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Research findings and health policy formulation in Zanzibar
(Mzumbe University, 2019) Abeid, Kassim A.
This study examined the use of research finding in health policy formulation in Zanzibar. The aim of this study was to see how the policy makers in the Ministry of Health use research findings as an input during the policy formulation. The general objective was to examine the use of research findings in formulation of health policy in Zanzibar. Specific objectives were: to determine how research findings have been used in the development of health policy in Zanzibar, to examine the linkage between policy makers and researchers, to identify the challenges that limited the use of research findings in formulation of health policy in Zanzibar and solutions thereof. Along this, the study adopted the qualitative approach using a case study design. 50 respondents were purposively selected as a sample size drawn from different area including Ministry of Health, Research Institutions and NGOs as sampling frame. In this study, primary and secondary data were collected through interviews and document reviews as the methods of gathering information and analysed by using content analysis technique. The findings of this study indicated that use of research findings is a fundamental input in the formulation of health policy. However, the policy makers rely on using inadequate evidence in formulating policy; this has been caused by poor coordination between policy makers and researchers which resulted to poor implementation of the policy. Such state of affairs is against evidence based policy. This substantiates the overriding views among policy makers that the connection between research and policy formulation remains to be one of the most commonly identified challenges of policy and ensures the formulation of evidence based policy that can solve problem in the country.
Assessment of quality of PMTCT service provided to HIV positive women and their HIV exposed infants in the Iringa District Council
(Mzumbe University, 2015) Kisika Firma Ambrose
This study was conducted to assess the quality of PMTCT services provided to HIV positive woman and their HIV exposed infants following the challenges of increasing dropouts. Specific objectives of the study were: to assess the input factors and their effects on the perceived quality to the satisfaction of the clients; and to assess the process factors and their effects on the perceived quality to the satisfaction of the clients. The study employed cross-sectional and descriptive designs in which data collection methods were questionnaire, in-depth interview, observation and documentary analysis. Data was analysed using Atlas it and SPSS version 16. The study findings revealed presence of some supplies and facilities requited for the provision of PMTCT services. However, it has been found that there are gaps/deficiencies in the structure, process and outcome that requited for providing PMTCT services. The study indicated that about half of the respondents had different views, both negative and positive, on the quality of PMTCT they received due to deficiencies in structural and process attributes that resulted in dissatisfaction. The study further showed deficiencies in structural attributes, in which majority of health care providers are not trained in PMTCT services, whereas it has been found that there is stock out of basic drugs for prevention of opportunistic infection. The study had opinions from CHMT concerning the problem of poor implementation at PMTCT services. The most and commonest problem is inadequate supervision. Further analysis indicated gaps in the process, where the majority of midwives demonstrated poor skills in counselling, whereas about half did not gather information. With regard to client provider interaction as they were not involved in the discussion. The study also revealed that none of the midwives used guidelines during provision of PMTCT services. In relation to history taking, it was observed that the majority of midwives did not obtain history and those few who attempted it came out with incomplete history. Almost all women and their HIV exposed infants were not examined. It is concluded that PMTCT services providers in Iringa District are poor quality.
Evaluation of USAID – Boresha afya program contributions among healthcare facilities in Lindi district council to improvement of the supply chain management of medical supplies.
(Mzumbe University, 2019) Mwihava, Oswald
This study evaluated the contributions of USAID Boresha Afya Progam to the medicine and medical equipment supply chain management system in Lindi District Council. The evaluation specifically focused on objectives: (i) to assess the use of data quality assessment (DQA) to supply chain management; (ii) to determine the efforts of USAID Boresha Afya Program to sharpen the skills on DQA among the health providers in the served facilities; and (iii) to establish the supervision of USAID Boresha Afya Program enhances supply chain management in healthcare facilities. The evaluation employed case study design with the qualitative approach. The sample size for the study was 33 participants purposively selected. Structured interviews were used to gather data from the participants who were 30 health workers in the selected health facilities and 3 officials of the Program. Because of qualitative nature of data, analysis of the findings employed the framework analysis that involved five stages of familiarization, thematic framework identification, indexing, charting and mapping and interpretation. The findings of the study revealed that the health facilities received Data Quality Assessment (DQA) for data cleaning and verification. It was found that DQA was effective for producing clean and verified data. The health personnel were well trained to handle and manage data for supply chain management of medicine and medical supply. The findings also showed that the health facilities needed supportive supervision from the Program officials. The Program officials offered the supervision but there was no auditing service of the Program. The evaluation reached a conclusion that Programs need clean and verified data to facilitate supply chain management without which it is impossible. Moreover, skills and knowledge are very important aspects in making the Program successful. Further, the most successful Program is that which is supportive supervision is in place. It was recommended that the Program management should establish auditing unit so as to avoid malicious behavior of some stakeholders in the Program.
Implementation process of maternal health project on emergency obstetric care and neonatal services in rural settings a case of Uvinza District council- Kigoma
(Mzumbe University, 2016) Steven Kimambo Haika
Background: Emergency obstetric care is one of the strategies for reducing maternal mortality, as pregnancy-related complications are unpredictable. However, maternal death due to problems related to unimproved comprehensive obstetric has been documented. Objectives: This evaluation aimed to assess the implementation process more specifically on the community awareness with regard to emergency obstetric and neonatal care (EmONC).The goal of the project has been to improve maternal and child health age in a population by ensuring the provision of quality health services through the utilisation of EmONC services by the community of Uvinza District Council. Methods: The study was conducted in four villages of Uvinza district in the Kigoma region. A cross-sectional descriptive study was conducted involving 120 respondents. Semi structured questionnaire was used to capture information related to implementation process of World Lung Foundation. The focus was on collecting information on several issues, such as assessing the level of community awareness in accessing EmONC services, identifying the roles of traditional birth attendants and challenges encounter by health care workers in facilities providing EmONC services. The evaluator randomly selected the participants to be included in the study. Results: The evaluation revealed institutional deliveries increased by 87.5% at CEmONC health centers, and 70% deliveries by caesarean section, the highest ever recorded. The level of community awareness in accessing EmONC services was high among the evaluation participants. Majority (87.5%) of the health care workers had received training supported by World lung foundation. The findings also revealed that traditional birth attendants have been undertaking early referrals of pregnant women to health facilities providing EmONC. vi Conclusion: The issue of 3 Ds (Delay in decisions making when to seek care, Decision of earlier referral and Decision on what time to start treatment) all these cut across as limitations to achieve millennium development goal number 5. Findings revealed that the maternal mortality rate (MMR) in all facilities decreased by 44% between January 2011 and June 2013(WLF report, 2013). Furthermore, there was a 70% increase in institutional deliveries in Project-supported facilities compared to a 30% decrease in non-Project-supported facilities; there were increased awareness of community in accessing care to health facilities providing EmONC services.
Practice and challenges in the implementation of education policy at pre-primary school level in Tanzania: A case of Bariadi district council
(Mzumbe University, 2018) Litinchi, Ally
This study is about practice and challenges in the implementation of education policy at pre-primary level done in Bariadi District in Simiyu, Tanzania. As many literatures realized that investment in early childhood education for children has promising future for the nation. Besides, few studies conducted in Tanzania show that provision of quality pre-primary education is not yet attained. The pre-primary level is encountered by number of setbacks, to mention few, there is shortage of qualified teachers for PPE, High pupils teachers ratio, few or absence of classes for pre-primary classes and teaching, learning and playing materials is a big challenge. With regard to that observation, this study seeks to find out why there is poor implementation of pre-primary education in Tanzania with special focus to Bariadi District Council. The study explore the stakeholders perception on education policy on improving quality of pre-primary education delivered at Bariadi District, to explore the existing situation in delivering of pre-primary education and examine the policy interventions available for improving pre-primary education. The study collected data from respondents by the use of interview, questionnaire and focus group Discussion for primary data and documentary review for secondary data. The findings of the study show that poor provision of pre-primary education is a result of lack of clear policy statement on how that level of education to be provided and be financed; lack of political commitment and coordination; failure to involve stakeholders such as parents and community in program aimed at improving pre-primary education. Basing on the study findings, it is time now for increasing work for improving pre-primary education through which can be used for financing building of pre-primary classes and equip them with necessary facilities such as desks, textbooks, teaching, learning and playing materials as well as employing qualified teacher specialised in pre-primary education teaching.