Public Knowledge, Perceptions and Practices in Relation to Infectious and other Communicable Diseases in Tanzania: Lessons Learnt from Babati District

We report public knowledge, perceptions and practices on selected infectious diseases in Tanzania using a study done in Babati district, and identify policy related messages in light of health promotion strategies instituted for communicable disease control. Data were gathered through semi-structured interviews with individual household members and focus group discussions with other residents in several villages; in-depth interviews with health workers, local government leaders, and district health managers. Many villagers associated malaria transmission with people’s exposure to intense sunrays; TB and brucellosis with people drinking raw-milk, animal blood and meat; sharing a bed or utensils with TB/brucellosis patients; TB with smoking or inhaling cigarette smoke; leprosy with witchcraft; and lymphatic filariasis and schistosomiasis with people contacting dirty-water or through sexual intercourse. Occasional shortage of drugs and laboratory services, lack of reliable transport facilities, low public use of latrines, unaffordable bednet prices, and common sale of counterfeit drugs by unregulated retailers were perceived to perpetuate the existence and widespread communicable diseases. Use of traditional medicines to treat these diseases was reported to be a common practice. Culturally rooted knowledge and beliefs about diseases influence people’s health care seeking practices and may perpetuate prevalence and transmission of diseases. There should be educational policy program considerations among the strategies aimed at effective disease control.\u

Employees’ Motivation and Local Governments Performance in Tanzania: A Case Mvomero District Council

Employee motivation is a universal concept that is accepted by human resource practitioners as a tool to improve organizational performance. This study sought to examine the effects of employee motivation in improving performance in local governments in Tanzania. The study aims at examining the contribution of employee motivation to local governments in Tanzania. This paper adopted a research case design whereby Mvomero District Council was the case study. A sample size of 78 respondents was taken for the study. The study adopted a mixed approach whereby qualitative and quantitative approaches in the data collection process. The data was collected through key informant interviews and questionnaires. The findings revealed that the majority of the respondents were negative about the employee motivation provided in Mvomero District Council, especially at ward and village levels. The findings also, found that there is a positive relationship between employees’ motivation and employees’ performance. The higher the employee’s motivation the higher the employee’s performance. The study indicated that employees are motivated by financial motivation rather than non-financial motivation. The study concluded that there is a greater relationship between employee performance and employee motivation and employees in rural settings are less motivated compared to their counterparts in an urban setting. The study recommended that the government incentives policies should be reversed not only to motivate top management levels and consider middle and lower levels employees. The study also, recommended for the Mvomero District Council to improve the working conditions of the employees who are working in remote area

Editorial

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Perceived Impact of Health Sector Reform on Motivation of Health Workers and Quality of Health Care in Tanzania: the Perspectives of Healthcare Workers and District Council Health Managers in Four Districts

Background: Literature on the impact of health sector reform (HSR) on motivation of healthcare workers (HWs) and performance in health service provision in developing countries is still limited. Objective: To describe the impact of HSR on HW motivation and performance in providing quality health care in Tanzania. Methods: Four districts selected from three regions were covered, involving in-depth interviews with HWs in public health facilities (HFs), focus group discussions with district managers and researchers’ observations. Data were analysed using a qualitative content analysis approach. Results: The cost-sharing system in public HFs and national health ‘basket’ funding system introduced in 1990s were the key HSR elements identified by the study participants as impacting on HWs motivation and performance. User-fees for public healthcare services was acknowledged as having supplemented government funds allocated to public HFs, although such facilities still experienced ‘stock-outs’ of essential medicines and other supplies, HF understaffing, low/lack of essential remuneration, shortage of and unrepaired staff houses, meagre office space, lack of transport facilities for emergency cases, minimal recognition of HWs at local primary healthcare committees and the district health service budgeting system being controlled by district and central level authorities, leaving little room for lower level stakeholders to participate. Conclusion: For the national healthcare system to succeed, HSRs will need to involve and motivate HWs who are frontline implementers of the reform strategies.Key words: Decentralisation, priority-setting, human resources, health staff morale, Tanzani

"My Children and I Will no Longer Suffer from Malaria": A Qualitative Study of the Acceptance and Rejection of Indoor Residual Spraying to Prevent Malaria in Tanzania.

The objective of this study was to identify attitudes and misconceptions related to acceptance or refusal of indoor residual spraying (IRS) in Tanzania for both the general population and among certain groups (e.g., farmers, fishermen, community leaders, and women). This study was a series of qualitative, semi-structured, in-depth interviews and focus group discussions conducted from October 2010 to March 2011 on Mainland Tanzania and Zanzibar. Three groups of participants were targeted: acceptors of IRS (those who have already had their homes sprayed), refusers (those whose communities have been sprayed, but refused to have their individual home sprayed), and those whose houses were about to be sprayed as part of IRS scale-up. Interviews were also conducted with farmers, fishermen, women, community leaders and members of non-government organizations responsible for community mobilization around IRS. Results showed refusers are a very small percentage of the population. They tend to be more knowledgeable people such as teachers, drivers, extension workers, and other civil servants who do not simply follow the orders of the local government or the sprayers, but are skeptical about the process until they see true results. Refusal took three forms: 1) refusing partially until thorough explanation is provided; 2) accepting spray to be done in a few rooms only; and 3) refusing outright. In most of the refusal interviews, refusers justified why their houses were not sprayed, often without admitting that they had refused. Reasons for refusal included initial ignorance about the reasons for IRS, uncertainty about its effectiveness, increased prevalence of other insects, potential physical side effects, odour, rumours about the chemical affecting fertility, embarrassment about moving poor quality possessions out of the house, and belief that the spray was politically motivated. To increase IRS acceptance, participants recommended more emphasis on providing thorough public education, ensuring the sprayers themselves are more knowledgeable about IRS, and asking that community leaders encourage participation by their constituents rather than threatening punishment for noncompliance. While there are several rumours and misconceptions concerning IRS in Tanzania, acceptance is very high and continues to increase as positive results become apparent

Evaluation of resting sites of Culex quinquefasciatus and Anopheles gambiae s.l in an urban-rural transect in Jos, Nigeria

Background: The city of Jos, Nigeria, has been expanding with a consequent increase in the contact between humans and wild monkeys inhabiting the surrounding hills. Such a situation could increase the danger of the spread of zoonoses as well as arboviruses.Objective: To determine the relative monthly abundance of Culex quinquefasciatus and Anopheles gambiae s.l in three different habitats.Design: A longitudinal study.Setting: Urban-rural transect in Jos, Nigeria.Results: A total of 853 mosquitoes were collected, comprising of 98.5% Culex quinquefasciatus from all the three habitats and 1.5% Anopheles gambiae s.l only from the house habitat. The house habitat, C, yielded the most numbers of both species of mosquitoes, while the handcatch method significantly exceeded the box shelters in the yield of Culex quinquefasciatus and Anopheles gambiae s.lConclusion: The indoor resting habit observed by Cx. quinquefasciatus and An. gambiae s.l. makes indoor residual spraying and use of insecticide treated nets suitable for their control

Is sickle cell disease sufficiently prioritized in policy and socio-economic research on diseases in Tanzania? Lessons for the past 50 years

Catastrophic health consequences associated with chronic and genetic disorders, including those related to sickle cell disease (SCD) remain lowly measured and understood. Illnesses associated with SCD, especially the, sickle cell anaemia (SCA) pose significant tolls to individual patients and their families and contribute to poverty due to loss in production and retardation of economic development. This paper synthesises evidence from systematic literature reviews on policy priorities both in theory and practice and studies carried out on SCD. The review was systematically done by drawing evidence from published and unpublished literature searched through online search engines and other sources. The magnitude of SCA problem is yet to be adequately measured and documented in terms of thescale of its prevalence in many countries including Tanzania. However, a few reports available pinpoint Tanzania as one of the African countries with a large number of patients with SCD. Social stigma and discrimination against patients with SCD pose psychological affect to either the individual patients or their family members and this is partly due to low community knowledge on this disease on one hand and the perceived socio-economic disturbances associated with the disease that at times reduce the morale of caregivers/takers in families to attend  patients. A few studies so far seem to have much focused on the medical dimensions of the disease usually reported at health facilities therefore, failing to establish the actual magnitude and socio-economic consequences of the disease, thus limiting the room for more informed policy decisions. Unfortunately, the inadequate public policy and research attention to this disease indicates that there is need for revisiting research and policy agenda towards making a difference in its interventions, and this include creation of public awareness and prioritizing research. &nbsp

An assessment of the contribution of Tumaini Love and Hope Children Center to the street children and young people in Dodoma urban district : the case of Msalato and Bihawana homes

This study was carried out with the main aim of assessing how Tumaini Love and Hope children center has faired in its noble task of meeting the needs of street children and young people. Specific objectives of the study included: (i) to investigate the nature and magnitude of the problems of street children and young people in relation to factors contributing to their abandonment from home and becoming street vendors; (ii) to identify current attempts to rehabilitate street children and young people; (iii) to examine the extent to which the center has attempted to offer social services to the street children and young people; (iv) to examine what street children and young people have learnt or gained at the respective sub- center; and finally (v) recommend on appropriate measures to deal with street children and youths affairs for their sustainable development. Four hypothesis were formulated to guide the study. They include: (i) The migration of street children and young people to towns is mainly caused by Economic / social hardships they face at their respective homes; (ii) Rehabilitation and reformation of street children and young people by the center has changed their behaviour and conduct; (iii) Education and other social services provided by the center have contributed to the improvement of knowledge, skills and satisfaction of street children and young people; and (iv) self help scheme involvement at the sub-centers has helped street children and young people to gain experience on how to raise their economic status and self employment. The study methodology included literature review and field survey by using various methods of data collection. Such as direct observation, focus group discussion, life history and open and semi-structured questionnaire. The study concluded that: (i) The root cause for the shifting of street children and young people to towns and becoming street vendors is poverty, that results from the economic hardships that their parents face at their places of origin. (ii) The Tumaini center had played a recommendable job on rehabilitation and reformation of street children and young people. (iii) The social services provided by the Tumaini center had quite significantly contributed to the improvement of street children and young people's knowledge, skill and satisfaction (iv) The involvement of street children and young people had also been quite significantly helped to gain experience and how to raise their economic status and search for self employment. The study recommendations included:(i) The central government, local authorities and other rural development agencies should device measures of helping the general public especially parents guardians of street children and young people, who are basically farmers, with capital so that they may invest more in Agriculture which is their major occupational activity, (ii) The Tumaini center is required to ensure that the registered street children and young people stay at their sub-centers until when they are officially re- unified with their respective families. (iii) The central government, local authorities and other interested stakeholders (both local and International) concerned with the deals of street children and young people should play their part in supporting the Tumaini children center and other interested organizations so that they might offer equitable social services to the street children and young people. (iv) After reformation the re- unified young people should be provided with soft loans in order to boost them in terms of initial capital so that they can invest it for their future developments and sustainability. (Author abstract)Njunwa, D. L. (2005). An assessment of the contribution of Tumaini Love and Hope Children Center to the street children and young people in Dodoma urban district : the case of Msalato and Bihawana homes. Retrieved from http://academicarchive.snhu.eduMaster of Science (M.S.)School of Community Economic Developmen

Studies on the productivity of 'Anopheles' breeding sites in relation to adult mosquito density

Entomological studies were conducted in Tanga region, Tanzania. over a two year period, to assess the effect of various environmental features and larval population density on the productivity of An. gambiae s.l. breeding sites for adult mosquitoes. These studies included: (i) Nineteen rounds of systematic dipping for larvae in about 150 mapped potential breeding sites around two villages. During this time records were kept for each potential breeding site of the dominant plants, suspended mud, odour, shade, depth, speed of water-flow, nature of margin, surface particles, and other features. The insects suspected of feeding on mosquito larvae were recorded. These included members of the family Notonectidae, Culex tigripes, and dragon- and damsel-fly larvae. (ii) Field experiments to assess the effect of different larval densities on the emergence of adult Anopheles gambiae s.l. (iii) Quantitative estimation of productivity of adult An. gambiae s.l. per unit area of water. (iv) Field monitoring of the relationship of water depth and the production of first instars of An. gambiae s.l. (v) Investigation of the impact of larviciding with temephos and Bacillus thuringiensis israelensis around one village on the larvae and on the density and parous rate of the adult female mosquito population in comparison with untreated controls. For these studies adult mosquitoes were trapped weekly using CDC light traps hung beside untreated bednets. (vi) Mark-release-recapture to quantify immigration of An. gambiae s.l. from other villages into the one in which larviciding was carried out

Prevalence and risk factors of asymptomatic malaria among underfive children in Huye District, Southern Rwanda

Background: Enhanced malaria control has resulted in its reduction in some areas of Sub Saharan Africa including Rwanda. However, asymptomatic hosts serve as a reservoir for the malaria parasite for communities. The objective of this study was to determine the prevalence of malaria parasites and risk factors associated with malaria infection among children underfive years in Huye district, Rwanda.Methods: This community-based cross sectional study was conducted from May to June 2016 among underfive years children.  Asymptomatic children underfive years of age were randomly selected from 13 villages. Thick and thin blood smears were prepared from each child for malaria parasite diagnosis.  Interviews with parents or guardians were conducted to collect data on malaria associated risk factors. Observations were made of the presence of mosquito breeding sites near and around the homestead.Results: A total of 222 children were included in the study. Nearly a third (28.8%) of the children were within the age of 25-36 months. The majority (54%) of the children were females. Most of the parents/guardians were married (95.9%), nearly all (99.5%) had attended primary school and most (97.3%) were peasants. The overall Plasmodium falciparum prevalence in children was 12.2%. Children aged 1 to 12 months were 3.5 times more likely to have malaria parasites than children aged 13 to 59 months [AOR=3.56; 95%CI=1.18-10.71; p=0.024]. Children who were not sleeping under insecticide treated nets were 15 times more likely to be infected with malaria parasites compared to those who were sleeping under nets [AOR=15.27; 95%CI=4.42-52.82; p<0.001].Conclusion: Malaria parasite prevalence in under-five year children in Huye District, Rwanda is moderate.  The asymptomatic infections in the community forms a reservoir for transmission in the area. Young age of the child and not sleeping under mosquito net were associated with malaria parasite infection. The continuing use of mosquito nets needs to be emphasized