Development Studies Collection

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Contribution of vocational education in poverty reduction in Mufindi district, Tanzania
(Sokoine University of Agriculture, 2007) NZALI,AGNES STEPHEN
The study was conducted in Mufindi district, Iringa region, Tanzania to determine the contribution of vocational education in poverty reduction among Vocational Education and Training (VET) graduates. The study adopted a cross sectional design by using a questionnaire with both open and closed ended questions from a sample size of 120 respondents (60 women and 60 men) who have completed vocational training in the past three to ten years. Data analysis was done using the Statistical Package for Social Sciences (SPSS) in which Principal Component Analysis (PCA) was done to determine socio-economic status of the respondents’ households. Key findings indicate that the majority (29.2%) of the respondents were engaged in tailoring activities followed by motor vehicle mechanics (20%). The mean income of VET graduates was Tshs. 102 775 per month with the minimum income of Tshs.18 000 and the maximum income of Tshs. 700 000 per month. Their mean income implies that the majority of the respondents earn income above the minimum government salary, which is Tshs. 80 000 per month. Results from the study also reveal that female VET graduates in Mufindi district earn less income compared to male graduates. The mean income of male graduates was found to be Tshs. 119 216.67 while that of female was Tshs. 86 333.33. This is to say men earn 30.1% more than women. The difference was also found to be statistically significant at p < 0.05. However, there was no significant association between income and type of skill, duration of training and form of training (p > 0.05). Study findings also revealed that 20.8% of the respondents’ households were poorest while 19.2% of them were better off. Major problems faced by respondents were inadequate capitaliii and high taxes charged for their enterprises. It was concluded that vocational education contributes a lot in poverty reduction among VET graduates in Mufindi district. Since capital was found to be the main constraint to VET graduates the study recommends that district councils and vocational training centres should help to link them with micro-financing institutions, which can provide them with credit facilities. If possible revolving loan funds should be established for the graduates and link with savings components. This will enable them acquire working capital easily and hence expand their enterprises.
Determinants of infant mortality in Kisarawe district,Tanzania
(Sokoine University of Agriculture, 2014) MBITTO,WILBERT DACHI
This study was conducted in Kisarawe District, being one of the Districts in Tanzania facing infant mortality (IM). The overall objective of this study was to investigate factors that determine infant mortality in the study area. The specific objectives were to describe neonatal mortality and postnatal mortality; to identify socio-economic factors which influence infant mortality; and to explore the demographic factors which influence infant mortality. A cross-sectional research design was applied in this study. A representative sample of 102 respondents was drawn from the sampling frame. Data from the questionnaires were analyzed statistically using statistical packages for social science (SPSS) and statistical test were done using the chi-squire to test the significant difference between the strata. The study revealed that (30.4%) of the respondents experienced IM, there were 33 incidences and (60.6%) of all incidences occurred at moment of delivery. Breastfeeding and place of delivery (p<0.05) were identified to be the main determinant of infant mortality. Weaknesses were as follows,(75.5%) were primary leavers; (10.8%) earned only 30000 Tsh a month; (68.6%) were not satisfied with medical services provided;(65.6%) gave birth below the age of 20; Traditional midwives are still in demand for (10.8%), all these are circumstances for IM. Yellow fever has been contributing (40.2%) of all death incidences. The study recommends that, the government should improve medical services; NGOs to invest in education and income generating activities; Mothers to seek medical help and attend clinic. Further research should be encouraged in the study area notably on yellow fever and neo-natal mortality which are generally high.
Socio- economic determinants of contraceptive use among women in Geita district
(Sokoine University of Agriculture, 2009) BYAGALAMA,JENITHA DAMASSEN
This study identified socio-economic factors influencing contraceptives use among women in Geita district; Specifically it determined the level of awareness about contraceptives, identified the types of contraceptives used, source of information about contraceptives as well as social economic factors which influence women use of contraceptives. A cross sectional study design was employed where by a multistage sampling technique was used in combination with simple and purposive sampling methods to obtain a representative sample. A total of 100 respondents were sampled. Questionnaires and a checklist was used to gather information from individuals, Focus Group Discussion (FGD) and Key informants. Statistical package for social science (SPSS) was employed for data entry and analysis. The study revealed that there was high awareness of contraceptives rampant, unavailability of contraceptives, inadequate knowledge of various contraceptives and limited access and use of contraceptives. This situation was mainly caused by a number of factors which include physical features, poor infrastructure, remoteness, inconsistent availability of contraceptives, ignorance and traditional practices. Furthermore, the study found that rural communities access contraceptives information through radio and MCH staff. The study findings further showed also that the use of contraceptives was influenced by socio-economic characteristics such as age, marital status, sex preference and household size. The recommendation made include the establishment of more health centers and hospitals in rural areas, training should be provided to contraceptives providers, raising awareness on different types of contraceptives methods, ensuring constant availability of all contraceptive methods, the provision of contraceptives education in schools for both sexes and provision of all necessary materials like flyers, brochures, posters and magazines which are needed foriii effective provision of information in different areas. There is a need for more development specialist in relevant Ministry, NGO’s, and development planners to establish more programmes on contraceptives issues.
Home based care and management of people living with HIV/ AIDS in Rufiji district
(Sokoine University of Agriculture, 2008) DISMAS,JOHN
HIV/AIDS has brought in new challenges of care and support to those who fall sick and the surviving family members. As the HIV/AIDS epidemic worsens, community home based care services are critical in the continuum of care to mitigate the burden of the disease on health facilities and families. The Government of Tanzania has developed different programmes, strategies and models for HBC to PLWHA. However, there is inadequate knowledge about the effectiveness of HBC and management of PLWHA. The current study examines the determinants of effectiveness of HBC and management of PLWHA in Rufiji District. The study specifically determines the characteristics of PLWHA under HBC system, best or bad practices for PLWHA, the types of home based care offered and key stakeholders involved in the caring for PLWHA. Cross-sectional survey using quantitative data collected from a sample of 104 PLWHA and 3 focus group discussion and in-depth interviews were used for the study. The analysis has been done using the Statistical Package for Social Sciences (SPSS). The findings show that of all the households of PLWHA that were interviewed, majority were male headed household (MHHs), than female headed household (FHHs). The study has shown that the type of HBC offered is the one which emphasizes on psychosocial support to PLWHA and their families delivering their services primarily through volunteer networks in the community together with program staff, who are not necessarily health professionals. PLWHA do not have information on where to get legal aid an aspects such as inheritance, writing of wills and human rights or PLWHA support groups. The study recommends the introduction and or strengthening of programmes that promote legal aid awareness along side other services provided to PLWHA. Finally HBC programmes cannot be successful unless they are accorded active support and participation from government, NGO’s and communities.
Cultural drivers of zoonotic diseases and impact of the diseases on poverty in Ngorongoro district, Tanzania
(Sokoine University of Agriculture, 2013) ONESMO,NEEMA PRISCA
There have been a lot of cultural practices which are risky for transmission of zoonotic diseases which are practised by pastoral societies despite efforts to combat such practices. The general objective of this study was to determine cultural drivers of zoonotic diseases and their impact on poverty, whereas the specific objectives were to: (a) assess cultural practices which are risky for transmission of zoonotic diseases, (b) identify the commonest animal and human infectious diseases and (c) determine the impact of zoonotic diseases on poverty. Purposive and random sampling methods were used to obtain a representative sample of 120 households. A questionnaire was used to obtain information in February 2013 from individuals representing the selected households in Orgosorok, Enduleni and Sale Wards of Ngorongoro District. SPSS was employed for data entry and analysis. The findings showed that risky cultural practices which are practised by the Masai community are drinking un-boiled milk, sleeping in the same houses with calves, eating raw or insufficiently cooked meat, drinking raw animal blood, and not cleaning the kraal for animals. The respondents were of the view that livestock infectious diseases such as anthrax, hydatid cyst, brucellosis and tuberculosis were among the leading diseases in the Masai community; they were mentioned by 21%, 18% 16% and 2% respectively of the respondents. Based on multiple linear regression analysis in which the dependent variable was poverty in terms household income and monetary value of assets owned, it was found that zoonotic diseases had negative impact on poverty (P = -0.074), albeit the impact was not significant (p = 0.425). On the basis of these findings, it is concluded that the occurrence of livestock infectious diseases is influenced by cultural practices and that the diseases in turn affect poverty negatively. In view of the conclusion, it is recommended that more education should be given on how to do away with cultural practices which are risky for transmission of zoonotic diseases, and knowledge should be imparted on how to prevent the occurrence of the diseases in order to alleviate poverty among pastoral societies.
Determinants of community health fund membership drop out in Lindi district council of Tanzania
(Sokoine University of Agriculture, 2014) REUBEN,DELFINA
Tanzania, have been implementing Community Health Fund scheme in its government health services since 1996. Lindi District Council is one of the six councils which make Lindi Region. There have been a lot of research and studies on CHF in Tanzania such as determinants for CHF enrolment, reasons for the continuing low enrolment in the district. There is scanty information about the actual factors that determine CHF membership drop out, in the study area. However, the overall objective of the study was to identify the factors determining the CHF membership drop out in Lindi District council. Specifically, the study aimed at determining the perception of CHF members on CHF management, determinants of joining the CHF scheme, duration which CHF members stay under the insurance before they drop out and determinants of CHF membership drop out. Interview and Focus Group Discussions were used to collect data. Statistical Package for Social Science Programme (SPSS) was applied to analyze both qualitative and quantitative data. By using multiple linear Regression analysis, the study revealed the factors that determined CHF membership drop out in the study area. Those factors included socio and economic and demographic characteristics such as ability to pay the premium. Finally the study provides four strong recommendations that could be done to improve CHF membership retention in the study area and other district councils where CHF scheme is implemented.
Knowledge and attitude towards male circumcission and HIV prevention among people of Makete district, Tanzania
(Sokoine University of Agriculture, 2013) SANGA,ABRAHAM P.
The study was conducted to assess knowledge and attitude towards male circumcission and HIV prevention among people of Makete District. Specifically the study assessed the knowlcgde towards HIV/AIDS and male circumcission as well as attitude towards male circumcission for HIV prevention. The study also assessed the effects of social economic characteristics on male circumcission. A cross-sectional survey using structured questionaires was used in collecting quantitative data, while qualitative data was collected using key informants chekilist as well as the focus group discussion guide. A total of 420 respondents were inlevicwed. It was observed that the majority (99.3%) of respondents have heard an illness called AIDS. On the other hand 60% male respondents reported to be uncircumcised while 40% reported to be circumcised. The study also determined the prevalence rate of HIV infection in Makete District by 2011 to be 11% (MDC, 2012). It was also observed that majority (51%) of respondents had high knowledge on HIV/AID transmission and prevention. On other hand a significant proportional (31.9%) of respondents had low knowledge towards male circumcission. Furthermore about (59.7%) of respondents had a negative attitude towards male circumcission while (32.7%) had a positive attitude. Positive attitude of men and women were found to be an important aspect towards male circumcission. The study findings also observed that cultural factors hinder male circumcission since 67.9% of uncircumcised male reported that they were not circumcised because they feel they should not get circumcised because this practice is not part of their culture. The study results could contribute to devising and implementing the planning of male circumcission and HIV prevention strategies that focus on the identified gaps in Makete Distrct and elsewhere in and out of Tanzania.
Civil society organisations and HIV/AIDS: A case of Iringa district, Tanzania.
(Sokoine University of Agriculture, 2008) SAMSON,SUZANA
This study was designed to determine the role of Civil Society Organisations (CSOs) in combating HIV/AIDS in Iringa District. Non Governmental Organisations (NGOs), Faith Based Organisations (FBOs) and Community Based Organisations (CBOs) were selected for the study. Specifically, the study aimed at identifying the HIV/AIDS thematic areas in which the CSOs were engaged; the institutional management structure of CSOs; the CSO’s achievements; the challenges faced by CSOs and at determining people’s attitude towards CSOs addressing HIV/AIDS. A cross sectional survey was employed where by both structured and non-structured interviews were used to collect data. Purposive sampling method was used to obtain CSOs that implemented HIV/AIDS interventions whereas stratified sampling method was used to get 18 NGOs, 6 FBOs and 6 CBOs to constitute the sample of 30 CSOs that were interviewed. The collected data were analysed using SPSS computer software where descriptive statistics and cross tabulation were used in presenting the study results. HIV/AIDS interventions implemented by CSOs were in four thematic areas namely awareness raising, impact mitigation, capacity building and HIV voluntary counselling and testing. HIV/AIDS impact mitigation was the intervention implemented by most of the sampled CSOs (41.8% of responses). However CBOs unlike FBOs and NGOs engaged mostly in HIV prevention through awareness raising. Despite of limited monitoring of CSOs’ activities by the government, community members have positive attitude towards CSOs addressing HIV/AIDS issues with the views that the government could not manage to implement all aspects of HIV/AIDS. CSOs’ interventions were affected by limited funding whereby 41.5% of sampled CSOs’ responses indicated that they relied on external funding. It is recommended that the government (both central and local government authorities) has to formulate an integrated programme of implementation together with a monitoring and evaluation system ofiii HIV/AIDS interventions for effective multisectoral approach towards combating the epidemic.
Gender perspective in effective utilization of water from Rufiji river for small scale irrigation
(Sokoine University of Agriculture, 2007) KONDOWE,GERALD JAMES
The study focused on factors constraining women from effective utilization of water from Rufiji River for improving small-scale irrigation farming. Specifically the study aimed at: (a) determining the types of irrigated crops (b) examining the women’s affordability of irrigation infrastructure, (c) assessing women’s knowledge and perception on irrigation farming, (d) identifying constraints to women’s effective utilization of water for small scale farming. The study was undertaken in Rufiji District in three wards; primary data were collected from 120 women and men farmers, using a structured questionnaire. Secondary data were also collected. Analyses were performed using SPSS and Limped computer software. Hypothesis testing was undertaken at 5 percent level of significance using Chi-square. The study found that major types of irrigated crops in Rufiji District were tomato, paddy, and green vegetables. 89.7% of women cannot afford to purchase irrigation infrastructures. Also 61.64% of women farmers had weak attitude and behavior towards irrigation. The following constrained women from utilizing water from the river for small-scale irrigation: Low income, limited availability of resources, lack of irrigation training and heavy household chores. Results indicated significant relationship between the sizes of land irrigated and the attitudes of women on irrigation. Household income has a significant effect on irrigation farming. The Logistic regression model showed that, the following factors had positive influence on women’s adoption of irrigation technology: size of land suitable for irrigation, primary occupation, irrigation training, income, education and farm’s location. The study recommends the following: provision of irrigation’s start up capital, improving women access to resources and increase in irrigation training.
Impact of climate variability and change adaptation strategies on technical efficiency of sorghum production in Manyoni District, Tanzania
(Tanzania Journal of Agricultural Sciences, 2023) Mbwambo, E. P.; Kabote, S. J.; Kazuzuru, B.
Climate variability and change adaptation strategies are increasingly becoming fundamental for improving efficiency in agricultural production in Tanzania and elsewhere in developing countries. However, empirical evidence on how adaptation strategies improve agricultural technical efficiency on drought resistant varieties like sorghum is inadequate in Tanzania. This study was conducted to address this knowledge lacuna in the literature. With cross-sectional research design, we used a household survey to collect data from 330 randomly selected household heads. A Cobb- Douglas stochastic frontier model was used to determine the impact of adaptation strategies on technical efficiency of sorghum production. Farmers adapted a number of strategies including drought tolerant crops, conservation agriculture, drainage system, early maturing crops, use of hired labour, resistant livestock breeds, membership in farmer organizations, access to extension services, and access to credit to cushion climate variability and change impact. Six strategies including use of drought tolerant crops, drainage systems, conservation agriculture, membership in farmer organizations, access to extension services and access to credit showed significant impact on technical efficiency of sorghum production at 5% level of significance. Such strategies were effective in improving technical efficiency of sorghum production. However, about half of the respondents were less efficient. Therefore, farmers’ adaptation strategies were indisputably essential in semi-arid environments like Manyoni district. Nevertheless, a policy to heighten use of the effective farmers’ adaptation strategies to cushion climate variability and change impact should be devised and effectively executed to strengthen farmers’ efficiency.
Public-private partnership supported health facilities and progress towards attainment of universal health coverage in Kilimanjaro,Tanzania
(Rwanda Journal of Medicine and Health Sciences, 2022) Kanti,Kimario; Kim,Kayunze; Mikidadi,Muhanga
Public-Private-Partnership-supported health facilities have been operational in Tanzania, and specifically, in Kilimanjaro since 1990s. This study provides a snapshot of the contribution of PPP-supported health facilities’ operations towards attainment of Universal Health Coverage (UHC) in Kilimanjaro region. Methods Adopting a cross-sectional research design, samples of 384 households and 30 health facilities were selected through a multi-stage and purposive sampling approaches, respectively. Questionnaires and key informant interviews (KIIs) were administered (June 2020 - February 2021). Using IBM-SPSS v.23, chi-square was used to compare PPP-supported and government health facilities’ service delivery quality and affordability. Content analysis was done on KIIs. Results With PPP-support unweighted mean index score for service availability (SA) was 46.59% and 29.14% without PPP-supported health facilities. With PPP-support, the GSR index score was 87% while it was 82% without PPP-support. This implies, with PPP-support, progress towards UHC attainment can be accelerated. There was no significant association between accessing services in PPP-supported or government health facilities by perceived service delivery quality and service affordability. Conclusion PPP-supported and government health facilities co-existence is essential at hastening the progress towards UHC in the study area. The government should strengthen policies and regulations to promote more PPPs in improving health facilities’ operations.
Trends in prevalence and factors associated with unintended pregnancies in Zambia (2001–2018)
(BMC, 2024) Sikaluzwe, Milika; Phiri, Million; Lemba, Musonda; Shasha, Liness; Muhanga, Mikidadi
Background Unintended pregnancies can pose significant public health concerns for both maternal and child health because of their associated risks and implications. Experience of unintended pregnancies may lead to delay in seeking antenatal care, thus leading to increased risk of complications during pregnancy and childbirth. Globally, the prevalence of unintended pregnancies has declined. However, the problem remains acute in sub-Saharan Africa. This study was conducted to examine the factors associated with an experience of unintended pregnancy among women of reproductive ages in Zambia. Methods This study used secondary data from the Zambia Demographic and Health Surveys (ZDHSs) which were conducted between 2001 and 2018. A pooled weighted sample of 4,090 pregnant women of reproductive age 15–49 years at the time of the survey was included in the analysis. Multivariable binary logistic regression model was employed to examine the association between independent correlates and experience of unintended pregnancy. All statistical analyses were conducted using Stata software. Results Findings show that the proportion of women of reproductive age who experienced unintended pregnancy in Zambia declined from 50.4% (95% CI: 47.1, 53.8) in 2001 to 45.2% (95% CI: 40.5, 49.9) in 2018. The decline in the prevalence of unintended pregnancy is more pronounced among women age groups 25–29 years and 30–34 years. Increasing age was associated with an increased risk of experiencing unintended pregnancies. On the other hand, women who were living in rural areas (aOR = 0.76; 95% CI: 0.58, 1.00) and those with tertiary education (aOR = 0.46; 95% CI: 0.26, 0.80) were less likely to experience an unintended pregnancy. Women who desired a large family (aOR = 0.45; 95% CI: 0.24, 0.85) and those who watched television (aOR = 0.75; 95% CI: 0.59, 0.94) had lower odds of experiencing unintended pregnancies. Conclusions The study has established that the prevalence of unintended pregnancy is still high in Zambia. Women’s age, place of residence, level of education, desired family size and exposure to media were associated with the risk of experiencing an unintended pregnancy. Enhancing access to family planning services and commodities targeting women with low education levels will be key to further reduce unintended pregnancies.
Public-private partnership supported health facilities and progress towards attainment of universal health coverage in Kilimanjaro, Tanzania
(Rwanda Journal of Medicine and Health Sciences, 2022) Kanti,Kimario; Kim,Kayunze; Mikidadi,Muhanga
Background Public-Private-Partnership-supported health facilities have been operational in Tanzania, and specifically, in Kilimanjaro since 1990s. This study provides a snapshot of the contribution of PPP-supported health facilities’ operations towards attainment of Universal Health Coverage (UHC) in Kilimanjaro region. Methods Adopting a cross-sectional research design, samples of 384 households and 30 health facilities were selected through a multi-stage and purposive sampling approaches, respectively. Questionnaires and key informant interviews (KIIs) were administered (June 2020 - February 2021). Using IBM-SPSS v.23, chi-square was used to compare PPP-supported and government health facilities’ service delivery quality and affordability. Content analysis was done on KIIs. Results With PPP-support unweighted mean index score for service availability (SA) was 46.59% and 29.14% without PPP-supported health facilities. With PPP-support, the GSR index score was 87% while it was 82% without PPP-support. This implies, with PPP-support, progress towards UHC attainment can be accelerated. There was no significant association between accessing services in PPP-supported or government health facilities by perceived service delivery quality and service affordability. Conclusion PPP-supported and government health facilities co-existence is essential at hastening the progress towards UHC in the study area. The government should strengthen policies and regulations to promote more PPPs in improving health facilities’ operations.
Tobacco farming and its implications on poverty status: farmers’ perspectives in Urambo district Tanzania
(Sokoine University of Agriculture, 2011) Mkufya Peter Stewart
In its efforts to alleviate poverty among tobacco growers, the government of Tanzania adopted sub-sectoral reform aiming at improving tobacco gross margin. One of the basic strategies was the empowerment of co-operatives to source out finance through banks. It was in view of these initiatives that this study was undertaken in December 2009 and February 2010, to find out why poverty persists among tobacco growers despite the high income ensuing from tobacco production. The specific objectives of the study were to: estimate profitability of tobacco production; determine poverty status; determine expenditure of income from tobacco: assess perception of tobacco growers on tobacco farming and finally assess socio-economic factors affecting tobacco growers. The study findings show that, the respondents produce average of 1192 kg/ha which is below the potential production of 1900 kg/ha. The gross margin analysis reveals that, respondents’ gross margin is 70% of total revenue per ha. Considering government minimum salary scale of Tshs 104 000 per month as a benchmark, respondents earn twice of the same from tobacco production per month. Regression analysis indicates that yield per ha had beta wait of +0.743(p<000), contributing significantly on increased gross margin than other variables. Further, respondents spend over 50% of their income on food, which accounts for the prevailing reality of poverty. Tobacco low yield, large household size, insufficient food crops production, inefficiency performance of cooperatives, lack of entrepreneurial training and lack of other income generating activities, contribute in accounting for poverty persistence. The study recommends that the Government provides goods which promote utilization of income generated from tobacco such as building materials, schools, health and communication.
Street children problems in Tanzania a case study of Moshi Municipality Kilimanjaro region
(Sokoine University of Agriculture, 2002) Mbatian Ntahilaja Ester
This study aimed at finding strategies for alleviating the street children (SC) problem in Tanzania. The study was carried out in Moshi Municipality, Kilimanjaro Region. This study has been prompted by the fact that there has been persistent problem of children running from their households and living in urban streets. This will have a negative impact on economic development if not taken care of. If this problem is not taken care of, in few years coming; there will be unmanageable number of street children in this country. It should also be noted that children are the future owner of this country. Ignoring this problem would mean impoverishing this country instead of developing it, since human labour is one of the most decisive element of any kind of development. The general objective of this study was to identify the social, cultural and economic factors influencing the increase of street children problem and specifically to: (i) Investigate the role of gender relations in households to street children problem, (ii) Investigate strategics used in alleviating street children problem in Tanzania with particular reference to Moshi Municipality (iii) Examine how street children centres function, (iv) Investigate the reasons why children are more willing to live in streets rather than in street children centres/The result shows that various factors have contributed to the problem of street children which include poverty; inefficiency of street children centres (SCC) established to combat this problem, ineffective National policies; too much dependence on foreign donor support to alleviate this problem etc. Basing on the study results some recommendations/ suggestion shows that the success in eradication of SC problem requires committed community and individuals the elements which are presently lacking. Second the Government should have clear, specific policy on eradication of street children iii problem. And there should be specific uniform policy guiding establishment and operation of centres for street children. This would be possible only alter clearly defining as ‘who is a child’. Parents and the whole community should also be involved in child development. Thus get knowledge on why children arc running from their households and on the danger of letting children in streets.
School-based efforts (sbes) towards promotion of health literacy (hl) and health-related knowledge (hrk) in selected primary schools in Morogoro,Tanzania
(The sub Saharan Journal of Social Sciences and Humanities, 2021) Mshingo,David; Muhanga,Mikidadi
Numerous efforts have been made by the government in Tanzania to improve health literacy (HL). Despite the efforts, there are notable incidents of low and problematic HL among the general population. Socialization agents, schools inclusive, have been observed to have significant influence on health promotion. It is not empirically known to what extent schools as socialization agents have been involved in these initiatives. The schools can initiate school-based efforts (SBEs) to promote HL and health related knowledge to nurture health consciousness hence healthier lives. This study was conducted to identify school-based efforts (SBEs) towards promotion of health literacy (HL) and health-related knowledge (HRK) in selected primary schools. A cross-sectional research design was adopted to collect data from 939 respondents. Data were collected using a questionnaire survey, focus group discussions, and key informant interview. Data was analysed using IBM - SPSS (v20). Findings from teachers, 50.3% (95% CI: 82 to 108) showed that environments and pupils inspections were among the SBEs to promote HL in schools. Whereas, health education provision 25.9% (95% CI: 38 to 61), presence of learning materials in schools 23.8% (95% CI: 34 to 57). Findings from pupils 59.6% (95% CI: 399 to 497) and 24.9% (95% CI: 165 to 211) revealed that time available for health education, and learning materials on health issues were insufficient in schools, while 15.5% (95% CI: 98 to 136) of the respondents were ignorant about the efforts being made to improve HL. About 23.7% (95% CI: 35 to 54) of the respondents confirmed efforts made by health workers on health issues in schools towards HL promotion. Most teachers 76.6% (95% CI: 118 to 176) complained about health workers failures to update teachers on health issues. Generally, this study concludes that there are several efforts which have been made to promote HL in schools. However, these efforts have not yet fully succeeded to bring much positive effects since HRK is still low in schools. It is recommended that, to fully succeed in promoting HL and HRK, governments and other partners should support the schools’ efforts undertaken to support HL in schools.
Choice of desired family size among young women in Zambia: what matters?
(Springer, 2023) Phiri,Million; Shasha,Liness; Musonda,Emmanuel; Muhanga,Mikidadi
In many developing countries, population expansion and high fertility rates have been of concern to individuals, society, and governments. Zambia is one of the countries in sub-Saharan Africa, which has been experiencing high fertility for more than four decades since it attained independence. Understanding of factors associ- ated with desired family size, especially amongst young women, is important be- cause their future reproductive behaviour has the potential to influence the country’s course of fertility. Therefore, this study was conducted to examine the determinants of family size choice among young women in Zambia. The study analysed data extracted from repeated cross-sectional surveys conducted in 2007, 2013 and 2018. The analysis was done on a pooled weighted sample of 15,528 young women aged 15–24 years. Multivariate logistic regression was used to examine factors associat- ed with the desired family size of young women. All analyses were conducted using Stata software version 17 and considered complex survey design. The prevalence of young women who had the desire of at least 4 children has been considerably high in Zambia, at 63.2%. Young women in the age group 20–24 were found to have higher odds (AOR = 1.31; 95% CI: 1.03, 1.66) of desiring at least 4 children compared to those aged 15–19. Women living in the rural areas were (AOR = 1.41; 95% CI: 1.10, 1.79) more likely to desire at least 4 children compared to their counterparts living in urban areas. Age of a young woman, place of residence, level of education, household wealth status, number of living children, and exposure to mass-media family planning messages were significantly associated with desire of at least 4 children. The desire for a large family size remains a social concern for reducing fertility in Zambia. This is because the proportion of young women who desire a large family size has been consistently high. Increasing access to education and sexual reproductive health information to young women especially to those in rural areas is key to changing their reproductive behaviour.
The quest for accountability of health facility governing committees implementing direct health facility financing in Tanzania: a supply-side experience
(PLOS, 2022) Kesale,Anosisye Mwandulusya; Mahonge,Christopher; Muhanga,Mikidadi
User committees, such as Health Facility Governing Committees, are popular platforms for representing communities and civil society in holding service providers accountable. Fiscal decentralization via various arrangements such as Direct Health Facility Financing is thought to strengthen Health Facility Governing Committees in improving accountability in carrying out the devolved tasks and mandates. The purpose of this study was to analyze the status of accountability of Health Facility Governing Committees in Tanzania under the Direct Health Facility Financing setting as perceived by the supply side. In 32 different health institutions, a cross-sectional design was used to collect both qualitative and quantitative data at one point in time. Data was collected through a closed-ended questionnaire, an in- depth interview, and a Focus Group Discussion. Descriptive statistics, multiple logistic regression, and theme analysis were used to analyze the data. According to the findings, Health Facility Governing Committees’ accountability is 78%. Committees have a high level of accountability in terms of encouraging the community to join community health funds (91.71%), receiving medicines and medical commodities (88.57%), and providing timely health services (84.29%). The health facility governance committee’s responsibility was shown to be substantially connected with the health planning component (p = 0.0048) and the financial management aspect (p = 0.0045). This study found that the fiscal decentraliza- tion setting permits Committees to be accountable for carrying out their obligations, resulting in improved health service delivery in developing nations.
The functionality variation among health facility governing committees under direct health facility financing in Tanzania
(PLOS, 2022) Kesale,Anosisye Mwandulusya; Mahonge,Christopher; Muhanga,Mikidadi
Decentralization reforms through Direct Health Facilities Financing (DHFF) have empow- ered Health Facility Governing Committees (HFGCs) to participate in different governance aspects to improve service delivery at the facility level. However, there is little research on how empowered HFGCs perform in the context of the DHFF. The purpose of this study was to evaluate the functionality of HFGCs under DHFF in Tanzanian primary health care facili- ties that had variation of performance in 2018. To collect both qualitative and quantitative data, the study used a cross-section design. The study had a sample size of 280 respon- dents, who were chosen using a multistage cluster sampling technique from 32 primary health care facilities that were practicing DHFF. Data was collected via a closed-ended structured questionnaire, in-depth interviews with chairpersons of HFGCs, and Focus Group Discussions. To examine the functionality of HFGCs, researchers used descriptive and theme analysis. In the 2018-star rating assessment, the study discovered that HFGCs functioned well in both high and low-performing health facilities. When HFGCs from high- performing health facilities were compared to HFGCs from low-performing health facilities, it was discovered that HFGCs from the high-performing health facilities had comparatively high functionality. The functionality of HFGCs in Tanzania has thus been impacted by the DHFF context.
Promoting up scaling of water system innovations: the case of Makanya watershed, Same, Kilimanjaro, Tanzania
(Sokoine University of Agriculture, 2007) Byakugila, Medardi Mukulasi
Many innovations have shown to be effective in pilot studies, but the adoption of most of these technologies on a wider scale has always been a concern. In the uplands of the Makanya river watershed, terraces have higher extent of diffusion than in midland. The reasons behind the high extent of adoption of terraces in the uplands were not clearly known. However, these suggested that there could be special strategies behind the diffusion of terraces, which when explored would help to develop strategies for wider adoption and diffusion of water system innovations (WSIs) in the area. A questionnaire survey was used in conjunction with qualitative approaches such as focus group discussions, key informant interviews, and semi structured interviews. Descriptive statistics were the main tool used for data analysis. The findings made on the adoption and diffusion of terraces technologies revealed that time factor, sufficient communities’ awareness on terraces, and intervention by NGOs and development projects were major factors for wider diffusion of terraces technology. Terraces were introduced in the area by the colonial government in 1930s, and in 1980s, NGOs with intervention in soil and water conservation started working in the area. Time factor provided enough opportunity to build sufficient communities’ awareness on terraces. Interventions by NGOs and development projects in the 1980s, underlined the reason for increased uptake of terrace innovations from 1980s though the technology was long before introduced in the study area. The understanding of the diffusion of terraces technology enabled the study to develop a framework that could promote up scaling of water systems innovations (WSIs) at watershed level. The framework could not be tested due to limitation by resources. However it is recommended that it should be tested and improved for successful scaling upiii of WSIs at watershed level. This will bring improved livelihood of people in the watershed. Key elements of the framework are: validation of innovation to be scaled up, introduction to authorities, identification of potential local change agents, establishment of local change agents, employment of appropriate diffusion pathways, and evaluation of the scaling up processes.

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