Local Knowledge on Ecosystem Management Practices and Human Plague Problems in West Usambaras, Tanzania

The human impact on natural landscapes has been steadily increasing during the last few decades and the current decline of biodiversity is largely the result of human activity. Many of these activities have resulted in a wide range of environmental changes that accelerate and interact with other environmental changes at local, regional and global scales. Ecosystem degradation in many areas of the world has been associated with the increase in the distribution of human plague cases, both land use and climate changes have been suggested as causes of the persistence of human plague in Africa, America and Asia. In West Usambaras, Tanzania, human plague is a public health problem, which has been associated with land use and land cover changes and the level of the spreading of the disease has increased from one village in 1980 to about 48 villages by the end of the year 2002, in the whole district. This case study shows how local people link the anthropogenic modifications of the ecosystems with the frequent outbreak of human plague in the area. Using a case study protocol developed by Initiative on Science and Technology for Sustainability (ISTS), the case study has been expanded to look at the issues such as stakeholder involvement in the development of this case study, the science policy- interface and the challenges of interdisciplinary research for sustainable development

Towards Integration of Sustainable Environmental and Biodiversity Conservation in Secondary Schools Students Extra-Curricular in Tanzania: Where do We Start?

In this paper the approach to integrate sustainable environmental and biodiversity conservation in secondary schools students’ extra-curricular is presented. The proposed approach is based on the case study from the East Usambara Biosphere Reserve in Tanzania, on a pilot project on environmental education in schools being developed by the UNESCO Office in Tanzania. The paper is based on the UN Decade of Education for Sustainable Development (DESD, 2005-2014) that highlights the need for engagement of people through innovative ways of learning about biodiversity by focusing on education and training to address the interlinking issues of ecosystems and livelihoods, the interactions of nature with culture, society and economy, and the actions that can be taken without affecting peoples quality of life. In developing the entry point to sustainable environmental and biodiversity conservation various key environmental and biodiversity challenges were identified in a participatory approach and the basic approaches to integrate sustainable management on the extracurricular activities of students in secondary schools were also identified. Literature review, validation workshops with teachers, students and elders in the areas surrounding East Usambara Biosphere Reserve were the main methodological approaches used. Environmental issues identified which are presented in this paper include high dependence on forest and forest related products notably Timber and Non-Timber Forest Products (NTFPs);illegal gold mining by artisanal miners; soil degradation contributed by poorly managed agricultural activities; forest degradation attributed to farmers involved in illegal and unsustainable land use practices; increased demand and treatment costs of water from Zigi River; soil erosion; erosion of local knowledge and local practices.  Other issues identified are population growth, inadequate participation and involvement of community in environmental conservation, inadequate environmental education and poaching, and climate change. Various extra-curricular activities are proposed as a way to address the impacts. The pilot chooses to propose the establishment of students clubs as a vehicle to ensure sustainable environmental and biodiversity management in the area surrounding East Usambara Biosphere Reserves in Tanzania and elsewhere in the world, a strategy that this paper strongly supports. Keywords: climate change, ecosystem services, livelihoods, participatory approach, quality of life

Explaining retention of healthcare workers in Tanzania: moving on, coming to 'look, see and go', or stay?

BACKGROUND: In the United Republic of Tanzania, as in many regions of Sub-Saharan Africa, staff shortages in the healthcare system are a persistent problem, particularly in rural areas. To explore staff shortages and ways of keeping workers in post, we ask, (a) Which cadres are most problematic to recruit and keep in post? (b) How and for what related reasons do health workers leave? (c) What critical incidents do those who stay face? (d) And why do they stay and cope? METHODS: This is a multi-method paper based on analysis of data collected as part of a cross-sectional health facility study supporting maternal and reproductive health services in the United Republic of Tanzania. Qualitative data were generated through semi-structured interviews with Council Health Management Teams, and Critical Incident Technique interviews with mid-level cadres. Complementary quantitative survey data were collected from district health officials, which are used to support the qualitative themes. RESULTS: Mid-level cadres were problematic to retain and caused significant disruptions to continuity of care when they left. Shortage of highly skilled workers is not only a rural issue but also a national one. Staff were categorised into a clear typology. Staff who left soon after arrival and are described by 'Look, See and Go'; 'Movers On' were those who left due to family commitments or because they were pushed to go. The remaining staff were 'Stayers'. Reasons for wanting to leave included perceptions of personal safety, feeling patient outcomes were compromised by poor care or as a result of perceived failed promises. Staying and coping with unsatisfactory conditions was often about being settled into a community, rather than into the post. CONCLUSIONS: The Human Resources for Health system in the United Republic of Tanzania appears to lack transparency. A centralised monitoring system could help to avoid early departures, misallocation of training, and other incentives. The system should match workers' profiles to the most suitable post for them and track their progress and rewards; training managers and holding them accountable. In addition, priority should be given to workplace safety, late night staff transport, modernised and secure compound housing, and involving the community in reforming health services culture and practices

The Role of Housing Licenses in Accessing Loans as a Strategy to Urban Poverty Alleviation

In Tanzania, formalization of the informal sector was established with the aim to increase participation of the informal properties in the formal economy of the country.

Natural Resources Based Conflicts and Their Gender Impacts in the Selected Farming and Pastoral Communities in Tanzania

In this paper we provide an evidence on how natural resources utilization in the farming and pastoral communities in Tanzania are influencing conflicts that have impacts on gender. We further reveal various types of conflicts that are affecting communities that integrate farming and pastoral societies. Literature has indicated that land conflicts can have disastrous effects on individuals as well as on groups and even entire nation. Many conflicts that are perceived to be clashes between different cultures are actually conflicts over land and related natural resources. Indeed, there are a long historical record of fluctuating conflicts, competition and co-operation between settled farmers and pastoral or transhumant herders. This includes periods of violent herder domination over settled farming production systems and the conversion of former pastoral lands to cultivation. This acknowledgement is not an exception in Tanzania and particularly in Kilosa and Mvemoro Districts in Morogoro Region where this case study is concentrated on

A qualitative process evaluation of training for non-physician clinicians/associate clinicians (NPCs/ACs) in emergency maternal, neonatal care and clinical leadership, impact on clinical services improvements in rural Tanzania: the ETATMBA project: Table 1

Objectives The Enhancing Human Resources and Use of Appropriate Training for Maternal and Perinatal Survival in sub-Saharan Africa (ETATMBA) project is training non-physician clinicians as advanced clinical leaders in emergency maternal and newborn care in Tanzania and Malawi. The main aims of this process evaluation were to explore the implementation of the programme of training in Tanzania, how it was received, how or if the training has been implemented into practice and the challenges faced along the way. Design Qualitative interviews with trainees, trainers, district officers and others exploring the application of the training into practice. Participants During late 2010 and 2011, 36 trainees including 19 assistant medical officers one senior clinical officer and 16 nurse midwives/nurses (anaesthesia) were recruited from districts across rural Tanzania and invited to join the ETATMBA training programme. Results Trainees (n=36) completed the training returning to 17 facilities, two left and one died shortly after training. Of the remaining trainees, 27 were interviewed at their health facility. Training was well received and knowledge and skills were increased. There were a number of challenges faced by trainees, not least that their new skills could not be practised because the facilities they returned to were not upgraded. Nonetheless, there is evidence that the training is having an effect locally on health outcomes, like maternal and neonatal mortality, and the trainees are sharing their new knowledge and skills with others. Conclusions The outcome of this evaluation is encouraging but highlights that there are many ongoing challenges relating to infrastructure (including appropriate facilities, electricity and water) and the availability of basic supplies and drugs. This cadre of workers is a dedicated and valuable resource that can make a difference, which with better support could make a greater contribution to healthcare in the country

Can training non-physician clinicians/associate clinicians (NPCs/ACs) in emergency obstetric, neonatal care and clinical leadership make a difference to practice and help towards reductions in maternal and neonatal mortality in rural Tanzania? The ETATMBA project

Objectives During late 2010, 36 trainees including 19 assistant medical officers (AMOs) 1 senior clinical officer (CO) and 16 nurse midwives/nurses were recruited from districts across rural Tanzania and invited to join the Enhancing Human Resources and Use of Appropriate Technologies for Maternal and Perinatal Survival in the sub-Saharan Africa (ETATMBA) training programme. The ETATMBA project was training associate clinicians (ACs) as advanced clinical leaders in emergency obstetric care. The trainees returned to health facilities across the country with the hope of being able to apply their new skills and knowledge. The main aim of this study was to explore the impact of the ETATMBA training on health outcomes including maternal and neonatal morbidity and mortality in their facilities. Secondly, to explore the challenges faced in working in these health facilities. Design The study is a pre-examination/postexamination of maternal and neonatal health indicators and a survey of health facilities in rural Tanzania. The facilities surveyed were those in which ETATMBA trainees were placed post-training. The maternal and neonatal indicators were collected for 2011 and 2013 and the survey of the facilities was in early 2014. Results 16 of 17 facilities were surveyed. Maternal deaths show a non-significant downward trend over the 2 years (282–232 cases/100 000 live births). There were no significant differences in maternal, neonatal and birth complication variables across the time-points. The survey of facilities revealed shortages in key areas and some are a serious concern. Conclusions This study represents a snapshot of rural health facilities providing maternal and neonatal care in Tanzania. Enhancing knowledge, practical skills, and clinical leadership of ACs may have a positive impact on health outcomes. However, any impact may be confounded by the significant challenges in delivering a service in terms of resources. Thus, training may be beneficial, but it requires an infrastructure that supports it

Decision Support Systems in Forest Management: An Integrated Approach

Decision making process - especially in natural resources management, encounters myriad of challenges to objective decisions, significant decision depends on amount of information and capability of decision makers to handle massive data. In forest management, these challenges such as lack of enough data and cost associated with obtaining insitu spatial data, have been minimised with the use Geospatial Decision Support System (GDSS). GDSS has shown great capability of capturing, storing, analysing, retrieving and manipulating data for aiding spatial decisions. This technology proliferates quickly and as a result decision makers overlook other systems for forest governing. Following this situation, people living adjacent to forests have found it difficult to accessing forest resources - and their livelihoods, which depends on forests have been compromised. The continuing degradation of forest resources despite existence of different management strategies - such as (community based forest management and joint forest management), has made it necessary to assess decisions on forest conservation. Focus Group Discussion (FGD) strategy was applied to capture extent of use of Indigenous and Local Knowledge (ILK) and GDSS in forest management decisions, observation was applied to implicitly relate the narration from FGD and the reality while interview method was applied to forest officials to capture use of ILK in forest decision making. The results revealed that ILK related to forest management; however the uncovered ILK has been insignificantly used together with GDSS in making decision for conservation. This paper establishes the ignorance on ILK as one among other factors behind the continued forest cover depletion despite existence of conventional conservation strategies. The developed framework integrates GDSS and ILK to aid forest decisions which will ensure sustainable forest conservation and serves for forest needs of the communities adjacent