Community knowledge and information communication gaps on HIV/AIDS in Iringa Municipality, Tanzania

This study was carried out to determine community knowledge and information communication gaps on HIV/AIDS in Iringa Municipality, Tanzania. In-depth interviews and focus group discussions were used to collect data from both the community and health workers. Results showed that eighty-one percent of the respondents were knowledgeable of at least one mode of HIV/AIDS transmission. Sexual intercourse, sharing of sharp instruments, blood transfusion and mother to child transmission were known to be the most common ways on how HIV is transmitted. The community knowledge on the symptoms of AIDS was poor. The main sources of information on HIV/AIDS were health facilities, radio, televisions, religious leaders and relatives. The information covered in most of the health education programmes included prevention, treatment and care for AIDS patients. The understanding of HIV/AIDS messages was found to vary significantly between respondents with different levels of education and marital status. It was higher among those with at least a primary school education than in those without education. Singles and individuals with primary or post-primary education sought more new information than those who had no education at all. Among the respondents, 59.7% reported to have difficulties in adopting and utilising HIV/AIDS educational messages. Singles had a better understanding of information provided than married respondents. However, the former had more difficulties in adopting and utilising health education information. Poor utilisation of the HIV/AIDS messages was attributed to culture, poverty, and illiteracy. The majority of the respondents, 370 (92.8%) reported to often carry out discussions with their family members (including children) on HIV/AIDS. It is concluded that health education should identify community needs and address economic and socio-cultural barriers to facilitate education utilisation and behavioural changes required in HIV/AIDS prevention and control in Tanzania. Keywords: HIV/AIDS, knowledge, information communication, Tanzania Tanzania Health Research Bulletin Vol. 8 (2) 2006: pp. 101-10

Mitigating lockdown challenges in response to COVID-19 in Sub-Saharan Africa

The coronavirus disease 2019 (COVID-19) which was first reported in Wuhan, China at the end of 2019 (Lu et al., 2020) has spread across the world with remarkable speed, with the World Health Organization (WHO) officially declaring a pandemic in March, 2020. Most countries in sub-Saharan Africa (SSA) are now reporting an increasing number of cases, both imported and acquired locally. As of 14th April 2020, a cumulative total of approximately, 10,757 confirmed COVID-19 cases with 520 deaths have been reported within the WHO African Region, with South Africa, Algeria and Cameroon recording the biggest number of cases (WHOa, 2020). A recent analysis has indicated that the risk of transmission of COVID-19 in Africa to be relatively lower than in other continents (Haider et al., 2020). However, the scale of COVID-19 infection in the continent and its impact on population health is still unclear. Routine information systems in many parts of the region are inadequate and the current data are likely to underestimate the true extent of the epidemic. Furthermore, because it is unclear as to how COVID-19 will interact with conditions such as malnutrition, HIV/AIDS, tuberculosis, and malaria, one cannot be certain that infection fatality rates in Africa will be similar to those that have been estimated elsewhere

Stakeholders' Participation in Planning and Priority Setting in the Context of a Decentralised Health Care system: the case of prevention of mother to child Transmission of HIV Programme in Tanzania.

In Tanzania, decentralisation processes and reforms in the health sector aimed at improving planning and accountability in the sector. As a result, districts were given authority to undertake local planning and set priorities as well as allocate resources fairly to promote the health of a population with varied needs. Nevertheless, priority setting in the health care service has remained a challenge. The study assessed the priority setting processes in the planning of the prevention of mother to child transmission of HIV (PMTCT) programme at the district level in Tanzania. This qualitative study was conducted in Mbarali district, south-western Tanzania. The study applied in-depth interviews and focus group discussions in the data collection. Informants included members of the Council Health Management Team, regional PMTCT managers and health facility providers. Two plans were reported where PMTCT activities could be accommodated; the Comprehensive Council Health Plan and the Regional PMTCT Plan that was donor funded. As donors had their own globally defined priorities, it proved difficult for district and regional managers to accommodate locally defined PMTCT priorities in these plans. As a result few of these were funded. Guidelines and main priority areas of the Ministry of Health and Social Welfare (MoHSW) also impacted on the ability of the districts and regions to act, undermining the effectiveness of the decentralisation policy in the health sector. The challenges in the priority setting processes revealed within the PMTCT initiative indicate substantial weaknesses in implementing the Tanzania decentralisation policy. There is an urgent need to revive the strategies and aims of the decentralisation policy at all levels of the health care system with a view to improving health service delivery

Public policy, health system, and community actions against illness as platforms for response to NCDs in Tanzania: a narrative review

This review was supported by grants from the Netherlands Organization for International Co-operation in Higher Education and the Ifakara Health Institute, Tanzania

Challenges to fair decision-making processes in the context of health care services: a qualitative assessment from Tanzania

Background: Fair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people’s needs. In Tanzania, the policy of decentralization and the health sector reform place an emphasis on community participation in making decisions in health care. However, aspects that can influence an individual’s opportunity to be listened to and to contribute to discussion have been researched to a very limited extent in low-income settings. The objective of this study was to explore challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory. Methods: The study was carried out in the Mbarali District of Tanzania. A qualitative study design was used. In-depth interviews and focus group discussion were conducted among members of the district health team, local government officials, health care providers and community members. Informal discussion on the topics was also of substantial value. Results: The study findings indicate a substantial influence of gender, wealth, ethnicity and education on health care decision-making processes. Men, wealthy individuals, members of strong ethnic groups and highly educated individuals had greater influence. Opinions varied among the study informants as to whether such differences should be considered fair. The differences in levels of influence emerged most clearly at the community level, and were largely perceived as legitimate. Conclusions: Existing challenges related to individuals’ influence of decision making processes in health care need to be addressed if greater participation is desired. There is a need for increased advocacy and a strengthening of responsive practices with an emphasis on the right of all individuals to participate in decision-making processes. This simultaneously implies an emphasis on assuring the distribution of information, training and education so that individuals can participate fully in informed decision making

Comparative evaluation of different methods of extraction and purification used in technical enzyme production from microorganisms

Tanzania Journal of Agricultural Sciences, 1998; I (2): 141-148A stlldy was conducted to compare the efficiency of two methods of microbial cell separation and enzyme purification using penicillin-G-acylase (PGA) from Escherichia coli. The efficiency of two methods of ceJ[ separation; centrifugation and cross flow filtration (CFF) were compared. The CFF method was found to have both higher separation efficiency and enzyme yield than centrifugation method. Centrifugation method gave a separation efficiency of 98.5% with enzyme yield of94 % whereas CFFmethod resulted in 100% separation efficiency and enzyme yield of98.8%. The Escherichia coli cells were disrupted by high pressure homogenization (HPH),and the disrupted cells were purified using two different techniques. Technique I was a combination of cross-flow-diafiltration (CFD) , ultrafiltration (UF) and heat/pH-shift treatments. This technique resulted in 47% enzyme yield with a purification factor of 12. Technique II which involved two extraction steps by' aqueous two - phase system (APS) coupled with UF resulted in 62 % enzyme yield with a pu;ificationfactor of 4. Technique I was therefore much better than techriique Il in purifying the enzyme. For higher enzyme yield, technique II would seem to be a better one than technique I

Community perspectives on the magnitude of Xeroderma pigmentosum and care-seeking practices in Micheweni district, Pemba: a mixed-methods cross-sectional study

Objectives To determine the community’s perception on the magnitude of Xeroderma pigmentosum (XP) disease and healthcare-seeking practices in Micheweni, Pemba in response to the public widespread information on the increased burden of the disease.Design Mixed-methods cross-sectional study.Setting Micheweni district, Pemba.Participants 211 male and female adults in the household survey, three caretakers/parents of patients with XP in the case study, 20 key community leaders/influential people and health workers in in-depth interviews and 50 community members and other leaders in six focus groups.Results This study has revealed that XP disease exists in few families of which some of them have more than one child affected. The record review showed that there were a total of 17 patients who were diagnosed with the disease for the past 3 years, however only 10 were alive during the time of the survey. Findings from the community members revealed that several patients were believed to have XP disease and perceived causes include inheritance, food types, beliefs and other sociocultural practices. Stigma and discrimination were reported by caretakers and religious leaders. However, some cases believed to be XP were identified as other skin conditions when clinical examination was performed by the team of our researchers. There is a great confusion about XP and other skin diseases.Conclusion The study has shown that XP affects only few families, hence termed as concentrated rather than a generalised disease. Due to the rareness of the disease, majority of people in the district are unaware of the disease, hence confusing it with other skin conditions. There is a need for the government in collaboration with other stakeholders to provide educational programme to community members about the disease to address the misconception about the magnitude of the disease