Targeted Subsidy for Malaria Control With Treated Nets Using a Discount Voucher System in Tanzania.

During the last decade insecticide-treated nets have become a key strategy for malaria control. Social marketing is an appealing tool for getting such nets to poor rural African communities who are most afflicted by malaria. This approach usually involves subsidized prices to make nets and insecticide more affordable and help establish a commercial market. We evaluated a voucher system for targeted subsidy of treated nets in young children and pregnant women in two rural districts of southern Tanzania. Qualitative work involved focus group discussions with community leaders, male and female parents of children under 5 years. In-depth interviews were held with maternal and child health clinic staff and retail agents. Quantitative data were collected through interviewing more than 750 mothers of children under 5 years during a cluster sample survey of child health. The voucher return rate was extremely high at 97% (7720/8000). However, 2 years after the start of the scheme awareness among target groups was only 43% (45/104), and only 12% of women (12/103; 95% CI 4-48%) had used a voucher towards the cost of a net. We found some evidence of increased voucher use among least poor households, compared with the poorest households. On the basis of these results we renewed our information, education and communication (IEC) campaign about vouchers. Discount vouchers are a feasible system for targeted subsidies, although a substantial amount of time and effort may be needed to achieve high awareness and uptake - by which we mean the proportion of eligible women who used the vouchers - among those targeted. Within a poor society, vouchers may not necessarily increase health equity unless they cover a high proportion of the total cost: since some cash is needed when using a voucher as part-payment, poorer women among the target group are likely to have lower uptake than richer women. The vouchers have two important additional functions: strengthening the role of public health services in the context of a social marketing programme and forming an IEC tool to demonstrate the group at most risk of severe malaria

Cluster-randomized study of intermittent preventive treatment for malaria in infants (IPTi) in southern Tanzania: evaluation of impact on survival.

BACKGROUND\ud \ud Intermittent Preventive Treatment for malaria control in infants (IPTi) consists of the administration of a treatment dose of an anti-malarial drug, usually sulphadoxine-pyrimethamine, at scheduled intervals, regardless of the presence of Plasmodium falciparum infection. A pooled analysis of individually randomized trials reported that IPTi reduced clinical episodes by 30%. This study evaluated the effect of IPTi on child survival in the context of a five-district implementation project in southern Tanzania. [Trial registration: clinical trials.gov NCT00152204].\ud \ud METHODS\ud \ud After baseline household and health facility surveys in 2004, five districts comprising 24 divisions were randomly assigned either to receive IPTi (n = 12) or not (n = 12). Implementation started in March 2005, led by routine health services with support from the research team. In 2007, a large household survey was undertaken to assess the impact of IPTi on survival in infants aged two-11 months through birth history interviews with all women aged 13-49 years. The analysis is based on an "intention-to-treat" ecological design, with survival outcomes analysed according to the cluster in which the mothers lived.\ud \ud RESULTS\ud \ud Survival in infants aged two-11 months was comparable in IPTi and comparison areas at baseline. In intervention areas in 2007, 48% of children aged 12-23 months had documented evidence of receiving three doses of IPTi, compared to 2% in comparison areas (P < 0.0001). Over the three years of the study there was a marked improvement in survival in both groups. Between 2001-4 and 2005-7, mortality rates in two-11 month olds fell from 34.1 to 23.6 per 1,000 person-years in intervention areas and from 32.3 to 20.7 in comparison areas. In 2007, divisions implementing IPTi had a 14% (95% CI -12%, 49%) higher mortality rate in two-11 month olds in comparison with non-implementing divisions (P = 0.31).\ud \ud CONCLUSION\ud \ud The lack of evidence of an effect of IPTi on survival could be a false negative result due to a lack of power or imbalance of unmeasured confounders. Alternatively, there could be no mortality impact of IPTi due to low coverage, late administration, drug resistance, decreased malaria transmission or improvements in vector control and case management. This study raises important questions for programme evaluation design

LAPORAN AKHIR SISTEM KEAMANAN RUANG MULTISENSOR (SOFTWARE)

Based on the issues that always happen about on the insecurity of a building, for example, a common fire hazards, and theft. This is what underlies the author designed the tool space multi sensor security system by SMS (Short Messege Service). With this tool, expected to be applied in maintaining good security space in buildings, apartments, houses shops, offices, malls, etc. to reduce the incidence of adverse criminals and fire hazards that can claimed lives. Sistem's Space Security Multi Sensor consists of three types of sensors that each censor had different functions. For example Ultrasonic Sensor types (SRF - 04) which serves to maintain the security of the thief and the work performance of this sensor is when an object blocking the transmitter of the sensor into the sensor receiver then automatically activated and provides notification via SMS (Short Service Mesagge) containing " DANGER THIEVES "to Mobile Users. That been programmed by program language BASCOM- AVR which contained “DANGER THIEVES” The next type of temperature sensor LM - 35 is used to detect when the room temperature exceeds room temperature> 40 ° C, the sensor will be active and provide notification via SMS (Short Service Mesagge) which contains "DANGER TEMPERATURE HEAT" to Mobile Users. And the smoke sensor types MQ - 02 serves to detect the concentration of flammable gas in the air and smoke when the smoke sensor detects the presence of smoke or gas concentration, the sensor will be active and provide notification via SMS (Short Service Mesagge) which contained "DANGER FIRE" for Mobile Users that been programmed on the programming language BASCOM-AVR which contained “DANGER FIRE” Keywords : Ultrasonik Detector ( SRF – 02 ), Temperature Detector ( LM – 35 ), Smoke Detector ( MQ – 02 ), Basic Compile

Social and Economic Analysis of the Production of Maradol Papaya (Carica papaya L.): Case study in the coast of Oaxaca, Mexico

Objective: To analyze social, productive and profitability indicators of the conventional agribusiness that produces Maradol papaya in the Coast region of Oaxaca. Methodology: The present research was perform in the agribusiness “Productores de la Costa Posa Verde, S.P.R. de R.L”, in the period June 2020 to August 2021. Semi-structured interviews to the producer and family members were carried out. The economic analysis was implemented using the methodology of budgets by activities. Results: The studied agribusiness is a family type, managed by the head of the family, who is 47 years old, with a high school education and 35 years of experience in managing papaya cultivation. During the studied period, the production cost was $365,190.01 ha-1. Of the total variable costs, the highest cost per cultivated ha were harvesting (38.2$117,633.6 ha-1 and a profitability of 24.4% were observed, and the equilibrium point was 31,268.86 kg. Conclusions: The papaya agribusiness studied is profitable. In addition, papaya production is an important source of job, it contributes to improving the quality of life of the inhabitants of the region. Keywords: Economic indicators, production cost, production profitability. &nbsp;Objective: To analyze the social, production, and profitability indicators of a conventional agribusiness producing Maradol papaya in the coastal region of Oaxaca. Methodology: This research was conducted at the agribusiness “Productores de la Costa Posa Verde, S.P.R. de R.L” from June 2020 to August 2021. Semi-structured interviews with the producer and his family were conducted. The economic analysis was done using the activity-based budgeting method. Results: The studied company is a family agribusiness run by the head of the family, a 47-year-old man with a high school education and approximately 35 years of experience in the cultivation of papaya. During the period of study, the production cost was $365,190.01 ha-1. From the total variable costs, the largest expenditures per cultivated ha went to harvesting (38.2$117,633.6 ha-1 was observed, together with a profitability of 24.4%, and an equilibrium point of 31,268.86 kg. Conclusions: This papaya farming agribusiness is profitable. Moreover, papaya farming is an important source of work, which contributes to improving the quality of life among the region’s inhabitants

Acceptability of Condom Promotion and Distribution Among 10-19 Year-Old Adolescents in Mpwapwa and Mbeya Rural Districts, Tanzania.

\ud The HIV/AIDS pandemic remains a leading challenge for global health. Although condoms are acknowledged for their key role on preventing HIV transmission, low and inappropriate use of condoms persists in Tanzania and elsewhere in Africa. This study assesses factors affecting acceptability of condom promotion and distribution among adolescents in Mpwapwa and Mbeya rural districts of Tanzania. Data were collected in 2011 as part of a larger cross-sectional survey on condom use among 10-19 year-olds in Mpwapwa and Mbeya rural districts of Tanzania using a structured questionnaire. Associations between acceptability of condom promotion and distribution and each of the explanatory variables were tested using Chi Square. Multivariate logistic regression model was used to examine independent predictors of the acceptability of condom promotion and distribution using STATA (11) statistical software at 5% significance level. Mean age of the 1,327 adolescent participants (50.5% being males) was 13.5 years (SD = 1.4). Acceptance of condom promotion and distribution was found among 37% (35% in Mpwapwa and 39% in Mbeya rural) of the adolescents. Being sexually active and aged 15-19 was the strongest predictor of the acceptability of condom promotion and distribution (OR = 7.78, 95% CI 4.65-12.99). Others were; not agreeing that a condom is effective in preventing transmissions of STIs including HIV (OR = 0.34, 95% CI 0.20-0.56), being a resident of Mbeya rural district (OR = 1.67, 95% CI 1.28-2.19), feeling comfortable being seen by parents/guardians holding/buying condoms (OR = 2.20, 95% CI 1.40-3.46) and living with a guardian (OR = 1.48, 95% CI 1.08-2.04). Acceptability of condom promotion and distribution among adolescents in Mpwapwa and Mbeya rural is low. Effect of sexual activity on the acceptability of condom promotion and distribution is age-dependent and was the strongest. Feeling comfortable being seen by parents/guardians buying or holding condoms, perceived ability of condoms to offer protection against HIV/AIDS infections, district of residence and living arrangements also offered significant predictive effect. Knowledge of these factors is vital in designing successful and sustainable condom promotion and distribution programs in Tanzania.\u

The acceptability of intermittent preventive treatment of malaria in infants (IPTi) delivered through the expanded programme of immunization in southern Tanzania

BACKGROUND\ud \ud Intermittent preventive treatment of malaria in infants (IPTi) reduces the incidence of clinical malaria. However, before making decisions about implementation, it is essential to ensure that IPTi is acceptable, that it does not adversely affect attitudes to immunization or existing health seeking behaviour. This paper reports on the reception of IPTi during the first implementation study of IPTi in southern Tanzania.\ud \ud METHODS\ud \ud Data were collected through in-depth interviews, focus group discussions and participant observation carried out by a central team of social scientists and a network of key informants/interviewers who resided permanently in the study sites.\ud \ud RESULTS\ud \ud IPTi was generally acceptable. This was related to routinization of immunization and resonance with traditional practices. Promoting "health" was considered more important than preventing specific diseases. Many women thought that immunization was obligatory and that health staff might be unwilling to assist in the future if they were non-adherent. Weighing and socialising were important reasons for clinic attendance. Non-adherence was due largely to practical, social and structural factors, many of which could be overcome. Reasons for non-adherence were sometimes interlinked. Health staff and "road to child health" cards were the main source of information on the intervention, rather than the specially designed posters. Women did not generally discuss child health matters outside the clinic, and information about the intervention percolated slowly through the community. Although there were some rumours about sulphadoxine pyrimethamine (SP), it was generally acceptable as a drug for IPTi, although mothers did not like the way tablets were administered. There is no evidence that IPTi had a negative effect on attitudes or adherence to the expanded programme on immunisation (EPI) or treatment seeking or existing malaria prevention.\ud \ud CONCLUSION\ud \ud In order to improve adherence to both EPI and IPTi local priorities should be taken into account. For example, local women are often more interested in weighing than in immunization, and they view vaccination and IPTi as vaguely "healthy" rather preventing specific diseases. There should be more emphasis on these factors and more critical consideration by policy makers of how much local knowledge and understanding is minimally necessary in order to make interventions successful

Identificación del índice de vulnerabilidad territorial a partir de modelos jerárquicos y heurísticos aplicando SOA

Auxiliar de InvestigaciónEn el proyecto se realiza el diseño y desarrollo de 4 servicios web implementando los modelos de toma de decisión (AHP, AHP FUZZY, ELECTRE y PROMETHEE), encargados de procesar datos obtenidos en campo en la primera fase del proyecto que se realizó a través de encuestas, formatos de entrevistas, talleres y metodologías de análisis. Los datos se procesaran de acuerdo al modelo de toma de decisión seleccionado, generando como resultado final un indicador de vulnerabilidad territorial.PregradoIngeniero de Sistema

Health and survival of young children in southern Tanzania

With a view to developing health systems strategies to improve reach to high-risk groups, we present information on health and survival from household and health facility perspectives in five districts of southern Tanzania. We documented availability of health workers, vaccines, drugs, supplies and services essential for child health through a survey of all health facilities in the area. We did a representative cluster sample survey of 21,600 households using a modular questionnaire including household assets, birth histories, and antenatal care in currently pregnant women. In a subsample of households we asked about health of all children under two years, including breastfeeding, mosquito net use, vaccination, vitamin A, and care-seeking for recent illness, and measured haemoglobin and malaria parasitaemia. In the health facility survey, a prescriber or nurse was present on the day of the survey in about 40% of 114 dispensaries. Less than half of health facilities had all seven 'essential oral treatments', and water was available in only 22%. In the household survey, antenatal attendance (88%) and DPT-HepB3 vaccine coverage in children (81%) were high. Neonatal and infant mortality were 43.2 and 76.4 per 1000 live births respectively. Infant mortality was 40% higher for teenage mothers than older women (RR 1.4, 95% confidence interval (CI) 1.1 - 1.7), and 20% higher for mothers with no formal education than those who had been to school (RR 1.2, CI 1.0 - 1.4). The benefits of education on survival were apparently restricted to post-neonatal infants. There was no evidence of inequality in infant mortality by socio-economic status. Vaccine coverage, net use, anaemia and parasitaemia were inequitable: the least poor had a consistent advantage over children from the poorest families. Infant mortality was higher in families living over 5 km from their nearest health facility compared to those living closer (RR 1.25, CI 1.0 - 1.5): 75% of households live within this distance. Relatively short distances to health facilities, high antenatal and vaccine coverage show that peripheral health facilities have huge potential to make a difference to health and survival at household level in rural Tanzania, even with current human resources