Satisfaction with health facility delivery care services and ssociated factors: The case of Lindi and Mtwara rural districts, southern Tanzania

Objective: To assess women’s satisfaction with health facility delivery care services and to determine the factors associated with satisfaction.Methods: A cross sectional study was conducted in 12 primary health facilities in Lindi and Mtwara rural districts. All women who gave birth in the facilities during the time of the study were interviewed using a pretested structured questionnaire. The questionnaire contained 29 items on likert scale including different aspects of delivery care service. Women were considered to be satisfied if they reported satisfaction to at least half of the items assessed.Results: Total of 504 women were interviewed. Overall a large proportion (80%) reported to be satisfied with the delivery care services. Proportion satisfied varied in different aspects of care ranging from 30% reporting to be satisfied with management of labour pains to 96% reporting to be satisfied with care of the newborn. Only age of the mother showed significant association with satisfaction. Women with formal education and those delivering for the first time were satisfied compared to their counterparts although the difference was not statistically significant.Conclusion and recommendations: Majority of women reported satisfaction with delivery services but there were significant variations across different care items. High levels of dissatisfaction were on aspects of provider client communication, labour pain management and drugs availability issues. Training of health providers on communication skills and ensuring availability of drugs should be prioritized. Allowing a companion during labour may be considered since it has been proven to make women comfortable and satisfied with the process of delivery elsewhere.Key words: delivery care services, satisfaction, factors influencing satisfaction, Tanzani

A Mixed-Method Study Exploring Experiences and Perceptions of Nutritionists Regarding Use of an Image-Based Dietary Assessment System in Tanzania

Due to global advances in technology, image-based food record methods have emerged as an alternative to traditional assessment methods. The use of image-based food records in low and lower-middle income countries such as Tanzania is limited, with countries still using traditional methods. The current study aimed to determine the feasibility of using a new voice and image-based dietary assessment system (VISIDA) in Dar es Salaam, Tanzania. This mixed-method study recruited 18 nutritionists as participants who collected image-based records of food and drinks they consumed using the VISIDA smartphone app. Participants viewed an online demonstration of the VISIDA web platform and the analysis process for intake data collected using the VISIDA app. Then, participants completed an online survey and were interviewed about the VISIDA app and web platform for food and nutrient intake analysis. The method was reported as being acceptable and was found to be easy to use, although technical challenges were experienced by some participants. Most participants indicated a willingness to use the VISIDA app again for one week or longer and were interested in using the VISIDA system in their current role. Participants acknowledged that the VISIDA web platform would simplify some aspects of their current job. Image-based food records could potentially be used in Tanzania to improve the assessment of dietary intake by nutritionists in urban areas. Participants recommended adding sound-on notifications, using the VISIDA app in both Apple and Android phones, enabling installation from the app store, and improving the quality of the fiducial markers