A Large Cross-Sectional Community-Based Study of Newborn Care Practices in Southern Tanzania

Despite recent improvements in child survival in sub-Saharan Africa, neonatal mortality rates remain largely unchanged. This study aimed to determine the frequency of delivery and newborn-care practices in southern Tanzania, where neonatal mortality is higher than the national average. All households in five districts of Southern Tanzania were approached to participate. Of 213,220 female residents aged 13-49 years, 92% participated. Cross-sectional, retrospective data on childbirth and newborn care practices were collected from 22,243 female respondents who had delivered a live baby in the preceding year. Health facility deliveries accounted for 41% of births, with nearly all non-facility deliveries occurring at home (57% of deliveries). Skilled attendants assisted 40% of births. Over half of women reported drying the baby and over a third reported wrapping the baby within 5 minutes of delivery. The majority of mothers delivering at home reported that they had made preparations for delivery, including buying soap (84%) and preparing a cloth for drying the child (85%). Although 95% of these women reported that the cord was cut with a clean razor blade, only half reported that it was tied with a clean thread. Furthermore, out of all respondents 10% reported that their baby was dipped in cold water immediately after delivery, around two-thirds reported bathing their babies within 6 hours of delivery, and 28% reported putting something on the cord to help it dry. Skin-to-skin contact between mother and baby after delivery was rarely practiced. Although 83% of women breastfed within 24 hours of delivery, only 18% did so within an hour. Fewer than half of women exclusively breastfed in the three days after delivery. The findings suggest a need to promote and facilitate health facility deliveries, hygienic delivery practices for home births, delayed bathing and immediate and exclusive breastfeeding in Southern Tanzania to improve newborn health

The Changing Epidemiology of Malaria in Ifakara Town, Southern Tanzania.

Between 1995 and 2000 there were marked changes in the epidemiology of malaria in Ifakara, southern Tanzania. We documented these changes using parasitological and clinical data from a series of community- and hospital-based studies involving children up to the age of 5 years. There was a right shift and lowering in the age-specific parasite prevalence in the community-based cohort studies. The incidence of clinical malaria in placebo-receiving infants in additional study cohorts dropped from 0.8 in 1995 to 0.43 episodes per infant per year in 2000, an incidence rate ratio of 0.53 (95% confidence interval: 0.404, 0.70, P<0.0001). At the same time, there was an increase in the total number of malaria admissions and a marked right shift in the age pattern of these admissions (median age in 1995 1.55 years vs. 2.33 in 2000, P<0.0001). However, the burden of malaria deaths remained in infants. We discuss how these dramatic changes in the epidemiology of malaria may have arisen from the use of currently available malaria control tools. Caution is required in the interpretation of hospital-based data as it is likely to underestimate the impact of anaemia on mortality in the community, where most paediatric deaths occur. Even in low/moderate malaria transmission settings, where older children suffer most malaria episodes, targeting effective malaria control at infants may produce important reductions in infant mortality caused by malaria

The root growth strategies of three wheatgrass in early seedlings

Non-Peer ReviewedResearch was conducted on crested, slender and northern wheatgrasses, commonly available wheatgrasses for the Canadian prairies, under 6% and 12% of gravimetric water content, to determine the effect of water stress on root growth for seedling growth. The results indicate that Root growth rate varies across early seedling phase for these grasses. Rapid root biomass accumulation occurred in the early phase of seedlings. Reducing water supplement increased biomass allocated to roots earlier for plant growth. Reduced water treatments demonstrated a non-linear changed root biomass growth rate for crested wheatgrasses and northern wheatgrasses

Where there’s ‘willingness’ there’s a way: barriers and facilitators to maternal, newborn and child health data sharing by the private health sector in Uttar Pradesh, India

In India and Uttar Pradesh (UP), the private health sector plays an important role in health care services, including institutional deliveries, but there is limited information on the availability of maternal, newborn and child health (MNCH) data that private facilities maintain and share with the public health information system. Sharing data could help the public sector plan their resources more efficiently. Aim of the study: To explore current practices of MNCH data availability and sharing/reporting by private health facilities and the barriers and facilitators to data sharing

Planning a Family:priorities and concerns in rural Tanzanmia

A fertility survey using qualitative and quantitative techniques described a high fertility setting (TFR 5.8) in southern Tanzania where family planning use was 16%. Current use was influenced by rising parity, educational level, age of last born child, breastfeeding status, a\ud preference for longer than the mean birth interval (32 months), not being related to the household head, and living in a house with a tin roof. Three principal concerns amongst women were outlined from the findings. First, that there is a large unmet need for family planning services in the area particularly among teenagers for whom it is associated with induced abortion. Second, that family planning is being used predominantly for spacing but fears\ud associated with it often curtail effective use. Third, that service provision is perceived to be lacking in two main areas — regularity of supply, and addressing rumours and fears associated with family planning. Reproductive health interventions in the area should ultimately be more\ud widespread and, in particular, abortion is highlighted as an urgent issue for further research.\ud The potential for a fast and positive impact is high, given the simplicity of the perceived needs of\ud women from this study. (Afr J Reprod Health 2004; 8[2]:111-123)\u

Empowering formative assessment using embedded Web Widgets in Wikis

The article can be viewed at: http://opensym.org/wsos2013/proceedings/p0901-notari.pdfIn this article we describe how we developed and how we use a tool for teachers enhancing inter-group collaboration of learners using wikis in project-based learning settings with over 100 participants, where different groups of students develop similar projects and each project has an own wiki page. To achieve our goal we extended typical wiki functionality by using web widgets, mini applications embedded anywhere in the wiki environment using the iframe tag. Two different evaluation widgets (rating widget and 'working progress' widget) are placed on each of the project pages. The project groups use the 'working progress' widget to declare the amount of work done. The teacher and the rest of the learning community use the 'rating' widget to rate the ongoing project work. A so called 'meta widget' showing a summary of the results of the 'rating' and 'working progress' widget can be displayed on the start page of the learning community or if a project is divided in different milestones, on the page describing the goals and timeline for the milestone. Evaluation widgets and meta widget, which easily can be embedded by the teacher potentially all over the wiki pages, enhances visibility of quality and termination degree of a project and enhance so the self, the tutor and the peer review opportunities in such large scale project based learning settings. The created evaluation widgets and meta widgets have been embedded in the wiki of a three months curriculum. The evaluation of utility and usability of the widgets is ongoing. The educational value of rating and reflecting about the working progress of a given task is discussed

Access to Artemisinin-Based Anti-Malarial Treatment and its Related Factors in Rural Tanzania.

Artemisinin-based combination treatment (ACT) has been widely adopted as one of the main malaria control strategies. However, its promise to save thousands of lives in sub-Saharan Africa depends on how effective the use of ACT is within the routine health system. The INESS platform evaluated effective coverage of ACT in several African countries. Timely access within 24 hours to an authorized ACT outlet is one of the determinants of effective coverage and was assessed for artemether-lumefantrine (Alu), in two district health systems in rural Tanzania. From October 2009 to June 2011we conducted continuous rolling household surveys in the Kilombero-Ulanga and the Rufiji Health and Demographic Surveillance Sites (HDSS). Surveys were linked to the routine HDSS update rounds. Members of randomly pre-selected households that had experienced a fever episode in the previous two weeks were eligible for a structured interview. Data on individual treatment seeking, access to treatment, timing, source of treatment and household costs per episode were collected. Data are presented on timely access from a total of 2,112 interviews in relation to demographics, seasonality, and socio economic status. In Kilombero-Ulanga, 41.8% (CI: 36.6-45.1) and in Rufiji 36.8% (33.7-40.1) of fever cases had access to an authorized ACT provider within 24 hours of fever onset. In neither of the HDSS site was age, sex, socio-economic status or seasonality of malaria found to be significantly correlated with timely access. Timely access to authorized ACT providers is below 50% despite interventions intended to improve access such as social marketing and accreditation of private dispensing outlets. To improve prompt diagnosis and treatment, access remains a major bottle neck and new more innovative interventions are needed to raise effective coverage of malaria treatment in Tanzania

Note on paramoudra-like carbonate concretions in the Urenui Formation, North Taranaki: possible plumbing system for a Late Miocene methane seep field

A reconnaissance study of calcitic and dolomitic tubular concretions in upper slope mudstone of the Late Miocene Urenui Formation exposed along the north Taranaki coastline indicates that they have a complex diagenetic history involving different phases of carbonate cementation and likely hydrofracturing associated with build up of fluid/gas pressures. The concretions resemble classical paramoudra in the European chalk, but are not siliceous and do not have a trace fossil origin. Stable oxygen and carbon isotope data suggest that the micritic carbonate cements in the Urenui paramoudra were probably sourced primarily from ascending methane fluid/gases, and that they precipitated entirely within the host mudstone below the seafloor. We suggest the paramoudra may mark the subsurface plumbing networks of a Late Miocene cold seep system, in which case they have relevance to the evolution and migration of hydrocarbons in Taranaki Basin, at this site perhaps focussed along the Taranaki Fault. The presence of dislodged and mass-emplaced paramoudra in the axial conglomerate of channels within the Urenui mudstone suggests there could be a connection between the loci of seep field development and slope failure and canyon cutting on the Late Miocene Taranaki margin