C. Mtamakaya, Joachim Kessy, Damian Jeremia, S. Msuya, B. Stray-Pedersen
Background : Microfinance Institutions (MFI) award small loans and women are the primary target. Whilst much literature has explored and acknowledged its impact on poverty alleviation and gender equality few studies have examined whether the added income also improves health outcomes to program clients. This study examined the association between participation in MFI programmes and wellbeing of clients and their family members via social determinants of health in Moshi, Tanzania. Methods : Cross-sectional data among non-elderly women were collected between October and December 2011. Multistage random sampling technique was employed to obtain study participants. The primary predictor variable was participation in MFI programs while the outcome measures were: odds of facing exclusion to health care, knowledge to health indicators related to health promotion, and self-assessed health status. A questionnaire was used to collect extensive data on demographic and socioeconomic information of the study participants. Results: A total of 900 women participated in the study. Program participation was found to be associated with increasing age (p<0.001), increasing number of living children (p<0.002) and level of income (p<0.001). We found no association between program participation and access to health care, knowledge to health indicators related to health promotion and self-assessed health status. Only one out of seven indicators (14.2%) was significantly associated with MFI participation and access to health care. Two out of six (33.3%) health indicators showed association to MFI programme participation, while only 3 out of 15 (20%) dimensions measured in self-assessed health status showed significant association to MFI programme participation. Conclusion: These findings indicate that MFI programme participation is not associated with improved health outcomes of clients and their family members in Moshi. Strategies are needed to enhance the health-promoting capacity of MFI programmes in Moshi as shown elsewhere.
{"title":"The impact of microfinance programmes on access to health care knowledge to health indicators and health status among women in Moshi Tanzania.","authors":"C. Mtamakaya, Joachim Kessy, Damian Jeremia, S. Msuya, B. Stray-Pedersen","doi":"10.4314/THRB.V20I2.7","DOIUrl":"https://doi.org/10.4314/THRB.V20I2.7","url":null,"abstract":"Background : Microfinance Institutions (MFI) award small loans and women are the primary target. Whilst much literature has explored and acknowledged its impact on poverty alleviation and gender equality few studies have examined whether the added income also improves health outcomes to program clients. This study examined the association between participation in MFI programmes and wellbeing of clients and their family members via social determinants of health in Moshi, Tanzania. Methods : Cross-sectional data among non-elderly women were collected between October and December 2011. Multistage random sampling technique was employed to obtain study participants. The primary predictor variable was participation in MFI programs while the outcome measures were: odds of facing exclusion to health care, knowledge to health indicators related to health promotion, and self-assessed health status. A questionnaire was used to collect extensive data on demographic and socioeconomic information of the study participants. Results: A total of 900 women participated in the study. Program participation was found to be associated with increasing age (p<0.001), increasing number of living children (p<0.002) and level of income (p<0.001). We found no association between program participation and access to health care, knowledge to health indicators related to health promotion and self-assessed health status. Only one out of seven indicators (14.2%) was significantly associated with MFI participation and access to health care. Two out of six (33.3%) health indicators showed association to MFI programme participation, while only 3 out of 15 (20%) dimensions measured in self-assessed health status showed significant association to MFI programme participation. Conclusion: These findings indicate that MFI programme participation is not associated with improved health outcomes of clients and their family members in Moshi. Strategies are needed to enhance the health-promoting capacity of MFI programmes in Moshi as shown elsewhere.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/THRB.V20I2.7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47715838","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}
Alfred Chibwae, A. Kapesa, O. Jahanpour, J. Seni, Namanya Basinda, Emmanuel Kadelya, E. Konje, E. Nyanza, S. Ngallaba, D. Dewey
Background: Male involvement in reproductive health (RH) services in Africa has been associated with improved maternal and child health outcomes. The objective of this study was to determine the prevalence and factors affecting male partner attendance to available reproductive health services in Shinyanga district, north-western Tanzania. Methods: A house to house survey using a structured questionnaire was conducted among randomly selected married men. Additional in-depth interviews were conducted among married men found attending RH services. Factors that motivates the uptake of locally available RH services together with their partners were explored. Results: A total of 204 men participated in the study, 94.4 % (193/204) of them reported to have ever attended the RH service with their female partners at least once whereas 50.6% (103/204) of them attended at least thrice. Three quarters (154/204) attended HIV counselling and testing (VCT) and 63% (129/204) attended antenatal services (ANC). Reported attendance to sexually transmitted infections (STIs/STDs), prevention of HIV transmission from mother to child (PMTCT), and reproductive health cancer services were all less than 13%. The male partners age group (25-34 years; χ 2 =9.347, df =3 p-value < 0.001), female partner invitation to HR services (χ 2 = 29.901, df=1, p-value <0.001) and having less than 2 children (χ 2 = 6. 201, df = 2, p -value < 0.05) were associated with higher RH service attendance. Only 20% (4/20) of married men attended RH because they expected better health outcomes in their presence whilst majority attended because they were summoned or just happen to be at the clinic for other purposes. Conclusion: The male attendance to RH services together with their female partners’ in rural Shinyanga was mainly focused ANC and VCT. Most of men attended because were verbally invited by their partners. Education on couple communication empowerment among women attending RH clinics could sustainably improve attendance to all RH services.
{"title":"Attendance of male partners to different reproductive health services in Shinyanga District North western Tanzania.","authors":"Alfred Chibwae, A. Kapesa, O. Jahanpour, J. Seni, Namanya Basinda, Emmanuel Kadelya, E. Konje, E. Nyanza, S. Ngallaba, D. Dewey","doi":"10.4314/THRB.V20I2.9","DOIUrl":"https://doi.org/10.4314/THRB.V20I2.9","url":null,"abstract":"Background: Male involvement in reproductive health (RH) services in Africa has been associated with improved maternal and child health outcomes. The objective of this study was to determine the prevalence and factors affecting male partner attendance to available reproductive health services in Shinyanga district, north-western Tanzania. Methods: A house to house survey using a structured questionnaire was conducted among randomly selected married men. Additional in-depth interviews were conducted among married men found attending RH services. Factors that motivates the uptake of locally available RH services together with their partners were explored. Results: A total of 204 men participated in the study, 94.4 % (193/204) of them reported to have ever attended the RH service with their female partners at least once whereas 50.6% (103/204) of them attended at least thrice. Three quarters (154/204) attended HIV counselling and testing (VCT) and 63% (129/204) attended antenatal services (ANC). Reported attendance to sexually transmitted infections (STIs/STDs), prevention of HIV transmission from mother to child (PMTCT), and reproductive health cancer services were all less than 13%. The male partners age group (25-34 years; χ 2 =9.347, df =3 p-value < 0.001), female partner invitation to HR services (χ 2 = 29.901, df=1, p-value <0.001) and having less than 2 children (χ 2 = 6. 201, df = 2, p -value < 0.05) were associated with higher RH service attendance. Only 20% (4/20) of married men attended RH because they expected better health outcomes in their presence whilst majority attended because they were summoned or just happen to be at the clinic for other purposes. Conclusion: The male attendance to RH services together with their female partners’ in rural Shinyanga was mainly focused ANC and VCT. Most of men attended because were verbally invited by their partners. Education on couple communication empowerment among women attending RH clinics could sustainably improve attendance to all RH services.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44626058","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}
W. Owiredu, S. Lokpo, J. Osei-Yeboah, C. Obirikorang, M. Agyei-Frempong, Samuel Ametepe
Background: Enhanced malaria control has resulted in its reduction in some areas of Sub Saharan Africa including Rwanda. However, asymptomatic hosts serve as a reservoir for the malaria parasite for communities. The objective of this study was to determine the prevalence of malaria parasites and risk factors associated with malaria infection among children underfive years in Huye district, Rwanda. Methods: This community-based cross sectional study was conducted from May to June 2016 among underfive years children. Asymptomatic children underfive years of age were randomly selected from 13 villages. Thick and thin blood smears were prepared from each child for malaria parasite diagnosis. Interviews with parents or guardians were conducted to collect data on malaria associated risk factors. Observations were made of the presence of mosquito breeding sites near and around the homestead. Results: A total of 222 children were included in the study. Nearly a third (28.8%) of the children were within the age of 25-36 months. The majority (54%) of the children were females. Most of the parents/guardians were married (95.9%), nearly all (99.5%) had attended primary school and most (97.3%) were peasants. The overall Plasmodium falciparum prevalence in children was 12.2%. Children aged 1 to 12 months were 3.5 times more likely to have malaria parasites than children aged 13 to 59 months [AOR=3.56; 95%CI=1.18-10.71; p =0.024]. Children who were not sleeping under insecticide treated nets were 15 times more likely to be infected with malaria parasites compared to those who were sleeping under nets [AOR=15.27; 95%CI=4.42-52.82; p<0.001]. Conclusion: Malaria parasite prevalence in under-five year children in Huye District, Rwanda is moderate. The asymptomatic infections in the community forms a reservoir for transmission in the area. Young age of the child and not sleeping under mosquito net were associated with malaria parasite infection. The continuing use of mosquito nets needs to be emphasized.
{"title":"Prevalence and risk factors of asymptomatic malaria among under-five children in Huye District, Southern Rwanda.","authors":"W. Owiredu, S. Lokpo, J. Osei-Yeboah, C. Obirikorang, M. Agyei-Frempong, Samuel Ametepe","doi":"10.4314/THRB.V20I1","DOIUrl":"https://doi.org/10.4314/THRB.V20I1","url":null,"abstract":"Background: Enhanced malaria control has resulted in its reduction in some areas of Sub Saharan Africa including Rwanda. However, asymptomatic hosts serve as a reservoir for the malaria parasite for communities. The objective of this study was to determine the prevalence of malaria parasites and risk factors associated with malaria infection among children underfive years in Huye district, Rwanda. Methods: This community-based cross sectional study was conducted from May to June 2016 among underfive years children. Asymptomatic children underfive years of age were randomly selected from 13 villages. Thick and thin blood smears were prepared from each child for malaria parasite diagnosis. Interviews with parents or guardians were conducted to collect data on malaria associated risk factors. Observations were made of the presence of mosquito breeding sites near and around the homestead. Results: A total of 222 children were included in the study. Nearly a third (28.8%) of the children were within the age of 25-36 months. The majority (54%) of the children were females. Most of the parents/guardians were married (95.9%), nearly all (99.5%) had attended primary school and most (97.3%) were peasants. The overall Plasmodium falciparum prevalence in children was 12.2%. Children aged 1 to 12 months were 3.5 times more likely to have malaria parasites than children aged 13 to 59 months [AOR=3.56; 95%CI=1.18-10.71; p =0.024]. Children who were not sleeping under insecticide treated nets were 15 times more likely to be infected with malaria parasites compared to those who were sleeping under nets [AOR=15.27; 95%CI=4.42-52.82; p<0.001]. Conclusion: Malaria parasite prevalence in under-five year children in Huye District, Rwanda is moderate. The asymptomatic infections in the community forms a reservoir for transmission in the area. Young age of the child and not sleeping under mosquito net were associated with malaria parasite infection. The continuing use of mosquito nets needs to be emphasized.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47382952","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}
G. Frumence, J. Chebet, Jennifer A. Callaghan-Koru, I. Mosha, D. Chitama, J. Killewo, P. Winch
Background: The Tanzanian health sector receives large amounts of funding from multiple international development partners to support a broad range of population-health interventions. However, little is known about the partners’ level of commitment to sustain funding, and the implications of uncertainties created by these funding mechanisms. This study had the following objectives: 1) To present a theoretical model for assessing funding commitments by health development partners in a specified region; 2) to describe development partner funding commitments against this framework, using a case study example of Morogoro Region, Tanzania; and 3) to discuss policy considerations using this framework for district, regional and national level. Methods: Qualitative case study methodology was used to assess funding commitments of health-related development partners in Morogoro Region, Tanzania. Using qualitative data, collected as part of an evaluation of maternal and child health programs in Morogoro Region, key informants from all development partners were interviewed and thematic analysis was conducted for the assessment. Results: Our findings show that decisions made on where to commit and direct funds were based on recipient government and development partner priorities. These decisions were based on government directives, such as the need to provide health services to vulnerable populations; the need to contribute towards alleviation of disease burden and development partner interests, including humanitarian concerns. Poor coordination of partner organizations and their funding priorities may undermine benefits to target populations. This weakness poses a major challenge on development partner investments in health, leading to duplication of efforts and resulting in stagnant disease burden levels. Conclusion: Effective coordination mechanisms between all stakeholders at each level should be advocated to provide a forum to discuss interests and priorities, so as to harmonize them and facilitate the implementation of development partner funded activities in the recipient countries.
{"title":"Development partner support to the health sector at the local level in Morogoro region, Tanzania","authors":"G. Frumence, J. Chebet, Jennifer A. Callaghan-Koru, I. Mosha, D. Chitama, J. Killewo, P. Winch","doi":"10.4314/THRB.V20I2.8","DOIUrl":"https://doi.org/10.4314/THRB.V20I2.8","url":null,"abstract":"Background: The Tanzanian health sector receives large amounts of funding from multiple international development partners to support a broad range of population-health interventions. However, little is known about the partners’ level of commitment to sustain funding, and the implications of uncertainties created by these funding mechanisms. This study had the following objectives: 1) To present a theoretical model for assessing funding commitments by health development partners in a specified region; 2) to describe development partner funding commitments against this framework, using a case study example of Morogoro Region, Tanzania; and 3) to discuss policy considerations using this framework for district, regional and national level. Methods: Qualitative case study methodology was used to assess funding commitments of health-related development partners in Morogoro Region, Tanzania. Using qualitative data, collected as part of an evaluation of maternal and child health programs in Morogoro Region, key informants from all development partners were interviewed and thematic analysis was conducted for the assessment. Results: Our findings show that decisions made on where to commit and direct funds were based on recipient government and development partner priorities. These decisions were based on government directives, such as the need to provide health services to vulnerable populations; the need to contribute towards alleviation of disease burden and development partner interests, including humanitarian concerns. Poor coordination of partner organizations and their funding priorities may undermine benefits to target populations. This weakness poses a major challenge on development partner investments in health, leading to duplication of efforts and resulting in stagnant disease burden levels. Conclusion: Effective coordination mechanisms between all stakeholders at each level should be advocated to provide a forum to discuss interests and priorities, so as to harmonize them and facilitate the implementation of development partner funded activities in the recipient countries.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70663687","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}
B. Idindili, Ul Haq Zaeem, Stephen Ayella, Sumaiya G. Thawar, Majige Selemani, Strinic Dragana, John Kallage
Background: Save the Children Tanzania has been supporting several projects in Lindi Region including implementation of health facility based Integrated Management of Childhood Illness (IMCI) services in Kilwa, Ruangwa and Lindi rural districts. The objective of this study was to assess the IMCI services in a sample of health facilities and explore factors affecting the service provision and sustainability in Lindi, Tanzania. Methods: A cross-sectional study was conducted involving 27 health facilities. Quantitative and qualitative approaches were used to collect the required data. Focus group discussions and in-depth interviews were also used to evaluate the IMCI services in these facilities. Results: All health facilities visited were found to have adequate supply of IMCI equipment. However, there was inadequate availability and distribution of clinical officers in the districts. None of the 41 clinical officers observed, assessed sick children for all items in the IMCI checklist. Furthermore, health centres and dispensaries were found to have a serious shortage of essential medicines. Oral antibiotics for bacterial infections were available across health facilities. Amoxicillin was found in 4(44%) health centres and 7 (46.7%) dispensaries; Ampicillin was only available at 4(44.4%) health centres and 1 (6.7%) dispensary. Considerable challenges in access to health services were identified and they included long distances to health facilities, inadequate and unaffordable transport systems and continuous limited quality of care due to shortages of trained staff and drug stock outs. In addition, caregivers were found to have limited awareness of danger signs and symptoms of childhood illnesses. Conclusions: The implementation of IMCI services in the three districts of Lindi region experiences multiple challenges despite the availability of adequate infrastructure for program implementation. This calls for strengthened supportive supervision, constant provision of medical supplies and training of IMCI health workers to improve services delivery to sick children. In addition community level promotion of prompt modern health care seeking behaviour is essential to enhance childhood illness care and treatment.
{"title":"Factors influencing implementation of integrated management of childhood illness in Lindi Region, Southern Tanzania","authors":"B. Idindili, Ul Haq Zaeem, Stephen Ayella, Sumaiya G. Thawar, Majige Selemani, Strinic Dragana, John Kallage","doi":"10.4314/THRB.V20I1.7","DOIUrl":"https://doi.org/10.4314/THRB.V20I1.7","url":null,"abstract":"Background: Save the Children Tanzania has been supporting several projects in Lindi Region including implementation of health facility based Integrated Management of Childhood Illness (IMCI) services in Kilwa, Ruangwa and Lindi rural districts. The objective of this study was to assess the IMCI services in a sample of health facilities and explore factors affecting the service provision and sustainability in Lindi, Tanzania. Methods: A cross-sectional study was conducted involving 27 health facilities. Quantitative and qualitative approaches were used to collect the required data. Focus group discussions and in-depth interviews were also used to evaluate the IMCI services in these facilities. Results: All health facilities visited were found to have adequate supply of IMCI equipment. However, there was inadequate availability and distribution of clinical officers in the districts. None of the 41 clinical officers observed, assessed sick children for all items in the IMCI checklist. Furthermore, health centres and dispensaries were found to have a serious shortage of essential medicines. Oral antibiotics for bacterial infections were available across health facilities. Amoxicillin was found in 4(44%) health centres and 7 (46.7%) dispensaries; Ampicillin was only available at 4(44.4%) health centres and 1 (6.7%) dispensary. Considerable challenges in access to health services were identified and they included long distances to health facilities, inadequate and unaffordable transport systems and continuous limited quality of care due to shortages of trained staff and drug stock outs. In addition, caregivers were found to have limited awareness of danger signs and symptoms of childhood illnesses. Conclusions: The implementation of IMCI services in the three districts of Lindi region experiences multiple challenges despite the availability of adequate infrastructure for program implementation. This calls for strengthened supportive supervision, constant provision of medical supplies and training of IMCI health workers to improve services delivery to sick children. In addition community level promotion of prompt modern health care seeking behaviour is essential to enhance childhood illness care and treatment.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70663678","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}
Background: Men who have sex with men (MSM) continue to be highly affected with the HIV infection worldwide. Studies have shown that the organization of healthcare systems and how the MSM perceive it play a major role in granting or denying them access to healthcare services. Little is known in Tanzania regarding the barriers that MSM face while accessing health services within the country. The study was geared towards determining the proportion of MSM who accessed health care and disclose their sexual orientations to health care workers (HCW). It also intended to find out the anticipated barriers from HCW’s if they were to disclose their sexual orientations to them and consider the types of social networks used when facing various challenges. Methods: The study employed both quantitative and qualitative methods. Participants were enrolled in the study Respondent Driven Sampling. Quantitative data was entered and analysed using the Statistical Package for the Social Sciences v.20. Qualitative data was collected using in-depth interviews read and interpreted to identify themes and create categories. These were manually analysed and interpreted according to the study objectives. Results : The majority (87.7%) of MSM accessed healthcare services when sick, only a few (3.4%) did nothing due to lack of financial resources. Only a third of them had ever disclosed their sexual orientations to healthcare workers. This was due to lack of confidentiality, fear of stigma and discrimination, shame and mistreatment at the health facilities, and fear of the healthcare worker’s reaction after they disclosed their sexual orientation to them. Conclusion : MSM need to be empowered to overcome their perceived fears towards healthcare workers and health facilities. Efforts should be put into breaking the cycle of negative information and perceptions MSM have about healthcare workers and how they deal with same sex practices’ health related problems.
{"title":"Perceived barriers to access available health services among men who have sex with men in Dar es Salaam, Tanzania","authors":"Daniel J Magesa, M. Leshabari","doi":"10.4314/THRB.V19I4.5","DOIUrl":"https://doi.org/10.4314/THRB.V19I4.5","url":null,"abstract":"Background: Men who have sex with men (MSM) continue to be highly affected with the HIV infection worldwide. Studies have shown that the organization of healthcare systems and how the MSM perceive it play a major role in granting or denying them access to healthcare services. Little is known in Tanzania regarding the barriers that MSM face while accessing health services within the country. The study was geared towards determining the proportion of MSM who accessed health care and disclose their sexual orientations to health care workers (HCW). It also intended to find out the anticipated barriers from HCW’s if they were to disclose their sexual orientations to them and consider the types of social networks used when facing various challenges. Methods: The study employed both quantitative and qualitative methods. Participants were enrolled in the study Respondent Driven Sampling. Quantitative data was entered and analysed using the Statistical Package for the Social Sciences v.20. Qualitative data was collected using in-depth interviews read and interpreted to identify themes and create categories. These were manually analysed and interpreted according to the study objectives. Results : The majority (87.7%) of MSM accessed healthcare services when sick, only a few (3.4%) did nothing due to lack of financial resources. Only a third of them had ever disclosed their sexual orientations to healthcare workers. This was due to lack of confidentiality, fear of stigma and discrimination, shame and mistreatment at the health facilities, and fear of the healthcare worker’s reaction after they disclosed their sexual orientation to them. Conclusion : MSM need to be empowered to overcome their perceived fears towards healthcare workers and health facilities. Efforts should be put into breaking the cycle of negative information and perceptions MSM have about healthcare workers and how they deal with same sex practices’ health related problems.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45022862","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}
Stanley Mwita, Nankondo Tunzo, M. Jande, K. Hamasaki
Many older people are unable to afford even basic treatment, let alone, the medications needed to control chronic diseases that become more prevalent in older age. This study was conducted to assess the implementation of the Tanzania national exemption policy on availability of prescribed medicines in elderly people. This cross-sectional study was conducted at Sekou-Toure Regional Referral Hospital in Mwanza, Tanzania, from April to June 2016. Randomly selected outpatients aged above 60 years who attended the hospital were involved in the study. Data were collected by using interview guided questionnaire. Each patient was privately interviewed to obtain information on availability of medicines prescribed and whether or not the medicines were provided free-of-charge according to the exemption policy. A total of 100 outpatients were involved in the study. The mean age was 66.25 years (range= 60 to 87 years). About one-third (31%) were members of social security fund receiving monthly retirement pension. Only 27% ( p -value=0.44) of elders received all medicines as per prescription. Majority of elder patients (39.7%) received 50% of prescribed medicines per prescription while 4.1% did not receive any medicine prescribed and only 1.4% received 80% of medicines prescribed. Results show that almost 50% of elders with diabetes received all anti-diabetics prescribed while 37% of elders received all antihypertensive prescribed. There is poor availability of medicines used by elderly people at Sekou-Toure Regional Mwanza thus elders do not get free medicines as per national cost sharing policy.
{"title":"Availability of prescribed medicines for elders at Sekou-Toure Regional Referral Hospital in Mwanza, Tanzania","authors":"Stanley Mwita, Nankondo Tunzo, M. Jande, K. Hamasaki","doi":"10.4314/THRB.V19I4","DOIUrl":"https://doi.org/10.4314/THRB.V19I4","url":null,"abstract":"Many older people are unable to afford even basic treatment, let alone, the medications needed to control chronic diseases that become more prevalent in older age. This study was conducted to assess the implementation of the Tanzania national exemption policy on availability of prescribed medicines in elderly people. This cross-sectional study was conducted at Sekou-Toure Regional Referral Hospital in Mwanza, Tanzania, from April to June 2016. Randomly selected outpatients aged above 60 years who attended the hospital were involved in the study. Data were collected by using interview guided questionnaire. Each patient was privately interviewed to obtain information on availability of medicines prescribed and whether or not the medicines were provided free-of-charge according to the exemption policy. A total of 100 outpatients were involved in the study. The mean age was 66.25 years (range= 60 to 87 years). About one-third (31%) were members of social security fund receiving monthly retirement pension. Only 27% ( p -value=0.44) of elders received all medicines as per prescription. Majority of elder patients (39.7%) received 50% of prescribed medicines per prescription while 4.1% did not receive any medicine prescribed and only 1.4% received 80% of medicines prescribed. Results show that almost 50% of elders with diabetes received all anti-diabetics prescribed while 37% of elders received all antihypertensive prescribed. There is poor availability of medicines used by elderly people at Sekou-Toure Regional Mwanza thus elders do not get free medicines as per national cost sharing policy.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46027084","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}
Background: It is almost two decades since various research works started documenting the debate surrounding the role of social capital on individual health outcomes in different contexts. However, in Tanzania there is a dearth of empirical evidence showing how social capital influences health outcomes. The objective of this study was to investigate the links between individual social capital and self-rated health by selected socio-demographic factors. Methods: We conducted a population-based cross-sectional study in Makete district in the south-western Tanzania. A semi-structured questionnaire was used to collect data using face to face interviews with the study participants. We collected information on individual structural social capita, which include memberships in organizations, giving social support, receiving social support and participation in voluntary activities. We also collected information on individual cognitive social capital including visiting neighbour, trusting neighbour, interaction with neighbour and ability to influence in decisions. Results: A total of 862 individuals from four villages participated in the study with the mean age of 31.3 years. Factor analysis (using principal components analysis) with varimax determined four domains of structural social capital: participation in collective activities, giving social support, membership in formal and informal organizations and receiving social support (factor loadings: 0.65 to 0.55). Four domains of cognitive social capital were also identified: visiting a sick neighbour, trusting a neighbour, and interacting with neighbour and ability to influence decisions (Factors loadings: 0.78 to 0.52). The multivariable logistic regression analysis shows that individuals with access to medium and high levels of structural social capital were almost 2 and 3 times more likely to report good health than individuals with low social capital [OR 2.3 (CI: 1.6-3.4)] and [OR 3.4 (CI: 2.3-5.1)], respectively. Conclusion : Our study findings support the argument that high level of structural social capital has positive health outcomes in rural Tanzania’ setting. Therefore, village leaders in particular and community members in general should promote social capital in their communities as one of the health interventions towards improving individual health.
{"title":"Social capital and self-rated health: experiences from Makete district, Tanzania","authors":"G. Frumence, T. Nyamhanga","doi":"10.4314/THRB.V19I3.10","DOIUrl":"https://doi.org/10.4314/THRB.V19I3.10","url":null,"abstract":"Background: It is almost two decades since various research works started documenting the debate surrounding the role of social capital on individual health outcomes in different contexts. However, in Tanzania there is a dearth of empirical evidence showing how social capital influences health outcomes. The objective of this study was to investigate the links between individual social capital and self-rated health by selected socio-demographic factors. Methods: We conducted a population-based cross-sectional study in Makete district in the south-western Tanzania. A semi-structured questionnaire was used to collect data using face to face interviews with the study participants. We collected information on individual structural social capita, which include memberships in organizations, giving social support, receiving social support and participation in voluntary activities. We also collected information on individual cognitive social capital including visiting neighbour, trusting neighbour, interaction with neighbour and ability to influence in decisions. Results: A total of 862 individuals from four villages participated in the study with the mean age of 31.3 years. Factor analysis (using principal components analysis) with varimax determined four domains of structural social capital: participation in collective activities, giving social support, membership in formal and informal organizations and receiving social support (factor loadings: 0.65 to 0.55). Four domains of cognitive social capital were also identified: visiting a sick neighbour, trusting a neighbour, and interacting with neighbour and ability to influence decisions (Factors loadings: 0.78 to 0.52). The multivariable logistic regression analysis shows that individuals with access to medium and high levels of structural social capital were almost 2 and 3 times more likely to report good health than individuals with low social capital [OR 2.3 (CI: 1.6-3.4)] and [OR 3.4 (CI: 2.3-5.1)], respectively. Conclusion : Our study findings support the argument that high level of structural social capital has positive health outcomes in rural Tanzania’ setting. Therefore, village leaders in particular and community members in general should promote social capital in their communities as one of the health interventions towards improving individual health.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41267723","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}
J. Kinabo, A. Mwanri, P. Mamiro, K. Kulwa, N. Bundala, J. Picado, J. Msuya, J. Ntwenya, Aneth Nombo, R. Mzimbiri, Fatma Ally, Asha Salmini, E. Macha, E. Cheung
Background: Undernutrition in children has remained a challenge despite the success achieved in reduction of other childhood diseases in Zanzibar. Most empirical studies on infants and young child feeding (IYCF) have examined nutritional value of foods fed to the children in terms of energy and micronutrient content. Little is known on the role of culture, traditions and social norms in influencing IYCF practices. This study aimed at assessing the existing IYCF practices and socio-cultural factors influencing these practises using Pro PAN tool to get an in-depth understanding of the mothers’ practices with respect to exclusive breastfeeding and infant and young child feeding. Methods: A cross sectional study involving mothers/caregivers was conducted using semi-structured interviews and opportunistic observations on Unguja Island, Zanzibar. A random selection of 36 Shehias and 213 households with children 0 – 23 months old was done proportional-to-size of Shehias and children. Quantitative and qualitative data were collected using the Pro PAN tool and embedded software for analyses. Results: A total of 213 of mothers/caregivers were involved in the study. Almost all new-borns were fed colostrum (96%). Proportion of mothers who initiated breastfeeding within one hour after giving birth was 63%. About 24% of the women practiced exclusive breastfeeding and 21% of the children were given pre-lacteal feeds 2-3 days after birth. The mean age of introduction of complementary foods was four months. Responsive feeding was not practiced by some mothers as 31% of the children 12-23 months of age were left to eat alone without any support from caregivers. The common reasons for non-adherence to the recommended feeding practices were related to income and socio-cultural norms which are strong in the community and supported by other family members. Conclusion: Infant and young child feeding in Unguja was suboptimal. Inadequate care practices, use of pre-lacteals, early introduction of complementary foods, low rate of exclusive breastfeeding and low meal frequency were among the common practices. The main causes of the observed feeding practice were related to socio-cultural norms and beliefs. There is a need to strengthen IYCF education into the antenatal clinic regime.
{"title":"Infant and young child feeding practices on Unguja Island in Zanzibar, Tanzania: a ProPAN based analysis","authors":"J. Kinabo, A. Mwanri, P. Mamiro, K. Kulwa, N. Bundala, J. Picado, J. Msuya, J. Ntwenya, Aneth Nombo, R. Mzimbiri, Fatma Ally, Asha Salmini, E. Macha, E. Cheung","doi":"10.4314/THRB.V19I3","DOIUrl":"https://doi.org/10.4314/THRB.V19I3","url":null,"abstract":"Background: Undernutrition in children has remained a challenge despite the success achieved in reduction of other childhood diseases in Zanzibar. Most empirical studies on infants and young child feeding (IYCF) have examined nutritional value of foods fed to the children in terms of energy and micronutrient content. Little is known on the role of culture, traditions and social norms in influencing IYCF practices. This study aimed at assessing the existing IYCF practices and socio-cultural factors influencing these practises using Pro PAN tool to get an in-depth understanding of the mothers’ practices with respect to exclusive breastfeeding and infant and young child feeding. Methods: A cross sectional study involving mothers/caregivers was conducted using semi-structured interviews and opportunistic observations on Unguja Island, Zanzibar. A random selection of 36 Shehias and 213 households with children 0 – 23 months old was done proportional-to-size of Shehias and children. Quantitative and qualitative data were collected using the Pro PAN tool and embedded software for analyses. Results: A total of 213 of mothers/caregivers were involved in the study. Almost all new-borns were fed colostrum (96%). Proportion of mothers who initiated breastfeeding within one hour after giving birth was 63%. About 24% of the women practiced exclusive breastfeeding and 21% of the children were given pre-lacteal feeds 2-3 days after birth. The mean age of introduction of complementary foods was four months. Responsive feeding was not practiced by some mothers as 31% of the children 12-23 months of age were left to eat alone without any support from caregivers. The common reasons for non-adherence to the recommended feeding practices were related to income and socio-cultural norms which are strong in the community and supported by other family members. Conclusion: Infant and young child feeding in Unguja was suboptimal. Inadequate care practices, use of pre-lacteals, early introduction of complementary foods, low rate of exclusive breastfeeding and low meal frequency were among the common practices. The main causes of the observed feeding practice were related to socio-cultural norms and beliefs. There is a need to strengthen IYCF education into the antenatal clinic regime.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70663632","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}
J. Manyahi, B. Jullu, Mathias I. Abuya, J. Juma, B. Kilama, V. Sambu, J. Nondi, Bernard Rabiel, N. Makyao, A. Ramadhani, G. Somi, M. I. Matee
Background: The Tanzania National AIDS Control Programme has established HIV sentinel surveillance among antenatal clinic (ANC) attendees as one of the methods for collecting data on HIV prevalence. This article provides trends on HIV prevalence for 92 sentinel sites that have constantly been part of the surveillance system since 2001 and have participated in at least three consecutive rounds. Method: The surveillance population included all pregnant women aged 15–49 years who were attending a selected sentinel ANC site for the first time for any pregnancy between 2001 and 2011. Serial testing for HIV infection was done anonymously by detecting for the presence of IgG antibodies to HIV on dried blood spot (DBS) specimens. HIV trends were calculated taking into account random effects from sites on the following variables: region, sites and socio-demographic characteristics defined as age, marital status, parity, education level and duration of stay at present residence. Results: Overall, there was a significant decline in HIV prevalence from 9.6% in 2001 to 5.6% in 2011 (p<0.01). Specifically, the HIV prevalence among 15-24 years’ pregnant women significantly declined from 7.8% in 2001/2002 to 4% in 2011 (p<0.01). The decline in HIV prevalence occurred irrespective of residence, marital status, education level or previous pregnancies. Conclusion: There has been a significant decline in HIV infections among young pregnant women attending ANC clinics in Tanzania since 2001. This study also indicates that ANC surveillance among pregnant women over time can provide useful estimates of HIV situation between the population surveys.
{"title":"Decline in the prevalence HIV among pregnant women attending antenatal clinics in Tanzania 2001-2011.","authors":"J. Manyahi, B. Jullu, Mathias I. Abuya, J. Juma, B. Kilama, V. Sambu, J. Nondi, Bernard Rabiel, N. Makyao, A. Ramadhani, G. Somi, M. I. Matee","doi":"10.4314/THRB.V19I2.1","DOIUrl":"https://doi.org/10.4314/THRB.V19I2.1","url":null,"abstract":"Background: The Tanzania National AIDS Control Programme has established HIV sentinel surveillance among antenatal clinic (ANC) attendees as one of the methods for collecting data on HIV prevalence. This article provides trends on HIV prevalence for 92 sentinel sites that have constantly been part of the surveillance system since 2001 and have participated in at least three consecutive rounds. Method: The surveillance population included all pregnant women aged 15–49 years who were attending a selected sentinel ANC site for the first time for any pregnancy between 2001 and 2011. Serial testing for HIV infection was done anonymously by detecting for the presence of IgG antibodies to HIV on dried blood spot (DBS) specimens. HIV trends were calculated taking into account random effects from sites on the following variables: region, sites and socio-demographic characteristics defined as age, marital status, parity, education level and duration of stay at present residence. Results: Overall, there was a significant decline in HIV prevalence from 9.6% in 2001 to 5.6% in 2011 (p<0.01). Specifically, the HIV prevalence among 15-24 years’ pregnant women significantly declined from 7.8% in 2001/2002 to 4% in 2011 (p<0.01). The decline in HIV prevalence occurred irrespective of residence, marital status, education level or previous pregnancies. Conclusion: There has been a significant decline in HIV infections among young pregnant women attending ANC clinics in Tanzania since 2001. This study also indicates that ANC surveillance among pregnant women over time can provide useful estimates of HIV situation between the population surveys.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45566195","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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