Browsing by Author "Mahonge, Christopher"
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Item The determinants of the performance of health facility governing committees (HFGC) in selected primary health facilities in Tanzania(TAJOCODE and CODEPATA, 2021) Kesale, Anosisye; Mahonge, Christopher; Mikidadi, MuhangaLower and Middle-Income Countries (LMICs) implement fiscal decentralization through Direct Health Facility Financing (DHFF) to empower Health Facility Governing Committees (HFGCs). The measure is designed to enable HFGCs to effectively participate in the planning, implementing and controlling health service delivery at primary health facilities. However, it is not empirically known what HFGCs members perceive to be determinants of the performance of these HFGCs under DHFF context. Drawing from community participation and decentralization literature, this study was conducted to assess the determinants of the HFGCs performance under DHFF as perceived by the HFGC members in four selected regions in Tanzania. A cross-sectional research design was employed to collect both qualitative and quantitative data from the four regions. The study has found that availability of finance to the health facility has RII 0.8964 score is ranked 1st important determinant of HFGC performance, followed by clarity of powers and functions with RII 0.8928 score (2nd) and communication between the HFGCs and community has RII 0.8792 score ranked third (3rd). This study concludes that contextual factors significantly influence the performance of HFGCs than HFGC members' characteristics in carrying out their devolved functions. The study recommends working environment for HFGCs to be improved for strengthening HFGCs performance.Item Effects of decentralization on the functionality of health facility governing committees in lower and middle-income countries: a systematic literature review(Taylor & Francis, 2022-05-02) Kesale, Anosisye M.; Mahonge, Christopher; Muhanga, MikidadiBackground: Health facility governing committees (HFGCs) were established by lower and middle-income countries (LMICs) to facilitate community participation at the primary facility level to improve health system performance. However, empirical evidence on their effects under decentralization reform on the functionality of HFGCs is scant and inconclusive. Objective: This article reviews the effects of decentralization on the functionality of HFGCs in LMICs. Methods: A systematic literature review was conducted using various search engines to obtain a total number of 24 relevant articles from 14 countries published between 2000 and 2020. Inclusion criteria include studies must be on community health committees, carried out under decentralization, HFGCs operating at the individual facility, effects of HFGCs on health performance or health outcomes and peer-reviewed empirical studies conducted in LMICs. Results: The study has found varied functionality of HFGCs under a decentralization context. The study has found many HFGCs to have very low functionality, while a few HFGCs in other LMICs countries are performing very well. The context and decentralization type, members’ awareness of their roles, membership allowance and availability of resource to the facility in which HFGCs operate to produce the desired outcomes play a significant role in facilitating/ limiting them to effectively carry out the devolved duties and responsibilities. Conclusion: Fiscal decentralization has largely been seen as important in making health committees more autonomous, even though it does not guarantee the performance of HFGCs.Item Knowledge, attitudes and practices related to taenia solium cysticercosis and taeniasis in Tanzania(BMC, 2022) Nyangi, Chacha; Stelzle, Dominik; Mkupasi, Ernatus M; Ngowi, Helena A; Churi, Ayubu J; Schmidt, Veronika; Mahonge, Christopher; Winkler, Andrea SBackground: Taenia solium cysticercosis/taeniasis (TSCT) is reported to be endemic in pig producing areas around the world, causing significant disease burden and economic losses. Methods: This cross-sectional study aimed at assessing Knowledge, Attitudes and Practices (KAP) regarding TSCT in four districts, namely Mbulu, Mpwapwa, Mbinga, and Rungwe in Tanzania. Data on KAP were collected through questionnaire-based interviews and household infrastructure observations. Results: Knowledge about porcine cysticercosis was good, particularly among pig keepers across the districts. Many participants had heard about the pork tapeworm (T. solium taeniasis), and the knowledge about signs/symptoms and treatment was fair, but the means of transmission and prevention measures were often unknown. Whilst most participants were familiar with epilepsy, no one knew anything about human cysticercosis and the link between cysticercosis and epileptic seizures. A similar trend is reflected through the attitudes toward the low risk perception of cysticercosis infection. Not surprisingly, the risk perception of the infection with the pork tapeworm was low too. Many participants reported not washing their hands before eating or after using the toilet which highlights potential risks for the development of human cysticercosis. Albeit nearly every participant reported using the toilet always, household observations revealed that toilets were either lacking or had no complete walls. Generally, household observations revealed a discrepancy between questionnaire answers on the one hand and the availability of toilet and handwashing facilities and the confinement of pigs on the other hand. Conclusion: This study demonstrates knowledge gaps and adverse practices which may hinder and/or slow down the control/elimination of T. solium in endemic countries. The study results are also useful for appropriate designing of TSCT health interventions that need to be planned carefully, taking into account the local context and designing TSCT in partnership with the local communities from the beginning to the end applying a One Health approach to allow the possible sustained and best impacts. Keywords: Knowledge, Attitude, Practices, Smallholder pig farming, Taenia solium, Cysticercosis, Taeniasis, Epilepsy, Neurocysticercosis, Cross-sectional studyItem Smallholder Farmers’ Adaptation Strategies to Impact of Climate Change in Semi-arid Areas of Iringa District Tanzania(International Institute for Science, Technology & Education (IISTE), 2015) Kihupi, Mary L; Mahonge, Christopher; Chingonikaya, Emmanuel E.The current climate is already marginal with respect to precipitation in many parts of Africa, especially in semiarid areas. Impact of climate change will bring substantial losses especially to smallholder farmers whose main source of livelihood derives from agriculture. Such impacts can be significantly reduced through adaptation. Given the high dependence on rain-fed agriculture and prevailing drought condition of semi-arid areas of Iringa district, the area may be quite vulnerable to the current and future climatic changes. The frequency supply of food relief from the Tanzania government to smallholder farmers in Ismani, emphasizes its vulnerability to climate changes. Therefore, this study determined adaptation measures carried out in semi-arid areas of Iringa District Ismani and Pawaga Divisions in particular. The research design was cross sectional. A multistage sampling procedure was applied in selecting divisions, wards, villages and households. Ismani and Pawaga divisions were purposeful selected basing on their climatic condition. A total of 240 respondents were selected randomly from eight villages. Data were collected through household survey, key informant interview, observation and focus group discussion methods. Quantitative data analysis was done using SPSS whereby descriptive statistics were computed. Qualitative data were analyzed using content analysis. The findings revealed that smallholder farmers in Pawaga and Ismani divisions were adapting to impact of climate change through irrigation, crop diversification, planting early maturing maize varieties, planting drought resistant crops, changing of planting dates, and agriculture diversification and non-farm activities. It can be concluded that the smallholder farmers in both divisions used various adaption strategies against climate change impact. However, the farmers in the two divisions still face the impact of climate change in their livelihoods. Based on the conclusion made in this study, there are required efforts from various stakeholders including government to improve the adaptation strategies to be appropriate and effective.