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Access to free health care services among elderly people in public hospitals: the case of Mwananyamala hospital in Dar es salaam, Tanzania.
(Hubert Kairuki Memorial University, 2017) Kawawa, Jacquiline G.
The study sought to assess the access to free health care services among elderly people in public hospitals. The objectives of the study included; i) To examine the ability of elderly people living in Dar es salaam on access to free health care services in public hospitals, ii) To examine challenges limiting elderly people from accessing free health care services in public hospitals iii) To assess measures taken to make free health care services accessible to elderly people living in Dar es Salaam seeking free health care services in public hospitals. The study employed qualitative study design of 20 participant’s .Purposive and Snowball sampling was adopted to select elderly people attending at Mwananyamala hospital. The study revealed that elderly people have no full ability to access free health care services in public hospitals. Moreover, study findings indicated that most of elderly people paid for medical charges in public hospitals when they become sick due to lack of information of their entitled free health care services and poor health facilities in public hospital. Again, the research showed that, there are different challenges facing elderly people in accessing free health care which are; Lack of trained health personnel to deal with elderly people, long waiting, Shortage of medication for elderly people, Distance and transport cost, elderly discrimination, Inability to pay for medical cost when asked to pay for some health charges. Hence, the study suggested measures to be taken in order improve elderly people health situation, which includes reviewing elderly peoples’ policy and good implementation of health policies, introduction of comprehensive health insurance and economic opportunities such as elderly pension.
Accessibility and affordability of health care services among diabetes mellitus patients in Ilala Municipality, Dar es Salaam
(Hubert Kairuki Memorial University, 2015) Machombo, Donard M.
Abstract: Background: In recent years, diabetes has been among the four priority non- communicable diseases. About 46 per cent of people in Dar es Salaam with diabetes have financial difficulties in managing this disease. Objectives: the aim was to analyze the accessibility and affordability of health care services among diabetes mellitus patients in Ilala municipality, Dar es Salaam. Methods: The study employed descriptive cross-sectional design whereby dependent variables involved accessibility and affordability of health care and independent variables included availability of drugs, availability of health care providers, payment methods and costs. The SPSS program version 16.0 was used for statistical analysis of variables. Results: The results of this study indicated that demographic factors have influence on diabetic patients such that it varies with age, education, sex, marital status and employment. This study showed that treatment using out of pocket were 27 (9%). This consumed high health-care costs leaving behind patients 148 (50%) who are too poor to pay but are suffering from diabetes. Those using insurance are 57 (19%) National Health Insurance Fund (NHIF) and 64 (22%) National Social Security Fund (NSSF). Furthermore, the diabetic health care services are limited despite the free treatment policy, concequently there is low affordability to diabetic patients given the high cost of drugs in the private pharmacies. Conclusion/Recommendation: The study concludes that there are challenges related to diabetic health care services including limited availability of drugs and inadequacy of healthcare providers. The study recommends for enrollment of all diabetic patients in the health insurance schemes
Accessibility of information on cervical cancer among women of higher learning institutions in Dar-es-Salaam Tanzania
(Hubert Kairuki Memorial University, 2015) Dahoma, Madina
Abstract: Background: Cervical cancer, the most common cancer among women in Tanzania is strongly linked to Human Papilloma Virus. Precancerous lesions detected by Papanicolaus smear screening. It is one of the preventable cancers and thus making access to health information regarding cervical cancer available and easily accessible to higher learning institutions and communities will be a foundation in the fight against cervical cancer. Objective: To assess accessibility and use of cervical cancer information by women in higher learning institutions in Ilala and Kinondoni districts Dar es Salaam. Method: This was a descriptive cross-sectional study that was carried out by using 300 questionnaires among medical and non-medical respondents from Kairuki University, Institute of financial Management and College of Business Education. Data collected included demographic data, health information, knowledge and awareness of cervical cancer. Descriptive statistics and chi-square analysis were performed in significance level was set up p <=0.001. Mean age was 23.16 years. Result: Majority of respondents got their source of information from media, TV and radio. Screening information on cervical cancer was accessed by 85% of medical and 61 % of nonmedical respondents. On answering the questions of whether they would use the cervical cancer information, nearly all respondents answered that they would use the information and requested for cervical cancer materials to be supplied to their institutions. Almost all respondents admitted that they and heard about cervical cancer and about 73 % of medical respondents and 38 percent of non-medical respondents respectively pointed out that cervical cancer is the most common cancer in women in Tanzania. However, 57 % medical and 13.1% of non-medical respondents knew about HPV vaccine and its practice value. Knowledge of cervical cancer demonstrated respectively by medical and non-medical respondents were 50% and 15.5% on causes, 71% and 17.1% on symptoms, 83 % and 44% on risk factors such as multi-sexual partners and 79% and 32% on early age activity. About 63 percent of medical and 41% percent of non-medical respondents indicated that the diseases could be treated and preventive measures through public vi health education were advocated by 88 % of medical and 63.3% respectively and 73 % and 15% by screening women for early signs of cervical cancer. Conclusion: Medical respondents showed the highest level in all areas and a high level of awareness of the disease compared to non-medical respondents. It is important that awareness campaigns, mobilization campaigns and National cancer programme should be carried out by ORHI, WAMATA and others to private sectors and general public, creation of cervical cancer prevention polices and strategies at all levels of the communities.
Accessibility of public buildings and services among people with disabilities, the contribution of national policy on disability in: the case study of Ilala municipality
(Hubert Kairuki Memorial University, 2020) Makero, Opportuna
Background: The dissertation report is about assessing the contribution of the National Policy on Disability towards access of public buildings and services among people with disability in Ilala municipal of Dar es Salaam. This is a common problem because many public buildings are not friendly to people with disabilities and the communities have negative attitude towards people with disabilities. Also the building planners do not consider people with disabilities during planning. Study objective: To assess the contribution of the National Policy on Disability towards access of public buildings and services among people with disability in Ilala municipal of Dar es salaam. Methodology: A descriptive cross sectional survey was conducted involving 90 people from selected sample in Dar es Salaam region, among them being people with disabilities, non disabled architects, civil engineers, and Ward leaders. Results: Not all respondent in the study were aware of the word disability, and only 53.3% of the respondents knew what exactly the meaning of disability. Majority of the respondents had poor knowledge on the National policy on Disability and the Persons with Disability act. Only 32.2% had heard the policy and the Act, and persons with disabilities only 28.3% of the respondents had heard the policy and the act of people with disabilities. The study revealed that only 70% agreed that the buildings are not accessible. The community also has a negative attitude towards people with disabilities and the study shows that among the non disabled who were interviewed about 63.3% said they are comfortable working the same office with PWD’s. Conclusion and Recommendations: The government in collaboration with other stakeholders like social workers should make sure that polices and laws that introduced are strengthen and strongly implemented so as to help people with disabilities in the community to achieve their goals and to become one family in the society by receiving the same services in the society.
Accuracy of obstetric ultrasound versus Johnson and Dare’s clinical methods to estimate fetal weight in fullterm pregnancy in regional referral hospitals, Dar es Salaam, from march to May 2024
(Kairuki University, 2024) Kumbakumba, Fadhil S.
Introduction: Fetal weight is among the determinants of birth outcomes for both the mother and the neonate. Various techniques have been used to estimate births with inconclusive results. This study has been done to compare the accuracy in estimating birth weight using the clinical methods and ultrasonography. Methods: This was a cross sectional, study that consisted of using interviews, consultation of medical record and assessment of 100 pregnant mother and neonatal in antenatal and postpartum period. Descriptive statistics, t paired sample test, were used for data analysis. Results: ultrasonography was the best technic observed to estimate birth weight with no significant difference (t=1.4, p value >0.05) with actual birth weight. The study found a low accuracy in estimating birth weight when using the Dares formula which have shown significant difference with actual birth weight (t=12.7, p value <0.05). However, there was no significant difference (t=2.1,p value >0.05) between estimating birth weight using the Johnson formula and actual birth weight with high accuracy. On the other side, there was a significant difference (t=12.5, p value < 0.05) in birth weight when estimating birth weight using ultrasonography and the clinical technique based on Dares formula. In contrast, there was no discernible difference (t=2.2;p value > 0.05) when the Johnson formula and ultrasound estimation were used. Conclusion: Ultrasonography and Johnson formula provided the best estimates of the birth weight before delivery compared to the Dares formula. Therefore, in absence of ultrasonography services, the use of the Johnson's clinical methods for estimating the birth weight should be encouraged.
Acute diarrhea in under five children in Dar es salaam: the burden of disease bacterial causes and pattern of antimicrobial resistance
(Hubert Kairuki Memorial University, 2016) Mpongo, Pauline L.
Background: Diarrhea is the second leading cause of morbidity and mortality in Sub-Saharan Africa; Tanzania included and is the leading cause of malnutrition globally. Each year diarrhea kills around 760,000 children less than five years and it is both preventable and treatable. Globally, there are nearly 1.7 billion cases of diarrhea disease every year. The aim of this study was to determine the burden of disease, microbial causes and pattern of antimicrobial resistant in children less than five years of age with acute diarrhea in Dar es Salaam, Tanzania. Method: This was a cross sectional descriptive study in which all children less than five years with acute diarrhea in the outpatient and inpatient of the 3 regional referral hospitals in Dar es Salaam. Stool samples were collected from 202 children and microbial pathogens were identified from stools by use of conventional method while viral rapid tests were used to identify viruses. Wet microscopic preparations for parasites and antimicrobial sensitivity were done using Kirby-Breuer disk diffusion method. Results: Most children with acute diarrhea 169 (83.7%) were below 24 months of age and only 33(16.3%) were above 24 months of age. More males 127 (62.9%) than females 75(37.1%) children were affected by acute diarrhea. Only male children in the age group less than 24 months had severe dehydration (1.8%). Fever was more common among children with bacteria diarrheal. In this study bacteria contributed to (7.5 %). B.coli (46.7%) being the commonest followed by Salmonella and Shigella 20% each. Least was V. cholera (13.3%). Viruses were the commonest causes of diarrhea in this study and were as follows:, Rotavirus, Adenovirus and Norovirus: 42%, 29% and 3.5% respectively. There was no case of Astrovirus isolated in this study. Protozoa and intestinal worms were identified in 5% each, while nonspecific findings were identified in 8% cases. All bacteria isolates of this study were susceptible to ciprofloxacin 91% and to Ceftriaxone 100%. On the other hand, all isolates were resistant to Cotrimoxazole except for Shigella which was moderately resistant (50%).
Adverse pregnancy outcomes among hiv-positive women on art before and during pregnancy delivered at Mwananyamala and amana hospitals.
(Hubert Kairuki Memorial University, 2019) Mzige, Hamza M.
Background: Adverse pregnancy outcome among HIV positive women who delivery are those observation in the studies which have shown that HIV infection with associated with varying with rates of stillbirth, perinatal and infants mortality, intra-uterine foetal growth restriction and low birth weight and chorioamnionitis. HIV in pregnancy is a problem that needs special consideration as far as foetal and maternal wellbeing was concerned. Is a major medical problem encountered especially in developing countries including Tanzania and is associated with high morbidities and mortality. It is associated with detrimental foetal outcome especially when the patient has advanced stage of the diseases. Objective: To determine adverse pregnancy outcomes among HIV-positive women delivered at Mwananyamala and Amana Hospitals in Dar es Salaam. Methodology: A Descriptive cross section study, was used on 384 participants attending at my at Mwananyamala and Amana hospitals in Dar es Salaam from December 2018 to July 2019. Sociodemographic information together with participants’ information was collected through a structured questionnaire. Data analysis was done by using SPSS Version 23. Results: In this study prevalence of adverse pregnancy outcome among HIV pregnancy women on ART was found to be: delivery by caesarean section19.5%, by assisted delivery 1.24%, while 27.02% had preterm delivery. The prevalence of Preterm delivery was higher compared to the study conducted in Tanzania Urban and Rural in 2014 where by the prevalence was 11%. This result was also contrary to the study conducted in Zanzibar prevalence was found to be lower by 3%. Conclusion: This study has found that postnatal women who were started ART during pregnancy were at higher risk of getting newborn with adverse outcome compared to those who started ART before pregnancy.
Assess awareness of patients' rights in health facilities in Kinondoni district
(Hubert Kairuki Memorial University, 2014) Nguruwe, Piensia F.
Low understanding of patient's rights in Tanzania health care facilities exposes patients to maltreatment, especially members of marginalized communities. That is why a researcher in this study aimed at assessing awareness of patient's rights in health facilities. Data were collected through semi structured interview and observation from 70 respondents (admitted patients and nurses) from Mwananyamala Regional hospital and Palestina Hospitals. Data collected were analyzed by using thematic technique method and SPSS 20 version. Findings revealed that about 65 percent of the inpatients were not aware of their rights. The study also revealed unavailability of patients 'rights charter from both health facilities under the study. Based on these finding it was concluded that inpatients from the two hospitals of Mwananyamala and Palestina had low understanding of their rights, which expose them to mistreatment, unsafe care and low quality of care. Furthermore, management procedures and protocols do not address patient's rights and there were no patient's charter. A researcher recommended to the Government to develop a National Patient Right Charter and that patients need to be educated of their rights as an initiative to improve quality of health care in the health facilities in Tanzania.
Assessing provision of care and support by the elderly to their families in Kinondoni district- Dar es Salaam.
(Hubert Kairuki Memorial University, 2015) Bagachwa, Judith N.
The basis of this research study was to assess provision of care and support provided by elderly people to their families. In this study purposive sampling technique was used in selecting area of study and participants were collected through the use of systematic random sampling. Through the use of local government leaders participants were identified and observed. Individual interviews and Focus Group Discussion were conducted so as to collect data needed for the study. Results indicate that elderly people provide psychosocial and economic support to family members. Despite the challenges that elderly people face like financial constrains, lack of social support from family members, burden of caring for their sick adult children and orphaned children, elderly people have contributed significantly in supporting and caring for their family members. Self-empowerment through entrepreneurship is being taken seriously as one of the coping methods in solving their financial problems. In conclusion elderly people provide both psychosocial and economic support when caring for their families. HIV/AIDS has put a substantial impact on the lives of elderly people and many have suffered deeply. There is hardly little support from community and family.
Assessing the quality of pre and post HIV counseling and testing provided in Tanzania a case study of Kinondoni municipal
(Hubert Kairuki Memorial University, 2015) Mramba, Emmanuel J.
The study focused on assessing the quality of provision of pre and post HIV counseling in VCT sites among the selected health facility in Kinondoni municipal. The consideration of this area of the study was coherently driven up by some facts existing in VCTs. The study specific objectives were to identify the VCT provider's level of knowledge on pre and post HIV/AIDS Counseling, to assess the VCT sites level of acceptability and responsiveness to the clients and to evaluate the quality of VCT services in relation to health facility and infrastructure available in Kinondoni Municipal. The study presents various literatures that reflect the area of the study which focused on assessing the quality of VCT services in pre and post HIV counseling sites. Also the study looked on the theoretical and conceptual frame works which together stipulate the validity and explicit of empirical literatures in relation to the current study. Personality theory was seen more appropriate in this study. Methodology was used whereas data collection methods were described and qualitative data collected through interview has been portrayed as well a facility checklist used to observe the physical environment has been condensed. From the analysis it was found that only 30% of the VCT sites have VCT policy along with the National Guideline for VCT. While, 70% of the VCT sites in Kinondoni Municipal have neither policy nor guideline that facilitates VCT services. The findings indicate that 70% of the VCT sites have less than two staffs while 30% of the VCT sites have more than two staffs. The following recommendations if put in place will contribute to the improvement of VCT quality services in Kinondoni municipal; training for all VCT service providers on counseling and testing, national guidelines for voluntary counseling and testing along with policies and lEC should be made available to all VCTs, availability of testing kits and enough supplies.
Assessment of community involvement in disaster management processes case study: Kinondoni Municipality in Dar es salaam
(Hubert Kairuki Memorial University, 2015-11) Dibogo, Raymond L.
The aim of this study was to assess the level of community involvement in disaster management processes in Kinondoni municipality Tanzania. Chapter one in this study comprised of introduction, background information, objectives of the study, research questions, and statement of the problem, significance and limitations of the study. Chapter two comprises of literature review and theoretical framework. Chapter three presents research methodology and design whereas descriptive researches design approach was applied, including the use of Interviews, questionnaires and documentation. Chapter four comprises of presentation and analysis of findings through the use of tables, graphs and pie charts respectively. The findings came up with some useful statistics on assessment of community members in the disaster management processes in their localities. The major findings of the study articulated that, 50% of communitarians lack knowledge necessary in avoiding and preventing disaster occurrences while 25% affected by the government systems which do not favor them in disaster occurrence. Likewise, 15% of community members seemed to have no clear operationalization of government policy on disaster management and the last 10% of community members seemed to have no skills on modem ways for managing the disaster situations. The study concludes that, the existing Community involvement in disaster management is not adequate and the study has proposed continuing education on disaster and policy review to make a sound disaster management plan.
Assessment of factors affecting adherence to antiretrtviral treatment among people attending HIV and AIDS clinics at Kairuki and Mwananyamala regional referral hospitals
(Hubert Kairuki Memorial University, 2018-11-30) Mwalugeni, Abraham, R.
This is a qualitative descriptive hospital-based study assessing factors affecting adherence to antiretroviral treatment amongst people attending HIV and AIDS clinics at two hospitals which are Kairuki and Mwananyamala Regional Referral Hospitals, and also to identify actions that could be implemented to increase patients' adherence levels. Low constraint methods were used to address the relationship between patients and adherence levels. Data collection (February-March 2018) involved using semi-structured questionnaires, in depth interviews, together with focus group discussions. The types of sampling used were purposeful sampling as the information needed for the study was provided directly by the objective group, predominantly the patients and health care workers themselves. Factors identified to affect adherence were stigma, disclosure, alcohol consumption, poor social support, mistaken beliefs, size of pills, time of taking medication, lack of access to adequate food, side-effects, inadequate counseling, stigma, frequency of taking medication, long waiting times and costs related to transport. Despite barriers to ARV adherence, the overall self-reported adherence among recruited persons who qualified to receive ARV drugs in the two areas surveyed were found to be relatively high (above 95%). Factors encouraging adherence include adherence counseling, disclosure to family members, social support, religion, free availability of ARVs, motivated staff and users, information and education.
Assessment of factors influencing low male's involvement in prevention of mother to child transmission (PMTCT) of HIV/AIDS a case study of Muhimbili national hospital in Dar es Salaam
(Hubert Kairuki Memorial University, 2015) Ngwahi, Maria A.
The study aimed at assessing the factors influencing the low involvement of men in prevention of mother to child transmission (PMTCT) of HIV programmes in the Ilala district, Tanzania. The factors studies were grouped as knowledge and awareness, socio cultural, programmatic and demographic characteristics. The study employed a case study design with questionnaires, focus group discussion and documentation review as the main data collection methods. This study used both Qualitative and Quantitative approaches and 127 men were interviewed. The major findings of the study revealed that, about 88 percent of the respondents they had knowledge that HIV positive mother could transmit the virus to her baby through breastfeeding and only 9 percent did not know and 3 percent of the respondent were not sure. Again, about 65 percent of the respondents were aware that, MTCT can occur during pregnancy, 30 percent did not know and 5 percent were not sure. The study also fm a culture have an influence to the involvement of men in the program. The results show that, about 67 percent thought women should get permission from their male before undergoing a test for PMTCT. On the other hands, 70 percent of the respondents did not think that men who accompanied their female partner to PMTCT clinics were bewitched. Programmatic factors found that, about 65 percent of the respondents did not think men should have male only PMTCT clinic and about 70 percent of the total respondents did not think that at the PMTCT clinics men should be attended by male health workers only. Among the demographic characteristics, age and level of education were positively associated with an increase in the level of involvement, while the duration of the relationship with the female partner was negatively associated with the level of men involvement. There is great need to design culturally appropriate and gender sensitive health promotion interventions that can address the reasons why men are afraid of HIV Testing and Counseling (HTC). The study further recommended that, in order to improve men's involvement in PMTCT the knowledge and awareness about PMTCT information should be given to all men and in particular to those in relationship with women in reproductive age. This information could be provided through couple concealing or campaigns to sensitize men to the issue. PMTCT clinics should be made friendlier to men and service provider should ensure that all efforts are made to involve men from the beginning in every PMTCT intervention.
Assessment of factors leading to schizophrenia among youth in Ifakara: a case study of Saint Francis hospital in Ifakara
(Hubert Kairuki Memorial University, 2015) Kanyopa, Anna T.
Schizophrenia is a severe mental illness affecting more than 21 million people worldwide (WHO, Mental Health Action Plan, 2013). The estimated lifetime prevalence is about 1%, with the trend ranging from 0.5% to 1.5% in different parts of the world. It affects all populations. Sr. Theresia Masawe (Registered Nurse) trained in Psychiatry helped me to determine the schizophrenic patients who were attending treatment at the hospital by making assessment and diagnosis due to the scarcity of psychiatric doctors. The study aimed to identify predisposing factors to schizophrenia among the youth in Ifakara. The objectives are: To asses socio economic factors lead to schizophrenia among youths in Ifakara. To asses socio-environment factors lead to schizophrenia among youths in Ifakara. To asses socio-cultural factors lead to schizophrenia among youths in Ifakara. This will be a descriptive cross sectional study which was done at St Francis Hospital in Ifakara District. Participants were aged 15 to 30 years who were thought not to be in very severe illness and willing to participate. They were selected by convenience sampling method according to attendance in the outpatient department. Kiswahili version questionnaire with open and closed ended questions was employed to collect desired information. The researcher collected data after a pilot study and did calibration of questions set forth. A written informed consent was sought before data collection. All in all, data collection was done by the researcher through writing the responses in the spaces after each question. Data was checked, coded and entered in a computer software program (SPSS Version 18) on a daily basis. Data was analyzed and mean, median; proportions and Chi square at 95% confidence interval was calculated. The report was disseminated to Hubert Kairuki Memorial University, St Francis Hospital and to the Ifakara District Executive Director.
Assessment of knowledge, attitude and practice with regard to Tuberculosis among drug users on Methadone treatment: A case of Temeke Regional Hospital
(Hubert Kairuki Memorial University, 2015) Madulu, Paschal C.
Abstract: The purpose of the study was to assess the knowledge, attitude and practice on TB among injecting drug users on Methadone treatment at Temeke Hospital. The objectives were to assess knowledge of Tuberculosis, explore the attitude towards TB and to identify practices related to TB among people who inject drugs. The data was collected by a structured questionnaire, interview and data review. The studies found that great majority (93%) of the respondents were males. Majority of the respondents fall in the age groups 25-34years and 35-44 years. Also, the study findings revealed that 40% of respondents had low knowledge on TB, 35% had misconceptions about TB. Negative attitude towards TB patient was observed among 11% of respondents. Out of 400 registered clients only 20 are on TB treatment. Those who had TB revealed to others that they were suffering from TB. Based on the study findings, we suggest that : Firstly, the TB program to establish proper information, education and communication channels specific to PWID in order to increase their knowledge and clear misconceptions on TB. Secondly, the established TB and Methadone clinic to work closely together with the clients of either clinic access services including counseling sessions regarding both treatment. Thirdly, social workers along with other health and community workers to put more effort to address and tackle stigma and misconceptions associated with TB and HIV
Assessment of partogram filling practices and its associated effect on labour outcome to low-risk pregnant women delivering at Amana hospital, ilala Municipality, Dar es salaam, Tanzania. from 1st April 2012 – 31st December 2012.
(Hubert Kairuki Memerial University, 2012) Bakengesa, Victor K.
Background: The World Health Organization has been advocating the use of Partograph as a necessary tool in the management of labour and recommends its universal use during labour. However, some health-care practitioners, especially in high-income countries, have questioned its effectiveness. Objective: The aim of this study was to assess Partogram filling practices and its associated effect on labor Outcomes to Low risk Pregnant women. Materials and Methods: This Cross sectional comparative study with a prospective follow up of Labor and Delivery till twenty four hours post delivery was conducted from April to December 2012 to women who delivered at Amana Municipal Hospital, Ilala district, Dar-es-salaam. The Partographs from attached Case Notes and Antenatal Cards were retrieved and reviewed for the necessary information including partogram filling components and the labor outcomes (Maternal and Fetal outcomes). A total of 1249 Patients were recruited in the study and only 702 Patients/Partographs were available for analysis. The rest were lost to follow up, some left before twenty four hours and others had misplaced Partographs. Results: A total of 661 (94.2%) Partographs were incompletely filled. In this study it was revealed that all participants with Bad Maternal Outcomes had incomplete Partograph and result was significant at (p<0.05). This was not true for fetal outcomes which showed no statistical significance. Assessment of Contractions once every four hours intervals 423(60.3%) and taking blood pressure at least once every hour 658(93.7%) were the most Partograph components which were not done. Ninety four percent (94%) with Perineal tears and eighty nine (89%) with Postpartum hemorrhage; the contractions component was not assessed as needed for at least once in 4 hours intervals (p<0.0001). The results also showed that out of 702 Participants, 89(12.7%) crossed the Action Line before delivery. The main clinical decision made after crossing the Action Line was Augmentation 60 (64%) and Caesarean Section 21 (23.6/o). Conclusions and Recommendations: The study revealed that Partograph tool was not properly filled and therefore the outcome of that Malpractice was associated with Bad maternal outcomes though didn't show significant association with fetal outcomes in Low risk Pregnant Women. Despite the above findings the health-care practitioners should not be discouraged from the utilization of the Partograph to reduce poor Maternal outcome and Fetal Outcome as well.
Assessment of quality of abortion and post abortal care services among women admitted in gynecological wards at Amana and Mwananyamala municipal hospital, Dar es salaam, Tanzania; from January 2013 - September 2013.
(Hubert Kairuki Memorial University, 2013-09) Kashagama, Ahmada M.
Background: The International Conference for Population Development [ICPD] in 1994 stated post abortion care being the element of safe motherhood initiative to reduce maternal morbidity and mortality. It is of great importance where access to safe abortion is restricted by law and services are inaccessible. Objective The objective of the study was to assess quality of post abortal care and prevalence of abortion among women admitted in gynecological wards at Mwananyamala and Amana municipal hospitals. Methodology The study was hospital based cross sectional study which was conducted within nine months from January 2013 to September 2013. Patient interview, health care provider interview and direct service delivery observation, data from register books were used to compute different aspects of care. Two government health facilities were involved in the study, where 350 post abortion patients were interviewed 21 health care providers were observed and 21 direct health care providers were interviewed. Results A total of 3283 patients were admitted, 1438 of them were abortion cases and only 350 post abortion patients met criteria and were interviewed. Twenty one health care providers were interviewed and were observed while providing services. From this study the prevalence of abortion found to be 43.8%. There was a delay to some patients before getting services because about 67.4% of the patients reported that they had to pay before the procedure. Moreover, drugs and other supplies were to be collected from other sources out of the facilities. Majority of the patients felt that there was no privacy during evacuation procedure, people could get in and out from procedure room, this was stated by 74.3% of respondents. About 65.7% of respondent left the facilities with no family planning information. Among interviewed post abortion women 72.3% were multigravida indicating that there is a need for family planning in order to prevent unplanned pregnancies. Most of the attended post abortion patients left without checking their BP and Hemoglobin level but majority reported to have been given analgesics and few of them were given antibiotics
Assessment of quality of focused antenatal care and its effectiveness among women attending selected clinics in ilala district in Dar-es-salaam Tanzania from March 2012 March 2013
(Hubert Kairuki Memorial University, 2013) Shinyala, A.
Background: The present study was conducted to investigate on the overall quality of provision of antenatal care services and its effect on the reduction of Maternal and Fetal Mortality and Morbidity among women attending selected health facilities at ilala municipality in Dare s salaam. Methods: A cross sectional comparative study was performed in ten months and follow up in the Antentenal Clinics from March 2012 to December 2012. Target population was all women attending antenatal clinics and government health workers providing services to those women. A sample size of 350 women has been attained in this study. Tools used were checklists and questionnaires and data analysis was performed through SPSS version 11.0. Frequencies and percentages were used to describe variables Univariate and multivariate logistics, regression analysis were used determine the odd ratio. T test and chi square tests were used to assess the statistical significance at a confidence level of 95%, where p values less than 0.005 indicated a statistical significance. RESULTS: The study has revealed that only 38% of the recruited mothers attending antenatal clinics had adequate awareness on pregnancy danger signs. A higher level of education was the most predictive factor for increased awareness of danger signs. Other factors associated with awareness include skilled health care providers, employment, attendance to health facilities and counseling of women during antenatal care services. In this study the number of children (parity) significantly associates with the use of ITN (P<0.05. more for those who had one parity. DISCUSSION: Educated women had higher awareness on danger signs than women with no formal education. Better education is associated with enlightenment and awareness of different health conditions although exposure to information is crucial. A study done by Okour in Jordan revealed that education level of study participants and receiving information about danger signs and symptoms were all associated with awareness (P=0.02 for all associations). Studies in Tanzania and elsewhere indicate that a higher level of education is associated with awareness on danger signs whereas other studies have shown no association. CONCLUSION AND RECOMMENDATION: The study concludes that there is still a need to improve quality of Antenatal Care Services in developing countries and that pregnant women are not aware of the pregnancy danger signs. There is suboptimal quality of counseling during antenatal care visits on pregnancy danger signs.
Assessment of risks of contracting HIV/AIDS among couples living separately in Tanzania: the case of Ilala municipality - Dar es Salaam Tanzania
(Hubert Kairuki Memorial University, 2015) Mugula, Beatrice K.
The study examined couples living separately and the risks of contracting HIV. Living apart sometimes can cause one of unfaithful partner to engage him/herself in sexual relationship with another man/woman so as to fulfill his/her sexual desire, and by doing so that couple can contract different sexual transmitted diseases including HIV/AIDS. The study used survey qualitative and quantitative research approaches, total sample size of 150 respondents was selected through purposive and simple random sampling techniques. The respondents included 120 couples living separately, 8 group's Represent actives and 10 religious’ leaders (churches and mosque). The study used questionnaires, in-depth face to face interviews and focus group discussion as data collection methods. Study findings revealed that 41.0 percent reported that job responsibility was the main factor that made the married couples to live separately. Then 62.3 percent reported that the main benefit that married couples got for living separately was an increase in family income. The main challenge reported involved temptations, responded by 36.0 percent. Finally, the study recommended that the government should keep a strong policy, which require married couples to stay together so as to avoid separation which can bring negative impact in the family. Religious leaders needs to insist on word of God to their believers which remind them to remain faithful to their marriage all the time even during the time of separation due to various reasons, because the word of God avoid sexual relationship before marriage and also it doesn't allow extra marital sexual relationship. Therefore, for those couples who due to unavoidable circumstances cannot live together all the time, they need to pay frequency visits to their partners, so that they can fulfill they are sexual desire to prevent them from acquiring HIV infection from other partners outside marriage.
Assessment of social support for Elderly People Living with HIV and AIDS at WAMATA and Kairuki Hospital - Dar es Salaam, Tanzania
(Hubert Kairuki Memorial University, 2019) Rweyemamu, Charles J.
Among people living with HIV, 15% are elderly, aged 50 years and above. Elderly people who are living with HIV are likely to have special needs which are not adequately addressed. These include the need for emotional support, practical support and informational support and they are vital in facilitating preventive and treatment strategies. Due to the availability of ARV drugs, more PLHIV are now living longer than before. This study set out to explore the social support offered to the elderly PLHIV in Dar es Salaam with the aim of defining their needs in this regard with the aim of providing them with better quality of life. The study design was qualitative case study method of 60 years and above PLHIV attending services at WAMATA and KH. Information was also obtained from 7 service providers in a focus group discussion. Clients were interviewed individually by using interview guide of semi-structured questions. Secondary data was obtained from the same institutions. The results show that for the elderly PLHIV to adhere to ART they need sustainable nutrition and that PLHIV with social support live healthier and longer lives although stigma limits disclosure. In conclusion, practitioners and policy makers need to facilitate social support at family and community levels. Limitations include the qualitative approach with a small sample size and the likely possibility of participant saying what they think the researcher wants to hear in self-report. Future research may be encouraged to include more elderly PLHIV in a quantitative research.