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Analysis of Activities and Operations in the Current E-Health Landscape in Tanzania: Focus on Interoperability and Collaboration  [PDF]
Alfred Kajirunga,Khamisi Kalegele
Computer Science , 2015,
Abstract: Although the basic application of Information and Communication Technologies (ICT) in the Tanzanian health care systems started years ago, still fragmentation of Information Systems (IS) and limited interoperability remain to be big challenges. In this paper, we present an analysis done on the present health care delivery service, HIS and on some of existing eHealth solutions focusing on interoperability and collaboration. Through interviews, questionnaires and analysis on e-health implementations in relation to interoperability and collaboration we have established that, the lack of standard procedures to guide the lifecycle of eHealth systems across the health sector and poor willingness to collaboration among health stakeholders are key issues which hinders the manifestation of the benefit of ICT use in the health sector of Tanzania. Based on the findings, we provide some recommendations with a view to improve interoperability and collaboration.
Mobility and maternal position during childbirth in Tanzania: an exploratory study at four government hospitals
Helen Lugina, Rose Mlay, Helen Smith
BMC Pregnancy and Childbirth , 2004, DOI: 10.1186/1471-2393-4-3
Abstract: This was an exploratory study using quantitative and qualitative methods. Practice rates were determined by exit interviews with a consecutive sample of postnatal women. Provider views were explored using semi-structured interviews (with doctors and traditional birth attendants) and focus group discussions (with midwives). The study was conducted at four government hospitals, two in Dar es Salaam and two in the neighbouring Coast region, Tanzania.Practice rates for mobility during labour and delivery position; women's experiences, preferences and views about the care provided; and provider views of current practice and barriers and opportunities to evidence-based obstetric practice.Across all study sites more women were mobile at home (15.0%) than in the labour ward (2.9%), but movement was quite restricted at home before women were admitted to labour ward (51.6% chose to rest with little movement). Supine position for delivery was used routinely at all four hospitals; this was consistent with women's preferred choice of position, although very few women are aware of other positions. Qualitative findings suggest obstetricians and midwives favoured confining to bed during the first stage of labour, and supine position for delivery.The barriers to change appear to be complicated and require providers to want to change, and women to be informed of alternative positions during the first stage of labour and delivery. We believe that highlighting the gap between actual practice and current evidence provides a platform for dialogue with providers to evaluate the threats and opportunities for changing practice.In Tanzania 98% of pregnant women receive antenatal care, but only 44% deliver at a health facility [1]. This varies by location; in urban Dar Es Salaam 86% of deliveries take place at a health facility, while only 51% of deliveries in the Coastal region (a rural area) are at a health facility [1]. Many health professionals working in maternity care at these facilitie
Addressing childhood under nutrition in Tanzania: Challenges and opportunities
N Bundara, L Mwanri, J Masika
African Journal of Food, Agriculture, Nutrition and Development , 2013,
Abstract: Childhood undernutrition is highly prevalent in low and middle-income countries resulting in a substantial increase in overall disease burden and mortality. The problem is markedly severe in low-income countries particularly in Africa, and Tanzania is not exceptional. Childhood undernutrition is associated with decreased productivity resulting in a vicious cycle of poverty in affected families, communities and nations. Children who survive after two years of life may develop poor health outcomes including faltering growth and irreversible damage to their cognitive, physical and psychosocial development. In a long term, childhood undernutrition can lead to poor socio-economic development of individuals, families and affected communities. Childhood undernutrition in African countries significantly contributes to poor development and the burden of disease as it complicates the existing problem of infectious diseases. Current strategies addressing this problem largely utilise a medical care model which aims to reduce mortality and may have limited selected preventative aspects confined broadly to vaccinations, food fortifications, and micronutrient supplementations. It is apparent that environmental, cultural and social factors are receiving limited attention. This complex and dire situation demands systematic, effective comprehensive multi-level and multi-sectoral policy drivers that provide effective socioeconomic, environmental, health policies and legislations in the pursuit of effective, equitable and just delivery of social and health services for all groups of its citizens regardless of their socio-economic status. Tanzania as a nation alongside other developing countries need to recognise the magnitude of this scourge and develop comprehensive approaches that will enable development of legislations, policies and long term solution to childhood undernutrition. This paper reviews strategies outside of the health sector with high potential for preventing childhood undernutrition in Tanzania and that can be translated in many developing countries. Comprehensive range of legislations and policies are recommended for implementation of interventions to reduce their occurrence or ameliorate childhood undernutrition consequences.
PROMOTING SCIENCE SUBJECTS CHOICES FOR SECONDARY SCHOOL STUDENTS IN TANZANIA: CHALLENGES AND OPPORTUNITIES  [PDF]
Nkuba Mabula
Academic Research International , 2012,
Abstract: Development of science and technology especially in developing nations demands the preparation of skilled individuals in science disciplines from lower levels of academic and skill training. This fact calls for the need to promote effective science teaching and learning insecondary schools. The purpose of this study was to examine the status of science teaching and learning, challenges facing the science learning in schools and opportunities for improvements. The study was conducted in four districts in Morogoro Region, Tanzania.Specifically, the study intended to identify the pass rates in science subjects, teachers’ professional development, science teachers’ teaching strategies, students’ level of satisfaction with the teaching and students’ readiness to take science subjects in their high schools. The study was conducted in twenty four secondary schools using a sample of 471 students and 66 teachers. The data from students and teachers were collected through a structured questionnaire and focus group discussions. The results revealed poor quality of scienceclassroom teaching and a serious decline in interest of students in science subjects. It was therefore concluded that, teacher-students interaction and relationship in classroom teaching and learning of science need improvement. It is suggested that, future research can observe on the influence of social factors in the decline of interest in science subjects among secondary school students in Tanzania.
Livelihood Opportunities Through Informal Housing in the New Capital City of Dodoma, Tanzania  [cached]
Albinus M. Makalle,Simeon Mesaki,Martern A. Victor
Cross-Cultural Communication , 2011, DOI: 10.3968/j.ccc.1923670020110704.262
Abstract: Between March 2008 and March 2009 we conducted a desk study and field work on informal and low cost housing endeavours undertaken by building artisans in the new capital city of Dodoma in Tanzania. The study focused on the livelihood opportunities that can be derived from the informal housing building sub-sector as semi-skilled artisans’ grapple with the realities of unmet housing needs of the designated capital city of Tanzania. The argument is that there is a market for construction of low-cost housing in informal settlements in the new capital city even though these settlements are beset with problems of lack of legal tenure, poor infrastructure and sanitation. It is further argued that informal construction work offers possibilities for employment and income earning for semi-skilled artisans. It was felt that a detailed study of informal housing building would provide a better understanding of the key factors and trends affecting the livelihood opportunities of people in the sub-sector and the expectation was that the findings would enlighten on the phenomenon and stimulate policy debates on how the sub-sector can be developed sustainably considering the fate of those concerned. The results show that the sub-sector could contribute immensely in the construction of the new capital city as well as improving the livelihoods of the practitioners if only they were well organised in cooperatives, enabled capacity-wise and training and given legal recognition. Key words: Artisan; Building; Capital; City; Dodoma; Informal; Housing; Livelihoods; Policies; Poverty; Settlements; Sub-sector; SWOT; Tanzania; Theory; Urbanisation; Vulnerability Résumé Entre Mars 2008 et Mars 2009, nous avons mené une étude théorique et travail de terrain sur le logement informel et peu de co ts efforts entrepris par la construction des artisans dans la nouvelle capitale de Dodoma en Tanzanie. L'étude a porté sur les moyens de subsistance qui peut être dérivé de la construction de logements informels sous-secteur de s'attaquer semi-qualifiés des artisans avec les réalités des besoins de logement non satisfaits de la capitale désigné de la Tanzanie. L'argument est qu'il ya un marché pour la construction de logements à bas prix dans des établissements informels dans la nouvelle capitale, même si ces établissements sont en proie à des problèmes de manque de tenure légale, la médiocrité des infrastructures et l'assainissement. Il est en outre soutenu que les travaux de construction informelle offre des possibilités d'emploi et de revenus pour les artisans semi-qualifiés. On a estimé qu
Teaching Spatial Science Courses in Public Universities in Tanzania: Challenges and Opportunities  [PDF]
Emiliana John Mwita
Journal of Geographic Information System (JGIS) , 2013, DOI: 10.4236/jgis.2013.56051
Abstract:

Spatial science courses that are Remote Sensing (RS) and Geographic Information System (GIS) are increasingly growing into extremely important disciplines that accommodate various applications in wider sectors of development. Effective teaching and learning of the courses, however, requires intensive investment in facilities and human resources, since the technology is sophisticated and growing fast. This study aims at exploring the challenges of teaching and learning spatial science courses, RS and GIS, particularly in public universities in Tanzania. The study also identifies possible opportunities to improve the situation. Using social survey techniques in data gathering and analysis and author’s own experience, lack of resources, poor background to the courses, delivery methods, limited number of staff and large classes were seen to be the major obstacles in successful learning and teaching. Opportunities exist in using open source resources, collaboration with other institutions within and outside the country and for the universities to give due weight to the courses by building capacity of their staff and procuring facilities, especially laboratories equipments.

 

GENDER AND EDUCATION OPPORTUNITIES IN TANZANIA: “DO WE BRIDGE THE GAP OF QUALITY?”  [PDF]
Budeba Petro Mlyakado
Academic Research International , 2012,
Abstract: Tanzania in response to the World Declaration on Education for All (EFA) – Universal Primary Education by 2000, Millennium Development Goals, and the Dakar EFA Goals embarked on different programmes and initiatives to address the issue of education as the major strategy to development challenges. The adoption of Education and Training Policy(1995) and subsequently the launching of Education Sector Development Programme (1997) were fundamental in reforming education in the country. Then, in the 2000s, two programmes [Primary Education Development Programme and Secondary Education DevelopmentProgramme] were launched to deal with issues of education in primary and secondary schools. By 2010, Tanzania has attained gender parity in primary school enrolment and near parity in lower secondary school enrolment. However, it remained difficult to resolve genderinequalities through education as many gender disparities persevere in higher levels of education and science fields; education for vulnerable and disadvantaged population groups is not well addressed; and, the quality of education has deteriorated overtime. It is high time then, for Tanzania to address gender equality through education and improve the quality of education by investing in Early Childhood Education and Development (ECED), educating the vulnerable and disadvantaged population groups, developing learning curiosity amongwomen and girls, and improving quality of teachers.
Archetype-based conversion of EHR content models: pilot experience with a regional EHR system
Rong Chen, Gunnar O Klein, Erik Sundvall, Daniel Karlsson, Hans ?hlfeldt
BMC Medical Informatics and Decision Making , 2009, DOI: 10.1186/1472-6947-9-33
Abstract: The openEHR EHR Reference Model (RM) and Archetype Model (AM) specifications were used. The template model of the Cambio COSMIC, a regional EHR product from Sweden, was analyzed and compared to the openEHR RM and AM. This study was focused on the convertibility of the EHR semantic models. A semantic mapping between the openEHR RM/AM and the COSMIC template model was produced and used as the basis for developing prototype software that performs automated bi-directional conversion between openEHR archetypes and COSMIC templates.Automated bi-directional conversion between openEHR archetype format and COSMIC template format has been achieved. Several archetypes from the openEHR Clinical Knowledge Repository have been imported into COSMIC, preserving most of the structural and terminology related constraints. COSMIC templates from a large regional installation were successfully converted into the openEHR archetype format. The conversion from the COSMIC templates into archetype format preserves nearly all structural and semantic definitions of the original content models. A strategy of gradually adding archetype support to legacy EHR systems was formulated in order to allow sharing of clinical content models defined using different formats.The openEHR RM and AM are expressive enough to represent the existing clinical content models from the template based EHR system tested and legacy content models can automatically be converted to archetype format for sharing of knowledge. With some limitations, internationally available archetypes could be converted to the legacy EHR models. Archetype support can be added to legacy EHR systems in an incremental way allowing a migration path to interoperability based on standards.Exchange of Electronic Health Record (EHR) data between systems from different suppliers is a major requirement and challenge for distributed health care computing. The two-level modelling paradigm using a standard reference model and archetypes [1] defining spe
Experiences, opportunities and challenges of implementing task shifting in underserved remote settings: the case of Kongwa district, central Tanzania  [cached]
Munga Michael A,Kilima Stella P,Mutalemwa Prince,Kisoka William J
BMC International Health and Human Rights , 2012, DOI: 10.1186/1472-698x-12-27
Abstract: Background Tanzania is experiencing acute shortages of Health Workers (HWs), a situation which has forced health managers, especially in the underserved districts, to hastily cope with health workers’ shortages by adopting task shifting. This has however been due to limited options for dealing with the crisis of health personnel. There are on-going discussions in the country on whether to scale up task shifting as one of the strategies for addressing health personnel crisis. However, these discussions are not backed up by rigorous scientific evidence. The aim of this paper is two-fold. Firstly, to describe the current situation of implementing task shifting in the context of acute shortages of health workers and, secondly, to provide a descriptive account of the potential opportunities or benefits and the likely challenges which might ensue as a result of implementing task shifting. Methods We employed in-depth interviews with informants at the district level and supplemented the information with additional interviews with informants at the national level. Interviews focussed on the informants’ practical experiences of implementing task shifting in their respective health facilities (district level) and their opinions regarding opportunities and challenges which might be associated with implementation of task shifting practices. At the national level, the main focus was on policy issues related to management of health personnel in the context of implementation of task shifting, in addition to seeking their opinions and perceptions regarding opportunities and challenges of implementing task shifting if formally adopted. Results Task shifting has been in practice for many years in Tanzania and has been perceived as an inevitable coping mechanism due to limited options for addressing health personnel shortages in the country. Majority of informants had the concern that quality of services is likely to be affected if appropriate policy infrastructures are not in place before formalising tasks shifting. There was also a perception that implementation of task shifting has ensured access to services especially in underserved remote areas. Professional discontent and challenges related to the management of health personnel policies were also perceived as important issues to consider when implementing task shifting practices. Additional resources for additional training and supervisory tasks were also considered important in the implementation of task shifting in order to make it deliver much the same way as it is for conventional modalities of deliveri
Outcome and Effectiveness of Inpatient Care of Malnourished under Five Children in District Hospitals of Mwanza Region, North Western Tanzania  [PDF]
Sospatro E. Ngallaba, Daniel J. Makerere, Anthony Kapesa, Stella Mongela, Basinda Namanya
Open Journal of Preventive Medicine (OJPM) , 2014, DOI: 10.4236/ojpm.2014.45036
Abstract:

Background: Malnutrition is a disease affecting commonly children from 0 to 5 years of age. In Tanzania it is still a problem with a prevalence of 36% and 28% mortality. Objective: This study aimed to compare the outcome and effectiveness of therapeutic regimes used by different district hospitals in the management of malnutrition of under five years old children in Mwanza Region. Methods: Patient charts were reviewed collecting social demographic attributes, diagnosis, type of therapeutic regimen given and treatment outcome. Results: The prevalence of malnutrition was found to be 30% with case fatality rate (CFR) of 8.8%, for the health facilities using WHO regime while 29% CFR for those using traditional regimen. The use of recommend malnutrition screening tests was generally poor. Conclusion: Malnutrition is still a public health problem with high mortality rate in Tanzania which is mainly caused by failure to use the WHO regimen. There is a need to use the available screening methods and recommended regimens to avert this.

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