Irrigated Improved forages for smallholder dairy in Kilosa, Mvomero and Babati Districts, Tanzania

Irish Ai

Forage choppers and crop residue based rations for cattle

United States Agency for International Developmen

Implications of the introduction of forage chopper machines

United States Agency for International Developmen

Gender and mechanization: exploring the sustainability of mechanized forage chopping in Tanzania

Mechanization is currently experiencing a revival in agricultural research and development, with a new emphasis on equity and sustainability. This study evaluates the introduction of forage chopper machines in seven villages in northern Tanzania from a farmer's perspective. Data collected through focus group discussions and a survey are used for a gender analysis of this technology within a broader sustainable intensification indicator framework. The results not only draw attention to unabated challenges to smallholder mechanization (such as high operational costs or weak supporting infrastructures), but also show how the technology's sustainability is contingent upon equity dynamics on the household and community levels. The evaluation framework proved suitable for a holistic assessment. A broader approach to gender issues would strengthen its interdisciplinary claim. Suggestions for promoting the chopper's sustainability include gender-sensitive training and the establishment of group models for machine operation based on agreed and fair regulations

Initial Rhythm and Resuscitation Outcomes for Patients Developing Cardiac Arrest in Hospital: Data From Low-Middle Income Country

Background: Health care resource allocation remains challenging in lower middle income countries such as Kenya with meager resources being allocated to resuscitation and critical care. The causes and outcomes for in-hospital cardiac arrest and resuscitation have not been studied. Objectives: This study sought to determine the initial rhythm and the survival for patients developing in hospital cardiac arrest. Methods: This was a prospective study for in-hospital cardiac arrest in 6 Kenyan hospitals from July 2014 to April 2016. Resuscitation teams were utilized to collect data during resuscitation using a standardized protocol. Patients with do-not-resuscitate orders, trauma, postsurgical, and pregnancy-related complications were excluded. The Modified Early Warning Score (MEWS)— systolic blood pressure, heart rate, respiration rate, temperature, and responsiveness—was determined based on worst parameters at least 4 hours prior to the arrest. Results: A total of 353 patients with cardiac arrest were included over 19 months. The mean age was 61 years, 53.5% were male, and admission diagnoses included cardiovascular disease (15%), pneumonia 18.13%, and cancer 9%. The mean MEWS was 4.48 and low, intermediate, and high MEWS were found in 25.8%, 29.5%, and 44.8%, respectively. The mean time to cardiopulmonary resuscitation was 0.84 min. The initial rhythm was asystole in 47.6%, pulseless electrical activity in 38.2%, ventricular tachycardia/ventricular fibrillation in 5.4%, and unknown in 8.8%. Return of spontaneous circulation (ROSC) occurred in 29.2% of patients with the mean time to ROSC being 5.3 min. ROSC occurred in 17.3% of patients with asystole, 40.7% in pulseless electrical activity, 57.9% in ventricular tachycardia/ventricular fibrillation, and 25.8% in patients with an unknown rhythm. Of all patients, 16 (4.2%) were discharged alive. Conclusions: Nonshockable rhythms account for the majority of the cardiac arrests in hospitals in a lower middle income country and are associated with unfavorable outcomes. Future work should be directed to training health care personnel in recognizing early warning signs and implementing appropriate measures in a resource-scarce environme