Health care professional knowledge and attitude towards the use of digital technologies in provision of maternal health services at Tumbi regional referral hospital in Tanzania

Objectives: In recent years Tanzania introduced digital technologies in health industry where several initiatives such as Government of Tanzania, Hospital Management Information System (GoT-HoMIS) along other digital devices are taken to ensure quality services delivery. The purpose of this study was to assess Health Care Providers (HCPs) knowledge and attitude towards the use of Digital Health Technology (DHT) in provision of maternal health services at Tumbi Regional Referral Hospital (TRRH). Methods: Descriptive cross-sectional design involving 50 purposively selected HCPs from obstetrics and gynecology department was used. A self-administered questionnaire and direct field observation was used to collect data from respondents. Data were analyzed using SPSS V.20 and presented by using tables, percentages and frequencies. Results: We found that, DHT are highly used by HCPs 49(98%). Also, DHT devices are available and functioning properly thus used in providing maternal health services by enhancing effective patient management. 43(86%) of HCPs were aware on DHT practice and about 46(92%) understood the use of DHT in provision of maternal health services despite of varying knowledge level. On the side of attitude, we found that, 43(86%) of the HCP had a positive attitude on the use of DHT. Conclusion: Knowledge, attitudes and rate of use of DHT by HCP was found to be good, despite notable challenges such as dependent on the internet signals for their proper functioning. More initiatives should be undertaken by the Ministry of Health, Community and other stakeholders to promote DHT practices in the health facilities

The Economics of Dialysis in Tanzania

Although End Stage Renal Disease (ESRD) is a disease of increasing epidemiological relevance very little is known about the cost of providing the respective dialysis services in Tanzania. This study analyses the cost of outpatient dialysis at Muhimbili National Hospital (MNH) in Tanzania in the year 2014 in order to address the question weather or not dialysis treatment should be a priority intervention in a poor resource country like Tanzania. Cost analyses were performed based on the provider’s perspective including only direct costs of dialysis treatment. Cost of drugs and consumables were obtained from the price list of Medical Stores Department in Tanzania. Overhead were collected from the respective departments and allocated to the final cost centres through step down approach. The results indicates that MNH performs on average 442 hemodialyses per month (34 patients, with three sessions per week) with a personnel placement of 20 nurses, four nephrologists, eight registrars, one nutritionist, two biomedical engineers, four health attendants and nine dialysis machines. The respective average unit cost per haemodialysis is 175.91 US$. Consequently, an average patient requiring three dialyses per week (i.e. 156 dialyses per year) will cause annual costs of 27,441.95 US$. The annual cost of dialysis is enormous for a least developed country like Tanzania where resources and technology are rather limited. Infectious diseases (such as malaria and tuberculosis) are the major health problems. Therefore, from the economic point of view, it seems rational to allocate health care budgets towards diseases that are curable, have higher cost- effectiveness and cater for the majority of the population. However, before a final decision on allocation of budget towards dialysis is made, all efforts that could improve technical efficiency and reduce the costs of materials in Tanzania must be invested. For instance, reducing the nursing time per dialysis.Obwohl terminales Nierenversagen (End Stage Renal Disease, ESRD) eine Erkrankung mit weltweiter steigender epidemiologischer Bedeutung ist, ist sehr wenig über die Kosten für die Bereitstellung der betreffenden Dialysedienstleistungen in Tansania bekannt. Die Studie analysiert die Kosten der ambulanten Dialyse im Muhimbili National Hospital (MNH) in Tansania im Jahr 2014 um die Frage zu klären, ob eine Dialysebehandlung in einem ressourcenarmen Land wie Tansania die vorrangige Intervention sein soll. Die Kostenanalysen basieren auf der Perspektive des Anbieters und schließen nur direkte Kosten der Dialysebehandlung ein. Kosten für Medikamente und Verbrauchsmaterialien wurden aus der Preisliste des Medical Store Departments in Tansania erhalten. Overheadkosten wurden aus den jeweiligen Abteilungen gesammelt und auf die endgültigen Kostenstellen nach dem Top-down-Ansatz zugeschlüsselt. Die Ergebnisse zeigen, dass das MNH im Durchschnitt 442 Hämodialysen pro Monat (34 Patienten, mit drei Sitzungen pro Woche) mit einem Personaleinsatz von 20 Krankenschwestern, vier Nephrologen, acht Nephrologen in Ausbildung, einer Ernährungsberaterin, zwei biomedizinischen Ingenieuren, vier Gesundheitsbegleitern und neun Dialysemaschinen durchführt. Die jeweiligen durchschnittlichen Kosten pro Hämodialyse betragen US$175,91. Folglich verursacht ein Durchschnittspatient mit drei Dialysen pro Woche (d. h. 156 Dialysen pro Jahr) jährliche Kosten von US$ 27,441.95. Die jährlichen Kosten der Dialyse sind enorm für die am wenigsten entwickelten Länder wie Tansania, wo Ressourcen und Technologien eher begrenzt sind. Infektionskrankheiten (z. B. Malaria und Tuberkulose) sind die wichtigsten gesundheitlichen Probleme. Daher erscheint es aus dem wirtschaftlichen Standpunkt heraus vernünftig, Gesundheitsbudgets vorrangig Krankheiten zuzuteilen, die heilbar sind, eine höhere Wirtschaftlichkeit haben und die Mehrheit der Bevölkerung betreffen. Doch bevor eine endgültige Entscheidung über die Zuteilung der Budgets in Richtung Dialyse geführt wird, müssen alle Bemühungen in Tansania unternommen werden, um die technische Effizienz zu verbessern und die Kosten für die Materialien zu reduzieren. Ein Beispiel wäre die Verringerung der Pflegezeit pro Dialyse

Effectiveness of prime vendor system on availability of medicines and medical supplies in the selected public health facilities in Arusha district council

Abstract Introduction The shortage of medicines and medical supplies remains to be a major issue that is facing public health facilities in Tanzania. This situation has been influenced by lack of consistency in the supply chain, increase in healthcare demand, poor regulatory system, insufficient funds, and lack of conducive infrastructure. Formerly, the Government initiatives such as engagement with the Prime Vendor System (PVS) demonstrated great assistance in getting rid of this challenge. Despite the operation of PVS, a recent shortage of medicines and medical supplies has been noticed. Objectives This study aimed to assess the effectiveness of PVS on the availability of medicine and medical supplies in the selected public health facilities in Arusha District Council. Methods The study used a case study design with mixed research approach. The study involved 77 respondents which included 25 health facility in-charges, 50 patients, 1 District Pharmacist and 1 Prime Vendor. Questionnaires, interviews, and observation methods were used to collect data. Data collected covered a period of 2021–2022. Thematic analysis was used to analyze the qualitative data whereas descriptive analysis was used to analyze the quantitative data with the help of Excel and the Statistical Package for Social Sciences (SPSS) version 28.0. Results The analysis indicates that PVS is not completely effective in supplying medicines and medical supplies due to its low capacity to conform to the orders placed by the public health facilities, a lack of supply competition, and a failure to adhere to contractual terms. Furthermore, at the time of data collection, the average availability of medicines and medical supplies at the selected public health facilities was 74.8%, while 80% of the selected public health facilities reported having a scarcity of medicines and medical supplies, and 92% of the interviewed patients reported having no full access to medicines. Conclusion Despite the shortcomings associated with the operation of the PVS, the system still seems to be very important for enhancing the availability of medicines and medical supplies once its effectiveness is strengthened. This study recommends a routine monitoring of PVS operations and timely interventions to reinforce an adherence to the contracted terms and improve PVS effectiveness

Social Entrepreneurship: How Social Entrepreneurs Pioneering Social Change - the Evidence from Tanzania

Social entrepreneur are genius, creative and innovative individuals who respond to the local problems by engaging their community in solving them to accelerate sustainable social transformation. This article aimed at understanding how social entrepreneurs create social value in the community. The paper is based on publicly available profiles of Fellows of Ashoka. We selected one sample out of five Ashoka fellows from Tanzania as a case study representing how social entrepreneurs create social value. The findings reveal that social entrepreneur identify problems which hinder social and economic development of the poor and marginalized group in the community and provide solutions to create sustainable social transformation. Keywords: Tanzania, social entrepreneurship, social entrepreneur, Ashok