219 research outputs found
Promoting community based initiatives for vulnerable and disadvantaged children Mererani Ward, Simanjiro-Manyara
No full textChild labor is one of the main problems in small-scale Tanzanite mining in Mererani, Simanjiro district Manyara region. Mererani is one of the fast growing areas in this industry. Mirerani Good Hope Programme for children and young people (MGHP) is a local and community based organization established as a community response to the problem.
This project "promoting community based initiatives for vulnerable and disadvantaged children" was a project under M.G.H.P. Its main objective was to contribute towards MGHP's mission of reduction of child labor in Mererani Ward through awareness raising by 20% by the end of the year 2006.
This project covered four villages near the mining area. Its main goal was to have a community which cares the rights of children hence improving their living standard within the ward. The expected impact indicators were improved school enrolment which was poor, reduced incidences of child labor, and reduced school drop out which was 30 to 40 percent. However the study recommended among other things that in order to achieve national target of eliminating child labor through time bound programmes by the year 2010, MGHP should utilize effectively knowledge acquired by trained members to work towards this objectives. The expected output which was 430 children to be recruited was not yet met. It was only 184 out of that which is 42.79%. Reasons being the shorter life span of the project, however more outcomes were expected as stated in the sustainability plan of this project and the summative evaluation done at the end of this project. (Author abstract)Urassa, E. J. (2007). Promoting community based initiatives for vulnerable and disadvantaged children Mererani Ward, Simanjiro-Manyara. Retrieved from http://academicarchive.snhu.eduMaster of Science (M.S.)School of Community Economic Developmen
Rescue children who are on the street : case study of Amani Children Home at Moshi Municipality
No full textThe number of street children is increasing on the street as well as on the children centers in Moshi municipality from day to day.
The purpose of this project is to explored why the number of street children is increasing in Moshi, what might be the root cause of the problem and what kind of intervention required in addressing the problem from community level.
This project examined Moshi response to the growing problem of street children taking Amani Children Centre as a case study and explored the kind of intervention which is in place and contribution of various stakeholders to address the problem of street children. Also aimed to explore the kind of policies and strategies that are in place in the community to mitigate the problem, how Tanzania is dealing with the increasing number of street children, how community structures could be empower, to play their roles in care and protection of vulnerable children. The roles of Non Governmental Organisations (NGOs) in addressing the problem. Which measures have being in place so far by African countries to deal with the problem.
The study was conducted at Amani Children Home as starting point to explore different information and views from street children t, Community Organisation staff, management and other stakeholders about the problem.
The methods used to explore the information from different sources were survey,. Report reviews/documentary which were obtained at the children centers, Focus Group Discussion, Transect walk, Observation method which took the author to the streets and observes the group of children.The findings of the Community Needs Assessment shows that the root cause of the problem is existing poverty among the families, lack of adequate education on children rights, death of parents as result of HIV/AIDS and other death cause, separation of parent and children behavior influenced by peer groups. (Author abstract)Urassa, N. A. (2007). Rescue children who are on the street: case study of Amani Children Home at Moshi Municipality. Retrieved from http://academicarchive.snhu.eduMaster of Science (M.S.)School of Community Economic Developmen
Barriers to sustaining antiretroviral treatment in Kisesa, Tanzania: a follow-up study to understand attrition from the antiretroviral program.
Get PDFTwo years after the introduction of free antiretroviral therapy (ART) in Tanzania and in spite of the logistical support provided to facilitate clinic attendance, a considerable level of attrition from the program was identified among clients from a semi-rural ward. Qualitative research on ART patients' health-seeking behavior identified factors affecting sustained attendance at treatment clinics. A mix of methods was used for data collection including semi-structured interviews with 42 clients and 11 service providers and 4 participatory group activities conducted with members of a post-test group between October and December 2006. A socio-ecological framework guided data analysis to categorize facilitators and barriers into individual, social, programmatic, and structural level influences, and subsequently explored their interaction and relative significance in shaping ART clients' behavior. Our findings suggest that personal motivation and self-efficacy contribute to program retention, and are affected by other individual-level experiences such as perceived health benefits or disease severity. However, these determinants are influenced by others' opinions and beliefs in the community, and constrained by programmatic and structural barriers. Individuals can develop the requisite willingness to sustain strict treatment requirements in a challenging context, but are more likely to do so within supportive family and community environments. Effectiveness and sustainability of ART roll-out could be strengthened by strategic intervention at different levels, with particular attention to community-level factors such as social networks' influence and support
The trade-off between accuracy and accessibility of syphilis screening assays.
Get PDFThe availability of rapid and sensitive methods to diagnose syphilis facilitates screening of pregnant women, which is one of the most cost-effective health interventions available. We have evaluated two screening methods in Tanzania: an enzyme immunoassay (EIA), and a point-of-care test (POCT). We evaluated the performance of each test against the Treponema pallidum particle agglutination assay (TPPA) as the reference method, and the accessibility of testing in a rural district of Tanzania. The POCT was performed in the clinic on whole blood, while the other assays were performed on plasma in the laboratory. Samples were also tested by the rapid plasma Reagin (RPR) test. With TPPA as reference assay, the sensitivity and specificity of EIA were 95.3% and 97.8%, and of the POCT were 59.6% and 99.4% respectively. The sensitivity of the POCT and EIA for active syphilis cases (TPPA positive and RPR titer ≥ 1/8) were 82% and 100% respectively. Only 15% of antenatal clinic attenders in this district visited a health facility with a laboratory capable of performing the EIA. Although it is less sensitive than EIA, its greater accessibility, and the fact that treatment can be given on the same day, means that the use of POCT would result in a higher proportion of women with syphilis receiving treatment than with the EIA in this district of Tanzania
The effect of antiretroviral therapy provision on all-cause, AIDS and non-AIDS mortality at the population level--a comparative analysis of data from four settings in Southern and East Africa.
Get PDFOBJECTIVE: To provide a broad and up-to-date picture of the effect of antiretroviral therapy (ART) provision on population-level mortality in Southern and East Africa. METHODS: Data on all-cause, AIDS and non-AIDS mortality among 15-59 year olds were analysed from demographic surveillance sites (DSS) in Karonga (Malawi), Kisesa (Tanzania), Masaka (Uganda) and the Africa Centre (South Africa), using Poisson regression. Trends over time from up to 5 years prior to ART roll-out, to 4-6 years afterwards, are presented, overall and by age and sex. For Masaka and Kisesa, trends are analysed separately for HIV-negative and HIV-positive individuals. For Karonga and the Africa Centre, trends in AIDS and non-AIDS mortality are analysed using verbal autopsy data. RESULTS: For all-cause mortality, overall rate ratios (RRs) comparing the period 2-6 years following ART roll-out with the pre-ART period were 0.58 (5.9 vs. 10.2 deaths per 1000 person-years) in Karonga, 0.79 (7.2 vs. 9.1 deaths per 1000 person-years) in Kisesa, 0.61 (6.7 compared with 11.0 deaths per 1000 person-years) in Masaka and 0.79 (14.8 compared with 18.6 deaths per 1000 person-years) in the Africa Centre DSS. The mortality decline was seen only in HIV-positive individuals/AIDS mortality, with no decline in HIV-negative individuals/non-AIDS mortality. Less difference was seen in Kisesa where ART uptake was lower. CONCLUSIONS: Falls in all-cause mortality are consistent with ART uptake. The largest falls occurred where ART provision has been decentralised or available locally, suggesting that this is important
Quality of Antenatal Care in Rural Tanzania: Counselling on Pregnancy Danger Signs.
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The high rate of antenatal care attendance in sub-Saharan Africa, should facilitate provision of information on signs of potential pregnancy complications. The aim of this study was to assess quality of antenatal care with respect to providers' counselling of pregnancy danger signs in Rufiji district, Tanzania. A cross-sectional study was conducted in 18 primary health facilities. Thirty two providers were observed providing antenatal care to 438 pregnant women. Information on counselling on pregnancy danger signs was collected by an observer. Exit interviews were conducted to 435 women. One hundred and eighty five (42%) clients were not informed of any pregnancy danger signs. The most common pregnancy danger sign informed on was vaginal bleeding 50% followed by severe headache/blurred vision 45%. Nurse auxiliaries were three times more likely to inform a client of a danger sign than registered/enrolled nurses (OR = 3.7; 95% CI: 2.1-6.5) and Maternal Child Health Aides (OR = 2.3: 95% CI: 1.3-4.3) and public health nurses (OR = 2.5; CI: 1.4-4.2) were two times more likely to provide information on danger signs than registered/enrolled nurses. The clients recalled less than half of the pregnancy danger signs they had been informed during the interaction. Two out of five clients were not counselled on pregnancy danger signs. The higher trained cadre, registered/enrolled nurses were not informing majority of clients pregnancy danger signs compared to the lower cadres. Supportive supervision should be made to enhance counselling of pregnancy danger signs. Nurse auxiliaries should be encouraged and given chance for further training and upgrading to improve their performance and increase human resource for health.\u
Rural Tanzanian women's awareness of danger signs of obstetric complications.
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Awareness of the danger signs of obstetric complications is the essential first step in accepting appropriate and timely referral to obstetric and newborn care. The objectives of this study were to assess women's awareness of danger signs of obstetric complications and to identify associated factors in a rural district in Tanzania. A total of 1118 women who had been pregnant in the past two years were interviewed. A list of medically recognized potentially life threatening obstetric signs was obtained from the responses given. Chi-square test was used to determine associations between categorical variables and multivariate logistic regression analysis was used to identify factors associated with awareness of obstetric danger signs. More than 98% of the women attended antenatal care at least once. Half of the women knew at least one obstetric danger sign. The percentage of women who knew at least one danger sign during pregnancy was 26%, during delivery 23% and after delivery 40%. Few women knew three or more danger signs. According to multivariate logistic regression analysis having secondary education or more increased the likelihood of awareness of obstetric danger signs six-fold (OR = 5.8; 95% CI: 1.8-19) in comparison with no education at all. The likelihood to have more awareness increased significantly by increasing age of the mother, number of deliveries, number of antenatal visits, whether the delivery took place at a health institution and whether the mother was informed of having a risks/complications during antenatal care. Women had low awareness of danger signs of obstetric complications. We recommend the following in order to increase awareness of danger signs of obstetrical complications: to improve quality of counseling and involving other family members in antenatal and postnatal care, to use radio messages and educational sessions targeting the whole community and to intensify provision of formal education as emphasized in the second millennium development goal.\u
Using audit to enhance quality of maternity care in resource limited countries: lessons learnt from rural Africa.
Get PDFAlthough clinical audit is an important instrument for quality care improvement, the concept has not yet been adequately taken on board in rural settings in most resource limited countries where the problem of maternal mortality is immense. Maternal mortality and morbidity audit was established at Saint Francis Designated District Hospital (SFDDH) in rural Tanzania in order to generate information upon which to base interventions. Methods are informed by the principles of operations research. An audit system was established, all patients fulfilling the inclusion criteria for maternal mortality and severe morbidity were reviewed and selected cases were audited from October 2008 to July 2010. The causes and underlying factors were identified and strategic action plans for improvement were developed and implemented. There were 6572 deliveries and 363 severe maternal morbidities of which 36 women died making institutional case fatality rate of 10%. Of all morbidities 341 (94%) had at least one area of substandard care. Patients, health workers and administration related substandard care factors were identified in 50% - 61% of women with severe morbidities. Improving responsiveness to obstetric emergencies, capacity building of the workforce for health care, referral system improvement and upgrading of health centres located in hard to reach areas to provide comprehensive emergency obstetric care (CEmOC) were proposed and implemented as a result of audit. Our findings indicate that audit can be implemented in rural resource limited settings and suggest that the vast majority of maternal mortalities and severe morbidities can be averted even where resources are limited if strategic interventions are implemented
Quality Aspects of Maternal Health Care in Tanzania
No full textThis thesis assesses some indicators of quality for maternity care in Tanzania, using antenatal management of anaemia and hypertension and emergency obstetric care as focal points. The care of pregnant women consecutively enrolled in antenatal care (n=379) was observed and compared with quality standard criteria. From a tertiary level labour ward 741 cases of eclampsia were identified and their antenatal care analyzed. A health systems analysis was performed for 205 cases of pregnancy complications at district level. There was inadequate equipment and drugs, inadequate staff knowledge and motivation, and incorrect measurements for investigating anaemia and hypertension in pregnancy. Hospital incidence of eclampsia at tertiary level was 200/10,000 live births, and was not modified by antenatal care. The quality observed in the antenatal programme indicated little impact on either anaemia or hypertensive complications. Compliance with obstetric referral was only 46% and all four observed maternal deaths occurred due to transport problems. The proposed process indicators for essential obstetric care were inadequate to assess the quality of care on a district level. There is a need to address structural weaknesses, to motivate health workers and to improve training on quality improvement. More research is warranted on indicators for obstetric needs, accessibility and referral system
Integration of Community Health Workers into a Formal Health System of Tanzania- Measuring satisfaction on the Training program using Kirk Patrick Model
No full textThis study aimed at assessing the satisfaction of Community Health Worker CHW -students with the training programme from Kahama and Shirati Health Institutes It employed Kirkpatrick s Model- focusing on Level 1 and a cross- sectional design The study sampled a total of 153 Community Health CHWs by Simple Random Sampling and a total of 14 tutors from Kahama and Shirati Health Institutes by purposively sampling Data were collected using i CHW survey-using questionnaire-Kirkpatrick tool ii Focus Group Discussion FGD - for the tutors Quantitative data were processed edited and descriptively analyzed using SPSS version 20 The Likert scale 1-5 was used for the computation of weighted scores The majority 66 weighted score 4 5 were strongly satisfied with the course content Call for curriculum review should go hand in hand with putting in place on job training programmes for tutors to enhance their teaching methodology skill
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