Infection prevention and control of highly infectious pathogens in resource-limited countries: an experience from Marburg viral disease outbreak in Kagera Region - Tanzania.

Marburg viral disease (MVD) is a highly infectious disease with a case fatality rate of up to 90%, particularly impacting resource-limited countries where implementing Infection Prevention and Control (IPC) measures is challenging. This paper shares the experience of how Tanzania has improved its capacity to prevent and control highly infectious diseases, and how this capacity was utilized during the outbreak of the MVD disease that occurred for the first time in the country in 2023.In 2016 and the subsequent years, Tanzania conducted self and external assessments that revealed limited IPC capacity in responding to highly infectious diseases.

Status of countrywide laboratory services quality and capacity in primary healthcare facilities in Tanzania: Findings from Star Rating Assessment.

Accurate disease diagnosis relies on a well-organized and reliable laboratory system. This study assesses the quality of laboratory services in Tanzania based on the nationwide Star Rating Assessment (SRA) of Primary Healthcare (PHC) facilities conducted in 2017/18. This cross-sectional study utilized secondary data from all the country's PHC facilities stored in the SRA database.

Aflatoxicosis outbreak and its associated factors in Kiteto, Chemba and Kondoa Districts, Tanzania.

Tanzania had experienced hundreds of cases of aflatoxicosis in the districts of Kiteto, Chemba, and Kondoa for the three consecutive years since 2016. Cases may end up with liver cancer. Aflatoxin-induced liver cancer had resulted in the demise of roughly three persons per 100,000 in the country during the same year, 2016.

A small area model to assess temporal trends and sub-national disparities in healthcare quality.

Monitoring subnational healthcare quality is important for identifying and addressing geographic inequities. Yet, health facility surveys are rarely powered to support the generation of estimates at more local levels. With this study, we propose an analytical approach for estimating both temporal and subnational patterns of healthcare quality indicators from health facility survey data.

Surveillance of antimicrobial resistance in human health in Tanzania: 2016-2021.

Background: Antimicrobial resistance (AMR) surveillance plays an important role in early detection of resistant strains of pathogens and informs treatments decisions at local, regional and national levels. In 2017, Tanzania developed a One Health AMR Surveillance Framework to guide establishment of AMR surveillance systems in the human and animal sectors.

Aim: We reviewed AMR surveillance studies in Tanzania to document progress towards establishing an AMR surveillance system and determine effective strengthening strategies.

Factors affecting compliance with infection prevention and control standard precautions among healthcare workers in Songwe region, Tanzania.

Background: Compliance with infection prevention and control standard precautions (IPCSPs) remains a major challenge in many countries including Tanzania. Lack of compliance exposes healthcare workers (HCWs) and patients to a high risk of developing healthcare-associated infections (HAIs) including antimicrobial-resistant microorganisms which can contribute to the spread of antimicrobial resistance (AMR). This study investigated compliance with IPCSPs and associated factors among HCWs in public healthcare facilities (HFs) in Songwe Region, Tanzania between January and March 2021.

Clients satisfaction at primary healthcare facilities and its association with implementation of client service charter in Tanzania.

Background: Client service charter (CSC) provides information about what people can expect in a facility's services; what is expected of clients and service providers. Tanzania implemented Star Rating Assessment (SRA) of primary health care (PHC) facilities in 2015/16 and 2017/18 using SRA tools with 12 service areas. This paper assesses the status of service area 7, namely client focus that checked if client was satisfied with services provided and implementation of CSC through three indicators-if: CSC was displayed; CSC was monitored; client feedback mechanism and complaints handling was in place.

Social accountability in primary health care facilities in Tanzania: Results from Star Rating Assessment.

Background: Star Rating Assessment (SRA) was initiated in 2015 in Tanzania aiming at improving the quality of services provided in Primary Healthcare (PHC) facilities. Social accountability (SA) is among the 12 assessment areas of SRA tools. We aimed to assess the SA performance and its predictors among PHC facilities in Tanzania based on findings of a nationwide reassessment conducted in 2017/18.

Addressing Inequalities Toward Inclusive Governance for Achieving One Health: A Rapid Review.

Sustainable development goals (SDGs) adopted in 2015 are geared toward sustainable development through various pathways, one being reducing inequality as covered in SDG 10. Inequalities are a threat to health and wellbeing of populations and a planet Earth in which we live. This rapid review aims to identify key issues that are likely to exacerbate inequalities around the six SDGs directly related to One Health, which are SDG 3, 6, 11, 13, 14 and 15, and suggest some actions that may help to address them using inclusive governance taking into account the coronavirus disease of 2019 (COVID-19) pandemic.

Measuring user experience of care among caregivers of sick children: Validation and descriptive analysis in a sample of 75 health facilities in rural Tanzania.

Objective: User experience is an important aspect of quality of care that is highly valued by patients. However, there are currently no validated tools for measuring user experience among caregivers of sick children in low- and middle-income countries. We aimed to develop and validate a measure of user experience in this population in primary healthcare facilities in rural Tanzania, where major quality improvement efforts to date have not included a large focus on user experience.

Surgical Safety Checklist Use and Post-Caesarean Sepsis in the Lake Zone of Tanzania: Results from Safe Surgery 2020.

Background: Maternal sepsis accounts for significant morbidity and mortality in lower income countries, and caesarean delivery, while often necessary, augments the risk of maternal sepsis. The aim of this study was to investigate the effect of Safe Surgery 2020 surgical safety checklist (SSC) implementation on post-caesarean sepsis in Tanzania.

Methods: We conducted a study in 20 facilities in Tanzania's Lake Zone as part of the Safe Surgery 2020 intervention.

Status of Infection Prevention and Control in Tanzanian Primary Health Care Facilities: Learning From Star Rating Assessment.

Background: The WHO estimates 10-30% of hospital admissions are associated with poor infection prevention and control (IPC). There are no reliable data on IPC status in Tanzanian healthcare facilities; hence the Star Rating Assessment (SRA) was established to address this. This study compared the health facility performances on adherence to IPC principles using baseline and reassessment data of SRA.

Assessment of health facility quality improvements, United Republic of Tanzania.

Objective: To identify contextual factors associated with quality improvements in primary health-care facilities in the United Republic of Tanzania between two star rating assessments, focusing on local district administration and proximity to other facilities.

Methods: Facilities underwent star rating assessments in 2015 and between 2017 and 2018; quality was rated from zero to five stars. The consolidated framework for implementation research, adapted to a low-income context, was used to identify variables associated with star rating improvements between assessments.

Basic Accountability to Stop Ill-Treatment (BASI); Study Protocol for a Cluster Randomized Controlled Trial in Rural Tanzania.

Poor health system experiences negatively affect the lives of poor people throughout the world. In East Africa, there is a growing body of evidence of poor quality care that in some cases is so poor that it is disrespectful or abusive. This study will assess whether community feedback through report cards (with and without non-financial rewards) can improve patient experience, which includes aspects of patient dignity, autonomy, confidentiality, communication, timely attention, quality of basic amenities, and social support.

Creating a national culture of quality: the Tanzania experience.

Although quality improvement has been a priority for Tanzania's health sector since the 1970s, few effective quality improvement initiatives were implemented, due to limited expertise, political commitment and resources. More recently, as the HIV epidemic gained momentum within the country, an influx of funding and of international organizations with quality improvement expertise accelerated the implementation of quality improvement projects, as well as efforts to institutionalize quality improvement at the national level. The support of US President's Emergency Plan for AIDS Relief (PEPFAR) and other donors, and the increasing numbers of HIV-implementing partners focused on quality management, and quality improvement strategies catalysed the development of HIV-specific quality improvement initiatives first, and then of national quality improvement frameworks.