Social Work Implication on Care and Vulnerability of Older People in Tanzania

This paper attempts to discuss the social work implications on ageing and vulnerability in Tanzania. The main objective of the study was to examine the social, economic and health status and the role of social workers in helping the older people to make them not only to make best choices about their future but also contribute to development to the communities surrounding them. The study was conducted in Bagamoyo district where four villages (i.e. Msigi, Tawalanda, Matipwili and Sadani) were selected. The main target population was the older people, community members, local government leaders and health providers. The main variables which were studied included social, economic, health and ideological issues. The main findings of the study revealed that, despite the existence of policies such as the national ageing policy, health policy, national social security policy,and old people remained vulnerable. It was noted for example that, the low level of income determined the type of food afforded by older people, accessibility to health services and other basic needs. The situation was worse to older people who shouldered the responsibility of grandchildren. The study also noted that, there were no social workers in the rural areas. The social workers were found at the district headquarters but also in few numbers. The study was not able to establish the capacity of social workers in making a meaningful intervention to older people’s concerns. The study recommends that, there was a dire need to provide reliable social services in the rural areas which would assist the older people. Further it is recommended that, the introduction of social pension would greatly increase the economic capacity of older people. Last but not least the study recommends for the need for research on dynamics of ageing with physiological, psychological, cultural and environmental factors in attempt to develop a positive attitudes to older people

The Plight of Social Pension Provision to Older People in Tanzania

This paper attempts to examine the plight of social pension provision to older people in Tanzania. The main objective of this paper is four folds namely to examine the social and economic condition status of older people in Tanzania, to highlight the main contributions made by old people in social and economic development, to examine the challenges faced by older people and to examine the relevance of social pension provision among the older people in Tanzania. In an attempt to achieve the above objectives the paper used a desk review approach by reviewing different research papers, books and articles on social protection and ageing. The major findings reveal that whereas the old people are not homogenous their vulnerability revolves around their accessibility of income, social services, disabilities, gender and where they live (e.g. urban and rural areas). The findings further reveal that despite older people’s contribution to the national economy as small farmers, fishermen, pastoralist and provision of other services they are excluded in formal pension system. The paper concludes that, extreme poverty amongst older persons is a reality in every region including Tanzania, lack of access to income, increased need for health care and dependency within the household are some of the factors that expose older persons to poverty. It is therefore argued that unless action is taken, the situation will deteriorate. The traditional reliance of many governments on contributory pension systems as the main source of social security in old age has left a significant portion of older persons unprotected. The study recommends that, the government must recognize social security as a human right issue and therefore they need to establish appropriate legal frameworks and design social pension schemes progressively to ensure access to social security for all. The paper further recommends that policy makers should see social protection as one of the essential component of a broader development strategy and thereby adopting a comprehensive and holistic approach to poverty reduction

Perceived Psychological Contract Breach on Organizational Continuance Commitment in the Tanzanian Public Universities: The Case of Selected Universities

This paper explores the effects of Perceived Psychological Contract Breach (PPCB) on Organizational Continuance Commitment (OCC) of the public universities’ academic staff in Tanzania.   A cross-sectional survey was carried out on a sample of 187 academic staff from five public universities. A 24-commitment scale of Allen and Meyer was used. The descriptive statistics, correlation, linear and multiple linear regression analysis techniques were applied.  The study found that PPCB significantly negatively affected organizational continuance commitment. Old academic staff above 51years of age showed more organizational commitment than the rest of the groups, married couples showed more organizational continuance commitment than the other demographic groups. The paper recommends young academic staff can be motivated to stay through university HR retentions schemes like providing training for masters and PhD Studies, proving research small grants and fully engaging them in academic and consultancy works. Academic staff regardless of their marital status could be provided with incentives like childcare services, house allowances and family support programme

Effectiveness of Exemption Measure in Providing Healthcare Services among Old People in Tanzania: The case of Kasulu District

The study aimed at assessing effectiveness of exemption measure in providing healthcare services for old people in public hospitals in Tanzania. The study was conducted in rural and urban areas of Kasulu district in Kigoma using cross sectional descriptive research design. The total number of respondents engaged in this study was 323. These included 304 old people, four medical doctors, eight nurses, one district medical officer and six social workers. Data were collected by using questionnaire, interview, focus group discussion, observation and documentary review. Qualitative data was analyzed by using thematic method while quantitative data were analyzed by using Statistical Package for the Social Sciences (SPSS) to obtain frequencies, percentages and statistical measures for triangulation purposes. Study findings revealed that exemption measure was partially implemented and less effective. Healthcare services in public hospitals were not easily accessible for old people under exemption measure. The major challenges affecting exemption measure is lack of essential medicine, bureaucratic procedures in executing exemption process and unofficial payments. The study hereby recommends that the government should enact law to enforce implementation of exemption and increase budget allocation to the health sector so as to increase availability of medicine and diagnostic instruments in public hospitals. Further, since the scope of the study was limited to Kasulu district; there is a need to conduct country survey to assess effectiveness of exemption measure in providing healthcare services for old people in Tanzania. &nbsp

Comparison of coverage with insecticide-treated nets in a Tanzanian town and villages where nets and insecticide are either marketed or provided free of charge

BACKGROUND: There is much emphasis on social marketing as a means of scaling up coverage with insecticide-treated nets and the question has arisen whether nets provided free-of-charge will be looked after by householders. METHODS: Over several years questionnaires and surveys of usage and condition of nets were carried out throughout a town and 15 villages in north-east Tanzania, where nets and insecticide have to be purchased and in 24 other villages where over 15000 nets had been donated and annual re-treatment is provided free-of-charge. RESULTS: There was very high population coverage in the town but, in the villages where nets have to be purchased, only 9.3% of people used nets which were intact and/or had been insecticide-treated and could, therefore, provide protection. However, where nets had been provided free, over 90% of the nets were still present and were brought for re-treatment several years later. CONCLUSION: In this part of Tanzania, social marketing has performed well in a town but very poorly in villages. However, the study showed that people look after and bring for re-treatment nets which had been provided free-of-charge

Awareness and Decision Making on Health Seeking and Utilization Behaviors Among Substance Abuse Youths

Substance abuse has continued to increase in Tanzania particularly among youth with minority of them seeking the available health services. This study sought to determine the relationship between awareness and decision making on health seeking and utilization behaviors among youth involved in substance abuse in Kinondoni municipality, Dar es Salaam. Concurrent mixed methodology was used. Data were collected among youth with substance abuse problems through face-to-face interviews (n=300) using a structured survey questionnaire. In addition, in-depth interviews (n=23), and focus group discussions (n=5) were conducted. The quantitative data were analyzed using SPSS version 23. Content analysis was used for analyzing qualitative data. Results showed that (74.3%, n=223) of the respondents did not seek and utilize the available treatment options. The majority (62.4%, n=187) of them did not know that their substance abuse problems can be treated using the available treatment options, and 78.2% (n=235) of the participants had little or no concerns about their substance abuse problems. The majority of participants had little information regarding the treatment of substance abuse and major sources of information about substance abuse treatment options were through friends and families followed by radio and television. The reasons related to not seeking and utilizing the available health services may be associated with the low awareness levels of the available treatment options among individuals with substance abuse, little belief that their substance abuse problem can be treated, and having less or no concern about their substance abuse problem. Thus future studies are needed to examine the accessibility and acceptability of the available rehabilitation services for substance abuse in Dar es Salaam

Novel use of stir bar sorptive extraction (SBSE) as a tool for isolation of oviposition site attractants for gravid Culex quinquefasciatus

Mosquitoes such as Culex quinquefasciatus Say (Diptera: Culicidae) are important vectors of organisms that cause disease in humans. Research into the development of effective standardized odour baits for blood-fed females (oviposition attractants), to enable entomological monitoring of vector populations, is hampered by complex protocols for extraction of physiologically active volatile chemicals from natural breeding site water samples, which have produced inconsistent results. Air entrainment and solvent extraction are technically demanding methods and are impractical for use in resource poor environments where mosquito-borne disease is most prevalent. This study reports the first use of a simple, robust extraction technique, stir bar sorptive extraction (SBSE), to extract behaviourally active small lipophilic molecules (SLMs) present in water samples collected from Cx. quinquefasciatus breeding sites in Tanzania. Extracts from a pit latrine and from a cess pool breeding site attracted more gravid Cx. quinquefasciatus in pair choice bioassays than control extracts, and coupled gas chromatography-electroantennography (GC-EAG) allowed tentative identification of 15 electrophysiologically active chemicals, including the known oviposition attractant, skatole (3-methylindole). Here, we have demonstrated, using simple pair choice bioassays in controlled laboratory conditions, that SBSE is effective for the extraction of behaviourally and electrophysiologically active semiochemicals from mosquito breeding site waters. Further research is required to confirm that SBSE is an appropriate technique for use in field surveys in the search for oviposition cues for Cx. quinquefasciatus

Users' and health service providers' perception on quality of laboratory malaria diagnosis in Tanzania

<p>Abstract</p> <p>Background</p> <p>Correct diagnosis of malaria is crucial for proper treatment of patients and surveillance of the disease. However, laboratory diagnosis of malaria in Tanzania is constrained by inadequate infrastructure, consumables and insufficient skilled personnel. Furthermore, the perceptions and attitude of health service providers (laboratory personnel and clinicians) and users (patients/care-takers) on the quality of laboratory services also present a significant challenge in the utilization of the available services. This study was conducted to assess perceptions of users and health-care providers on the quality and utilization of laboratory malaria diagnostic services in six districts from three regions in Tanzania.</p> <p>Methods</p> <p>Questionnaires were used to collect information from laboratory personnel, clinicians and patients or care-takers.</p> <p>Results</p> <p>A total of 63 laboratory personnel, 61 clinicians and 753 patients/care-takers were interviewed. Forty-six (73%) laboratory personnel claimed to be overworked, poorly motivated and that their laboratories were under-equipped. About 19% (N = 12) of the laboratory personnel were lacking professional qualification. Thirty-seven clinicians (60.7%) always requested for blood smear examination to confirm malaria. Only twenty five (41.0%) clinicians considered malaria microscopy results from their respective laboratories to be reliable. Forty-five (73.8%) clinicians reported to have been satisfied with malaria diagnostic services provided by their respective laboratories. Majority (90.2%, N = 679) of the patients or care-takers were satisfied with the laboratory services.</p> <p>Conclusion</p> <p>The findings show that laboratory personnel were not satisfied with the prevailing working conditions, which were reported to undermine laboratory performance. It was evident that there was no standard criteria for ordering malaria laboratory tests and test results were under-utilized. Majority of the clinicians and patients or care-takers were comfortable with the overall performance of laboratories, but laboratory results were having less impact on patient management.</p

Is the Current Decline in Malaria Burden in Sub-Saharan Africa due to a Decrease in Vector Population?

In sub-Saharan Africa (SSA), malaria caused by Plasmodium falciparum has historically been a major contributor to morbidity and mortality. Recent reports indicate a pronounced decline in infection and disease rates which are commonly ascribed to large-scale bed net programmes and improved case management. However, the decline has also occurred in areas with limited or no intervention. The present study assessed temporal changes in Anopheline populations in two highly malaria-endemic communities of NE Tanzania during the period 1998-2009. Between 1998 and 2001 (1st period) and between 2003 and 2009 (2nd period), mosquitoes were collected weekly in 50 households using CDC light traps. Data on rainfall were obtained from the nearby climate station and were used to analyze the association between monthly rainfall and malaria mosquito populations.\ud The average number of Anopheles gambiae and Anopheles funestus per trap decreased by 76.8% and 55.3%, respectively over the 1st period, and by 99.7% and 99.8% over the 2nd period. During the last year of sampling (2009), the use of 2368 traps produced a total of only 14 Anopheline mosquitoes. With the exception of the decline in An. gambiae during the 1st period, the results did not reveal any statistical association between mean trend in monthly rainfall and declining malaria vector populations. A longitudinal decline in the density of malaria mosquito vectors was seen during both study periods despite the absence of organized vector control. Part of the decline could be associated with changes in the pattern of monthly rainfall, but other factors may also contribute to the dramatic downward trend. A similar decline in malaria vector densities could contribute to the decrease in levels of malaria infection reported from many parts of SSA

Depletion and activation of mucosal CD4 T cells in HIV infected women with HPV-associated lesions of the cervix uteri

Background: The burden of HPV-associated premalignant and malignant cervical lesions remains high in HIV+ women even under ART treatment. In order to identify possible underlying pathophysiologic mechanisms, we studied activation and HIV co-receptor expression in cervical T-cell populations in relation to HIV, HPV and cervical lesion status. Methods Cervical cytobrush (n = 468: 253 HIV- and 215 HIV+;71% on ART) and blood (in a subset of 39 women) was collected from women in Mbeya, Tanzania. Clinical data on HIV and HPV infection, as well as ART status was collected. T cell populations were characterized using multiparametric flow cytometry-based on their expression of markers for cellular activation (HLA-DR), and memory (CD45RO), as well as HIV co-receptors (CCR5, alpha(4)beta(7)). Results Cervical and blood T cells differed significantly, with higher frequencies of T cells expressing CD45RO, as well as the HIV co-receptors CCR5 and alpha(4)beta(7)in the cervical mucosa. The skewed CD4/CD8 T cell ratio in blood of HIV+ women was mirrored in the cervical mucosa and HPV co-infection was linked to lower levels of mucosal CD4 T cells in HIV+ women (%median: 22 vs 32;p = 0.04). In addition, HIV and HPV infection, and especially HPV-associated cervical lesions were linked to significantly higher frequencies of HLA-DR+ CD4 and CD8 T cells (p-values < 0.05). Interestingly, HPV infection did not significantly alter frequencies of CCR5+ or alpha(4)beta(7)+ CD4 T cells. Conclusion The increased proportion of activated cervical T cells associated with HPV and HIV infection, as well as HPV-associated lesions, together with the HIV-induced depletion of cervical CD4 T cells, may increase the risk for HPV infection, associated premalignant lesions and cancer in HIV+ women. Further, high levels of activated CD4 T cells associated with HPV and HPV-associated lesions could contribute to a higher susceptibility to HIV in HPV infected women