Tanzania Medical Journal最新文献

{"title":"Prevalence of Incidental Prostate Carcinoma among Patients Undergoing Turp for Benign Prostatic Enlargement","authors":"I. Mawalla, Masawa K. Nyamuryekung’e, Athar Ali, Aidan Njau, P. Adebayo, A. Zehri","doi":"10.4314/TMJ.V32I4.417","DOIUrl":"https://doi.org/10.4314/TMJ.V32I4.417","url":null,"abstract":"Background\u0000Incidental prostate cancer is detected by histological examination of resected biopsy tissue that has been previously diagnosed as benign. It has the potential for progressing to become a disease necessitating active treatment. There is paucity of data on detection of incidental prostate cancer in Tanzania. A study done in northern Tanzania among the urban public sector revealed an alarming detection rate of 21.71%. We aimed to establish the prevalence of incidental prostate cancer among men surgically treated for benign prostate enlargement with considered normal range of prostate specific antigen.\u0000 Methods\u0000This was a retrospective hospital-based cross-sectional study conducted to establish the prevalence of incidental prostate cancer among men who underwent transurethral resection of prostate with considered normal range of prostate-specific antigen from 2010 to 2019 at Aga Khan Hospital Dar es salaam, Tanzania. To find the prevalence of incidental prostate cancer with 95% confidence level, 5% tolerable error, minimum of 195 participants’ data was reviewed, and factors associated with incidental prostate carcinoma were evaluated by binary regression analysis.\u0000 Results\u0000Total of 195 men were included in the study. The prevalence of incidental prostate cancer among men with prostate-specific antigen levels of less than 5.5ng/mL was 7.2% (95% CI, 4.0 to 11.8%). More than half of the patients had high-grade cancer and three quarters had T1b histological subtype making up the clinically significant category. For every 1-year increase in age from age of 65 years, risk of incidental prostate cancer increased by 1.6 (95% CI, 1.054 to 23.38; P<0.05) and for every unit increase in prostate specific antigen, incidental prostate cancer increased by 2.2 (95% CI, 1.953 to 42.28; P<0.05).\u0000 Conclusion\u0000The Incidental prostate cancer detection rate of 7.2% in our settings is within the range found internationally.","PeriodicalId":412432,"journal":{"name":"Tanzania Medical Journal","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123642047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-Demographic and Clinical Profiles of End-Stage Renal Disease Patients Undergoing Haemodialysis in Gaborone, Botswana","authors":"Kebaabetswe Mosiko, G. Rwegerera, D. Basu","doi":"10.4314/TMJ.V32I4.447","DOIUrl":"https://doi.org/10.4314/TMJ.V32I4.447","url":null,"abstract":"Background\u0000Chronic kidney disease has been on the rise worldwide as well as in sub- Saharan Africa. End-stage renal disease (ESRD) is a major public health problem worldwide and is associated with significant morbidity and mortality. There is a dearth of data on the epidemiology of ESRD patients on renal replacement therapy in sub-Saharan Africa including Botswana.\u0000Aim\u0000To describe the socio-demographic and clinical profiles of ESRD participants on haemodialysis by gender and HIV status in Botswana.\u0000Methods\u0000A cross sectional study involving participants undergoing maintenance haemodialysis in three centers was conducted between February and June 2019.  Data was analysed using Stata 14 statistical software. Chi-square test, Fisher’s exact test and t-test were used to determine association between socio-demographic/clinical characteristics and gender/HIV status.\u0000Results\u0000Overall, 107 participants were enrolled and 65.4% were males. Their mean age± standard deviation at the time of initiation of haemodialysis was 47.5+13.0 years. The prevalence of HIV-infection, diabetes mellitus and hypertension were 24.3%, 26.2% and 90.7%, respectively. The regular use of traditional medicine was ascertained in 43.9% of participants. HIV-infection was significantly associated with hypertension (p=0.04) and low body mass index (p<0.01). Reported use of traditional herbal medicine was a significant associated factor among males (p= 0.01).  Unemployment rate among participants was 41.1%, with 54.5% of these participants attributing their unemployment to ill health, with women significantly more affected than men (p=0.04).\u0000Conclusion\u0000Hypertension was the most common associated factor among our study participants. Participants on maintenance haemodialysis in our study were mostly males. Traditional herbal medicine use was significantly more common in men whereas female participants appeared to have higher prevalence of obesity compared to male counterparts. HIV-infected participants were significantly more likely to have low body mass index and be hypertensive. Women were significantly more likely to be unemployed due to ill health as compared to men. Prospective studies with large sample sizes are recommended to help understanding the role of individual associated factors in causing ESRD in Botswana and similar settings in sub-Saharan Africa.","PeriodicalId":412432,"journal":{"name":"Tanzania Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132794907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunological and Virological Outcomes among Treatment Experienced HIV-Infected Patients on Dolutegravir Regimen in Tanzania","authors":"B. Maganda, Baraka Kavuraya, R. Mutagonda, M. Temu","doi":"10.4314/TMJ.V32I4.512","DOIUrl":"https://doi.org/10.4314/TMJ.V32I4.512","url":null,"abstract":"Introduction\u0000The integrase inhibitor dolutegravir (DTG) has recently replaced the non-nucleoside reverse transcriptase inhibitors (efavirenz and nevirapine) in several Sub-Saharan African countries, including Tanzania. Since this change, there is scarce data on the current treatment outcomes focusing on treatment-experienced HIV-infected patients switched to DTG based regimens in Tanzania.\u0000Objectives\u0000This study aimed to investigate immunological and virological outcomes among treatment-experienced HIV-infected patients who were switched to DTG based regimen in Tanzania.\u0000Results\u0000We enrolled 397 patients, majority (65%) were female patients with mean age of 42.7 (95% CI; 40.7 – 44.7) years. The mean baseline CD4+ cell count was 457.1 (95% CI; 426.6 – 489.8) cells/mm3 with 8.3% of patients with CD4+ cell count <200 cells/mm3. The mean baseline viral load (VL) was 169.8 (95% CI; 128.8 – 223.9) copies/ml, whereby 20.6% had VL ≥ 1000 copies/ml. After the use of a new fixed dose combination of Tenofovir (TDF) 300 mg + Lamivudine (3TC) 300 mg + DTG 50 mg (TLD) for at least 24 weeks, the overall rate of virological suppression (<50 copies/ml) was 89.9% (95%CI 86.7% - 92.7%). The significant predictors of virological failure were overall duration on ART use (p = 0.004), duration on TDF + 3TC, and Efavirenz (EFV) (TLE) (p = 0.007), and baseline VL (p < 0.001).\u0000Conclusion\u0000TLD regimen has provided favorable preliminary results among patients who previously used TLE in HIV/AIDS treatment by showing good virological and immunological outcomes. The long-term treatment outcomes require further investigation.","PeriodicalId":412432,"journal":{"name":"Tanzania Medical Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117227701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing ‘Adhesive Small Bowel Obstruction’ in Tanzania: A Single Center Retrospective Review of Treatment Approach and its Outcomes","authors":"L. Akoko, S. Harya, M. Mwashambwa","doi":"10.4314/TMJ.V32I4.455","DOIUrl":"https://doi.org/10.4314/TMJ.V32I4.455","url":null,"abstract":"Background\u0000The management of adhesive small bowel obstruction has evolved significantly in high income countries with improvements in diagnosis and treatment, from conservative to minimally invasive approaches. In Tanzania, like in many low and middle income economies, these developments have not been herald. Addressing adhesive small bowel obstruction in this setting is therefore vital to improve outcomes. This study aimed to explore current treatment modalities and their outcome among patients with ‘adhesive small bowel obstruction’ at Muhimbili national hospital. \u0000Methodology\u0000A descriptive retrospective, cross-sectional study was conducted at Muhimbili National Hospital covering the period 2014 to 2016. Patients with a documented diagnosis of adhesive Small Bowel Obstruction were sought from medical records. Using a predefined data capture sheets, age, sex, type of management, complications, mortality and time to feeding (among patients who were managed conservatively) were captured. The study had 80% power to detect a mortality rate of 8.7% at 95% confidence interval. Descriptive statistics were populated and summarized as proportions while mortality between the operated versus the conservative group compared using chi square test with significant value set at p value of <5%. \u0000Results\u0000A total of 127 patients with diagnosis of adhesive small bowel obstruction were identified. The mean age was 40.5±17.6 and a slight male predominance at a ratio of 1.6:1. Operative approach was predominant over conservative at ratio of 1.7:1. One third of the surgical group had bowel resection and anastomosis performed. In 18.8% of the operated cases, a complication was reported with Enterocutaneous fistula and surgical site infection being the most common. Overall mortality was 8.7% being higher in the operated group at 10%. \u0000Conclusion\u0000Open surgical approach is the predominant management approach in patients with Adhesive Small Bowel Obstruction. One in three of surgically managed required bowel resection signifying late presentation. Managing adhesive small bowel obstruction carries high morbidity and mortality. There is no standardized protocol for the management of these patients at the tertiary level.\u0000 Recommendation\u0000Locally adoptable protocol for diagnosis and treatment of adhesive small bowel obstruction is needed. This should maximize on resources that are available even at district level facilities with much consideration of the role of surgery.","PeriodicalId":412432,"journal":{"name":"Tanzania Medical Journal","volume":"198 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122010738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of Oesophageal Cancer Treatment at a National Hospital, from 2015 to 2017","authors":"Merina D. Tupa, R. Khamisi, Charles Komba","doi":"10.4314/TMJ.V32I4.484","DOIUrl":"https://doi.org/10.4314/TMJ.V32I4.484","url":null,"abstract":"Background \u0000Oesophageal cancer is among the most common cancers in Tanzania. Patients usually, unfortunately, come to medical care with advanced disease and for this reason, despite advancement in treatment of cancer and multidisciplinary treatment approaches (surgery and chemoradiotherapy), Oesophageal cancer still has a 5-year survival rate of less than 20% and high rate of recurrence after initial treatments. Here in Dar es Salaam, we studied the outcomes of treatment in these cases to have an estimation of the general prognosis of patients and have a general picture of the treatment modalities and outcomes.\u0000Methods\u0000In this retrospective study we reviewed data of patients which included cancer stage at diagnosis, types of treatments and their treatment outcomes. This involved data from patients who were admitted from January 2015 to December 2017. The total period of survival recorded was taken up to 2yrs from the date of onset of treatment. This study was done in Muhimbili National hospital and Ocean Road Cancer Institute, both located in Dar es Salaam, Tanzania.\u0000Results\u0000The Study included 128 patients of which 77(60.2%) were males with a general median age of 55.9 years (range: 20 years to 91 years). Majority of the patients were diagnosed at an advanced stage of the disease. Stage III or IV was observed in 82.5% (106/128) of patients with Oesophageal cancer, rendering them to get only palliative therapy (79%). The overall 2-year survival rate was 8%, and the mean duration for local recurrence was 3.6 ± 1.2 months. Late diagnosis was the main factor for poor outcomes and hence low 2-year survival rate.\u0000Conclusion and recommendation\u0000Oesophageal cancer has higher mortality and shorter survival period because it is diagnosed very late. The treatment offered, therefore, at this stage is usually palliative which doesn’t alter the dismal course of the disease. More efforts are needed to sensitize the general population to seek consultation for early diagnosis and treatment.","PeriodicalId":412432,"journal":{"name":"Tanzania Medical Journal","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128630117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic Choroidal melanoma to the Liver, Kidney and Lungs","authors":"Cyprian Gabriel Ntomoka, Jerry Jecha, Ahmed Attas, M. Yusufa, S. Vaitha","doi":"10.4314/TMJ.V32I4.423","DOIUrl":"https://doi.org/10.4314/TMJ.V32I4.423","url":null,"abstract":"Background\u0000Choroidal melanoma presents the most common type of uveal melanoma commonly diagnosed as a local tumor with about 2% already spread to distant organs necessitating early diagnosis and intervention. The case is presented to show the challenge of managing metastatic choroidal melanoma in a Tanzanian setting.\u0000Case report\u0000A 45 years old male presented at The Comprehensive Community Rehabilitation in Tanzania (CCBRT) hospital with four weeks’ history of acute painful progressing right eye visual loss associated with headache, nausea and vomiting. On examination the eye had a dome shaped retinochoroidal tumor on the inferior extending to the macula associated with shallow retinal detachment. Ultrasonography showed an acoustically silent zone within the tumor, choroidal excavation with some orbital shadowing whereas orbital CT scan revealed a hyper dense lesion. Systemic evaluation for metastasis gave imaging evidence of spread to the liver, lungs and kidneys. Tissue histology of the enucleated eye confirmed epithelioid melanocytic tumor cells. The patient was counselled on the prognosis, referred for palliative care but absconded and died four months later.\u0000Conclusion\u0000Management of metastatic choroidal melanomas is clinically challenging owing to faster growth with poor prognosis even in good hands. Early diagnosis and treatment is important as the final prognosis depends largely on the size, location and extent of metastasis. Enucleation is the final treatment modality for most of the large tumors though it has limited a value in the metastatic type, which ends up with palliative care or death.","PeriodicalId":412432,"journal":{"name":"Tanzania Medical Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127334552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Pattern of Hearing Loss among Head and Neck Cancer Patients Receiving Chemotherapy with or without Radiation Therapy at Ocean Road Cancer Institute, Tanzania","authors":"A. Kahinga, Proscovia C Mugyabuso, Z. Abraham, John Kimario, E. Richard","doi":"10.4314/TMJ.V32I4.496","DOIUrl":"https://doi.org/10.4314/TMJ.V32I4.496","url":null,"abstract":"Background \u0000Head and neck cancers are primarily treated by three main modalities; surgery, radiotherapy and chemotherapy administered alone or in combination. Radiotherapy and chemotherapy may cause complications to patients including hearing loss with various outcomes on types and severity.\u0000Broad objective\u0000To determine the prevalence and pattern of hearing loss among head and neck cancer patients receiving chemotherapy with or without radiation therapy at Ocean Road Cancer Institute, Tanzania.\u0000Methodology  \u0000This was a hospital based descriptive cross sectional study which included 138 histopathological confirmed   head and neck cancer patients from June to December 2017. Data collected using structured questionnaires included demographic characteristics, site of the tumor, treatment modality, type of chemotherapy groups used, dosage and duration.  Pure tone audiometry at a frequency range of 250HZ to 8000HZ using Amplivox 270 audiometer was performed to all patients after otoscopy.  Data was analyzed using Statistical Package for Social Science version 20 and a p value of <0.05 was considered to be statistically significant.\u0000 Results\u0000Out of 138 patients who were involved in the study, 98(71%) had hearing loss. Among 98 patients who had hearing loss, 53(54.1%) received chemotherapy alone and all had sensorineural hearing loss, the remaining 45(45.9%) patients received concurrent chemoradiation and 40(88.9%) had sensorineural hearing loss. Conductive and mixed hearing loss were observed in 3 (6.7%) and 2 (4.4%) patients who received chemoradiation, respectively (p value = 0.045).  The severity of sensorineural hearing loss was higher among patients who received chemoradiation than those who received chemotherapy alone (p value =0.682).  Use of a single drug group or combined drug groups had no significant difference in terms of outcomes on severity of hearing loss (p value =0.603) but high cumulative doses of platinum and taxane compounds had significant increase in terms of outcomes on severity of hearing loss. (p value =0.003, 0.021 respectively).\u0000Conclusion and recommendation\u0000Hearing loss following chemotherapy alone or with concurrent chemoradiation therapy is quite prevalent in our settings thus hearing evaluation pre, during and post chemotherapy/radiotherapy is encouraged for earlier detection of hearing loss and establishing prompt intervention.","PeriodicalId":412432,"journal":{"name":"Tanzania Medical Journal","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121023008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge on Glasgow Coma Scale Scoring Among Nurses in Intensive Care and Emergency Department: A Descriptive Cross-Sectional Study","authors":"Levis Richard, E. Sumari, D. Mkoka","doi":"10.4314/TMJ.V32I3.451","DOIUrl":"https://doi.org/10.4314/TMJ.V32I3.451","url":null,"abstract":"Background\u0000Knowledge on the assessment of patients' conscious level by using the Glasgow Coma Scale (GCS) among nurses working in the Intensive Care Unit (ICU) and Emergency Medicine Department (EMD) remains a major challenge. Lack of knowledge and expert skills on assessment of conscious level among nurses has been associated with outcomes such as mortality, prolonged hospitalization, and development of complications associated with the primary conditions and hospitalization. This study aimed at assessing the knowledge on GCS scoring among nurses working in EMD and ICU for possible interventions to improve the quality of nursing care to patients in need of close monitoring.\u0000Methods\u0000The study used a cross-sectional descriptive approach. Data were obtained from 76 nurses working in EMD and ICU recruited by simple random sampling technique. Data were collected by using a self-administered English structured questionnaire after obtaining informed consent from the study participants. Data were then cleaned for missing information analyzed using SPSS computer software version 21. Descriptive and inferential statistics were used to analyze the demographic and knowledge responses. Fisher's exact test was used to determine the association between socio-demographic characteristics and knowledge level; p<0.05 was considered statistically significant.\u0000Results\u0000This study included 76 nurses; the majority 42(55.3%) working at the ICU. In general, none of the nurses had attended any formal training on GCS Scoring. Majority of the nurses had  moderate level of knowledge 51(67.1%) and none had poor knowledge. Although there was no statistically significant difference in knowledge level among the study nurses based on the socio-demographic characteristics, nurses with age 21-30years, working experience 1-3years, and working in ICU, had good knowledge compared to other subgroups.\u0000Conclusion and Recommendations\u0000The study found that the majority of the nurses had moderate level of knowledge. Since none of them had attended any formal training hence the level of knowledge demonstrated might be from experience sharing and bedside training. The findings suggest the need for post-basic education training for nurses on GCS scoring. In addition, continual profession training focusing at improving nurses’ skills on GCS scoring should be strengthened.","PeriodicalId":412432,"journal":{"name":"Tanzania Medical Journal","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127213114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Postnatal Mothers’ Level Satisfaction with Institutional Delivery and Factors Influencing Satisfaction among Postnatal Mothers in Rural Tanzania; An Analytical Cross-Sectional Study","authors":"Jane Andrew Wado, F. Moshi","doi":"10.4314/TMJ.V32I3.473","DOIUrl":"https://doi.org/10.4314/TMJ.V32I3.473","url":null,"abstract":"Background \u0000At a time when efforts to reduce maternal mortality have been stepped up, it is important to look at mothers’ satisfaction with institutional delivery and factors associated with it. According to WHO the main goal of health care is to deliver equitable, effective, and accessible health care, which will provide client satisfaction. Thus, this study aimed at assessing the mothers’ level of satisfaction with institutional delivery services and factors associated with it.\u0000Method\u0000It was a hospital-based analytical cross-sectional study. A multistage sampling technique was used to obtain a sample size of 329 respondents. An interviewer-administered structured questionnaire was the main method used for data collection. Data were analyzed by statistical package for social science (SPSS) version 20. Multivariate and binary logistic regression was applied to identify factors associated with satisfaction with delivery services.\u0000Result\u0000Mother's satisfaction with institutional delivery was 188/329 (57.1%). Half of the respondents 168/329 (51.1%), 166/329 (50.5%) and 173/329 (52.6%) were satisfied with privacy, waiting time and health workers’ communication, respectively. The majority 208/329 (63.2%) were dissatisfied with perceived attendants’ competencies. Predictors of satisfaction were age group >20years (AOR=3.149, 95% CI 1.169-8.481 p=0.023) and 30 years and above (AOR=4.421, 95% CI 1.451-13.474 p=0.006) and employment (AOR=1.936, 95%Cl 1.190-3.150, p=0.008).\u0000Conclusion \u0000Substantial numbers of post-delivery mothers were not satisfied with institutional health delivery services. Young women and unemployed were less likely to be satisfied with institutional health deliveries. The study recommends an interventional study, which will determine cost-effective strategies to improve satisfaction with health facility delivery.","PeriodicalId":412432,"journal":{"name":"Tanzania Medical Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128773235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Access to Family Planning Services in Rorya District, Tanzania: Qualitative Findings from A Pilot Study","authors":"G. Webber, B. Chirangi, N. Magatti","doi":"10.4314/TMJ.V32I3.428","DOIUrl":"https://doi.org/10.4314/TMJ.V32I3.428","url":null,"abstract":"Background\u0000Access to modern family planning methods is essential for African women to avoid repeated pregnancies, and the subsequent risk of maternal mortality, particularly in rural contexts. This study addressed the gap in access to family planning services for women living in a rural district of northern Tanzania.\u0000Objectives\u0000In this pilot study, we trained community health workers to educate couples, distribute condoms and oral contraceptives, and refer women and men for more advanced methods of family planning. The purpose of this study was to explore the views of community members, nurses, and policymakers to this project to improve access to modern family planning methods, to understand the barriers and solutions for accessing family planning services in this rural context.\u0000Methods\u0000Twenty focus group discussions were held separately with women, men, community health workers, nurses and policymakers (total 173 participants) from across the district. The focus group transcripts were subjected to a thematic analysis by the first author through repeated readings focusing on the barriers and solutions to accessing family planning services in Rorya District. \u0000Results\u0000The barriers to family planning access were most commonly negative male attitudes towards women using family planning methods. The community held myths regarding methods, institutional barriers impeding access and specific family planning method challenges were also problematic. Solutions focused on community health education, provider training, reliable supply of family planning methods in the community, and free access to these methods.\u0000Conclusion\u0000The community members, nurses and policymakers interviewed about this project agree that community health workers can successfully provide family planning education and basic methods to community members, and refer couples for more advanced methods. Challenges remain to ensure the supply of contraceptive methods is sustainable, and that male partners are engaged and supportive. The four pillars of a successful program in family planning are community-based health education, training of nurses in advanced methods, consistent supply of family planning methods and provision of free supplies to the population.","PeriodicalId":412432,"journal":{"name":"Tanzania Medical Journal","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115220029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}