Knowledge, attitudes and practice pertaining to depression among primary health care workers in Tanzania

Examination of consultation data in a variety of primary care settings in Tanzania shows that, while psychoses are routinely diagnosed and treated at primary care level, depression is rarely recorded as a reason for consultation. Since, epidemiological studies elsewhere show that depression is a much more common disorder than psychosis, a series of studies were undertaken to elucidate this apparent paradox in Tanzania and inform mental health policy; firstly, a household prevalence study to ascertain the prevalence of common mental disorders at community level in Tanzania; secondly, a study to ascertain the prevalence of common mental disorders in primary care attenders; and thirdly, a study to ascertain the current status of the knowledge, attitude and practice pertaining to depression among primary health care workers. This paper reports the findings of the latter study. All the primary health care workers (N = 14) in four primary health care centres in Tanzania were asked to complete the Depression Attitude Questionnaire, which assesses the health worker's knowledge and attitude towards the causes, consequences and treatment of depression. The majority of respondents felt that rates of depression had increased in recent years, believed that life events were important in the aetiology of depression, and generally held positive views about pharmacological and psychological treatments of depression, prognosis and their own involvement in the treatment of depressed patients.However, the majority of respondents felt that becoming depressed is a way that people with poor stamina deal with life difficulties. The findings suggest a need to strengthen the training of primary health care workers in Tanzania about the detection of depression, pharmacological and psychological treatments, and psychosocial interventions

Developing and implementing mental health policy in Zanzibar, a low income country off the coast of East Africa

<p>Abstract</p> <p>Background</p> <p>The Zanzibar Ministry of Health and Social Welfare, concerned about mental health in the country, requested technical assistance from WHO in 1997.</p> <p>Aims</p> <p>This article describes the facilitation over many years by a WHO Collaborating Centre, of sustainable mental health developments in Zanzibar, one of the poorest countries in the world, using systematic approaches to policy design and implementation.</p> <p>Methods</p> <p>Based on intensive prior situation appraisal and consultation, a multi-faceted set of interventions combining situation appraisal to inform planning; sustained policy dialogue at Union and state levels; development of policy and legislation, development of strategic action plans, establishment of intersectoral national mental health implementation committee, establishment of national mental health coordination system, integration of mental health into primary care, strengthening of primary-secondary care liaison, rationalisation and strengthening of secondary care system, ensuring adequate supply of medicines, use of good practice guidelines and health information systems, development of services for people with intellectual disability, establishment of formal mechanism for close liaison between the mental health services and other governmental, non-governmental and traditional sectors, mental health promotion, suicide prevention, and research and development.</p> <p>Results</p> <p>The policy and legislation introduced in 1999 have resulted in enhanced mental health activities over the ensuing decade, within a setting of extreme low resource. However, advances ebb and flow and continued efforts are required to maintain progress and continue mental health developments. Lessons learnt have informed the development of mental health policies in neighbouring countries.</p> <p>Conclusions</p> <p>A multi-faceted and comprehensive programme can be effective in achieving considerable strengthening of mental health programmes and services even in extremely low resource settings, but requires sustained input and advocacy if gains are to be maintained and enhanced.</p

Prevalence of Psychotic Symptoms and Their Risk Factors in Urban Tanzania

This study aimed to determine the prevalence of psychotic symptoms in urban Tanzania and their relationship with demographic, socio-economic and social factors. A random sample of 899 adults aged 15–59 was surveyed. The main outcome measure was endorsement of one or more psychotic symptoms identified by the Psychosis Screening Questionnaire. 3.9% respondents reported one or more psychotic symptoms in the preceding year. Significantly higher rates of symptoms were found in those who had recently experienced two or more stressful life events, those with CMD and people who had used cannabis in the preceding year

Common Mental Disorders and Risk Factors in Urban Tanzania

A cross sectional population based epidemiological survey of 899 adults aged between 15 and 59 was undertaken in two urban areas of demographic surveillance sites in Dar es Salaam, Tanzania, using the Clinical Interview Schedule Revised. Significantly higher rates were found among those who had experienced more than three severe life events in the last six months and relationship difficulties and death of a loved one

Prevalence of Alcohol Consumption and Hazardous Drinking, Tobacco and Drug Use in Urban Tanzania, and Their Associated Risk Factors

Evidence suggests substance abuse in Tanzania is a growing public health problem. A random sample of 899 adults aged 15–59 in two urban sites of differing levels of poverty surveyed alcohol, tobacco and illicit substance use. Rates of substance use were 17.2%. 8.7% and 0.8% for alcohol, tobacco and cannabis, respectively. Living in the less affluent area was associated with higher lifetime rates of tobacco and alcohol use. Substance use is less prevalent in Tanzania than in richer countries, but lifetime consumption is higher in poorer areas. The association of substance use with a range of socio-economic factors warrants further research

Hand hygiene practices among primary and secondary school students in sub-Saharan Africa: a systematic review

The purpose of this study was to comprehensively appraise and synthesize studies on hand hygiene practices among primary and secondary school students in sub-Saharan Africa (SSA). This is a thorough review of scientific papers published between 2015 and 2023 from primary databases such as the Web of Science, Science Direct, PubMed, and Google Scholar. The review criteria were met by 26 out of 63 studies assessed for legibility. The review demonstrated that students in SSA had moderate and good hand washing practices in terms of regular hand washing, cleaning hands after defecation, and before and after eating. Furthermore, the review pinpoints hand washing practices as influenced by factors such as knowledge, hand washing facilities and materials, influences from parents and teachers or others, personal and social factors, media, gender, age, and other factors such as location, attitudes, and school modernity. Furthermore, the reviewed studies highlighted recommendations for improving hand hygiene practices, such as enhancing hand hygiene and environmental health education, mobilizing resources for hand washing, creating and implementing health policy, and conducting further studies. This review provides data for policymakers on how to improve student hand hygiene and adds to existing knowledge on hand hygiene practices. HIGHLIGHTS This study presents evidence from the existing literature on school students’ hand hygiene practices in sub-Saharan Africa (SSA).; The review covered papers published in SSA from 2015 to 2023.; The hand hygiene practices of students were shown to be moderate and good.; The hand hygiene practices are subject to several factors including knowledge.; The findings encourage further efforts to promote hand hygiene at the school and home levels.