A cross-sectional study on knowledge and implementation of the nursing process among nurses at Muhimbili National Hospital-Tanzania

Background: The nursing process involves a series of actions that begin with assessing the patient, identifying problems, setting goals with expected outcomes, implementing care to achieve those goals, and finally evaluating the effectiveness of the care given. Utilization of the nursing process to guide nursing care enhances the quality of patient care and outcomes for both the patient and family members. The purpose of this study was to assess the knowledge and implementation of the nursing process among nurses working at Muhimbili National Hospital, Dar es Salaam, Tanzania. Methods: We conducted a descriptive cross-sectional study design. A convenient sample of 102 registered nurses (RN) completed a self-administered questionnaire in April 2016. Descriptive statistics and non-parametric tests were used to assess the significance levels of associated variables. Results: Of 102 respondents, only 16 (15.7%) had high knowledge of the nursing process. Similarly, a few (11, 10.8%) respondents had a high level of practice. The majority of RN (94, 92.2%) were aware of the role of the nurses in providing care to admitted patients. However, only a few (32, 31.4%) were aware of the purpose of the nursing process. Respondents were more likely to have high knowledge in the nursing process if they had a diploma in nursing education (95% CI 0.000-0.029, p < 0.01). The small number of nurses in the ward and inadequate motivational strategies were reported to deprive the implementation of the nursing process. Conclusion: Overall, low knowledge of the nursing process, understaffing and workload have contributed to the ineffective implementation of the nursing process.  On-the-job refresher courses are a short-term strategy that may improve the nurses’ knowledge and motivation to implement the nursing process. This study underscores the need for policymakers to advocate for the employment of a sufficient number of nurses to enable implementation of the nursing process to all admitted patients

Factors Influencing Knowledge Level of COVID-19 among Healthcare Workers: A Cross-sectional Survey in Four Regions of Tanzania

Up to April 24th 2020, the Government of Tanzania announced 284 cases of COVID-19, among them 7 were in intensive care, 37 recoveries, 10 deaths and the rest in stable condition while Dar es Salaam region was leading in number of infected cases followed by Mwanza, Arusha and Dodoma regions. This study was conducted to evaluate level of COVID-19 knowledge among healthcare workers in selected regions of Tanzania in order to identify the existing gap of knowledge in combating COVID-19. This study applied a quantitative analytical cross-sectional survey design in Dar es Salaam, Arusha, Mwanza and Dodoma regions of Tanzania from 24th of August till 3rd October, 2022. A total of 596 healthcare workers from 40 healthcare facilities were involved. Frequencies and percentages were analyzed for categorical variables. Association between categorical variables were analyzed by using Chi-square and variables were significant at P-value < 0.05. This study found that, healthcare workers have an average of 79.4% correct answers with overall level of knowledge at 70%, 24% and 6% of healthcare workers holding good, moderate and low levels of knowledge respectively. Multinomial logistic regression showed significant associations with service experience of 1-5 years (OR = 0.093, 95% CI, 0.011-0.759, P-value= 0.027) when good and poor knowledge compared. This study found moderate knowledge among healthcare workers. Significant association with level of knowledge reported in age, field profession, level of education, category of healthcare facility and situation of caring COVID-19 patients in facility

Healthcare facilities’ level of preparedness response on COVID-19 preventive measures in selected regions of Tanzania: A perspective of healthcare workers

Background: After the first patient of COVID-19 was announced by the Ministry of Health in Tanzania from Arusha region, the hottest discussion in the community was the fear on how our health facilities were prepared against the spread of coronavirus disease. Objective and significance: This study aims at assessing healthcare facilities level of preparedness response on preventive measures against COVID-19 in selected regions of Tanzania through the contributions of healthcare workers. This study will add value in building capacity to fight COVID-19 pandemic and possibly any other pandemic of similar significance in the future. Methods: Analytical cross-sectional study design which applied quantitative research strategy was conducted from August to October 2022. A total of 596 healthcare workers were involved in the study from 40 healthcare facilities in Dar es Salaam, Mwanza, Arusha, and Dodoma regions of Tanzania. Descriptive statistics were analyzed by a statistical package SPSS version 26 (IBM Corp., Armonk, NY) giving frequencies, percentages, and significant association between variables. Results: Overall level of preparedness was poor at 52%, only 25% of preventive measures were good prepared and 23% moderately prepared. Availability of hand washing station with soap and water to ensure hand hygiene for healthcare workers was most prepared by 87.1% while designated ambulance facility for transporting patients from isolation area to other COVID-19 referral facilities was less prepared by 30.4% in this study. Conclusion: Thepreparedness responses was poor in selected regions of Tanzania which cause less capacity to fight against COVID-19 whenever it emerges

Prevalence, Intensity, and Factors Associated with Urogenital Schistosomiasis among Women of Reproductive Age in Mbogwe District Council, Geita Region, Tanzania

Background. Urogenital schistosomiasis remains a public health problem in Tanzania. Control programs mostly target school-going children ignoring other vulnerable groups like women of child bearing age. Previous evidence has shown that women of reproductive age suffer greatest morbidities in endemic areas. This study sought to determine the prevalence, intensity, and factors associated with urogenital schistosomiasis among women of reproductive age in the Mbogwe District. Methods. A population-based analytical cross-section study was conducted in the Mbogwe District. A semistructured questionnaire was administered. Urine samples of 20-30 mils collected between 10.00 am to 02.00 pm and examined for Schistosoma eggs and infection intensity microscopically. Data analysis was done using SPSS version 20. Results. A total of 426 women of reproductive age, with median age of 26, and interquartile range of 11years were recruited and assessed. The prevalence of urogenital schistosomiasis was 4.5% and mean egg intensity of 19.5eggs/10mil of urine. After adjusting for confounders, lower level of education was associated with an increased risk of urogenital schistosomiasis infections (AOR 8.355, 95% CI 3.055-23.001). Conclusion. Urogenital schistosomiasis among women of reproductive age in the Mbogwe District is a problem. Education is the factor associated with the disease; the neglected tropical disease control program should develop strategies that should include provision of health education and should involve women of reproductive age as they act as infection reservoir. More studies are recommended to explore the possibility of reproductive complications among infected women in endemic areas

The impact of HIV/AIDS on mortality and household mobility in rural Tanzania.

OBJECTIVE: To assess the impact of the AIDS epidemic on mortality and household mobility before and after death. DESIGN: Open community cohort study with a demographic surveillance system and two sero-epidemiological surveys. METHODS: Ten rounds of demographic surveillance were completed during 1994-1998 in the study area, which has a population of about 20 000 people in a rural ward in north-west Tanzania. Households with deaths were visited for a detailed interview, including a verbal autopsy. Data on HIV status were collected in two surveys of all residents aged 15-44 years. RESULTS: Mortality rates among HIV-infected adults were 15 times higher than those among HIV-negative adults and HIV/AIDS was associated with nearly half of deaths at ages 15-44 years. Verbal autopsies without HIV test results considerably underestimated the proportion of deaths associated with HIV/AIDS. The mortality probability between 15 and 60 years was 49% for men and 46% for women and life expectancy was 43 years for men and 44 years for women. By their second birthday nearly one-quarter of the newborns of HIV-infected mothers had died, which was 2.5 times higher than among children of HIV-negative mothers. Mobility of household members before and after death was high. In 44% of households in which the head died all members moved out of the household. CONCLUSIONS: In this rural population with HIV prevalence close to 7% among adults aged 15-44 years during the mid-1990s, HIV/AIDS is having substantial impact on adult mortality. A common response to death of a head of household in this community is household dissolution, which has implications for measurement of the demographic and socio-economic impact of AIDS

Measuring and correcting biased child mortality statistics in countries with generalized epidemics of HIV infection

OBJECTIVE: Under Millennium Development Goal 4, countries are required to reduce child mortality by two-thirds between 1990 and 2015. In countries with generalized epidemics of human immunodeficiency virus (HIV) infection, standard statistics based on fertility history may misrepresent progress towards this target owing to the correlation between deaths among mothers and early childhood deaths from acquired immunodeficiency syndrome. METHODS: To empirically estimate this bias, child mortality data and fertility history, including births to deceased women, were collected through prospective household surveys in eastern Zimbabwe during 1998-2005. A mathematical model was then used to investigate the determinants and temporal dynamics of the bias, first in Zimbabwe and then in other countries with different background mortality rates and HIV-related epidemic profiles. FINDINGS: According to the empirical data, standard cross-sectional survey statistics underestimated true infant and under-5 mortality by 6.7% and 9.8%, respectively. These estimates were in agreement with the output from the model, in which the bias varied according to the magnitude and stage of the epidemic of HIV infection and background mortality rates. The bias was greater the longer the period elapsed before the survey and in later stages of the epidemic. Bias could substantially distort the measured effect of interventions to reduce non-HIV-related mortality and of programmes to prevent mother-to-child transmission, especially when trends are based on data from a single survey. CONCLUSION: The correlation between the HIV-related deaths of mothers and their children can bias survey estimates of early child mortality. A mathematical model with a user-friendly interface is available to correct for this bias when measuring progress towards Millennium Development Goal 4 in countries with generalized epidemics of HIV infection