Patients' perception on quality of care for prostate cancer at tertiary hospitals in Tanzania: a qualitative study.

Background: Prostate cancer is a common cancer among men globally and its treatment affects quality of life. Poor patients' perception of prostate cancer services may lead to their late presentation for care, often presenting with the advanced stage of the disease. This may vary from one region to another.

Provision of prostate cancer services in Tanzania: perspectives from five tertiary hospitals.

Background: Access to quality prostate cancer services remains a global challenge, particularly in Low- and Middle-Income countries. This is often due to weak health systems that struggle to meet the population's needs. The provision of quality health services to patients with prostate cancer requires a comprehensive approach involving multiple stakeholders and structural inputs.

High Child Mortality and Interventions Coverage in the City of Dar es Salaam, Tanzania: Are the Poorest Paying an Urban Penalty?

The 'urban penalty' in health refers to the loss of a presumed survival advantage due to adverse consequences of urban life. This study investigated the levels and trends in neonatal, post-neonatal and under-5 mortality rate and key determinants of child survival using data from Tanzania Demographic and Health Surveys (TDHS) (2004/05, 2010 and 2015/16), AIDS Indicator Survey (AIS), Malaria Indicator survey (MIS) and health facility data in Tanzania mainland. We compared Dar es Salaam results with other urban and rural areas in Tanzania mainland, and between the poorest and richest wealth tertiles within Dar es Salaam.

Quality of reporting and trends of emergency obstetric and neonatal care indicators: an analysis from Tanzania district health information system data between 2016 and 2020.

Background: Routine health facility data provides the opportunity to monitor progress in quality and uptake of health care continuously. Our study aimed to assess the reliability and usefulness of emergency obstetric care data including temporal and regional variations over the past five years in Tanzania Mainland.

Methods: Data were compiled from the routine monthly district reports compiled as part of the health management information systems for 2016-2020.

Perceived Usefulness, Competency, and Associated Factors in Using District Health Information System Data Among District Health Managers in Tanzania: Cross-sectional Study.

Background: Tanzania introduced District Health Information Software (version 2; DHIS2) in 2013 to support existing health management information systems and to improve data quality and use. However, to achieve these objectives, it is imperative to build human resource capabilities to address the challenges of new technologies, especially in resource-constrained countries.

Objective: This study aimed to determine the perceived usefulness, competency, and associated factors in using DHIS2 data among district health managers (DHMs) in Tanzania.

Health service utilisation during the COVID-19 pandemic in sub-Saharan Africa in 2020: a multicountry empirical assessment with a focus on maternal, newborn and child health services.

Introduction: There are concerns about the impact of the COVID-19 pandemic on the continuation of essential health services in sub-Saharan Africa. Through the Countdown to 2030 for Women's, Children's and Adolescents' Health country collaborations, analysts from country and global public health institutions and ministries of health assessed the trends in selected services for maternal, newborn and child health, general service utilisation.

Methods: Monthly routine health facility data by district for the period 2017-2020 were compiled by 12 country teams and adjusted after extensive quality assessments.

Accommodate or Reject: The Role of Local Communities in the Retention of Health Workers in Rural Tanzania.

Background: While over 70% of the population in Tanzania reside in rural areas, only 25% of physicians and 55% of nurses serve these areas. Tanzania operates a decentralised health system which aims to bring health services closer to its people through collaborative citizen efforts. While community engagement was intended as a mechanism to support the retention of the health workforce in rural areas, the reality on the ground does not always match this ideal.

It is beyond remuneration: Bottom-up health workers' retention strategies at the primary health care system in Tanzania.

Although Tanzania is operating a decentralized health system, most of the health workers' retention strategies are designed at the central level and implemented at the local level. This study sought to explore the bottom-up health workers' retention strategies by analyzing experiences from two rural districts, Rombo and Kilwa in Tanzania by conducting a cross-sectional exploratory qualitative study in the said districts. Nineteen key informants were purposefully selected based on their involvement in the health workers' retention scheme at the district and then interviewed.

Lessons learned in the implementation of supplementary immunization activity (SIA) field guidelines for injectable vaccines - Experiences from Tanzania.

Background: To achieve Measles and Rubella elimination and Polio Endgame goals, Tanzania implemented country-wide integrated Supplementary Immunization Activities (SIAs) in October 2019 involving two injectable vaccines of MR and IPV. The SIAs targeted children aged between 9 and 59 months for Measles-Rubella and 18 to 42 months for IPV vaccines. This article aims to share lessons learnt in the implementation of SIAs field guidelines in Tanzania in 2019 to inform future implementation of the SIAs within and outside the country's boundaries.

Male partner approval on the use of modern contraceptive methods: factors determining usage among couples in Kibaha district, Tanzania.

Background: Men in developing countries play an important role in the adoption of family planning (FP), either as actual users or supporters of their partners. Notwithstanding the universal knowledge on the contraceptive methods, their approval and use have been low among men in Tanzania. This study determined the magnitude and factors that influence men to use or approve the use of modern contraceptive methods with their spouses.

Improving prompt access to malaria diagnostics and treatment in rural remote areas using financial benefit for community health workers in Kilosa district, Tanzania.

Purpose: Improving access to malaria treatment in rural remote areas remains a major challenge facing innovative strategies, such as Accredited Drug Dispensing Outlets (ADDOs) and Community Health Workers (CHWs) programs in Tanzania. This study tested the effectiveness of a financial benefit approach to motivate CHWs to improve prompt access to malaria treatment.

Patients And Methods: We applied a quasi-experimental study design in rural-remote areas in Kilosa district, Tanzania.

Prevention of mother to child transmission of HIV in Tanzania: assessing gender mainstreaming on paper and in practice.

Although gender mainstreaming has been long recognized as a strategy for addressing gender inequalities and associated negative health outcomes; its implementation has remained a challenge, even in the area of prevention of mother to child transmission of HIV (PMTCT). Despite recognition of gender in Tanzania's political arena and prioritization of PMTCT by the health sector, there is very little information on how well gender has been mainstreamed into National PMTCT guidelines and organizational practices at service delivery level. Using a case study methodology, we combined document review with key informant interviews to assess gender mainstreaming in PMTCT on paper and in practice in Tanzania.

Household Knowledge of Antimicrobials and Antimicrobial Resistance in the Wake of an Accredited Drug Dispensing Outlet (ADDO) Program Rollout in Tanzania.

Introduction: Private sector drug shops are an important source of medicines in Tanzania. In 2003, the government introduced the accredited drug dispensing outlet (ADDO) program to improve access to good-quality medicines in rural and peri-urban areas that have frequent drug shortages in public health facilities and few or no registered pharmacies. However, increasing access may also contribute to antimicrobial resistance (AMR) due to the potential overuse and misuse of drugs.

Institutional capacity for health systems research in East and Central African Schools of Public Health: strengthening human and financial resources.

Background: Despite its importance in providing evidence for health-related policy and decision-making, an insufficient amount of health systems research (HSR) is conducted in low-income countries (LICs). Schools of public health (SPHs) are key stakeholders in HSR. This paper, one in a series of four, examines human and financial resources capacities, policies and organizational support for HSR in seven Africa Hub SPHs in East and Central Africa.

How rational are indications for emergency caesarean section in a tertiary hospital in Tanzania?

The rate of caesarean section (CS) at Muhimbili National Hospital (MNH) in Tanzania has been on progressive increase for past three decades. Concerns have been raised if this increase is justified by rational decisions but no study so far has investigated this problem. The aim of the study was to find out whether decisions made for CS comply with a set of locally made standards, with an assumption that if the standards are met, then the increase in CS rate seen at MNH is genuine.

Primacy of effective communication and its influence on adherence to artemether-lumefantrine treatment for children under five years of age: a qualitative study.

Background: Prompt access to artemesinin-combination therapy (ACT) is not adequate unless the drug is taken according to treatment guidelines. Adherence to the treatment schedule is important to preserve efficacy of the drug. Although some community based studies have reported fairly high levels of adherence, data on factors influencing adherence to artemether-lumefantrine (AL) treatment schedule remain inadequate.

Access to subsidized artemether-lumefantrine from the private sector among febrile children in rural setting in Kilosa, Tanzania.

The World Health Organization aims at universal access to effective antimalarial treatment by the year 2015. Consequently, an enormous financial resource has been invested on Artemisinin Combination Therapy (ACT) subsidy. In Tanzania, strategies to increase access of artemether-lumufantrine (ALu) rural areas, where the burden is highest, includes subsidy to the Faith-based Organisations (FBO) facilities and accredited drug dispensing outlets (ADDOs).

Adherence to artemether/lumefantrine treatment in children under real-life situations in rural Tanzania.

A follow-up study was conducted to determine the magnitude of and factors related to adherence to artemether/lumefantrine (ALu) treatment in rural settings in Tanzania. Children in five villages of Kilosa District treated at health facilities were followed-up at their homes on Day 7 after the first dose of ALu. For those found to be positive using a rapid diagnostic test for malaria and treated with ALu, their caretakers were interviewed on drug administration habits.

Reaching the poor through community-based distributors of contraceptives: experiences from Muheza district, Tanzania.

Community based distribution (CBD) programmes were introduced as a strategy to ensure access of contraceptives to the needy. The strategy is reported to increase contraceptive knowledge and use. Although CBD agents have the advantage of reaching the poor in rural areas, wealth gap does exist even in these settings.

Who gets prompt access to artemisinin-based combination therapy? A prospective community-based study in children from rural Kilosa, Tanzania.

Background: Effective and timely case management remains one of the fundamental pillars for control of malaria. Tanzania introduced artemisinin-combination therapy [ACT] for uncomplicated malaria; however, the policy change is challenged by limited availability of ACTs due to high cost. This study aimed to determine factors influencing prompt access to ACTs among febrile children in rural Kilosa, Tanzania.

Volunteerism among out-of-school adolescent reproductive health peer educators: is it a sustainable strategy in resource constrained countries?

Out-of-school peer educators [PE] are resourceful in transmitting reproductive health information but their retention remains a contentious issue. This study aimed to assess motivation and sustainability of out-of-school PEs in disseminating reproductive health information among adolescents. A structured questionnaire was used to interview 406 PEs in Mbeya region, Tanzania.

Understanding caretakers' dilemma in deciding whether or not to adhere with referral advice after pre-referral treatment with rectal artesunate.

Background: Malaria kills. A single rectal dose of artesunate before referral can reduce mortality and prevent permanent disability. However, the success of this intervention depends on caretakers' adherence to referral advice for follow-up care.

Factors influencing adherence to referral advice following pre-referral treatment with artesunate suppositories in children in rural Tanzania.

Objective: WHO recommends artemisinin suppository formulations as pre-referral treatment for children who are unable to take oral medication and cannot rapidly reach a facility for parenteral treatment. We investigated factors influencing caretakers' adherence to referral advice following pre-referral treatment of their children with rectal artesunate suppositories.

Methods: The study was nested within an intervention study that involved pre-referral treatment of all children who came to a community dispenser for treatment because they were unable to take oral medications because of repeated vomiting, lethargy, convulsions or altered consciousness.

The impact of scaling-up prevention of mother-to-child transmission (PMTCT) of HIV infection on the human resource requirement: the need to go beyond numbers.

Although the mother-to-child transmission (MTCT) contributes only 5% of transmission of HIV infection, its impact has reversed the decline in infant and child mortality rates. With antenatal service coverage of over 90%, the integration of prevention of MTCT (PMTCT) of HIV infection into the Reproductive and Child Health (RCH) services in Tanzania, this is likely to overstretch the staff capacity and undermine the already compromised quality of health care services. A retrospective study was conducted to assess the impact of integrating and scaling-up PMTCT of HIV infection into routine RCH services, on the magnitude of staff workload in RCH clinics.

Referral pattern of patients received at the national referral hospital: challenges in low income countries.

Objective: To examine the medical referral pattern of patients received at the Muhimbili National Hospital (MNH) in order to inform the process of strengthening the referral system.

Methods: The study design was a prospective study conducted at MNH during a 10-week study period from January to March 2004. The study sample consisted of patients referred to MNH.