The Third Sector in Tanzania: Learning More About Civil Society Organisations, Their Capabilities and Challenges

This is a book about the state of civil society in Tanzania based on rigorous field work in 2001, and updated to 2007

The Prevalence of Asymptomatic Bacteriuria and Associated Factors among Women Attending Antenatal Clinics in Lower Mulago Hospital, Uganda

Asymptomatic bacteriuria (ASB) complicates 2-14% of pregnancies. If not treated in pregnancy it may progress to symptomatic urinary tract infection in 25 % of the cases. Some of the complications of untreated ASB in pregnancy include maternal anaemia, pregnancy and premature rupture of membranes.  In the fetus it may cause abortion, and premature labour. Our objective was to determine the prevalence of asymptomatic bacteriuria in pregnancy and associated factors.  This cross sectional study was carried out in lower Mulago hospital antenatal clinic. We consecutively recruited 385 women with no symptoms of urinary tract infection. The outcome of interest was asymptomatic bacteriuria. A questionnaire was used to record clients’ data. Urine specimens were taken for culture and sensitivity. The prevalence of asymptomatic bacteria was determined. Bivariate analysis was done to find the association between asymptomatic bacteriuria, with maternal risk factors. Four hundred and eight (408) pregnant women were enrolled in the study. The prevalence of ASB+ was found to be 12.2%.The factors associated with asymptomatic bacteriuria were maternal age ≥35 years, OR 2.84, 95 % CI ( 1.2-6.4), Gravidity≥5, OR 2.2, 95%CI  (1.1-4.4), history of UTI, OR 2.6, 95 % CI (1.3-5.1). The prevalence of asymptomatic bacteriuria among women attending antenatal clinic in lower Mulago hospital is high.  Screening for asymptomatic bacteriuria should be done for all women attending lower Mulago hospital antenatal clinic with particular emphasis in all women of the age of  ³ 35 years, multiparous women and those with history of urinary tract infection.

Maternal and umbilical cord blood lactate for predicting perinatal death: a secondary analysis of data from a randomized controlled trial.

BackgroundIn high resource settings, lactate and pH levels measured from fetal scalp and umbilical cord blood are widely used as predictors of perinatal mortality. However, the same is not true in low resource settings, where much of perinatal mortality occurs. The scalability of this practice has been hindered by difficulty in collecting fetal scalp and umbilical blood sample. Little is known about the use of alternatives such as maternal blood, which is easier and safer to obtain. Therefore, we aimed to compare maternal and umbilical cord blood lactate levels for predicting perinatal deaths.MethodsThis was secondary analysis of data from a randomized controlled trial assessing the effect of sodium bicarbonate on maternal and perinatal outcomes among women with obstructed labour at Mbale regional referral hospital in Eastern Uganda. Lactate concentration in maternal capillary, myometrial, umbilical venous and arterial blood was measured at the bedside using a lactate Pro 2 device (Akray, Japan Shiga) upon diagnosis of obstructed labour. We constructed Receiver Operating Characteristic curves to compare the predictive ability of maternal and umbilical cord lactate and the optimal cutoffs calculated basing on the maximal Youden and Liu indices.ResultsPerinatal mortality risk was: 102.2 deaths per 1,000 live births: 95% CI (78.1-130.6). The areas under the ROC curves were 0.86 for umbilical arterial lactate, 0.71 for umbilical venous lactate, and 0.65 for myometrial lactate, 0.59 for maternal lactate baseline, and 0.65 at1hr after administration of bicarbonate. The optimal cutoffs for predicting perinatal death were 15 0.85 mmol/L for umbilical arterial lactate, 10.15mmol/L for umbilical venous lactate, 8.75mmol/L for myometrial lactate, and 3.95mmol/L for maternal lactate at recruitment and 7.35mmol/L after 1 h.ConclusionMaternal lactate was a poor predictor of perinatal death, but umbilical artery lactate has a high predictive value. There is need for future studies on the utility of amniotic fluid in predicting intrapartum perinatal deaths

Civil Society in Tanzania

There has been a tremendous growth in non-governmental organisations in Tanzania over the last decades, and with the many reforms presently taking place, the civil society is expected to play a central role in both service delivery and the development of democracy. This report provides an overview of the complex civic sector in Tanzania and the dynamics within it. The study focuses on non-governmental organisations (NGOs) with a special emphasis on advocacy organisations and organisations active in social service delivery (district development trusts and religious organisations). While the former are donor depended, the latter are able to mobilise local resources. Both NGO and CBO activities are concentrated in the areas that were privileged already in the colonial times. As the local government reform may increase regional and religious differences, donors are adviced to pay increased attention to these issues when supporting local organisations. The main challenge in further support to civil society in Tanzania is to enhance popular participation and to support processes which mobilises local resources. The report suggests that mass media and popular culture should be used to disseminate both the new sectoral policies and reforms as well as awareness programmes that may engender increased popular participation in the development process

Civil Society in Tanzania

There has been a tremendous growth in non-governmental organisations in Tanzania over the last decades, and with the many reforms presently taking place, the civil society is expected to play a central role in both service delivery and the development of democracy. This report provides an overview of the complex civic sector in Tanzania and the dynamics within it. The study focuses on non-governmental organisations (NGOs) with a special emphasis on advocacy organisations and organisations active in social service delivery (district development trusts and religious organisations). While the former are donor depended, the latter are able to mobilise local resources. Both NGO and CBO activities are concentrated in the areas that were privileged already in the colonial times. As the local government reform may increase regional and religious differences, donors are adviced to pay increased attention to these issues when supporting local organisations. The main challenge in further support to civil society in Tanzania is to enhance popular participation and to support processes which mobilises local resources. The report suggests that mass media and popular culture should be used to disseminate both the new sectoral policies and reforms as well as awareness programmes that may engender increased popular participation in the development process

The new local level politics in East Africa : studies on Uganda, Tanzania and Kenya

This research report consists of three studies: Per Tidemand's Ugandan study concentrates on the politics of the new representative local state institutions which emerged in 1986. Andrew Kiondo's Tanzania study focuses on the myriad of local-level non-state institutions which have emerged there in recent years. Karuti Kanyinga examines the phenomenen of local-level competitive party politic in Kenya. His essay also analyses the interactions between local-level and national party politics