Gender Roles in Small Holder Dairy Farming: Pertinent Issues on Access and Control over Dairy Farming in Arumeru District, Tanzania

A study on gender roles in dairy farming and management was conducted in Arumeru district, Tanzania. The study involved women in dairy farming groups and those not in groups. The objective of this study was to assess gender role in dairy farming and management, access and control over income obtained as well as, animal ownership, decision making  and opportunities in dairy farming system in Arumeru. Cross sectional research design was adopted using structured questionnaires to collect information from households from six villages namely Bangata, Sasi, Inshupu, Enaboishu, Sokoni II and Nkoaranga. Descriptive analysis and Chi-square were used to test the statistical significance of categorical and continuous data respectively. The results showed that women contribute more labour force in dairy management than men, those women who were not in groups did not have a full access and control over dairy farming enterprise. Furthermore, it was observed that those women in groups were in a good position to overcome traditional practice. Women who belonged to groups controlled and had access to resources such as livestock (dairy cattle) and income generated from them. However, since most of the farmer groups were still infants, it has been recommended that the women groups should get financial assistance from the government agencies. Similarly, in conjunction with encouraging more women to join groups, gender relations in dairy management should be reassessed to minimize the work load burden to women which affects the level of production and sustainability of the dairy enterprise. Keywords: Access and control, dairy management, gender, women groups.

Major Disease Vectors in Tanzania: Distribution, Control and Challenges

Disease vectors remain a major public health challenge in spite of efforts done to control across Tanzania. Different disease vectors have been controlled and efforts are on to eradicate them but challenges are still emerging and managed. In spite of all these success, different disease vectors have been observed to have developed resistance to all classes of insecticides used in public health practices in Tanzania.Resistance reports to main different vectors have been coming throughout Tanzania. The resistance of vectors to insecticides has been of different mechanisms depending on species, insecticides and mechanisms of action of the pesticides. Social economic factors and housing style still a major factor for the distribution and foci of vector abundance. The impact of public health intervention has been observed but still disease vector existence is noticed. Careful monitoring of the public health priorities for disease vectors control should be rethought to keep the elimination track live. Different tools such as insecticides use, understanding control measures, vector distribution and human lifestyle can lead to reduced burden caused by disease vectors. This chapter has described mosquitoes, tsetse flies, soft ticks, blackflies, and houseflies in terms of distribution, abundance, control and challenges of eradication in Tanzania

Understanding the introduction and use of a mobile device-supported health information system in Nigeria

Copyright @ 2014 The Authors.This paper presents an in-depth analysis of efforts to introduce a mobile health information system in Nigeria as part of a development initiative aimed at improving maternal and child health. Specifically, it examines the use of mobile devices to facilitate maternal health information accessibility and exchange among health practitioners in order to reducing maternal, newborn and child mortality. Further, it also looks at the challenges raised while introducing mobile devices into work practices in the healthcare sector. The study adopts a case study approach, relying on semi-structured interviews and document analysis as its main methods for collecting data. The specific case examined is a mobile phone-based information system introduced to support a national government effort in Nigeria, known as the midwives service scheme. The findings of this study show that this integrated approach of using mobile phones to support (health) information systems has vast potential; for instance increasing the timeliness of (health) data available to stakeholders for monitoring and planning purposes. However, we also find that over time, attaining the potential of development efforts such as this remains difficult as initiatives involving the use of mobile devices is not just about getting the technical aspect right. It is equally dependent on deep seated social-cultural influences such as poor political and financial commitment. These two mutually reinforcing influences have been identified in this study as significant impediments to efforts of this kind. Therefore, this paper argues for, first a strong political commitment across all levels of government whereby their words are backed with action. Second it is important that the government maintains financial integrity by releasing the funds budgeted to support the smooth running of these efforts, for such initiatives to thrive and ultimately contribute to development

Patient's dissatisfaction with the public and private laboratory services in conducting HIV related testing in Tanzania

<p>Abstract</p> <p>Background</p> <p>Patient's satisfaction with both private and public laboratory services is important for the improvement of the health care delivery in any country.</p> <p>Methods</p> <p>A cross-sectional survey was conducted in 24 randomly selected health facilities with laboratories that are conducting HIV related testing, in Mainland Tanzania. The study assessed patient's satisfaction with the laboratory services where by a total of 295 patients were interviewed.</p> <p>Results</p> <p>Of data analyzed for a varying totals from 224 to 294 patients, the percentage of dissatisfaction with both public and private laboratory services, ranged from 4.3% to 34.8%, with most of variables being more than 15%. Patients who sought private laboratory services were less dissatisfied with the cleanness (3/72, 4.2%) and the privacy (10/72, 13.9%) than those sought public laboratory service for the same services of cleanness (41/222, 18.5%) and privacy (61/222, 27.5%), and proportional differences were statistically significant (X²= 8.7, p = 0.003 and X²= 5.5, p = 0.01, respectively). Patients with higher education were more likely to be dissatisfied with privacy (OR = 1.8, 95% CI: 1.1–3.1) and waiting time (OR = 2.5, 95% CI: 1.5 – 4.2) in both private and public facilities. Patients with secondary education were more likely to be dissatisfied with the waiting time (OR = 5.2; 95%CI: 2.2–12.2) and result notification (OR = 5.1 95%CI (2.2–12.2) than those with lower education.</p> <p>Conclusion</p> <p>About 15.0% to 34.8% of patients were not satisfied with waiting time, privacy, results notification cleanness and timely instructions. Patients visited private facilities were less dissatisfied with cleanness and privacy of laboratory services than those visited public facilities. Patients with higher education were more likely to be dissatisfied with privacy and waiting time in both private and public facilities.</p

Contributions of integrated soil fertility management (ISFM) to various sustainable intensification impact domains in Tanzania

Open Access Article; Published online: 18 Sep 2022CONTEXT The implementation of integrated soil fertility management (ISFM) varies widely among farmers, from no ISFM to multiple computations of ISFM components (i.e., improved germplasm, organic resources, fertilizers, and local adaptations e.g., soil and water conservation (SWC)). There is no comprehensive report on farmers' use of ISFM components and their impact on sustainable intensification domains of productivity, economic, social, human condition, and environment and the associated variations across farmer fields and agro-ecological zones (AEZs). OBJECTIVE This study 1) evaluated the current implementation status of ISFM by farmers in relation to the various ISFM components and 2) provided multi-dimensional multi-scale evidence of ISFM implications that can guide ISFM investments within SSA contexts, with a specific focus on Tanzania. METHODS We used data collected from 1406 plots between 2013 and 2020 in semi-arid and sub-humid AEZs. The data are from farmer practices. The plots were grouped by the various combinations of ISFM components implemented and analysed using Tukey's test to examine the association of ISFM use with selected indicators within a domain. RESULTS AND CONCLUSIONS The number of ISFM components used by farmers is higher in sub-humid (1 to 4) than in semi-arid AEZ (0 to 3). Except for SWC used by 40% of farmers in both AEZs, the proportion of farmers using improved seeds (95%) and manure (55%) in the sub-humid AEZ are more than double those using these ISFM components in the semi-arid AEZ. Productivity and economic benefits increase with the number of ISFM components at the expense of higher labour demand. Increasing plot-level ISFM benefits also translate to increased household-level whole-farm income but contributions to human nutrition are unclear. The contribution to SOC by increasing ISFM is insignificant, compounded by strong effects of slope position of the field. Differential access to resources, decision-making and control rights drive the number and choice of the specific ISFM components. SIGNIFICANCE Understanding of ISFM impacts across domains is essential to guide the scaling of ISFM in Tanzania and beyond and therefore recommended in future studies

QuantiFERON®-TB gold in-tube performance for diagnosing active tuberculosis in children and adults in a high burden setting.

To determine whether QuantiFERON®-TB Gold In-Tube (QFT) can contribute to the diagnosis of active tuberculosis (TB) in children in a high-burden setting and to assess the performance of QFT and tuberculin skin test (TST) in a prospective cohort of TB suspect children compared to adults with confirmed TB in Tanzania. Sensitivity and specificity of QFT and TST for diagnosing active TB as well as indeterminate QFT rates and IFN-γ levels were assessed in 211 TB suspect children in a Tanzanian district hospital and contrasted in 90 adults with confirmed pulmonary TB. Sensitivity of QFT and TST in children with confirmed TB was 19% (5/27) and 6% (2/31) respectively. In adults sensitivity of QFT and TST was 84% (73/87) and 85% (63/74). The QFT indeterminate rate in children and adults was 27% and 3%. Median levels of IFN-γ were lower in children than adults, particularly children <2 years and HIV infected. An indeterminate result was associated with age <2 years but not malnutrition or HIV status. Overall childhood mortality was 19% and associated with an indeterminate QFT result at baseline. QFT and TST showed poor performance and a surprisingly low sensitivity in children. In contrast the performance in Tanzanian adults was good and comparable to performance in high-income countries. Indeterminate results in children were associated with young age and increased mortality. Neither test can be recommended for diagnosing active TB in children with immature or impaired immunity in a high-burden setting

Perceptions about data-informed decisions: an assessment of information-use in high HIV-prevalence settings in South Africa

BACKGROUND: Information-use is an integral component of a routine health information system and essential to influence policy-making, program actions and research. Despite an increased amount of routine data collected, planning and resource-allocation decisions made by health managers for managing HIV programs are often not based on data. This study investigated the use of information, and barriers to using routine data for monitoring the prevention of mother-to-child transmission of HIV (PMTCT) programs in two high HIV-prevalence districts in South Africa. METHODS: We undertook an observational study using a multi-method approach, including an inventory of facility records and reports. The performance of routine information systems management (PRISM) diagnostic ‘Use of Information’ tool was used to assess the PMTCT information system for evidence of data use in 57 health facilities in two districts. Twenty-two in-depth interviews were conducted with key informants to investigate barriers to information use in decision-making. Participants were purposively selected based on their positions and experience with either producing PMTCT data and/or using data for management purposes. We computed descriptive statistics and used a general inductive approach to analyze the qualitative data. RESULTS: Despite the availability of mechanisms and processes to facilitate information-use in about two-thirds of the facilities, evidence of information-use (i.e., indication of some form of information-use in available RHIS reports) was demonstrated in 53% of the facilities. Information was inadequately used at district and facility levels to inform decisions and planning, but was selectively used for reporting and monitoring program outputs at the provincial level. The inadequate use of information stemmed from organizational issues such as the lack of a culture of information-use, lack of trust in the data, and the inability of program and facility managers to analyze, interpret and use information. CONCLCUSIONS: Managers’ inability to use information implied that decisions for program implementation and improving service delivery were not always based on data. This lack of data use could influence the delivery of health care services negatively. Facility and program managers should be provided with opportunities for capacity development as well as practice-based, in-service training, and be supported to use information for planning, management and decision-making

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially