Health workers\u27 counselling practices on and women\u27s awareness of pregnancy danger signs in selected rural health facilities in Burkina Faso, Ghana and Tanzania

Background: This study assessed health workers’ counselling practices on danger signs during antenatal consultation and pregnant women’s awareness of these signs and identified factors affecting counselling practices and women’s awareness. The study is part of QUALMAT, an intervention research project funded by the European Commission aiming to improve maternal and newborn health. QUALMAT is conducted in Burkina Faso, Ghana and Tanzania. Methods: A cross-sectional study was performed in 12 selected primary healthcare facilities in each country. WHOguidelines were used as standard for good counselling. We assessed providers’ counselling practice on seven danger signs through direct observation study (35 observations/facility). Exit interviews (63 interviews/facility) were used to assess women’s awareness of the same seven signs. We used negative binomial regression to assess associations with health services’ and sociodemographic characteristics. Results: About one in three women were not informed on any danger sign. For most single signs, less than half of the women were counselled. Vaginal bleeding and severe abdominal pain were the signs most counselled on (between 52 and 66%). At study facilities in Burkina Faso 58% of women were not able mentioning a danger sign, in Ghana this was 22% and in Tanzania 30%. Fever, vaginal bleeding and severe abdominal pain were signs most frequently mentioned. Kind of health worker (depending on training) was significantly associated with counselling practices. Depending on the study site, characteristics significantly associated with awareness of signs were women’s age, gestational age, gravidity and women’s educational level. Conclusion: Counselling practice is poor and not very efficient. A new approach of informing pregnant women ondanger signs is needed. Adopting a more client-centred approach might be an option. However as effects of ANC education remain largely unknown it is very well possible that improved counselling will not have effect on maternal and newborn mortality and morbidity

Efficiency of antenatal care and childbirth services in selected primary health care facilities in rural Tanzania : a cross-sectional study

Background: Cost studies are paramount for demonstrating how resources have been spent and identifying opportunities for more efficient use of resources. The main objective of this study was to assess the actual dimension and distribution of the costs of providing antenatal care (ANC) and childbirth services in selected rural primary health care facilities in Tanzania. In addition, the study analyzed determining factors of service provision efficiency in order to inform health policy and planning. Methods: This was a retrospective quantitative cross-sectional study conducted in 11 health centers and dispensaries in Lindi and Mtwara rural districts. Cost analysis was carried out using step down cost accounting technique. Unit costs reflected efficiency of service provision. Multivariate regression analysis on the drivers of observed relative efficiency in service provision between the study facilities was conducted. Reported personnel workload was also described. Results: The health facilities spent on average 7 USD per capita in 2009. As expected, fewer resources were spent for service provision at dispensaries than at health centers. Personnel costs contributed a high approximate 44% to total costs. ANC and childbirth consumed approximately 11% and 12% of total costs; and 8% and 10% of reported service provision time respectively. On average, unit costs were rather high, 16 USD per ANC visit and 79.4 USD per childbirth. The unit costs showed variation in relative efficiency in providing the services between the health facilities. The results showed that efficiency in ANC depended on the number of staff, structural quality of care, process quality of care and perceived quality of care. Population-staff ratio and structural quality of basic emergency obstetric care services highly influenced childbirth efficiency. Conclusions: Differences in the efficiency of service provision present an opportunity for efficiency improvement. Taking into consideration client heterogeneity, quality improvements are possible and necessary. This will stimulate utilization of ANC and childbirth services in resource-constrained health facilities. Efficiency analyses through simple techniques such as measurement of unit costs should be made standard in health care provision, health managers can then use the performance results to gauge progress and reward efficiency through performance based incentives

Effects of Road Traffic Congestion on Economic Activities of Dar es Salaam Region in Tanzania

The general objective of this study was to examine the effects of road traffic congestion on economic activities of Dar es Salaam Region in Tanzania. The findings show that congestion is caused by narrow roads, bad road conditions, rainfall, non-operating traffic lights, double parking, inadequate feeder-roads, road accidents, road work, many pedestrians crossing the road and many bumps in the roads. Also, congestion on average increases costs of fuel by Tsh. 32,167.00 paid from bus drivers’ pocket and reduces productive time of workers by 2.5 hours. Similarly, employees with formal employment got up between 3:00am and 4:00am early in the morning to avoid road congestion but due to unreliable transport services employee with income of Tsh. 90,000.00 spend 39% of the income as fare because they pay twice in a single journey. However, during their return home they are easily caught in congestion as they get home late at 22:00pm. Therefore, congestion affects the economy by reducing the turnover, profit margin and sales of individuals and in aggregates the economic activities of Dar es Salaam region. This study recommends that, roads be enlarged and pedestrian bridges, feeder-roads and bumps be constructed in a way that reduces congestion. Keywords: Road Traffic Congestion and Economic Activities DOI: 10.7176/JESD/12-6-05 Publication date:March 31st 202

Breeding in bambara groundnut (Vigna subterranea (L.) Verdc.): strategic considerations

Bambara groundnut (Vigna subterranea (L.) Verdc.) has a large number of landraces throughout Africa where small-scale farmers have preserved its genetic diversity on-farm. To date, the full genetic diversity of the crop remains largely unexploited. Until recently bambara groundnut never received any appreciable research effort, especially for its genetic improvement. Until then, only selection breeding was practised in which existing landraces were evaluated and their seeds multiplied. However, no new combinations resulting from hybridisation had ever been produced. Recently, collaborative research efforts involving partners from Africa and Europe have produced the first crosses of bambara groundnut. The creation of these crosses is a significant scientific and practical achievement and opens up the possibility of breeding true varieties of this crop. This paper shows how different strategies have been combined to establish the basis of a strategic breeding programme in bambara groundnut. The paper also illustrates the use of landraces in the bambara groundnut breeding programme, as an example of the contribution that landraces can make to increasing productivity in marginal environments and the conservation of a crop's genetic resources on-farm.African Journal of Biotechnology Vol. 4 (6), pp. 463-471, 200

Common interest

SummaryOne of the West's frontline bases during the Cold War has been turned into an innovative conservation project. Nigel Williams reports

Student Awareness of their Future Careers in Tanzania: A Case of One Private and Two Public Universities in Dar es Salaam

Career awareness is important in ensuring that individuals choose right career and are motivated in their studies. This study assessed career awareness among university students in Tanzania. Specifically, the study assessed the nature of students’ awareness about career choices; the effect of lacking career awareness and strategies of overcoming the challenge of lack of career awareness. To address these objectives, the study utilized 88 university students and 5 lecturers selected from three universities in Dar es Salaam region. Clustered and purposive sampling approaches were used in selecting respondents. They responded to a questionnaire and data were analyzed descriptively using SPSS. The findings revealed that majority of the respondents acquired career awareness at secondary level of education. Role models and professionals were the main source of career awareness to students. Poor performance and suppression of inborn talents were among the effects of lacking career awareness. To overcome the challenge, higher learning institutions should initiate career awareness programmes, the government should review curricula and parents should provide career guidance to their children. It is concluded that, a collaborative role from different stakeholders in ensuring young generations are well guided on their future careers could yield better results

Expression of Insoluble Influenza Neuraminidase Type 1 (NA1) Protein in Tobacco

The avian influenza virus, particularly H5N1 strain, is highly virulent to poultry and mankind. Several expression systems, like yeast, baculovirus and mammalian cells, have been adopted to produce vaccine candidate for this lethal disease. The present research aimed at developing a recombinant vaccine candidate, neuraminidase type 1 (NA1), for the Malaysia isolate of H5N1 in Nicotiana benthamiana. The NA1 gene was fused directly in-frame in cowpea mosaic virus (CPMV)-based pEAQ-HT vector with C-terminal polyhistidine-tag incorporated to ease the subsequent purification step. The expression of the NA1 gene in tobacco was confirmed at RNA and protein levels at 6 days post-infiltration (Dpi). From the insoluble fraction of the protein, a recombinant glycosylated NA1 protein with a molecular weight of ~56 kDa was immunogenically detected by a specific anti-NA polyclonal antibody. We report for the first time the insolubility of the plant-made NA1 protein where a native sequence was used for its expression. This study signifies the necessity of the use of optimised sequences for expression work and provides great opportunity for the exploration of plant-manufactured NA1 protein as vaccine candidate