signs, birth preparedness, complication readiness and facility delivery, among women in Rural Tanzania.

    Science.gov (United States)

    August, Furaha; Pembe, Andrea B; Mpembeni, Rose; Axemo, Pia; Darj, Elisabeth

    2016-06-02

    In spite of government efforts, maternal mortality in Tanzania is currently at more than 400 per 100,000 live births. Community-based interventions that encourage safe motherhood and improved health-seeking behaviour through acquiring knowledge on the danger signs and improving birth preparedness, and, ultimately, reduce maternal mortality, have been initiated in different parts of low-income countries. Our aim was to evaluate if the Home Based Life Saving Skills education by community health workers would improve knowledge of danger signs, birth preparedness and complication readiness and facility-based deliveries in a rural community in Tanzania. A quasi-experimental study design was used to evaluate the effectiveness of Home Based Life Saving Skills education to pregnant women and their families through a community intervention. An intervention district received training with routine care. A comparison district continued to receive routine antenatal care. A structured household questionnaire was used in order to gather information from women who had delivered a child within the last two years before the intervention. This questionnaire was used in both the intervention and comparison districts before and after the intervention. The net intervention effect was estimated using the difference between the differences in the intervention and control districts at baseline and endline. A total of 1,584 and 1,486 women were interviewed at pre-intervention and post intervention, respectively. We observed significant improvement of knowledge of three or more danger signs during pregnancy (15.2 % vs. 48.1 %) with a net intervention effect of 29.0 % (95 % CI: 12.8-36.2; p effect on the knowledge of three or more danger signs during childbirth (15.3 % vs. 43.1 %) with a net intervention effect of 18.3 % (95 % CI: 11.4-25.2; p effect of 9.4 % (95 % CI: 6.4-15.7; p effect of 10.3 % (95 % CI: 10.3-20.3; p effect of 25.3 % (95 % CI: 16.9-33.2; p

  9. INNOVATIVE METHODS IN THE DEVELOPMENT OF RURAL TOURISM IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Avram Daniel

    2015-05-01

    Full Text Available Innovations are considered the engine of economic growth, because they serve a s basis for obtaining the competitive advantage. Tourism is one of the most profitable and dynamic sectors of economy, occupying the second position in the international trade after oil. Rural tourism also has major implications in the economic, social and cultural development of villages. This study presents an analysis of the fluctuation of the number of employees and of the number of accommodation units specific to rural tourism in Romania, between 2007-2014. To this end statistical data from the National Statistics Institute has been used. Volunteer tourism, the development of national portals for presentation of vacant jobs in the tourism sector and the development of human resources by absorption of European funds, are the three suggestions presented in this study, which have the purpose ofreinvigorating rural tourism in Romania.

  10. Community-Based Wildlife Management In Tanzania: The Policy ...

    African Journals Online (AJOL)

    Community-based wildlife management (CWM) approach – known to others as community-based conservation – was first introduced in Tanzania in 1987/88. The approach intends to reconcile wildlife conservation and rural economic development. In the 1990s Tanzanians witnessed a rush by government Ministries and ...

  11. Bureaucratic Blockages : Water, Civil Servants, and Community in Tanzania

    OpenAIRE

    Bailey, Juli

    2017-01-01

    How do civil servants in district water and sanitation departments address problems of water access in rural communities in Tanzania? What are the bureaucratic procedures they follow? How do the bureaucratic procedures around formulating budgets, managing money, and interacting with communities impede or enhance their ability to manage water projects? This report addresses these and related ...

  12. 'Mum never loved me.' How structural factors influence adolescent sexual and reproductive health through parent-child connectedness: a qualitative study in rural Tanzania.

    Science.gov (United States)

    Wamoyi, Joyce; Wight, Daniel

    2014-01-01

    Research in high income countries shows parent-child connectedness to be protective against undesirable sexual and reproductive health (SRH) outcomes among young people. Little has been done to understand the nature of parent-child connectedness, the structural factors that impact on connectedness and parents' understanding of how connectedness affects their children's sexual behaviour in sub-Saharan Africa and Tanzania in particular. Ethnographic research involved 30 days of observation in 10 households, 9 focus group discussions and 60 in-depth interviews. Thematic analysis was conducted using NVIVO qualitative data analysis software. The structural factors with greatest influence on connectedness were economic circumstances, gender, social status, state education, and globalisation. Economic circumstances impacted on parent-child connectedness through parents' ability to provide for their children's material needs, and the time their occupation allowed for them to spend with their children and monitor their activities. Appropriate parent-child interactions were shaped by gender norms and by social status in the form of respectability, adolescents' adherence to norms of respect/obedience shaping their parents' affection. State education affected parents' preferences between children but also undermined parental authority, as did broader globalisation. Connectedness was related to SRH in a bi-directional way: lack of connectedness was linked to young people's low self-esteem and risky sexual behaviour while unplanned pregnancies seriously undermined young women's connectedness with their parents. Since material provision was perceived to be a central element of parent-child connectedness, structural factors limiting provision made transactional sex more likely both through direct material pathways and emotional ones. Motives for transactional sex were said to be material needs and to feel loved and cared for. An important pathway by which structural factors shape

  13. A community-based intervention for improving health-seeking behavior among sexual violence survivors: a controlled before and after design study in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Muzdalifat Abeid

    2015-09-01

    Full Text Available Background: Despite global recognition that sexual violence is a violation of human rights, evidence still shows it is a pervasive problem across all societies. Promising community intervention studies in the low- and middle-income countries are limited. Objective: This study assessed the impact of a community-based intervention, focusing on improving the community's knowledge and reducing social acceptability of violence against women norms with the goal to prevent and respond to sexual violence. Design: The strategies used to create awareness included radio programs, information, education communication materials, and advocacy meetings with local leaders. The intervention took place in Morogoro region in Tanzania. The evaluation used a quasi-experimental design including cross-sectional surveys at baseline (2012 and endline (2014 with men and women aged 18–49 years. Main outcome measures were number of reported rape cases at health facilities and the community's knowledge and attitudes toward sexual violence. Results: The number of reported rape events increased by more than 50% at health facilities during the intervention. Knowledge on sexual violence increased significantly in both areas over the study period (from 57.3 to 80.6% in the intervention area and from 55.5 to 71.9% in the comparison area; p<0.001, and the net effect of the intervention between the two areas was statistically significant (6.9, 95% CI 0.2–13.5, p=0.03. There was significant improvement in most of the attitude indicators in the intervention area, but not in the comparison area. However, the intervention had no significant effect on the overall scores of acceptance attitudes in the final assessment when comparing the two areas (−2.4, 95% CI: −8.4 to 3.6, p=0.42. Conclusions: The intervention had an effect on some indicators on knowledge and attitudes toward sexual violence even after a short period of intervention. This finding informs the public health

  14. Rural Household Attitude towards Traditional Methods of Malaria ...

    African Journals Online (AJOL)

    User

    Food and Agricultural Organization (FAO), CABI and Scopus ... Agriculture supports the health of rural households but poor health reduces farmers' ability to ... inequitably distributed because decisions for prevention or treatment are made ... Analysis of “what respondents will do first” during malaria attack showed that only.

  15. MARKET TOURS, PEDDLER RECEIPTS AND THE SHOPKEEPER GRAPE VINE: AN IMPORT WHOLESALER’S ATTEMPTS TO GAUGE RURAL, AFRICAN CONSUMER DEMAND IN EARLY COLONIAL NORTHWESTERN TANZANIA

    Directory of Open Access Journals (Sweden)

    Laird Jones

    1999-01-01

    Full Text Available This paper examines how early colonial, town-based wholesalers discerned rural African consumer tastes and measured demand for imported goods by focusing on the experience of the O’Swald Mwanza branch from 1906 through 1916. Like many metropolitan firms, O’Swald had extensive experience in the earlier caravan trade. Thus, several decades later, its representatives arrived in Mwanza expecting that import sales would still conform to the tastes of elite caravan era consumers. With the extension of steam transport into the interior and the onset of an early colonial “Cash Crop Revolution,” however, many more rural cultivators and herdspeople than ever before had the means to acquire imports, and these new consumers proved far more fickle with regard to brand, style and novelty than firms like O’Swald had anticipated. They no longer accepted some caravan era favorites, and desired others in increasing variety. Thus, in order to stay on top of what the firm only slowly came to understand as an emerging mass market, the O’Swald men spied on their competition, engaged in brand name advertising, interrogated shopkeepers and peddlers, and increasingly market-tested new products.

  16. Tanzania - Water Supply & Expansion

    Data.gov (United States)

    Millennium Challenge Corporation — Social Impact (SI) has been contracted by MCC to carry out an impact evaluation (IE) of the Tanzania Water Sector Project. This IE examines the effect of the WSP...

  17. Tanzania Medical Journal

    African Journals Online (AJOL)

    The journal publishes any contribution that advances medical science or ... these core objectives the journal publishes papers on original scientific research, short ... The Tanzania Medical Journal is an international Journal - ISSN: 0856-0719 ...

  18. A Comparison of Didactic and Inquiry Teaching Methods in a Rural Community College Earth Science Course

    Science.gov (United States)

    Beam, Margery Elizabeth

    The combination of increasing enrollment and the importance of providing transfer students a solid foundation in science calls for science faculty to evaluate teaching methods in rural community colleges. The purpose of this study was to examine and compare the effectiveness of two teaching methods, inquiry teaching methods and didactic teaching methods, applied in a rural community college earth science course. Two groups of students were taught the same content via inquiry and didactic teaching methods. Analysis of quantitative data included a non-parametric ranking statistical testing method in which the difference between the rankings and the median of the post-test scores was analyzed for significance. Results indicated there was not a significant statistical difference between the teaching methods for the group of students participating in the research. The practical and educational significance of this study provides valuable perspectives on teaching methods and student learning styles in rural community colleges.

  19. Establishing a faith-based organisation nursing school within a national primary health care programme in rural Tanzania: an auto-ethnographic case study

    Directory of Open Access Journals (Sweden)

    Alexander Bischoff

    2016-05-01

    Full Text Available Background: In 2007, the Tanzanian government called for improvements in its primary health care services. Part of this initiative was to accelerate the training rate for nurses qualified to work in rural areas. The aim of this study was to reflect on the issues experienced whilst establishing and implementing a faith-based organisation (FBO nursing school and make recommendations for other similar initiatives. Design: This paper describes an auto-ethnographic case study design to identify the key difficulties involved with establishing and implementing a new nursing school, and which factors helped the project achieve its goals. Results: Six themes emerged from the experiences that shaped the course of the project: 1 Motivation can be sustained if the rationale of the project is in line with its aims. Indeed, the project's primary health care focus was to strengthen the nursing workforce and build a public–private partnership with an FBO. All these were strengths, which helped in the midst of all the uncertainties. 2 Communication was an important and often underrated factor for all types of development projects. 3 Managing the unknown and 4 managing expectations characterised the project inception. Almost all themes had to do with 5 handling conflicts. With so many participants having their own agendas, tensions were unavoidable. A final theme was 6 the need to adjust to ever-changing targets. Conclusions: This retrospective auto-ethnographic manuscript serves as a small-scale case study, to illustrate how issues that can be generalised to other settings can be deconstructed to demonstrate how they influence health development projects in developing countries. From this narrative of experiences, key recommendations include the following: 1 Find the right ratio of stakeholders, participants, and agendas, and do not overload the project; 2 Be alert and communicate as much as possible with staff and do not ignore issues hoping they will solve

  20. Establishing a faith-based organisation nursing school within a national primary health care programme in rural Tanzania: an auto-ethnographic case study.

    Science.gov (United States)

    Bischoff, Alexander

    2016-01-01

    In 2007, the Tanzanian government called for improvements in its primary health care services. Part of this initiative was to accelerate the training rate for nurses qualified to work in rural areas. The aim of this study was to reflect on the issues experienced whilst establishing and implementing a faith-based organisation (FBO) nursing school and make recommendations for other similar initiatives. This paper describes an auto-ethnographic case study design to identify the key difficulties involved with establishing and implementing a new nursing school, and which factors helped the project achieve its goals. Six themes emerged from the experiences that shaped the course of the project: 1) Motivation can be sustained if the rationale of the project is in line with its aims. Indeed, the project's primary health care focus was to strengthen the nursing workforce and build a public-private partnership with an FBO. All these were strengths, which helped in the midst of all the uncertainties. 2) Communication was an important and often underrated factor for all types of development projects. 3) Managing the unknown and 4) managing expectations characterised the project inception. Almost all themes had to do with 5) handling conflicts. With so many participants having their own agendas, tensions were unavoidable. A final theme was 6) the need to adjust to ever-changing targets. This retrospective auto-ethnographic manuscript serves as a small-scale case study, to illustrate how issues that can be generalised to other settings can be deconstructed to demonstrate how they influence health development projects in developing countries. From this narrative of experiences, key recommendations include the following: 1) Find the right ratio of stakeholders, participants, and agendas, and do not overload the project; 2) Be alert and communicate as much as possible with staff and do not ignore issues hoping they will solve themselves; 3) Think flexibly and do not stubbornly

  1. "Once the government employs you, it forgets you": Health workers' and managers' perspectives on factors influencing working conditions for provision of maternal health care services in a rural district of Tanzania.

    Science.gov (United States)

    Mkoka, Dickson Ally; Mahiti, Gladys Reuben; Kiwara, Angwara; Mwangu, Mughwira; Goicolea, Isabel; Hurtig, Anna-Karin

    2015-09-14

    In many developing countries, health workforce crisis is one of the predominant challenges affecting the health care systems' function of providing quality services, including maternal care. The challenge is related to how these countries establish conducive working conditions that attract and retain health workers into the health care sector and enable them to perform effectively and efficiently to improve health services particularly in rural settings. This study explored the perspectives of health workers and managers on factors influencing working conditions for providing maternal health care services in rural Tanzania. The researchers took a broad approach to understand the status of the current working conditions through a governance lens and brought into context the role of government and its decentralized organs in handling health workers in order to improve their performance and retention. In-depth interviews were conducted with 22 informants (15 health workers, 5 members of Council Health Management Team and 2 informants from the District Executive Director's office). An interview guide was used with questions pertaining to informants' perspective on provision of maternal health care service, working environment, living conditions, handling of staff's financial claims, avenue for sharing concerns, opportunities for training and career progression. Probing questions on how these issues affect the health workers' role of providing maternal health care were employed. Document reviews and observations of health facilities were conducted to supplement the data. The interviews were analysed using a qualitative content analysis approach. Overall, health workers felt abandoned and lost within an unsupportive system they serve. Difficult working and living environments that affect health workers' role of providing maternal health care services were dominant concerns raised from interviews with both health workers and managers. Existence of a bureaucratic and

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

    Directory of Open Access Journals (Sweden)

    Exavery Amon

    2012-12-01

    Full Text Available Abstract 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.

  3. Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia

    DEFF Research Database (Denmark)

    Phiri, Selia Ng'anjo; Kiserud, Torvid; Kvåle, Gunnar

    2014-01-01

    of delivery. Socioeconomic position was measured by employing a construct of educational attainment and wealth index. All analyses were stratified by district and urban-rural residence. RESULTS: There were substantial inter-district differences in proportion of health facility childbirth. Facility childbirth......BACKGROUND: Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban...... areas of three districts in Kenya, Tanzania and Zambia. METHODS: A population-based survey was conducted in 2007 as part of the 'REsponse to ACcountable priority setting for Trust in health systems' (REACT) project. Stratified random cluster sampling was used and the data included information on place...

  4. A method multi criterio to evaluate projects of rural electrification

    International Nuclear Information System (INIS)

    Gonzalez Posse, E.

    1994-01-01

    In this document about the problem of the evaluation projects methodologies in rural electrification.The low analysis problem is of complex nature, because each project is evaluation object and an economic agent. One of these agents identifies different benefits and cost, and also has a different approaches for value them.In consequence, the form in that it is carried out the evaluation of the one project for each one of this agents that it is usually solved for mechanisms linked to the capacity of incidence or of determination of each one of them, this does not assures a satisfactory results for the general interest

  5. District health manager and mid-level provider perceptions of practice environments in acute obstetric settings in Tanzania: a mixed-method study.

    Science.gov (United States)

    Ng'ang'a, Njoki; Byrne, Mary Woods; Kruk, Margaret E; Shemdoe, Aloisia; de Pinho, Helen

    2016-08-08

    In sub-Saharan Africa, the capacity of human resources for health (HRH) managers to create positive practice environments that enable motivated, productive, and high-performing HRH is weak. We implemented a unique approach to examining HRH management practices by comparing perspectives offered by mid-level providers (MLPs) of emergency obstetric care (EmOC) in Tanzania to those presented by local health authorities, known as council health management teams (CHMTs). This study was guided by the basic strategic human resources management (SHRM) component model. A convergent mixed-method design was utilized to assess qualitative and quantitative data from the Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers project. Survey data was obtained from 837 mid-level providers, 83 of whom participated in a critical incident interview whose aim was to elicit negative events in the practice environment that induced intention to leave their job. HRH management practices were assessed quantitatively in 48 districts with 37 members of CHMTs participating in semi-structured interviews. The eight human resources management practices enumerated in the basic SHRM component model were implemented unevenly. On the one hand, members of CHMTs and mid-level providers agreed that there were severe shortages of health workers, deficient salaries, and an overwhelming workload. On the other hand, members of CHMTs and mid-level providers differed in their perspectives on rewards and allocation of opportunities for in-service training. Although written standards of performance and supervision requirements were available in most districts, they did not reflect actual duties. Members of CHMTs reported high levels of autonomy in key HRH management practices, but mid-level providers disputed the degree to which the real situation on the ground was factored into job-related decision-making by CHMTs. The incongruence in perspectives offered by members of CHMTs

  6. Improving smallholder livelihoods: Dairy production in Tanzania

    Directory of Open Access Journals (Sweden)

    Edward Ulicky

    2013-12-01

    Full Text Available Tanzania is primarily an agro-based economy, characterized by subsistence agricultural production that employs more than 80% of the population and contributes up to 45% of the GDP (2005. This country is endowed with a cattle population of 21.3 M, composed mainly of indigenous Zebu breeds and about 680 000 improved dairy animals. About 70% of the milk produced comes from the traditional sector (indigenous cattle kept in rural areas, while the remaining 30% comes from improved cattle, mainly kept by smallholder producers. In Northern Tanzania and particularly in Hai district of Kilimanjaro Region, some dairy farmers organize themselves into small producer groups for the purpose of milk collecting, marketing and general promotion of the dairy sector in their community. Nronga Women Dairy Cooperative Society (NWDCS Limited is one of such organizations dedicated to improve the well-being of the Nronga village community through promoting small-scale dairy farming and its flow-on benefits. Milk flows out of the village, and services for investment and dairy production flow into the village, ensuring a sustainable financial circulation necessary for poverty reduction, rural development and better life for the rural community. In 2001 NWDCS introduced a school milk feeding program that has attracted Australian donors since 2005. Guided by Global Development Group, a multi-faceted project, integrating micro-enterprises, business, education and child health/nutrition, was proposed and initiated by building a dairy plant in Hai District headquarters, the Boma plant. In March 2013, the Australian High Commission to East Africa approved Direct Aid Program funding of AUD 30 000 towards the NWDCS - Biogas Pilot Project in Tanzania, which included the renovation of zero-grazing cow shade units, the construction of 6-m3 biodigester plants on each farm, and encouragement of the use of bioslurry for pasture production and home gardens.

  7. Preliminary observations of birds of Songo Songo Island, Tanzania

    African Journals Online (AJOL)

    Materials and methods ... The island rises some 10 m above sea level and is c. ... PM a. Greater Sandplover Charadrius leschenaultii. Obs. Littoral. PM a .... terrestrial birds on Pemba Island (Tanzania), with particular reference to six endemic ...

  8. Factors associated with child sexual abuse in Tanzania: a qualitative ...

    African Journals Online (AJOL)

    user

    Tanzania Journal of Health Research ... Methods: Key informant interviews were conducted among adults including parents of the ... factors for child sexual abuse, the type of perpetrators and the context into which these abuses take place.

  9. An assessment method and a case study of rural electrification technologies

    International Nuclear Information System (INIS)

    Muguerza, D.; Santander, P.R.; Bordon, H.C.; Gomez, A.R.

    1991-01-01

    From 1985 to 1987, a research team from the Institute of Energy Economics and the National University of Misiones, Argentina, in co-operation with Obera University Foundation, Argentina and the International Development Research Centre, Canada, developed a comprehensive method for analyzing electric power supply alternatives in depressed rural areas as an integral part of the development planning. The method compares the economics of centralized and decentralized power supply systems, including all conventional and non-conventional technology alternatives, and is based on the natural resources and development of the region. It also provides a method for the analytical processing of data on the energy requirements of rural populations and makes it possible to determine energy consumption by use and income level of a rural family resulting in a realistic estimation of the electric power supply needs. 3 tabs

  10. Application of Participatory Learning and Action Methods in Educational Technology Research A Rural Bangladeshi Case

    DEFF Research Database (Denmark)

    Khalid, Md. Saifuddin; Nyvang, Tom

    2013-01-01

    This chapter examines barriers and methods to identify barriers to educational technology in a rural technical vocational education and training institute in Bangladesh. It also examines how the application of participatory learning and action methods can provide information for barrier research ...

  11. Gender and performance of community treatment assistants in Tanzania.

    Science.gov (United States)

    Jenson, Alexander; Gracewello, Catherine; Mkocha, Harran; Roter, Debra; Munoz, Beatriz; West, Sheila

    2014-10-01

    To examine the effects of gender and demographics of community treatment assistants (CTAs) on their performance of assigned tasks and quantity of speech during mass drug administration of azithromycin for trachoma in rural Tanzania. Surveys of CTAs and audio recordings of interactions between CTAs and villagers during drug distribution. Mass drug administration program in rural Kongwa district. Fifty-seven randomly selected CTAs, and 3122 residents of villages receiving azithromycin as part of the Kongwa Trachoma Project. None. Speech quantity graded by Roter interaction analysis system, presence of culturally appropriate greeting and education on facial hygiene for trachoma prevention from coded analysis of audio-recorded interactions. At sites with all female CTAs, each CTA spent more time and spoke more in each interaction in comparison with CTAs at sites with only male CTAs and CTAs at 'mixed gender' sites (sites with both male and female CTAs). At 'mixed gender' sites, males spoke significantly more than females. Female CTAs mentioned trachoma prevention with facial cleanliness more than twice as often as male CTAs; however, both genders mentioned hygiene in genders had culturally appropriate greetings in Gender dynamics affect the amount of time that CTAs spend with villagers during drug distribution, and the relative amount of speech when both genders work together. Both genders are not meeting expectations for trachoma prevention education and greeting villagers, and novel training methods are necessary. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  12. Evaluation of the Widal tube agglutination test for the diagnosis of typhoid fever among children admitted to a rural hdospital in Tanzania and a comparison with previous studies

    Directory of Open Access Journals (Sweden)

    Malahiyo Rajabu

    2010-06-01

    Full Text Available Abstract Background The diagnosis of typhoid fever is confirmed by culture of Salmonella enterica serotype Typhi (S. typhi. However, a more rapid, simpler, and cheaper diagnostic method would be very useful especially in developing countries. The Widal test is widely used in Africa but little information exists about its reliability. Methods We assessed the performance of the Widal tube agglutination test among febrile hospitalized Tanzanian children. We calculated the sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV of various anti-TH and -TO titers using culture-confirmed typhoid fever cases as the "true positives" and all other febrile children with blood culture negative for S. typhi as the "true negatives." Results We found that 16 (1% of 1,680 children had culture-proven typhoid fever. A single anti-TH titer of 1:80 and higher was the optimal indicator of typhoid fever. This had a sensitivity of 75%, specificity of 98%, NPV of 100%, but PPV was only 26%. We compared our main findings with those from previous studies. Conclusion Among febrile hospitalized Tanzanian children with a low prevalence of typhoid fever, a Widal titer of ≥ 1:80 performed well in terms of sensitivity, specificity, and NPV. However a test with improved PPV that is similarly easy to apply and cost-efficient is desirable.

  13. Coping with Rainfall Variability in Northern Tanzania

    DEFF Research Database (Denmark)

    Trærup, Sara Lærke Meltofte

    2012-01-01

    This paper explores a potential relationship between rainfall data and household self-reported harvest shocks and local (spatial) variability of harvest shocks and coping strategies based on a survey of 2700 rural households in the Kagera region of northern Tanzania. In addition, correlations...... of household reported harvest shocks differs significantly between districts and correspond to the observed variability in local climate patterns. Coping strategies are focused on spreading risks and include reduced consumption, casual employment, new crops, external support and the selling of assets....... There are no large differences in applied coping strategies across the region, but district-level data demonstrate how local strategies differ between localities within the districts. The results emphasize that in order to target rural policies and make them efficient, it is important to take into account the local...

  14. Tanzania Dental Association

    African Journals Online (AJOL)

    Committee of Tanzania Dental. Association would like to Thank. [fUfNJfNJU[[j)~ for its magnanimity towards meeting the cost of this Journal ... ceps is token out of the dental kit and the tooth is removed out of its socket. The tooth is dropped into the waste bucket. The fareceps is placed in the water basin. The socket site is ...

  15. YOUTH EMPLOYMENTin Tanzania

    International Development Research Centre (IDRC) Digital Library (Canada)

    Some 17.5 millionTanzanians are between 15 and 34 years of age. This number is expected to almost double by 2035. For more information, please refer to Haji, Mahjabeen (2015) Tanzania: Skills and youth employment, a scoping paper commissioned by IDRC and the MasterCard Foundation. Young self-employed.

  16. IDRC in Tanzania

    International Development Research Centre (IDRC) Digital Library (Canada)

    worth CA$60 million since 1973. By identifying the major causes of death and disease, IDRC-supported research has helped to significantly reduced child and adult mortality rates in ... mental conditions in communities in. Tanzania and Malawi. Researchers and com- munity members will use the survey results to design ...

  17. Tanzania Journal of Science

    African Journals Online (AJOL)

    The Tanzania Journal of Science (Tanz. J. Sci.) was established in 1975 as a forum for communication and co-ordination between and among scientists and allied professionals. It is also intended as a medium for dissemination of scientific knowledge among scientists and the public at large to promote the advancement of ...

  18. Tanzania Medical Journal: Submissions

    African Journals Online (AJOL)

    The Tanzania Medical Journal is a multi – disciplinary journal published two times a year in March - June and September – December. ... To achieve its objectives the journal invites papers on original scientific research, short communications, case reports and letters to the editor, in any branch of medical science. Original ...

  19. The incidence of local government allocations in Tanzania

    OpenAIRE

    Jameson Boex

    2003-01-01

    Since 1999, Tanzania has been actively pursuing reforms of the way in which the central government finances local government activities. This paper looks at the current incidence of central government allocations to local authorities in Tanzania through: 1) examining of potential problems with the current financing method, 2) showing large variations between local government allocations, and 3) finding that surprisingly what drives t his distribution of resources maybe substantial pro-wealthy...

  20. A Mixed Methods Comparison of Urban and Rural Retail Corner Stores

    Directory of Open Access Journals (Sweden)

    Jared T McGuirt

    2015-08-01

    Full Text Available Efforts to transform corner stores to better meet community dietary needs have mostly occurred in urban areas but are also needed in rural areas. Given important contextual differences between urban and rural areas, it is important to increase our understanding of the elements that might translate successfully to similar interventions involving stores in more rural areas. Thus, an in-depth examination and comparison of corner stores in each setting is needed. A mixed methods approach, including windshield tours, spatial visualization with analysis of frequency distribution, and spatial regression techniques were used to compare a rural North Carolina and large urban (Los Angeles food environment. Important similarities and differences were seen between the two settings in regards to food environment context, spatial distribution of stores, food products available, and the factors predicting corner store density. Urban stores were more likely to have fresh fruits (Pearson chi2 = 27.0423; p < 0.001 and vegetables (Pearson chi2 = 27.0423; p < 0.001. In the urban setting, corner stores in high income areas were more likely to have fresh fruit (Pearson chi2 = 6.00; p = 0.014, while in the rural setting, there was no difference between high and low income area in terms of fresh fruit availability. For the urban area, total population, no vehicle and Hispanic population were significantly positively associated (p < 0.05, and median household income (p < 0.001 and Percent Minority (p < 0.05 were significantly negatively associated with corner store count. For the rural area, total population (p < 0.05 and supermarket count were positively associated (p < 0.001, and median household income negatively associated (P < 0.001, with corner store count. Translational efforts should be informed by these findings, which might influence the success of future interventions and policies in both rural and urban contexts.

  1. The Methods for Diagnosing the Attractiveness of Ecological Entrepreneurship in Rural Areas

    Directory of Open Access Journals (Sweden)

    Shuliak Bogdan V.

    2018-03-01

    Full Text Available The study is aimed at substantiating the methods for diagnosing the attractiveness of ecological entrepreneurship in rural areas. The article defines the objectives of diagnosing the attractiveness of ecological entrepreneurship in rural areas. It is determined that the methods for diagnosing the attractiveness of environmentally oriented entrepreneurial activity should take into account its effectiveness in the context of economic, ecological, and social components; current status, dynamics and tendencies of development of basic indicators of attractiveness; relationship between the actual and target values of such indicators. The system of methods which is expedient for use in the process of diagnosing, has been defined as follows: methods of correlation analysis (substantiation of the purposes of diagnostics; coefficient analysis and fuzzy logic methods (estimation of the actual levels of attractiveness indicators; regression analysis and mathematical-statistical method (estimation of tendencies, building of forecasts; cluster analysis, ranking, rationing, and integral estimation (comparative analysis of the estimation results.

  2. Factors affecting adoption, implementation fidelity, and sustainability of the Redesigned Community Health Fund in Tanzania: a mixed methods protocol for process evaluation in the Dodoma region

    Directory of Open Access Journals (Sweden)

    Albino Kalolo

    2015-12-01

    Full Text Available Background: Despite the implementation of various initiatives to address low enrollment in voluntary micro health insurance (MHI schemes in sub-Saharan Africa, the problem of low enrollment remains unresolved. The lack of process evaluations of such interventions makes it difficult to ascertain whether their poor results are because of design failures or implementation weaknesses. Objective: In this paper, we describe a process evaluation protocol aimed at opening the ‘black box’ to evaluate the implementation processes of the Redesigned Community Health Fund (CHF program in the Dodoma region of Tanzania. Design: The study employs a cross-sectional mixed methods design and is being carried out 3 years after the launch of the Redesigned CHF program. The study is grounded in a conceptual framework which rests on the Diffusion of Innovation Theory and the Implementation Fidelity Framework. The study utilizes a mixture of quantitative and qualitative data collection tools (questionnaires, focus group discussions, in-depth interviews, and document review, and aligns the evaluation to the Theory of Intervention developed by our team. Quantitative data will be used to measure program adoption, implementation fidelity, and their moderating factors. Qualitative data will be used to explore the responses of stakeholders to the intervention, contextual factors, and moderators of adoption, implementation fidelity, and sustainability. Discussion: This protocol describes a systematic process evaluation in relation to the implementation of a reformed MHI. We trust that the theoretical approaches and methodologies described in our protocol may be useful to inform the design of future process evaluations focused on the assessment of complex interventions, such as MHI schemes.

  3. Factors affecting adoption, implementation fidelity, and sustainability of the Redesigned Community Health Fund in Tanzania: a mixed methods protocol for process evaluation in the Dodoma region

    Science.gov (United States)

    Kalolo, Albino; Radermacher, Ralf; Stoermer, Manfred; Meshack, Menoris; De Allegri, Manuela

    2015-01-01

    Background Despite the implementation of various initiatives to address low enrollment in voluntary micro health insurance (MHI) schemes in sub-Saharan Africa, the problem of low enrollment remains unresolved. The lack of process evaluations of such interventions makes it difficult to ascertain whether their poor results are because of design failures or implementation weaknesses. Objective In this paper, we describe a process evaluation protocol aimed at opening the ‘black box’ to evaluate the implementation processes of the Redesigned Community Health Fund (CHF) program in the Dodoma region of Tanzania. Design The study employs a cross-sectional mixed methods design and is being carried out 3 years after the launch of the Redesigned CHF program. The study is grounded in a conceptual framework which rests on the Diffusion of Innovation Theory and the Implementation Fidelity Framework. The study utilizes a mixture of quantitative and qualitative data collection tools (questionnaires, focus group discussions, in-depth interviews, and document review), and aligns the evaluation to the Theory of Intervention developed by our team. Quantitative data will be used to measure program adoption, implementation fidelity, and their moderating factors. Qualitative data will be used to explore the responses of stakeholders to the intervention, contextual factors, and moderators of adoption, implementation fidelity, and sustainability. Discussion This protocol describes a systematic process evaluation in relation to the implementation of a reformed MHI. We trust that the theoretical approaches and methodologies described in our protocol may be useful to inform the design of future process evaluations focused on the assessment of complex interventions, such as MHI schemes. PMID:26679408

  4. Marine fisheries in Tanzania.

    Science.gov (United States)

    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.

  5. Assessment and comparative analysis of a rapid diagnostic test (Tubex® for the diagnosis of typhoid fever among hospitalized children in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Shoo Aikande

    2011-05-01

    Full Text Available Abstract Background Typhoid fever remains a significant health problem in many developing countries. A rapid test with a performance comparable to that of blood culture would be highly useful. A rapid diagnostic test for typhoid fever, Tubex®, is commercially available that uses particle separation to detect immunoglobulin M directed towards Salmonella Typhi O9 lipopolysaccharide in sera. Methods We assessed the sensitivity and specificity of the Tubex test among Tanzanian children hospitalized with febrile illness using blood culture as gold standard. Evaluation was done considering blood culture confirmed S. Typhi with non-typhi salmonella (NTS and non - salmonella isolates as controls as well as with non-salmonella isolates only. Results Of 139 samples tested with Tubex, 33 were positive for S. Typhi in blood culture, 49 were culture-confirmed NTS infections, and 57 were other non-salmonella infections. Thirteen hemolyzed samples were excluded. Using all non - S. Typhi isolates as controls, we showed a sensitivity of 79% and a specificity of 89%. When the analysis was repeated excluding NTS from the pool of controls we showed a sensitivity of 79% and a specificity of 97%. There was no significant difference in the test performance using the two different control groups (p > 0.05. Conclusion This first evaluation of the Tubex test in an African setting showed a similar performance to those seen in some Asian settings. Comparison with the earlier results of a Widal test using the same samples showed no significant difference (p > 0.05 for any of the performance indicators, irrespective of the applied control group.

  6. Subnational variation for care at birth in Tanzania: is this explained by place, people, money or drugs?

    Directory of Open Access Journals (Sweden)

    Corinne E. Armstrong

    2016-09-01

    Full Text Available Abstract Background Tanzania achieved the Millennium Development Goal for child survival, yet made insufficient progress for maternal and neonatal survival and stillbirths, due to low coverage and quality of services for care at birth, with rural women left behind. Our study aimed to evaluate Tanzania’s subnational (regional-level variations for rural care at birth outcomes, i.e., rural women giving birth in a facility and by Caesarean section (C-section, and associations with health systems inputs (financing, health workforce, facilities, and commodities, outputs (readiness and quality of care and context (education and GDP. Methods We undertook correlation analyses of subnational-level associations between health system inputs, outputs, context, and rural care at birth outcomes; and constructed implementation readiness barometers using benchmarks for each health system input indicator. We used geographical information system (GIS mapping to visualise subnational variations in care at birth for rural women, with a focus on service availability and readiness, and collected qualitative data to investigate financial flows from national to council level to understand variation in financing inputs. Results We found wide subnational variation for rural care at birth outcomes, health systems inputs, and contextual indicators. There was a positive association between rural women giving birth in a facility and by C-section; maternal education; workforce and facility density; and quality of care. There was a negative association between these outcomes and proportion of all births to rural women, total fertility rate, and availability of essential commodities at facilities. Per capita recurrent expenditure was positively associated with facility births (correlation coefficient = 0.43; p = 0.05 but not with C-section. Qualitative results showed that the health financing system is complex and insufficient for providing care at birth services

  7. METHODICAL APPROACHES TO ASSESSMENT OF EFFICIENCY OF INVESTMENT PROJECTS OF DEVELOPMENT OF RURAL TERRITORIES

    Directory of Open Access Journals (Sweden)

    Nadejda Shatsilo

    2018-05-01

    Full Text Available The purpose is to justify the principles of assessing the effectiveness of innovation and investment projects of rural areas development on the basis of sustainability. Research methodology. In the course of the research general scientific and special methods for solving the tasks and obtaining the corresponding results were used, in particular: the method of logical analysis - in determining the factors of influence on the efficiency of investment projects; Systematization and generalization - in the synthesis of modern methodological approaches to the evaluation of innovation and investment projects of rural areas development; Abstract-logical - for theoretical generalizations and formulation of the findings of the study. Results.The principles of estimation of efficiency of innovative-investment projects are generalized. The interrelation and interdependence of goals and tasks in the development of three subsystems of sustainability have been studied, which need to be taken into account when identifying the effects arising from the implementation of investment projects. The methodological principles of evaluation of innovation-investment projects of rural areas development in conditions of observance of the requirements of sustainable development are highlighted. The deterrent factors hindering the implementation of the processes of investment of investment resources in the development of rural areas are determined. The principles of implementation of investment projects oriented on sustainable development are substantiated. Priority directions of investing resources investment in the development of rural areas on the principles of sustainability within the framework of solving economic, social and environmental problems have been identified. The mechanism of estimation of efficiency of innovative-investment project of development of rural territory in the conditions of limited financial resources is offered. It is substantiated that it is

  8. Factors Influencing the Consumption of Pulses in Rural and Urban ...

    African Journals Online (AJOL)

    Model results revealed that household sizes and education levels of the decision makers residing ... Key words: Pulses consumption, urban and rural areas, Tanzania and double hurdle model ...... Food and Agriculture Organization Statistics.

  9. Mobile Phone Use in Two Secondary Schools in Tanzania

    Science.gov (United States)

    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…

  10. Women, donors and land administration: The Tanzania case

    OpenAIRE

    Pedersen, Rasmus Hundsbæk; Haule, Scholastica

    2013-01-01

    Tanzania's land reform from 1999 has been evaluated as among the most gender-sensitive of its kind in Sub-Saharan Africa. However, there is a gap between the legal framework and what is happening on the ground. This working paper analyses the challenges related to the protection of women's rights to land in rural areas. It provides detailed information on reform implementation experiences so far by analysing a number of government and NGO interventions. It furthermore discusses the ambiguous ...

  11. Knowledge and use of modern family planning methods by rural women in Zambia

    Directory of Open Access Journals (Sweden)

    C. Mubita-Ngoma

    2010-09-01

    Full Text Available The main aim of the study was to determine knowledge and use of modem contractive methods among reproductive age group rural women in Zambia. The study is a descriptive cross-sectional study of 105 randomly selected rural women. Data was collected using semi-structured interview schedule and analyzed using EPI Info version 6 statistical packages. The findings revealed that 63% of the respondents were within the age group 21-35 years, 65% were married and 64% were peasant farmers. 90% of the respondents had heard about modem contraceptives and their main source of information was the Health worker (62%. 76% of the respondents stated that modem contraceptive methods could be obtained from public health facilities. 56% of the respondents were currently using modem contraceptive methods and 46% were not using modem contraceptive methods. Reasons for non use of contraceptive methods were religious beliefs (50%, partner disapproval (30% and side effects (20%. The results showed a relationship between educational level and use of contraceptives (Chi-square 7.83, df = 3, P < 0.05 and spouse approval or support of contractive methods and use of contraceptive (Chisquare 5.9, df = 2, P < 0.05. Therefore, efforts to promote modem contraceptive use among the rural women should be intensified to overcome barriers to contraceptive use and should involve men.

  12. In the way of clean and safe drinking water : exploring limitations to improvement of the water supply in Bagamoyo District, Tanzania

    OpenAIRE

    Bemspång, Josefina; Segerström, Rebecka

    2009-01-01

    Bagamoyo District, in the Pwani region in Tanzania, supplies a large part of Tanzania'sbiggest city, Dar es Salaam, with water. At the same time many people in rural villages in thedistrict do not have access to clean and safe water. This thesis aims to explore what limitationsthere are to improvement of the rural water supply in Bagamoyo District. Specific attention ispaid to the organizational structure of the water sector and how roles and responsibilities aredivided, defined and communica...

  13. High maternal mortality in rural south-west Ethiopia: estimate by using the sisterhood method

    Directory of Open Access Journals (Sweden)

    Yaya Yaliso

    2012-11-01

    Full Text Available Abstract Background Estimation of maternal mortality is difficult in developing countries without complete vital registration. The indirect sisterhood method represents an alternative in places where there is high fertility and mortality rates. The objective of the current study was to estimate maternal mortality indices using the sisterhood method in a rural district in south-west Ethiopia. Method We interviewed 8,870 adults, 15–49 years age, in 15 randomly selected rural villages of Bonke in Gamo Gofa. By constructing a retrospective cohort of women of reproductive age, we obtained sister units of risk exposure to maternal mortality, and calculated the lifetime risk of maternal mortality. Based on the total fertility for the rural Ethiopian population, the maternal mortality ratio was approximated. Results We analyzed 8503 of 8870 (96% respondents (5262 [62%] men and 3241 ([38%] women. The 8503 respondents reported 22,473 sisters (average = 2.6 sisters for each respondent who survived to reproductive age. Of the 2552 (11.4% sisters who had died, 819 (32% occurred during pregnancy and childbirth. This provided a lifetime risk of 10.2% from pregnancy and childbirth with a corresponding maternal mortality ratio of 1667 (95% CI: 1564–1769 per 100,000 live births. The time period for this estimate was in 1998. Separate analysis for male and female respondents provided similar estimates. Conclusion The impoverished rural area of Gamo Gofa had very high maternal mortality in 1998. This highlights the need for strengthening emergency obstetric care for the Bonke population and similar rural populations in Ethiopia.

  14. Connecting rural-urban economies?

    DEFF Research Database (Denmark)

    Larsen, Marianne Nylandsted; Birch-Thomsen, Torben; Lazaro, Evelyn

    The interlinked relationships between urban settlements and their rural hinterlands in Sub-Saharan Africa are perceived crucial in enhancing possibilities for livelihood diversification and poverty reduction. Urban settlements provide opportunities for investment in more remunerative economic...... activities, job/employment opportunities that retain potential migrants in the area, and access to services for the rural hinterlands. This paper examines the role of emerging urban centres (EUCs) as ‘drivers’ of rural development based on a study of two EUCs and their rural hinterlands in Tanzania. Findings...... and poverty reduction....

  15. Tanzania country study

    Energy Technology Data Exchange (ETDEWEB)

    Meena, H E [Centre for Energy, Environment, Science and Technology, Dar es Salaam (Tanzania, United Republic of)

    1998-10-01

    An objective of this study is to analyse the role of the land use sectors of Tanzania (especially forestry) on mitigation of greenhouse gases. Specific emphasis is placed on the relationship between forestry and energy supply from biomass. This is a follow up study on an earlier effort which worked on mitigation options in the country without an in-depth analysis of the forestry and land use sectors. (au)

  16. Tanzania country study

    International Nuclear Information System (INIS)

    Meena, H.E.

    1998-01-01

    An objective of this study is to analyse the role of the land use sectors of Tanzania (especially forestry) on mitigation of greenhouse gases. Specific emphasis is placed on the relationship between forestry and energy supply from biomass. This is a follow up study on an earlier effort which worked on mitigation options in the country without an in-depth analysis of the forestry and land use sectors. (au)

  17. Hypertension in sub-Saharan Africa: cross-sectional surveys in four rural and urban communities.

    Directory of Open Access Journals (Sweden)

    Marleen E Hendriks

    Full Text Available BACKGROUND: Cardiovascular disease (CVD is the leading cause of adult mortality in low-income countries but data on the prevalence of cardiovascular risk factors such as hypertension are scarce, especially in sub-Saharan Africa (SSA. This study aims to assess the prevalence of hypertension and determinants of blood pressure in four SSA populations in rural Nigeria and Kenya, and urban Namibia and Tanzania. METHODS AND FINDINGS: We performed four cross-sectional household surveys in Kwara State, Nigeria; Nandi district, Kenya; Dar es Salaam, Tanzania and Greater Windhoek, Namibia, between 2009-2011. Representative population-based samples were drawn in Nigeria and Namibia. The Kenya and Tanzania study populations consisted of specific target groups. Within a final sample size of 5,500 households, 9,857 non-pregnant adults were eligible for analysis on hypertension. Of those, 7,568 respondents ≥ 18 years were included. The primary outcome measure was the prevalence of hypertension in each of the populations under study. The age-standardized prevalence of hypertension was 19.3% (95%CI:17.3-21.3 in rural Nigeria, 21.4% (19.8-23.0 in rural Kenya, 23.7% (21.3-26.2 in urban Tanzania, and 38.0% (35.9-40.1 in urban Namibia. In individuals with hypertension, the proportion of grade 2 (≥ 160/100 mmHg or grade 3 hypertension (≥ 180/110 mmHg ranged from 29.2% (Namibia to 43.3% (Nigeria. Control of hypertension ranged from 2.6% in Kenya to 17.8% in Namibia. Obesity prevalence (BMI ≥ 30 ranged from 6.1% (Nigeria to 17.4% (Tanzania and together with age and gender, BMI independently predicted blood pressure level in all study populations. Diabetes prevalence ranged from 2.1% (Namibia to 3.7% (Tanzania. CONCLUSION: Hypertension was the most frequently observed risk factor for CVD in both urban and rural communities in SSA and will contribute to the growing burden of CVD in SSA. Low levels of control of hypertension are alarming. Strengthening of health

  18. Metodo y Proceso de la Investigacion Participativa en la Capacitacion Rural (The Method and Process of Participatory Research in Rural Leadership Training). Cuadernos del CREFAL 19.

    Science.gov (United States)

    de Schutter, Anton

    In participatory research, education and learner participation are directly connected. The document analyzes the role of a participatory research method in the basic education of rural adults. The different phases of the Participant Research method are presented, along with a profound analysis of both research and participation. The claim is that…

  19. Does the Spectrum model accurately predict trends in adult mortality? Evaluation of model estimates using empirical data from a rural HIV community cohort study in north-western Tanzania

    Directory of Open Access Journals (Sweden)

    Denna Michael

    2014-01-01

    Full Text Available Introduction: Spectrum epidemiological models are used by UNAIDS to provide global, regional and national HIV estimates and projections, which are then used for evidence-based health planning for HIV services. However, there are no validations of the Spectrum model against empirical serological and mortality data from populations in sub-Saharan Africa. Methods: Serologic, demographic and verbal autopsy data have been regularly collected among over 30,000 residents in north-western Tanzania since 1994. Five-year age-specific mortality rates (ASMRs per 1,000 person years and the probability of dying between 15 and 60 years of age (45Q15, were calculated and compared with the Spectrum model outputs. Mortality trends by HIV status are shown for periods before the introduction of antiretroviral therapy (1994–1999, 2000–2005 and the first 5 years afterwards (2005–2009. Results: Among 30–34 year olds of both sexes, observed ASMRs per 1,000 person years were 13.33 (95% CI: 10.75–16.52 in the period 1994–1999, 11.03 (95% CI: 8.84–13.77 in 2000–2004, and 6.22 (95% CI; 4.75–8.15 in 2005–2009. Among the same age group, the ASMRs estimated by the Spectrum model were 10.55, 11.13 and 8.15 for the periods 1994–1999, 2000–2004 and 2005–2009, respectively. The cohort data, for both sexes combined, showed that the 45Q15 declined from 39% (95% CI: 27–55% in 1994 to 22% (95% CI: 17–29% in 2009, whereas the Spectrum model predicted a decline from 43% in 1994 to 37% in 2009. Conclusion: From 1994 to 2009, the observed decrease in ASMRs was steeper in younger age groups than that predicted by the Spectrum model, perhaps because the Spectrum model under-estimated the ASMRs in 30–34 year olds in 1994–99. However, the Spectrum model predicted a greater decrease in 45Q15 mortality than observed in the cohort, although the reasons for this over-estimate are unclear.

  20. Geocoding rural addresses in a community contaminated by PFOA: a comparison of methods

    Directory of Open Access Journals (Sweden)

    Gallagher Lisa G

    2010-04-01

    Full Text Available Abstract Background Location is often an important component of exposure assessment, and positional errors in geocoding may result in exposure misclassification. In rural areas, successful geocoding to a street address is limited by rural route boxes. Communities have assigned physical street addresses to rural route boxes as part of E911 readdressing projects for improved emergency response. Our study compared automated and E911 methods for recovering and geocoding valid street addresses and assessed the impact of positional errors on exposure classification. Methods The current study is a secondary analysis of existing data that included 135 addresses self-reported by participants of a rural community study who were exposed via public drinking water to perfluorooctanoate (PFOA released from a DuPont facility in Parkersburg, West Virginia. We converted pre-E911 to post-E911 addresses using two methods: automated ZP4 address-correction software with the U.S. Postal Service LACS database and E911 data provided by Wood County, West Virginia. Addresses were geocoded using TeleAtlas, an online commercial service, and ArcView with StreetMap Premium North America NAVTEQ 2008 enhanced street dataset. We calculated positional errors using GPS measurements collected at each address and assessed exposure based on geocoded location in relation to public water pipes. Results The county E911 data converted 89% of the eligible addresses compared to 35% by ZP4 LACS. ArcView/NAVTEQ geocoded more addresses (n = 130 and with smaller median distance between geocodes and GPS coordinates (39 meters than TeleAtlas (n = 85, 188 meters. Without E911 address conversion, 25% of the geocodes would have been more than 1000 meters from the true location. Positional errors in TeleAtlas geocoding resulted in exposure misclassification of seven addresses whereas ArcView/NAVTEQ methods did not misclassify any addresses. Conclusions Although the study was limited by small

  1. Corporal Punishment in Tanzania's Schools

    Science.gov (United States)

    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…

  2. SAR-aided method for rural soil evaluation

    Science.gov (United States)

    Lay-Ekuakille, Aime; Dellisanti, Carmelo; Pelillo, Vincenza; Tralli, Francesco

    2003-03-01

    The principal land characteristics that can be estimated by means of airphoto interpretation are bedrock type, landform, soil texture, site drainage conditions, susceptibility to flooding, and depth of unconsolidated materials over bedrock. In addition, the slope of the land surface can be estimated by airphoto interpretation and measured by phptpgrammetric methods. The aim of this paper is to show an experimental use of satellite images in determining soil quality affected by anthropic activities as rock crushing, or scarifying. Scarifying activities began, in Murgia area, Apulia Region, Italy), as land improvement for agriculture uses. Scarifying is defined as loosening (the surface of soil) by using an agricultural tool or a machine with prongs. This kind of activity is facilitated by the availability, on the market, of scarifying machines and the objective is to get a stratum of agriculture-useful loose material on the soil surface. Apulia Region Government has permitted calcareous stone scarifying with Regional Law n.54 (August 31, 1981) according to National Law n.984 (Dicember 27,1977), that provides for encouraging to transform grazing in sown land in order to create new possibility of forage production to increase zootecnical facilities. We have used ERS-2/SAR images as contribution in the process of soil characterization.The area we have considered is in Puglia Region and is subject to soil transformation due to rocks crushed on land for agricultural facilities. European Union, through the same Apulia Region Government, has renewed funds for the improvement of meadow and grazing for an overall surface of 2000 hectares. In this way it is clear to understand the importance of qualitative and quantitative evaluation of rock crushing or scarifying by using airphoto interpretation. We have evaluated the soil quality by introducing a multicriteria, analysis by using a qualitative and quantitative methodology, so that it will be possible to prevent damages on

  3. Geocoding rural addresses in a community contaminated by PFOA: a comparison of methods.

    Science.gov (United States)

    Vieira, Verónica M; Howard, Gregory J; Gallagher, Lisa G; Fletcher, Tony

    2010-04-21

    Location is often an important component of exposure assessment, and positional errors in geocoding may result in exposure misclassification. In rural areas, successful geocoding to a street address is limited by rural route boxes. Communities have assigned physical street addresses to rural route boxes as part of E911 readdressing projects for improved emergency response. Our study compared automated and E911 methods for recovering and geocoding valid street addresses and assessed the impact of positional errors on exposure classification. The current study is a secondary analysis of existing data that included 135 addresses self-reported by participants of a rural community study who were exposed via public drinking water to perfluorooctanoate (PFOA) released from a DuPont facility in Parkersburg, West Virginia. We converted pre-E911 to post-E911 addresses using two methods: automated ZP4 address-correction software with the U.S. Postal Service LACS database and E911 data provided by Wood County, West Virginia. Addresses were geocoded using TeleAtlas, an online commercial service, and ArcView with StreetMap Premium North America NAVTEQ 2008 enhanced street dataset. We calculated positional errors using GPS measurements collected at each address and assessed exposure based on geocoded location in relation to public water pipes. The county E911 data converted 89% of the eligible addresses compared to 35% by ZP4 LACS. ArcView/NAVTEQ geocoded more addresses (n = 130) and with smaller median distance between geocodes and GPS coordinates (39 meters) than TeleAtlas (n = 85, 188 meters). Without E911 address conversion, 25% of the geocodes would have been more than 1000 meters from the true location. Positional errors in TeleAtlas geocoding resulted in exposure misclassification of seven addresses whereas ArcView/NAVTEQ methods did not misclassify any addresses. Although the study was limited by small numbers, our results suggest that the use of county E911 data in rural

  4. Factors influencing access to agricultural knowledge: The case of smallholder rice farmers in the Kilombero district of Tanzania

    Directory of Open Access Journals (Sweden)

    Wulystan P. Mtega

    2016-05-01

    Full Text Available Background: Access to agricultural knowledge is important in transforming livelihoods of those relying on agriculture for a living and in enhancing food security. This access to agricultural knowledge is influenced by infrastructure needed for information dissemination. However, information infrastructure is not uniformly distributed within and between countries. It is because of this that some of the farming communities are information rich while others are information poor. In Tanzania, the agricultural sector is characterised by poor research-extension-farmers linkage and inaccessibility of agricultural knowledge at farm level Objective: The study investigated the factors influencing access to agricultural knowledge among smallholder rice farmers in the Kilombero district of Tanzania. Specifically, the study identified categories of agricultural knowledge needed by farmers, determined how farmers access agricultural knowledge, and assessed the factors limiting the accessibility of agricultural knowledge among rice farmers in the Kilombero district. Method: Quantitative data were collected via semi-structured questionnaires administered face-to-face with rice farmers, community leaders, and agricultural agents in four villages at the Kilombero district of the Morogoro region in Tanzania. Results: The key finding indicates that farmers accessed and used agricultural knowledge in undertaking agricultural activities. It was further revealed that the level of acquisition of agricultural knowledge increased with an increase in age. Farmers needed agricultural knowledge on land preparation, seed selection, and rice planting, while few acquired knowledge on agricultural markets. Among the agricultural knowledge sources used, demonstration plots and agricultural extension agents were found to be used by the majority of the farmers. It was also found that a limited number of demonstration plots, late delivery of information services, a limited number

  5. Interdependence of domestic malaria prevention measures and mosquito-human interactions in urban Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Mshinda Hassan

    2007-09-01

    Full Text Available Abstract Background Successful malaria vector control depends on understanding behavioural interactions between mosquitoes and humans, which are highly setting-specific and may have characteristic features in urban environments. Here mosquito biting patterns in Dar es Salaam, Tanzania are examined and the protection against exposure to malaria transmission that is afforded to residents by using an insecticide-treated net (ITN is estimated. Methods Mosquito biting activity over the course of the night was estimated by human landing catch in 216 houses and 1,064 residents were interviewed to determine usage of protection measures and the proportion of each hour of the night spent sleeping indoors, awake indoors, and outdoors. Results Hourly variations in biting activity by members of the Anopheles gambiae complex were consistent with classical reports but the proportion of these vectors caught outdoors in Dar es Salaam was almost double that of rural Tanzania. Overall, ITNs confer less protection against exophagic vectors in Dar es Salaam than in rural southern Tanzania (59% versus 70%. More alarmingly, a biting activity maximum that precedes 10 pm and much lower levels of ITN protection against exposure (38% were observed for Anopheles arabiensis, a vector of modest importance locally, but which predominates transmission in large parts of Africa. Conclusion In a situation of changing mosquito and human behaviour, ITNs may confer lower, but still useful, levels of personal protection which can be complemented by communal transmission suppression at high coverage. Mosquito-proofing houses appeared to be the intervention of choice amongst residents and further options for preventing outdoor transmission include larviciding and environmental management.

  6. Smart density: a more accurate method of measuring rural residential density for health-related research

    Directory of Open Access Journals (Sweden)

    Gibson Lucinda

    2010-02-01

    Full Text Available Abstract Background Studies involving the built environment have typically relied on US Census data to measure residential density. However, census geographic units are often unsuited to health-related research, especially in rural areas where development is clustered and discontinuous. Objective We evaluated the accuracy of both standard census methods and alternative GIS-based methods to measure rural density. Methods We compared residential density (units/acre in 335 Vermont school neighborhoods using conventional census geographic units (tract, block group and block with two GIS buffer measures: a 1-kilometer (km circle around the school and a 1-km circle intersected with a 100-meter (m road-network buffer. The accuracy of each method was validated against the actual residential density for each neighborhood based on the Vermont e911 database, which provides an exact geo-location for all residential structures in the state. Results Standard census measures underestimate residential density in rural areas. In addition, the degree of error is inconsistent so even the relative rank of neighborhood densities varies across census measures. Census measures explain only 61% to 66% of the variation in actual residential density. In contrast, GIS buffer measures explain approximately 90% of the variation. Combining a 1-km circle with a road-network buffer provides the closest approximation of actual residential density. Conclusion Residential density based on census units can mask clusters of development in rural areas and distort associations between residential density and health-related behaviors and outcomes. GIS-defined buffers, including a 1-km circle and a road-network buffer, can be used in conjunction with census data to obtain a more accurate measure of residential density.

  7. Laws for Access to and Management of Drinking Water in Tanzania

    Directory of Open Access Journals (Sweden)

    Leticia K. Nkonya

    2006-06-01

    Full Text Available Increasing human population, economic development and climatic changes in Sub-Saharan Africa (SSA have fuelled water scarcity, hence there is an urgent need for effective water management laws and institutions. Unfortunately, national and local governments rarely possess enough personnel or money to enforce their laws adequately. In SSA countries formal water management laws and institutions tend to ignore the customary laws and institutions. Additionally, local communities both filter and ignore formal laws and institutions and use their customary laws and institutions to manage their water resources. Despite their importance, there are only few empirical studies on customary laws and institutions for water management in SSA. This study attempts to fill this gap by analysing the impact of customary (informal laws on water management in Tanzania and show how they might be used to complement the statutory (formal laws for management of drinking water in rural Tanzania. The study will use both qualitative and quantitative methods to achieve this objective. This study found that customary laws and institutions are the most influential in water access, prevention of pollution and abuse of water. The awareness of the customary and water user group laws was also generally high, perhaps due to the participatory nature of those institutions. The study also found that statutory laws were important for water development issues but community awareness of these laws was low. These results suggest the need of using both customary and statutory laws since the two instruments complement each other.

  8. Smart density: A more accurate method of measuring rural residential density for health-related research.

    Science.gov (United States)

    Owens, Peter M; Titus-Ernstoff, Linda; Gibson, Lucinda; Beach, Michael L; Beauregard, Sandy; Dalton, Madeline A

    2010-02-12

    Studies involving the built environment have typically relied on US Census data to measure residential density. However, census geographic units are often unsuited to health-related research, especially in rural areas where development is clustered and discontinuous. We evaluated the accuracy of both standard census methods and alternative GIS-based methods to measure rural density. We compared residential density (units/acre) in 335 Vermont school neighborhoods using conventional census geographic units (tract, block group and block) with two GIS buffer measures: a 1-kilometer (km) circle around the school and a 1-km circle intersected with a 100-meter (m) road-network buffer. The accuracy of each method was validated against the actual residential density for each neighborhood based on the Vermont e911 database, which provides an exact geo-location for all residential structures in the state. Standard census measures underestimate residential density in rural areas. In addition, the degree of error is inconsistent so even the relative rank of neighborhood densities varies across census measures. Census measures explain only 61% to 66% of the variation in actual residential density. In contrast, GIS buffer measures explain approximately 90% of the variation. Combining a 1-km circle with a road-network buffer provides the closest approximation of actual residential density. Residential density based on census units can mask clusters of development in rural areas and distort associations between residential density and health-related behaviors and outcomes. GIS-defined buffers, including a 1-km circle and a road-network buffer, can be used in conjunction with census data to obtain a more accurate measure of residential density.

  9. Implementing Modular Interactive Tiles for Rehabilitation in Tanzania – a pilot study

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop; Jensen, Line Steiness Dejnbjerg; Ssessanga, Yusuf

    2014-01-01

    The pilot study in the Iringa region, Tanzania, indicates how the modular interactive tiles can be used for playful physical rehabilitation for many diverse patient groups (handicapped children, stroke, cardiac, diabetic patients, etc.) in both urban and rural areas, and how it motivates the user...... and adaptive playful technology for rehabilitation in sub-Saharan Africa....... through play to perform the physical rehabilitative actions. The system can be easily used by rehabilitation workers, and through the modularity it is robust to failure (e.g. power failure) in remote areas. The analyses of the use by many different user groups was condensed to a higher abstraction level...... to provide insight on the generalisation over the different user groups, and to provide pointers of opportunities and the means to meet these opportunities through subsequent development in the next cycles in the iterative research method. The pilot study indicates that the system can be a flexible...

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

    Science.gov (United States)

    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.

  11. Country Presentation Tanzania

    International Nuclear Information System (INIS)

    KIFANGA, L.D.; GYIMBI, H.; MLOWOLA, V.; KASONGWA, M.

    2010-01-01

    Discusses overview of incidents and developments involving illicit trafficking of nuclear and other radioactive materials in Tanzania.13 cases have been recorded between 1996 and 2008. All cases occurred in Dar Es Salam. Police, customs and security staff intercepted the sources and culprits arrested. The latest incident occurred in May 2008 and involved illegal possession of a capsule labelled nuclear material (U-238). A total of 14 sources were seized . Types of sources seized were u-238, Caesium-137, Strontium-90 and Radium-226.

  12. Trapped in decline : a sociological analysis of economic life in Mgeta, Uluguru Mountains Tanzania

    NARCIS (Netherlands)

    Donge, van J.K.

    1993-01-01

    The research for this thesis was carried out in Tanzania during the period 1985- 89 and focuses on the Mgeta division in the Uluguru mountains, Morogoro rural district. Research was also undertaken among migrants from the area living in Dar es Salaam where they traded in foodstuffs. I made

  13. Sleeping sickness situation in Tanzania | Kibona | Tanzania Journal ...

    African Journals Online (AJOL)

    Tanzania Journal of Health Research. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 4, No 2 (2002) >. Log in or Register to get access to full text downloads.

  14. Comparing two survey methods for estimating maternal and perinatal mortality in rural Cambodia.

    Science.gov (United States)

    Chandy, Hoeuy; Heng, Yang Van; Samol, Ha; Husum, Hans

    2008-03-01

    We need solid estimates of maternal mortality rates (MMR) to monitor the impact of maternal care programs. Cambodian health authorities and WHO report the MMR in Cambodia at 450 per 100,000 live births. The figure is drawn from surveys where information is obtained by interviewing respondents about the survival of all their adult sisters (sisterhood method). The estimate is statistically imprecise, 95% confidence intervals ranging from 260 to 620/100,000. The MMR estimate is also uncertain due to under-reporting; where 80-90% of women deliver at home maternal fatalities may go undetected especially where mortality is highest, in remote rural areas. The aim of this study was to attain more reliable MMR estimates by using survey methods other than the sisterhood method prior to an intervention targeting obstetric rural emergencies. The study was carried out in rural Northwestern Cambodia where access to health services is poor and poverty, endemic diseases, and land mines are endemic. Two survey methods were applied in two separate sectors: a community-based survey gathering data from public sources and a household survey gathering data direct from primary sources. There was no statistically significant difference between the two survey results for maternal deaths, both types of survey reported mortality rates around the public figure. The household survey reported a significantly higher perinatal mortality rate as compared to the community-based survey, 8.6% versus 5.0%. Also the household survey gave qualitative data important for a better understanding of the many problems faced by mothers giving birth in the remote villages. There are detection failures in both surveys; the failure rate may be as high as 30-40%. PRINCIPLE CONCLUSION: Both survey methods are inaccurate, therefore inappropriate for evaluation of short-term changes of mortality rates. Surveys based on primary informants yield qualitative information about mothers' hardships important for the design

  15. Increasing the availability and quality of caesarean section in Tanzania.

    Science.gov (United States)

    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 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.

  16. Rural transformations in the context of changing rural-urban connections

    DEFF Research Database (Denmark)

    Birch-Thomsen, Torben; Ørtenblad, Sinne Borby; Msese, Lukelo

    , the infrastructure, including road systems and means of communication, has in general increased and improved. This development has among a number of other things caused changing patterns of mobility. These changes are highly interrelated and connected to changing rural-urban linkages, which include flows of people......, capital, resources, agricultural commodities, goods, services, technology and information, between rural and urban locations. We emphasize that the rural-urban connections go beyond the spatial dichotomy and that the linkages often occur in a dynamic rural-urban continuum. Influenced by these changes......, this paper sets out to elucidate patterns and dynamics of rural transformation in Tanzania in the context of changing rural-urban linkages by presenting data from a particularly dynamic region; namely Njombe Region in the Southern Highlands of Tanzania. Based on fieldwork conducted during 2014 and 2015...

  17. Can REDD+ Reconcile Local Priorities and Needs with Global Mitigation Benefits? Lessons from Angai Forest, Tanzania

    Directory of Open Access Journals (Sweden)

    Irmeli Mustalahti

    2012-03-01

    Full Text Available The scope of the reducing emissions from deforestation and forest degradation (REDD mechanism has broadened REDD+ to accommodate different country interests such as natural forests, protected areas, as well as forests under community-based management. In Tanzania the REDD+ mechanism is still under development and pilot projects are at an early stage. In this paper, we seek to understand how local priorities and needs could be met in REDD+ implementation and how these expectations match with global mitigation benefits. We examine the local priorities and needs in the use of land and forest resources in the Angai Villages Land Forest Reserve (AVLFR in the Liwale District of Lindi Region in Tanzania. Primary data was collected in two villages, Mihumo and Lilombe, using semistructured key informant interviews and participatory rural appraisal methods. In addition, the key informant interviews were conducted with other village, district, and national level actors, as well as international donors. Findings show that in the two communities REDD+ is seen as something new and is generating new expectations among communities. However, the Angai villagers highlight three key priorities that have yet to be integrated into the design of REDD+: water scarcity, rural development, and food security. At the local level improved forest governance and sustainable management of forest resources have been identified as one way to achieve livelihood diversification. Although the national goals of REDD+ include poverty reduction, these goals are not necessarily conducive to the goals of these communities. There exist both structural and cultural limits to the ability of the Angai villages to implement these goals and to improve forestry governance. Given the vulnerability to current and future climate variability and change it will be important to consider how the AVLFR will be managed and for whose benefit?

  18. Tanzania Journal of Health Research

    African Journals Online (AJOL)

    Tanzania Journal of Health Research (TJHR) aims to facilitate the advance of health sciences by publishing high quality research and review articles that communicate new ideas and developments in biomedical and health research. TJHR is ...

  19. Tanzania's healthcare breakthrough | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-11-18

    Nov 18, 2010 ... A model for success. The effects have ... health systems. Globally, there is a growing acceptance of the TEHIP lessons. ... has ended." — Hassan Mshinda, Director General, Tanzania Commission for Science and Technology ...

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

    Directory of Open Access Journals (Sweden)

    Massay Deodatus

    2011-02-01

    Full Text Available Abstract 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

  1. Gender Differences in Rural Off-farm Employment Participation in ...

    African Journals Online (AJOL)

    This paper investigates gender differences in spatial mobility with respect to participation in off-farm employment in rural Tanzania. The mobility issue arises because the recent increase in women participation in off-farm employment is likely to saturate the local labor market/off-farm opportunities and dampen the rural ...

  2. TelePresence in Rural Medical Education: A Mixed Methods Evaluation

    Directory of Open Access Journals (Sweden)

    Katherine Gray

    2014-01-01

    Full Text Available In response to rural health workforce shortages, universities and training providers offer rural and remote clinical placements. This has led to development of educational methods to counter the barriers of distance. In this emerging field, recent improvements in technology have provided solutions including the use of sophisticated videoconferencing systems such as the Cisco TelePresence model CTS-500. This paper evaluates the use of TelePresence in diverse medical education activities using a mixed methods design—questionnaires n=60, individual interviews n=33, and observed practice of activities n=22. TelePresence was found to be beneficial to learning and teaching and superior to other systems participants had used. In particular, the audiovisual quality, resulting intimacy, convenience, and ease of use facilitated teaching and learning, while the fixed camera and poorly arranged physical environment were found to be limitations. The system is best suited for small group activities. Clinical skills-based activities are viable. It is recommended that technical support be available during setup and use and a picture-in-picture mode be included and improved integration of office suite software to provide a joint workspace for display of presentations, images, editing or annotation of documents, and file sharing.

  3. Environmental degradation and intra-household welfare: the case of the Tanzanian rural South Pare Highlands

    NARCIS (Netherlands)

    Dimoso, R.L.

    2009-01-01

    Key words: Environmental degradation, intrahousehold labour allocation, intrahousehold welfare.
    Rural south Pare highlands in Tanzania experience a deteriorating environmental situation. Of particular importance is the disappearance of forests and woodlands. The consequence are declining

  4. Urban agriculture in Tanzania : issues of sustainability

    NARCIS (Netherlands)

    Foeken, D.W.J.

    2004-01-01

    This book, the result of a collaborative study carried out by researchers from Tanzania, Israel and the Netherlands, assesses the sustainability of urban agriculture in two medium-sized towns in Tanzania: Morogoro and Mbeya. It first gives an overview of urban agriculture in Tanzania and a

  5. Institutional Support : African Technology Policy Studies - Tanzania ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    African Technology Policy Studies - Tanzania (ATPS-Tanzania) was registered as a national nongovernmental organization in 2001. ... While resource flows to ATPS-Tanzania from ATPS headquarters in Nairobi were reliable, the organization produced a larger volume of research outputs than most other ATPS national ...

  6. Rural and urban women entrepreneurs: A comparison of service needs and delivery methods priorities

    Directory of Open Access Journals (Sweden)

    Davis, A.

    2011-01-01

    Full Text Available Women entrepreneurs face a wide variety of barriers and challenges throughout the life and growth of their entrepreneurial venture. This study expands the knowledge base on women entrepreneurs’ needs, specifically their needs in terms of service areas and service delivery method preferences. Twenty three “needed” service areas were identified by 95 Manitoba based women entrepreneurs. The first five included: finding new customers, growth benefits and tools, market expansion, general marketing, and networking skills. This study also examined the differences between urban and rural based entrepreneurs. Two service need areas “how to find mentors and role models” and “legal issues” exhibited statistically significant priority differences. Service delivery methods did not produce any statistically significant differences. Overall, this study concludes that regardless of location, women entrepreneurs’ training and support needs are not significantly that different. The effects of entrepreneurial stage and years in business on entrepreneurial support needs are also examined.

  7. A method multi criterio to evaluate projects of rural electrification; Un metodo multicriterio para evaluar proyectos de electrificacion rural

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez Posse, E

    1994-07-01

    In this document about the problem of the evaluation projects methodologies in rural electrification.The low analysis problem is of complex nature, because each project is evaluation object and an economic agent. One of these agents identifies different benefits and cost, and also has a different approaches for value them.In consequence, the form in that it is carried out the evaluation of the one project for each one of this agents that it is usually solved for mechanisms linked to the capacity of incidence or of determination of each one of them, this does not assures a satisfactory results for the general interest.

  8. Antiproliferation effects of selected Tanzania plants | Choi | African ...

    African Journals Online (AJOL)

    Background: Plants still remain a prime source of drugs for the treatment of cancer and can provide leads for the development of novel anticancer agents. Our screening of indigenous medicinal plants from Tanzania has led to the identification of the number of anticancer activity. Material and methods: The current study ...

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

    NARCIS (Netherlands)

    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.

    2008-01-01

    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:

  10. Health care access for rural youth on equal terms? A mixed methods study protocol in northern Sweden.

    Science.gov (United States)

    Goicolea, Isabel; Carson, Dean; San Sebastian, Miguel; Christianson, Monica; Wiklund, Maria; Hurtig, Anna-Karin

    2018-01-11

    The purpose of this paper is to propose a protocol for researching the impact of rural youth health service strategies on health care access. There has been no published comprehensive assessment of the effectiveness of youth health strategies in rural areas, and there is no clearly articulated model of how such assessments might be conducted. The protocol described here aims to gather information to; i) Assess rural youth access to health care according to their needs, ii) Identify and understand the strategies developed in rural areas to promote youth access to health care, and iii) Propose actions for further improvement. The protocol is described with particular reference to research being undertaken in the four northernmost counties of Sweden, which contain a widely dispersed and diverse youth population. The protocol proposes qualitative and quantitative methodologies sequentially in four phases. First, to map youth access to health care according to their health care needs, including assessing horizontal equity (equal use of health care for equivalent health needs,) and vertical equity (people with greater health needs should receive more health care than those with lesser needs). Second, a multiple case study design investigates strategies developed across the region (youth clinics, internet applications, public health programs) to improve youth access to health care. Third, qualitative comparative analysis of the 24 rural municipalities in the region identifies the best combination of conditions leading to high youth access to health care. Fourth, a concept mapping study involving rural stakeholders, care providers and youth provides recommended actions to improve rural youth access to health care. The implementation of this research protocol will contribute to 1) generating knowledge that could contribute to strengthening rural youth access to health care, as well as to 2) advancing the application of mixed methods to explore access to health care.

  11. Characteristics of Women with Unwanted Pregnancies and Reasons for Contraceptive Methods Discontination: Sample of Rural Area

    Directory of Open Access Journals (Sweden)

    Semra Ay

    2012-06-01

    Full Text Available AIM: The aim of the study was to explore the prevalence and characteristics of women with unwanted pregnancy in rural area and to examine pregnant women’s contraceptive method preferences, satisfaction with the methods and reason the methods discontinuation. METHOD: This study was carried out in Manisa city rural area between the dates of January and June 2011 in women who agreed to participate in the study. The sample of the research is composed of 239 pregnant women. The research was a descriptive, cross-sectional and field study and the data was collected by using questionnaire which was prepared by researcher. Data was gathered through the face to face interview with the women at their home. Statistical analyses were undertaken using SPSS version 11.5. Descriptive analysis, Pearson’s Chi-square (χ² test, fisher exact test, and t-test were used statistical evaluation. RESULTS: Of the 239 pregnancies, 64 (26.8% were unwanted pregnancies. The mean age of women was respectively 25.0±5.0, and 29.0±5.4 years, for wanted, and unwanted pregnancies. Women with unwanted pregnancies were older, less educated, they had less educated husbands, had low income level, had more pregnancies, deliveries, had less than two years interval between their births. Unwanted pregnancies were observed in women using the coitus interrupts method (%53.1, effective contraceptive methods (%54.3 and not using any method (%16.3 (p<0.05. The most reasons for discontinuation were reported pregnant women as follows: side effects of methods, disapproval for husband, pregnancy occurs using the method, believe for ineffective contraceptive methods. CONCLUSION: In order to reduce the number of unwanted pregnancies and wanted abortions which reversely affect the women healthy; an appropriate contraception method must be employed. Health care providers should identify women with unwanted pregnancy to understand women's concerns and experiences using contraception. This

  12. Effect of repeated mass drug administration with praziquantel and track and treat of taeniosis cases on the prevalence of taeniosis in Taenia solium endemic rural communities of Tanzania

    DEFF Research Database (Denmark)

    Braae, Uffe Christian; Magnussen, Pascal; Ndawi, Benedict

    received MDA with praziquantel in 2012 (both districts) and in 2013 (Mbozi only). Three cross-sectional population-based surveys were performed in 2012 (R0), 2013 (R1), and 2014 (R2). In each survey approximately 3,000 participants of all ages were tested using copro-antigen-ELISA. The prevalence......This study evaluated the effect of mass drug administration (MDA) with praziquantel administered to school-aged children (SAC) combined with ‘track and treat’ of taeniosis cases on the prevalence of taeniosis. The study was conducted in 14 villages in Mbozi and Mbeya district, Tanzania. SAC.......004, OR 0.12 CI: 0.02-0.41) and R2 (p=0.001, OR 0.24, CI: 0.09-0.53) when comparing to R0. In Mbeya infection decreased at R1 (p=0.013, OR 0.14, CI: 0.02-0.55), but no difference was found for R2 (p=0. 089), compared to R0 among SAC. This study showed that school-based MDA with praziquantel in combination...

  13. Incidence of human brucellosis in the Kilimanjaro Region of Tanzania in the periods 2007–2008 and 2012–2014

    Science.gov (United States)

    Carugati, Manuela; Biggs, Holly M; Maze, Michael J; Stoddard, Robyn A; Cash-Goldwasser, Shama; Hertz, Julian T; Halliday, Jo E B; Saganda, Wilbrod; Lwezaula, Bingileki F; Kazwala, Rudovick R; Cleaveland, Sarah; Maro, Venance P; Rubach, Matthew P; Crump, John A

    2018-01-01

    Abstract Background Brucellosis causes substantial morbidity among humans and their livestock. There are few robust estimates of the incidence of brucellosis in sub-Saharan Africa. Using cases identified through sentinel hospital surveillance and health care utilization data, we estimated the incidence of brucellosis in Moshi Urban and Moshi Rural Districts, Kilimanjaro Region, Tanzania, for the periods 2007–2008 and 2012–2014. Methods Cases were identified among febrile patients at two sentinel hospitals and were defined as having either a 4-fold increase in Brucella microscopic agglutination test titres between acute and convalescent serum or a blood culture positive for Brucella spp. Findings from a health care utilization survey were used to estimate multipliers to account for cases not seen at sentinel hospitals. Results Of 585 patients enrolled in the period 2007–2008, 13 (2.2%) had brucellosis. Among 1095 patients enrolled in the period 2012–2014, 32 (2.9%) had brucellosis. We estimated an incidence (range based on sensitivity analysis) of brucellosis of 35 (range 32–93) cases per 100 000 persons annually in the period 2007–2008 and 33 (range 30–89) cases per 100 000 persons annually in the period 2012–2014. Conclusions We found a moderate incidence of brucellosis in northern Tanzania, suggesting that the disease is endemic and an important human health problem in this area. PMID:29697848

  14. Equity and coverage of insecticide-treated bed nets in an area of intense transmission of Plasmodium falciparum in Tanzania

    Directory of Open Access Journals (Sweden)

    Mtei Frank

    2009-04-01

    Full Text Available Abstract Background There is no clear consensus on the most sustainable and effective distribution strategy for insecticide treated bed nets (ITNs. Tanzania has been a leader in social marketing but it is still not clear if this can result in high and equitable levels of coverage. Methods A cluster-randomized survey of ITN and bed net ownership and use was conducted in a rural area exposed to intense Plasmodium falciparum transmission in NE Tanzania where ITN distribution had been subject to routine delivery of national strategies and episodic free distribution through local clinics. Data were collected on household assets to assess equity of ITN coverage and a rapid diagnostic test for malaria (RDT was performed in all ages. Results Among 598 households in four villages the use of any or insecticidal bed nets in children less than five years of age was 71% and 54% respectively. However there was a 19.8% increase in the number of bed nets per person (p Conclusion Marked inequity persists with the poorest households still experiencing the highest risk of malaria and the lowest ITN coverage. Abolition of this inequity within the foreseeable future is likely to require mass or targeted free distribution, but risks damaging what is otherwise an effective commercial market.

  15. A building characterization-based method for the advancement of knowledge on external architectural features of traditional rural buildings

    Directory of Open Access Journals (Sweden)

    Porto, S. M. C.

    2013-12-01

    Full Text Available The significant role that traditional rural buildings have with regard to environmental conservation and rural development is widely acknowledged by the scientific community. These buildings must be protected from inappropriate building interventions that may stem from their rather superficial knowledge. Therefore, this study was directed towards overcoming such a limitation by developing a method based on traditional rural buildings’ characterization. In particular, the study aimed at the characterization of building materials and techniques used for the construction of a number of building components that make up the external envelope of traditional rural buildings. The application of the method to a homogeneous area of the Etna Regional Park (Italy highlighted the need to improve the technical norms of the park’s Territorial Coordination Plan to respect the building characteristics of the traditional rural buildings located in the protected area.La comunidad científica le atribuye a las construcciones rurales tradicionales un papel fundamental en términos de conservación del medioambiente y de evolución rural. Dichos edificios deben ser protegidos contra obras inapropiadas debidas a un conocimiento más bien superficial. Por lo tanto, el objetivo de este estudio fue el de eliminar dichas limitaciones desarrollando un método basado en la caracterización de las construcciones rurales tradicionales, que puede ser aplicado para mejorar el conocimiento de estas últimas. En particular, el susodicho estudio tiene la finalidad de caracterizar los materiales y las técnicas constructivas a emplear para la construcción de algunos componentes del envoltorio externo de las construcciones rurales tradicionales. La aplicación del método propuesto a una zona homogénea del Parque Regional del Etna (Italia puso de relieve la necesidad de mejorar las normas técnicas del Plan de Coordinación Territorial del parque para respetar las caracter

  16. The Farmer Field School: a method for enhancing the role of rural communities in malaria control ?

    Directory of Open Access Journals (Sweden)

    Knols Bart GJ

    2006-01-01

    Full Text Available Abstract Malaria has strong linkages with agriculture, and farmers in malarious regions have a central position in creating or controlling the conditions that favour disease transmission. An interdisciplinary and integrated approach is needed to involve farmers and more than one sector in control efforts. It is suggested that malaria control can benefit from a complementary intervention in rural development, the Farmer Field School (FFS on Integrated Pest Management (IPM. This is a form of education that uses experiential learning methods to build farmers' expertise, and has proven farm-level and empowerment effects. The benefits of incorporating malaria control into the IPM curriculum are discussed. An example of a combined health-agriculture curriculum, labeled Integrated Pest and Vector Management (IPVM, developed in Sri Lanka is presented. Institutional ownership and support for IPVM could potentially be spread over several public sectors requiring a process for institutional learning and reform.

  17. Fruit and vegetable consumption and prevalence of diet-related chronic non-communicable diseases in Zanzibar, Tanzania: a mixed methods study

    DEFF Research Database (Denmark)

    Keller, Amélie; de Courten, Max; Dræbel, Tania

    2012-01-01

    did the independent sample t test for obesity and blood pressure and obesity and fruit and vegetable consumption in rural and urban areas. We did ANOVA to assess the association between hypertension and fruit and vegetable intake. We used SPSS (version 20) for the analyses. The qualitative component...

  18. Tanzania country study

    Energy Technology Data Exchange (ETDEWEB)

    1999-09-01

    Objectives of this study are to analyse the role of the land use sectors of Tanzania (especially forestry) on mitigation of greenhouse gases. Specific emphasis is placed on the relationship between forestry and energy supply from biomass, as well as other forestry products. This is a follow up study on an earlier effort which worked on mitigation options in the country without and in-depth analysis of the forestry and land use sectors. Analysis of the mitigation scenario has been based on Comprehensive Mitigation Analysis (COMAP). This study has analysed the forestry and land use sector behaviour on the basis of the current policies on land and environment. Furthermore three scenarios have been developed on the basis of what is expected to happen in the sectors, the worse scenario being a catastrophic one where if things takes the business as usual trend then the forest resources will easily be depleted. The TFAP scenario takes into account the implementation of the current plans as scheduled while the mitigation scenario takes into account the GHG mitigation in the implementation of the plans. A Comprehensive Mitigation Analysis Process (COMAP) has been used to analyse the GHG and cost implications of the various programmes under the mitigation scenario. (au) 30 refs.

  19. Crater Highlands, Tanzania

    Science.gov (United States)

    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, and host rain

  20. Tanzania Journal of Agricultural Sciences

    African Journals Online (AJOL)

    Agricultural Policy Analysis Studies in Tanzania: A Historical and Thematic Perspective with Implications on Future Policy Research for Crop Production and Marketing · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. A.C. Isinika, G.M. Mibavu, J.J. VanSickle ...

  1. Tanzania : Country Procurement Assessment Report

    OpenAIRE

    World Bank

    2003-01-01

    This Country Procurement Assessment Report (CPAR)intends to determine the compatibility of national procurement law, and practices, with the principles of economy, and with international procurement practices. This CPAR, the second of its kind in Tanzania, looks at the legislative framework, the performance of regulatory functions, the enforcement regime, and the capacity of public sector ...

  2. Tanzania Veterinary Journal: Editorial Policies

    African Journals Online (AJOL)

    Focus and Scope. The Tanzania Veterinary Journal (The Tropical Veterinarian) is a biannual Journal, which publishes original contribution to knowledge on Veterinary Science, Animal Science and Production, and allied sciences including new techniques and developments in Veterinary Medicine. The target readers of the ...

  3. Health and self-reliance: the experience of Tanzania.

    Science.gov (United States)

    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.

  4. Research on the evaluation method of rural hollowing based on RS and GIS technology: a case study of the Ningxia Hui autonomous region in China

    Science.gov (United States)

    Yin, Kai; Wen, MeiPing; Zhang, FeiFei; Yuan, Chao; Chen, Qiang; Zhang, Xiupeng

    2016-10-01

    With the acceleration of urbanization in China, most rural areas formed a widespread phenomenon, i.e., destitute village, labor population loss, land abandonment and rural hollowing. And it formed a unique hollow village problem in China finally. The governance of hollow village was the objective need of the development of economic and social development in rural area for Chinese government, and the research on the evaluation method of rural hollowing was the premise and basis of the hollow village governance. In this paper, several evaluation methods were used to evaluate the rural hollowing based on the survey data, land use data, social and economic development data. And these evaluation indexes were the transition of homesteads, the development intensity of rural residential areas, the per capita housing construction area, the residential population proportion in rural area, and the average annual electricity consumption, which can reflect the rural hollowing degree from the land, population, and economy point of view, respectively. After that, spatial analysis method of GIS was used to analyze the evaluation result for each index. Based on spatial raster data generated by Kriging interpolation, we carried out re-classification of all the results. Using the fuzzy clustering method, the rural hollowing degree in Ningxia area was reclassified based on the two spatial scales of county and village. The results showed that the rural hollowing pattern in the Ningxia Hui Autonomous Region had a spatial distribution characteristics that the rural hollowing degree was obvious high in the middle of the study area but was low around the study area. On a county scale, the specific performances of the serious rural hollowing were the higher degree of extensive land use, and the lower level of rural economic development and population transfer concentration. On a village scale, the main performances of the rural hollowing were the rural population loss and idle land. The

  5. Application of basic pharmacology and dispensing practice of antibiotics in accredited drug-dispensing outlets in Tanzania

    Directory of Open Access Journals (Sweden)

    Minzi OM

    2013-01-01

    Full Text Available OM Minzi,1 VS Manyilizu21Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, 2Logistics System Strengthening Unit, John Snow Inc, Dar es Salaam, TanzaniaBackground: Provision of pharmaceutical services in accredited drug-dispensing outlets (ADDOs in Tanzania has not been reported. This study compared the antibiotics dispensing practice between ADDOs and part II shops, or duka la dawa baridi (DLDBs, in Tanzania.Methodology: This was a cross-sectional study that was conducted in ADDOs and DLDBs. A simulated client method for data collection was used, and a total of 85 ADDOs, located in Mvomero, Kilombero, and Morogoro rural districts, were compared with 60 DLDBs located in Kibaha district. The research assistants posed as simulated clients and requested to buy antibiotics from ADDOs and DLDBs after presenting a case scenario or disease condition. Among the diseases presented were those requiring antibiotics and those usually managed only by oral rehydration salt or analgesics. The simulated clients wanted to know the antibiotics that were available at the shop. The posed questions set a convincing ground to the dispenser either to dispense the antibiotic directly, request a prescription, or refer the patient to a health facility. Proportions were used to summarize categorical variables between ADDOs and DLDBs, and the chi-square test was used to test for statistical difference between the two drug-outlet types in terms of antibiotic-dispensing practice.Results: As many as 40% of trained ADDO dispensers no longer worked at the ADDO shops, so some of the shops employed untrained staff. A larger proportion of ADDOs than DLDBs dispensed antibiotics without prescriptions (P = 0.004. The overall results indicate that there was no difference between the two types of shops in terms of adhering to regulations for dispensing antibiotics. However, in some circumstances, eg

  6. Sexual practices among unmarried adolescents in Tanzania

    Directory of Open Access Journals (Sweden)

    Masatu Melkiory C

    2009-10-01

    Full Text Available Abstract 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.

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

    Science.gov (United States)

    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.

  8. Off-farm employment and income poverty in favourable agro-climatic areas of Tanzania

    DEFF Research Database (Denmark)

    Msinde, John Victor; Urassa, Justin K.; Nathan, Iben

    2016-01-01

    Income poverty in Tanzania as elsewhere in developing countries is predominantly a rural phenomenon and affects largely households relying on subsistence farming. This is despite the fact that poverty reduction strategies have devoted increasing attention on the role farm employment in enhancing...... household income. This paper argues that, off-farm employment may have potential to contribute to reduction of rural households’ income poverty. Hence the main objective of the paper is set to examine effects of off-farm employment on income poverty. Data was collected from a random sample of 309 households...... in the first quarter of 2014 in five villages of Kilombero Valley, Tanzania using a structured questionnaire. Income poverty was analysed using the Foster-Greer-Thorbecke (FGT) poverty index and two stage least square (2SLS) regression. Households with off-farm employment income were found to be less poor...

  9. Winners and losers of IWRM in Tanzania

    Directory of Open Access Journals (Sweden)

    Barbara van Koppen,

    2016-10-01

    Full Text Available This paper focuses on the application of the concept of Integrated Water Resources Management (IWRM in Tanzania. It asks: how did IWRM affect the rural and fast-growing majority of smallholder farmersʼ access to water which contributes directly to poverty alleviation and employment creation in a country where poverty and joblessness are high? Around 1990, there were both a strong government-led infrastructure development agenda and IWRM ingredients in place, including cost-recovery of state services aligning with the Structural Adjustment Programmes, water management according to basin boundaries and the dormant colonial water rights (permits system. After the 1990s, the World Bank and other donors promoted IWRM with a strong focus on hydroelectric power development, River Basin Water Boards, transformation of the water right system into a taxation tool, and assessment of environmental flows. These practices became formalised in the National Water Policy (2002 and in the Water Resources Management Act (2009. Activities in the name of IWRM came to be closely associated with the post-2008 surge in large-scale land and water deals. Analysing 25 years of IWRM, the paper identifies the processes and identities of the losers (smallholders and – at least partially – the government and the winners (large-scale water users, including recent investors. We conclude that, overall, IWRM harmed smallholdersʼ access to water and rendered them more vulnerable to poverty and unemployment.

  10. Rural Latinos' mental wellbeing: a mixed-methods pilot study of family, environment and social isolation factors.

    Science.gov (United States)

    Stacciarini, Jeanne-Marie R; Smith, Rebekah; Garvan, Cynthia Wilson; Wiens, Brenda; Cottler, Linda B

    2015-05-01

    Upon immigration to the rural areas in the US, Latino families may experience cultural, geographic, linguistic and social isolation, which can detrimentally affect their wellbeing by acting as chronic stressors. Using a community engagement approach, this is a pilot mixed-method study with an embedded design using concurrent qualitative and quantitative data. The purpose of this study is to evaluate family and social environments in terms of protective factors and modifiable risks associated with mental well-being in Latino immigrants living in rural areas of Florida. Latino immigrant mother and adolescent dyads were interviewed by using in-depth ethnographic semistructured interviews and subsequent quantitative assessments, including a demographic questionnaire and three structured instruments: the Family Environment Scale Real Form, the SF-12v2™ Health Survey and the short version (eight items) of PROMIS Health Organization Social Isolation. This mixed-method pilot study highlighted how family, rural, and social environments can protect or impair wellbeing in rural Latino immigrant mother and adolescent dyads.

  11. A reassessment of the indicators of primary education quality in developing countries: Emerging evidence from Tanzania

    Science.gov (United States)

    Mosha, Herme Joseph

    1988-03-01

    This article seeks to identify factors affecting the quality of primary education in five regions of Tanzania by extensively reviewing relevant literature and empirical data. Some of the shortcomings emphasised by the author are: frequent staff turnover, declining financial support for primary education, ineffective curricula, shortage of teachers' guides and textbooks, and unfavourable working conditions for teachers in rural areas. Beyond this, the need for freely available material, efficient school management and regular inspections is stressed by the author.

  12. Tanzania Diagnostic Review of Consumer Protection and Financial Literacy : Volume 1. Key Findings and Recommendations

    OpenAIRE

    World Bank Group

    2013-01-01

    In 2011, only 17.3 percemt of adults in Tanzania had an account at a formal financial institution and 56 percemt did not have any access to financial services. Most of the population lives in rural areas with very low incomes and poor infrastructure, and women are especially disadvantaged. Such limited access to formal financial services also inhibits financial literacy – awareness of bene...

  13. Tanzania Diagnostic Review of Consumer Protection and Financial Literacy : Volume 2. Comparison with Good Practices

    OpenAIRE

    World Bank Group

    2013-01-01

    In 2011, only 17.3 percemt of adults in Tanzania had an account at a formal financial institution and 56 percemt did not have any access to financial services. Most of the population lives in rural areas with very low incomes and poor infrastructure, and women are especially disadvantaged. Such limited access to formal financial services also inhibits financial literacy – awareness of bene...

  14. Completed Suicide with Violent and Non-Violent Methods in Rural Shandong, China: A Psychological Autopsy Study

    Science.gov (United States)

    Sun, Shi-Hua; Jia, Cun-Xian

    2014-01-01

    Background This study aims to describe the specific characteristics of completed suicides by violent methods and non-violent methods in rural Chinese population, and to explore the related factors for corresponding methods. Methods Data of this study came from investigation of 199 completed suicide cases and their paired controls of rural areas in three different counties in Shandong, China, by interviewing one informant of each subject using the method of Psychological Autopsy (PA). Results There were 78 (39.2%) suicides with violent methods and 121 (60.8%) suicides with non-violent methods. Ingesting pesticides, as a non-violent method, appeared to be the most common suicide method (103, 51.8%). Hanging (73 cases, 36.7%) and drowning (5 cases, 2.5%) were the only violent methods observed. Storage of pesticides at home and higher suicide intent score were significantly associated with choice of violent methods while committing suicide. Risk factors related to suicide death included negative life events and hopelessness. Conclusions Suicide with violent methods has different factors from suicide with non-violent methods. Suicide methods should be considered in suicide prevention and intervention strategies. PMID:25111835

  15. Spatial analysis methods and land-use planning models for rural areas

    Directory of Open Access Journals (Sweden)

    Patrizia Tassinari

    2009-10-01

    Full Text Available The work presents a brief report of the main results of a study carried out by the Spatial Engineering Division of the Department of Agricultural Economics and Engineering of the University of Bologna, within a broader PRIN 2005 research project concerning landscape and economic analysis, planning and programming. In particular, the study focuses on the design of spatial analysis methods aimed at building knowledge frameworks of the various natural and anthropic resources of rural areas. The goal is to increase the level of spatial and information detail of common databases, thus allowing higher accuracy and effectiveness of the analyses needed to achieve the goals of new generation spatial and agriculture planning. Specific in-depth analyses allowed to define techniques useful in order to reduce the increase in survey costs. Moreover, the work reports the main results regarding a multicriteria model for the analysis of the countryside defined by the research. Such model is aimed to assess the various agricultural, environmental and landscape features, vocations, expressions and attitudes, and support the definition and implementation of specific and targeted planning and programming policies.

  16. Improvements in access to malaria treatment in Tanzania following community, retail sector and health facility interventions -- a user perspective

    Directory of Open Access Journals (Sweden)

    Obrist Brigit

    2010-06-01

    Full Text Available Abstract Background The ACCESS programme aims at understanding and improving access to prompt and effective malaria treatment. Between 2004 and 2008 the programme implemented a social marketing campaign for improved treatment-seeking. 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 in 2006. Tanzania changed its first-line treatment for malaria from sulphadoxine-pyrimethamine (SP to artemether-lumefantrine (ALu in 2007 and subsidized ALu was made available in both health facilities and ADDOs. The effect of these interventions on understanding and treatment of malaria was studied in rural Tanzania. The data also enabled an investigation of the determinants of access to treatment. Methods Three treatment-seeking surveys were conducted in 2004, 2006 and 2008 in the rural areas of the Ifakara demographic surveillance system (DSS and in Ifakara town. Each survey included approximately 150 people who had suffered a fever case in the previous 14 days. Results Treatment-seeking and awareness of malaria was already high at baseline, but various improvements were seen between 2004 and 2008, namely: better understanding causes of malaria (from 62% to 84%; an increase in health facility attendance as first treatment option for patients older than five years (27% to 52%; higher treatment coverage with anti-malarials (86% to 96% and more timely use of anti-malarials (80% to 93-97% treatments taken within 24 hrs. Unfortunately, the change of treatment policy led to a low availability of ALu in the private sector and, therefore, to a drop in the proportion of patients taking a recommended malaria treatment (85% to 53%. The availability of outlets (health facilities or drug shops is the most important determinant of whether patients receive prompt and effective treatment, whereas affordability and accessibility contribute to a lesser extent. Conclusions An

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

    Science.gov (United States)

    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.

  18. Radioactive waste management in Tanzania

    International Nuclear Information System (INIS)

    Banzi, F.P.; Bundala, F.M.; Nyanda, A.M.; Msaki, P.

    2002-01-01

    Radioactive waste, like many other hazardous wastes, is of great concern in Tanzania because of its undesirable health effects. The stochastic effects due to prolonged exposure to ionizing radiation produce cancer and hereditary effects. The deterministic effects due to higher doses cause vomiting, skin reddening, leukemia, and death to exposed victims. The aim of this paper is to give an overview of the status of radioactive wastes in Tanzania, how they are generated and managed to protect humans and the environment. As Tanzania develops, it is bound to increase the use of ionizing radiation in research and teaching, industry, health and agriculture. Already there are more than 42 Centers which use one form of radioisotopes or another for these purposes: Teletherapy (Co-60), Brach-therapy (Cs-137, Sr-89), Nuclear Medicine (P-32, Tc-99m, 1-131, 1-125, Ga-67, In-111, Tl-206), Nuclear gauge (Am-241, Cs- 137, Sr-90, Kr-85), Industrial radiography (Am-241, C-137, Co-60, lr-92), Research and Teaching (1-125, Am241/Be, Co-60, Cs-137, H-3 etc). According to IAEA definition, these radioactive sources become radioactive waste if they meet the following criteria: if they have outlived their usefulness, if they have been abandoned, if they have been displaced without authorization, and if they contaminate other substances. Besides the origin of radioactive wastes, special emphasis will also be placed on the existing radiation regulations that guide disposal of radioactive waste, and the radioactive infrastructure Tanzania needs for ultimate radioactive waste management. Specific examples of incidences (theft, loss, abandonment and illegal possession) of radioactive waste that could have led to serious deterministic radiation effects to humans will also be presented. (author)

  19. Tanzania | IDRC - International Development Research Centre

    International Development Research Centre (IDRC) Digital Library (Canada)

    We have a rich history of supporting research in Tanzania, a politically stable democracy. ... importance of improving health and agriculture in order to reduce poverty. ... For more than a decade, we have provided grants that foster the capacity to ... fellowships and foster links between researchers and institutions in Tanzania ...

  20. Micro Level Perspectives on Growth (Tanzania) | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Poverty reduction through growth is the idea behind the market-oriented reforms that Tanzania has undertaken since the mid-1980s. However, poverty is still ... Outputs. Papers. Private sector development in Tanzania : opportunities, challenges and strategic interventions to enhance competitiveness; final report. 42201.

  1. Tanzania | Page 41 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Alexander Soucy is correct to identify insecticide-treated bednets and inexpensive anti-malarial drugs as crucial to the global fight against malaria ('An easy way to save three million lives,' April 26). Read more about Tanzania ... Legislation on competition brings productivity and business investment to Tanzania. Increasing ...

  2. Water resources management in Tanzania: identifying research ...

    African Journals Online (AJOL)

    This paper aims at identifying research gaps and needs and recommendations for a research agenda on water resources management in Tanzania. We reviewed published literature on water resources management in Tanzania in order to highlight what is currently known, and to identify knowledge gaps, and suggest ...

  3. WILDLIFE-BASED DOMESTIC TOURISM IN TANZANIA ...

    African Journals Online (AJOL)

    Dr Osondu

    WILDLIFE-BASED DOMESTIC TOURISM IN TANZANIA: EXPERIENCES FROM. NORTHERN ... affecting domestic tourism was carried out in northern Tanzania tourist circuit. .... Serengeti Plains are shared by NCA and the SNP. Normally, in .... communication network) and social services .... motivation to conserve nature.

  4. Industrializing Secondary Schools in Tanzania through Scientific ...

    African Journals Online (AJOL)

    Industrializing Secondary Schools in Tanzania through Scientific Innovations. ... Huria: Journal of the Open University of Tanzania ... Through review of various innovations developed by universities including SUA, it was established that there are several innovations in different fields especially in crop cultivation, animal ...

  5. Total Energy Expenditure by the doubly labelled water method in rural pre-school children in Cuba

    International Nuclear Information System (INIS)

    Hernandez-Triana, M.H.; Gonzalez-Calderin, S.; Sanchez, V.; Basabe-Tuero, B.; Salazar, G.; Diaz, E.

    2002-01-01

    Aim: Total Energy Expenditure (TEE) was measured by the doubly labelled water method in nineteen 5 y old children of a rural mountain community in Cuba. Materials and Methods. Ten males and nine females (18.4 and 18.5 kg average weight) with mean BMI values of 16.3 and 16.1 kg/m2 were included in the study. RMR was previously measured in year 2000 by indirect calorimetry in a sample of 11 children and values correlated properly with the estimations using the proposed equations of Henry and Rees. This estimate was used then for the whole group. Energy intake measured by 3-day weighed dietary record was 3.73 MJ/day. Tee was measured by the doubly labelled water method. Results: TEE values of well nourished children were 7.15 and 5.77 MJ/d for boys and girls, respectively. These findings imply that well nourished boys and girls are having a moderate to heavy physical activity requiring 93 and 75 kcal/kg per day. Physical activity of normal Cuban boys and girls living in rural areas was 1.88 and 1.59 METS, which is much higher than those values reported for children from developed countries using DLW. Energy intake was 1639 ± 381 in boys and 1230 ± 355 kcal/d in girls. Conclusions: TEE and physical activity level of rural Cuban children was higher than reported values of children living in developed countries

  6. Increasing Access to Subsidized Artemisinin-based Combination Therapy through Accredited Drug Dispensing Outlets in Tanzania

    Directory of Open Access Journals (Sweden)

    Gabra Michael

    2011-06-01

    Full Text Available Abstract Background In Tanzania, many people seek malaria treatment from retail drug sellers. The National Malaria Control Program identified the accredited drug dispensing outlet (ADDO program as a private sector mechanism to supplement the distribution of subsidized artemisinin-based combination therapies (ACTs from public facilities and increase access to the first-line antimalarial in rural and underserved areas. The ADDO program strengthens private sector pharmaceutical services by improving regulatory and supervisory support, dispenser training, and record keeping practices. Methods The government's pilot program made subsidized ACTs available through ADDOs in 10 districts in the Morogoro and Ruvuma regions, covering about 2.9 million people. The program established a supply of subsidized ACTs, created a price system with a cost recovery plan, developed a plan to distribute the subsidized products to the ADDOs, trained dispensers, and strengthened the adverse drug reactions reporting system. As part of the evaluation, 448 ADDO dispensers brought their records to central locations for analysis, representing nearly 70% of ADDOs operating in the two regions. ADDO drug register data were available from July 2007-June 2008 for Morogoro and from July 2007-September 2008 for Ruvuma. This intervention was implemented from 2007-2008. Results During the pilot, over 300,000 people received treatment for malaria at the 448 ADDOs. The percentage of ADDOs that dispensed at least one course of ACT rose from 26.2% during July-September 2007 to 72.6% during April-June 2008. The number of malaria patients treated with ACTs gradually increased after the start of the pilot, while the use of non-ACT antimalarials declined; ACTs went from 3% of all antimalarials sold in July 2007 to 26% in June 2008. District-specific data showed substantial variation among the districts in ACT uptake through ADDOs, ranging from ACTs representing 10% of all antimalarial sales

  7. Vitamin A supplementation in Tanzania: the impact of a change in programmatic delivery strategy on coverage

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    Shekar Meera

    2006-11-01

    Full Text Available Abstract Background Efficient delivery strategies for health interventions are essential for high and sustainable coverage. We report impact of a change in programmatic delivery strategy from routine delivery through the Expanded Programme on Immunization (EPI+ approach to twice-yearly mass distribution campaigns on coverage of vitamin A supplementation in Tanzania Methods We investigated disparities in age, sex, socio-economic status, nutritional status and maternal education within vitamin A coverage in children between 1 and 2 years of age from two independent household level child health surveys conducted (1 during a continuous universal targeting scheme based on routine EPI contacts for children aged 9, 15 and 21 months (1999; and (2 three years later after the introduction of twice-yearly vitamin A supplementation campaigns for children aged 6 months to 5 years, a 6-monthly universal targeting scheme (2002. A representative cluster sample of approximately 2,400 rural households was obtained from Rufiji, Morogoro Rural, Kilombero and Ulanga districts. A modular questionnaire about the health of all children under the age of five was administered to consenting heads of households and caretakers of children. Information on the use of child health interventions including vitamin A was asked. Results Coverage of vitamin A supplementation among 1–2 year old children increased from 13% [95% CI 10–18%] in 1999 to 76% [95%CI 72–81%] in 2002. In 2002 knowledge of two or more child health danger signs was negatively associated with vitamin A supplementation coverage (80% versus 70% (p = 0.04. Nevertheless, we did not find any disparities in coverage of vitamin A by district, gender, socio-economic status and DPT vaccinations. Conclusion Change in programmatic delivery of vitamin A supplementation was associated with a major improvement in coverage in Tanzania that was been sustained by repeated campaigns for at least three years. There is a

  8. Barriers to conducting effective obstetric audit in Ifakara: a qualitative assessment in an under-resourced setting in Tanzania

    NARCIS (Netherlands)

    van Hamersveld, K.T.; Bakker, E.; Nyamtema, A.S.; van den Akker, T.; Mfinanga, E.H.; van Elteren, M.; van Roosmalen, J.

    2012-01-01

    Objective To explore barriers to and solutions for effective implementation of obstetric audit at Saint Francis Designated District Hospital in Ifakara, Tanzania, where audit results have been disappointing 2years after its introduction. Methods Qualitative study involving participative observation

  9. History and current status of peste des petits ruminants virus in Tanzania.

    Science.gov (United States)

    Torsson, Emeli; Kgotlele, Tebogo; Berg, Mikael; Mtui-Malamsha, Niwael; Swai, Emanuel S; Wensman, Jonas Johansson; Misinzo, Gerald

    2016-01-01

    Peste des petits ruminants virus (PPRV) causes the acute, highly contagious disease peste des petits ruminants (PPR) that affects small domestic and wild ruminants. PPR is of importance in the small livestock-keeping industry in Tanzania, especially in rural areas as it is an important source of livelihood. Morbidity and case fatality rate can be as high as 80-100% in naïve herds; however, in endemic areas, morbidity and case fatality range between 10 and 100% where previous immunity, age, and species of infected animal determine severity of outcome. PPR was officially confirmed in domestic animals in the Ngorongoro district of Tanzania in 2008. It is now considered to be endemic in the domestic sheep and goat populations throughout Tanzania, but restricted to one or more areas in the small ruminant wildlife population. In this article, we review the history and the current status of PPR in Tanzania and neighboring countries. To control and eradicate PPR in the region, a joint effort between these countries needs to be undertaken. The effort must also secure genuine engagement from the animal holders to succeed.

  10. History and current status of peste des petits ruminants virus in Tanzania

    Directory of Open Access Journals (Sweden)

    Emeli Torsson

    2016-10-01

    Full Text Available Peste des petits ruminants virus (PPRV causes the acute, highly contagious disease peste des petits ruminants (PPR that affects small domestic and wild ruminants. PPR is of importance in the small livestock-keeping industry in Tanzania, especially in rural areas as it is an important source of livelihood. Morbidity and case fatality rate can be as high as 80–100% in naïve herds; however, in endemic areas, morbidity and case fatality range between 10 and 100% where previous immunity, age, and species of infected animal determine severity of outcome. PPR was officially confirmed in domestic animals in the Ngorongoro district of Tanzania in 2008. It is now considered to be endemic in the domestic sheep and goat populations throughout Tanzania, but restricted to one or more areas in the small ruminant wildlife population. In this article, we review the history and the current status of PPR in Tanzania and neighboring countries. To control and eradicate PPR in the region, a joint effort between these countries needs to be undertaken. The effort must also secure genuine engagement from the animal holders to succeed.

  11. Multi-Criteria Optimization of the Deployment of a Grid for Rural Electrification Based on a Heuristic Method

    Science.gov (United States)

    Ortiz-Matos, L.; Aguila-Tellez, A.; Hincapié-Reyes, R. C.; González-Sanchez, J. W.

    2017-07-01

    In order to design electrification systems, recent mathematical models solve the problem of location, type of electrification components, and the design of possible distribution microgrids. However, due to the amount of points to be electrified increases, the solution to these models require high computational times, thereby becoming unviable practice models. This study posed a new heuristic method for the electrification of rural areas in order to solve the problem. This heuristic algorithm presents the deployment of rural electrification microgrids in the world, by finding routes for optimal placement lines and transformers in transmission and distribution microgrids. The challenge is to obtain a display with equity in losses, considering the capacity constraints of the devices and topology of the land at minimal economic cost. An optimal scenario ensures the electrification of all neighbourhoods to a minimum investment cost in terms of the distance between electric conductors and the amount of transformation devices.

  12. Methods for estimating the magnitude and frequency of floods for urban and small, rural streams in Georgia, South Carolina, and North Carolina, 2011.

    Science.gov (United States)

    2014-03-01

    The central purpose of this report is to present methods : for estimating the magnitude and frequency of floods on : urban and small, rural streams in the Southeast United States : with particular focus on Georgia, South Carolina, and North : Carolin...

  13. Leptospirosis among Hospitalized Febrile Patients in Northern Tanzania

    Science.gov (United States)

    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

  14. Performance of rapid diagnostic test, blood-film microscopy and PCR for the diagnosis of malaria infection among febrile children from Korogwe District, Tanzania

    DEFF Research Database (Denmark)

    Mahende, Coline; Ngasala, Billy; Lusingu, John

    2016-01-01

    with fever and/or history of fever in the previous 48 h attending outpatient clinics. Blood samples were collected for identification of Plasmodium falciparum infection using histidine-rich-protein-2 (HRP-2)-based malaria RDT, light microscopy and conventional PCR. Results: A total of 867 febrile patients......Background: Rapid diagnostic tests (RDT) and light microscopy are still recommended for diagnosis to guide the clinical management of malaria despite difficult challenges in rural settings. The performance of these tests may be affected by several factors, including malaria prevalence and intensity...... of transmission. The study evaluated the diagnostic performance of malaria RDT, light microscopy and polymerase chain reaction (PCR) in detecting malaria infections among febrile children at outpatient clinic in Korogwe District, northeastern Tanzania. Methods: The study enrolled children aged 2-59 months...

  15. Cigarette smoking and use of smokeless tobacco in Moshi rural ...

    African Journals Online (AJOL)

    Cigarette smoking and use of smokeless tobacco in Moshi rural district of Kilimanjaro region, northern Tanzania. KS Mnyika, E Klouman, K-I Klepp. Abstract. No Abstract. East African Journal of Public Health Vol. 3 (1) April 2006: 24-27. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD ...

  16. Basal Metabolic Rate and Energy Expenditure of Rural Farmers in ...

    African Journals Online (AJOL)

    Measurement of basal metabolic rate (BMR) provides an important baseline for the determination of an individual's total energy requirement. The study sought to establish human energy expenditure of rural farmers in Magubike village in Tanzania, through determination of BMR, physical activity level (PAL) and total energy ...

  17. Understanding low uptake of contraceptives in resource-limited settings: a mixed-methods study in rural Burundi.

    Science.gov (United States)

    Ndayizigiye, M; Fawzi, M C Smith; Lively, C Thompson; Ware, N C

    2017-03-15

    Family planning can reduce deaths, improve health, and facilitate economic development in resource-limited settings. Yet, modern contraceptive methods are often underused. This mixed-methods study, conducted in rural Burundi, sought to explain low uptake of contraceptives by identifying utilization barriers. Results may inform development of family planning interventions in Burundi and elsewhere. We investigated uptake of contraceptives among women of reproductive age in two rural districts of Burundi, using an explanatory sequential, mixed-methods research design. We first assessed availability and utilization rates of modern contraceptives through a facility-based survey in 39 health clinics. Barriers to uptake of contraceptives were then explored through qualitative interviews (N = 10) and focus groups (N = 7). Contraceptives were generally available in the 39 clinics studied, yet uptake of family planning averaged only 2.96%. Greater uptake was positively associated with the number of health professionals engaged and trained in family planning service provision, and with the number of different types of contraceptives available. Four uptake barriers were identified: (1) lack of providers to administer contraception, (2) lack of fit between available and preferred contraceptive methods, (3) a climate of fear surrounding contraceptive use, and (4) provider refusal to offer family planning services. Where resources are scarce, availability of modern contraceptives alone will likely not ensure uptake. Interventions addressing multiple uptake barriers simultaneously have the greatest chance of success. In rural Burundi, examples are community distribution of contraceptive methods, public information campaigns, improved training for health professionals and community health workers, and strengthening of the health infrastructure.

  18. Trends in HIV & syphilis prevalence and correlates of HIV infection: results from cross-sectional surveys among women attending ante-natal clinics in Northern Tanzania

    Directory of Open Access Journals (Sweden)

    Kumogola Yusufu

    2010-09-01

    Full Text Available Abstract Background Sentinel surveillance for HIV in ante-natal clinics (ANC remains the primary method for collecting timely trend data on HIV prevalence in most of sub-Saharan Africa. We describe prevalence of HIV and syphilis infection and trends over time in HIV prevalence among women attending ante-natal clinics (ANC in Magu district and Mwanza city, part of Mwanza region in Northern Tanzania. HIV prevalence from ANC surveys in 2000 and 2002 was 10.5% and 10.8% respectively. In previous rounds urban residence, residential mobility, the length of time sexually active before marriage, time since marriage and age of the partner were associated with HIV infection. Methods A third round of HIV sentinel surveillance was conducted at ante-natal clinics in Mwanza region, Tanzania during 2006. We interviewed women attending 27 ante-natal clinics. In 15 clinics we also anonymously tested women for syphilis and HIV infection and linked these results to the questionnaire data. Results HIV prevalence was 7.6% overall in 2006 and 7.4% at the 11 clinics used in previous rounds. Geographical variations in HIV prevalence, apparent in previous rounds, have largely disappeared but syphilis prevalence is still higher in rural clinics. HIV prevalence has declined in urban clinics and is stable in rural clinics. The correlates of HIV infection have changed over time. In this round older age, lower gravidity, remarriage, duration of marriage, sexual activity before marriage, long interval between last birth and pregnancy and child death were all associated with infection. Conclusions HIV prevalence trends concur with results from a community-based cohort in the region. Correlates of HIV infection have also changed and more proximate, individual level factors are now more important, in line with the changing epidemiology of infection in this population.

  19. Væksten i Tanzania

    OpenAIRE

    Haagen Larsen, Pernille; Schack Wiedenbeien, Emma; Nørreager Christensen, Martin; Høj Brunn, Christoffer; Ferklov, Vladik

    2014-01-01

    In our group, it has been decided to write about the growth in Africa. We believe a conflict can be seen between the year of focus to effort an improvement in Africa’s growth and the lack of change. However it is to be seen that there is a noticeable change compared to the time minimal effort spent. As case we have chosen to look at the conditions of establishing further expanding, development and growth of one of the poorest countries in the world, Tanzania. We have chosen to look into the e...

  20. The impact of privatization on access in Tanzania.

    Science.gov (United States)

    Benson, J S

    2001-06-01

    In the late 1980s, many developing countries were forced to adopt structural adjustment policies as a condition for securing loans from the International Monetary Fund (IMF) and the World Bank. One of the World Bank's recommended policies was to change the mix of private and public health facilities. This study, based on fieldwork done in Tanzania in 1993, examines the impact of this policy on health-care accessibility in two northern Tanzanian districts, one rural and one urban. Accessibility was measured in terms of equality and equity of coverage. The placement of the very few government clinics opened during the years 1985-1993 did much more to improve coverage than the haphazard location of many new private clinics. Equity was not improved as very few clinics were placed in demographically needy areas.

  1. Conservation biology: lion attacks on humans in Tanzania.

    Science.gov (United States)

    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.

  2. Pesticides in the Southern Agricultural Growth Corridor of Tanzania (SAGCOT) : a scoping study of current and future use, associated risks and identification of actions for risk mitigation

    NARCIS (Netherlands)

    Lahr, Joost; Buij, Ralph; Katagira, Franciska; Valk, van der Harold

    2016-01-01

    SAGCOT, the ‘Southern Agricultural Growth Corridor of Tanzania’, is a coordinated initiative to boost agricultural output in southern Tanzania through public and private investment, to improve food security, reduce rural poverty and sustain the environment. The ‘Sustainability and Inclusion Strategy

  3. Out-of-School and "At Risk?" Socio-Demographic Characteristics, AIDS Knowledge and Risk Perception among Young People in Northern Tanzania

    Science.gov (United States)

    Bastien, Sheri

    2008-01-01

    This paper investigates the reasons why young people in urban and rural Kilimanjaro, Tanzania do not attend school, their socio-demographic characteristics, AIDS knowledge and risk perception. A structured face-to-face interview was conducted with 1007 young people between the ages of 13 and 18. Findings suggest that non-attendance is the product…

  4. The impact on orchid species abundance of gathering their edible tubers by HIV/AIDS orphans : a case of three villages in the Southern Highlands of Tanzania

    NARCIS (Netherlands)

    Challe, J.F.X.; Struik, P.C.

    2008-01-01

    This paper examines the gathering of wild orchids and its effect on orchid species diversity and abundance in rural communities with high prevalence of HIV/AIDS and high numbers of orphans. The study was conducted in three villages in the Makete District of Tanzania. The study used a triangulation

  5. Religion and HIV in Tanzania: influence of religious beliefs on HIV stigma, disclosure, and treatment attitudes

    Directory of Open Access Journals (Sweden)

    Ostermann Jan

    2009-03-01

    Full Text Available Abstract Background Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV treatment. Methods A self-administered survey was distributed to a convenience sample of parishioners (n = 438 attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and people living with HIV/AIDS. Results Results indicate that shame-related HIV stigma is strongly associated with religious beliefs such as the belief that HIV is a punishment from God (p Conclusion The decision to start ARVs hinged primarily on education-level and knowledge about ARVs rather than on religious factors. Research results highlight the influence of religious beliefs on HIV-related stigma and willingness to disclose, and should help to inform HIV-education outreach for religious groups.

  6. A qualitative pilot study of food insecurity among Maasai women in Tanzania.

    Science.gov (United States)

    Fenton, Carol; Hatfield, Jennifer; McIntyre, Lynn

    2012-01-01

    Food insecurity is an ongoing threat in rural sub-Saharan Africa and is complicated by cultural practices, the rise of chronic conditions such as HIV and land use availability. In order to develop a successful food security intervention program, it is important to be informed of the realities and needs of the target population. The purpose of this study was to pilot a qualitative method to understand food insecurity based on the lived experience of women of the Maasai population in the Ngorongoro Conservation Area of Tanzania. Short semi-structured qualitative interviews with 4 Maasai women. FOOD INSECURITY WAS PRESENT IN THE MAASAI COMMUNITY: the participants revealed that they did not always have access to safe and nutritious food that met the needs of themselves and their families. Themes that emerged from the data fell into three categories: Current practices (food sources, planning for enough, food preparation, and food preservation), food Insecurity (lack of food, emotions, coping strategies, and possible solutions), and division (co-wives, food distribution, and community relationships). This pilot study suggested the presence of food insecurity in the Maasai community. Larger sample studies are needed to clarify the extent and severity of food insecurity among this population. Having a detailed understanding of the various aspects of the food insecurity lived experience could inform a targeted intervention program.

  7. Hydrothermal carbonization as innovative technology in sustainable sanitation in Tanzania

    Energy Technology Data Exchange (ETDEWEB)

    Krause, Ariane [Engineers Without Boarders (Germany), Berlin (DE). Project ' ' Carbonization as Sanitation' ' (CaSa)

    2011-07-01

    The need for sustainable systems is apparent as climate change and other adverse anthropogenic activities continue to negatively affect the soil fertility in Africa. One of the indicators of the loss of soil fertility is the continuous decrease in soil organic matter, which is the major building block of a fertile soil. This is mainly attributed to the inappropriate practice of human-beings of taking more substances from the ecosystem than the amount replaced. As the soil fertility is increasingly lost, food insecurity, due to dropped productivity of the soil, is becoming a critical issue in many areas of Africa, Tanzania is not any different in this respect. On the other hand, most people in rural areas of Africa still lack possibilities to cover their daily energy needs in a more sustainable way and many people mainly rely on firewood. This, in turn, has an adverse impact on the climate and the soil, causing a local viscous circle of poor soil and productivity conditions. Moreover, the sanitation coverage of those areas is very low and there is a need for appropriate sanitation systems. Therefore, the aim of this project is, to conduct research on the possibility of establishing a self-sustaining system for the rural areas of Kagera, Tanzania, to address the three basic issues: sanitation, energy supply and soil fertility. The system consists of a small-scale biogas digester, a urine diverting dehydrating toilet (UDDT) and an adaptive hydrothermal carbonization (HTC) unit. Biogas is produced from crop residues and other domestic organic waste. The fermentation residues and the dehydrated fecal matter from the UDDT is then treated with HTC. The carbonised and sanitized residue is then applied as soil amendment to improve the soil fertility as manifested by the Terra Preta in the Amazon. This holistic approach is a new development in ecological sanitation. Therefore, a comprehensive sustainability assessment including environmental, economic and socio

  8. Popular soap opera helps raise contraceptive use. Tanzania.

    Science.gov (United States)

    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.

  9. City mouse, country mouse: a mixed-methods evaluation of perceived communication barriers between rural family physicians and urban consultants in Newfoundland and Labrador, Canada.

    Science.gov (United States)

    Renouf, Tia; Alani, Sabrina; Whalen, Desmond; Harty, Chris; Pollard, Megan; Morrison, Megan; Coombs-Thorne, Heidi; Dubrowski, Adam

    2016-05-06

    To examine perceived communication barriers between urban consultants and rural family physicians practising routine and emergency care in remote subarctic Newfoundland and Labrador (NL). This study used a mixed-methods design. Quantitative and qualitative data were collected through exploratory surveys, comprised of closed and open-ended questions. The quantitative data was analysed using comparative statistical analyses, and a thematic analysis was applied to the qualitative data. 52 self-identified rural family physicians and 23 urban consultants were recruited via email. Rural participants were also recruited at the Family Medicine Rural Preceptor meetings in St John's, NL. Rural family physicians and urban consultants in NL completed a survey assessing perceived barriers to effective communication. Data confirmed that both groups perceived communication difficulties with one another; with 23.1% rural and 27.8% urban, rating the difficulties as frequent (p=0.935); 71.2% rural and 72.2% urban as sometimes (p=0.825); 5.8% rural and 0% urban acknowledged never perceiving difficulties (p=0.714). Overall, 87.1% of participants indicated that perceived communication difficulties impacted patient care. Primary trends that emerged as perceived barriers for rural physicians were time constraints and misunderstanding of site limitations. Urban consultants' perceived barriers were inadequate patient information and lack of native language skills. Barriers to effective communication are perceived between rural family physicians and urban consultants in NL. 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/

  10. Urban–rural and geographic differences in overweight and obesity in four sub-Saharan African adult populations: a multi-country cross-sectional study

    Directory of Open Access Journals (Sweden)

    IkeOluwapo O. Ajayi

    2016-10-01

    Full Text Available Abstract Background Overweight and obesity are on the rise in developing countries including sub-Saharan Africa. We undertook a four-country survey to show the collective burden of these health conditions as they occur currently in sub-Saharan Africa and to determine the differences between urban and rural populations and other socio-economic factors. Methods Participants were nurses in two hospitals in Nigeria (200, school teachers in South Africa (489 and Tanzania (229, and village residents in one peri-urban (297 and one rural location in Uganda (200 who completed a standardised questionnaire. Their height and weight were measured and body mass index calculated. Factor analysis procedure (Principal component was used to generate a wealth index. Univariate and multivariate analyses with binary logistic regression models were conducted to examine the associations between potential correlates and the prevalence of overweight and obesity with 95 % confidence intervals. Results The prevalence of overweight and obese (combined was 46 %, 48 %, 68 %, 75 % and 85 % in rural Uganda, peri-urban Uganda, Nigeria, Tanzania and South Africa (SA, respectively. Rural Uganda, Peri- urban Uganda, Nigeria, Tanzania and SA had obesity prevalence of 10 %, 14 %, 31 %, 40 % and 54 %, respectively (p  =25 kg/m2 in Nigeria [Age > =45 - AOR = 9.11; 95 % CI: 1.72, 48.16] and SA [AOR = 6.22; 95 % CI: 2.75, 14.07], while marital status was predictor of BMI > =25 kg/m2 only in peri-urban Uganda. [Married - AOR = 4.49; 95 % CI: 1.74, 11.57]. Those in Nigeria [AOR = 2.56; 95 % CI: 1.45, 4.53], SA [AOR = 4.97; 95 % CI: 3.18, 7.78], and Tanzania [AOR = 2.68; 95 % CI: 1.60, 4.49] were more likely to have BMI > =25 kg/m2 compared with the rural and peri-urban sites. Conclusion The high prevalence of overweight and obesity in these sub-Saharan African countries and the differentials in prevalence and risk factors further

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

    Science.gov (United States)

    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.

  12. Managing nuclear information in Tanzania

    International Nuclear Information System (INIS)

    Sawe, S.F.; Sungita, Y.Y.

    2004-01-01

    Nuclear information management and the applications of nuclear technology in Tanzania are limited to medical, agriculture, research and some industrial applications. It is demanding that the National database for nuclear information be established to keep the track of the information on radiation facilities, manpower development, radiation sources and radioactive waste management. In this paper the current status of nuclear information management in Tanzania is presented. The development, setbacks and future plans for establishment of national database with consequent improvement of nuclear information management are discussed. The National Radiation Commission (NRC) which is an official government body responsible for atomic energy matters in collaboration with other institutions applying nuclear technology keeps the records and inventory of facilities, manpower development and projects related to the nuclear field. The available information about nuclear application activities has been obtained through possessors' declaration, monitoring at entry/exit points, periodic reports from the licensees, radiation safety inspections, and the available link with the International Atomic Energy Agency (IAEA). In order to facilitate the dissemination of information, five ICT centres to serve in the fields of research, nuclear instrumentation, human health and agriculture have been established. The inventory of radiation facilities/materials and human resource is being build up as an initial input to the National database. Establishment of INIS centre is expected to improve the nuclear information management system in the country. The government and the IAEA are encouraged to support nuclear information management especially by strengthening ICT centres and facilitating the establishment of INIS National centre. (author)

  13. Managing nuclear information in Tanzania

    International Nuclear Information System (INIS)

    Sawe, S.F.; Sungita, Y.Y.

    2004-01-01

    Full text: Nuclear information management and the applications of nuclear technology in Tanzania are limited to medical, agriculture, research and some industrial applications. It is demanding that the National database for nuclear information be established to keep the track of the information on radiation facilities, manpower development, radiation sources and radioactive waste management. In this paper the current status of nuclear information management in Tanzania is presented. The development, setbacks and future plans for establishment of national database with consequent improvement of nuclear information management are discussed. The National Radiation Commission (NRC) which is an official government body responsible for atomic energy matters in collaboration with other institutions applying nuclear technology, keeps the records and inventory of facilities, manpower development and projects related to the nuclear field. The available information about nuclear application activities has been obtained through possessors' declaration, monitoring at entry/exit points, periodic reports from the licensees, radiation safety inspections, and the available link with the International Atomic Agency (IAEA). In order to facilitate the dissemination of information, five ICT centers to serve in the fields of research, nuclear instrumentation, human health and agriculture have been established. The inventory of radiation facilities/materials and human resource is being build up as an initial input to the National database. Establishment of INIS center is expected to improve the nuclear information management system in the country. The government and the IAEA are encouraged to support nuclear information management especially by strengthening ICT centers and facilitating the establishment of INIS National center. (author)

  14. Improving hypertension management through pharmacist prescribing; the rural alberta clinical trial in optimizing hypertension (Rural RxACTION: trial design and methods

    Directory of Open Access Journals (Sweden)

    Campbell Norman RC

    2011-08-01

    Full Text Available Abstract Background Patients with hypertension continue to have less than optimal blood pressure control, with nearly one in five Canadian adults having hypertension. Pharmacist prescribing is gaining favor as a potential clinically efficacious and cost-effective means to improve both access and quality of care. With Alberta being the first province in Canada to have independent prescribing by pharmacists, it offers a unique opportunity to evaluate outcomes in patients who are prescribed antihypertensive therapy by pharmacists. Methods The study is a randomized controlled trial of enhanced pharmacist care, with the unit of randomization being the patient. Participants will be randomized to enhanced pharmacist care (patient identification, assessment, education, close follow-up, and prescribing/titration of antihypertensive medications or usual care. Participants are patients in rural Alberta with undiagnosed/uncontrolled blood pressure, as defined by the Canadian Hypertension Education Program. The primary outcome is the change in systolic blood pressure between baseline and 24 weeks in the enhanced-care versus usual-care arms. There are also three substudies running in conjunction with the project examining different remuneration models, investigating patient knowledge, and assessing health-resource utilization amongst patients in each group. Discussion To date, one-third of the required sample size has been recruited. There are 15 communities and 17 pharmacists actively screening, recruiting, and following patients. This study will provide high-level evidence regarding pharmacist prescribing. Trial Registration Clinicaltrials.gov NCT00878566.

  15. Volume and aboveground biomass models for dry Miombo woodland in Tanzania

    DEFF Research Database (Denmark)

    Mwakalukwa, Ezekiel Edward; Meilby, Henrik; Treue, Thorsten

    2014-01-01

    Tools to accurately estimate tree volume and biomass are scarce for most forest types in East Africa, including Tanzania. Based on a sample of 142 trees and 57 shrubs from a 6,065 ha area of dry miombo woodland in Iringa rural district in Tanzania, regression models were developed for volume...... and biomass of three important species, Brachystegia spiciformis Benth. (n=40), Combretum molle G. Don (n=41), and Dalbergia arbutifolia Baker (n=37) separately, and for broader samples of trees (28 species, n=72), shrubs (16 species, n=31), and trees and shrubs combined (44 species, n=104). Applied...... of the predictions tended to increase from general to species-specific models. Except for a few volume and biomass models developed for shrubs, all models had R2 values of 96–99%. Thus, the models appear robust and should be applicable to forests with similar site conditions, species, and diameter ranges....

  16. Ethnobotanical survey and toxicity evaluation of medicinal plants used for fungal remedy in the Southern Highlands of Tanzania

    Directory of Open Access Journals (Sweden)

    Mourice Victor Nyangabo Mbunde

    2017-03-01

    Full Text Available Background/Aim: Some of the antifungal drugs used in current treatments regime are responding to antimicrobial resistance. In rural areas of Southern Tanzania, indigenous people use antifungal drugs alone or together with medicinal plants to curb the effects of antibiotic resistance. This study documented ethnobotanical information of medicinal plants used for managing fungal infections in the Southern highlands of Tanzania and further assess their safety. Methods: Ethnobotanical survey was conducted in Makete and Mufindi districts between July 2014 and December 2015 using semi-structured questionnaires followed by two focus group discussions to verify respondents’ information. Cytotoxicity study was conducted on extracts of collected plants using Brine Shrimp Lethality Test and analyzed by MS Excel 2013 programme. Results: During this survey about 46 plant species belonging to 28 families of angiosperms were reported to be traditionally useful in managing fungal and other health conditions. Among these, Terminalia sericea, Aloe nutii, Aloe lateritia, Zanthoxylum chalybeum, Zanthoxym deremense and Kigelia africana were frequently mentioned to be used for managing fungal infections. The preparation of these herbals was mostly by boiling plant parts especially the leaves and roots. Cytotoxicity study revealed that most of the plants tested were non-toxic with LC¬50¬ >100 which implies that most compounds from these plants are safe for therapeutic use. The dichloromethane extract of Croton macrostachys recorded the highest with LC50 value 12.94 μg/ml. The ethnobotanical survey correlated well with documented literature from elsewhere about the bioactivity of most plants. Conclusions: The ethnobotanical survey has revealed that traditional healers are rich of knowledge to build on for therapeutic studies. Most of the plants are safe for use; and thus can be considered for further studies on drug discovery. [J Complement Med Res 2017; 6(1.000: 84-96

  17. Regional Dermatology Training Centre in Moshi, Tanzania ...

    African Journals Online (AJOL)

    because, in many parts of the world, there ... Annual prizes are awarded for the student achieving the highest mark in the overall assessment ... 31 No. 7. Dermatology in Tanzania prize). A second training programme (MMed) provides 4-year.

  18. Abyssinian Scimitarbill Rhinopomastus minor cabanisi in Tanzania ...

    African Journals Online (AJOL)

    2013-12-27

    Dec 27, 2013 ... in Tanzania: a breeding record in a traditional beehive ... Scimitarbills Rhinopomastus minor entering a hole on the bottom of one of the bee- ... resident of open bushed and wooded habitats in lower rainfall areas east of Lake.

  19. Read full report, Youth employment in Tanzania

    International Development Research Centre (IDRC) Digital Library (Canada)

    But the quality of formal education in Tanzania is poor. Less than 12 percent ... NGOs offer a broad range of services and training for youth, including fostering ..... Service workers. 20.6 ..... customer/market validation training provided by profes-.

  20. Financial Institutions And Poverty Alleviation In Tanzania ...

    African Journals Online (AJOL)

    Financial institutions in Tanzania have operated under a competitive financial system ... to move away from the tenets of a centrally planned economy towards free-market orientation. ... They have also favored traders rather than producers.

  1. WILDLIFE-BASED DOMESTIC TOURISM IN TANZANIA ...

    African Journals Online (AJOL)

    Dr Osondu

    industry in Tanzania economy, it has been shown repeatedly ... What factors restrain faster growth of domestic .... needs (i.e. food, clothing and shelter) is no longer ... communication network) and social services ..... Advertising, Promotion and.

  2. Tanzania Journal of Science: Editorial Policies

    African Journals Online (AJOL)

    Tanzania Journal of Science (TJS), is professional, peer reviewed journal, published in ... Optics, Thin films, Zoography, Military sciences, Biological sciences, Biodiversity, ... animal and veterinary sciences, Geology, Agricultural Sciences, Cytology, ... available to the public supports a greater global exchange of knowledge.

  3. Water Resources Management in Tanzania: Identifying Research ...

    African Journals Online (AJOL)

    by human-induced activities. Over the past ... Review of water resources management in Tanzania; Global literature review on water resources ..... requirements for biodiversity and human health. .... Global warming is altering regional climates.

  4. Tanzania's Revealed Comparative Advantage and Structural ...

    African Journals Online (AJOL)

    example, the contribution from vegetable products fell by 7%, and that from textiles .... 43 -‐ Furskins and artificial fur, manufactures thereof ... example, while Tanzania has comparative advantage in raw hides and skins (see Figure 6), it.

  5. african indigenous and traditional vegetables in tanzania

    African Journals Online (AJOL)

    ACSS

    A questionnaire-based survey was conducted in four regions of Tanzania with a total of 160 sellers ... washing; and (iii) marketing: retail markup, price variation by season, year and region, ..... and endosulfan and metalaxyl/mencozeb mix as.

  6. Tanzania Monitoring and Evaluation Management Services

    Data.gov (United States)

    US Agency for International Development — MEMS II is a two-year project to enable USAID/Tanzania and a number of its partners to meet their multifold performance reporting responsibilities; upgrade,...

  7. Knowledge and attitude towards zoonoses among animal health workers and livestock keepers in Arusha and Tanga, Tanzania.

    Science.gov (United States)

    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 (Pzoonosis was significantly higher in traditional livestock (86%; 6/7) than smallholder dairy keepers (Pzoonosis 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 respondents to an increased risk of contracting zoonoses. Public health promotion on education and

  8. Toward a nitrogen footprint calculator for Tanzania

    Science.gov (United States)

    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.

  9. Marathon maternity oral history project: Exploring rural birthing through narrative methods.

    Science.gov (United States)

    Orkin, Aaron; Newbery, Sarah

    2014-01-01

    To explore how birthing and maternity care are understood and valued in a rural community. Oral history research. The rural community of Marathon, Ont, with a population of approximately 3500. A purposive selection of mothers, grandmothers, nurses, physicians, and community leaders in the Marathon medical catchment area. Interviews were conducted with a purposive sample, employing an oral history research methodology. Interviews were conducted non-anonymously in order to preserve the identity and personhood of participants. Interview transcripts were edited into short narratives. Oral histories offer perspectives and information not revealed in other quantitative or qualitative research methodologies. Narratives re-personalize and humanize medical research by offering researchers and practitioners the opportunity to bear witness to the personal stories affected through medical decision making. Eleven stand-alone narratives, published in this issue of Canadian Family Physician, form the project's findings. Similar to a literary text or short story, they are intended for personal reflection and interpretation by the reader. Presenting the results of these interviews as narratives requires the reader to participate in the research exercise and take part in listening to these women's voices. The project's narratives will be accessible to readers from academic and non-academic backgrounds and will interest readers in medicine and allied health professions, medical humanities, community development, gender studies, social anthropology and history, and literature. Sharing personal birthing experiences might inspire others to reevaluate and reconsider birthing practices and services in other communities. Where local maternity services are under threat, Marathon's stories might contribute to understanding the meaning and challenges of local birthing, and the implications of losing maternity services in rural Canada.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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…

  12. The need to promote behaviour change at the cultural level: one factor explaining the limited impact of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzania. A process evaluation

    Directory of Open Access Journals (Sweden)

    Wight Daniel

    2012-09-01

    Full Text Available Abstract Background Few of the many behavioral sexual health interventions in Africa have been rigorously evaluated. Where biological outcomes have been measured, improvements have rarely been found. One of the most rigorous trials was of the multi-component MEMA kwa Vijana adolescent sexual health programme, which showed improvements in knowledge and reported attitudes and behaviour, but none in biological outcomes. This paper attempts to explain these outcomes by reviewing the process evaluation findings, particularly in terms of contextual factors. Methods A large-scale, primarily qualitative process evaluation based mainly on participant observation identified the principal contextual barriers and facilitators of behavioural change. Results The contextual barriers involved four interrelated socio-structural factors: culture (i.e. shared practices and systems of belief, economic circumstances, social status, and gender. At an individual level they appeared to operate through the constructs of the theories underlying MEMA kwa Vijana - Social Cognitive Theory and the Theory of Reasoned Action – but the intervention was unable to substantially modify these individual-level constructs, apart from knowledge. Conclusion The process evaluation suggests that one important reason for this failure is that the intervention did not operate sufficiently at a structural level, particularly in regard to culture. Recently most structural interventions have focused on gender or/and economics. Complementing these with a cultural approach could address the belief systems that justify and perpetuate gender and economic inequalities, as well as other barriers to behaviour change.

  13. All projects related to Tanzania | Page 4 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Across Africa, postharvest losses along the food chain from farm to fork jeopardize the food ... Region: North of Sahara, South of Sahara, Benin, Ghana, Kenya, Malawi, Mozambique, Tanzania ... Integrated crop and goat breeding in Tanzania.

  14. Archives: Tanzania Journal of Forestry and Nature Conservation

    African Journals Online (AJOL)

    Items 1 - 18 of 18 ... Archives: Tanzania Journal of Forestry and Nature Conservation. Journal Home > Archives: Tanzania Journal of Forestry and Nature Conservation. Log in or Register to get access to full text downloads.

  15. Tanzania Journal of Forestry and Nature Conservation: Journal ...

    African Journals Online (AJOL)

    Tanzania Journal of Forestry and Nature Conservation: Journal Sponsorship. Journal Home > About the Journal > Tanzania Journal of Forestry and Nature Conservation: Journal Sponsorship. Log in or Register to get access to full text downloads.

  16. Tanzania Veterinary Journal - Vol 32, No 1 (2017)

    African Journals Online (AJOL)

    Tanzania Veterinary Journal - Vol 32, No 1 (2017) ... factors for porcine cysticercosis transmission and animal welfare in selected villages in Nyasa, Tanzania ... Thoracic radiographic anatomy in sheep · EMAIL FULL TEXT EMAIL FULL TEXT

  17. Feasibility of supervised self-testing using an oral fluid-based HIV rapid testing method: a cross-sectional, mixed method study among pregnant women in rural India

    OpenAIRE

    Sarkar, Archana; Mburu, Gitau; Shivkumar, Poonam Varma; Sharma, Pankhuri; Campbell, Fiona; Behera, Jagannath; Dargan, Ritu; Mishra, Surendra Kumar; Mehra, Sunil

    2016-01-01

    Introduction: HIV self-testing can increase coverage of essential HIV services. This study aimed to establish the acceptability, concordance and feasibility of supervised HIV self-testing among pregnant women in rural India. Methods: A cross-sectional, mixed methods study was conducted among 202 consenting pregnant women in a rural Indian hospital between August 2014 and January 2015. Participants were provided with instructions on how to self-test using OraQuick® HIV antibody test, and subse...

  18. Barriers in implementing evidence-informed health decisions in rural rehabilitation settings: a mixed methods pilot study.

    Science.gov (United States)

    Prakash, V; Hariohm, K; Balaganapathy, M

    2014-08-01

    Literature on the barriers to implementing research findings into physiotherapy practice are often urban centric, using self report based on the hypothetical patient scenario. The objective of this study was to investigate the occurrence of barriers, encountered by evidence informed practice-trained physiotherapists in the management of "real world" patients in rural rehabilitation settings. A mixed-methods research design was used. Physiotherapists working in rural outpatient rehabilitation settings participated in the study. In the first phase, we asked all participants (N = 5) to maintain a log book for a 4-week period to record questions that arose during their routine clinical encounters and asked them also to follow first four of the five steps of evidence-informed practice (ask, access, appraise and apply). In the second phase (after 4 weeks), we conducted a semistructured, direct interviews with the participants exploring their experiences involved in the process of implementing evidence-informed clinical decisions made during the study period. At the end of 4 weeks, 30 questions were recorded. For 17 questions, the participants found evidence but applied that evidence into their practice only in 9 instances. Being generalist practitioners, lack of outcomes specific to the patients were reported as barriers more so than time constraints in implementing evidence-informed practice. Practice setting, lack of patient-centered research and evidence-informed practice competency of physiotherapists can be significant barriers to implementing evidence-informed health decisions in rural rehabilitation setting. © 2014 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

  19. Tanzania Health Information Technology (T-HIT) System: Pilot Test of a Tablet-Based System to Improve Prevention of Mother-to-Child Transmission of HIV

    Science.gov (United States)

    Bull, Sheana; Nyanza, Elias C; Ngallaba, Sospatro E

    2018-01-01

    Background The prevention of mother-to-child transmission (PMTCT) of HIV requires innovative solutions. Although routine monitoring is effective in some areas, standardized and easy-to-scale solutions to identify and monitor pregnant women, test them for HIV, and treat them and their children is still lacking. Mobile health (mHealth) offers opportunities for surveillance and reporting in rural areas of low- and middle-income countries. Objective The aim of this study was to document the preliminary impacts of the Tanzania Health Information Technology (T-HIT) system mHealth intervention aimed at health workers for PMTCT care delivery and capacity building in a rural area of Tanzania. Methods We developed T-HIT as a tablet-based system for an electronic data collection system designed to capture and report PMTCT data during antenatal, delivery, and postnatal visits in Misungwi, Tanzania. T-HIT was tested by health workers in a pilot randomized trial comparing seven sites using T-HIT assigned at random to seven control sites; all sites maintained standard paper record-keeping during the pilot intervention period. We compared numbers of antenatal visits, number of HIV tests administered, and women testing positive across all sites. Results Health workers recorded data from antenatal visits for 1530 women; of these, 695 (45.42%) were tested for HIV and 3.59% (55/1530) tested positive. Health workers were unable to conduct an HIV test for 103 women (6.73%, 103/1530) because of lack of reagent, which is not captured on paper logs. There was no difference in the activity level for testing when comparing sites T-HIT to non-T-HIT sites. We observed a significant postintervention increase in the numbers of women testing positive for HIV compared with the preintervention period (P=.04), but this was likely not attributable to the T-HIT system. Conclusions T-HIT had a high degree of acceptability and feasibility and is perceived as useful by health workers, who documented more

  20. Back to Office Report. Mission no.1 to Tanzania as counterpart institution to Cleaner Production Centre of Tanzania

    DEFF Research Database (Denmark)

    Jørgensen, Michael Søgaard

    1996-01-01

    A presentation of some important actors and institutions in the capacity building within cleaner production in Tanzania......A presentation of some important actors and institutions in the capacity building within cleaner production in Tanzania...

  1. The Quality of Selected Essential Medicines Sold in Accredited Drug Dispensing Outlets and Pharmacies in Tanzania.

    Directory of Open Access Journals (Sweden)

    Eliangiringa Kaale

    Full Text Available The purpose of this study was to investigate the quality of a select group of medicines sold in accredited drug dispensing outlets (ADDOs and pharmacies in different regions of Tanzania as part of an in-depth cross-sectional assessment of community access to medicines and community use of medicines.We collected 242 samples of amoxicillin trihydrate, artemether-lumefantrine (ALu, co-trimoxazole, ergometrine maleate, paracetamol, and quinine from selected ADDOs and pharmacies in Mbeya, Morogoro, Singida, and Tanga regions. The analysis included physical examination and testing with validated analytical techniques. Assays for eight of nine products were conducted using high-performance thin-layer chromatography (HPTLC. For ALu tablets, we used a two-tiered approach, where tier 1 was a semi-quantitative Global Pharma Health Fund-Minilab® method and tier 2 was high-performance liquid chromatography (HPLC as described in The International Pharmacopoeia's monograph for artemether-lumefantrine.The physical examination of samples revealed no defects in the solid and oral liquid dosage forms, but unusual discoloration in an injectable solution, ergometrine maleate. For ALu, the results showed that of 38 samples, 31 (81.6% passed tier 1 testing and 7 (18.4% gave inconclusive drug content results. The inconclusive ALu samples were submitted for tier 2 testing and all met the quality standards. The pass rate using the HPTLC and TLC/HPLC assays was 93.8%; the failures were the ergometrine maleate samples purchased from both ADDOs and pharmacies. The disintegration testing of the solid dosage forms was conducted in accordance with US Pharmacopeia monographs. Only two samples of paracetamol, 1.2% of the solid dosage forms, failed to comply to standards. The study revealed a high overall rate of 92.6% of samples that met the quality standards. Although the overall failure rate was 7.4%, it is important to note that this was largely limited to one product and

  2. The Quality of Selected Essential Medicines Sold in Accredited Drug Dispensing Outlets and Pharmacies in Tanzania.

    Science.gov (United States)

    Kaale, Eliangiringa; Manyanga, Vicky; Chambuso, Mhina; Liana, Jafary; Rutta, Edmund; Embrey, Martha; Layloff, Thomas; Johnson, Keith

    2016-01-01

    The purpose of this study was to investigate the quality of a select group of medicines sold in accredited drug dispensing outlets (ADDOs) and pharmacies in different regions of Tanzania as part of an in-depth cross-sectional assessment of community access to medicines and community use of medicines. We collected 242 samples of amoxicillin trihydrate, artemether-lumefantrine (ALu), co-trimoxazole, ergometrine maleate, paracetamol, and quinine from selected ADDOs and pharmacies in Mbeya, Morogoro, Singida, and Tanga regions. The analysis included physical examination and testing with validated analytical techniques. Assays for eight of nine products were conducted using high-performance thin-layer chromatography (HPTLC). For ALu tablets, we used a two-tiered approach, where tier 1 was a semi-quantitative Global Pharma Health Fund-Minilab® method and tier 2 was high-performance liquid chromatography (HPLC) as described in The International Pharmacopoeia's monograph for artemether-lumefantrine. The physical examination of samples revealed no defects in the solid and oral liquid dosage forms, but unusual discoloration in an injectable solution, ergometrine maleate. For ALu, the results showed that of 38 samples, 31 (81.6%) passed tier 1 testing and 7 (18.4%) gave inconclusive drug content results. The inconclusive ALu samples were submitted for tier 2 testing and all met the quality standards. The pass rate using the HPTLC and TLC/HPLC assays was 93.8%; the failures were the ergometrine maleate samples purchased from both ADDOs and pharmacies. The disintegration testing of the solid dosage forms was conducted in accordance with US Pharmacopeia monographs. Only two samples of paracetamol, 1.2% of the solid dosage forms, failed to comply to standards. The study revealed a high overall rate of 92.6% of samples that met the quality standards. Although the overall failure rate was 7.4%, it is important to note that this was largely limited to one product and likely due to

  3. The use of a modified pairwise comparison method in evaluating critical success factors for community-based rural homestay programmes

    Science.gov (United States)

    Daud, Shahidah Md; Ramli, Razamin; Kasim, Maznah Mat; Kayat, Kalsom; Razak, Rafidah Abd

    2014-12-01

    Tourism industry has become the highlighted sector which has amazingly increased the national income level. Despite the tourism industry being one of the highest income generating sectors, Homestay Programme as a Community-Based Tourism (CBT) product in Malaysia does not absorbed much of the incoming wealth. Homestay Programme refers to a programme in a community where a tourist stays together with a host family and experiences the everyday way of life of the family in both direct and indirect manner. There are over 100 Homestay Programme currently being registered with the Ministry of Culture and Tourism Malaysia which mostly are located in rural areas, but only a few excel and enjoying the fruit of the booming industry. Hence, this article seeks to identify the critical success factors for a Community-Based Rural Homestay Programme in Malaysia. A modified pairwise method is utilized to further evaluate the identified success factors in a more meaningful way. The findings will help Homestay Programme function as a community development tool that manages tourism resources. Thus, help the community in improving local economy and creating job opportunities.

  4. Evaluation of criteria for sustainability of community-based rural homestay programs via a modified pairwise comparison method

    Science.gov (United States)

    Ramli, Rohaini; Kasim, Maznah Mat; Ramli, Razamin; Kayat, Kalsom; Razak, Rafidah Abd

    2014-12-01

    Ministry of Tourism and Culture Malaysia has long introduced homestay programs across the country to enhance the quality of life of people, especially those living in rural areas. This type of program is classified as a community-based tourism (CBT) as it is expected to economically improve livelihood through cultural and community associated activities. It is the aspiration of the ministry to see that the income imbalance between people in the rural and urban areas is reduced, thus would contribute towards creating more developed states of Malaysia. Since 1970s, there are 154 homestay programs registered with the ministry. However, the performance and sustainability of the programs are still not satisfying. There are only a number of homestay programs that perform well and able to sustain. Thus, the aim of this paper is to identify relevant criteria contributing to the sustainability of a homestay program. The criteria are evaluated for their levels of importance via the use of a modified pairwise method and analyzed for other potentials. The findings will help the homestay operators to focus on the necessary criteria and thus, effectively perform as the CBT business initiative.

  5. Replicating the MamaToto Program in Rural Tanzania (IMCHA ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project draws on the low-cost MamaToto (mother-baby) process implemented in Uganda, where substantial gains in maternal and child health were achieved. These gains took place through an approach that strengthened services at health facilities and within communities. This project will implement and evaluate a ...

  6. Causes and Risk Factors for Maternal Mortality in Rural Tanzania ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    , School of Public Health ... Keywords: Maternal death, maternal mortality, risk factors and developing country .... technique which encompasses use of educational ..... Farm. Workers. 0.70. 0.547. (0.213-2.267). Cannot work 2.67. 0.396. (0.277-.

  7. Qualitative study on maternal referrals in rural Tanzania: Decision ...

    African Journals Online (AJOL)

    The process in deciding to seek referral care is envisaged within community perception of seriousness of the condition, difficulty to access and cost involved in transport, living expenses at the hospital, and perceived quality of care at facility level. The hospitals were seen as providing acceptable quality of care, whereas, the ...

  8. Qualitative study on maternal referrals in rural Tanzania: Decision ...

    African Journals Online (AJOL)

    Administrator

    discussions (FGDs) with health workers and community members, stratified by age and ..... health facilities and not listening carefully ..... Projects. Int J Gynaecol Obstet. 1997(59). S259-S265. 22. Campbell O, Koblinsky M, Taylor P. Off to.

  9. Qualitative study on maternal referrals in rural Tanzania: Decision ...

    African Journals Online (AJOL)

    Administrator

    The process in deciding to seek referral care is envisaged within community .... The three phases of delays model in accessing .... as dangerous at home and immediate care is required, the ... referral or is unable to pay the costs of referral, the ...

  10. Tanzania.

    African Journals Online (AJOL)

    variation (Seebeck, 1973: Mackinnon-e't ar: 1990): Majority of paststlidies"on' reproductive performance from' tropicar-are'as have been' largely limited to'the assessment of effects of>. ·no'n.,genetk factors and breed difference's : '(Galiila. and Arthur, 1989), Genetic parameter es-, timates and infonnation. on the'extent of ...

  11. Trapped in decline : a sociological analysis of economic life in Mgeta, Uluguru Mountains Tanzania

    OpenAIRE

    Donge, van, J.K.

    1993-01-01

    The research for this thesis was carried out in Tanzania during the period 1985- 89 and focuses on the Mgeta division in the Uluguru mountains, Morogoro rural district. Research was also undertaken among migrants from the area living in Dar es Salaam where they traded in foodstuffs. I made a return visit to the area in November 1991 to look again at questions which arose during writing up. The research also reflects seven years' employment at the University of Dar es Salaam (1982-89)...

  12. Prices and availability of locally produced and imported medicines in Ethiopia and Tanzania

    NARCIS (Netherlands)

    Ewen, M.; Kaplan, W.; Gedif, T.; Justin-Temu, M.; Vialle-Valentin, C.; Mirza, Z.; Regeer, B.; Zweekhorst, M.; Laing, Richard

    2017-01-01

    Background: To assess the effect of policies supporting local medicine production to improve access to medicines. Methods: We adapted the WHO/HAI instruments measuring medicines availability and prices to differentiate local from imported products, then pilot tested in Ethiopia and Tanzania. In each

  13. Basic Density and Strength Properties Variations in Cordia Africana (Lam) Grown Under Agroforestry in Arumeru, Tanzania

    NARCIS (Netherlands)

    Mahonge, C.P.I.

    2007-01-01

    Variations in basic density and strength properties of Cordia africana (lam) grown under agroforestry in Arumeru district Arusha Tanzania were determined. Tree sampling procedure and data collection based on standard methods (ISO 3129.of 1975). The main results indicated that basic density increased

  14. Mob justice in Tanzania: a medico-social problem | Ng'walali ...

    African Journals Online (AJOL)

    Objective: To investigate the magnitude of mob justice and associated factors. Background: 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. Materials and Methods: A four-year autopsy ...

  15. Teachers' Commitment To, and Experiences of, the Teaching Profession in Tanzania: Findings of Focus Group Research

    Science.gov (United States)

    Mkumbo, Kitila A. K.

    2012-01-01

    This qualitative study examined teachers' commitment to, and experiences of, the teaching profession in six regions of Tanzania. The study used focus group discussions as research method and data collection tool. Twenty four groups were conducted, with group membership ranging from five to nine participants. The results show that the teachers'…

  16. Evaluation of an anti-stigma campaign related to common mental disorders in rural India: a mixed methods approach.

    Science.gov (United States)

    Maulik, P K; Devarapalli, S; Kallakuri, S; Tewari, A; Chilappagari, S; Koschorke, M; Thornicroft, G

    2017-02-01

    Stigma related to mental health is a major barrier to help-seeking resulting in a large treatment gap in low- and middle-income countries (LMIC). This study assessed changes in knowledge, attitude and behaviour, and stigma related to help-seeking among participants exposed to an anti-stigma campaign. The campaign, using multi-media interventions, was part of the SMART Mental Health Project, conducted for 3 months, across 42 villages in rural Andhra Pradesh, in South India. Mixed-methods evaluation was conducted in two villages using a pre-post design. A total of 1576 and 2100 participants were interviewed, at pre- and post-intervention phases of the campaign. Knowledge was not increased. Attitudes and behaviours improved significantly (p Stigma related to help-seeking reduced significantly (p stigma related to help-seeking. Social contact was the most effective intervention. The study had implications for future research in LMIC.

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

    Science.gov (United States)

    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.

  18. [Prediction method of rural landscape pattern evolution based on life cycle: a case study of Jinjing Town, Hunan Province, China].

    Science.gov (United States)

    Ji, Xiang; Liu, Li-Ming; Li, Hong-Qing

    2014-11-01

    Taking Jinjing Town in Dongting Lake area as a case, this paper analyzed the evolution of rural landscape patterns by means of life cycle theory, simulated the evolution cycle curve, and calculated its evolution period, then combining CA-Markov model, a complete prediction model was built based on the rule of rural landscape change. The results showed that rural settlement and paddy landscapes of Jinjing Town would change most in 2020, with the rural settlement landscape increased to 1194.01 hm2 and paddy landscape greatly reduced to 3090.24 hm2. The quantitative and spatial prediction accuracies of the model were up to 99.3% and 96.4%, respectively, being more explicit than single CA-Markov model. The prediction model of rural landscape patterns change proposed in this paper would be helpful for rural landscape planning in future.

  19. AN EXPLORATION OF FACTORS AFFECTING DEVELOPMENT OF CITRUS INDUSTRY IN TANZANIA: EMPIRICAL EVIDENCE FROM MUHEZA DISTRICT, TANGA REGION

    Directory of Open Access Journals (Sweden)

    Robert Makorere

    2014-04-01

    Full Text Available The paper stresses on understanding factors affecting development of citrus industry in Tanzania particularly in Muheza District, in Tanga region. Citrus fruit is one of the most important crops in Muheza District of Tanga region in Tanzania particularly in improving rural farmers’ income. The study employed institutional framework methodology. The study disclosed that the government of Tanzania has been implementing various agricultural development programmes in improving citrus fruit production as well as to enhance farmers’ income. However, yet the results reveal that the citrus farming practices in the surveyed area are not well developed. And these are because citruses are still grown under rain fed regime without any form of irrigation, citrus seedlings are produced by individual farmers locally in their backyard nurseries. There is no professional company responsible for seedling production. Also, citrus farmers’ skills in citrus husbandry practices are limited. Lastly, all citrus varieties used contain many seeds in the citrus fruits whereas the market demands seedless citrus fruits. It is therefore, recommended that the policy maker should focus on development of citrus industry in Tanzania using proper institutional framework support, which could increase growth and development of citrus production through the provision of subsides for inputs to reduce cost of production and enlightenment campaigns to improve farmer’s knowledge and technical skills on how to reach lucrative markets.

  20. Healthcare Provider Views on Transitioning From Task Shifting to Advanced Practice Nursing in Tanzania.

    Science.gov (United States)

    Mboineki, Joanes Faustine; Zhang, Weihong

    The Tanzanian health sector suffers from shortages of healthcare workers as well as uneven distribution of healthcare workers in urban and rural areas. Task shifting-delegation of tasks from professionals to other healthcare team members with less training, such as medical attendants-is practiced, compromising quality of care. Advanced practice nursing is underutilized. The purpose of this study was to explore the views of nurses and physicians on current responses to shortages of healthcare workers and the potential for utilization of advanced practice nurses. A descriptive, qualitative design was used. Purposeful sampling was used to select 20 participants. An in-depth interview guide was used to obtain information. Interviews were conducted in Swahili or English. Content analysis was used to identify themes. Shortage of human resources in rural primary healthcare facilities was identified as a major rationale for implementation of the advanced practice nurse practitioner role because the current health providers in rural health facilities are less trained and doctors are not ready to work in these settings. Opposition from physicians is expected during the course of implementing the nurse practitioner role. Professional bodies and government should reach consensus before the implementation of this role in such a way that they should agree on scope and standards of practice of nurse practitioners in Tanzania. Shortage of human resources for health is greater in rural primary healthcare facilities. Task shifting in Tanzania is neither effective nor legally recognized. Transition to advanced practice nursing roles-particularly the nurse practitioner role-can facilitate provision of optimal care. Nurse practitioners should be prepared to work in rural primary healthcare facilities.

  1. Type 1 diabetes care updates: Tanzania

    Directory of Open Access Journals (Sweden)

    Kandi Catherine Muze

    2015-01-01

    Full Text Available Tanzania is located in east Africa with a population of 45 million. The country′s population is growing at 2.5% annually. The International Diabetes Federation Child Sponsorship Program was launched in Tanzania in 2005. The number of type 1 diabetes mellitus children enrolled in the changing diabetes in children program in Tanzania has augmented from almost below 50 in 2005 to over 1200 in 2014. The country had an overall trend of HbA1c value of 14% in 2005 while the same has reduced over the years to 10% in 2012-13. The program has been able to reduce the proportion of patients with HbA1c values of 11-14%; from 71.9% in 2008 to 49.8% in 2012-13. The challenges, which CDiC faces are misdiagnosis, low public awareness, and stigma especially in the reproductive age/adolescent groups.

  2. Occupational dose trends in Tanzania

    International Nuclear Information System (INIS)

    Muhogora, W.E.; Nyanda, A.M.; Ngaile, J.E.; Lema, U.S.

    1998-01-01

    This paper describes the present status of occupational radiation exposure of monitored workers in Tanzania from 1986 to 1997. The analysis of dose records observes over this period, a fluctuating trend both in the individual and collective doses. The trend is more related to the fluctuations of the number of radiation workers than to the possible radiation safety changes of the working conditions. It has been found that, the maximum annual dose for the worker in all work categories was about 18 mSv y -1 . This suggests that the occupational radiation exposure in all practices satisfies the current dose limitation system. The national exposure summary shows that, the highest collective dose of 12.8 man-Sv which is 90% of the total collective dose, was due to medical applications. The applications in industry and research had a contribution of nearly 0.8 and 0.7 man-Sv respectively. From the professional point of view, the medical diagnostic radiographers received the highest collective dose of 11.2 man-Sv. Although the medical physicists recorded the minimum collective dose of nearly 0.07 man-Sv, the data shows that this profession received the highest mean dose of about 33 mSv in 12 years. Some achievements of the personnel monitoring services and suggestions for future improvement are pointed out. (author)

  3. Transcultural nursing course in Tanzania, Africa.

    Science.gov (United States)

    Owens, Rhoda

    2012-06-01

    A transcultural nursing course in Tanzania was offered in fall 2010 at Williston State College, located in North Dakota. Madeleine Leininger's Culture Care: Diversity and Universality Theory (Principles of Developing Cultural Competence) was the framework used for the experience. The course provided nursing students the opportunity to learn about the culture, health, and illness beliefs of Tanzanians; their values and practices; the prevalence of HIV/AIDS; and the differences and similarities between the healthcare systems, hospice/palliative care, and home visits in Tanzania as compared to the United States.

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

    Science.gov (United States)

    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.

  5. Knowledge of Food Production Methods Informs Attitudes toward Food but Not Food Choice in Adults Residing in Socioeconomically Deprived Rural Areas within the United Kingdom

    Science.gov (United States)

    Barton, Maria; Kearney, John; Stewart-Knox, Barbara J.

    2011-01-01

    Objective: Understand food choice, from the perspective of people residing in socioeconomically deprived rural neighborhoods. Methods: Focus groups (n = 7) were undertaken within a community setting involving 42 adults (2 males and 40 females) recruited through voluntary action groups. Data were recorded, transcribed verbatim, and content…

  6. Milk Options Observation (MOO): A Mixed-Methods Study of Chocolate Milk Removal on Beverage Consumption and Student/Staff Behaviors in a Rural Elementary School

    Science.gov (United States)

    Davis, Melinda M.; Spurlock, Margaret; Ramsey, Katrina; Smith, Jamie; Beamer, Beth Ann; Aromaa, Susan; McGinnis, Paul B.

    2017-01-01

    Providing flavored milk in school lunches is controversial, with conflicting evidence on its impact on nutritional intake versus added sugar consumption and excess weight gain. Nonindustry-sponsored studies using individual-level analyses are needed. Therefore, we conducted this mixed-methods study of flavored milk removal at a rural primary…

  7. Alternative method to trace sediment sources in a subtropical rural catchment of southern Brazil by using near-infrared spectroscopy

    Science.gov (United States)

    Tiecher, Tales; Caner, Laurent; Gomes Minella, Jean Paolo; Henrique Ciotti, Lucas; Antônio Bender, Marcos; dos Santos Rheinheimer, Danilo

    2014-05-01

    Conventional fingerprinting methods based on geochemical composition still require a time-consuming and critical preliminary sample preparation. Thus, fingerprinting characteristics that can be measured in a rapid and cheap way requiring a minimal sample preparation, such as spectroscopy methods, should be used. The present study aimed to evaluate the sediment sources contribution in a rural catchment by using conventional method based on geochemical composition and on an alternative method based on near-infrared spectroscopy. This study was carried out in a rural catchment with an area of 1,19 km2 located in southern Brazil. The sediment sources evaluated were crop fields (n=20), unpaved roads (n=10) and stream channels (n=10). Thirty suspended sediment samples were collected from eight significant storm runoff events between 2009 and 2011. Sources and sediment samples were dried at 50oC and sieved at 63 µm. The total concentration of Ag, As, B, Ba, Be, Ca, Cd, Co, Cr, Cu, Fe, K, La, Li, Mg, Mn, Mo, Na, Ni, P, Pb, Sb, Se, Sr, Ti, Tl, V and Zn were estimated by ICP-OES after microwave assisted digestion with concentrated HNO3 and HCl. Total organic carbon (TOC) was estimated by wet oxidation with K2Cr2O7 and H2SO4. The near-infrared spectra scan range was 4000 to 10000 cm-1 at a resolution of 2 cm-1, with 100 co added scans per spectrum. The steps used in the conventional method were: i) tracer selection based on Kruskal-Wallis test, ii) selection of the best set of tracers using discriminant analyses and finally iii) the use of a mixed linear model to calculate the sediment sources contribution. The steps used in the alternative method were i) principal component analyses to reduce the number of variables, ii) discriminant analyses to determine the tracer potential of the near-infrared spectroscopy, and finally iii) the use of past least square based on 48 mixtures of the sediment sources in various weight proportions to calculate the sediment sources

  8. The impact of mobile phones on knowledge access and transfer of small-scale horticultural farmers in Tanzania

    Directory of Open Access Journals (Sweden)

    Krone, Madlen

    2014-09-01

    Full Text Available Agriculture is the main economic activity in Tanzania and the country´s largest employer, providing livelihood for at least 80 % of the economically active population. Many studies have identified key challenges facing the sector for Africa in general – among these lack of access to knowledge. For agricultural producers, access to knowledge is important for an improved productivity and competitiveness. The fast diffusion of information and communication technologies (ICT such as mobile phones across Africa in the last years has resulted in an improved access and transfer of agricultural knowledge. Studies have shown that rural actors like farmers in remote areas even use mobile phones for their farming business. Based on qualitative interviews in the Mwanza Region in northwestern Tanzania, this study aims to identify and categorise the different types of knowledge which are transferred via mobile phones. Our results show that mobile phones enlarge the ability of farmers to access business-relevant knowledge at an increasing spatial scale. However, the effects of the use depend on the type of knowledge and other factors. The results add to existing studies by deepening the understanding of the benefits of ICT on knowledge access and transfer for the context of rural small-scale framers in Tanzania.

  9. The societal cost of Taenia solium cysticercosis in Tanzania.

    Science.gov (United States)

    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

  10. Integrated urban malaria control: a case study in dar es salaam, Tanzania.

    Science.gov (United States)

    Caldas de Castro, Marcia; Yamagata, Yoichi; Mtasiwa, Deo; Tanner, Marcel; Utzinger, Jurg; Keiser, Jennifer; Singer, Burton H

    2004-08-01

    The rapid growth of cities in sub-Saharan Africa, much of it driven by rural-urban migration, is associated with complex transformations of these ecosystems and an intricate set of challenges for malaria control. Urban malaria transmission is substantially less intense and much more focal than in rural and peri-urban settings. However, the danger of epidemics is higher and the presence of substantial non-immune populations places people of all ages at comparable levels of risk. The limited number of breeding sites in urban centers suggests that prevention strategies based on vector control, with emphasis on environmental management, should be a central feature of urban malaria control programs. We focus on malaria in the city of Dar es Salaam, Tanzania. Following a brief review of the 100-year history of malaria control in this urban center, we describe and evaluate a control program that operated from 1988 to 1996 as a consequence of a bilateral agreement between the governments of Tanzania and Japan. We present an innovative urban malaria risk mapping methodology based on high-resolution aerial photography with ground-based validation. This strategy clarifies that remote sensing technology at a level of resolution of one meter is essential if this kind of information is to play a role in guiding the detailed specification of intervention strategies for urban malaria control. The Tanzania-Japan multiple-intervention malaria control program, adaptively implemented over time, is described and evaluated with implications for urban malaria control in sub-Saharan Africa more generally. Copyright 2004 The American Society of Tropical Medicine and Hygiene

  11. Promising adoption of an electronic clinical decision support system for antenatal and intrapartum care in rural primary healthcare facilities in sub-Saharan Africa: The QUALMAT experience.

    Science.gov (United States)

    Sukums, Felix; Mensah, Nathan; Mpembeni, Rose; Massawe, Siriel; Duysburgh, Els; Williams, Afua; Kaltschmidt, Jens; Loukanova, Svetla; Haefeli, Walter E; Blank, Antje

    2015-09-01

    The QUALMAT project has successfully implemented an electronic clinical decision support system (eCDSS) for antenatal and intrapartum care in two sub-Saharan African countries. The system was introduced to facilitate adherence to clinical practice guidelines and to support decision making during client encounter to bridge the know-do gap of health workers. This study aimed to describe health workers' acceptance and use of the eCDSS for maternal care in rural primary health care (PHC) facilities of Ghana and Tanzania and to identify factors affecting successful adoption of such a system. This longitudinal study was conducted in Lindi rural district in Tanzania and Kassena-Nankana district in Ghana between October 2011 and December 2013 employing mixed methods. The study population included healthcare workers who were involved in the provision of maternal care in six rural PHC facilities from one district in each country where the eCDSS was implemented. All eCDSS users participated in the study with 61 and 56 participants at the midterm and final assessment, respectively. After several rounds of user training and support the eCDSS has been successfully adopted and constantly used during patient care in antenatal clinics and maternity wards. The eCDSS was used in 71% (2703/3798) and 59% (14,189/24,204) of all ANC clients in Tanzania and Ghana respectively, while it was also used in 83% (1185/1427) and 67% (1435/2144) of all deliveries in Tanzania and in Ghana, respectively. Several barriers reported to hinder eCDSS use were related to individual users, tasks, technology, and organization attributes. Implementation of an eCDSS in resource-constrained PHC facilities in sub-Saharan Africa was successful and the health workers accepted and continuously used the system for maternal care. Facilitators for eCDSS use included sufficient training and regular support whereas the challenges to sustained use were unreliable power supply and perceived high workload. However our

  12. Construction and Demolition Waste Characteristics in Tanzania ...

    African Journals Online (AJOL)

    The construction industry generates a lot of construction and demolition (C&D) waste which puts some challenges to its management. For example, currently, in many towns in Tanzania, there are no landfill sites for solid waste disposal; and as a consequence open air dumping sites are used. Dumping C&D waste puts ...

  13. Marketing Dental Services | Tuominen | Tanzania Dental Journal

    African Journals Online (AJOL)

    Tanzania Dental Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 9, No 1 (2000) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Marketing Dental Services. R Tuominen. Abstract. No Abstract.

  14. Boosting youth employment prospects in Tanzania | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2015-12-16

    Dec 16, 2015 ... Return to main page, Addressing the youth employment challenge in Africa. Related links: Youth Employment Promotion a Priority Agenda for Tanzania, The Guardian; Report: National Stakeholders Consultative Workshop on Youth Employment (PDF, 1.74 MB); Watch the workshop video on YouTube ...

  15. Country programme review. United Republic of Tanzania

    International Nuclear Information System (INIS)

    Cuaron, A.; Hance, R.; Yurtsever, Y.; Maudarbocus, V.

    1992-01-01

    This document provides a review of past and present IAEA Technical Co-operation Activities in Tanzania and gives descriptions of the current status of nuclear applications in food and agriculture, human health, water resources and industrial applications/nuclear instrumentation

  16. Tanzania | Page 26 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Home · South of Sahara. Tanzania. Tanzanie. Read more about Community Based Adaptation to Climate Change in Africa. Language English. Read more about Free and Open Source Management Information Systems and Microfinance - Phase II. Language English. Read more about La microfinance et les TIC : systèmes ...

  17. Teaching 'natural product chemistry' in Tanzania | Buchanan ...

    African Journals Online (AJOL)

    Natural products 'historically' and 'today' have vast importance. This article describes the course 'Natural Product Chemistry', a new course in the 2011/2012 academic year in the Faculty of Natural and Applied Sciences at St. John's University of Tanzania. It reveals how the course has been applied to the African and ...

  18. Tanzania | Page 35 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Researchers working in Tanzania's Morogoro and Dodoma districts have made an important discovery. By fortifying hay with cassava tops and sweet potato vines, they provided dairy goats with a cheap, protein-rich feed that enabled them to produce more milk. Read more about Better feed for animals means better food for ...

  19. Tanzania | Page 30 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Introducing dairy goats in semi-arid regions of Tanzania has led to farmers earning US$160 from milk sales during the first lactation, as well as an increase in household milk consumption. In these trials led by Canadian and Tanzanian researchers, cassava and sweet potato leaves are a significant feed supplement.

  20. AIDS in dentistry | Muya | Tanzania Dental Journal

    African Journals Online (AJOL)

    Tanzania Dental Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 4, No 1 (1989) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. AIDS in dentistry. RJ Muya. Abstract. No Abstract. Full Text:.

  1. AIDS in dentistry | Muya | Tanzania Dental Journal

    African Journals Online (AJOL)

    Tanzania Dental Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 4, No 1 (1989) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

  2. Tanzania | Page 2 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about ​Promoting locally fortified sunflower oil using e-vouchers. Language English. Read more about ​Affordable natural product reduces fruit losses, increases incomes. Language English. Read more about Integrated crop and goat breeding in Tanzania. Language English. Read more about Élevage de la ...

  3. Newspaper coverage of agricultural information in Tanzania ...

    African Journals Online (AJOL)

    A.S.Sife

    Introduction. Agriculture is a key sector of economy in Tanzania. ... media to reach a wide audience, newspapers have additional advantages of being in permanent form ... advertisements, politics, entertainment, and crime events while ignoring developmental topics such as ..... Social Sciences, 3(8): 578–582. Kayode, J.

  4. Tanzania Journal of Forestry and Nature Conservation

    African Journals Online (AJOL)

    The Tanzania Journal of Forestry and Nature Conservation accommodates the current diverse and multidisciplinary approaches towards ecosystem conservation at national and global levels. The journal is published biannually and accepts research and review papers covering technological, physical, biological, social and ...

  5. Tanzania : Country Procurement Assessment Report, Executive Summary

    OpenAIRE

    World Bank

    2004-01-01

    This Country Procurement Assessment Report (CPAR)intends to determine the compatibility of national procurement law, and practices, with the principles of economy, and with international procurement practices. This CPAR, the second of its kind in Tanzania, looks at the legislative framework, the performance of regulatory functions, the enforcement regime, and the capacity of public sector ...

  6. Cigarette Taxation in Tanzania | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Tobacco consumption in Tanzania rose by 20% between 2002 and 2007, and is predicted to increase by a further 46% by 2016. The impact of this increase in consumption on public health and economic development is likely to be serious. Experience elsewhere has shown that the single most effective way to reverse this ...

  7. Tanzania | Page 28 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Language English. Read more about Taxes sur les cigarettes en Tanzanie. Language French. Read more about Cigarette Taxation in Tanzania. Language English. Read more about Réseau des développeurs - logiciels d'exploitation libre pour assistants numériques personnels utilisés dans la collecte de données sur la ...

  8. Opalescence: Tooth Whitening Systems | Fischer | Tanzania Dental ...

    African Journals Online (AJOL)

    Tanzania Dental Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 15, No 2 (2009) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

  9. Tanzania | Page 36 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The Kenyan sociologist and gender specialist at the International Livestock Research Institute (ILRI) has heard the stories first-hand from her work in hundreds of communities throughout Kenya, Tanzania, and southern Africa. Read more about Empowering African women and communities through agriculture. Language ...

  10. Deficiency within pavement Maintenance Organization in Tanzania ...

    African Journals Online (AJOL)

    In addition, the rules and regulations of the public administrative system do not allow for an effective and efficient management of road maintenance. Lack of equipment and adequate qualified personnel in the field of road maintenance is too an added deficiency. As a consequence, Tanzania has started to put road ...

  11. Access to Money and Relation to Women's Use of Family Planning Methods Among Young Married Women in Rural India.

    Science.gov (United States)

    Reed, Elizabeth; Donta, Balaiah; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusudana; Nair, Saritha; Silverman, Jay; Jadhav, Arun; Palaye, Prajakta; Saggurti, Niranjan; Raj, Anita

    2016-06-01

    Objectives The social positioning (i.e. social status and autonomy) of women in the household facilitates women's access to and decision-making power related to family planning (FP). Women's access to spending money, which may be an indicator of greater social positioning in the household, may also be greater among women who engage in income generating activities for their families, regardless of women's status in the household. However, in both scenarios, access to money may independently afford greater opportunity to obtain family planning services among women. This study seeks to assess whether access to money is associated with FP outcomes independently of women's social positioning in their households. Methods Using survey data from married couples in rural Maharashtra, India (n = 855), crude and adjusted regression was used to assess women's access to their own spending money in relation to past 3 month use of condoms and other forms of contraceptives (pills, injectables, intrauterine device). Results Access to money (59 %) was associated with condom and other contraceptive use (AORs ranged 1.5-1.8). These findings remained significant after adjusting for women's FP decision-making power in the household and mobility to seek FP services. Conclusion While preliminary, findings suggest that access to money may increase women's ability to obtain FP methods, even in contexts where social norms to support women's power in FP decision-making may not be readily adopted.

  12. Distribution of Aedes mosquitoes in the Kilimanjaro Region of northern Tanzania.

    Science.gov (United States)

    Hertz, Julian T; Lyaruu, Lucille J; Ooi, Eng Eong; Mosha, Franklin W; Crump, John A

    2016-05-01

    Little is known about the presence and distribution of Aedes mosquitoes in northern Tanzania despite the occurence of viruses transmitted by these mosquitoes such as Chikungunya virus (CHIKV) and Dengue virus (DENV) in the region. Adult and larval mosquitoes were collected from rural and urban settings across a wide range of altitudes in the Kilimanjaro Region using the Mosquito Magnet CO2 Trap for collection of adults and old tires for breeding of larvae. Polymerase chain reaction assays were performed on captured adult mosquitoes to detect the presence of CHIKV and DENV. A total of 2609 Aedes aegypti adult mosquitoes were collected; no other Aedes species larvae were found. Mosquito yields were significantly higher in urban settings than rural settings (26.5 vs. 1.9 mosquitoes per day, p = 0.037). A total of 6570 Ae. aegypti larvae were collected from old tires; no other Aedes species larvae were found. Of the 2609 adult mosquitoes collected, none tested positive for CHIKV or DENV. As far as we are aware, this paper reports for the first time the presence of Ae. aegypti in the Kilimanjaro Region of northern Tanzania. Although CHIKV and DENV were not isolated from any of the collected mosquitoes in this study, the apparent absence of other Aedes species in the area suggests that Ae. aegypti is the primary local vector of these infections.

  13. The burden of rabies in Tanzania and its impact on local communities.

    Directory of Open Access Journals (Sweden)

    Maganga Sambo

    2013-11-01

    Full Text Available 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.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.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.

  14. Locally manufactured wheelchairs in Tanzania – are users satisfied ...

    African Journals Online (AJOL)

    Methods: A descriptive cross-sectional analytical design was utilized to collect data through .... fold-able (n=15), ten of whom lived in rural set- ..... retest reliability and cross validation of the Func- ... Samuelsson K, Wressle E. User satisfaction.

  15. Prevalence and assessment of malnutrition among children attending the Reproductive and Child Health clinic at Bagamoyo District Hospital, Tanzania

    Directory of Open Access Journals (Sweden)

    Omar Ali Juma

    2016-10-01

    Full Text Available Abstract Background Malnutrition has long been associated with poverty, poor diet and inadequate access to health care, and it remains a key global health issue that both stems from and contributes to ill-health, with 50 % of childhood deaths due to underlying undernutrition. The purpose of this study was to determine the prevalence of malnutrition among children under-five seen at Bagamoyo District Hospital (BDH and three rural health facilities ranging between 25 and 55 km from Bagamoyo: Kiwangwa, Fukayosi, and Yombo. Methods A total of 63,237 children under-five presenting to Bagamoyo District Hospital and the three rural health facilities participated in the study. Anthropometric measures of age, height/length and weight and measurements of mid-upper arm circumference were obtained and compared with reference anthropometric indices to assess nutritional status for patients presenting to the hospital and health facilities. Results Overall proportion of stunting, underweight and wasting was 8.37, 5.74 and 1.41 % respectively. Boys were significantly more stunted, under weight and wasted than girls (p-value < 0.05. Children aged 24–59 months were more underweight than 6–23 months (p-value = <0.0001. But, there was no statistical significance difference between the age groups for stunting and wasting. Children from rural areas experienced increased rates of stunting, underweight and wasting than children in urban areas (p-value < 0.05. The results of this study concur with other studies that malnutrition remains a problem within Tanzania; however our data suggests that the population presenting to BDH and rural health facilities presented with decreased rates of malnutrition compared to the general population. Conclusions Hospital and facility attending populations of under-five children in and around Bagamoyo suffer moderately high rates of malnutrition. Current nutrition programs focus on education for at risk children and

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

    Science.gov (United States)

    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.

  17. Mapping the interprofessional education landscape for students on rural clinical placements: an integrative literature review.

    Science.gov (United States)

    Walker, Lorraine; Cross, Merylin; Barnett, Tony

    2018-05-01

    Interprofessional collaboration and effective teamwork are core to optimising rural health outcomes; however, little is known about the opportunities available for interprofessional education (IPE) in rural clinical learning environments. This integrative literature review addresses this deficit by identifying, analysing and synthesising the research available about the nature of and potential for IPE provided to undergraduate students undertaking rural placements, the settings and disciplines involved and the outcomes achieved. An integrative review method was adopted to capture the breadth of evidence available about IPE in the rural context. This integrative review is based on a search of nine electronic databases: CINAHL, Cochrane Library, EMBASE, MEDLINE, ProQuest, PubMed, SCOPUS, Web of Science and Google Scholar. Search terms were adapted to suit those used by different disciplines and each database and included key words related to IPE, rurality, undergraduate students and clinical placement. The inclusion criteria included primary research and reports of IPE in rural settings, peer reviewed, and published in English between 2000 and mid-2016. This review integrates the results of 27 primary research studies undertaken in seven countries: Australia, Canada, USA, New Zealand, the Philippines, South Africa and Tanzania. Despite geographical, cultural and health system differences, all of the studies reviewed were concerned with developing collaborative, interprofessional practice-ready graduates and adopted a similar mix of research methods. Overall, the 27 studies involved more than 3800 students (range 3-1360) from 36 disciplinary areas, including some not commonly associated with interprofessional education, such as theology. Interprofessional education was provided in a combination of university and rural placement settings including hospitals, community health services and other rural venues. The education activities most frequently utilised were

  18. Fertility desire and intention of people living with HIV/AIDS in Tanzania: a call for restructuring care and treatment services

    Directory of Open Access Journals (Sweden)

    Mmbaga Elia J

    2013-01-01

    Full Text Available Abstract Background Scaling up of antiretroviral therapy (ART is currently underway in sub-Saharan Africa including, Tanzania, increasing survival of people living with HIV/AIDS (PLWHA. Programmes pay little attention to PLWHA’s reproductive health needs. Information on fertility desire and intention would assist in the integration of sexual and reproductive health in routine care and treatment clinics. Methods A cross-sectional study of all PLWHA aged 15–49 residing in Kahe ward in rural Kilimanjaro Tanzania was conducted. Participants were recruited from the community and a local counselling centre located in the ward. Data on socio-demographic, medical and reproductive characteristics were collected through face-to-face interviews. Data were entered and analysed using STATA statistical software. Results A total of 410 PLWHA with a mean age of 34.2 and constituting 264 (64.4% females participated. Fifty-one per cent reported to be married/cohabiting, 73.9% lived with their partners and 60.5% were sexually active. The rate of unprotected sex was 69.0% with 12.5% of women reporting to be pregnant at the time of the survey. Further biological children were desired by 37.1% of the participants and lifetime fertility intention was 2.4 children. Increased fertility desire was associated with living and having sex with a partner, HIV disclosure, good perceived health status and CD4 count ≥200 cells for both sexes. Reduced desire was associated with havingmore than 2 children among females, divorce or separation, and having a child with the current partner among both males and females. Conclusion Fertility desire and intention of PLWHA was substantially high though lower than that of the general population in Tanzania. Practice of unprotected sexual intercourse with higher pregnancy rate was observed. Fertility desire was determined by individual perceived health and socio-family related factors. With increasing ART coverage and subsequent

  19. A method of assessing the resilience of whole communities of children: An example from rural Australia

    Directory of Open Access Journals (Sweden)

    Dunstan Debra A

    2012-05-01

    Full Text Available Abstract Background Children living in socioeconomic disadvantage are at risk of poor mental health outcomes. In order to focus and evaluate population health programs to facilitate children’s resilience, it is important to accurately assess baseline levels of functioning. With this end in mind, the aim of this study was to test the utility of 1 a voluntary random sampling method and 2 quantitative measures of adaptation (with national normative data for assessing the resilience of children in an identified community. Method This cross-sectional study utilized a sample of participants (N = 309, including parents (n = 169, teachers (n = 20 and children (n = 170; age range = 5-16 years, recruited from the schools in Tenterfield; a socioeconomically disadvantaged community in New South Wales, Australia. The Strengths and Difficulties Questionnaire (SDQ; including parent, teacher and youth versions was used to measure psychological well-being and pro-social functioning, and NAPLAN results (individual children’s and whole school’s performance in literacy and numeracy were used to measure level of academic achievement. Results The community’s disadvantage was evident in the whole school NAPLAN performance but not in the sample’s NAPLAN or SDQ results. The teacher SDQ ratings appeared to be more reliable than parent’s ratings. The voluntary random sampling method (requiring parental consent led to sampling bias. Conclusions The key indicators of resilience - psychological well-being, pro-social functioning and academic achievement – can be measured in whole communities using the teacher version of the SDQ and whole school results on a national test of literacy and numeracy (e.g., Australia’s NAPLAN. A voluntary random sample (dependent upon parental consent appears to have limited value due to the likelihood of sampling bias.

  20. Evaluating Adaptation of a Cancer Clinical Trial Decision Aid for Rural Cancer Patients: A Mixed-Methods Approach.

    Science.gov (United States)

    Pathak, Swati; George, Nerissa; Monti, Denise; Robinson, Kathy; Politi, Mary C

    2018-06-03

    Rural-residing cancer patients often do not participate in clinical trials. Many patients misunderstand cancer clinical trials and their rights as participant. The purpose of this study is to modify a previously developed cancer clinical trials decision aid (DA), incorporating the unique needs of rural populations, and test its impact on knowledge and decision outcomes. The study was conducted in two phases. Phase I recruited 15 rural-residing cancer survivors in a qualitative usability study. Participants navigated the original DA and provided feedback regarding usability and implementation in rural settings. Phase II recruited 31 newly diagnosed rural-residing cancer patients. Patients completed a survey before and after using the revised DA, R-CHOICES. Primary outcomes included decisional conflict, decision self-efficacy, knowledge, communication self-efficacy, and attitudes towards and willingness to consider joining a trial. In phase I, the DA was viewed positively by rural-residing cancer survivors. Participants provided important feedback about factors rural-residing patients consider when thinking about trial participation. In phase II, after using R-CHOICES, participants had higher certainty about their choice (mean post-test = 3.10 vs. pre-test = 2.67; P = 0.025) and higher trial knowledge (mean percentage correct at post-test = 73.58 vs. pre-test = 57.77; P decision self-efficacy, communication self-efficacy, and attitudes towards or willingness to join trials. The R-CHOICES improved rural-residing patients' knowledge of cancer clinical trials and reduced conflict about making a trial decision. More research is needed on ways to further support decisions about trial participation among this population.

  1. Methods for estimating the magnitude and frequency of floods for urban and small, rural streams in Georgia, South Carolina, and North Carolina, 2011

    Science.gov (United States)

    Feaster, Toby D.; Gotvald, Anthony J.; Weaver, J. Curtis

    2014-01-01

    Reliable estimates of the magnitude and frequency of floods are essential for the design of transportation and water-conveyance structures, flood-insurance studies, and flood-plain management. Such estimates are particularly important in densely populated urban areas. In order to increase the number of streamflow-gaging stations (streamgages) available for analysis, expand the geographical coverage that would allow for application of regional regression equations across State boundaries, and build on a previous flood-frequency investigation of rural U.S Geological Survey streamgages in the Southeast United States, a multistate approach was used to update methods for determining the magnitude and frequency of floods in urban and small, rural streams that are not substantially affected by regulation or tidal fluctuations in Georgia, South Carolina, and North Carolina. The at-site flood-frequency analysis of annual peak-flow data for urban and small, rural streams (through September 30, 2011) included 116 urban streamgages and 32 small, rural streamgages, defined in this report as basins draining less than 1 square mile. The regional regression analysis included annual peak-flow data from an additional 338 rural streamgages previously included in U.S. Geological Survey flood-frequency reports and 2 additional rural streamgages in North Carolina that were not included in the previous Southeast rural flood-frequency investigation for a total of 488 streamgages included in the urban and small, rural regression analysis. The at-site flood-frequency analyses for the urban and small, rural streamgages included the expected moments algorithm, which is a modification of the Bulletin 17B log-Pearson type III method for fitting the statistical distribution to the logarithms of the annual peak flows. Where applicable, the flood-frequency analysis also included low-outlier and historic information. Additionally, the application of a generalized Grubbs-Becks test allowed for the

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

    Directory of Open Access Journals (Sweden)

    Shah Ajit

    2009-02-01

    Full Text Available Abstract 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.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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…

  5. Decision Making in Uncertain Rural Scenarios by means of Fuzzy TOPSIS Method

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    Eva Armero

    2011-01-01

    Full Text Available A great deal of uncertain information which is difficult to quantify is taken into account by farmers and experts in the enterprise when making decisions. We are interested in the problems of the implementation of a rabbit-breeding farm. One of the first decisions to be taken refers to the design or type of structure for housing the animals, which is determined by the level of environmental control sought to be maintained in its interior. A farmer was consulted, and his answers were incorporated into the analysis, by means of the fuzzy TOPSIS methodology. The main purpose of this paper is to study the problem by means of the fuzzy TOPSIS method as multicriteria decision making, when the information was given in linguistic terms.

  6. The school as a force for community change in Tanzania

    Science.gov (United States)

    Maliyamkono, T. L.

    1980-09-01

    In newly independent countries where traditional theories of educational policy have continued to be followed, education has persisted as little more than a sophisticated mechanism for the recruitment of elites, and there has been an increased dependence on the advanced industrial nations for aid, experts and educational models. Tanzania, however, has attempted to break away from traditional strategies, and the author here describes and analyses the impact of two of the most far-reaching reforms — Education for Self-Reliance, and Decentralization — on national goals and policies. President Nyerere enunciated the objectives for Education for Self-Reliance in 1967 as relating education to rural life, correcting the elitist bias of education, and changing negative attitudes among students towards agriculture and rural life. Five major programmes of reform covering primary and secondary education, teacher and higher education, and examinations were to be pursued, ensuring a closer integration of schools with local communities, e.g., through school farms and co-operative shops, and making curricula directly relevant to local needs. A policy of Decentralization is being implemented, allowing, theoretically at least, a much greater participation at community level in decision-making. In primary and adult education this has already been effected to some extent, though there is evidence to suggest that decentralization in some regions and districts has resulted in the creation of local bureaucratic machinery for control, defeating the intention of the reform. Decentralization of secondary and teacher education is likely to follow, leaving only higher education centrally controlled for manpower training and allocation purposes. Finally the author discusses the question of the transferability of the Tanzanian reforms.

  7. Feasibility of Rainfed Viticulture in Marivan Rural Region Using SWOT Method, Sarkal County

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    Rehaneh soltani moqadas

    2016-02-01

    Full Text Available Abstract Due to being in mountainous regions, Sarkal County has not developed much either physically or agriculturally. However, its specific climatic conditions have provided an opportunity to establish rainfed vineyards. The aim of this study was to evaluate the potentials and capability of the region for establishing rainfed vineyards as well as identify the benefits of rainfed vineyards for future planning. For this purpose, a questionnaire was prepared and sent to 83 grape growers in 31 villages. In addition, associated managers were interviewed according to 343 Kookran formula. The current study offers solutions for developing rainfed vineyards, applying the measurement method, case studies, and also enumerating the pros and cons, and opportunities as well as threats based on SWOT. As the next step, the provided solutions were prioritized based on QSPM matrix. The results showed that the solutions for developing rainfed vineyards are kind of aggressive solutions. According to the internal factors assessment Matrix, the final score of 2.52 shows that establishing and developing rainfed vineyards based on internal factors in Sarkal County is highly possible. Moreover, the external factors assessment Matrix with a total score of 3.44 shows that in the present conditions, the development of rainfed vineyards in Sarkal County reinforces the opportunities. Finally, SO6 approach titled “constructing Agro-processing industries to save the vintage and cut down the damages” was selected and introduced using QSPM matrix, which reads.

  8. Factors associated with intended and effective settlement of nursing students and newly graduated nurses in a rural setting after graduation: a mixed-methods review.

    Science.gov (United States)

    Trépanier, Amélie; Gagnon, Marie-Pierre; Mbemba, Gisèle Irène Claudine; Côté, José; Paré, Guy; Fortin, Jean-Paul; Duplàa, Emmanuel; Courcy, François

    2013-03-01

    To identify factors that influence the initial plan and final decision to choose a rural area as first employment location in final-year nursing students or newly graduated nurses. We conducted a mixed-methods review of the literature, including both published and gray literature, using established criteria. Two reviewers performed data extraction of relevant information independently. We retrieved empirical studies from the following databases: PubMED, Embase, CINAHL (EBSCO), Web of Science (SCI and SSCI), The Cochrane Library, Business Source Premier (EBSCO), ERIC, Proquest and PsychInfo. We also searched for empirical studies in the technical and gray literature and reviewed journals related to rural health. Additionally, we conducted searches in websites such as the Center for Health Workforce Planning and Analysis, as well as Google and Google Scholar search engines. Of the 523 studies thus screened, 15 were included for data extraction. We identified more than 40 factors associated with initial plans and final decision to settle in a rural area among nursing graduates. Only limited literature is currently available on the factors associated with the intention of nursing students or newly graduated nurses of practicing in rural areas and on the relationship between intention and effective behavior. This review highlights the needs for further research in this field. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Rural Airports

    Data.gov (United States)

    Department of Transportation — The Rural Airports database is the list of rural airports compiled annually by BTS for the Treasury Department/IRS. It is used by airlines to assist in establishing...

  10. Comparison of the CDC Backpack aspirator and the Prokopack aspirator for sampling indoor- and outdoor-resting mosquitoes in southern Tanzania

    Directory of Open Access Journals (Sweden)

    Mgando Joseph

    2011-06-01

    Full Text Available Abstract Background Resting mosquitoes can easily be collected using an aspirating device. The most commonly used mechanical aspirator is the CDC Backpack aspirator. Recently, a simple, and low-cost aspirator called the Prokopack has been devised and proved to have comparable performance. The following study evaluates the Prokopack aspirator compared to the CDC backpack aspirator when sampling resting mosquitoes in rural Tanzania. Methods Mosquitoes were sampled in- and outdoors of 48 typical rural African households using both aspirators. The aspirators were rotated between collectors and households in a randomized, Latin Square design. Outdoor collections were performed using artificial resting places (large barrel and car tyre, underneath the outdoor kitchen (kibanda roof and from a drop-net. Data were analysed with generalized linear models. Results The number of mosquitoes collected using the CDC Backpack and the Prokopack aspirator were not significantly different both in- and outdoors (indoors p = 0.735; large barrel p = 0.867; car tyre p = 0.418; kibanda p = 0.519. The Prokopack was superior for sampling of drop-nets due to its smaller size. The number mosquitoes collected per technician was more consistent when using the Prokopack aspirator. The Prokopack was more user-friendly: technicians preferred using the it over the CDC backpack aspirator as it weighs considerably less, retains its charge for longer and is easier to manoeuvre. Conclusions The Prokopack proved in the field to be more advantageous than the CDC Backpack aspirator. It can be self assembled using simple, low-cost and easily attainable materials. This device is a useful tool for researchers or vector-control surveillance programs operating in rural Africa, as it is far simpler and quicker than traditional means of sampling resting mosquitoes. Further longitudinal evaluations of the Prokopack aspirator versus the gold standard pyrethrum spray catch for indoor resting

  11. Using information communication technology to identify deficits in rural health care: a mixed-methods evaluation from Guatemala.

    Science.gov (United States)

    Wahedi, Katharina; Flores, Walter; Beiersmann, Claudia; Bozorgmehr, Kayvan; Jahn, Albrecht

    2018-01-01

    In August 2014, the Centre for the Studies of Equity and Governance in Health Systems (CEGSS) in Guatemala launched an online platform, which facilitates complaints about health services via text messages. The aim is to collect, systemise and forward such complaints to relevant institutions, and to create a data pool on perceived deficits of health care in rural Guatemala. To evaluate if the online platform is an accepted, user-friendly and efficient medium to engage citizens in the reporting of health care deficiencies in Guatemala. The general study design of this research was a mixed-method approach including a quantitative analysis of complaints received and a qualitative exploration of the attitude of community leaders towards the platform. User statistics showed that a total of N = 228 messages were sent to the platform in the period August 2014-March 2015. The majority of complaints (n = 162, 71%) fell under the 'lack of drugs, equipment or supplies' category. The community leaders welcomed the platform, describing it as modern and progressive. Despite feedback mechanisms and methods to respond to complaints not yet being fully developed, many users showed a high intrinsic motivation to use the new tool. Others, however, were restrained by fear of personal consequences and distrust of the state's judicial system. Access to mobile phones, reception, and phone credit or battery life did not pose major obstacles, but the producing and sending of correctly formatted messages was observed to be difficult. The online platform paired with SMS technology appears to be a viable approach to collect citizens' complaints in health care and connect citizens with relevant institutions. Further studies should be conducted to quantify follow-up activities and the impact on local health care provision.

  12. Attempt to assess tourist products in rural areas based on the Kano method as basis of customer experience

    Directory of Open Access Journals (Sweden)

    Bartlomiej Walas

    2018-01-01

    Full Text Available Rural tourism, which is at the same time a kind of broadly understood sustainable tourism, is a concept, although widely used, difficult to define. Many researchers such as M. Jansen-Verbeke distinguish between rural tourism, agritourism and farm tourism. Ecotourism is also often found, although each of them represents another phenomenon. Rural tourism is a very important part of active participation in the life of a farm, in the socio-cultural life of the village and is inherent in its connection to the natural environment. It is ecologically-oriented farming and the protection of natural and socio-cultural environments that are the foundation of ecotourism. The only significant differences that can be identified are some forms of rural tourism that do not fall into the category of ecotourism, such as alienated tourism, as well as a partial focus of ecotourism, out of cities areas but not in rural areas. In the countryside there is also a tourist of the stream "bleisure".

  13. Application of Deep Learning and Supervised Learning Methods to Recognize Nonlinear Hidden Pattern in Water Stress Levels from Spatiotemporal Datasets across Rural and Urban US Counties

    Science.gov (United States)

    Eisenhart, T.; Josset, L.; Rising, J. A.; Devineni, N.; Lall, U.

    2017-12-01

    In the wake of recent water crises, the need to understand and predict the risk of water stress in urban and rural areas has grown. This understanding has the potential to improve decision making in public resource management, policy making, risk management and investment decisions. Assuming an underlying relationship between urban and rural water stress and observable features, we apply Deep Learning and Supervised Learning models to uncover hidden nonlinear patterns from spatiotemporal datasets. Results of interest includes prediction accuracy on extreme categories (i.e. urban areas highly prone to water stress) and not solely the average risk for urban or rural area, which adds complexity to the tuning of model parameters. We first label urban water stressed counties using annual water quality violations and compile a comprehensive spatiotemporal dataset that captures the yearly evolution of climatic, demographic and economic factors of more than 3,000 US counties over the 1980-2010 period. As county-level data reporting is not done on a yearly basis, we test multiple imputation methods to get around the issue of missing data. Using Python libraries, TensorFlow and scikit-learn, we apply and compare the ability of, amongst other methods, Recurrent Neural Networks (testing both LSTM and GRU cells), Convolutional Neural Networks and Support Vector Machines to predict urban water stress. We evaluate the performance of those models over multiple time spans and combine methods to diminish the risk of overfitting and increase prediction power on test sets. This methodology seeks to identify hidden nonlinear patterns to assess the predominant data features that influence urban and rural water stress. Results from this application at the national scale will assess the performance of deep learning models to predict water stress risk areas across all US counties and will highlight a predominant Machine Learning method for modeling water stress risk using spatiotemporal

  14. Diagnosing cancer in the bush: a mixed-methods study of symptom appraisal and help-seeking behaviour in people with cancer from rural Western Australia.

    Science.gov (United States)

    Emery, Jon D; Walter, Fiona M; Gray, Vicky; Sinclair, Craig; Howting, Denise; Bulsara, Max; Bulsara, Caroline; Webster, Andrew; Auret, Kirsten; Saunders, Christobel; Nowak, Anna; Holman, C D'Arcy

    2013-06-01

    Previous studies have focused on the treatment received by rural cancer patients and have not examined their diagnostic pathways as reasons for poorer outcomes in rural Australia. To compare and explore symptom appraisal and help-seeking behaviour in patients with breast, lung, prostate or colorectal cancer from rural Western Australia (WA). A mixed-methods study of people recently diagnosed with breast, lung, prostate or colorectal cancer from rural WA. The time from first symptom to diagnosis (i.e. total diagnostic interval, TDI) was calculated from interviews and medical records. Sixty-six participants were recruited (24 breast, 20 colorectal, 14 prostate and 8 lung cancer patients). There was a highly significant difference in time from symptom onset to seeking help between cancers (P = 0.006). Geometric mean symptom appraisal for colorectal cancer was significantly longer than that for breast and lung cancers [geometric mean differences: 2.58 (95% confidence interval, CI: 0.64-4.53), P = 0.01; 3.97 (1.63-6.30), P = 0.001, respectively]. There was a significant overall difference in arithmetic mean TDI (P = 0.046); breast cancer TDI was significantly shorter than colorectal or prostate cancer TDI [mean difference : 266.3 days (95% CI: 45.9-486.8), P = 0.019; 277.0 days, (32.1-521.9), P = 0.027, respectively]. These differences were explained by the nature and personal interpretation of symptoms, perceived as well as real problems of access to health care, optimism, stoicism, machismo, fear, embarrassment and competing demands. Longer symptom appraisal was observed for colorectal cancer. Participants defined core characteristics of rural Australians as optimism, stoicism and machismo. These features, as well as access to health care, contribute to later presentation of cancer.

  15. Tanzania | Page 12 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    It is 2002. Parents and babies wait patiently to see the community health worker in Mvomero, Tanzania. “People have faith in the services. They are treated well and diagnosed properly,” says Samuel Hassain, here with his sick grandson. Health worker Y.E. Kapito marvels that “it has been six to eight months since I heard of ...

  16. Who are more responsive? Mixed-methods comparison of public and private sector physicians in rural Bangladesh.

    Science.gov (United States)

    Joarder, Taufique; George, Asha; Sarker, Malabika; Ahmed, Saifuddin; Peters, David H

    2017-11-01

    Responsiveness of physicians (ROPs) reflects the social actions by physicians to meet the legitimate expectations of health care users. Responsiveness is important since it improves understanding and care seeking by users, as well as fostering trust in health systems rather than replicating discrimination and entrenching inequality. Given widespread public and private sector health care provision in Bangladesh, we undertook a mixed-methods study comparing responsiveness of public and private physicians in rural Bangladesh. The study included in-depth interviews with physicians (n = 12, seven public, five private) and patients (n = 7, three male, four female); focus group discussions with users (four sessions, two male and two female); and observations in consultation rooms of public and private sector physicians (1 week in each setting). This was followed by structured observation of patient consultations with 195 public and 198 private physicians using the ROPs Scale, consisting of five domains (Friendliness; Respecting; Informing and guiding; Gaining trust; and Financial sensitivity). Qualitative data were analysed by framework analysis and quantitative data were analyzed using two-sample t-test, multiple linear regression, multivariate analysis of variance, and descriptive discriminant analyses. The mean responsiveness score of public sector physicians was statistically different from private sector physicians: -0.29 vs 0.29, i.e. a difference of - 0.58 (P-value private sector, according to qualitative findings, neither of the sectors performed optimally. Private physicians scored higher in Friendliness, Respecting and Informing and guiding; while public sector physicians scored higher in other domains. 'Respecting' domain was found as the most important. Unlike findings from other studies in Bangladesh, instead of seeing one sector as better than the other, this study identified areas of responsiveness where each sector needs improvements. © The Author

  17. Factors Affecting the Uptake of HIV Testing among Men: A Mixed-Methods Study in Rural Burkina Faso.

    Directory of Open Access Journals (Sweden)

    Manuela De Allegri

    Full Text Available This study aimed to explore factors shaping the decision to undergo Human Immunodeficiency Virus (HIV testing among men in rural Burkina Faso.The study took place in 2009 in the Nouna Health District and adopted a triangulation mixed methods design. The quantitative component relied on data collected through a structured survey on a representative sample of 1130 households. The qualitative component relied on 38 in-depth interviews, with men purposely selected to represent variation in testing decision, age, and place of residence. A two-part model was conducted, with two distinct outcome variables, i.e. "being offered an HIV test" and "having done an HIV test". The qualitative data analysis relied on inductive coding conducted by three independent analysts.Of the 937 men, 357 had been offered an HIV test and 97 had taken the test. Younger age, household wealth, living in a village under demographic surveillance, and knowing that HIV testing is available at primary health facilities were all positively associated with the probability of being offered an HIV test. Household wealth and literacy were found to be positively associated, and distance was found to be negatively associated with the probability of having taken an HIV test. Qualitative findings indicated that the limited uptake of HIV testing was linked to poor knowledge on service availability and to low risk perceptions.With only 10% of the total sample ever having tested for HIV, our study confirmed that male HIV testing remains unacceptably low in Sub-Saharan Africa. This results from a combination of health system factors, indicating general barriers to access, and motivational factors, such as one's own knowledge of service availability and risk perceptions. Our findings suggested that using antenatal care and curative services as the exclusive entry points into HIV testing may not be sufficient to reach large portions of the male population. Thus, additional strategies are urgently

  18. Coral Reefs and Their Management in Tanzania | Wagner | Western ...

    African Journals Online (AJOL)

    management approaches and strategies implemented by various ICM programs, conservation areas and marine parks in Tanzania. It also provides recommendations for further research and coral reef management strategies. Keywords: coral reefs, threats, management, recent initiatives, Tanzania West Indian Ocean ...

  19. Creating Fiscal Space for Social Sectors Development in Tanzania ...

    African Journals Online (AJOL)

    This paper discusses fiscal space creation and use in the context of development of social sectors in Tanzania. The paper observes that Tanzania is making good progress in creating and using her fiscal space. The priority being accorded to social sectors, especially in education and health is in the right direction. However ...

  20. All projects related to tanzania | Page 4 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Topic: ACCESS TO HEALTH CARE, HEALTH EXPENDITURE, HEALTH FINANCING. Region: South of Sahara, Ghana, Kenya, Uganda, Tanzania, Zambia, South Africa. Program: Maternal and Child Health. Total Funding: CA$ 366,015.00. Food Security, Adequate Care and Environment (Tanzania and Malawi). Project.