9 research outputs found
Factors Affecting Sustainability of Donor Funded Programs: A Case Study of the Newborn Resuscitation Program in Dar es Salaam Region
Get PDFThe purpose of this study was to determine the factors affecting sustainability of projects that are funded by donors with a case study of Dar es Salaam region. The study was conducted in the three districts of Dar es salaam; Ilala, Kinondoni and Temeke where 195 health care providers were contacted as respondents by using a purposive sampling. The study used in-depth interviews, focused group discussion and standard questionnaires to collect data. Descriptive data analysis was found in SPSS (Statistical Package for social Sciences (SPSS) and Microsoft Access was used for data storage. The study findings have revealed that program design and management have a direct relationship with sustainability of donor funded projects. The study found that if the project was designed to accommodate sustainability component from the beginning there is a higher chance of the project to be able continue with implementation beyond the donor funding period. Management of the project was seemed to have an effect towards sustainability of the project. In this study the project was partly managed by the Ministry of health who are the key pillars to continuity of the program. Results are also showing that for a project to easily sustain, there is importance of the project to really fit to the existing settings. There is a high chance for a project to sustain its implementation if the activities are part of the national health care setting big picture for instance in clinical practices and national health reporting system. Failure of this may hinder sustainability of the donor funded project. In order for donor funded projects to sustain beyond funding discontinue, organizations running the projects should ensure that the local and central authorities are part and parcel of the project implementation. It is important for the project to advocate for the government to start budgeting for activities that have been funded by donors
Fig 2 -
No full textPictorial representation of typical local house types in the study area: (a) a house with grass thatch roofing with mud walls; (b) a house with corrugated iron roof and brick walls; (c) grass thatch roof with brick walls; and (d) a house with iron sheet roofing and plastered brick walls. Photos by the author.</p
Implementation of "Helping Babies Breathe": A Three-Year Experience in Tanzania
Get PDFOBJECTIVES: This first-ever country-level study assesses the implementation of the Helping Babies Breathe (HBB) program in 15 of Tanzania’s mainland regions by measuring coverage, adoption and retention of provider skills, acceptability among providers, and barriers and challenges to at-scale implementation.
METHODS: Longitudinal facility-level follow-up visits assessed provider resuscitation knowledge and skills in using objective structured clinical examinations and readiness of facilities to resuscitate newborns, in terms of birth attendants trained and essential equipment available and functional. Focus group discussions were held with providers to determine the acceptability, challenges, and barriers to implementation of the HBB program.
RESULTS: Immediately after HBB training, 87.1% of providers passed the objective structured clinical examination. This number dropped to 79.4% at 4 to 6 weeks and 55.8% at 4 to 6months (P 90% of facilities had bag-mask devices available to all beds in the labor and delivery ward, and 96% were functional. Overall, providers were highly satisfied with the HBB program but thought that the 1-day training used in Tanzania was too short, so they would welcome additional training and follow-up visits to reinforce skills.
CONCLUSIONS: The HBB program in Tanzania has gained acceptability and shown success in equipping providers with neonatal resuscitation knowledge, skills, and supplies. However, assessing the program’s impact on neonatal mortality has proven challenging
Structured on-the-job training to improve retention of newborn resuscitation skills: a national cohort Helping Babies Breathe study in Tanzania
Get PDFBackgroundNewborn resuscitation is a life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Improving provider newborn resuscitation skills is critical for delivering quality care, but the retention of these skills has been a challenge. Tanzania implemented a national newborn resuscitation using the Helping Babies Breathe (HBB) training program to help address this problem. Our objective was to evaluate the effectiveness of two training approaches to newborn resuscitation skills retention implemented across 16 regions of Tanzania.MethodsAn initial training approach implemented included verbal instructions for participating providers to replicate the training back at their service delivery site to others who were not trained. After a noted drop in skills, the program developed structured on-the-job training guidance and included this in the training. The approaches were implemented sequentially in 8 regions each with nurses/ midwives, other clinicians and medical attendants who had not received HBB training before. Newborn resuscitation skills were assessed immediately after training and 4-6weeks after training using a validated objective structured clinical examination, and retention, measured through degree of skills drop, was compared between the two training approaches.ResultsEight thousand, three hundred and ninety-one providers were trained and assessed: 3592 underwent the initial training approach and 4799 underwent the modified approach. Immediately post-training, average skills scores were similar between initial and modified training groups: 80.5 and 81.3%, respectively (p-value 0.07). Both groups experienced statistically significant drops in newborn resuscitation skills over time. However, the modified training approach was associated with significantly higher skills scores 4-6weeks post training: 77.6% among the modified training approach versus 70.7% among the initial training approach (p-valu
Cost analysis of large-scale implementation of the ‘Helping Babies Breathe’ newborn resuscitation-training program in Tanzania
Get PDFBackground: Helping Babies Breathe (HBB) has become the gold standard globally for training birth-attendants in neonatal resuscitation in low-resource settings in efforts to reduce early newborn asphyxia and mortality. The purpose of this study was to do a first-ever activity-based cost-analysis of at-scale HBB program implementation and initial follow-up in a large region of Tanzania and evaluate costs of national scale-up as one component of a multi-method external evaluation of the implementation of HBB at scale in Tanzania. Methods: We used activity-based costing to examine budget expense data during the two-month implementation and follow-up of HBB in one of the target regions. Activity-cost centers included administrative, initial training (including resuscitation equipment), and follow-up training expenses. Sensitivity analysis was utilized to project cost scenarios incurred to achieve countrywide expansion of the program across all mainland regions of Tanzania and to model costs of program maintenance over one and five years following initiation. Results: Total costs for the Mbeya Region were 4,000,000 (around 2,934,793 to 2,019,115 for a further one year and $5,640,794 for a further five years of ongoing program support. Conclusion: HBB implementation is a relatively low-cost intervention with potential for high impact on perinatal mortality in resource-poor settings. It is shown here that nationwide expansion of this program across the range of health provision levels and regions of Tanzania would be feasible. This study provides policymakers and investors with the relevant cost-estimation for national rollout of this potentially neonatal life-saving intervention
Additional file 1: of Structured on-the-job training to improve retention of newborn resuscitation skills: a national cohort Helping Babies Breathe study in Tanzania
No full textBMC Pediatrics Supplementary File. Supplemental Material 1: On-the-job Training Tool. Description:On-the-job training tool to improve retention of Helping Babies Breathe skills. (PDF 283 kb
Volatile pyrethroid spatial repellents for preventing mosquito bites: a systematic review and meta-analysis.
Get PDFVolatile pyrethroid spatial repellents (VPSRs) can prevent mosquito-borne diseases including malaria and dengue fever, but the use of varied evaluation methods has resulted in a lack of clarity regarding their protective efficacy (PE) against contact with mosquitoes. This systematic review and meta-analysis consolidates the entomological evidence base on the PE of VPSRs against Anopheles, Aedes, and Culex mosquitoes and different test methods used. We identified studies completed between January 2000 and September 2023 by searching through databases, conference abstracts, and personal correspondences. Included studies were semi-field or field studies that measured the PE of VPSRs using human landing catch (HLC) of mosquito landings on human legs and/or mosquito trap density, the number of mosquitoes captured using traps per set time period, compared to control groups. The systematic review summarised study-level data using a generalised linear mixed model with random effects. The meta-analysis pooled individual mosquito-level data and weather data on temperature, humidity, and wind from satellites, analysing PE subgrouped by product format, active ingredient, mosquito capture method used, mosquito species, and indoor vs outdoor setting. Risk of bias was assessed using a SYRCLE tool adapted for mosquito studies. Additional studies published from October 2023 to July 2025 were summarised. PROSPERO registration: CRD42021268852. 58 eligible publications showed that VPSRs provided an average of 56% (95% CI 50, 62%) PE from mosquito bites. Meta-analysis of individual mosquito-level data from 50 (86%) of eligible studies involving 1,703,120 mosquitoes showed that PE was highest when measured using HLC, with similar results seen in semi-field (58%, 95% CI 54, 62%) and field studies (50%, 95% CI 40, 59%). Differences between indoor (54%, 95% CI 18, 68%) and outdoor settings (56%, 95% CI 51, 60%) were unclear. Species-level differences were observed with low PE seen in Anopheles funestus (31%, 95% CI 19, 43%); the potential for cross-resistance to solid-state pyrethroids is unclear. Efficacy was not sensitive to combined weather effects. VPSRs offer protection from contact with mosquitoes, with semi-field studies reflecting field data and species-level differences observed. HLC provided the best quality data. Additional field studies that evaluate outdoor protection in malaria-endemic settings are needed, especially in West African, South American, and Southeast Asian settings. National Institutes of Health (National Institute of Allergy and Infectious Diseases (K01AI156182)) and "Accelerate to Eliminate Malaria" program. [Abstract copyright: Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.
Validation of a novel tool for assessing newborn resuscitation skills among birth attendants trained by the Helping Babies Breathe program.
No full textObjectives: To validate a simplified objective structured clinical examination (OSCE) tool for evaluating the competency of birth attendants in low-resource countries who have been trained in neonatal resuscitation by the Helping Babies Breathe (HBB) program.
Methods: A prospective cross-sectional study of the OSCE tool was conducted among trained birth attendants working at dispensaries, health centers, or hospitals in five regions of Tanzania between October 1, 2013, and May 1, 2014. A 13-item checklist was used to assess clinical competency in a simulated newborn resuscitation scenario. The OSCE tool was simultaneously administered by HBB trainers and experienced external evaluators. Paired results were compared using the Cohen κ value to measure inter-rater reliability. Participant performance was rated by health cadre, region, and facility type.
Results: Inter-rater reliability was moderate (κ = 0.41-0.60) or substantial (κ = 0.61-0.80) for eight of the OSCE items; agreement was fair (κ = 0.21-0.41) for the remaining five items. The best OSCE performances were recorded among nurses and providers from facilities with high annual birth volumes.
Conclusion: The simplified OSCE tool could facilitate efficient implementation of national-level HBB programs. Limitations in inter-rater reliability might be improved through additional training
Abstracts of Tanzania Health Summit 2020
Get PDFThis book contains the abstracts of the papers/posters presented at the Tanzania Health Summit 2020 (THS-2020) Organized by the Ministry of Health Community Development, Gender, Elderly and Children (MoHCDGEC); President Office Regional Administration and Local Government (PORALG); Ministry of Health, Social Welfare, Elderly, Gender, and Children Zanzibar; Association of Private Health Facilities in Tanzania (APHFTA); National Muslim Council of Tanzania (BAKWATA); Christian Social Services Commission (CSSC); & Tindwa Medical and Health Services (TMHS) held on 25–26 November 2020. The Tanzania Health Summit is the annual largest healthcare platform in Tanzania that attracts more than 1000 participants, national and international experts, from policymakers, health researchers, public health professionals, health insurers, medical doctors, nurses, pharmacists, private health investors, supply chain experts, and the civil society. During the three-day summit, stakeholders and decision-makers from every field in healthcare work together to find solutions to the country’s and regional health challenges and set the agenda for a healthier future.
Summit Title: Tanzania Health SummitSummit Acronym: THS-2020Summit Date: 25–26 November 2020Summit Location: St. Gasper Hotel and Conference Centre in Dodoma, TanzaniaSummit Organizers: Ministry of Health Community Development, Gender, Elderly and Children (MoHCDGEC); President Office Regional Administration and Local Government (PORALG); Ministry of Health, Social Welfare, Elderly, Gender and Children Zanzibar; Association of Private Health Facilities in Tanzania (APHFTA); National Muslim Council of Tanzania (BAKWATA); Christian Social Services Commission (CSSC); & Tindwa Medical and Health Services (TMHS)
