Comparative Analysis of Youth Sexual Behaviour Risks for HIV and AIDS Infection in Mbulu and Mufindi Districts, Tanzania

The youth are among the vulnerable population for contracting Human Immune deficiency Virus (HIV) and Acquired Immuno deficiency Syndrome (AIDS), which are behavioural related problems.  This paper examines sexual behaviour risks for HIV and AIDS infection among youth.  A total of 232 youth both in and out of school aged 15-35 years were involved in the study.  A cross sectional study design was adopted and data was collected through questionnaire, Non participant observation and documentary review.  The study used descriptive statistics to determine frequency, percentages and the mean scores for sexual behaviour risks among the youth in the study areas.  The findings showed that more than a half of the sexually active youth had had sexual intercourse and among the youth who had already had sexual intercourse, a half of them did not use condoms.  The results showed significant differences in sexual behaviour risks among youth in the study areas (p < 0.05).  Youth in Mufindi were at a higher risk than was the case with their counterparts in Mbulu. The study call for creation of youth programmes that will focus on reduction of sexual behaviour risks among the youth.  Programmes for youth can focus on a range of services including prevention strategies, risk reduction, and behaviour change. Keywords: Youth, Sexual behaviour risks, HIV and AIDS, Infection, prevention, Tanzania DOI: 10.7176/DCS/9-5-06 Publication date:May 31st 201

Illness and Food Security in Rufiji District, Tanzania

A socio-economic survey was conducted among 225 households comprising 1,193 individuals in Rufiji District, Tanzania, in 2006 to: (a) determine the number of people who were ill; (b) find the commonest illnesses; and (c) compare food security in households where members were ill for fewer days and where they were ill for more days. It was found that 13% of the individuals were ill during the survey and that the top ten illnesses were malaria (29.9%), joints/body pains (19.5%), fever (9.1%), chest/TB (5.8%), headache (5.8%), stomach ache (4.5%), asthma (3.3%), eyes (3.3%), UTI/STI (2.6%), and diarrhoea (2.0%). Multiple one-way ANOVA comparisons of mean differences in dietary energy consumed (DEC) in five groups of the households based on the number of days that the individuals were ill showed significant difference between the fourth and the fifth groups (p = 0.021). It is concluded that with few days of household members being ill food security in terms of DEC is affected little, but that with more days of illness, food security is substantially affected. Therefore, if health services are not improved in rural areas, particularly in Rufiji District, the problem of low food production leading to food insecurity will linger on. It is recommended that the Government and other stakeholders should scale-up health interventions in rural areas, among other strategies, in order to improve food security. Key words: illness, food security, dietary energy consumed, health service

Towards Programs Sustainability: An Empirical Analysis of the Socio-Cultural Determinants for Effective Community Participation in Development Programs in Tanzania

The link between participation and development programs is embedded in the concept of participatory development. As such, there is no doubt that community participation has indeed been a constant theme in development dialogues for the past 50 years. This shows how important the concept of community participation continues to stand out as one of those key catalysts for successful implementation of development programs such that they remain sustainable.On account of this perception, this paper therefore set out to explore socio-cultural determinants for effective community participation in development programs in the context of Tanzania. Precisely, the paper posits that in order to achieve program sustainability, effective community participation in such programs is of paramount importance. Hence the need to ensure that any factors that have the potential to influence the extent of peoples’ participation in development programs need to be well responded to and addressed. In light of this view, this paper therefore looked into the socio-cultural factors or determinants so as to establish what could be the key socio-cultural factors for influencing effective community participation in development programs. Keywords: Sustainability, Development Programs, Program Sustainability, Community Participation, Socio-cultural determinants DOI: 10.7176/JESD/12-18-03 Publication date:September 30th 202

Care-seeking patterns for fatal malaria in Tanzania.

BACKGROUND\ud \ud Once malaria occurs, deaths can be prevented by prompt treatment with relatively affordable and efficacious drugs. Yet this goal is elusive in Africa. The paradox of a continuing but easily preventable cause of high mortality raises important questions for policy makers concerning care-seeking and access to health systems. Although patterns of care-seeking during uncomplicated malaria episodes are well known, studies in cases of fatal malaria are rare. Care-seeking behaviours may differ between these groups.\ud \ud METHODS\ud \ud This study documents care-seeking events in 320 children less than five years of age with fatal malaria seen between 1999 and 2001 during over 240,000 person-years of follow-up in a stable perennial malaria transmission setting in southern Tanzania. Accounts of care-seeking recorded in verbal autopsy histories were analysed to determine providers attended and the sequence of choices made as the patients' condition deteriorated.\ud \ud RESULTS\ud \ud As first resort to care, 78.7% of malaria-attributable deaths used modern biomedical care in the form of antimalarial pharmaceuticals from shops or government or non-governmental heath facilities, 9.4% used initial traditional care at home or from traditional practitioners and 11.9% sought no care of any kind. There were no differences in patterns of choice by sex of the child, sex of the head of the household, socioeconomic status of the household or presence or absence of convulsions. In malaria deaths of all ages who sought care more than once, modern care was included in the first or second resort to care in 90.0% and 99.4% with and without convulsions respectively.\ud \ud CONCLUSIONS\ud \ud In this study of fatal malaria in southern Tanzania, biomedical care is the preferred choice of an overwhelming majority of suspected malaria cases, even those complicated by convulsions. Traditional care is no longer a significant delaying factor. To reduce mortality further will require greater emphasis on recognizing danger signs at home, prompter care-seeking, improved quality of care at health facilities and better adherence to treatment

Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania – challenges in implementation

BACKGROUND: In the past decade there has been increasing visibility of malaria control efforts at the national and international levels. The factors that have enhanced this scenario are the availability of proven interventions such as artemisinin-based combination therapy, the wide scale use of insecticide-treated nets (ITNs) and a renewed emphasis in indoor residual house-spraying. Concurrently, there has been a window of opportunity of financial commitments from organizations such as the Global Fund for HIV/AIDS, Tuberculosis and Malaria (GFATM), the President's Malaria Initiative and the World Bank Booster programme. METHODS: The case study uses the health policy analysis framework to analyse the implementation of a public-private partnership approach embarked upon by the government of Tanzania in malaria control - 'The Tanzania National Voucher Scheme'- and in this synthesis, emphasis is on the challenges faced by the scheme during the pre-implementation (2001 - 2004) and implementation phases (2004 - 2005). Qualitative research tools used include: document review, interview with key informants, stakeholder's analysis, force-field analysis, time line of events, policy characteristic analysis and focus group discussions. The study is also complemented by a cross-sectional survey, which was conducted at the Rufiji Health Demographic Surveillance Site, where a cohort of women of child-bearing age were followed up regarding access and use of ITNs. RESULTS: The major challenges observed include: the re-introduction of taxes on mosquito nets and related products, procurement and tendering procedures in the implementation of the GFATM, and organizational arrangements and free delivery of mosquito nets through a Presidential initiative. CONCLUSION: The lessons gleaned from this synthesis include: (a) the consistency of the stakeholders with a common vision, was an important strength in overcoming obstacles, (b) senior politicians often steered the policy agenda when the policy in question was a 'crisis event', the stakes and the visibility were high, (c) national stakeholders in policy making have an advantage in strengthening alliances with international organizations, where the latter can become extremely influential in solving bottlenecks as the need arises, and (d) conflict can be turned into an opportunity, for example the Presidential initiative has inadvertently provided Tanzania with important lessons in the organization of 'catch-up' campaigns

Cause-specific mortality rates in sub-Saharan Africa and Bangladesh

OBJECTIVE: To provide internationally comparable data on the frequencies of different causes of death. METHODS: We analysed verbal autopsies obtained during 1999 -2002 from 12 demographic surveillance sites in sub-Saharan Africa and Bangladesh to find cause-specific and age-specific mortality rates. The cause-of-death codes used by the sites were harmonized to conform to the ICD-10 system, and summarized with the classification system of the Global Burden of Disease 2000 (Version 2). FINDINGS: Causes of death in the African sites differ strongly from those in Bangladesh, where there is some evidence of a health transition from communicable to noncommunicable diseases, and little malaria. HIV dominates in causes of mortality in the South African sites, which contrast with those in highly malaria endemic sites elsewhere in sub-Saharan Africa (even in neighbouring Mozambique). The contributions of measles and diarrhoeal diseases to mortality in sub-Saharan Africa are lower than has been previously suggested, while malaria is of relatively greater importance. CONCLUSION: The different patterns of mortality we identified may be a result of recent changes in the availability and effectiveness of health interventions against childhood cluster diseases

Cause-specific mortality rates in sub-Saharan Africa and Bangladesh.

OBJECTIVE: To provide internationally comparable data on the frequencies of different causes of death. METHODS: We analysed verbal autopsies obtained during 1999 -2002 from 12 demographic surveillance sites in sub-Saharan Africa and Bangladesh to find cause-specific and age-specific mortality rates. The cause-of-death codes used by the sites were harmonized to conform to the ICD-10 system, and summarized with the classification system of the Global Burden of Disease 2000 (Version 2). FINDINGS: Causes of death in the African sites differ strongly from those in Bangladesh, where there is some evidence of a health transition from communicable to noncommunicable diseases, and little malaria. HIV dominates in causes of mortality in the South African sites, which contrast with those in highly malaria endemic sites elsewhere in sub-Saharan Africa (even in neighbouring Mozambique). The contributions of measles and diarrhoeal diseases to mortality in sub-Saharan Africa are lower than has been previously suggested, while malaria is of relatively greater importance. CONCLUSION: The different patterns of mortality we identified may be a result of recent changes in the availability and effectiveness of health interventions against childhood cluster diseases