Implementation and Acceptability of Strategies Instituted for Engaging Men in Family Planning Services in Kibaha District, Tanzania.

Men as the main decision makers in most of African families have an important role to play towards acceptance of family planning methods. This study sought to identify strategies used to engage men in family planning services and determine the extent to which men in Kibaha district in Tanzania accept these interventions. We conducted a cross sectional study using both quantitative and qualitative techniques. We used a questionnaire to interview a random sample of 365 of currently married or cohabiting men who had at least one child under the age of five years. We further conducted in-depth interviews with health workers involved in delivering reproductive health services as well as community dispensers of family planning commodities. Descriptive analysis was used to determine the extent to which men were engaged in family planning services. The data from the indepth interviews were analysed manually according to the predetermined themes, guided by the grounded theory to identify the existing strategies used to encourage male involvement in family planning services. According to the key informants, strategies that are used to encourage men to engage in family planning services include invitations through their spouses, either verbally or by using partner notification cards, incorporating family planning messages during monthly meetings and community outreach reproductive health programs. Of 365 men responding to the questionnaire, only 31 (8.4%) said they were invited to accompany their spouses to family planning clinics. Among them, 71% (22/31) visited family planning clinics. A third (32%) of the respondents had heard of community health meetings and only 20.7% of them attended these meetings. More than a third (12/34) of men who attended these meeting asserted that family planning messages targeting men featured in the agenda and subsequently half of them visited health facilities for family planning services. Existing strategies such as invitations to clinics and community sensitization have shown to encourage men to engage in family planning services. However, these interventions reach few men and hence there is a need to rolling them up to improve uptake of family planning services

Utilisation of voluntary counselling and testing services among bar waitresses in Kinondoni District, Dar es Salaam, Tanzania

 Background: Tanzania is among sub-Saharan countries severely affected by the HIV and AIDS epidemic, with an increased burden among high-risk populations, such as bar waitresses. Voluntary counselling and testing (VCT) is among effective approaches to slow down the spread of HIV infection and minimize its impact. However, little information is available on the extent of utilisation of VCT services among bar waitresses. The study examined utilisation of VCT services and its influencing factors among bar waitresses in Kinondoni district, Dar es Salaam, Tanzania.Methods: We used an interview schedule to gather information on VCT utilisation from 378 bar waitresses, identified using a multi-stage sampling technique. Data were analysed using the Statistical Package for Social Science (Version 15.0). A p-value less than 0.05 was used as a cut-off value for availability of a statistical association between VCT utilisation and related independent factors. Logistic regression models were employed to assess independent correlates of VCT use.Results: The mean (standard deviation) age of the respondents was 26.1 (5.0) years. About 60% had never been married and about 70% had at least one child at the time of the survey. Majority of the bar waitresses (89.7%) affirmed to have ever utilized VCT services at some point in their lifetime. Despite the high level of knowledge on VCT (71.4%), the services were irregularly utilized with less than half (45.5%) of the respondents utilizing them within six months prior to the survey. Independent predictors for service utilisation included having a child, having higher knowledge on VCT, using a condom in the most recent sexual act as well as lack of fear of positive HIV results or stigmatization.Conclusions: Utilisation of VCT services is high among bar waitresses in Kinondoni district. However, the services are not utilised regularly as recommended for high-risk populations. Findings call for comprehensive strategies to enhance effective service utilisation and further studies based on a broader and more inclusive sample size.

“I eat two meals per day” impact of climate variability on eating habits among households in Rufiji district, Tanzania: a qualitative study

Background: Improved understanding of the influence of climate variability on eating habits is required to manage health outcomes that could be produced. Agriculture production is the main source of income to people in Rufiji district, where communities produce food for household and also for income. Effects of climate variability and weather extremes include occurrence of floods and prolonged dry seasons, which are recently reported to be very frequent in Africa continent, affecting food production. Prolonged dry seasons as well as frequent floods have been reported to destroy cultivated food crops in Rufiji district. However, there is little evidence on climate variability effects on household food security and their eating habits in Tanzania. Therefore, this study assessed the influence of climate variability impacts such as prolonged dry seasons and floods on the eating habits of Tanzanian rural households. Results: Study findings showed that respondents recognized changes in seasonal trends such as rainfall pattern and increase in temperature in the area. Drought and floods reduce food production and cause shortages in households. Low and poor harvest of food crops is the major contributing factor in their farms of rice and maize, the main staple food crops grown amidst prolonged dry seasons. They reported existence of household food shortage which was not there 10years ago. Participants developed adaptation mechanisms that included reducing food quantity, eating of new meals which were not eaten before as a main meal such as cooked unripe mangoes and stiff porridge. Household members decided to change eating habits as an adaptation strategy to the situation of food shortage. Some discussants acknowledged reducing number of meals, eating two meals a day instead of three or four as it was 10years ago. Conclusion: Climate variability has led to reduced amount of annual rainfall, thus affecting food productivity and consequently food shortages and changes in dietary habits among the people in Rufiji. Additional research is warranted to assess the impacts of climate variability on nutritional quality of meals

LEVELS OF KNOWLEDGE AND SOURCES OF INFORMATION ON SEXUALLY TRANSMITTED INFECTIONS AMONG SECONDARY SCHOOL YOUTH IN DAR ES SALAAM, TANZANIA

Objective: The main purpose of this study was to explore sources of information and levels of knowledge on sexually transmitted infections (STIs) among youth in secondary schools in Ilala district, Dar es Salaam. Methods: A cross sectional survey was undertaken among secondary school youth selected randomly from three public secondary schools. A self-administered questionnaire was used to gather information on socio-demographic characteristics, sexual activity, STIs-related knowledge and sources of information on STIs among the respondents. Results: A total of 312 youth aged 12-22 years participated, 54.3 percent being female. The large majority of the participants were aged 15-18 years (57.3 percent). About 28 percent of the respondents (40.4 percent of boys and 16.9 percent of girls) reported to have experienced sexual intercourse. While teachers were reported to be the least source of information on STIs, the mass media, particularly television was perceived to be the commonest source from which a greater part of the youth got such information (23.4 and 75.0 percent respectively). Generally, less than three-quarters (70 percent) of the students had a good level of STIs-related knowledge and this knowledge was significantly associated with increasing chronological age and current level of education of the respondents (Chi square for trend = 15.06, p = 0.000 and 13.06, p = 0.000 respectively). Conclusion: Despite STIs being rampant among young people worldwide, these findings suggest a high sexual activity among the respondents and a relatively low level of knowledge on STIs. Moreover, although family life education has been integrated into the school national school curriculum, majority of the students got information on STIs via the media. In view of the findings, it is recommended that additional efforts are required to raise the level of knowledge on STIs amongst the youth in schools to enable them make informed sexual decisions. It is also imperative that heath messages targeting youth take into consideration the acceptability of the medium exploited

UTILIZATION OF MODERN FAMILY PLANNING METHODS AMONG WOMEN OF REPRODUCTIVE AGE IN A RURAL SETTING: THE CASE OF SHINYANGA RURAL DISTRICT, TANZANIA

Objective: This study investigated prevalence and determinants of modern family planning practice among women in Shinyanga rural district, Tanzania Methods: A contraceptive prevalence survey was conducted among 271 women of reproductive age (15-49 years) from six villages in the district. Data was collected using an interview administered structured questionnaire. Information gathered included socio-demographic characteristics, parity, family size, knowledge of modern family planning methods as well as current use of the methods. Results: Modern family planning methods were generally known, with the pill being the most commonly mentioned method (81.2 percent) followed by the injectable type (76.8%). More than half of the women (56.5 percent) had low level of knowledge of the methods and the use rate was low, 12.2 percent. Respondents' religious denomination, their levels of knowledge of the methods as well as communication between spouses regarding family planning issues were significantly associated with contraceptive use (p < 0.05). Conclusion: We conclude that it is imperative for reproductive health programmes to intensify efforts in improving women's knowledge of modern FP methods and encourage partner communication in order to raise contraceptive prevalence rate. In addition, further studies are necessary to identify other potential factors facilitating use of modern FP methods among rural women

Data from: Social capital as a determinant of pregnant mother’s place of delivery: experience from Kongwa District in central Tanzania

Introduction: Maternal ill health contributes highly to the global burden of diseases in countries South of Sahara including Tanzania. Ensuring that all deliveries take place in health facilities and hence attended by skilled health personnel is one of the strategies advocated by global and national policies, including the Millennium Development Goals (MDGs). However, the number of women delivered by skilled health personnel has remained low in sub Saharan Africa despite of a number of interventions. We sought to determine the role of social capital in facilitating health facility delivery. Methods: We randomly selected 744 households with children aged less than five years from two randomly selected wards in a rural area in Tanzania. Mothers were enquired about place of delivery of the last child. Social capital was assessed using a modified questionnaire with both structural and cognitive aspects of social capital, administered in face-to-face interviews. Principal Component Analysis (PCA) was used to develop asocial capital index measure. Uni-variate and multivariable regression models were run using STATA 12. Results: Majority (85.9%) of the mothers reported to have delivered in a health facility during their last birth. Compared to the lowest social capital quintile, delivering in a health facility increased significantly with increase in social capital level: low (Adjusted Odds Ratio (AOR) = 2.9; Confidence Interval (CI): 1.4–6.1, p = 0.004); moderate (AOR = 5.5, CI: 2.3–13.3, p-value<0.001); high (AOR = 4.7; CI: 1.9–11.6, p-value<0.001) and highest (AOR = 5.6, CI: 2.4–13.4, p-value<0.001) and χ2-test for the trend was significant (χ2 = 17.21, p<0.001). Conclusion: Overall, social capital seems to play an important role in enhancing health facility delivery that may lead to improved maternal and child health. Concerted efforts should focus on promoting and supporting effective social capital and in particular cognitive social capital

Utilization of Health Care Services for STD Treatment in Kahe Community of Kilimanjaro Region in Tanzania.

A population based survey set to find out the existence of Sexually Transmitted Diseases (STDs) and use of health care services among residents of Oria village in Kahe ward of Kilimanjaro region in northern Tanzania in 1997. A few of the STDs symptoms covered were history of painful micturation (dysuria), urethral discharge and genital ulcer(s). This was a cross-sectional study using quantitative data collection technique in which a total of 898 villagers were interviewed. Findings revealed that in the past 223 (25.4%) had dysuria, 69 (7.7%) had urethral discharge while 28 (3.1%) had genital ulcer. At the time of the interview, 88 (9.8%) people had dysuria, 29 (3.2%) had urethral discharge and 9 (1.0%) had genital ulcer. Health care was sought from different sources, mostly from modern health care especially government health facilities (HFs) followed by private HFs and less so to pharmacies and traditional healers. No significant differences were found between the proportions of respondents that pertained to the different demographic variables with regard to utilization of the different health services. However, it is doubtful as to whether people treat themselves adequately since among those currently having STDs symptoms, some had previous history of treatment for the same problems. This may be due to either inadequate treatment, re-infection from untreated partners or new infections. A real explanation ought to be explored through future studies. Meanwhile, there is need to re-direct the existing strategies in addressing STDs in Oria village. The increasing demand for STDs management requires an increase in the number of HFs both private and public that have skilled health workers, the necessary supplies and drugs. Special efforts be made to target high risk groups using different health education packages on STDs and reinforce contact tracing while alternative sources of health care need to be explored further

Household and socio-demographic characteristics of respondents (N = 744).

<p>Household and socio-demographic characteristics of respondents (N = 744).</p

Prevalence, Awareness, Treatment, and Control of Hypertension among Young and Middle-Aged Adults: Results from a Community-Based Survey in Rural Tanzania

Background. Hypertension, which is the single most important risk factor for CVDs, is increasing at an alarming rate in most developing countries. This study estimated the prevalence, awareness, treatment, and control of hypertension among young and middle-aged adults in rural Morogoro, Tanzania. Furthermore, it explored factors associated with both prevalence and awareness of hypertension. Methods. A cross-sectional survey was conducted as part of the cluster randomized controlled study of community health workers (CHWs) interventions for reduction of blood pressure in a randomly selected sample of young and middle-aged population in rural Morogoro. Sociodemographics, lifestyle-related factors, history of diagnosis, and treatment for hypertension were collected using a questionnaire adopted from the STEPS survey tool. Blood pressure, height, and weight were measured at home following standard procedures. Descriptive statistics were used to estimate prevalence, awareness, treatment, and control of hypertension. Multiple logistic regression models were used to assess determinants of hypertension and awareness. Result. The prevalence of hypertension was 29.3% (95% CI: 27.7–31.0). Among individuals with hypertension, only 34.3% were aware of their hypertension status. Only around one-third (35.4%) of those who were aware of their hypertension status were currently on antihypertensive medication. Hypertension control was attained in only 29.9% among those on medications. Older age (p<0.001), use of raw table salt (p<0.001), and being overweight/obese (p<0.001) were associated with hypertension. Predictors of awareness of hypertension status were older age, being a female, higher socioeconomic status, use of raw table salt, a history of diabetes, and overweight/obesity (all p<0.001). Alcohol drinking was associated with low awareness for hypertension status (p<0.001). Conclusion. There is high prevalence of hypertension with low rates of awareness, treatment, and control among young and middle-aged adults in rural Tanzania. Community-level health promotion and screening campaigns for hypertension and other CVD risk factors should be intensified