Health System Management Monitoring & Evaluation(HSME)
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Item Factors towards low contraceptive uptake: does providers’ capacity matter : A case in Morogoro District Council(Mzumbe University, 2015) Stephen J. MdumaThe 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.Item 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 HaikaBackground: 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.Item Factors affecting continuity in attending antenatal care services among pregnant women in Chemba district(Mzumbe University, 2019) Hamisi, AzizaBackground: Maternal mortality has remained to be the leading cause of death among women of reproductive age. In developing countries like Tanzania, the occurrence of maternal deaths has been linked with low level of attendance and utilization of skilled maternal health services like Antenatal Care (ANC) services. This is because some deaths among pregnant mothers could have been prevented if women early utilize skilled maternal health services especially ANC services. Objective: This study aimed to determine the factors affecting continuity in attending antenatal care services among pregnant women. Methodology: The study adopted a cross-sectional design. Data were collected from 384 conveniently selected respondents enrolled in 7 health facilities of Chemba. Questionnaire was used during data collection. SPSS version 17 was used for data analysis. Findings: The findings of this study indicated that description of ANC services from health care workers (HCW) (Harsh or irrelevant description of ANC by HCW to clients), awareness on the day to start ANC and awareness on the frequency in which a pregnant mother is supposed to attend ANC services are the client related hindrances for continuity of ANC attendance. Service providers related factors that hinder continuity of attendance to ANC include long waiting hours of ANC services, modality of counseling for HIV test and STI test, provision of ANC services by male health providers, provision of ANC services by younger health providers, and shortage of medicines and medical equipment. The socio-economic factors that hinder continuity of ANC attendance include low family monthly income, religion objections, lack of spouse’s escort to ANC, lack of spouse’s financial support, family responsibilities, existence of traditional birth attendants and long distance from ANC clinics. Conclusion: In respect to the findings of this study, planners and implementers should consider multiple factors such as client related factors, service providers’ related factors and socio-economic factors in order to enhance continuity of ANC attendance among pregnant mothers.