Household Socioeconomic Status and Health Care Demand for Childhood Fever and Diarrhea in Tanzania

This study uses 2015/16 Tanzania Demographic and Health Survey (TDHS) data to estimate determinants of treatment seeking for childhood illness and the choice of health provider by employing logistic and multinomial probit model, respectively. Our empirical results from Binary logistic regression results show that treatment seeking for childhood illness is significantly related with mother’s occupation, household wealth status, distance to the health facilities, child’s age and place of residence. On the other hand, multinomial probit model results show that the choice of health provider is significantly related with mother’s occupation and access to mass media, household health insurance, household wealth status, and distance to the health facilities. Our results from both logistic and multinomial probit estimations are robust to alternative models’ specifications. In terms of policy implication, this study strongly recommends promotion of health insurance as well as creation of awareness on maternal and reproductive health to mothers. Moreover, the government should enhance, strengthen and ensure that health facilities are constructed close to households’ domicile and that these health facilities are provided with adequate services

Household Socioeconomic Status and Health Care Demand for Childhood Fever and Diarrhea in Tanzania

This study uses 2015/16 Tanzania Demographic and Health Survey (TDHS) data to estimate determinants of treatment seeking for childhood illness and the choice of health provider by employing logistic and multinomial probit model, respectively. Our empirical results from Binary logistic regression results show that treatment seeking for childhood illness is significantly related with mother’s occupation, household wealth status, distance to the health facilities, child’s age and place of residence. On the other hand, multinomial probit model results show that the choice of health provider is significantly related with mother’s occupation and access to mass media, household health insurance, household wealth status, and distance to the health facilities. Our results from both logistic and multinomial probit estimations are robust to alternative models’ specifications. In terms of policy implication, this study strongly recommends promotion of health insurance as well as creation of awareness on maternal and reproductive health to mothers. Moreover, the government should enhance, strengthen and ensure that health facilities are constructed close to households’ domicile and that these health facilities are provided with adequate services

Explaining the rise of economic and rural-urban inequality in clean cooking fuel use in Tanzania

Despite the high rate of economic growth and electrification in the last two decades in Tanzania, only 6.9 % of the nation's households have access to clean cooking fuel technology which is concentrated among the rich urban households. Analysing data from two waves of the Tanzania National Panel Survey (2014/15 and 2020/21), we estimate the economic and rural-urban inequalities in the use of clean cooking fuel. Using the concentration curve, Erreygers concentration index and non-linear Fairlie decomposition, we find an increase in economic inequality and rural-urban inequality in the use of clean cooking fuel. Based on our analysis, factors such as the household head's education, household economic status and household connection to electricity contribute to the rural-urban inequality in the use of clean cooking fuel. Policy changes are vital for ensuring both rural and urban households have equitable access to education, electricity connection and household economic status to address inequality in the use of clean cooking fuel

Determinants of Intimate Partner Violence in Tanzania: Evidence from the National Demographic and Health Survey

The prevalence of intimate partner violence (IPV) against ever married women in Tanzania remains high. This has an implication on development at both micro and macro level given the resulting socio-economic costs relating to IPV. It is for this reason that the present study intended to examine determinants of IPV among married women in Tanzania. Determinants are estimated by analysing the 2015/16 Tanzania Demographic and Health Survey (TDHS) data using logistic regression. Results show that risk factors which are positively associating with IPV include male partner alcohol abuse, history of domestic violence in childhood, years in marriage, polygamy marriage and household size. Meanwhile, deterrent factors comprise of the age of married women and male partner’s education. Furthermore, results indicate varied determinants of different forms of IPV across different zone in Tanzania. It is against this backdrop that we recommend for policies that ensure both women and men have equal access to quality education; amendments of relevant laws as well as raising IPV awareness using zone-specific determinants to discourage cultural norms that condone IPV

Socioeconomic Inequality in Maternal Healthcare Services: The Case of Tanzania

Low utilisation of maternal healthcare among women in developing countries increases the health risk of the child and mother during pregnancy, childbirth, and the postnatal period. It is in this context that this study intends to assess socioeconomic inequalities in maternal healthcare utilisation in Tanzania using the 2004/05, 2010, and 2015/16 Demographic and Health Survey. We first use the Concentration index to measure the presence of inequalities. Thereafter, we execute decomposition analysis to examine contributing factors of inequality in maternal healthcare utilization. Results from the Concentration index indicate that there is pro-rich inequality in maternal health utilisation and has increased over time. Meanwhile, the decomposition analysis reveals that household wealth status and women's education level contribute to the observed inequality. This could be due to the long distance to the health facilities, inadequate capacity of health facilities, and sociocultural barriers. We thus recommend that maternal healthcare in Tanzania should target the less privileged pregnant women to redress the inequality problem and ultimately alleviate maternal and child death rates in Tanzania

Socioeconomic Inequality in Maternal Healthcare Services: The Case of Tanzania

Low utilisation of maternal healthcare among women in developing countries increases the health risk of the child and mother during pregnancy, childbirth, and the postnatal period. It is in this context that this study intends to assess socioeconomic inequalities in maternal healthcare utilisation in Tanzania using the 2004/05, 2010, and 2015/16 Demographic and Health Survey. We first use the Concentration index to measure the presence of inequalities. Thereafter, we execute decomposition analysis to examine contributing factors of inequality in maternal healthcare utilization. Results from the Concentration index indicate that there is pro-rich inequality in maternal health utilisation and has increased over time. Meanwhile, the decomposition analysis reveals that household wealth status and women's education level contribute to the observed inequality. This could be due to the long distance to the health facilities, inadequate capacity of health facilities, and sociocultural barriers. We thus recommend that maternal healthcare in Tanzania should target the less privileged pregnant women to redress the inequality problem and ultimately alleviate maternal and child death rates in Tanzania

Abstracts of Tanzania Health Summit 2020

This book contains the abstracts of the papers/posters presented at the Tanzania Health Summit 2020 (THS-2020) Organized by the Ministry of Health Community Development, Gender, Elderly and Children (MoHCDGEC); President Office Regional Administration and Local Government (PORALG); Ministry of Health, Social Welfare, Elderly, Gender, and Children Zanzibar; Association of Private Health Facilities in Tanzania (APHFTA); National Muslim Council of Tanzania (BAKWATA); Christian Social Services Commission (CSSC); & Tindwa Medical and Health Services (TMHS) held on 25–26 November 2020. The Tanzania Health Summit is the annual largest healthcare platform in Tanzania that attracts more than 1000 participants, national and international experts, from policymakers, health researchers, public health professionals, health insurers, medical doctors, nurses, pharmacists, private health investors, supply chain experts, and the civil society. During the three-day summit, stakeholders and decision-makers from every field in healthcare work together to find solutions to the country’s and regional health challenges and set the agenda for a healthier future. Summit Title: Tanzania Health SummitSummit Acronym: THS-2020Summit Date: 25–26 November 2020Summit Location: St. Gasper Hotel and Conference Centre in Dodoma, TanzaniaSummit Organizers: Ministry of Health Community Development, Gender, Elderly and Children (MoHCDGEC); President Office Regional Administration and Local Government (PORALG); Ministry of Health, Social Welfare, Elderly, Gender and Children Zanzibar; Association of Private Health Facilities in Tanzania (APHFTA); National Muslim Council of Tanzania (BAKWATA); Christian Social Services Commission (CSSC); & Tindwa Medical and Health Services (TMHS)

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways