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Assessing the influence of health facility factors on utilisation of early infant diagnosis for HIV infection in Kilolo District Council
(Mzumbe University, 2016) Wilfred William Rwechungura
This study, which involved a sample of 200 respondents, was conducted in Kilolo District Council in Tanzania to assess the influence of health facility factors on utilizations of Early Infant Diagnosis of HIV infection (EID) services. The study problem was that there are HIV exposed infants who are enrolled in the EID programmed but they don’t access the intended services and hence the need for conducting the study. The specific objectives were (i) to evaluate availability of EID materials and its influence on utilizations of EID services in Kilolo health facilities; (ii) to assess availability of sample and results transportation system and its influence on utilizations of EID services in Kilolo health facilities; (iii) to assess the competence of healthcare workers and its influence on utilization of EID services at Kilolo health facilities; and (iv) to assess the satisfaction of mothers / guardians of HIV exposed infants on EID services provided in Kilolo health facilities. The study findings revealed that utilizations of EID service was indeed low (at 38%) as data suggested. Among contributing factors was inadequate EID materials at health facilities. Forty eight percent (48%) of the health worker respondents strongly disagree that there are adequate DBS materials at health facilities. On the same issue, when health workers were asked on whether they experienced stock outs of EID materials, fifty seven percent (57%) answered in the affirmative. The other finding was that health facility cares workers do not have sufficient skills for providing EID services. Forty three percent (43%) of the healthcare worker respondents reported that the sample and results transportation system is not reliable. The results showed that availability of EID materials and sample and results transportation system positively influence utilization of EID services at the health facilities whereas competence of healthcare workers influences negatively the utilization of EID services. This study recommends that the healthcare workers be trained in providing EID services and that arrangements be done for ensuring availability of EID materials, sample and results transportation system and availability of competent healthcare workers.
Assessment on 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) Kimambo Haika Steven
Background: Emergency obstetric care is one of the strategies for reducing the maternal mortality as pregnancy related complications are unpredictable. However, maternal death due problems related to unimproved comprehensive obstetric has been documented. Objectives: The aim of this evaluation was to assess the implementation process more specifically on the community awareness with regards 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 provision of quality health services by utilization of EmONC services by the community of Uvinza District Council. Methods: The study was conducted in four villages of Uvinza district in 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 collected 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. 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.
Assessing factors influencing reporting of weekly diseases data from regions to ministry of health and social welfare in Tanzania Mainland
(Mzumbe University, 2015) Moshi, Solomon Frank
Background: Reporting weekly diseases data from regions to Ministry of Health and Social Welfare is one of method which is used to submit weekly diseases information from regions to the Ministry according to number of weeks in a year from 1st to 52 th week. This method is a paper based, that enables diseases information to be available at the national level on time to allow for quick and important public health action. This is an evaluation study designed to assess factors which tended to influence weekly diseases data from regions to Ministry of Health and Social Welfare, to determine technical challenges and determine measures to improving the reporting design.
Methodology: The quantitative study design was conducted in Tanzania mainland which consist all regions. A primary data type was collected through structured closed questionnaire which was administered to a total of 25 respondents’ samples size that was 100% countrywide, since each region was represented by single reporter. Data was processed and analyzed by using Microsoft Excel 2010.
Results: Findings showed that there was higher understanding of factors which influenced reporting. Findings indicate that 100% of the participants were Health officers, 68% were regional IDSR focal person who understood well the system of reporting weekly disease data. The evaluation also revealed technical challenges associated with reporting; whereas 88% of participants acknowledged to have incurred cost during reporting, 71% viewed that approving weekly diseases data contributed to untimely reporting. Finally, there were measures identified for improving reporting; these include feedback report, supportive supervision and availability of IDSR guidelines.
Conclusions: The evaluation concludes that, the ineffectiveness of reporting weekly diseases data was due to several reasons which include weekly reporter having many responsibilities, approving and signing weekly diseases by RMO before submission, costs of reporting incurred by reporters and weak or no supportive supervision and feedback.. So the evaluation recommends that government through its ministry must take responsibilities of making sure that reporting forms are available. The Ministry and its development partners should take responsibilities to elevating the costs incurred by IDSR focal person. The study also recommends to the Ministry and RMHT to strategize on how to speed up reporting, and that weekly disease data should not be approved only by RMO but other RHMT members. Lastly, the study recommends that the Ministry set aside some fund and schedule a time table to enable them to conduct supportive supervision from National level to Regional levels
Effects of exemptions on cost sharing practices in government health facilities: A case study Chunya District Council
(Mzumbe University, 2015) Chengula, Veronica ,Andreas.
The study looks into the effects of exemptions on cost sharing practices at Chunya district hospital. The research objectives were to determine the awareness of health service providers on exemption mechanisms, how exemptions are implemented and satisfy the eligible groups, what are the effects of exemptions and identifying appropriate mechanisms of improving the implementation of exemptions. The study adopted a case study design by using questionnaires and interviews for primary data collection while secondary data were obtained from reviewed relate documents. The study was completed by 60 respondents working in different departments of Chunya district hospital including CHMT. Moreover, the sampling techniques were both non-probability and probability sampling, which include purposive sampling and simple random sampling. From the findings of the study, the majority 55 (91%) were aware with exemption Mechanisms in their work place. Moreover, on the satisfaction of the groups who are exempted 35 (58%) the system is satisfying with some challenges. Furthermore, on the effects of exemptions on cost sharing the result showed that 56 (93%) of respondents agreed that exemptions has effects of cost sharing due to lower revenue collections, workforce crisis and inadequate medicine and medical supplies. Tanzania should implement cost sharing and exemption mechanisms in situations that can maximize the revenue collection, compensate the revenue lost in exemption by using tax collected from natural resources i.e. gold mining, tourism, gas and mobilization of CHF.
Factors towards low contraceptive uptake: does providers’ capacity matter : A case in Morogoro District Council
(Mzumbe University, 2015) Stephen J. Mduma
The main objective of the study was to determine the role of providers’ capacity in enhancing contraceptive uptake. A descriptive cross sectional study design was used to a randomly selected 51 respondents of whom 26 were health providers and 25 were clients. The specific objectives were to determine magnitude of FP providers availability, to examine providers’ capacity in terms of training, skills, mentorship, experience, data generation and use for provision of FP services, to determine the magnitude of providers’ capacity for FP advocacy, to determine the degree of provider capacity in FP supply forecasting and to determine the level of provider capacity in meeting FP consumers’ choice. Findings revealed that, contraceptive uptake in Morogoro DC was 28% which was low compared to 37% of the region. Also, findings on availability of FP providers revealed that overall deficit of HCPs were 46.7% for dispensaries and 28.6% for health centers respectively. There was no statistically significant different between current contraceptive utilization and availability of health care providers with X2 Pr = 0.933>0.05 at 95% confident limit. Further findings on FP providers capacity revealed that lack of mentorship was at 66.6% for health centers and 100% for dispensaries and it was statistically significant with X2 Pr = 0.007 and correlation coefficient with P>|t| 0.006t 0.006 which is < 0.05 at 95% confident limit. Findings for FP/providers/clients decision making tool revealed that 92.31% of respondent reported that there was no tool available in their health facilities, statistically significant with X2 Pr 0.007 and correlation at P>t 0.006>0.05 at 95% confident limit. Conclusively: This research study had revealed that, consistent availability of contraceptives, health care providers, providers /clients’ decision-making tools and mentorship could enhance contraceptives uptake level in the community.