Understanding the link between trafficking in persons and HIV and AIDS risk in Tanzania

The magnitude of trafficking in persons in Tanzania is unknown. Consequently, available information on health risks of persons trafficked for different forms of exploitation is extremely scanty. We conducted a baseline study in eight administrative regions of Tanzania using both qualitative and quantitative methods to generate data on the health conditions of trafficked persons to inform trafficking in persons control measures through HIV and AIDS interventions. Study participants included the national, regional and district community development officers, district medical officers, local government leaders, managers or representatives of non-governmental organizations involved in anti-trafficking in persons activities, members of the community and victims. Findings indicated that common forms of labour into which persons are trafficked include domestic services, agriculture (farming), construction, mining/quarrying, fishing, lumbering and manufacturing. Trafficked persons are reported to be exposed to risks like overcrowding, long working hours, psychological problems, physical injuries, impotence, breathing problems and sexually transmitted infections including HIV. It is concluded that the reported occupational hazards in industries where trafficked persons are forced into are not specific to trafficked persons as they affect all labourers. However, the underground nature of the trafficking in persons process increases health problems and risks, including the vulnerability to HIV infection. More tailored research is needed, especially to find means of how to reach out and provide services to this particular vulnerable population, validate labour forms of exploitation into which persons are trafficked to enable the integration or mainstreaming of HIV and AIDS and trafficking in persons at the policy and programmatic levels. In addition, findings would facilitate the understanding of the link between increased risk of HIV and trafficking in persons

Factors associated with child sexual abuse in Tanzania: a qualitative study

Background: Child sexual abuse (CSA) is one of the most pervasive occurrences which are reported all over the world. It often goes unnoticed and undocumented due to surrounding taboos; its sensitivity in nature and affects the less powerful population. Anecdote information is available on the nature and extent of sexual abuse among children in Tanzania. The aim of this study was to explore factors, forms, context of abuse and perpetrators of child sex abuse in selected regions of Tanzania.Methods: Key informant interviews were conducted among adults including parents of the victims to explore factors associated with sexual abuse of children under 10 years old in Tanzania. The interview guide centred on factors for child sexual abuse, the type of perpetrators and the context into which these abuses take place.Results: There were incidences of child sexual abuse in Tanzania and the major forms were anal and vaginal penetration, and the most affected were girls. The abuses were rarely reported due to shame and embarrassment faced by the affected children and parents. The causes of child sexual abuse were poverty, ambitions and moral degradation, myths and beliefs, urbanization, foreign culture and poor parental care. Incidents of CSA were reported to occur in perpetrators’ homes and in semi-finished housing structures, madrassa and recreational venues where children can freely access entertainment by watching movies. These acts were committed by people in position of power, close relationship and trusted by the children. Contexts where child sexual abuses occur included overcrowded living spaces and social activities that go on late into the night.Conclusion: We recommend for strengthened interventions at different levels within the society to address the root causes and different contexts in which child sex abuse occurs. Increased awareness of the root causes should go hand in hand with measures to encourage parents and survivors to report incidents to relevant authorities timely as they occur

Predictors of condom use among unmarried sexually active women of Reproductive age in Tanzania

Background: Condom is one of the methods for prevention against Human Immunodeficiency Virus and other Sexually Transmitted Infections. It is also considered an effective method for preventing unwanted pregnancies. Despite the several interventions that have been put to promote condom use, still a large proportion of women do not use condom during sexual intercourse. Objectives: This study aimed at determining predictors of condom use among unmarried sexually active women of reproductive age in Tanzania. Methods: This study used secondary data from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2015-16 TDHS-MIS). It involved unmarried sexually active women aged 15-49 years. Multiple binary logistic regression was used to determine predictors for condom use at last sexual intercourse. Results: Overall, lower proportion (31.1%) of unmarried sexually active women used condom at last sexual intercourse. The odds of using condom during last sexual intercourse was lower aOR=0.67 and aOR=0.65 for women aged 20-24 and 25+ years respectively). Women who reported higher age (18+ years) at first sex had higher odds (aOR=1.65) of using condom compared to those started sex before 15 years old. Women owning telephone had higher odds (aOR=1.44) compared to women without telephone. Also, higher odds of using condom were observed for women in the Southern, South West highlands, and Eastern zones compared to the Central zone. Discussion: Age, marital union, parity, wealth, ownership of; mobile phone, television, access to newspapers, and radio significantly predicts condom use among unmarried sexually active women of reproductive age in Tanzania. Conclusion: The level of condom use among unmarried women in Tanzania is very low and varies by age, age at sex intercourse, ownership of phone and zones. Targeted interventions are needed to promote the condom use among unmarried women in order to mitigate the risk of HIV and un-intended pregnancies

Response to Rift Valley Fever in Tanzania: Challenges and Opportunities

Rift Valley Fever (RVF) is an arthropod borne viral disease affecting livestock (cattle, sheep, goats and camels), wildlife and humans caused by Phlebovirus. The disease occurs in periodic cycles of 4-15 years associated with flooding from unusually high precipitations in many flood-prone habitats. Aedes and Culex spp and other mosquito species are important epidemic vectors. Because of poor living conditions and lack of knowledge on the pathogenesis of RVF, nomadic pastoralists and agro-pastoralists are at high risk of contracting the disease during epidemics. RVF is a professional hazard for health and livestock workers because of poor biosafety measures in routine activities including lack of proper Personal Protective Equipment (PPE). Direct exposure to infected animals can occur during handling and slaughter or through veterinary and obstetric procedures or handling of specimens in laboratory. The episodic nature of the disease creates special challenges for its mitigation and control and many of the epidemics happen when the governments are not prepared and have limited resource to contain the disease at source. Since its first description in 1930s Tanzania has recorded six epidemics, three of which were after independence in 1961. However, the 2007 epidemic was the most notable and wide spread with fatal human cases among pastoralists and agro-pastoralists concurrent with high livestock mortality. Given all the knowledge that exist on the epidemiology of the disease, still the 2006/2007 epidemic occurred when the government of Tanzania was not prepared to contain the disease at source. This paper reviews the epidemiology, reporting and outbreak investigation, public awareness, preparedness plans and policy as well as challenges for its control in Tanzania

Fertility Desire and Intention of People Living with HIV/AIDS in Tanzania: A call for Restructuring Care and Treatment Services.

Scaling up of antiretroviral therapy (ART) is currently underway in sub-Saharan Africa including, Tanzania, increasing survival of people living with HIV/AIDS (PLWHA). Programmes pay little attention to PLWHA's reproductive health needs. Information on fertility desire and intention would assist in the integration of sexual and reproductive health in routine care and treatment clinics. A cross-sectional study of all PLWHA aged 15--49 residing in Kahe ward in rural Kilimanjaro Tanzania was conducted. Participants were recruited from the community and a local counselling centre located in the ward. Data on socio-demographic, medical and reproductive characteristics were collected through face-to-face interviews. Data were entered and analysed using STATA statistical software. A total of 410 PLWHA with a mean age of 34.2 and constituting 264 (64.4%) females participated. Fifty-one per cent reported to be married/cohabiting, 73.9% lived with their partners and 60.5% were sexually active. The rate of unprotected sex was 69.0% with 12.5% of women reporting to be pregnant at the time of the survey. Further biological children were desired by 37.1% of the participants and lifetime fertility intention was 2.4 children. Increased fertility desire was associated with living and having sex with a partner, HIV disclosure, good perceived health status and CD4 count >=200 cells for both sexes. Reduced desire was associated with havingmore than 2 children among females, divorce or separation, and having a child with the current partner among both males and females. Fertility desire and intention of PLWHA was substantially high though lower than that of the general population in Tanzania. Practice of unprotected sexual intercourse with higher pregnancy rate was observed. Fertility desire was determined by individual perceived health and socio-family related factors. With increasing ART coverage and subsequent improved quality of life of PLWHA, these findings underscore the importance of integrating reproductive health services in the routine care and treatment of HIV/AIDS worldwide. The results also highlight a group of PLWHA with potentially high desire for children who need to be targeted during care

COMPARE Forum: The idea of North-South and South-South collaboration

The idea of having a Compare Forum focusing on the above title was first discussed with one of the Editors of Compare during a PhD defence in Oslo in 2011. The PhD dissertation itself was linked to a larger project in which researchers from the North (Norway) and the South (South Africa) had been collaborating in educational research for over 10 years. Despite the fact that North-South collaboration is not a new issue on the agenda (King 1985) it is still a timely topic to explore, particularly given the recent growth and moves towards North-South-South collaboration or even South-South Cooperation in Education and Development (Chisholm and Steiner-Khamsi 2009). Thus, any discussion of research collaboration, whether North-South or South-South, is seen as an ideal topic for comparative education, particularly when exploring why there should be collaboration at all and if so what are some of the challenges. While it may be argued that the difference between North-South and South-South collaboration may simply be a question of geography, King (1985) reminds us that collaboration is not necessarily between equals and that collaboration at times ‘appears to be a process initiated in the North, and in which the South participates, as a counterpart’ (184). Ultimately, the differences go beyond simple geographic location to issues of funding and power, something that each of the contributions will touch upon in their own way. While cooperation may mean working with someone, it does suggest that one partner provides information or resources to the other, while collaboration suggests a more equal partnership in which researchers work alongside each other. For the majority of our contributors, we use collaboration as opposed to cooperation, although the literature is not always so clear on this distinction.Web of Scienc

Magnitude and factors associated with intimate partner violence in mainland Tanzania

Abstract Background In Tanzania like in many sub-Saharan countries the data about Intimate Partner Violence (IPV) are scarce and diverse. This study aims to determine the magnitude of IPV and associated factors among ever partnered women in urban mainland Tanzania. Methods Data for this report were extracted from a big quasi-experimental survey that was used to evaluate MAP (MAP - Men as Partners) project. Data were collected using standard questions as those in big surveys like Demographic and Health Surveys. Data analyses involved descriptive statistics to characterize IPV. Associations between IPV and selected variables were based on Chi-square test and we used binary logistic regression to assess factors associated with women’s perpetration to physical IPV and Odds Ratio (OR) as outcome measures with their 95 % confidence intervals (CI). Results The lifetime exposure to IPV was 65 % among ever-married or ever–partnered women with 34, 18 and 21 % reporting current emotional, physical and sexual violence respectively. Seven percent of women reported having ever physically abused partners. The prevalence of women perpetration to physical IPV was above 10 % regardless to their exposure to emotional, physical or sexual IPV. Conclusions IPV towards women in this study was high. Although rates are low, there is some evidence to suggest that women may also perpetrate IPV against their partners. Based on hypothesis of IPV and HIV co-existence, there should be strategies to address the problem of IPV especially among women

Factors associated with uptake of postpartum family planning services in Dodoma City Council, Tanzania: A cross-section study

Background: Postpartum family planning is very essential to mothers’ health. However, its utilization remains low in developing countries. Objective: To determine the proportion and factors associated with uptake of PPFP services in Dodoma Tanzania. Methods: A cross-sectional study employing a quantitative approach was conducted among women who gave birth one year before the study period (June 2020) in Dodoma city council. A two-stage sampling technique was employed to recruit a total number of 209 participants. An interviewer-administered questionnaire was used to collect data. Data were entered and cleaned using Epi Info 7 and later exported to and analyzed using SPSS version 25.0. Bivariate and multiple logistic regression models were employed during data analysis. Odds ratios with 95% confidence intervals were computed to identify factors associated with postpartum family planning. Results: Majority (53.6%) of women used contraceptives within one year after delivery. Three factors were significantly associated with the uptake of postpartum family planning. Lower odds for uptake of PPFP were found among self-employed women (AOR: 0.5, 95% CI 0.25–0.74) and unemployed women (AOR: 0.2, 95% CI 0.05–0.31) when compared with employed women. Using community health fund insurance (AOR: 2.4, 95% CI 1.09–6.42) and National Health Insurance Fund (AOR: 2.7, 95% CI 1.54–5.99) as a mode of payments for health had higher odds for uptake of PPFP compared to cash mode. Women with an adequate number of antenatal care visits had higher odds (AOR: 2.9, 95% CI 1.24–6.89) of uptake of PPFP compared to women with an inadequate number of antenatal care visits. Conclusion: The uptake of PPFP among women was not adequate and was associated with being employed, being covered by health insurance and adequate antenatal care visits. More interventions are needed to enhance PPFP use among women

"Are all referrals necessary?" Experiences and perceptions of maternity healthcare providers on emergency intrapartum referrals in Dar es Salaam, Tanzania.

BackgroundIntrapartum continuity of care to reduce maternal morbidity and mortality relies heavily on a functional and effective referral system between tiers of care. Capacity building of providers in managing intrapartum referrals is expected to improve the efficiency of the referral system, but this does not always work in practice. This study explored the experiences and perceptions of maternity healthcare providers on emergency intrapartum referrals in Dar es Salaam, Tanzania.MethodsAn exploratory qualitative study was conducted at Amana Regional Referral Hospital and Muhimbili National Hospital in Dar es Salaam. Maternity healthcare providers were purposively recruited based on cadre, working experience of more than three years in the maternity wards. An in-depth interview guide which involved questions and probes was used to conduct eleven interviews. Data was thematically analyzed.ResultsThree major themes emerged, namely: 1) causes of referrals are beyond medical indications; 2) limited maternity healthcare provider capability at referring facilities; and 3) limited communication between referring and receiving facilities. According to maternity healthcare professionals, referrals were seen as a way to minimize blame and a clinical management tool to prevent difficulties. They advocated for more understanding of the skill set among maternity healthcare providers, but some had negative perceptions towards performing their responsibilities.ConclusionsSkills gaps among maternity healthcare providers at referring hospitals influenced referral decision-making and service provision. There was hostility between referring and receiving hospitals. Capacity-strengthening strategies such as ongoing skills training and changes in attitudes toward referrals require improvements. The referring hospital should only consider referrals as a last resort after other case management has been completed