Determinants of Early Initiation of Breastfeeding in Rural Tanzania.

Breastfeeding is widely known for its imperative contribution in improving maternal and newborn health outcomes. However, evidence regarding timing of initiation of breastfeeding is limited in Tanzania. This study examines the extent of and factors associated with early initiation of breastfeeding in three rural districts of Tanzania. Data were collected in 2011 in a cross-sectional survey of random households in Rufiji, Kilombero and Ulanga districts of Tanzania. From the survey, 889 women who had given birth within 2 years preceding the survey were analyzed. Both descriptive and inferential statistical analyses were conducted. Associations between the outcome variable and each of the independent variables were tested using chi-square. Logistic regression was used for multivariate analysis. Early initiation of breastfeeding (i.e. breastfeeding initiation within 1 h of birth) stood at 51 %. The odds of early initiation of breastfeeding was significantly 78 % lower following childbirth by caesarean section than vaginal birth (adjusted odds ratio (OR) = 0.22; 95 % confidence interval (CI) 0.14, 0.36). However, this was almost twice as high for women who gave birth in health facilities as for those who gave birth at home (OR = 1.75; 95 % CI 1.25, 2.45). Furthermore, maternal knowledge of newborn danger signs was negatively associated with early initiation of breastfeeding (moderate vs. high: OR = 1.73; 95 % CI 1.23, 2.42; low vs. high: OR = 2.06; 95 % CI 1.43, 2.96). The study found also that early initiation of breastfeeding was less likely in Rufiji compared to Kilombero (OR = 0.52; 95 % CI 0.31, 0.89), as well as among ever married than currently married women (OR = 0.46; 95 % CI 0.25, 0.87). To enhance early initiation of breastfeeding, using health facilities for childbirth must be emphasized and facilitated among women in rural Tanzania. Further, interventions to promote and enforce early initiation of breastfeeding should be devised especially for caesarean births. Women residing in rural locations and women who are not currently married should be specifically targeted with interventions aimed at enhancing early initiation of breastfeeding to ensure healthy outcomes for newborns

Sociodemographic Drivers of Multiple Sexual Partnerships among Women in three Rural Districts of Tanzania

This study examines prevalence and correlates of multiple sexual partnerships (MSP) among women aged 15+ years in Rufiji, Kilombero, and Ulanga districts of Tanzania. Data were collected in a cross-sectional household survey in Rufiji, Kilombero, and Ulanga districts in Tanzania in 2011. From the survey, a total of 2,643 sexually active women ages 15+ years were selected for this analysis. While the chi-square test was used for testing association between MSP and each of the independent variables, logistic regression was used for multivariate analysis. Number of sexual partners reported ranged from 1 to 7, with 7.8% of the women reporting multiple sexual partners (2+) in the past year. MSP was more likely among both ever married women (adjusted odds ratio [AOR] =3.83, 95% confidence interval [CI] 1.40–10.49) and single women (AOR =6.13, 95% CI 2.45–15.34) than currently married women. There was an interaction between marital status and education, whereby MSP was 85% less likely among single women with secondary or higher education compared to married women with no education (AOR =0.15, 95% CI 0.03–0.61). Furthermore, women aged 40+ years were 56% less likely compared to the youngest women (,20 years) to report MSP (AOR =0.44, 95% CI 0.24–0.80). The odds of MSP among Muslim women was 1.56 times as high as that for Christians women (AOR =1.56, 95% CI 1.11–2.21). Ndengereko women were 67% less likely to report MSP compared to Pogoro women (AOR =0.33, 95% CI 0.18–0.59). Eight percent of the women aged 15+ in Rufiji, Kilombero, and Ulanga districts of Tanzania are engaged in MSP. Encouraging achievement of formal education, especially at secondary level or beyond, may be a viable strategy toward partner reduction among unmarried women. Age, religion, and ethnicity are also important dimensions for partner reduction efforts

Estimation of Indices of Health Service Readiness with A Principal Component Analysis of the Tanzania Service Provision Assessment Survey.

Service Provision Assessment (SPA) surveys have been conducted to gauge primary health care and family planning clinical readiness throughout East and South Asia as well as sub-Saharan Africa. Intended to provide useful descriptive information on health system functioning to supplement the Demographic and Health Survey data, each SPA produces a plethora of discrete indicators that are so numerous as to be impossible to analyze in conjunction with population and health survey data or to rate the relative readiness of individual health facilities. Moreover, sequential SPA surveys have yet to be analyzed in ways that provide systematic evidence that service readiness is improving or deteriorating over time. This paper presents an illustrative analysis of the 2006 Tanzania SPA with the goal of demonstrating a practical solution to SPA data utilization challenges using a subset of variables selected to represent the six building blocks of health system strength identified by the World Health Organization (WHO) with a focus on system readiness to provide service. Principal Components Analytical (PCA) models extract indices representing common variance of readiness indicators. Possible uses of results include the application of PCA loadings to checklist data, either for the comparison of current circumstances in a locality with a national standard, for the ranking of the relative strength of operation of clinics, or for the estimation of trends in clinic service quality improvement or deterioration over time. Among hospitals and health centers in Tanzania, indices representing two components explain 32 % of the common variance of 141 SPA indicators. For dispensaries, a single principal component explains 26 % of the common variance of 86 SPA indicators. For hospitals/HCs, the principal component is characterized by preventive measures and indicators of basic primary health care capabilities. For dispensaries, the principal component is characterized by very basic newborn care as well as preparedness for delivery. PCA of complex facility survey data generates composite scale coefficients that can be used to reduce indicators to indices for application in comparative analyses of clinical readiness, or for multi-level analysis of the impact of clinical capability on health outcomes or on survival

A micro gas preconcentrator with improved performance for pollution monitoring and explosives detection

International audienceThis paper presents the optimization of a micro gas preconcentrator based on a micro-channel in porous and non-porous silicon filled with an adequate adsorbent. This micro gas preconcentrator is both applicable in the fields of atmospheric pollution monitoring (Volatil organic compounds—VOCs) and explosives detection (nitroaromatic compounds). Different designs of micro-devices and adsorbent materials have been investigated since these two parameters are of importance in the performances of the micro-device. The optimization of the device and its operation were driven by its future application in outdoor environments. Parameters such as the preconcentration factor, cycle time and the influence of the humidity were considered along the optimization process. As a result of this study, a preconcentrator with a total cycle time of 10 min and the use of single wall carbon nanotubes (SWCNTs) as adsorbent exhibits a good preconcentration factor for VOCs with a limited influence of the humidity. The benefits of using porous silicon to modify the gas desorption kinetics are also investigated

Projection methods in conic optimization

There exist efficient algorithms to project a point onto the intersection of a convex cone and an affine subspace. Those conic projections are in turn the work-horse of a range of algorithms in conic optimization, having a variety of applications in science, finance and engineering. This chapter reviews some of these algorithms, emphasizing the so-called regularization algorithms for linear conic optimization, and applications in polynomial optimization. This is a presentation of the material of several recent research articles; we aim here at clarifying the ideas, presenting them in a general framework, and pointing out important techniques

Trends in socioeconomic disparities in a rapid under-five mortality transition: a longitudinal study in United Republic of Tanzania

Abstract: Objective To explore trends in socioeconomic disparities and under-five mortality rates in rural parts of United Republic of Tanzania between 2000 and 2011. Methods: We used longitudinal data on births, deaths, migrations, maternal educational attainment and household characteristics from the Ifakara and Rufiji health and demographic surveillance systems. We estimated hazard ratios (HR) for associations between mortality and maternal educational attainment or relative household wealth, using Cox hazard regression models. Findings: The under-five mortality rate declined in Ifakara from 132.7 deaths per 1000 live births (95% confidence interval, CI: 119.3–147.4) in 2000 to 66.2 (95%CI: 59.0–74.3) in 2011 and in Rufiji from 118.4 deaths per 1000 live births (95% CI: 107.1– 130.7) in 2000 to 76.2 (95% CI: 66.7–86.9) in 2011. Combining both sites, in 2000– 2001, the risk of dying for children of uneducated mothers was 1.44 (95% CI: 1.08– 1.92) higher than for children of mothers who had received education beyond primary school. In 2010–2011, the HR was 1.18 (95% CI: 0.90–1.55). In contrast mortality disparities between richest and poorest quintiles worsened in Rufiji, from 1.20 (95% CI: 0.99–1.47) in 2000–2001 to 1.48 (95% CI: 1.15–1.89) in 2010–2011, while in Ifakara, disparities narrowed from 1.30 (95% CI: 1.09–1.55) to 1.15 (95% CI: 0.95–1.39) in the same period. Conclusion: While childhood survival has improved, mortality disparities still persist, suggesting a need for policies and programmes that both reduce child mortality and address socioeconomic disparities

Micro gas preconcentrator in porous silicon filled with a carbon absorbent

International audienceThis paper presents the development of a gas preconcentrator based on a micro-channel in porous silicon filled with carbon nanopowders by a micro-fluidic process. The particularity of this device is its applicability in the fields of atmospheric pollution monitoring by targeting VOCS (volatiles organic compounds). Various designs of micro-devices have been investigated and a special focus has been dedicated to the carbon adsorbent. The optimization of the device and its operation were driven by its future application in outdoor environments. The benefits of using porous silicon to ease the fixing of the carbon absorbent in micro-channels and to modify the gas desorption kinetic are also investigated. Results on a device based on a carbon adsorbent powder filled in a porous silicon micro-channel for benzene preconcentration are reported

Predictors of mistimed, and unwanted pregnancies among women of childbearing age in Rufiji, Kilombero, and Ulanga districts of Tanzania

Background: While unintended pregnancies pose a serious threat to the health and well-being of families globally, characteristics of Tanzanian women who conceive unintentionally are rarely documented. This analysis identifies factors associated with unintended pregnancies—both mistimed and unwanted—in three rural districts of Tanzania. Methods: A cross-sectional survey of 2,183 random households was conducted in three Tanzanian districts of Rufiji, Kilombero, and Ulanga in 2011 to assess women’s health behavior and service utilization patterns. These households produced 3,127 women age 15+ years from which 2,199 gravid women aged 15–49 were selected for the current analysis. Unintended pregnancies were identified as either mistimed (wanted later) or unwanted (not wanted at all). Correlates of mistimed, and unwanted pregnancies were identified through Chi-squared tests to assess associations and multinomial logistic regression for multivariate analysis. Results: Mean age of the participants was 32.1 years. While 54.1% of the participants reported that their most recent pregnancy was intended, 32.5% indicated their most recent pregnancy as mistimed and 13.4% as unwanted. Multivariate analysis revealed that young age (<20 years), and single marital status were significant predictors of both mistimed and unwanted pregnancies. Lack of inter-partner communication about family planning increased the risk of mistimed pregnancy significantly, and multi-gravidity was shown to significantly increase the risk of unwanted pregnancy. Conclusions: About one half of women in Rufiji, Kilombero, and Ulanga districts of Tanzania conceive unintentionally. Women, especially the most vulnerable should be empowered to avoid pregnancy at their own will and discretion

Cinematic and aesthetic cartographies of subjective mutation

This article exmaines the use of cinema as a mapping of subjective mutation in the work of Deleuze, Gauttari and Berardi. Drawing on Deleuze's distinciton between the reduction of the art-work to the symptom and the idea of art as symptomatology, the article focuses on Berardi's use of cinematic examples, posing the quesiton in each case of to what extent they function as symptomatologies or mere symptoms of cultural and subjective mutations in examples ranging from Bergman's Persona to Van Sant's Elephant to finish on speculations about Fincher's The Social Network as a cirtical engagement with subjective mutation in the 21st Century

Determinants of early initiation of breastfeeding in rural Tanzania

Background Breastfeeding is widely known for its imperative contribution in improving maternal and newborn health outcomes. However, evidence regarding timing of initiation of breastfeeding is limited in Tanzania. This study examines the extent of and factors associated with early initiation of breastfeeding in three rural districts of Tanzania. Methods Data were collected in 2011 in a cross–sectional survey of random households in Rufiji, Kilombero and Ulanga districts of Tanzania. From the survey, 889 women who had given birth within 2 years preceding the survey were analyzed. Both descriptive and inferential statistical analyses were conducted. Associations between the outcome variable and each of the independent variables were tested using chi–square. Logistic regression was used for multivariate analysis. Results Early initiation of breastfeeding (i.e. breastfeeding initiation within 1 h of birth) stood at 51 %. The odds of early initiation of breastfeeding was significantly 78 % lower following childbirth by caesarean section than vaginal birth (adjusted odds ratio (OR) = 0.22; 95 % confidence interval (CI) 0.14, 0.36). However, this was almost twice as high for women who gave birth in health facilities as for those who gave birth at home (OR = 1.75; 95 % CI 1.25, 2.45). Furthermore, maternal knowledge of newborn danger signs was negatively associated with early initiation of breastfeeding (moderate vs. high: OR = 1.73; 95 % CI 1.23, 2.42; low vs. high: OR = 2.06; 95 % CI 1.43, 2.96). The study found also that early initiation of breastfeeding was less likely in Rufiji compared to Kilombero (OR = 0.52; 95 % CI 0.31, 0.89), as well as among ever married than currently married women (OR = 0.46; 95 % CI 0.25, 0.87). Conclusions To enhance early initiation of breastfeeding, using health facilities for childbirth must be emphasized and facilitated among women in rural Tanzania. Further, interventions to promote and enforce early initiation of breastfeeding should be devised especially for caesarean births. Women residing in rural locations and women who are not currently married should be specifically targeted with interventions aimed at enhancing early initiation of breastfeeding to ensure healthy outcomes for newborns