9 research outputs found
Effect of Working Environment on Employees Performance in Tanzania Local Government Authorities: The Case of Njombe Town Council.
No full textThis study investigated the impact of the working environment on employees’ performance within local government agencies in Tanzania, specifically focusing on the Njombe Town Council. This study was directed by three objectives: to ascertain the impact of the physical environment, health and safety, and work-life balance on employee performance at Njombe Town Council. This study utilized the Job Demands-Resources paradigm. This study employed a positivist research philosophy, a quantitative research approach, and an explanatory research design. Structured questionnaires were employed to gather data from a sample of 190 respondents selected by stratified random sampling from 372 workers of the Njombe town council. The study revealed that all three independent variables physical environment, health and safety, and work-life balance were positively and significantly correlated with employee performance at Njombe Town Council. The study shows that the work environment substantially affects employee performance at Njombe Town Council, emphasizing the vital importance of physical conditions, health and safety, and work-life balance in improving productivity within Tanzania's local government authority. The study advises the council to invest in contemporary and ergonomic office furniture to alleviate physical strain, enhance lighting and ventilation systems for improved comfort and productivity, and ensure regular maintenance and cleanliness of workspaces to foster a hygienic and appealing environment. Furthermore, the council should establish and enforce comprehensive occupational health and safety policies, conduct regular safety training and awareness programs for all staff, and guarantee the availability and utilization of personal protective equipment. Finally, establish flexible working hours and remote work options when possible, and advocate for regulations that support sufficient rest and leave usage.
Keywords: Working Environment, physical Environment, Health and safety, Work Life Balanc
The fragmented politics of sugarcane contract farming in Uganda
Get PDFIn the last decade, contract farming has regained momentum among policymakers and global development agencies as a tool to promote inclusive rural development and responsible investments. Integrating smallholders within global, regional and national agricultural value chains, we are told, represents the sine qua non for alleviating rural poverty. In Uganda, under the label of out-grower schemes, contract farming is currently undergoing massive expansion, driven especially by the boom in sugarcane cultivation. Drawing from three case studies of sugarcane contract farming in Uganda, the paper re-politicizes the debate around contract farming by looking at the power relations within which these schemes are embedded. We argue, what is seen in Uganda's expansion is a political dynamic derived both from the major dislocations and dispossessions required to establish the plantation estate and its work force, as well as from the effort to bring many smallholders using unimproved methods on land with sometimes unclear tenure arrangements into contracted arrangements for supplying sugarcane. The result has been highly contentious politics around sugar's expansion, where struggles over land dispossession merge with those around exploitative wage labour, around the loss and transformation of livelihoods, and around debt, power inequalities and environmental harm, a matrix in which state violence and co-optation are ever-present. © 2021 John Wiley & Sons Lt
Fighting HIV/AIDS: Reconfiguring the State?
No full textThe author wishes to thank the anonymous reviewers of the article and the ESRC for funding part of this research
Development of emergency medicine in Rwanda
No full textAbstractRwanda, known as the “Land of a Thousand Hills,” is a small, East African country that was the site of the devastating 1994 genocide. In the past 18years, this post-conflict country has made tremendous progress in rebuilding itself and its health infrastructure. The country has recovered or surpassed many of its pre-1994 health levels, including reduction in HIV/AIDS prevalence, under-five mortality and road traffic accidents. Nevertheless, Rwanda continues to face a high burden of disease. The leading causes of mortality in Rwanda include complications of HIV/AIDS and related opportunistic infections, severe malaria, pulmonary infections, and trauma, and are best managed with emergency and acute care services. However, health care personal resources remain significantly lacking, and there is currently no emergency medicine-trained workforce.The Rwandan government, partnering with international organizations, has launched a campaign to improve human resources for health, and as a part of that effort the creation of training programs in emergency medicine is now underway. The Rwandan Human Resources for Health program can serve as a guide to the development of similar programs within other African countries. The emergency medicine component of this program includes two tracks: a 2-year postgraduate diploma course, followed by a 3-year Masters of Medicine in Emergency Medicine. The program is slated to graduate its first cohort of trained Emergency Physicians in 2017
Modulation of immune responses by Plasmodium falciparum infection in asymptomatic children living in the endemic region of Mbita, western Kenya
Get PDFNagasaki University (長崎大学)博士(医学)Individuals living in malaria endemic areas become clinically immune after multiple re-infections over time and remain infected without apparent symptoms. However, it is unclear why a long period is required to gain clinical immunity to malaria, and how such immunity is maintained. Although malaria infection is reported to induce inhibition of immune responses, studies on asymptomatic individuals living in endemic regions of malaria are relatively scarce. We conducted a cross-sectional study of immune responses in asymptomatic school children aged 4?16 years living in an area where Plasmodium falciparum and Schistosoma mansoni infections are co-endemic in Kenya. Peripheral blood mononuclear cells were subjected to flow cytometric analysis and cultured to determine proliferative responses and cytokine production. The proportions of cellular subsets in children positive for P. falciparum infection at the level of microscopy were comparable to the negative children, except for a reduction in central memory-phenotype CD8+ T cells and natural killer cells. In functional studies, the production of cytokines by peripheral blood mononuclear cells in response to P. falciparum crude antigens exhibited strong heterogeneity among children. In addition, production of IL-2 in response to anti-CD3 and anti-CD28 monoclonal antibodies was significantly reduced in P. falciparum-positive children as compared to -negative children, suggesting a state of unresponsiveness. These data suggest that the quality of T cell immune responses is heterogeneous among asymptomatic children living in the endemic region of P. falciparum, and that the responses are generally suppressed by active infection with Plasmodium parasites.長崎大学学位論文 学位記番号:博(医歯薬)甲第1055号 学位授与年月日:平成30年3月20日Author: Caroline Kijogi, Daisuke Kimura, Lam Quoc Bao, Risa Nakamura, Evans Asena Chadeka, Ngetich Benard Cheruiyot, Felix Bahati, Kazuhide Yahata, Osamu Kaneko, Sammy M. Njenga, Yoshio Ichinose, Shinjiro Hamano, Katsuyuki YuiCitation: Parasitology International, 67(3), pp.284-293; 2018Nagasaki University (長崎大学), 博士(医学) (2018-03-20)doctoral thesi
The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries: A Systematic Review
Get PDFThis paper summarizes the literature on the impact of state subsidized or social health insurance schemes that have been offered, mostly on a voluntary basis, to the informal sector in low-and middle-income countries. A substantial number of papers provide estimations of average treatment on the treated effect for insured persons. We summarize papers that correct for the problem of self-selection into insurance and papers that estimate the average intention to treat effect. Summarizing the literature was difficult because of the lack of (1) uniformity in the use of meaningful definitions of outcomes that indicate welfare improvements and (2) clarity in the consideration of selection issues. We find the uptake of insurance schemes, in many cases, to be less than expected. In general, we find no strong evidence of an impact on utilization, protection from financial risk, and health status. However, a few insurance schemes afford significant protection from high levels of out-of-pocket expenditures. In these cases, however, the impact on the poor is weaker. More information is needed to understand the reasons for low enrollment and to explain the limited impact of health insurance among the insured. JEL codes: I10, I15. © The Author 2012. Published by Oxford University Press on behalf of the International Bank for Reconstruction and Development/ THE WORLD BANK. All rights reserved
Microscopic Features , Chromatographic Fingerprints and Antioxidant Property of Some Unconventional Green Leafy Vegetables Consumed in Bandundu , DR Congo
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Integration of tuberculosis (TB) and HIV services in Ghana
Get PDFIntegration of health services involves managing services to enhance quality for patient needs that cut across multiple services, providers and settings. The rapid growth of human immunodeficiency virus (HIV) has increased tuberculosis (TB) cases, and TB/HIV integration offers a unified strategy for control. This study evaluated TB/HIV integration in Ghana. The three sites evaluated applied varying degrees of integration. A mixed methods approach comprised an uncontrolled before-and-after study involving 1330 TB cases, and qualitative interviews with 29 providers and patients.
TB treatment success was 51% before and 69% after integration [p<0.01; OR(95% CI)=2.17 (1.72 to 2.74)]. Treatment success increased in all sites after integration: 43% to 53% at the one-stop shop (OSS), 69% to 78% at the partially integrated site (PIS), and 46% to 78% at the referral site (RS). The change was significant only at the RS [(Χ2=64.54; p<0.01; OR(95% CI)=4.28 (2.97 to 6.18)]. HIV screening was highest (99%) at the OSS (Χ2=68.26; p<0.01), HIV-positive cases on CPT were highest (93.8%) at the RS (Χ2=9.29; p<0.01), and the PIS had the highest number (59.5%) on ART (Χ2=95.00; p<0.01).
TB/HIV integration may improve TB treatment outcomes but effectiveness is difficult to ascertain due to study design limitations. TB treatment success and TB mortality might be more informative indicators for TB/HIV activities. TB/HIV outputs seemed unrelated to greater integration when compared across sites. This was probably due to existing barriers to integration including missed opportunities, provider fear of loss of influence, financial burden of illness, and stigma. Patient-provider interactions offered privacy and counselling but patients’ illness experiences were not explored, and there was lack of decision-sharing. Patients were also unaware of their right to dignity and respect, or their role in disease management. Facilitators of integration included direct supervision, mutual adjustment and standardisation.
Recommendations include conducting more rigorous evaluation studies, including TB mortality in TB/HIV monitoring, prioritising health system strengthening instead of increasing degrees of integration, and improving patient-centred care through provider communication and patient empowerment
The Impact of Antiretroviral Therapy on Mortality in HIV Positive People during Tuberculosis Treatment: A Systematic Review and Meta-Analysis
Get PDFObjective: To quantify the impact of antiretroviral therapy (ART) on mortality in HIV-positive people during tuberculosis (TB) treatment. Design: We conducted a systematic literature review and meta-analysis. Studies published from 1996 through February 15, 2013, were identified by searching electronic resources (Pubmed and Embase) and conference books, manual searches of references, and expert consultation. Pooled estimates for the outcome of interest were acquired using random effects meta-analysis. Subjects The study population included individuals receiving ART before or during TB treatment. Main Outcome Measures: Main outcome measures were: (i) TB-case fatality ratio (CFR), defined as the proportion of individuals dying during TB treatment and, if mortality in HIV-positive people not on ART was also reported, (ii) the relative risk of death during TB treatment by ART status. Results: Twenty-one studies were included in the systematic review. Random effects pooled meta-analysis estimated the CFR between 8% and 14% (pooled estimate 11%). Among HIV-positive TB cases, those receiving ART had a reduction in mortality during TB treatment of between 44% and 71% (RR = 0.42, 95%CI: 0.29–0.56). Conclusion: Starting ART before or during TB therapy reduces the risk of death during TB treatment by around three-fifths in clinical settings. National programmes should continue to expand coverage of ART for HIV positive in order to control the dual epidemic.Version of Recor
