Experiences, Opportunities and Challenges of Implementing Task Shifting in Underserved Remote Settings: The Case of Kongwa District, Central Tanzania.

Tanzania is experiencing acute shortages of Health Workers (HWs), a situation which has forced health managers, especially in the underserved districts, to hastily cope with health workers' shortages by adopting task shifting. This has however been due to limited options for dealing with the crisis of health personnel. There are on-going discussions in the country on whether to scale up task shifting as one of the strategies for addressing health personnel crisis. However, these discussions are not backed up by rigorous scientific evidence. The aim of this paper is two-fold. Firstly, to describe the current situation of implementing task shifting in the context of acute shortages of health workers and, secondly, to provide a descriptive account of the potential opportunities or benefits and the likely challenges which might ensue as a result of implementing task shifting. We employed in-depth interviews with informants at the district level and supplemented the information with additional interviews with informants at the national level. Interviews focussed on the informants' practical experiences of implementing task shifting in their respective health facilities (district level) and their opinions regarding opportunities and challenges which might be associated with implementation of task shifting practices. At the national level, the main focus was on policy issues related to management of health personnel in the context of implementation of task shifting, in addition to seeking their opinions and perceptions regarding opportunities and challenges of implementing task shifting if formally adopted. Task shifting has been in practice for many years in Tanzania and has been perceived as an inevitable coping mechanism due to limited options for addressing health personnel shortages in the country. Majority of informants had the concern that quality of services is likely to be affected if appropriate policy infrastructures are not in place before formalising tasks shifting. There was also a perception that implementation of task shifting has ensured access to services especially in underserved remote areas. Professional discontent and challenges related to the management of health personnel policies were also perceived as important issues to consider when implementing task shifting practices. Additional resources for additional training and supervisory tasks were also considered important in the implementation of task shifting in order to make it deliver much the same way as it is for conventional modalities of delivering care. Task shifting implementation occurs as an ad hoc coping mechanism to the existing shortages of health workers in many undeserved areas of the country, not just in the study site whose findings are reported in this paper. It is recommended that the most important thing to do now is not to determine whether task shifting is possible or effective but to define the limits of task shifting so as to reach a consensus on where it can have the strongest and most sustainable impact in the delivery of quality health services. Any action towards this end needs to be evidence-based

Design drivers for affordable and sustainable housing in developing countries

Current demand for housing worldwide has reached unprecedented levels due to factors such as human population growth, natural disasters and conflict. This is felt no more so than in developing countries which have experienced disproportionate levels of demand due to their innate vulnerability. Many current approaches to housing delivery in developing countries continue to utilize inappropriate construction methods and implementation procedures that are often problematic and unsustainable. As such affordability and sustainability are now vital considerations in the international development debate for housing the poor in developing countries in order to meet the long term sustainable development goals and needs of housing inhabitants. This paper utilized an extensive scoping study to examine the various facets impacting on design decision making relative to sustainable and affordable housing delivery in developing country contexts. Aspects of affordability, sustainability, design decision making, appropriate technology use, cultural awareness, as well as current barriers to affordable and sustainable construction in developing countries are examined in detail. Results highlighted the capability of indigenous knowledge, skills and materials as well as selected appropriate technology transfer and cultural awareness by foreign bodies can be utilized in innovative ways in addressing current housing needs in many developing country contexts

The Africa Center for Biostatistical Excellence: a proposal for enhancing biostatistics capacity for sub-Saharan Africa

Sub-Saharan Africa has a shortage of well-trained biomedical research methodologists, in particular, biostatisticians. In July 2014, a group of biostatisticians and researchers from the region attended a brainstorming workshop to identify ways in which to reduce the deficit in this critical skill. The workshop recognized that recommendations from previous workshops on building biostatistics capacity in sub-Saharan Africa had not been implemented. The discussions culminated with a proposal to setup an Africa Center for Biostatistical Excellence, a collaborative effort across academic and researcher institutions within the region, as a vehicle for promoting biostatistics capacity building through specialized academic masters programs as well as regular workshops targeting researchers

Challenges of being a researcher in Africa: A narrative synthesis of literature

Background: The importance of research in the development agenda of Africa has received better recognition in recent years, with an increasing number of publications by African researchers. However, the number and quality of the research outputs are not on a par with the health problems and population size of the continent. This review was carried out with the aim of identifying the challenges researchers face in Africa. Materials and Methods: We conducted a narrative synthesis of the available literature. We searched for relevant articles on PubMed, Hinari and Google Scholar databases. We searched for additional articles from the reference lists of studies identified through the search. The date of the last search was 05 April 2018. We thematically synthesized the results in terms of individual, institutional and policy challenges. Results: We retrieved 610 articles, of which 12 were eligible for inclusion. Limited institutional research capacity, including a shortage of local funds, shortage of skilled researchers and weak infrastructure, were the prevailing challenges. A lack of technical capacity in scientific writing, including lack of English language writing skills, were the common individual-level challenges. A further finding was that research evidence generated in Africa was not generally used to inform the policy-making process. Conclusions: The challenge for researchers in Africa is primarily the weak capacity of research institutes that are not well equipped to produce the next generation of researchers. Efforts should be made to strengthen their capacity to improve the production of skilled scientists and visibility of research work in Africa. Ethiop. J. Health Dev. 2019; 33(4):229-238] Key words: Scientist, research, researcher, challenge, Africa, narrative, systematic revie

Trends in South African child welfare from 2001-2010.

Child welfare potentially plays a key role in South Africa. While families suffered intensely under the apartheid regime, the burden on children, their caregivers and their communities seems to have increased despite the advent of democracy. Various local and global factors have resulted in an increase in poverty and a greater income divide. Increasing numbers of people have left the rural areas for opportunities in the cities. HIV and AIDs have ravished the social structures around children. Many children have lost one or both parents and require alternative care arrangements. The violence of the past has been inherited and seems to have become ingrained in social life. Identifying and implementing meaningful responses remains an ongoing challenge

The things (we think) we (ought to) do: Ideological processes and practices in teaching

A

Exploring potential impacts of hydraulic fracturing (fracking) on groundwater contamination in the Karoo: perspectives on institutional capabilities in water management in South Africa

A dissertation submitted in fulfilment of the requirements for the degree of Master of Environmental Science. with Witwatersrand University, Johannesburg, South Africa, (School of Geography, Archaeological and Environmental Science within the Faculty of Science) 2nd June 2017.Hydraulic fracturing in the Karoo is said to be a game changer of energy sector in South Africa, but it is said to pose potential groundwater contamination. Therefore the aim of the study was to investigate the extent to which current institutional set up in South Africa can deal and address potential environmental challenges that are associated to fracking. The study was particularly interested in investigating the institutional capabilities in the context of water management. The literature review of this study showed that water resource is a major environmental concern that revolves around hydraulic fracturing, including the water resources use and potential contamination. In addition, it should be considered that hydraulic fracturing is a new mining process in South Africa and Africa as a whole with controversial mining techniques and environmental impacts involved within this process. The review indicates that the biggest issue with proposed hydraulic fracking mining process in the Karoo is if the South African Government has taken into consideration the resources, infrastructures and skills to execute the process successfully. The literature asserts that even if proper enforcement of any regulations on this rapidly expanding industry will still be difficult as the regulation is insufficient due to certain explicit exemptions. In South Africa, the starting point for hydraulic fracturing and the associated regulations that governs fracking, is the recognition of an argument that South Africa does not possess any fracking specific laws, guidelines or even polices. Research participants were asked to give their views on the research topic by answering the semi structured interview questions. Data from the semi-structured interviews and literature review was analysed and discussed to address the research questions. The results of the investigation confirmed that there was no any legislation in place to govern this mining process in South Africa. Currently there are legislations which are under review and development to also address hydraulic fracking and the protection of water resources. The government should also involve other research institutes in the drafting and decision making of the legal institute governing hydraulic fracking to ensure that all gaps are identified before fracking can be permitted in the Karoo.MT 201

Can Economic Empowerment Reduce Vulnerability of Girls and Young Women to HIV?

In April 2010, the International Center for Research on Women (ICRW), with support from the Nike Foundation, convened an expert meeting of researchers, program implementers, policymakers and donors to explore emerging insights into the linkages between economic empowerment and HIV outcomes for girls and young women. This report synthesizes the key insights, questions, challenges and recommendations that emerged from the meeting. It addresses two key questions:What are the links between economic status and HIV vulnerability of girls and young women?What is the role of economic empowerment in preventing and mitigating HIV among girls and young women?The report also summarizes general principles that should apply to programs and policies aiming to address the vulnerability of girls in a context of poverty and HIV