Compulsory Land Acquisition and Good Governance: An Assessment of the Luguruni Satellite Town Project in Dar es Salaam Tanzania

Despite a comprehensive regulatory framework on land matters, compulsory land acquisition in Tanzania has been associated with complaints and delays in compensation payments an indication that good governance principles might not be under serious consideration. This paper evaluates land acquisition practices in Tanzania in the light of good governance principles based on interviews and focus group discussions with project affected people and government officials who were involved in Luguruni Satellite Town Project in Dar es Salaam.  It was observed that failure to observe good governance principles was one of the major reasons for dissatisfaction among affected people due to lack of adequate and clear information about the project, little participation, inadequate compensation and non-adherence to procedures.  Enforcement of governance principles would have facilitated the smooth implementation of compulsory land acquisition thereby reducing conflicts and enhance PAPs chance to voluntarily relocate

Collaborative Governance in Land Acquisition and Aggregation Practices: The Impacts on Neighbourhood Functionalities in Tanzania

In urban development projects, the amount of land needs to be large enough to support not only the intended development but also the subsequent well-functioning of the neighbourhood through enhanced accessibility, service provision and liveability in general. Obtaining land for public goods and services at neighbourhood level may however be difficult especially in developing countries’ cities where the formal-informal continuum hampers the effective urban planning and development. This is attributed to the fact that a larger part of land in these cities is occupied and any public good or service provision initiative must be through either compulsory land acquisition or land aggregation approaches. In either approach there are pros and cons towards realising the well-functioning of the neighbourhood in terms accessibility, recreation, social services and other public amenities. Based on non-parametric tests of neighbourhood functionality differences across land access modalities, the survey data across wards in Dar es Salaam City, Tanzania it has been revealed that government action through compulsory acquisition of land may be justifiable in as much as the functioning of social and physical infrastructure is concerned but can limitedly be relied upon in making such facilities available in the first place. Voluntary contribution of land, open market purchase and even the voluntary contribution of cash are working better than compulsory acquisition of land for that purpose. Further evidence alludes to the fact that compulsory acquisition of land is not only detrimental to neighbourhood social networks but also can worsen neighbourhood level economic opportunities. As such alternatives to compulsory acquisition need be used in well-developed inner city neighbourhoods while some combination of compulsory or voluntary land and cash contributions are well suited in outskirt neighbourhoods

Collaborative Governance in Land Acquisition and Aggregation Practices: The Impacts on Neighbourhood Functionalities in Tanzania

In urban development projects, the amount of land needs to be large enough to support not only the intended development but also the subsequent well-functioning of the neighbourhood through enhanced accessibility, service provision and liveability in general. Obtaining land for public goods and services at neighbourhood level may however be difficult especially in developing countries’ cities where the formal-informal continuum hampers the effective urban planning and development. This is attributed to the fact that a larger part of land in these cities is occupied and any public good or service provision initiative must be through either compulsory land acquisition or land aggregation approaches. In either approach there are pros and cons towards realising the well-functioning of the neighbourhood in terms accessibility, recreation, social services and other public amenities. Based on non-parametric tests of neighbourhood functionality differences across land access modalities, the survey data across wards in Dar es Salaam City, Tanzania it has been revealed that government action through compulsory acquisition of land may be justifiable in as much as the functioning of social and physical infrastructure is concerned but can limitedly be relied upon in making such facilities available in the first place. Voluntary contribution of land, open market purchase and even the voluntary contribution of cash are working better than compulsory acquisition of land for that purpose. Further evidence alludes to the fact that compulsory acquisition of land is not only detrimental to neighbourhood social networks but also can worsen neighbourhood level economic opportunities. As such alternatives to compulsory acquisition need be used in well-developed inner city neighbourhoods while some combination of compulsory or voluntary land and cash contributions are well suited in outskirt neighbourhoods

Food Security Survey Research

Despite the fact that agriculture is the Major means of livelihood for most people in Mombo Division the food security situation at the household level is still unsatisfactory. To find out the courses of food insecurity, the survey was carried out to 300 households, focus group discussion, documentary review and field visit using both qualitative and quantitative research methodology. The approach that was applied was participatory action research involving host organization leaders' village leaders, District community development officers and agricultural extension officers. Quantitative data were collected using semi-structured questionnaire and focus group discussion, documentary review, direct observation and secondary data studies were used to compliment the information collected by quantitative method. The information from questionnaire was analyzed by using Epin-for statistical package. The results revealed that during acute food shortage which takes place from January to June 126(50%) according to respondents interviewed consume only 1 meal that means they forego two of the 3 meals (lunch, dinner or breakfast) while at normal situation 210 respondent equivalent to 85% consume 3 meals. About 112 respond equivalent to 47% during the survey had no enough food. The main reason according to 231 (92%) was drought, poor harvest, and storage and poor crop production skills. The survey team suggests development of food security proposal that may check food insecurity in the area

Pain management among adult patients with fractures of long bones at Muhimbili Orthopaedic Institute in Dar es Salaam, Tanzania

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage and is one of the leading complaints in emergency departments (EDs). Despite the important and the advantages of pain control, still patients do not receive appropriate attention. The objective of this study was to assess pain management among adult patients with fractures of long bones at Muhimbili Orthopaedic Institute in Dar es Salaam, Tanzania. A descriptive Cross-sectional study design (Hospital based) was used.  Total of 250 patients aged 18 – 60 years old with fractures of long bones were recruited from March to June 2008. Structured questionnaires and observation guide were used to collect data. Verbal rating scale was used, to determine the intensity of pain. The study shows that there is no documentation for pain assessment or reassessment at Emergency Department. Slightly above half (54%; 135/250) of patients were not given analgesics. The commonest analgesic given was diclofenac sodium (46%). There was no patient given opioids (pethedine/ morphine). The rate of analgesics administration or splinting before and after admission did not differ between sexes (P=0.314 vs P= 0.230) and (P=0.314 vs P= 0.114), respectively. Almost half (47.0%) of them spent >20 min to 1 hour before the administration of analgesics. After administration of analgesia 76% of the patients continued to have severe to moderate pain. A large proportion (62.4%; N=156/250) of the patients scored their pain as severe. Of these, 28 (17.9%) patients received analgesia within 20 min, 42 (26.9%) after 30-60 min and 73 (46.8%) were not given analgesics at all. In conclusion pain at Moi Orthopaedic Institute is under treated. It is important that this is addressed properly to minimize pains among patients attending hospitals for fracture management

Food security survey research

Despite the fact that agriculture is the major means of livelihood for most people in Mombo Division the food security situation at the household level is still unsatisfactory. To find out the courses of food insecurity, the survey was carried out to 300 households, focus group discussion, documentary review and field visit using both qualitative and quantitative research methodology. The approach that was applied was participatory action research involving host organization leaders' village leaders, District community development officers and agricultural extension officers. Quantitative data were collected using semi-structured questionnaire and focus group discussion, documentary review, direct observation and secondary data studies were used to compliment the information collected by quantitative method. The information from questionnaire was analyzed by using Epin-for statistical package. The results revealed that during acute food shortage which takes place from January to June 126(50%) according to respondents interviewed consume only 1 meal that means they forego two of the 3 meals (lunch, dinner or breakfast) while at normal situation 210 respondent equivalent to 85% consume 3 meals. About 112 respond equivalent to 47% during the survey had no enough food. The main reason according to 231 (92%) was drought, poor harvest, and storage and poor crop production skills. The survey team suggests development of food security proposal that may check food insecurity in the area. (Author abstract)Makupa, F. F. (2005). Food security survey research. Retrieved from http://academicarchive.snhu.eduMaster of Science (M.S.)School of Community Economic Developmen

Short-term outcome of patients with closed comminuted femoral shaft fracture treated with locking intramedullary sign nail at Muhimbili Orthopaedic Institute in Tanzania

Background: Comminuted femoral shaft fractures are complex to treat because of increased risk of limb length discrepancies and mal-rotation deformities. Currently the interlocking intramedullary nail using image intensifiers is a suggested treatment for comminuted femoral shaft fractures. This study aimed to evaluate the short-term outcome of patients with closed comminuted femoral shaft fracture treated with locking intramedullary SIGN nail without image intensifiers at Muhimbili Orthopaedic Institute (MOI) in Tanzania.Methods: A prospective hospital base study was conducted on patients with closed comminuted femoral shaft fractures admitted at MOI from March 2011 to February 2012. A total of 91 adult patients (18 to 84 years) were enrolled in the study. Of the total patients, 80 (88%) patients were male, 11 were lost to follow-up, and 80 patients completed follow-ups of 18 weeks post operatively. Structured questionnaires and checklist forms were used to collect information. Operations were carried out either by antegrade or retrograde SIGN nail. Post operatively control radiographs, the lower limb length and mal-rotation deformities were assessed.Results: Comminuted femoral shaft fracture accounted for 20.3% of all adult femoral shaft fractures admitted at MOI. Deep wound infection occurred in 2.5%. Shortening of 2-3cm was seen in 3.8% of the patients. No patient had shortening of more than 3cm. External rotation deformity of more than 20 degrees occurred in 6.3% of the cases. Internal rotation deformity of more than 15 degrees was seen in 7.9%. Knee flexion of less than 90 degree was encountered in 7.5% of patients. By 18th week 95% of the patients had callus formation. Conclusion: SIGN nail appears to be an effective treatment for comminuted femoral shaft fractures in settings where image intensifiers and fracture tables are not readily available. They have excellent to good outcomes in rate of callus formation, limb length and limb alignment outcomes

Severity of Visual Field Loss at First Presentation to Glaucoma Clinics in England and Tanzania

Purpose: To compare severity of visual field (VF) loss at first presentation in glaucoma clinics in England and Tanzania. Methods: Large archives of VF records from automated perimetry were used to retrospectively examine vision loss at first presentation in glaucoma clinics in Tanzania (N = 1,502) and England (N = 9,264). Mean deviation (MD) of the worse eye at the first hospital visit was used as an estimate of detectable VF loss severity. Results: In Tanzania, 44.7% {CI95%: 42.2, 47.2} of patients presented with severe VF loss (< −20 dB), versus 4.6% {4.1, 5.0} in England. If we consider late presentation to also include cases of advanced loss (-12.01 dB to -20 dB), then the proportion of patients presenting late was 58.1% {55.6, 60.6} and 14.0% {13.3, 14.7}, respectively. The proportion of late presentations was greater in Tanzania at all ages, but the difference was particularly pronounced among working-age adults, with 50.3% {46.9, 53.7} of 18–65-year-olds presenting with advanced or severe VF loss, versus 10.2% {9.3, 11.3} in England. In both countries, men were more likely to present late than women. Conclusions: Late presentation of glaucoma is a problem in England, and an even greater challenge in Tanzania. Possible solutions are discussed, including increased community eye-care, and a more proactive approach to case finding through the use of disruptive new technologies, such as low-cost, portable diagnostic aids

Diabetic retinopathy in Tanzania: prevalence and risk factors at entry into a regional screening programme.

OBJECTIVE: The number of adults with diabetes in sub-Saharan Africa (SSA) is expected to almost double by 2035. This study investigated the prevalence of diabetic retinopathy (DR) and its risk factors at entry into a community-based screening programme. METHODS: All persons with diabetes screened for retinopathy at entry into a screening programme in Kilimanjaro Region, Tanzania between November 2010 and December 2014 were included. Fundus photographs were taken with a Topcon retinal camera following pupil dilation. Data were collected on BP, random blood sugar, duration of diabetes, BMI and visual acuity on entry. RESULTS: A total of 3187 persons were screened for DR. The prevalence of any DR was 27.9% (95%CI 26.4-29.5%) with background diabetic retinopathy (BDR), pre-proliferative diabetic retinopathy (PPDR) and proliferative diabetic retinopathy (PDR) having a prevalence of 19.1% (95% CI 17.7-20.4%), 6.0% (95%CI 5.2-6.8%) and 2.9% (95%CI 2.3-3.5%), respectively. Maculopathy was present in 16.1% (95%CI 14.8-17.4%) of participants. Multivariable logistic regression analysis for the presence of any DR found independent associations with duration of diabetes (P < 0.0001), systolic BP (P < 0.0001), random blood sugar (P < 0.0001) and attending a government hospital diabetic clinic (P = 0.0339). CONCLUSIONS: This study is the first to present data from a DR screening programme in SSA. The results will provide policymakers with data to aid planning of DR screening and treatment services in the African region. The study highlights the importance of managing comorbidities within DR screening programmes