Understanding home-based neonatal care practice in rural southern Tanzania.

In order to understand home-based neonatal care practices in rural Tanzania, with the aim of providing a basis for the development of strategies for improving neonatal survival, we conducted a qualitative study in southern Tanzania. In-depth interviews, focus group discussions and case studies were used through a network of female community-based informants in eight villages of Lindi Rural and Tandahimba districts. Data collection took place between March 2005 and April 2007. The results show that although women and families do make efforts to prepare for childbirth, most home births are assisted by unskilled attendants, which contributes to a lack of immediate appropriate care for both mother and baby. The umbilical cord is thought to make the baby vulnerable to witchcraft and great care is taken to shield both mother and baby from bad spirits until the cord stump falls off. Some neonates are denied colostrum, which is perceived as dirty. Behaviour-change communication efforts are needed to improve early newborn care practices

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

Development of behaviour change communication strategy for a vaccination-linked malaria control tool in southern Tanzania.

BACKGROUND\ud \ud Intermittent preventive treatment of malaria in infants (IPTi) using sulphadoxine-pyrimethamine and linked to the expanded programme on immunization (EPI) is a promising strategy for malaria control in young children. As evidence grows on the efficacy of IPTi as public health strategy, information is needed so that this novel control tool can be put into practice promptly, once a policy recommendation is made to implement it. This paper describes the development of a behaviour change communication strategy to support implementation of IPTi by the routine health services in southern Tanzania, in the context of a five-year research programme evaluating the community effectiveness of IPTi.\ud \ud METHODS\ud \ud Mixed methods including a rapid qualitative assessment and quantitative health facility survey were used to investigate communities' and providers' knowledge and practices relating to malaria, EPI, sulphadoxine-pyrimethamine and existing health posters. Results were applied to develop an appropriate behaviour change communication strategy for IPTi involving personal communication between mothers and health staff, supported by a brand name and two posters.\ud \ud RESULTS\ud \ud Malaria in young children was considered to be a nuisance because it causes sleepless nights. Vaccination services were well accepted and their use was considered the mother's responsibility. Babies were generally taken for vaccination despite complaints about fevers and swellings after the injections. Sulphadoxine-pyrimethamine was widely used for malaria treatment and intermittent preventive treatment of malaria in pregnancy, despite widespread rumours of adverse reactions based on hearsay and newspaper reports. Almost all health providers said that they or their spouse were ready to take SP in pregnancy (96%, 223/242). A brand name, key messages and images were developed and pre-tested as behaviour change communication materials. The posters contained public health messages, which explained the intervention itself, how and when children receive it and safety issues. Implementation of IPTi started in January 2005 and evaluation is ongoing.\ud \ud CONCLUSION\ud \ud Behaviour Change Communication (BCC) strategies for health interventions must be both culturally appropriate and technically sound. A mixed methods approach can facilitate an interactive process among relevant actors to develop a BCC strategy

Intermittent preventive treatment for malaria and anaemia control in Tanzanian infants; the development and implementation of a public health strategy.

Minimizing the time between efficacy studies and public health action is important to maximize health gains. We report the rationale, development and implementation of a district-based strategy for the implementation of intermittent preventive treatment in infants (IPTi) for malaria and anaemia control in Tanzania. From the outset, a research team worked with staff from all levels of the health system to develop a public-health strategy that could continue to function once the research team withdrew. The IPTi strategy was then implemented by routine health services to ensure that IPTi behaviour-change communication materials were available in health facilities, that health workers were trained to administer and to document doses of IPTi, that the necessary drugs were available in facilities and that systems were in place for stock management and supervision. The strategy was integrated into existing systems as far as possible and well accepted by health staff. Time-and-motion studies documented that IPTi implementation took a median of 12.4 min (range 1.6-28.9) per nurse per vaccination clinic. The collaborative approach between researchers and health staff effectively translated research findings into a strategy fit for public health implementation

Field evaluation of the "Bait-lamina test" to determine the soil microfauna feeding activity

Non-Peer ReviewedThe soil microfauna regulate nutrient cycling through predation on soil microorganisms but also through comminution of organic residues in soils. The feeding activity of the soil microfauna has a large impact on nutrient cycling and soil function, but is rarely considered because it is difficult to assess. The Baitlamina test was proposed as a practical mean to assess microfauna feeding activity. The test consists of vertically inserting 16-hole-bearing plastic sticks stuffed with a plant material preparation into the soil. We tested if the plant material used to prepare the bait would be differentially utilized by microfaunal population present under different plant species or mixtures of plants. We evaluated the Bait-lamina test in a 5-year old field experiment with five levels of plant communities (monocultures of Russian wild rye, switchgrass, green needlegrass, or western wheatgrass, and a grass mixture) distributed in four complete blocks, using six levels of bait flavour (Russian wild rye, switchgrass, green needlegrass, western wheatgrass, alfalfa, and wheat bran). Bait-lamina strips were equally spaced at five locations between plant rows. We found that the bait flavour had no significant (P = 0.22) effect on feeding, although the concentration of crude protein in the plant material used in the baits varied (P = 0.006) from 2.9% in switchgrass to 5.9% in Russian wild rye. We found low feeding activity in our field plots over the period of the test ( 13 June to 17 August 2005), with only 2.7% of the lamina (hole stuffing) showing signs of feeding. The data nevertheless revealed that microfauna feeding was more important close to the soil surface (0.5 mm deep), and in Russian wild rye plot mid-rows as compared to green needlegrass or switchgrass plots. Closer to plant rows, however, differences were not significant. We conclude that bait prepared with any plant material used in this study can be used to compare microfauna feeding in different plant stands. We recommend the use of a large number of replicated strips in agricultural field experiments where the microfauna may be scarce

Understanding home-based neonatal care practice in rural southern Tanzania

In order to understand home-based neonatal care practices in rural Tanzania, with the aim of providing a basis for the development of strategies for improving neonatal survival, we conducted a qualitative study in southern Tanzania. In-depth interviews, focus group discussions and case studies were used through a network of female community-based informants in eight villages of Lindi Rural and Tandahimba districts. Data collection took place between March 2005 and April 2007. The results show that although women and families do make efforts to prepare for childbirth, most home births are assisted by unskilled attendants, which contributes to a lack of immediate appropriate care for both mother and baby. The umbilical cord is thought to make the baby vulnerable to witchcraft and great care is taken to shield both mother and baby from bad spirits until the cord stump falls off. Some neonates are denied colostrum, which is perceived as dirty. Behaviour-change communication efforts are needed to improve early newborn care practice

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

Low-energy three-body charge transfer reactions with Coulomb interaction in the final state

Three-body charge transfer reactions with Coulomb interaction in the final state are considered in the framework of coordinate-space integro-differential Faddeev-Hahn-type equations within two- and six-state close coupling approximations. The method is employed to study direct muon transfer in low-energy collisions of the muonic hydrogen H$_\mu$ by helium (He$^{++}$) and lithium (Li$^{+++}$) nuclei. The experimentally observed isotopic dependence is reproduced.Comment: 14 pages REVTeX, accepted for publication in Journal of Physics

High and low plant biodiversity: two strategies encountered in southwest Saskatchewan prairie

Non-Peer Reviewe

Grass growth promotion by dark septate endophytic fungi is host specific

Non-Peer ReviewedIsolates of dark septate endophytic fungi (DSE) were obtained from healthy looking roots of two early season grasses [crested wheatgrass (Agropyron cristatum L), Russian wildrye (Elymus junceus Fisch)] and one late season grass [blue gramma (Bouteloua gracilis (Willd. ex Kunth) Lag. ex Griffiths] growing in southwest Saskatchewan. The capacity of some fungal isolates to colonize the roots or to promote the growth of these grasses was tested under controlled conditions. A first study revealed that DSE isolates AC 1 and EJ 5 colonize with more intensity the roots of the grass species from which they were isolated. A second study showed that the ability of each fungal isolate to promote plant growth depended on the plant species inoculated. Inoculation with four out of five isolates reduced B. gracilis growth, but increased the growth of one of the early season grasses. The results indicate that DSE fungal isolates are not species specific colonizers but have a strong preference for certain plant species, and some isolates can promote or depress plant growth depending on specific DSE isolate-grass combinations