The adoption of decentralization by devolution in Tanzania has enabled the implementation of a Direct Health Facility Financing (DHFF) program in the facilities. While copious gains have been reported under DHFF, there are also notable failures to improve health service provision. This study aims to explore the experience of implementing the DHFF program in the rural areas of the Kigoma District Council. An exploratory qualitative study was conducted in Primary Health Care (PHC) facilities of the Kigoma District Council. A purposive sampling technique was used to draw 21 Key Informants including leaders of health facilities and members of the Health Facility Governing Committees (HFGC). Key Informant Interviews (KII) were used to solicit information from the study participants. Content analysis technique was used to analyze data collected from study participants. Our findings present enablers and barriers in the implementation of DHFF. Successful implementation of DHFF was enabled by the availability of formal training and supportive supervision, adherence to DHFF guidelines, availability of planning guidelines at the health facility, functionality of the HFGC, and adherence to the procurement process. A low sense of ownership of the program, delays and insufficient fund disbursement, shortage of health workers, and inadequate knowledge of DHFF program implementation emerged as the barriers that impeded successful program implementation. Evaluating the implementation experience of the DHFF program requires policymakers at the national level to devise a mechanism for the timely disbursement of funds, reinforcing capacity building to increase the autonomy of health facilities in their daily operations. Furthermore, structural and operational barriers warrant further operational and implementation research.
{"title":"Implementation of direct health facility financing in the Rural District of Kigoma in Western Tanzania","authors":"Flora Joram, Jairos Hiliza, Sirili Nathanael, Amani Anaeli","doi":"10.11604/pamj.2023.46.19.41052","DOIUrl":"https://doi.org/10.11604/pamj.2023.46.19.41052","url":null,"abstract":"The adoption of decentralization by devolution in Tanzania has enabled the implementation of a Direct Health Facility Financing (DHFF) program in the facilities. While copious gains have been reported under DHFF, there are also notable failures to improve health service provision. This study aims to explore the experience of implementing the DHFF program in the rural areas of the Kigoma District Council. An exploratory qualitative study was conducted in Primary Health Care (PHC) facilities of the Kigoma District Council. A purposive sampling technique was used to draw 21 Key Informants including leaders of health facilities and members of the Health Facility Governing Committees (HFGC). Key Informant Interviews (KII) were used to solicit information from the study participants. Content analysis technique was used to analyze data collected from study participants. Our findings present enablers and barriers in the implementation of DHFF. Successful implementation of DHFF was enabled by the availability of formal training and supportive supervision, adherence to DHFF guidelines, availability of planning guidelines at the health facility, functionality of the HFGC, and adherence to the procurement process. A low sense of ownership of the program, delays and insufficient fund disbursement, shortage of health workers, and inadequate knowledge of DHFF program implementation emerged as the barriers that impeded successful program implementation. Evaluating the implementation experience of the DHFF program requires policymakers at the national level to devise a mechanism for the timely disbursement of funds, reinforcing capacity building to increase the autonomy of health facilities in their daily operations. Furthermore, structural and operational barriers warrant further operational and implementation research.","PeriodicalId":131455,"journal":{"name":"The Pan African Medical Journal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135444870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.11604/pamj.2023.46.67.39778
Devis Mhagama, Manase Kilonzi, Peter Kunambi, Deus Buma, Fredrick Kalokola, Paschal Ruggajo, Ritah Francis Mutagonda
{"title":"Pharmacological management of hypertension and outcome among patients on hemodialysis at Muhimbili National Hospital, Tanzania: a cross-sectional study","authors":"Devis Mhagama, Manase Kilonzi, Peter Kunambi, Deus Buma, Fredrick Kalokola, Paschal Ruggajo, Ritah Francis Mutagonda","doi":"10.11604/pamj.2023.46.67.39778","DOIUrl":"https://doi.org/10.11604/pamj.2023.46.67.39778","url":null,"abstract":"","PeriodicalId":131455,"journal":{"name":"The Pan African Medical Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134981298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: human immunodeficiency virus (HIV) and tuberculosis (TB) remain global health problems and impose a substantial reduction in people´s quality of life (QoL). This study aimed to assess and comparing the QoL in HIV and TB patients and factors associated with QoL between those groups.
{"title":"Determinants of quality of life among people with HIV and tuberculosis in an underserved area in Indonesia: a cross-sectional study","authors":"Elfride Irawati Sianturi, Zamrotul Izzah, Khoirul Huda, Evelyn Magrid Sada, Dyah Aryani Perwitasari, Steven Yohanes Yulianus Mantiri, Elsye Gunawan","doi":"10.11604/pamj.2023.46.61.41521","DOIUrl":"https://doi.org/10.11604/pamj.2023.46.61.41521","url":null,"abstract":"Introduction: human immunodeficiency virus (HIV) and tuberculosis (TB) remain global health problems and impose a substantial reduction in people´s quality of life (QoL). This study aimed to assess and comparing the QoL in HIV and TB patients and factors associated with QoL between those groups.","PeriodicalId":131455,"journal":{"name":"The Pan African Medical Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135007956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.11604/pamj.2023.46.57.41547
Loveline Lum Niba, Lifoter Kenneth Navti, Ahmadou Jingi Musa
Introduction: measures of obesity such as body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) have been shown to be associated with high blood pressure (BP) in children and adolescents. The purpose of this study was to determine the proportion of secondary school adolescents with elevated BP and high BP in relation to some measures of adiposity (BMI, WC, WHtR) and to examine the association between BP and adiposity indices amongst the children.
{"title":"Relationship between measures of adiposity and hypertension amongst secondary school adolescents in an urban setting in Cameroon","authors":"Loveline Lum Niba, Lifoter Kenneth Navti, Ahmadou Jingi Musa","doi":"10.11604/pamj.2023.46.57.41547","DOIUrl":"https://doi.org/10.11604/pamj.2023.46.57.41547","url":null,"abstract":"Introduction: measures of obesity such as body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) have been shown to be associated with high blood pressure (BP) in children and adolescents. The purpose of this study was to determine the proportion of secondary school adolescents with elevated BP and high BP in relation to some measures of adiposity (BMI, WC, WHtR) and to examine the association between BP and adiposity indices amongst the children.","PeriodicalId":131455,"journal":{"name":"The Pan African Medical Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136374401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.11604/pamj.2023.46.26.34933
Renu Bharat Rathi, Arun Naphe Khatri
{"title":"Bilateral symmetric dry gangrene of the feet in a newborn","authors":"Renu Bharat Rathi, Arun Naphe Khatri","doi":"10.11604/pamj.2023.46.26.34933","DOIUrl":"https://doi.org/10.11604/pamj.2023.46.26.34933","url":null,"abstract":"","PeriodicalId":131455,"journal":{"name":"The Pan African Medical Journal","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135550952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiac myxoma is a very rare benign cardiac neoplasm. Its annual incidence globally is between 0.5 to 1 case per one million individuals. It has a 0.03% prevalence rate in the general population. It commonly occurs in the left atrium, but can also be located in the other heart chambers. Its clinical presentations are variable, non-specific, and can mimic various cardiovascular and systemic diseases, posing a diagnostic dilemma. Thus, a high index of suspicion with appropriate use of radiologic and laboratory diagnostic tools is essential for its accurate diagnosis and management. The diagnosis and management of a rare case of left atrial myxoma in a middle-aged African woman who presented with heart failure-like symptoms, features of acute pulmonary edema, and syncope is presented in this literature. The diagnosis was suspected following echocardiography. The tumor was surgically excised, and the diagnosis was confirmed histopathologically. The patient´s post-operative condition has been excellent.
{"title":"Left atrial myxoma presenting with acute pulmonary edema and syncope in a middle-aged black African woman: a case report","authors":"Kasiemobi Eberechukwu Uchime, Oladipo Ayoola Olanipekun, Olamide Nelson Ogidan, Stephen Olawale Oguntola, Okechukwu Obumneme Ezekpo, Olaniyi Abiodun Oluwafemi Olatunde, Akinola Akinmade","doi":"10.11604/pamj.2023.46.31.41414","DOIUrl":"https://doi.org/10.11604/pamj.2023.46.31.41414","url":null,"abstract":"Cardiac myxoma is a very rare benign cardiac neoplasm. Its annual incidence globally is between 0.5 to 1 case per one million individuals. It has a 0.03% prevalence rate in the general population. It commonly occurs in the left atrium, but can also be located in the other heart chambers. Its clinical presentations are variable, non-specific, and can mimic various cardiovascular and systemic diseases, posing a diagnostic dilemma. Thus, a high index of suspicion with appropriate use of radiologic and laboratory diagnostic tools is essential for its accurate diagnosis and management. The diagnosis and management of a rare case of left atrial myxoma in a middle-aged African woman who presented with heart failure-like symptoms, features of acute pulmonary edema, and syncope is presented in this literature. The diagnosis was suspected following echocardiography. The tumor was surgically excised, and the diagnosis was confirmed histopathologically. The patient´s post-operative condition has been excellent.","PeriodicalId":131455,"journal":{"name":"The Pan African Medical Journal","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135650160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.11604/pamj.2023.46.62.41687
Muhammadnur Rachim Enoch, Muhammad Irfan, Rachmad Budianto, Achmad Hardin
Cardiac tamponade as the initial manifestation of Hashimoto's thyroiditis is an exceedingly uncommon occurrence. We present the case of a 36-year-old female who was admitted due to acute respiratory distress. A cardiac ultrasound revealed a severe pericardial effusion with tamponade signs. Subsequently, percutaneous pericardiocentesis was performed, resulting in a swift clinical improvement. Laboratory examinations confirmed severe hypothyroidism associated with Hashimoto's disease. Despite undergoing hormone replacement therapy, histological analysis of the pericardium revealed a chronic inflammation process. A follow-up cardiac ultrasound conducted six months later indicated the presence of a well-tolerated chronic pericardial effusion. In conclusion, clinicians should consider hypothyroidism as a potential cause when cardiac tamponade is observed, particularly in the absence of tachycardia. The prognosis is generally favorable with hormone replacement therapy, but regular ultrasound monitoring should be maintained until the patient achieves a euthyroid state.
{"title":"Hashimoto’s thyroiditis presenting with cardiac tamponade: a case report","authors":"Muhammadnur Rachim Enoch, Muhammad Irfan, Rachmad Budianto, Achmad Hardin","doi":"10.11604/pamj.2023.46.62.41687","DOIUrl":"https://doi.org/10.11604/pamj.2023.46.62.41687","url":null,"abstract":"Cardiac tamponade as the initial manifestation of Hashimoto's thyroiditis is an exceedingly uncommon occurrence. We present the case of a 36-year-old female who was admitted due to acute respiratory distress. A cardiac ultrasound revealed a severe pericardial effusion with tamponade signs. Subsequently, percutaneous pericardiocentesis was performed, resulting in a swift clinical improvement. Laboratory examinations confirmed severe hypothyroidism associated with Hashimoto's disease. Despite undergoing hormone replacement therapy, histological analysis of the pericardium revealed a chronic inflammation process. A follow-up cardiac ultrasound conducted six months later indicated the presence of a well-tolerated chronic pericardial effusion. In conclusion, clinicians should consider hypothyroidism as a potential cause when cardiac tamponade is observed, particularly in the absence of tachycardia. The prognosis is generally favorable with hormone replacement therapy, but regular ultrasound monitoring should be maintained until the patient achieves a euthyroid state.","PeriodicalId":131455,"journal":{"name":"The Pan African Medical Journal","volume":"126 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135009403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.11604/pamj.2023.46.68.28293
Samuel Kizito, Milton Wamboko Musaba, Julius Wandabwa, Paul Kiondo
Introduction: pregnancy related lumbopelvic pain, which refers to low back pain and pelvic girdle pain , is a common musculoskeletal disorder affecting quality of life. The purpose of this study was to establish the prevalence and the factors associated with lumbopelvic pain among pregnant women in their third trimester
{"title":"Prevalence and factors associated with lumbopelvic pain among pregnant women in their third trimester: a cross sectional study","authors":"Samuel Kizito, Milton Wamboko Musaba, Julius Wandabwa, Paul Kiondo","doi":"10.11604/pamj.2023.46.68.28293","DOIUrl":"https://doi.org/10.11604/pamj.2023.46.68.28293","url":null,"abstract":"Introduction: pregnancy related lumbopelvic pain, which refers to low back pain and pelvic girdle pain , is a common musculoskeletal disorder affecting quality of life. The purpose of this study was to establish the prevalence and the factors associated with lumbopelvic pain among pregnant women in their third trimester","PeriodicalId":131455,"journal":{"name":"The Pan African Medical Journal","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135211052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.11604/pamj.2023.46.13.41152
René Ghislain Essomba, Rostand Munkam Mbe, Marie Paule Ngongang, Claire Bitchong Ekono, Valentina Josiane Ngo, Nassif Seni, Philippe Salomon Nguwoh, Pulchérie Thérèse Ateba, Severin Donald Kamdem, Justin Komguep Nono, Myriam Sylvie Ambomo, Marie Claire Okomo, François Xavier Mbopi-Kéou
Introduction: HIV-1 and Mtb are characterized by immune activation and unbalances production of cytokines, but the expression of IL33 in HIV/TB coinfection remain understudied. This study aimed to evaluate the level of IL-33 in plasma of HIV and M.tuberculosis (HIV/TB) coinfected patients compared to patients with respective mono infections in Yaoundé.
{"title":"Plasma IL-33 levels and immune activation in HIV-TB coinfection: a cross-sectional study in Yaoundé, Cameroon","authors":"René Ghislain Essomba, Rostand Munkam Mbe, Marie Paule Ngongang, Claire Bitchong Ekono, Valentina Josiane Ngo, Nassif Seni, Philippe Salomon Nguwoh, Pulchérie Thérèse Ateba, Severin Donald Kamdem, Justin Komguep Nono, Myriam Sylvie Ambomo, Marie Claire Okomo, François Xavier Mbopi-Kéou","doi":"10.11604/pamj.2023.46.13.41152","DOIUrl":"https://doi.org/10.11604/pamj.2023.46.13.41152","url":null,"abstract":"Introduction: HIV-1 and Mtb are characterized by immune activation and unbalances production of cytokines, but the expression of IL33 in HIV/TB coinfection remain understudied. This study aimed to evaluate the level of IL-33 in plasma of HIV and M.tuberculosis (HIV/TB) coinfected patients compared to patients with respective mono infections in Yaoundé.","PeriodicalId":131455,"journal":{"name":"The Pan African Medical Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135361722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.11604/pamj.2023.46.47.38892
Abdessamad El Bahri, Ahmed Ameur
{"title":"Bladder hernia","authors":"Abdessamad El Bahri, Ahmed Ameur","doi":"10.11604/pamj.2023.46.47.38892","DOIUrl":"https://doi.org/10.11604/pamj.2023.46.47.38892","url":null,"abstract":"","PeriodicalId":131455,"journal":{"name":"The Pan African Medical Journal","volume":"2016 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135909485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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