Stakeholders' Participation in Planning and Priority Setting in the Context of a Decentralised Health Care system: the case of prevention of mother to child Transmission of HIV Programme in Tanzania.

In Tanzania, decentralisation processes and reforms in the health sector aimed at improving planning and accountability in the sector. As a result, districts were given authority to undertake local planning and set priorities as well as allocate resources fairly to promote the health of a population with varied needs. Nevertheless, priority setting in the health care service has remained a challenge. The study assessed the priority setting processes in the planning of the prevention of mother to child transmission of HIV (PMTCT) programme at the district level in Tanzania. This qualitative study was conducted in Mbarali district, south-western Tanzania. The study applied in-depth interviews and focus group discussions in the data collection. Informants included members of the Council Health Management Team, regional PMTCT managers and health facility providers. Two plans were reported where PMTCT activities could be accommodated; the Comprehensive Council Health Plan and the Regional PMTCT Plan that was donor funded. As donors had their own globally defined priorities, it proved difficult for district and regional managers to accommodate locally defined PMTCT priorities in these plans. As a result few of these were funded. Guidelines and main priority areas of the Ministry of Health and Social Welfare (MoHSW) also impacted on the ability of the districts and regions to act, undermining the effectiveness of the decentralisation policy in the health sector. The challenges in the priority setting processes revealed within the PMTCT initiative indicate substantial weaknesses in implementing the Tanzania decentralisation policy. There is an urgent need to revive the strategies and aims of the decentralisation policy at all levels of the health care system with a view to improving health service delivery

Can You Hear us Now? Voices from the Margin: Using Indigenous Methodologies in Geographic Research

Indigenous methodologies are an alternative way of thinking about research processes. Although these methodologies vary according to the ways in which different Indigenous communities express their own unique knowledge systems, they do have common traits. This article argues that research on Indigenous issues should be carried out in a manner which is respectful and ethically sound from an Indigenous perspective. This naturally challenges Western research paradigms, yet it also affords opportunities to contribute to the body of knowledge about Indigenous peoples. It is further argued that providing a mechanism for Indigenous peoples to participate in and direct these research agendas ensures that their communal needs are met, and that geographers then learn how to build ethical research relationships with them. Indigenous methodologies do not privilege Indigenous researchers because of their Indigeneity, since there are many ‘insider’ views, and these are thus suitable for both Indigenous and non-Indigenous researchers. However, there is a difference between research done within an Indigenous context using Western methodologies and research done using Indig- enous methodologies which integrates Indigenous voices. This paper will discuss those differences while presenting a historical context of research on Indigenous peoples, providing further insights into what Indigenous methodologies entail, and proposing ways in which the academy can create space for this discourse

Creating Indigenous Discourse: History, Power, and Imperialism in Academia, Palestinian Case

This article examines the impossibilities of implementing decolonizing research for indigenous scholars. In addition, it articulates the relationship between a decolonizing research approach and the historical and current forms of academic imperialism; a prototype of the Palestinian legacy is presented. The author argues that the current indigenous discourse is a remnant of oppression. The existing indigenous discourse is not due to the original quest but instead, it is in response to oppression. Also, the author explains the struggles of some indigenous scholars in complying with the reporting and ownership of knowledge that is required by Cartesian principles.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania – challenges in implementation

BACKGROUND: In the past decade there has been increasing visibility of malaria control efforts at the national and international levels. The factors that have enhanced this scenario are the availability of proven interventions such as artemisinin-based combination therapy, the wide scale use of insecticide-treated nets (ITNs) and a renewed emphasis in indoor residual house-spraying. Concurrently, there has been a window of opportunity of financial commitments from organizations such as the Global Fund for HIV/AIDS, Tuberculosis and Malaria (GFATM), the President's Malaria Initiative and the World Bank Booster programme. METHODS: The case study uses the health policy analysis framework to analyse the implementation of a public-private partnership approach embarked upon by the government of Tanzania in malaria control - 'The Tanzania National Voucher Scheme'- and in this synthesis, emphasis is on the challenges faced by the scheme during the pre-implementation (2001 - 2004) and implementation phases (2004 - 2005). Qualitative research tools used include: document review, interview with key informants, stakeholder's analysis, force-field analysis, time line of events, policy characteristic analysis and focus group discussions. The study is also complemented by a cross-sectional survey, which was conducted at the Rufiji Health Demographic Surveillance Site, where a cohort of women of child-bearing age were followed up regarding access and use of ITNs. RESULTS: The major challenges observed include: the re-introduction of taxes on mosquito nets and related products, procurement and tendering procedures in the implementation of the GFATM, and organizational arrangements and free delivery of mosquito nets through a Presidential initiative. CONCLUSION: The lessons gleaned from this synthesis include: (a) the consistency of the stakeholders with a common vision, was an important strength in overcoming obstacles, (b) senior politicians often steered the policy agenda when the policy in question was a 'crisis event', the stakes and the visibility were high, (c) national stakeholders in policy making have an advantage in strengthening alliances with international organizations, where the latter can become extremely influential in solving bottlenecks as the need arises, and (d) conflict can be turned into an opportunity, for example the Presidential initiative has inadvertently provided Tanzania with important lessons in the organization of 'catch-up' campaigns

Weaving indigenous agricultural knowledge with formal education to enhance community food security : school competition as a pedagogical space in rural Anchetty, India

In communities from the remote rural regions of Anchetty, young learners’ informal learning experiences often come through interactions with local agriculture and the environment in which they and their families work and learn. These informal learning experiences are essential to what are otherwise called ‘indigenous knowledge systems’. For primary school students in Anchetty, the ways in which they engage in learning community-based agricultural knowledge are challenged by school-based formal education processes. Using a school competition as a pedagogical strategy for integrative space, this paper supports and explores the meaning and characteristics of indigenous agricultural knowledge (IAK)