Improving quality of medical certification of causes of death in health facilities in Tanzania 2014-2019

BACKGROUND: Monitoring medically certified causes of death is essential to shape national health policies, track progress to Sustainable Development Goals, and gauge responses to epidemic and pandemic disease. The combination of electronic health information systems with new methods for data quality monitoring can facilitate quality assessments and help target quality improvement. Since 2015, Tanzania has been upgrading its Civil Registration and Vital Statistics system including efforts to improve the availability and quality of mortality data. METHODS: We used a computer application (ANACONDA v4.01) to assess the quality of medical certification of cause of death (MCCD) and ICD-10 coding for the underlying cause of death for 155,461 deaths from health facilities from 2014 to 2018. From 2018 to 2019, we continued quality analysis for 2690 deaths in one large administrative region 9 months before, and 9 months following MCCD quality improvement interventions. Interventions addressed governance, training, process, and practice. We assessed changes in the levels, distributions, and nature of unusable and insufficiently specified codes, and how these influenced estimates of the leading causes of death. RESULTS: 9.7% of expected annual deaths in Tanzania obtained a medically certified cause of death. Of these, 52% of MCCD ICD-10 codes were usable for health policy and planning, with no significant improvement over 5 years. Of certified deaths, 25% had unusable codes, 17% had insufficiently specified codes, and 6% were undetermined causes. Comparing the before and after intervention periods in one Region, codes usable for public health policy purposes improved from 48 to 65% within 1 year and the resulting distortions in the top twenty cause-specific mortality fractions due to unusable causes reduced from 27.4 to 13.5%. CONCLUSION: Data from less than 5% of annual deaths in Tanzania are usable for informing policy. For deaths with medical certification, errors were prevalent in almost half. This constrains capacity to monitor the 15 SDG indicators that require cause-specific mortality. Sustainable quality assurance mechanisms and interventions can result in rapid improvements in the quality of medically certified causes of death. ANACONDA provides an effective means for evaluation of such changes and helps target interventions to remaining weaknesses

Local Responses to Marginalisation: Human-Wildlife Conflict in Ethiopia’s Wetlands.

In western Ethiopia, population pressure, upland land degradation and recurrent food shortages have forced many local communities to extend their agricultural activities into marginal areas such as wetlands. This move into wetland agriculture, however, has brought humans in closer proximity to wild animals, and wild vertebrate crop-raiding has now emerged as a serious problem affecting food security from wetlands in region. Drawing upon qualitative field research undertaken with wetland farmers in the area, this article explores the nature of this conflict through the lens of the marginalisation of both humans and wild animals, within the contested space of wetlands. The results suggest that the escalation of crop-raiding can be attributed to the interaction of various environmental, social and political factors including conservation legislation, land use change, and the erosion of local institutional arrangements governing wetland management. The development of local-level adaptation and mitigation strategies that build on local knowledge, are offered as potentially sustainable solutions to current problems

Pedological characterization, fertility status and classification of the soils under maize production of Bako Tibe and Toke Kutaye Districts of Western Showa, Ethiopia

Ethiopian journal of applied science and technology, 2016; 7 (1): 18-33Maize farm fields were selected in two districts of western Showa, Ethiopia. Four representative maize fields were selected based on landforms and other physiographic attributes in humid highland and sub humid mid altitude areas of Toke Kutaye and Bako Tibe Districts. The objective was to characterize and classify the soils under maize production in Toke Kutaye and Bako Tibe Districts of western Showa, Ethiopia. Four soil profiles were opened and characterized. Pedons are formed under udic and perudic moisture and iso-thermic temperature regimes for both districts. The soils were very deep, well-drained reddish brown to dark reddish brown loamy sand to sandy clay loams, with thick reddish brown loamy sand top and sub soil for Bako Tibe and Toke Kutaye. Three pedons had clayey top and sub soils. The pH of surface soil ranged from 4.48-5.52 which was very strongly acidic to strongly acidic. The soil organic carbon contents of the topsoil and subsoil of the four pedons ranged from 2.07 to 2.69% and 0.35 to 2.85 %, which were rated as medium to high, but very low to high respectively. Both two highland pedons had CEC ranging from 20.06 to 54.17 cmol c kg -1 soil, which was rated as medium to very high, while in the two mid altitude pedons it ranged from 10.82 to 23.52 cmol c kg -1 soil CEC, which was low to medium. The total nitrogen levels ranged from 0.19 to 0.23% for topsoils, which was low to medium, and from 0.03 to 0.07 % for subsoils, which was very low. According to USDA Soil Taxonomy, the four pedons were classified as Typic Palehumults (Acrisols and Alisols according to WRB). The four pedons were different in physicochemical properties, indicating the need to characterize soils to give site-specific fertilizer recommendations for maize production

Pedological characterization of typical soils of Dodoma Capital City District, Tanzania: soil morphology, physico-chemical properties, classification and soil fertility trends

Journal of Annals of Advanced Agricultural Sciences, 2018; 2 (4): 59-73Pedolological characterization was done in Dodoma Capital City District, Tanzania. Three soil profiles developed from in-situ weathering of granic rocks and designated as HIS-P1, HIS- P2 and HIS-P3 were described. Fifteen samples were taken from genetic horizons and analyzed for physical and chemical characteristics. The soils were generally very deep, with varying textures. Whereas profile HIS-P2 was dominantly loamy, profiles HIS-P1 and HIS-P3 were both clayey but the latter had heavy clay type. In profile HIS-P1, clay eluviation-illuviation was a dominant pedogenic process manifested by presence of clay cutans in the subsoil. Profile HIS-P2 displayed redoximorphic features due to fluctuating water table. Shrinking and swelling, and argilli-pedoturbation were typical pedogenic processes in profile HIS-P3. Profile HIS-P1 had more developed structure (subangular blocky) followed by HIS-P3 and lastly profile HIS-P2 which was structureless massive breaking into weak subangular blocks. Whereas topsoil bulk density values of the soils were within acceptable range, subsoil BD values are likely to cause problems of root penetration particularly for deep rooted crops. Profiles HIS-P1 and HIS-P3 may present limitations to crop growth due to high pH values (> 7.5) in the subsoil which may limit availability of plant nutrients e.g. phosphorus. Organic carbon and nitrogen were generally low and very low in all profiles with most values being < 1.25% and < 0.10%, respectively. Availabe P values were low to very low (< 7 mg/kg) throughout the three profiles. Topsoil base saturation values were high (> 50%) in profiles HIS-P1 and HIS-P2 but very high throughout proflie HIS-P3 (83 - 118%). Zn and Fe levels were rated as inadequate for crop production. According to USDA Soil Taxonomy, the soils were classified as Typic Rhodustults (HIS- P1), Fluventic Dystrustepts (HIS-P2) and Chromic Calcitorrerts (HIS-P3) corresponding to Haplic Cutanic Acrisols, Haplic Cambisols and Calcic Mazic Vertisols in the WRB for Soil Resources. The three soils had different physico-chemical properties, hence the need to characterize soils before fertilizer recommendations is met

Contribution of legume rotations to the nitrogen requirements of a subsequent maize crop on a rhodic ferralsol in Tanga, Tanzania

Tanzania Journal of Agricultural Sciences 2013, Vol. 12(1) : 23-29Industrial fertilizers are expensive for small-scale farmers who, as alternative, rely on legume crops for providing N for a subsequent maize crop. A legume-maize rotational experiment was carried out on a Rhodic Ferralsol at Mlingano Agricultural Research Institute in Muheza, Tanga, Tanzania, to evaluate the effects of legumes rotation in meeting the N fertilizer requirements of maize. The experimental site was located at 39o 52’E, 5o 10’S and 183 metres above sea level (m.a.s.l.). The experiment was conducted for two rotation cycles whereby cowpea, pigeonpea or greengram were grown during the short rains followed by maize during the long rains. The maize rotations were imposed on plots on which legumes had been grown during the previous legume rotation. Monoculture maize was grown with treatments of 0, 25, 50 and 100 kg N ha-1 imposed for purposes of plotting N fertilizer response curves. Based on the response curve lines, the effects of the legume rotation on maize yields were compared and translated as N fertilizer equivalency of the legumes in question. The grain and residue yields of the three legumes were significantly different (P<0.01), a fact which was attributed to the genetic differences of the legume species. The maize yields following rotation with each of the three legumes were significantly higher (P<0.05) than those under continuous maize. The effects of the rotations on increasing the maize yields were equivalent to application of 25, 19 and 16 kg N ha-1 for the cowpea, pigeonpea and greengram rotations, respectively. It was, however, concluded that the contributions of N by the legumes in the legume-maize rotations were not enough to satisfy the maize N requirements of 50 kg N/ha; hence supplementation with mineral N, in addition to the rotations, is necessary for increased yields

Quantification of atmospheric n2 fixed by cowpea, pigeonpea and greengram grown on ferralsols in Muheza District, Tanzania

Tanzania Journal of Agricultural Sciences 2013, Vol. 10(1) : 29-37Legume crops are usually intercropped with cereals in small-scale farming systems in Tanzania. This aims at taking advantage of legumes to replenish soil nitrogen (N due to legumes’ N2 fixation). Glasshouse pot experiments and field trials were carried out atMlingano Agricultural Research Institute in Tanga, Tanzania, with the objective to find out how much N2 can be fixed by cowpea, pigeonpea and greengram using native Rhizobia, thus substituting for the use of N-mineral fertilizers in maize production on Ferralsols. In the glasshouse pot experiment, the legumes were grown in 5L plastic pots for 40 days in soil sampled from 0 – 20 cm layer. The field experiment was maize – legumes intercropping whereby the N2 fixation assessment was done 35 days after planting. In both cases, maize (Katumani variety) was the non- N2- fixing reference crop. The legumes formed effective nodules with the native Rhizobia. Different quantities of N2 gas were fixed by the different legumes, the differences being attributed to the legumes’ differences in their genetic characteristics. In the field, monocropped cowpea, pigeonpea and greengram fixed 38, 21, and 49 kg N2, respectively. In the intercrop system cowpea, pigeonpea and greengram fixed 16, 4, and 24 kg N2, respectively. In both cases, the quantities of N2 fixed were less than 50% of their total N accumulation. It was concluded that in Muheza, maize grown in association with the legumes would continue to need supplementation of mineral N fertilizer to maximize its yields

Contribution of legume rotations to the nitrogen requirements of a subsequent maize crop on a rhodic ferralsol in Tanga, Tanzania

Tanzania Journal of Agricultural Sciences 2013, Vol. 12(1) : 23-29Industrial fertilizers are expensive for small-scale farmers who, as alternative, rely on legume crops for providing N for a subsequent maize crop. A legume-maize rotational experiment was carried out on a Rhodic Ferralsol at Mlingano Agricultural Research Institute in Muheza, Tanga, Tanzania, to evaluate the effects of legumes rotation in meeting the N fertilizer requirements of maize. The experimental site was located at 39o 52’E, 5o 10’S and 183 metres above sea level (m.a.s.l.). The experiment was conducted for two rotation cycles whereby cowpea, pigeonpea or greengram were grown during the short rains followed by maize during the long rains. The maize rotations were imposed on plots on which legumes had been grown during the previous legume rotation. Monoculture maize was grown with treatments of 0, 25, 50 and 100 kg N ha-1 imposed for purposes of plotting N fertilizer response curves. Based on the response curve lines, the effects of the legume rotation on maize yields were compared and translated as N fertilizer equivalency of the legumes in question. The grain and residue yields of the three legumes were significantly different (P<0.01), a fact which was attributed to the genetic differences of the legume species. The maize yields following rotation with each of the three legumes were significantly higher (P<0.05) than those under continuous maize. The effects of the rotations on increasing the maize yields were equivalent to application of 25, 19 and 16 kg N ha-1 for the cowpea, pigeonpea and greengram rotations, respectively. It was, however, concluded that the contributions of N by the legumes in the legume-maize rotations were not enough to satisfy the maize N requirements of 50 kg N/ha; hence supplementation with mineral N, in addition to the rotations, is necessary for increased yields

Pedological characterization of typical soils of Dodoma Capital City District, Tanzania: soil morphology, physico-chemical properties, classification and soil fertility trends

Journal of Annals of Advanced Agricultural Sciences, 2018; 2 (4): 59-73Pedolological characterization was done in Dodoma Capital City District, Tanzania. Three soil profiles developed from in-situ weathering of granic rocks and designated as HIS-P1, HIS- P2 and HIS-P3 were described. Fifteen samples were taken from genetic horizons and analyzed for physical and chemical characteristics. The soils were generally very deep, with varying textures. Whereas profile HIS-P2 was dominantly loamy, profiles HIS-P1 and HIS-P3 were both clayey but the latter had heavy clay type. In profile HIS-P1, clay eluviation-illuviation was a dominant pedogenic process manifested by presence of clay cutans in the subsoil. Profile HIS-P2 displayed redoximorphic features due to fluctuating water table. Shrinking and swelling, and argilli-pedoturbation were typical pedogenic processes in profile HIS-P3. Profile HIS-P1 had more developed structure (subangular blocky) followed by HIS-P3 and lastly profile HIS-P2 which was structureless massive breaking into weak subangular blocks. Whereas topsoil bulk density values of the soils were within acceptable range, subsoil BD values are likely to cause problems of root penetration particularly for deep rooted crops. Profiles HIS-P1 and HIS-P3 may present limitations to crop growth due to high pH values (> 7.5) in the subsoil which may limit availability of plant nutrients e.g. phosphorus. Organic carbon and nitrogen were generally low and very low in all profiles with most values being < 1.25% and < 0.10%, respectively. Availabe P values were low to very low (< 7 mg/kg) throughout the three profiles. Topsoil base saturation values were high (> 50%) in profiles HIS-P1 and HIS-P2 but very high throughout proflie HIS-P3 (83 - 118%). Zn and Fe levels were rated as inadequate for crop production. According to USDA Soil Taxonomy, the soils were classified as Typic Rhodustults (HIS- P1), Fluventic Dystrustepts (HIS-P2) and Chromic Calcitorrerts (HIS-P3) corresponding to Haplic Cutanic Acrisols, Haplic Cambisols and Calcic Mazic Vertisols in the WRB for Soil Resources. The three soils had different physico-chemical properties, hence the need to characterize soils before fertilizer recommendations is met

Soil organic carbon stocks in the dominant soils of the Miombo woodland ecosystem of Kitonga Forest Reserve, Iringa, Tanzania

Few studies have determined the soil organic carbon (SOC) stocks in the Miombo woodlands ecosystem in Tanzania. Standard field and laboratory procedures were used to evaluate SOC storage in the Miombo woodlands ecosystem of Kitonga Forest Reserve Iringa, Tanzania. A study area of 52 km 2 was selected and ten soil profiles were studied. Representative sampling points were geo-referenced and soil samples collected from natural horizons to the depth of 60 cm. Results show that the total soil organic carbon stocks in soil profiles varied from 19.4 to 28.9 Mg C ha-1 in leptosols; from 45.6 to 80.1 Mg C ha-1 in fluvisols; and from 33.9 to 134.6 Mg C ha-1 in cambisols. The SOC increased significantly (p< 0.05) with increasing elevation, horizon thickness and % clay, but it decreased significantly (p< 0.05) with increasing slope gradient and increasing % sand. The areal distribution of the soil types was 61%, for cambisols, 19% for leptosols, 11% for fluvisols and 9% for natural forest which was not surveyed because of inaccessibility. Proper management of Miombo woodlands would increase the SOC storage and contribute to climate change regulation.This article is available at http://www.journalissues.orgThe Climate Change Impacts Adaptation and Mitigation (CCIAM) programme under NORAD suppor