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Environmental factors associated with diarrhoea among under-five children attending at Muhimbili National Hospital, Tanzania
(Tanzania J Clin Nur Rep, 2024-06-30) Mathias, Victor A.
Generally, diarrhoea is still a second major reason of death and illness in children below the age of five years. It holds breathes of around half a million under five children every year and causes million more to be admitted. Every year diarrhoea kills around 525000 children under five years. Globally there are nearly 1.7 billion cases of child- hood diarrhoea disease every year. Unfortunately, environmental factors associated with diarrhoea among under five children in Tanzania have not yet well addressed. Therefore, this study aimed to determine environmental factors associated with diarrhoea among under-five children attending at Muhimbili National Hospital (MNH), in Tanzania. A quantitative cross-sectional study design of 100 simple randomly selected participants was applied. Questionnaires were used to collect data from mothers/ carers with a child of under-five children suffering from diarrhoea admitted at MNH. Data were analysed using SPSS. Environmental risk factors associated with diarrhoea were determined with a p value of ≤ 0.05. Unsuitable infrastructure for grey water disposal, improper hand washing before feeding the baby and hand washing without using clean water and soap had strongly association with diarrhoea in under-five children attending at MNH with P-value of 0.001, 0.001, and 0.01 respectively. Identified risk factors for diarrhoea among under-five children call for the importance of providing health education to the caregivers on the causes, prevention, and treatment on the problem.
Tanzanian mothers’ cultural beliefs and misinformation regarding the reasons for their cesarean sections
(International Journal of Childbirth, 2019) Mathias, Victor A.
BACKGROUND: In Tanzania, cesarean section (CS) rates have been steadily increasing, yet little is known about mothers’ understanding of the medical rationale for their CSs. ID:p0060 AIM: To identify mothers’ cultural understandings of the rationale for their CSs. ID:p0065 METHODS: Design: A qualitative descriptive design was employed. ID:p0070 Setting: A government hospital in the western region in Tanzania. ID:p0075 Participants: A total of 117 mothers were interviewed using convenience sampling post CS. ID:p0080 FINDINGS: Forty percent of the mothers were younger than 18 years, with more than 50% having had five or more live babies. Among multigravida women, 40.2% had had one or more previous CSs. ID:p0085 The emergent themes were lack of dietary knowledge, use of local herbs, delays in coming to hospital, avoiding stressful labor pains and no ability to exercise, and no personal preferences of “push or go for an operation.” ID:p0090 CONCLUSION: Pregnant women in Tanzania need improved health education to make informed choices about childbirth and be involved all processes of antepartum care decision making to achieve optimal birth outcomes.
Knowledge and practice on early breastfeeding initiation among postpartal mothers at Amana Hospital, Tanzania.
(International Journal of Childbirth, 2021-12) Mathias, Victor A.
BACKGROUND: Early breastfeeding initiation refers to putting the newborn to the breast within 1 hour of birth. However, rates of exclusive breastfeeding are low both globally (42%) and in Tanzania (51%). AIM: To assess knowledge about, attitudes toward, and practice of early breastfeeding initiation among postpartal mothers in Tanzania. METHODS: This study used a cross-sectional design. Simple random sampling was used to recruit 100 postpartal mothers who had delivered within the previous 48 hours at Amana Regional Referral Hospital, which is in the Eastern zone of Tanzania. FINDINGS: Of the participating postpartal mothers, 65% were knowledgeable about early breastfeeding initiation and the remaining 35% were not knowledgeable. Most mothers (62%) had positive attitudes toward early breastfeeding initiation, and 38% had negative attitudes. Furthermore, 45% of participating mothers had initiated early breastfeeding (within 1 hour), whereas 55% had delayed initiation of early breastfeeding (after 1 hour). Mothers' age was positively associated with knowledge about breastfeeding (p =.048), but the association between knowledge about early breastfeeding and education was non-significant (p =.514). Associations between attitude toward early breastfeeding and age and education were also nonsignificant (p = 1.000 and p =.132, respectively). Furthermore, associations between the practice of early breastfeeding and age and education were nonsignificant (p = 1.000 andp =.204, respectively). CONCLUSION: Postpartal mothers may benefit from being informed about the health benefits of early initiation of breastfeeding after delivery for both mother and baby. Improving their knowledge and attitudes toward this practice may help to avoid unnecessary morbidity and mortality among newborns.
Situation analysis of healthcare standards and criteria that contribute to the care of residents in homes for older people in Tanzania
(Sage publication, 2022-12) Mathias, Victor A.
Problems experienced in homes for older people in Tanzania highlighted the need for a situation analysis of healthcare standards to identify the baseline of care provided to residents in these homes. This study conducted a situation analysis of structure healthcare standards and associated criteria with the aim of contributing to improved quality of care for residents in homes for older people in Tanzania. Thirty-two homes for older people in Tanzania were audited using an audit instrument that included seven fields, 26 structure standards, and 262 associated criteria. The analysis showed that overall, the homes were non-compliant with healthcare structure standards and associated criteria. The Tanzanian Government should urgently introduce measures to address the missing standards and associated criteria.
Structure healthcare standards and criteria that contribute to the care of residents in homes for the elderly: a narrative review
(Journal of Aging and Environment, 2023-01-16) Mathias, Victor A.
Meaningful life for the residents is mostly influenced by the context of the homes for the elderly. Context in terms of structure healthcare standards should recognize protection needs of residents as their rights to safety. The review aimed to identify structure healthcare standards and criteria that contribute to the care of residents in homes for the elderly. The literature reviewed included theoretical and empirical literature. Peer-reviewed scientific journals based on the structure standards in healthcare that contribute to the care of residents in homes for the elderly were obtained from three databases (Google scholar, PubMed, HINARI). Key words search of these databases were used. One hundred twenty-eight studies (n = 128) on healthcare standards were identified. Latter analysis was followed to analyze the studies whereby researchers merged findings of single and independent studies. Seven main themes emerged from the analysis namely infrastructure, clinical management, meals and water, residents’ rights, guiding documents for the care of residents, human resources required, and safety and security. Homes for the elderly should involve the elderly in their care to promote ownership of their services. In addition, the homes must improve the physical set-up to balance residents’ needs and protecting them from physical and psychological maltreatment.
HIV retesting among pregnant women with gestational age of 36 weeks or higher attending antenatal clinic at Temeke regional referral hospital, Tanzania
(Tanzania Medical Journal, 2022-06-15) Protas, Joyce
Abstract Background Although Tanzania has set a target of 90% Human Immunodeficiency Virus (HIV), retesting among pregnant women, the rate of re-uptake is still low despite the service being free of charge. This study determined HIV retesting among pregnant women with the gestational age of 36 weeks or higher attending the antenatal clinic at Temeke Regional Referral Hospital. Methods The cross-sectional study design was used. The data was collected from 12th October 2020 to 9th November 2020 in Temeke regional referral Hospital. Two hundred pregnant mothers attending the Reproductive and child health clinic (RCH) clinic who had a gestational age of 36 weeks or above and tested HIV negative from the first test were included. The demographic and obstetrics information were collected by using a structured questionnaire. The descriptive and factors analysis was done by using SPSS version 20. The Chi-square test determined the relationship between variables, and the P-value of less or equal to 0.05 was considered statistically significant. Results The percentage for re-uptake of second HIV test was 30% (60/200). Out of 60 who repeated the test, 6.7% (4/60) were HIV seroconverted. Factors associated with re-test were being married (p-value 0.05, X2=7.8), being self-employed (p-value is 0.00 , X2=18.838 ) ,four and above antenatal clinic visit (p-value is 0.003, X2=11.737 ) ,having knowledge of repeating (p-value is 0.00 ,X2=59.294) , multiparty ( p-value is 0.015 ,X2=8.334 ,positive perception during the first test (p-value is 0.044, X2= 4.039) ,maternal age of 25-29 years old (p-value is 0.053, X2= 10.901) ,and having access to radio and television (p-value is 0.04, X2= 6.442). Conclusion The proportion of HIV retesting was 30%, and factors associated with retesting were being married, being self-employed, more than four ANC visits, multiparity, having knowledge about retesting, and positive perception during the first test.
Markers of perceived managerial success within the Tanzanian nursing profession
(International Journal of Africa Nursing Sciences, 2015) Mella, Pauline P.
This study explores the views of nurse managers in Tanzania regarding desirable attributes for effective management of their health services. The mixed method study utilised an initial questionnaire (n = 78) and subsequent responses from two semi-structured focus group interviews (n = 14) with purposive samples of consenting nurse managers who had completed the original questionnaire. Overall, ‘Skills’ were considered the most important dimension, followed by ‘Knowledge and Learning’. Specific skills, such as decision making, were considered essential. Culture was perceived to be a key influence on management potential, with education providing a pathway to overcome early and subsequent barriers. A lack of delegation was highlighted. An overall transactional style perpetuates as a means of maximising scant resources which impedes trust and sharing of power through delegation. The provision of culturally appropriate management education, relevant to the local context, is essential for the development of nursing in Tanzania.
Major factors that impact on women’s health in Tanzania: the way forward
(Health Care for Women International, 2003) Mella, Pauline P.
Tanzania’s health policy is to improve the health of all Tanzanians with a focus on those most at risk. One of the major objectives is to reduce infant and maternal morbidity and mortality and increase life expectancy. The life expectancy in Tanzania is 49 years for males and 53 years for females. Maternal mortality is recorded at 300–400 deaths per 100,000 women. The main causes are haemorrhage, sepsis, rupture of the uterus, anaemia, and others. The risk factors associated with the above causes include maternal height, age, child spacing, and number of births per woman; malaria and anaemia; imbalance of energy and food intake; HIV/AIDS; women’s workload; and female genital mutilation (FGM). To address issues of women’s health, the government has put in place many strategies, for example, a ministry to look after women’s issues, the safe motherhood initiatives, improvement of the knowledge and skill of health care providers, as well as collaboration with nongovernmental organizations (NGOs) and private agencies. The health sector reform is important because it has negatively affected women’s access to health care. To improve the health of women in Tanzania, health and health-related sectors should cooperate and collaborate in order to empower women in the areas of education, social status, and technology. Policies must also address poverty, nutrition, adolescent health, and violence and sexual abuse.
Effects of educated professionals on the health and care of women in Tanzania
(Health care for women international, 1987) Mella, Pauline P.
Education of women in Tanzania, one of the 31 least developed countries of the world, is a farily recent event. Education of Tanzanian women has afforded better health for whole families through better knowledge of self‐care, employment opportunities, birth planning, and status in the community. A negative effect of education and employment is an erosion of traditional cultural patterns. Children often do not learn the values thought important in their tribes. The value of education, however, seems to outweigh the disadvantages, as the health of the country as measured by the infant mortality rates improves. A study of Tanzanian women indicated that professional nurses were identified as the source of the most useful and reliable health advice.
Prevalence and factors associated with neonatal sepsis among neonates in Temeke and Mwananyamala Hospitals in Dar es Salaam, Tanzania
(Tanzania Journal of Health Research, 2016) Protas, Joyce; Semiono, Avelina; Sariah, Adellah
Background: Neonatal sepsis contributes significantly to neonatal mortality. This study was carried out to determine the prevalence and factors associated with neonatal sepsis in Dar es Salaam, Tanzania. Methods: A hospital based cross-sectional study was conducted at Mwananyamala and Temeke hospitals in Dar es Salaam, during August-September, 2015. A standardized questionnaire was used to obtain demographic, obstetrics and clinical information. Diagnosis of neonatal sepsis was done clinically. Relationship between outcome variable and exposure variable was done using Chi square test. Multivariate logistic regression was used to measure association after controlling for confounders. Results: A total of 220 neonates were recruited, 69 (31.4%) had sepsis. The risk factors associated with neonatal sepsis were maternal age of >35 years (AOR=6.7; 95%CI 2.1-20.1; p-value-0.001) and resuscitation at birth (AOR=1.25195%CI1. 22-3.88; p-value=0.025). Conclusion: Neonatal sepsis among neonates in Dar es Salaam is associated with maternal and health services related factors. The findings underscore the importance of routine assessment and close monitoring of neonates. It is therefore recommended to have more skilled health personnel and advanced equipment while providing maternal and new-born health care services.
Surgical Site Infection among Patients Undergone Orthopaedic Surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania.
(East and Central African Journal of Surgery, 2017) Protas, Joyce; Semiono, Avelina; Mika, Elizabeth Z.; Sariah, Adellah
Background: The aim of this study was to determine prevalence and factors associated with surgical site infection at Muhimbili Orthopedic Institute. Method: This was a cross-sectional study conducted at Muhimbili Orthopaedic Institute (MOI) in Dar es Salaam, from August, 2015 to October 2015. Convenience sampling technique was used to recruit postoperative patients for this study. Standardized questionnaires were used to obtain demographic, social, and clinical information from respondents. Determination of the relationship between outcome and exposure variables was done using chi square test. Multivariate logistic regression was used to measure the association after controlling for confounders. Odds ratio corresponding to 95% confidence interval with a p value of ≤ 0.05 was considered significant. Results: Out of 300 study participants 75(25.0%) had surgical site infection. This was highly determined by more than 2 hours length of surgical procedure (AOR= 1.4; 95%CI 1.14-6.69; P value=0.05), none prophylactic use of antibiotics (AOR= 3.4; 95%CI 1.6-7.78; P value=0.03), more than one week stay before surgery (AOR=3.3; 95%CI 2.24-3.34; P value =0.00). Conclusion: The overall prevalence of surgical site infection at Muhimbili Orthopedic Institute was high. This was associated with more than 2 hours length of surgery, lack of prophylaxis use, and pre-operative hospital stay.
Risk factors associated with pre-term birth in Dar es Salaam, Tanzania: a case-control study
(Tanzania Journal of Health Research, 2016) Kumpuni,Kitindi ,Protas, Joyce
Background: Preterm birth remains one of the most serious problems in obstetrics care. Its aetiology is complex and multifactorial. This study was carried out to determine risk factors for preterm birth in Dar es Salaam City in Tanzania.Methods: This case-control study was conducted in three municipal hospitals namely, Amani, Mwananyamala and Temeke in Dar es Salaam. It involved 377 pairs of women with preterm birth (cases) and term birth (controls). Eligible women who agreed to participate and who signed the consent form completed a short interview regarding demographic and lifestyle factors, had their baby examined for maturity, and had their medical records abstracted. All cases and controls were interviewed face-to-face using a specially designed questionnaire. Multivariate logistic regression after controlling for potential confounders was used to measure the strength of associations between preterm birth and related factors.Results: Several significant risk factors associations with pre-term birth were multiple pregnancies (AOR = 8.6; 95%CI 4.5-16.5; p-value <0.001), untreated vaginal discharge (AOR = 5.2; 95%CI 1.1-24.4; p-value 0.034), public prenatal care (AOR = 2.1; 95%CI 1.1-4.1; p-value 0.017), untreated urinary tract infection (AOR = 2.7; 95%CI 1.2-6.1; p-value 0.016), complication during pregnancy (AOR = 2.7; 95%CI 1.3-5.3; p-value 0.004), cervical incompetence (AOR = 11.6; 95%CI 1.1-121.5; p-value 0.04), polyhydramnios (AOR = 8.3; 95%CI 1.7-40.2; p-value 0.008), and lack of antenatal visits (AOR = 5.1; 95%CI 1.4-17.8; p-value 0.042).Conclusion: This study has identified several risk factors for preterm birth in the city of Dar es Salaam. It is important that planners design community-based interventions to address complications from preterm birth.
Prevalence and factors associated with late antenatal care visit among pregnant women in Lushoto, Tanzania
(Tanzania Journal of Health Research, 2017) Sariah, Adellah; Protas, Joyce
Background: Adequate utilization of antenatal health care services is associated with improved maternal and neonatal health outcomes. The World Health Organization recommends pregnant women to attend antenatal care services as early as in the first trimester. However, many women due to various reasons fail to meet the recommendations. The objective of this study was to determine the prevalence and factors associated with late antenatal booking among pregnant women in Lushoto district of north-eastern Tanzania. Methods: This hospital based cross sectional study involved pregnant women and was conducted in August-September 2015. A standardized questionnaire was used to obtain participants demographic characteristics and obstetrics history. Data analysis was done using (SPSS) and relationship between outcome variables and exposure variable was done using Chi-square test. Multivariate logistic regression was used to measure the association. Results: A total of 240 participants were involved in the study. Out of these, 169 (70.4%) participants booked late for antenatal care (ANC) services. Delayed booking was mainly associated with not being married (AOR=3.08; 95%CI 1.149-8.275; P value=0.025) and unemployment (AOR=4.28; 95% CI 2.11-8.679; p-value=0.000) Conclusion: Late first antenatal clinic visit was high in Lushoto, and was highly associated with unmarried and unemployment status. Therefore, provision of continuous health education and community sensitization on the importance of timely seeking ANC services should be strengthened.
The partten and management outcome of gastric and intestnal foreign bodies in children seen at Muhimbili National Hospital
(East and Central African Journal of Surgery, 2015) Protas, Joyce
Background: Finding an ingested sub-diaphragmatic foreign body in paediatrics is common and represents a considerable nervousness to parents. The vast majority is expelled uneventfully within one week of ingestion, however, sometimes can lead to complications and mortality. The purpose of this study was to explain the pattern of ingested gastric and intestinal foreign bodies, its management and outcomes in children at Muhimbili National Hospital. Methods: A prospective cross-sectional study was conducted in the paediatric surgery unit from April 2012 to October 2013 to children below 10 years of age using a structured questionnaire. Symptoms free children were discharged for observation at home and symptomatic children or with risky objects were planned to be cared in the hospital. Results: A total of 33 children were studied, Boys being 72.7% (24/33), M: F=2.7:1. The under 5-years were the majority (78.8%, 26/33). The commonest ingested foreign bodies were Coins (42.4%, 14/33), Nails (18.2%, 6/33) and screws (12.1%, 4/33). The mean length of ingested foreign bodies was 2.47 centimeters (±0.56 SD). The transient time was less than one week in the majority of children (90.9%, 30/33). The average transient time was 4.1±0.05 SD days. All children passed theirs foreign bodies under observation at home uneventfully. Conclusion: Foreign bodies risk of ingestion is high in under fives and conservative observational treatment is successful in the majority.
Determinants of timely uptake of ITN and SP (IPT) and pregnancy time protected against malaria in Bukoba, Tanzania
(BMC research notes, 2016) Protas, Joyce
Objective: Insecticides treated nets (ITNs) and intermittent preventive therapy with two doses of sulfadoxine pyrimethamine (SP IPTp) are the cornerstone for malaria control in pregnancy. Despite the coverage of these interventions being high, it is not known whether they confer optimal protection time against malaria in pregnancy. This study investigated the timing and determinants of timely uptake of SP(IPTp) and ITNs and the pregnancy time protected. Methods: A health facility based cross-sectional study was carried out in Bukoba urban district from 16th April to 29 May 2013. Involving pregnant women and post natal mothers attending Reproductive and Child Health (RCH) clinics. Data on their socio-economic background, pregnancy history and attendance to RCH, receipt of a voucher and acquisition of an ITN as well as SP for IPTp were collected. Their responses were validated from the records of antenatal cards. Data was analysed using SPSS computer program version 20. Results: A total of 530 mothers were recruited. The overall uptake of SP IPTp was 96 % and the uptake of two SP (IPTp) doses was 86 %. Timely uptake of 1st dose was predicted by early antenatal booking, [AOR 2.59; 95 % CI 1.51–4.46; P = 0.001], and the availability of SP at the facility [AOR 4.63; 95 % CI 2.51–8.54; P < 0.0001]. Uptake of 2nd dose was independent of any predictor factors. A total of 486 (91.6 %) women received ITNs discount vouchers at different gestational age and of these, less than a quarter (21.4 %) received timely. Timely receipt of discount voucher was highly predicted by early antenatal booking [AOR 200; 95 % CI 80.38–498; P < 0.0001]. Conclusion: Although there is a high coverage of SP IPTp and discount vouchers for ITNs, timely uptake and therefore optimal protection time depended on early antenatal booking, the availability of (SP IPTp) and discount voucher at the health facility.

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