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Despite being subject to criticism, qualitative research methodology remains a unique and valuable approach in collecting rich and informative data. However, this may vary from one context to another and researchers understanding of the context. Grounded on the decolonization notion of qualitative research, this paper explains leeways and obstacles in conducting research, reflecting upon the procedural and practical aspects that represent the reality in Tanzania based on two cases. Our paper emphasizes that it is essential to understand and capture the real-world reflective of the voices of the population whom the study targets, which may be easier for local/native researchers. This is because the local/native researchers may be able to explain the research processes and findings in consideration of the socio-cultural settings and political environment. The paper acknowledges that qualitative research requires patience and time, which may have financial implications. It also acknowledges that some populations are facing research fatigue exacerbated by inadequate research dissemination plans. Understanding the context of the study area or topic and applying appropriate methodological approaches to overcome obstacles and gather required adequate and relevant information is thus of importance. [ABSTRACT FROM AUTHOR]

Interactions between people and large carnivores on shared landscapes can have harmful social and ecological consequences. Human–carnivore coexistence depends on an assemblage of sociological factors including effective management institutions that address the social costs of carnivore conservation and promote tolerance toward wildlife. In East Africa, large carnivores are particularly troublesome for herders who depend on livestock for subsistence and wellbeing. This paper provides an overview of human–hyena conflict in the Tarangire ecosystem of northern Tanzania. It presents descriptive results from a questionnaire survey (n = 1076) administered as part of an anthropological study (2019–2020; 2022; 2023) of human–wildlife interactions across twelve villages inhabited by Maasai agropastoralists. The survey instrument was designed through community-based participatory research methods to convey herder concerns about the impacts of spotted hyenas (Crocuta crocuta) on the livestock economy. Based on the perceptions and local ecological knowledge of Maasai interlocutors, the paper provides an overview of the spatial and temporal patterns of human–hyena interactions. Perceived frequencies of hyena attacks on kraaled livestock were unevenly distributed geographically, with those homesteads surrounding Manyara Ranch most heavily affected. Based on herder-reported livestock losses, the costs of depredation by spotted hyenas across the study area were estimated at approximately USD 904.84 per household per year. Most homesteads lacked fortified bomas and would benefit from the provision of lights and fencing materials to improve kraal structures. The paper's central finding is that spotted hyenas represent a pressing, everyday concern for local pastoralists. Unsurprisingly, herders despise hyenas and are intolerant of sharing landscapes with them. For carnivore conservation outside protected areas to thrive in Tanzania, conservationists and policy makers must engage more meaningfully with the lived experiences of local herders who bear the brunt of conservation costs on their livelihoods. [ABSTRACT FROM AUTHOR]

Marburg viral disease (MVD) is a highly infectious disease with a case fatality rate of up to 90%, particularly impacting resource-limited countries where implementing Infection Prevention and Control (IPC) measures is challenging. This paper shares the experience of how Tanzania has improved its capacity to prevent and control highly infectious diseases, and how this capacity was utilized during the outbreak of the MVD disease that occurred for the first time in the country in 2023. In 2016 and the subsequent years, Tanzania conducted self and external assessments that revealed limited IPC capacity in responding to highly infectious diseases. To address these gaps, initiatives were undertaken, including the enhancement of IPC readiness through the development and dissemination of guidelines, assessments of healthcare facilities, supportive supervision and mentorship, procurement of supplies, and the renovation or construction of environments to bolster IPC implementation. The official confirmation and declaration of MVD on March 21, 2023, came after five patients had already died of the disease. MVD primarily spreads through contact and presents with severe symptoms, which make patient care and prevention challenging, especially in resource-limited settings. However, with the use of a trained workforce; IPC rapid needs assessment was conducted, identifying specific gaps. Based on the results; mentorship programs were carried out, specific policies and guidelines were developed, security measures were enhanced, all burial activities in the area were supervised, and both patients and staff were monitored across all facilities. By the end of the outbreak response on June 1, 2023, a total of 212 contacts had been identified, with the addition of only three deaths. Invasive procedures like dialysis and Manual Vacuum Aspiration prevented some deaths in infected patients, procedures previously discouraged. In summary, this experience underscores the critical importance of strict adherence to IPC practices in controlling highly infectious diseases. Recommendations for low-income countries include motivating healthcare providers and improving working conditions to enhance commitment in challenging environments. This report offers valuable insights and practical interventions for preparing for and addressing highly infectious disease outbreaks through implementation of IPC measures. [ABSTRACT FROM AUTHOR]

Background: Malaria transmission in Tanzania is driven by mosquitoes of the Anopheles gambiae complex and Anopheles funestus group. The latter includes An. funestus s.s., an anthropophilic vector, which is now strongly resistant to public health insecticides, and several sibling species, which remain largely understudied despite their potential as secondary vectors. This paper provides the initial results of a cross-country study of the species composition, distribution and malaria transmission potential of members of the Anopheles funestus group in Tanzania. Methods: Mosquitoes were collected inside homes in 12 regions across Tanzania between 2018 and 2022 using Centres for Disease Control and Prevention (CDC) light traps and Prokopack aspirators. Polymerase chain reaction (PCR) assays targeting the noncoding internal transcribed spacer 2 (ITS2) and 18S ribosomal DNA (18S rDNA) were used to identify sibling species in the An. funestus group and presence of Plasmodium infections, respectively. Where DNA fragments failed to amplify during PCR, we sequenced the ITS2 region to identify any polymorphisms. Results: The following sibling species of the An. funestus group were found across Tanzania: An. funestus s.s. (50.3%), An. parensis (11.4%), An. rivulorum (1.1%), An. leesoni (0.3%). Sequencing of the ITS2 region in the nonamplified samples showed that polymorphisms at the priming sites of standard species-specific primers obstructed PCR amplification, although the ITS2 sequences closely matched those of An. funestus s.s., barring these polymorphisms. Of the 914 samples tested for Plasmodium infections, 11 An. funestus s.s. (1.2%), and 2 An. parensis (0.2%) individuals were confirmed positive for P. falciparum. The highest malaria transmission intensities [entomological inoculation rate (EIR)] contributed by the Funestus group were in the north-western region [108.3 infectious bites/person/year (ib/p/y)] and the south-eastern region (72.2 ib/p/y). Conclusions: Whereas An. funestus s.s. is the dominant malaria vector in the Funestus group in Tanzania, this survey confirms the occurrence of Plasmodium-infected An. parensis, an observation previously made in at least two other occasions in the country. The findings indicate the need to better understand the ecology and vectorial capacity of this and other secondary malaria vectors in the region to improve malaria control. [ABSTRACT FROM AUTHOR]

Background: Effective testing for malaria, including the detection of infections at very low densities, is vital for the successful elimination of the disease. Unfortunately, existing methods are either inexpensive but poorly sensitive or sensitive but costly. Recent studies have shown that mid-infrared spectroscopy coupled with machine learning (MIRs-ML) has potential for rapidly detecting malaria infections but requires further evaluation on diverse samples representative of natural infections in endemic areas. The aim of this study was, therefore, to demonstrate a simple AI-powered, reagent-free, and user-friendly approach that uses mid-infrared spectra from dried blood spots to accurately detect malaria infections across varying parasite densities and anaemic conditions. Methods: Plasmodium falciparum strains NF54 and FCR3 were cultured and mixed with blood from 70 malaria-free individuals to create various malaria parasitaemia and anaemic conditions. Blood dilutions produced three haematocrit ratios (50%, 25%, 12.5%) and five parasitaemia levels (6%, 0.1%, 0.002%, 0.00003%, 0%). Dried blood spots were prepared on Whatman™ filter papers and scanned using attenuated total reflection-Fourier Transform Infrared (ATR-FTIR) for machine-learning analysis. Three classifiers were trained on an 80%/20% split of 4655 spectra: (I) high contrast (6% parasitaemia vs. negative), (II) low contrast (0.00003% vs. negative) and (III) all concentrations (all positive levels vs. negative). The classifiers were validated with unseen datasets to detect malaria at various parasitaemia levels and anaemic conditions. Additionally, these classifiers were tested on samples from a population survey in malaria-endemic villages of southeastern Tanzania. Results: The AI classifiers attained over 90% accuracy in detecting malaria infections as low as one parasite per microlitre of blood, a sensitivity unattainable by conventional RDTs and microscopy. These laboratory-developed classifiers seamlessly transitioned to field applicability, achieving over 80% accuracy in predicting natural P. falciparum infections in blood samples collected during the field survey. Crucially, the performance remained unaffected by various levels of anaemia, a common complication in malaria patients. Conclusion: These findings suggest that the AI-driven mid-infrared spectroscopy approach holds promise as a simplified, sensitive and cost-effective method for malaria screening, consistently performing well despite variations in parasite densities and anaemic conditions. The technique simply involves scanning dried blood spots with a desktop mid-infrared scanner and analysing the spectra using pre-trained AI classifiers, making it readily adaptable to field conditions in low-resource settings. In this study, the approach was successfully adapted to field use, effectively predicting natural malaria infections in blood samples from a population-level survey in Tanzania. With additional field trials and validation, this technique could significantly enhance malaria surveillance and contribute to accelerating malaria elimination efforts. [ABSTRACT FROM AUTHOR]

This paper explores motivations behind voluntary activities of youth in Dar es Salaam, Tanzania, during an increasingly common period of 'waithood,' characterized by prolonged status as youth and delay in adulthood due to challenges with unemployment. Drawing on ethnographic anthropological fieldwork conducted in 2019, this paper uses stories of two youths from two youth-led organizations located in Dar es Salaam to explore differing motivations for engaging in volunteering. These examples illustrate how volunteering either acts as a stepping-stone to future employment or as a replacement for formal employment, dependent on class identity. It is argued that for Tanzanian youths, volunteering is a creative response to the challenges of waithood. This paper suggests that policymakers and civil society organizations addressing youth issues in Tanzania should recognize the diverse motivations and creative and strategic dimensions of volunteering to better support young people in navigating waithood and their futures. [ABSTRACT FROM AUTHOR]

Introduction: Patient feedback system (PFS) forms an important entry point for the medical personnel and healthcare administrators to identify healthcare service delivery gaps and develop responsive interventions. This may foster patient trust consequently increasing healthcare-seeking, engagement in decision, continuity, and satisfaction. However, research on the PFS in rural primary healthcare settings appears limited. Objective: The paper examines the perceived role and effectiveness of PFS in improving therapeutic relationships building on the recent research on patient-provider relationships in rural Tanzania. Methods: The paper examines the findings of qualitative descriptive research conducted in the Shinyanga Region which employed a human-centred design (HCD) approach to co-create an intervention package for improving nurse-client relationships between January and September 2022. The study used semi-structured interviews in Swahili to first explore drivers of poor provider-patient relationships with purposefully selected providers, patients, and administrators. The findings guided the co-designing of an intervention package in subsequent HCD steps. Interviews were concurrently translated and transcribed, then systematically coded to facilitate the development of themes using a deductive thematic analysis approach. Results: PFS emerged as one of the key themes in the deductive analysis when examining factors shaping provider–client relationships. The PFS theme was characterized by three major subthemes, which included perceived benefits, availability and accessibility, and perceived effectiveness. The perceived benefits of PFS cited by most participants included: reducing patients' confusion around the complaints process, promoting patients' positivity towards providers and hospitals, and reducing tensions between patients and providers. Suggestion boxes (SBs) were the most frequently cited PFS, but there were widespread concerns and disagreements among participants about their accessibility and effectiveness. Despite the providers (nurses) and administrators describing SBs as widely available, they stated that they had not received feedback or complaints from patients for a very long time. In contrast, most patients stated that SBs were either unavailable or ineffective in many facilities, with concerns about non-user friendliness and lack of responsiveness as the main issues when discussing effectiveness. Conclusion: Despite the many benefits of PFS in improving healthcare service quality, their availability, user-friendliness, and responsiveness still pose challenges. A call is made to providers, health administrators and researchers to prioritize the PFS as both a useful entry point to reducing tensions in therapeutic relationships and, a tool for improving patient service uptake, continuity of care and satisfaction. [ABSTRACT FROM AUTHOR]

Background: Stakeholder engagement is essential to the design, implementation and evaluation of complex mental health interventions like peer support. Theory of Change (ToC) is commonly used in global health research to help structure and promote stakeholder engagement throughout the project cycle. Stakeholder insights are especially important in the context of a multi-site trial, in which an intervention may need to be adapted for implementation across very different settings while maintaining fidelity to a core model. This paper describes the development of a ToC for a peer support intervention to be delivered to people with severe mental health conditions in five countries as part of the UPSIDES trial. Methods: One hundred thirty-four stakeholders from diverse backgrounds participated in a total of 17 workshops carried out at six UPSIDES implementing sites across high-, middle- and low-income settings (one site each in India, Israel, Uganda and Tanzania; two sites in Germany). The initial ToC maps created by stakeholders at each site were integrated into a cross-site ToC map, which was then revised to incorporate additional insights from the academic literature and updated iteratively through multiple rounds of feedback provided by the implementers. Results: The final ToC map divides the implementation of the UPSIDES peer support intervention into three main stages: preparation, implementation, and sustainability. The map also identifies three levels of actors involved in peer support: individuals (service users and peer support workers), organisations (and their staff members), and the public. In the UPSIDES trial, the ToC map proved especially helpful in characterising and distinguishing between (a) common features of peer support, (b) shared approaches to implementation and (c) informing adaptations to peer support or implementation to account for contextual differences. Conclusions: UPSIDES is the first project to develop a multi-national ToC for a mental health peer support intervention. Stakeholder engagement in the ToC process helped to improve the cultural and contextual appropriateness of a complex intervention and ensure equivalence across sites for the purposes of a multi-site trial. It may serve as a blueprint for implementing similar interventions with a focus on recovery and social inclusion among people with mental ill-health across diverse settings. Trial registration: ISRCTN26008944 (Registration Date: 30/10/2019). [ABSTRACT FROM AUTHOR]

A laboratory-based lateral flow (LF) test that utilizes up-converting reporter particles (UCP) for ultrasensitive quantification of Schistosoma circulating anodic antigen (CAA) in urine is a well-accepted test to identify active infection. However, this UCP-LF CAA test requires sample pre-treatment steps not compatible with field applications. Flow, a new low-cost disposable, allows integration of large-volume pre-concentration of urine analytes and LF detection into a single field-deployable device. We assessed a prototype Flow-Schistosoma (Flow-S) device with an integrated UCP-LF CAA test strip, omitting all laboratory-based steps, to enable diagnosis of active Schistosoma infection in the field using urine. Flow-S is designed for large-volume (5–20 mL) urine, applying passive paper-based filtration and antibody-based CAA concentration. Samples tested for schistosome infection were collected from women of reproductive age living in a Tanzania region where S. haematobium infection is endemic. Fifteen negative and fifteen positive urine samples, selected based on CAA levels quantified in paired serum, were analyzed with the prototype Flow-S. The current Flow-S prototype, with an analytical lower detection limit of 1 pg CAA/mL, produced results correlated with the laboratory-based UCP-LF CAA test. Urine precipitates occurred in frozen banked samples and affected accurate quantification; however, this should not occur in fresh urine. Based on the findings of this study, Flow-S appears suitable to replace the urine pre-treatment required for the laboratory-based UCP-LF CAA test, thus allowing true field-based applications with fresh urine samples. The urine precipitates observed with frozen samples, though less important given the goal of testing fresh urines, warrant additional investigation to evaluate methods for mitigation. Flow-S devices permit testing of pooled urine samples with applications for population stratified testing. A field test with fresh urine samples, a further optimized Flow-S device, and larger statistical power has been scheduled. [ABSTRACT FROM AUTHOR]

Background: Tanzania is currently implementing therapeutic efficacy studies (TES) in areas of varying malaria transmission intensities as per the World Health Organization (WHO) recommendations. In TES, distinguishing reinfection from recrudescence is critical for the determination of anti-malarial efficacy. Recently, the WHO recommended genotyping polymorphic coding genes, merozoite surface proteins 1 and 2 (msp1 and msp2), and replacing the glutamate-rich protein (glurp) gene with one of the highly polymorphic microsatellites in Plasmodium falciparum to adjust the efficacy of antimalarials in TES. This study assessed the polymorphisms of six neutral microsatellite markers and their potential use in TES, which is routinely performed in Tanzania. Methods: Plasmodium falciparum samples were obtained from four TES sentinel sites, Kibaha (Pwani), Mkuzi (Tanga), Mlimba (Morogoro) and Ujiji (Kigoma), between April and September 2016. Parasite genomic DNA was extracted from dried blood spots on filter papers using commercial kits. Genotyping was done using six microsatellites (Poly-α, PfPK2, TA1, C3M69, C2M34 and M2490) by capillary method, and the data were analysed to determine the extent of their polymorphisms and genetic diversity at the four sites. Results: Overall, 83 (88.3%) of the 94 samples were successfully genotyped (with positive results for ≥ 50.0% of the markers), and > 50.0% of the samples (range = 47.6–59.1%) were polyclonal, with a mean multiplicity of infection (MOI) ranging from 1.68 to 1.88 among the four sites. There was high genetic diversity but limited variability among the four sites based on mean allelic richness (RS = 7.48, range = 7.27–8.03, for an adjusted minimum sample size of 18 per site) and mean expected heterozygosity (He = 0.83, range = 0.80–0.85). Cluster analysis of haplotypes using STRUCTURE, principal component analysis, and pairwise genetic differentiation (FST) did not reveal population structure or clustering of parasites according to geographic origin. Of the six markers, Poly-α was the most polymorphic, followed by C2M34, TA1 and C3M69, while M2490 was the least polymorphic. Conclusion: Microsatellite genotyping revealed high polyclonality and genetic diversity but no significant population structure. Poly-α, C2M34, TA1 and C3M69 were the most polymorphic markers, and Poly-α alone or with any of the other three markers could be adopted for use in TES in Tanzania. [ABSTRACT FROM AUTHOR]

Land conflicts remain the major character of informal settlements in urban areas. Goal and Objectives This paper explores the nature and characteristics of land conflicts in areas with informal settlements as experienced from regularization projects in Tanzania. Methodology The study used field observations to collect data on boundary conflicts and household interviews to collect data on border conflicts, land use conflicts, and ownership conflicts. The data was collected through a combination of primary and secondary methods. The focus discussion was conducted with members of the Mtaa Regularisation Committee for different sub-wards. Results The study discovered that the major types of land conflicts in informal settlements include boundary conflicts, land use conflicts, inheritance conflicts, accessibility conflicts, sales, and transfer of ownership. Boundary conflicts remain the main form of conflict appearing in informal settlements. Regularization of informal settlements is now seen as a tool to address the problem of informal settlement conflicts in urban areas. [ABSTRACT FROM AUTHOR]

Background: There has been a persistent increase in clients' dissatisfaction with providers' competencies in maternal and child healthcare (MCH). Existing interventions have failed to address the complexity of provider-client relationships. Therefore, targeted, contextualized innovative solutions that place providers and clients at the forefront as agents of change in optimizing intervention design and implementation are needed. The study team adopted a co-design strategy as part of Human- Centered Design (HCD) approach, where MCH nurses, clients, and stakeholders partnered to design an intervention package to improve provider-client relationships in rural Tanzania. Objective: This paper explored nurses', clients', and MCH stakeholders' perspectives following participation in a co-design stage of the HCD study to generate interventions to strengthen nurse-client relationships in Shinyanga Region. Methods: A qualitative descriptive design was used. Thirty semi-structured key informant interviews were conducted in the Swahili language with purposefully selected nurses, clients, and MCH stakeholders. The inclusion criterion was participation in consultative workshops to co-design an intervention package to strengthen nurse-client relationships. Data were transcribed and translated simultaneously, managed using NVivo, and analyzed thematically. Results: Three main themes were developed from the analysis, encompassing key learnings from engagement in the co-design process, the potential benefits of co-designing interventions, and co-designing as a tool for behavior change and personal commitment. The key learnings from participation in the co-design process included the acknowledgment that both nurses and clients contributed to tensions within their relationships. Additionally, it was recognized that the benefits of a good nurse-client relationship extend beyond nurses and clients to the health sector. Furthermore, it was learned that improving nurse-client relationships requires interventions targeting nurses, clients, and the health sector. Co-designing was considered beneficial as it offers a promising strategy for designing effective and impactful solutions for addressing many challenges facing the health sector beyond interpersonal relationships. This is because co-designing is regarded as innovative, simple, and friendly, bringing together parties and end-users impacted by the problem to generate feasible and acceptable interventions that contribute to enhanced satisfaction. Furthermore, co-designing was described as facilitating the co-learning of new skills and knowledge among participants. Additionally, co-designing was regarded as a tool for behavior change and personal commitment, influencing changes in participants' own behaviors and cementing a commitment to change their practices even before the implementation of the generated solutions. Conclusion: End-users' perspectives after engagement in the co-design process suggest it provides a novel entry point for strengthening provider-client relationships and addressing other health sector challenges. Researchers and interventionists should consider embracing co-design and the HCD approach in general to address health service delivery challenges. [ABSTRACT FROM AUTHOR]

Heavy rainfall in eastern Africa between late 2019 and mid 2020 caused devastating floods and landslides throughout the region. These rains drove the levels of Lake Victoria to a record-breaking maximum in the second half of May 2020. The combination of high lake levels, consequent shoreline flooding, and flooding of tributary rivers caused hundreds of casualties and damage to housing, agriculture, and infrastructure in the riparian countries of Uganda, Kenya, and Tanzania. Media and government reports linked the heavy precipitation and floods to anthropogenic climate change, but a formal scientific attribution study has not been carried out so far. In this study, we characterize the spatial extent and impacts of the floods in the Lake Victoria basin and then investigate to what extent human-induced climate change influenced the probability and magnitude of the record-breaking lake levels and associated flooding by applying a multi-model extreme event attribution methodology. Using remote-sensing-based flood mapping tools, we find that more than 29 000 people living within a 50 km radius of the lake shorelines were affected by floods between April and July 2020. Precipitation in the basin was the highest recorded in at least 3 decades, causing lake levels to rise by 1.21 m between late 2019 and mid 2020. The flood, defined as a 6-month rise in lake levels as extreme as that observed in the lead-up to May 2020, is estimated to be a 63-year event in the current climate. Based on observations and climate model simulations, the best estimate is that the event has become more likely by a factor of 1.8 in the current climate compared to a pre-industrial climate and that in the absence of anthropogenic climate change an event with the same return period would have led lake levels to rise by 7 cm less than observed. Nonetheless, uncertainties in the attribution statement are relatively large due to large natural variability and include the possibility of no observed attributable change in the probability of the event (probability ratio, 95 % confidence interval 0.8–15.8) or in the magnitude of lake level rise during an event with the same return period (magnitude change, 95 % confidence interval 0–14 cm). In addition to anthropogenic climate change, other possible drivers of the floods and their impacts include human land and water management, the exposure and vulnerability of settlements and economic activities located in flood-prone areas, and modes of climate variability that modulate seasonal precipitation. The attribution statement could be strengthened by using a larger number of climate model simulations, as well as by quantitatively accounting for non-meteorological drivers of the flood and potential unforced modes of climate variability. By disentangling the role of anthropogenic climate change and natural variability in the high-impact 2020 floods in the Lake Victoria basin, this paper contributes to a better understanding of changing hydrometeorological extremes in eastern Africa and the African Great Lakes region. [ABSTRACT FROM AUTHOR]

Background: Face to face mode of delivery has been a standard method of teaching courses in the majority of African Universities Tanzania included. The COVID-19 pandemic has caused the closure of all schools and universities worldwide; therefore, face-to-face teaching is no longer the only appropriate and feasible teaching method. This requires changes in the teaching method with the remarkable rise of e-learning, whereby teaching must be undertaken remotely and on digital platforms. Objective: The main objective of this study is to determine the perceived factors that hinder the adoption of online teaching in Tanzanian universities. Method: A mixed method dominated by a quantitative approach was used to answer the research questions. A total of 173 academic and ICT staff from nineteen universities in Tanzania participated in this study. Descriptive statistics (univariate analysis) and binary logistic regression were applied to analyse the frequency and compare the mean to describe the characteristics of respondents and determine the factors influencing the academic staff to have an online course. This was followed by content analysis to analyse the academic staff's proposed adaptation to online classes. Results: The findings indicated that the main hindrances to online teaching are lack of capacity; knowledge on how to conduct online courses; knowledge and technological factors; environmental factors; staff attitudes towards delivering online courses, and years spent using eLearning. The academic staff proposed improving ICT infrastructure and strengthening the capacity of academic staff to provide online courses. Conclusion: The study concludes that most academic staff are willing to adopt online teaching while suggesting improving the organisational and individual factors to enhance online education. The paper recommends that the university use freely available online teaching tools and platforms while simultaneously focusing on addressing the corporate and individual factors identified in this paper to enhance online teaching, which is mandatory in response to lockdown measures. [ABSTRACT FROM AUTHOR]

Rubella is a viral disease that can lead to severe health complications, especially in pregnant women and their unborn babies. Understanding the dynamics of the Rubella disease model is crucial for developing effective strategies to control its spread. This paper introduces a major innovation by employing a novel piecewise approach that incorporates two different kernels. This innovative approach significantly enhances the accuracy of modeling Rubella disease dynamics. In the first interval, the Caputo operator is employed to address initial conditions, while the Atangana–Baleanu derivative is utilized in the second interval to account for anomalous diffusion processes. A thorough theoretical analysis of the piecewise derivative for the problem is provided, discussing mathematical properties, stability, and convergence. To solve the proposed problem effectively, the piecewise numerical Newton polynomial technique is employed and the numerical scheme for both kernels is established. Through extensive numerical simulations with various fractional orders, the paper demonstrates the approach's effectiveness and flexibility in modeling the spread of the Rubella virus. Furthermore, to validate the findings, the simulated results are compared with real data obtained from Rubella outbreaks in Uganda and Tanzania, confirming the practical relevance and accuracy of this innovative model. [ABSTRACT FROM AUTHOR]

Background: Amref Health Africa, with support from Global Affairs Canada, examines if women's access to reproductive health services in Tanzania is affected by Gender social norms, decision-making power, roles and responsibility, and access to resources in relation to the utilization of reproductive Health Services in Tanzania. A Gender Need Assessment (GNA) was conducted in five districts in ' 'Tanzania Simiyu Region to improve the infrastructure, supply, quality, and demand for integrated Reproductive, Maternal, Newborn, and Child and Adolescent Health (RMNCAH), Nutrition, and Water, Sanitation, and Hygiene (WASH) services. The analysis identifies gender as a fundamental maternal and child health driver through existing gender inequality at the household and community levels that dictates women's status. Methods: The qualitative assessment involved data collected from gender- and age-desegregated focus group discussions (FGDs) and in-depth interviews (IDIs) of key informants in three districts; Bariadi, Busega, and Meatu, in Simiyu region, Tanzania. Participants comprised 8-10 married women and men, unmarried women and men, and adolescent boys and girls. A total of 129 participants were involved in the FGDs. Results: This paper reports the critical drivers influencing gender inequality in Simiyu by detailing how Gender inequality affected women's access to reproductive health care in relation to; gender social norms, decision-making power, access to resources at the household and community level, roles and responsibilities, including men's and 'boys' roles are more valued than the roles and responsibilities of women and girls resulted to limited free time to do things for themselves, such as visiting the health facilities for RMNCAH. Conclusions: This paper explored gender-based enablers and/or barriers influencing women and girls' realization of their sexual and reproductive health and rights. It was found that social norms, decision-making powers, and lack of access to and control over resources presented as key barriers. In contrast, continuous community sensitization and increased scope of women's participation in decision-making served as enabling environment to overcome gender inequities that influence woman's use of RMNCAH services in Tanzania. Such insights will shape interventions geared towards valuing differences in a manner that overcome gender inequities that influence woman's use of RMNCAH services in Tanzania. [ABSTRACT FROM AUTHOR]

Introduction: Schistosomiasis is a parasitic disease in Tanzania affecting over 50% of the population. Current control strategies involve mass drug administration (MDA) campaigns at the district level, which have led to problems of over- and under-treatment in different areas. WHO guidelines have called for more targeted MDA to circumvent these problems, however a scarcity of prevalence data inhibits decision makers from prioritizing sub-district areas for MDA. This study demonstrated how geostatistics can be used to inform planning for targeted MDA. Methods: Geostatistical sub-district (ward-level) prevalence estimates were generated through combining a zero-inflated poisson model and kriging approach (regression kriging). To make predictions, the model used prevalence survey data collected in 2021 of 17,400 school children in six regions of Tanzania, along with several open source ecological and socio-demographic variables with known associations with schistosomiasis. Results: The model results show that regression kriging can be used to effectively predict the ward level parasite prevalence of the two species of Schistosoma endemic to the study area. Kriging was found to further improve the regression model fit, with an adjusted R-squared value of 0.51 and 0.32 for intestinal and urogenital schistosomiasis, respectively. Targeted treatment based on model predictions would represent a shift in treatment away from 193 wards estimated to be over-treated to 149 wards that would have been omitted from the district level MDA. Conclusions: Geostatistical models can help to support NTD program efficiency and reduce disease transmission by facilitating WHO recommended targeted MDA treatment through provision of prevalence estimates where data is scarce. Author summary: In Tanzania, schistosomiasis is a vast public health problem treated through mass drug administration (MDA) campaigns that target large groups of the population. Such mass drug administration (MDA) campaigns require significant amounts of resources challenging the capacity of chronically underfunded schistosomiasis control programs to sustain annually. The way in which MDA campaigns have been conducted, by targeting whole districts believed to be endemic, have not had optimal results for reducing disease transmission, have facilitated problems of under-treating in many population groups while over-treating other non-endemic areas, and have placed a significant strain on the limited resources available. To circumvent such problems, the World Health Organization (WHO) has recommended that treatment efforts need to be more targeted to endemic communities and administrative areas within districts, and that MDA campaigns should be conducted at a sub-district level. The WHO also provides explicit guidelines for treatments of communities based on parasitological prevalence of schistosomiasis. While there is sound rationale in making this switch, most schistosomiasis endemic countries including Tanzania do not have adequate surveillance data to make such informed decisions at this level. Limited data on schistosomiasis prevalence inhibits disease control programs from making data informed decision on where to treat, as well as adhering to WHO recommendations for conducting targeted treatment at the sub-district level. Geostatistical models are spatial analysis tools that have been used in the past to help predict the likelihood of disease prevalence in nearby areas where there is limited data. They are particularly helpful in predicting diseases like schistosomiasis that have strong associations with environmental and socio-demographic elements that we do have data on widespread across much of the world. Publications on the use geostatistical models to predict schistosomiasis prevalence in different settings date back more than 20 years, but have not yet been integrated to aid the decision process of making of national programs, nor have they been specifically advocated for by the WHO. The study seeks to examine the implications of using model predictions to guide targeted, sub-district level treatment, in terms of populations requiring treatments when compared with conventional district level approaches. This publication demonstrates that use of geostatistical models for predicting schistosomiasis is possible, can be a valuable tool to inform where to treat. It furthermore estimates that the populations eligible for targeted treatment are considerably different than the populations who would be receiving treatment under conventional district level treatment approached, placing emphasis on the importance of switching to targeted treatment. The paper argues that uptake of geostatistical models can enable targeted planning below the district level, a major step to facilitate a systematic change that the WHO believes will drive down transmission of the disease, the importance of which cannot be understated in an area that is so historically burdened by the disease and its associated health complications. [ABSTRACT FROM AUTHOR]

Background: After a decade of successful control, malaria is on the rise again. The prevalence of malaria in Tanzania has increased from 7% in 2017 to 8% in 2022 and reached 18% in Kagera region in the North West of Tanzania. Malaria vectors in Muleba district Kagera have high level of pyrethroid resistance. The aim of this paper is to explore factors associated with malaria infection prevalence in children aged 6 months to 14 years in Muleba, where Long Lasting Insecticidal Net (LLIN) combining a pyrethroid insecticide and synergist piperonyl butoxide (PBO) that counteract resistance in the mosquitoes, was first distributed under trial conditions in 2015. Methods: The trial was a community randomized control in which there were two malaria prevalence cross-sectional household surveys each year (June and December) from 2015 to 2017 in Muleba. In this study we conducted a secondary data analysis of the December surveys only. Multilevel Poisson regression analysis was used to assess factors associated with malaria infection. Results: A total of 10,941 children and 4,611 households were included in this study. Overall malaria prevalence was 35.8%, 53.3% and 54.4% in the year 2015, 2016 and 2017 respectively. Living in an area with standard LLIN as opposed to the novel PBO synergist LLIN, being a male child, above 5 years of age, living in a house with open eaves, living in house without IRS, having head of household with no formal education, lower socioeconomic status and survey year were associated with increased risk of malaria infection. Conclusions: Using PBO LLIN reduced the risk of malaria infection. However, additional measures could further reduce malaria infection in areas of insecticide resistance such as housing improvement. [ABSTRACT FROM AUTHOR]

Background: Insecticide resistance is a serious threat to the continued effectiveness of insecticide-based malaria vector control measures, such as long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS). This paper describes trends and dynamics of insecticide resistance and its underlying mechanisms from annual resistance monitoring surveys on Anopheles gambiae sensu lato (s.l.) populations conducted across mainland Tanzania from 2004 to 2020. Methods: The World Health Organization (WHO) standard protocols were used to assess susceptibility of the wild female An. gambiae s.l. mosquitoes to insecticides, with mosquitoes exposed to diagnostic concentrations of permethrin, deltamethrin, lambdacyhalothrin, bendiocarb, and pirimiphos-methyl. WHO test papers at 5× and 10× the diagnostic concentrations were used to assess the intensity of resistance to pyrethroids; synergist tests using piperonyl butoxide (PBO) were carried out in sites where mosquitoes were found to be resistant to pyrethroids. To estimate insecticide resistance trends from 2004 to 2020, percentage mortalities from each site and time point were aggregated and regression analysis of mortality versus the Julian dates of bioassays was performed. Results: Percentage of sites with pyrethroid resistance increased from 0% in 2004 to more than 80% in the 2020, suggesting resistance has been spreading geographically. Results indicate a strong negative association (p = 0.0001) between pyrethroids susceptibility status and survey year. The regression model shows that by 2020 over 40% of An. gambiae mosquitoes survived exposure to pyrethroids at their respective diagnostic doses. A decreasing trend of An. gambiae susceptibility to bendiocarb was observed over time, but this was not statistically significant (p = 0.8413). Anopheles gambiae exhibited high level of susceptibility to the pirimiphos-methyl in sampled sites. Conclusions: Anopheles gambiae Tanzania's major malaria vector, is now resistant to pyrethroids across the country with resistance increasing in prevalence and intensity and has been spreading geographically. This calls for urgent action for efficient malaria vector control tools to sustain the gains obtained in malaria control. Strengthening insecticide resistance monitoring is important for its management through evidence generation for effective malaria vector control decision. [ABSTRACT FROM AUTHOR]

Organizations have to constantly monitor the changes around their internal and external environment in order to compete and maintain the business interests due to the pressure and brutal competitive conditions of technetronic age posed by globalization and Digital Revolution. Human Resources Information System (HRIS) has become an important feature of Human Resource Management (HRM) in the emerging economies including Tanzania. The system has been adopted by several organizations but evaluation of its contribution to organization performance is rarely undertaken. In this paper, we report on the usefulness associated with the Human Resources Information System (HRIS) in banking sector. This study reviews literature and provides a scholarly background to the study by including some contributions given by various researchers as well as different fields were taken into consideration with regards to online mobile adoption. 15 articles from 1996 to 2023 were extracted through systematic procedure of search, also exclusion and inclusion criteria were adopted for the study. Results were found that the HRIS has the potential to enhance the speed and quality of decision making and the realisation of the HR strategy, thereby enhancing organizational effectiveness. After reviewing the literature various benefits of using human resource information system in the banks are found such as data integration, one-time updation, Access to any number of people and accurate data. This paper also provides different suggestions for effective implementation of human resource information system to various managers, employees working in banking sector. [ABSTRACT FROM AUTHOR]

Harmful algal blooms (HABs) pose a significant threat to aquatic ecosystems and human health due to the production of toxins. The identification and quantification of these toxins are crucial for water quality management decisions. This study used DNA analysis (PCR techniques) to identify toxin-producing strains and liquid-chromatography-tandem mass spectrometry (LC-MS/MS) to quantify microcystins in samples from Mindu and Nyumba ya Mungu Dams in Tanzania. The results showed that HABs were detected in both dams. The BLAST results revealed that the 16S gene sequences of uncultured samples were very similar to an Antarctic cyanobacterium, Leptolyngbya sp, Anabaena sp, and Microcystis aeruginosa. Sequences of the cultured samples were most similar to Nodularia spumigena, Amazoninema brasiliense, Anabaena sp, and Microcystis aeruginosa. Further analyses showed that the nucleotide sequence similarity of uncultured isolates from this study and those from the GenBank ranged from 85 to 100%. For cultured isolates from this study and others from the GenBank, nucleotide identity ranged from 81 to 100%. The molecular identification of Microcystis aeruginosa confirmed the presence of HABs in both Mindu and Nyumba ya Mungu Dams in Tanzania. At Mindu Dam, the mean concentrations (± standard deviation) of microcystin-LR, -RR, and -YR were 1.08 ± 0.749 ppm, 0.120 ± 0.0211 ppm, and 1.37 ± 0.862 ppm, respectively. Similarly, at Nyumba ya Mungu Dam, the concentrations of microcystin-LR, -RR, and -YR were 1.07 ± 0.499 ppm, 0.124 ± 0.0224 ppm, and 0.961 ± 0.408 ppm, respectively. This paper represents the first application of PCR and LC-MS/MS to study microcystins in small freshwater reservoirs in Tanzania. This study confirms the presence of toxin-producing strains of Microcystis aeruginosa in both dams and also provides evidence of the occurrence of microcystins from these strains. These findings contribute in improving the monitoring of HABs contamination and their potential impact on water quality in Tanzanian reservoirs. [ABSTRACT FROM AUTHOR]

Heavy rainfall in East Africa between late 2019 and mid 2020 caused devastating floods and landslides throughout the region. These rains drove the levels of Lake Victoria to a record-breaking maximum in the second half of May 2020. The combination of high lake levels, consequent shoreline flooding, and flooding of tributary rivers caused hundreds of casualties and damage to housing, agriculture and infrastructure in the riparian countries of Uganda, Kenya and Tanzania. Media and government reports linked the heavy precipitation and floods to anthropogenic climate change, but a formal scientific attribution study has not been carried out so far. In this study, we characterise the spatial extent and impacts of the floods in the Lake Victoria basin, and then investigate to what extent human-induced climate change influenced the probability and magnitude of the record-breaking lake levels and associated flooding, by applying a multi-model extreme event attribution methodology. Using remote sensing-based flood mapping tools, we find that more than 29 thousand people living within a 50 km radius of the lake shorelines were affected by floods between April and July 2020. Precipitation in the basin was the highest recorded in at least three decades, causing lake levels to rise by 1.21 m between late 2019 and mid 2020. The flood, defined as a 6-month rise in lake levels as extreme as that observed in the lead-up to May 2020, is estimated to be a 63-year event in the current climate. Based on observations and climate model simulations, the best estimate is that the event has become more likely by a factor of 1.8 in the current climate compared to a pre-industrial climate, and that in the absence of anthropogenic climate change an event with the same return period would have led lake levels to rise by 7 cm less than observed. Nonetheless, uncertainties in the attribution statement are relatively large due to large natural variability, and include the possibility of no observed attributable change in the probability of the event (probability ratio, 95% confidence interval 0.8 - 15.8) or in the magnitude of lake level rise during an event with the same return period (magnitude change, 95% confidence interval 0 - 14 cm). In addition to anthropogenic climate change, other possible drivers of the floods and their impacts include human land and water management, the exposure and vulnerability of settlements and economic activities located in flood-prone areas, and modes of climate variability that modulate seasonal precipitation. The attribution statement could be strengthened by using a larger number of climate model simulations, as well as by quantitatively accounting for non-meteorological drivers of the flood and potential unforced modes of climate variability. By disentangling the role of anthropogenic climate change and natural variability in the high-impact 2020 floods in the Lake Victoria basin, this paper contributes to a better understanding of changing hydrometeorological extremes in East Africa and the African Great Lakes region. [ABSTRACT FROM AUTHOR]

Background: Because of critical shortage of physician anaesthesiologists, the government of Tanzania adopted a task shifting strategy for provision of anaesthesia services. This paper describes the results of an operational study designed to increase the number of anaesthesia providers for emergency obstetric surgeries in order to reduce maternal and perinatal mortality in underserved rural Tanzania. Methods: In 2016 a before-after cohort study was conducted in seven health centres in rural Tanzania. Five health centres received an intervention and two were selected to track secular trends (control group). Ten associate clinicians, i.e. assistant medical officers, clinical officers, and nurse midwives, from five health centres were trained in anaesthesia skills for emergency obstetric surgeries for three months followed by quarterly supportive supervision, mentoring and teleconsultation to reinforce skills. Primary and secondary outcome measures included Caesarean delivery (CD) rate, quality and safety of anaesthesia, and uptake of the educational program for anaesthesia. Results: Out of the 2,179 CDs performed in the intervention facilities from 2016 to 2019, two women died from complications of anaesthesia. The risk of death from anaesthetic complications was 0.9 per 1000 CD (95% CI 0.1–3.3. The risk of death was not established in the control group because of inadequate documentation and records keeping. The proportion of CD performed under spinal anaesthesia in intervention facilities doubled from 28% (60/214 with 95% CI 22–35) at baseline (July 2014 – June 2016) to 57% (558/971 with 95% CI of 54–61) in year three (July 2018 - June 2019), while in the control group increased by only 40% from 19% (92/475 with 95% CI of 16–23) at baseline and 27% (68/251 with 95% CI of 22–33) in year three. In 2020I, this educational training program was then adopted by the government with minor content changes and increasing duration of training to six months. Conclusions: This three month educational training program for associate clinicians in anaesthesia, complemented by supportive supervision, can increase the CD rate to one that fills the "unmet need" and the proportion of operations performed under spinal anaesthesia, the gold standard technique for CD. The program can be used to meet the urgent demand for anaesthesia services in other underserved areas in Africa. [ABSTRACT FROM AUTHOR]

Context and background: With the advent of rising global initiatives to address climate change and sustainability, interest in addressing theoretical and practical alignment of how professional valuers consider environmental attributes has become the focus of much attention. Yet the overlap between consideration and non-consideration of environmental factors might significantly impact the value. Goal and objectives: This paper evaluates the perceptions of professional valuers on the consideration of environmental features during their valuation. Methodology: Data to inform the study was collected through questionnaires distributed to 89 randomly selected valuers registered with the VRB. The collected data were analyzed by using SPSS, and Cronbach's alpha was used to determine the reliability of the questionnaire survey. The relative importance index was used to rank the importance of environmental factors, whereas the Chi-square test was used to examine existing practices in terms of prominent tools and methodologies used to incorporate environmental attributes into their valuation assignments. Results: The study reveals that, in Tanzania, there is a growing consciousness of the need to consider environmental attributes in practice though indicated that there is a challenge with how they consider these attributes using prominent valuation techniques in place. The study suggests that valuers and other stakeholders are eager to learn how to consider and integrate environmental features and contemporary valuation techniques to provide up-to-date estimates to support informed decision. The study recommends introducing Environmental, Social, and Governance (ESG) factors in terms of their theoretical foundation and practical implication on property valuation studies. [ABSTRACT FROM AUTHOR]

The role of civil society in economic development, improving livelihoods and in providing pathways towards achieving health for all has become increasingly evident. By mapping these organizations, the scope and scale as well as existing capacities, gaps, and opportunities are brought to light. This paper describes the implementation of a digital mapping platform for NGOs; an interactive site which collects, analyses, and visualizes data from a variety of sources about NGOs in Tanzania, through a series of interactive maps, graphs, and charts. We describe the approach and the technology used to develop the platform and its potential contribution towards improving health outcomes. A situation analysis and needs assessment exercise was conducted in February 2023. The developed system requirement specification document served as the guiding document in the design and development of new modules. Participatory techniques and agile iterative methodologies comprising regular stakeholder engagement were employed. A distributed revision control system was used to keep track of system revisions. The modules were deployed to the production server at the National Internet Data Center (NIDC) server room, followed by a system commissioning activity in October 2023. The NGO Information System, NGO Digital Mapping tool, NGO Analytic tool, NGO Search tool and NGO Opportunities module were designed, developed, and commissioned to support NGO operations in Tanzania. The platform was launched during the annual NGO Forum in Dodoma, Tanzania, on October 5, 2023. The modules are publicly accessible and are housed within the NGO Information System (NIS) platform. Investment in whole-of-society engagement to build health systems resilience for universal health coverage is crucial. Leveraging the unique positioning of NGOs draws us a step closer to the ambitious goal of achieving health for all. Through this one-stop web application system, information on the near realtime status, existing gaps, and opportunities for collaboration to serve communities is readily available for all stakeholders. Wide dissemination and enhancement of utilization of the platform across all sectors is now needed, for data to truly inform action. [ABSTRACT FROM AUTHOR]

Background: Adolescent pregnancy remains a major global health issue, increasing the risk of complications during pregnancy and childbirth in mothers and babies. In Tanzania, adolescent pregnancy threatens girls' education and makes it difficult for them to obtain a proper job; hence, the majority fall into poverty. Previous studies have developed and conducted reproductive health education for adolescent students; however, they evaluated only the effect immediately after education. Therefore, this study investigated the effects of reproductive health education on attitudes and behaviors toward reproductive health among adolescent girls and boys one year after the intervention in rural Tanzania. Methods: A longitudinal quasi-experimental study was conducted with 3295 primary and secondary students (2123 in the intervention group, 1172 in the control group) from three purposefully selected wards in Korogwe District. In the intervention group, the students received reproductive health education. We used paper-based questionnaires to evaluate the effect of the adolescent education program on attitudes and behaviors toward reproductive health education. To analyze the association between the intervention and each outcome, mixed-effect multiple regression analyses was conducted. Results: The mean age, primary school proportion, and female proportion of the intervention and the control group was 13.05 (standard deviation (SD) 1.59), 14.14 (SD 1.7), 77.9% and 34.3%, and 54.2% and 52.6%, respectively. There was no statistically significant effect of reproductive health education on adolescent health attitudes and behaviors in the multiple regression analyses (coefficient: − 0.24 (95% confidence interval (CI): − 0.98 to 0.50), coefficient: 0.01 (95%CI: − 0.42 to 0.43)). Conclusion: A statistically significant effect of reproductive health education on adolescent health attitudes and behaviors was not found. An effective reproductive health education intervention to improve the attitude and behaviors of reproductive health among Tanzania adolescents in the long term remain to be determined, particularly in real-world settings. Trial registration The National Institute for Medical Research, Tanzania (NIMR/HQ/R.8a/Vol. IX988). Plain Language Summary: Adolescent pregnancy increases the risk of complications during pregnancy and childbirth, which could cause death among 15–19-year-old girls. In Tanzania, one in four adolescents aged 15–19 began childbearing. However, there is no officially recognized curriculum for reproductive health in schools. Additionally, cultural and traditional norms prevent parents from discussing sexuality with their children. A solution to this issue is for a third party, such as a non-profit organization, to provide adolescents with adequate reproductive health education in schools. Previous studies have developed and evaluated a reproductive health education program and found significant effects on improved knowledge and behavior among adolescent girls and boys immediately after the intervention. This study examined the effects of reproductive health education on adolescents' attitudes and behavior toward reproductive health one year after the intervention in rural Tanzania. We could not find a statistically significant effect of reproductive health education on adolescents' attitudes and behavior during a one-year period in the multiple regression analyses. These results could have been influenced by the location of the intervention, contents, period of evaluation, and other potentially unknown factors. [ABSTRACT FROM AUTHOR]

Background: Over 150 million people, mostly from low and middle-income countries (LMICs) suffer from catastrophic health expenditure (CHE) every year because of high out-of-pocket (OOP) payments. In Tanzania, OOP payments account for about a quarter of the total health expenditure. This paper compares healthcare utilization and the incidence of CHE among improved Community Health Fund (iCHF) members and non-members in central Tanzania. Methods: A survey was conducted in 722 households in Bahi and Chamwino districts in Dodoma region. CHE was defined as a household health expenditure exceeding 40% of total non-food expenditure (capacity to pay). Concentration index (CI) and logistic regression were used to assess the socioeconomic inequalities in the distribution of healthcare utilization and the association between CHE and iCHF enrollment status, respectively. Results: 50% of the members and 29% of the non-members utilized outpatient care in the previous month, while 19% (members) and 15% (non-members) utilized inpatient care in the previous twelve months. The degree of inequality for utilization of inpatient care was higher (insured, CI = 0.38; noninsured CI = 0.29) than for outpatient care (insured, CI = 0.09; noninsured CI = 0.16). Overall, 15% of the households experienced CHE, however, when disaggregated by enrollment status, the incidence of CHE was 13% and 15% among members and non-members, respectively. The odds of iCHF-members incurring CHE were 0.4 times less compared to non-members (OR = 0.41, 95%CI: 0.27–0.63). The key determinants of CHE were iCHF enrollment status, health status, socioeconomic status, chronic illness, and the utilization of inpatient and outpatient care. Conclusion: The utilization of healthcare services was higher while the incidence of CHE was lower among households enrolled in the iCHF insurance scheme relative to those not enrolled. More studies are needed to establish the reasons for the relatively high incidence of CHE among iCHF members and the low degree of healthcare utilization among households with low socioeconomic status. [ABSTRACT FROM AUTHOR]

Land inequality stalls economic development, entrenches poverty, and is associated with environmental degradation. Yet, rigorous assessments of land-use interventions attend to inequality only rarely. A land inequality lens is especially important to understand how recent large-scale land acquisitions (LSLAs) affect smallholder and indigenous communities across as much as 100 million hectares around the world. This paper studies inequalities in land assets, specifically landholdings and farm size, to derive insights into the distributional outcomes of LSLAs. Using a household survey covering four pairs of land acquisition and control sites in Tanzania, we use a quasi-experimental design to characterize changes in land inequality and subsequent impacts on well-being. We find convincing evidence that LSLAs in Tanzania lead to both reduced landholdings and greater farmland inequality among smallholders. Households in proximity to LSLAs are associated with 21.1% (P = 0.02) smaller landholdings while evidence, although insignificant, is suggestive that farm sizes are also declining. Aggregate estimates, however, hide that households in the bottom quartiles of farm size suffer the brunt of landlessness and land loss induced by LSLAs that combine to generate greater farmland inequality. Additional analyses find that land inequality is not offset by improvements in other livelihood dimensions, rather farm size decreases among households near LSLAs are associated with no income improvements, lower wealth, increased poverty, and higher food insecurity. The results demonstrate that without explicit consideration of distributional outcomes, land-use policies can systematically reinforce existing inequalities. [ABSTRACT FROM AUTHOR]

This scientific paper examines the role of Integrated Coastal Management (ICM) approach in the protection of coastal and marine resources in Tanzania. It engages coastal resource users and practitioners in focus group discussions and interviews, and complements the data obtained with documented sources. A modified version of the Benefit Analysis Framework is adopted from Wenger et al. (2011) to analyze the extent to which ICM yields a wide range of benefits that may potentially promote the protection of coastal ecosystem and enhance the commitment of communities that live adjacent to the coastal strip to manage mangroves, fisheries, coral reefs, and coastal land in a sustainable manner. [ABSTRACT FROM AUTHOR]

Background: The standard face-to-face training for the integrated management of childhood illness (IMCI) continues to be plagued by concerns of low coverage of trainees, the prolonged absence of trainees from the health facility to attend training and the high cost of training. Consequently, the distance learning IMCI training model is increasingly being promoted to address some of these challenges in resource-limited settings. This paper examines participants' accounts of the paper-based IMCI distance learning training programme in three district councils in Mbeya region, Tanzania. Methods: A cross-sectional qualitative descriptive design was employed as part of an endline evaluation study of the management of possible serious bacterial infection in Busokelo, Kyela and Mbarali district councils of Mbeya Region in Tanzania. Key informant interviews were conducted with purposefully selected policymakers, partners, programme managers and healthcare workers, including beneficiaries and training facilitators. Results: About 60 key informant interviews were conducted, of which 53% of participants were healthcare workers, including nurses, clinicians and pharmacists, and 22% were healthcare administrators, including district medical officers, reproductive and child health coordinators and programme officers. The findings indicate that the distance learning IMCI training model (DIMCI) was designed to address concerns about the standard IMCI model by enhancing efficiency, increasing outputs and reducing training costs. DIMCI included a mix of brief face-to-face orientation sessions, several weeks of self-directed learning, group discussions and brief face-to-face review sessions with facilitators. The DIMCI course covered topics related to management of sick newborns, referral decisions and reporting with nurses and clinicians as the main beneficiaries of the training. The problems with DIMCI included technological challenges related to limited access to proper learning technology (e.g., computers) and unfriendly learning materials. Personal challenges included work-study-family demands, and design and coordination challenges, including low financial incentives, which contributed to participants defaulting, and limited mentorship and follow-up due to limited funding and transport. Conclusion: DIMCI was implemented successfully in rural Tanzania. It facilitated the training of many healthcare workers at low cost and resulted in improved knowledge, competence and confidence among healthcare workers in managing sick newborns. However, technological, personal, and design and coordination challenges continue to face learners in rural areas; these will need to be addressed to maximize the success of DIMCI. [ABSTRACT FROM AUTHOR]

Globally, there have been calls for an integrated zoonotic disease surveillance system. This study aimed to assess human and animal health surveillance systems to identify opportunities for One Health surveillance platform in Tanzania. A desk review of policies, acts and strategies addressing disease surveillance that support inter-sectoral collaboration was conducted. A semi-structured questionnaire was administered to key informants from the two sectors. Databases with potential relevance for surveillance were assessed. One Health-focused policies, acts, strategic plans and guidelines emphasising inter-sectoral collaboration strengthening were in place. Stable systems for collecting surveillance data with trained staff to implement surveillance activities at all levels in both sectors were available. While the human surveillance system was a mix of paper-based and web-based, the animal health system was mainly paper-based. The laboratory information system existed in both sectors, though not integrated with the epidemiological surveillance systems. Both the animal and human surveillance systems had low sensitivity to alert outbreaks. The findings indicate that individual, organisational, and infrastructure opportunities that support the integration of surveillance systems from multiple sectors exist. Challenges related to data sharing and quality need to be addressed for the effective implementation of the platform. [ABSTRACT FROM AUTHOR]

The existing literature on urban governance regards street vendors as passive victims of evictions and re-allocations threats, focusing largely on their inability to cope. Using the case study of the urban street vendors in Dar es Salaam, Tanzania, this paper suggests that urban street vendors are not just passive victims of evictions and re-allocations but also utilize various capabilities to cope with this threat. The paper examines evictions and re-allocations threat among urban street vendors in Dar es Salaam Tanzania, to determine the vendors' capability to cope with the threat and recommend factors for supporting the vendors to cope more competently. Based on the multilayered social resilience framework, a qualitative approach was utilized and drew data on a sample of 50 respondents through in-depth interviews, focus group discussions (FGDs), observations, and a review of secondary data. Findings indicated that on the one hand, the vendors managed to develop reactive and less proactive capacities of coping with the evictions and re-allocations threat mainly based on the individual, household, community level, and to a lesser degree, national and international levels. On the other hand, vendors' coping capacities were impeded by their lack of financial ability, less supportive government structures and politics, lack of union among the vendors, and business skills. These factors should be considered in supporting the vendors to more competently cope with the threat. These findings provide insights on alternative ways of understanding and alleviating the negative consequences of evictions and re-allocations of the urban street vendors in Dar es Salaam and other cities in Tanzania. [ABSTRACT FROM AUTHOR]

Background: Same-sex attracted men in Tanzania and globally carry a disproportionate burden of HIV. Drawing on qualitative research, this article explores healthcare providers' ideas and recommendations regarding how to improve HIV prevention among same-sex attracted men. Methods: We carried out a qualitative study among healthcare workers in the cities of Dar es Salaam and Tanga in Tanzania between August 2018 and October 2019. Data were collected using qualitative methods of data collection, specifically in-depth interviews, focus group discussions, and participant observation. Study participants were recruited through a purposive sampling strategy that aimed to ensure variation in age, education, and work experience. Forty-eight interviews with 24 healthcare workers, six focus group discussions, and participant observation were conducted. A total of 64 persons participated in the study. Results: This paper describes five different "ways of reasoning" that were identified among healthcare workers regarding how to strengthen HIV prevention among same-sex attracted men. One held that punitive measures should be taken to prevent HIV transmission, another that health services needed to become more friendly towards men who have sex with men, a third that healthcare workers should reach out to provide more education to this population, a fourth called for strengthened collaboration between healthcare providers and same-sex attracted men in healthcare delivery, and the fifth proposed that activistic efforts be taken to remove structural barriers for same-sex attracted men to access healthcare. Conclusion: When reflecting on what is needed to strengthen HIV prevention among men who have sex with men, healthcare workers described six different ideas. One was that restrictive and punitive measures ought to be taken to prevent HIV transmission through same-sex sex. The remaining five promoted understanding of and support for same-sex attracted men. They prescribed more healthcare education, measures to improve attitudes among healthcare workers, healthcare delivery with user involvement, and political action to achieve law reform. Finally, some study participants raised concerns about the implementation of the national comprehensive package for key populations. [ABSTRACT FROM AUTHOR]

Background: Same-sex attracted men in Tanzania and globally carry a disproportionate burden of HIV. Drawing on qualitative research, this article explores healthcare providers' ideas and recommendations regarding how to improve HIV prevention among same-sex attracted men. Methods: We carried out a qualitative study among healthcare workers in the cities of Dar es Salaam and Tanga in Tanzania between August 2018 and October 2019. Data were collected using qualitative methods of data collection, specifically in-depth interviews, focus group discussions, and participant observation. Study participants were recruited through a purposive sampling strategy that aimed to ensure variation in age, education, and work experience. Forty-eight interviews with 24 healthcare workers, six focus group discussions, and participant observation were conducted. A total of 64 persons participated in the study. Results: This paper describes five different "ways of reasoning" that were identified among healthcare workers regarding how to strengthen HIV prevention among same-sex attracted men. One held that punitive measures should be taken to prevent HIV transmission, another that health services needed to become more friendly towards men who have sex with men, a third that healthcare workers should reach out to provide more education to this population, a fourth called for strengthened collaboration between healthcare providers and same-sex attracted men in healthcare delivery, and the fifth proposed that activistic efforts be taken to remove structural barriers for same-sex attracted men to access healthcare. Conclusion: When reflecting on what is needed to strengthen HIV prevention among men who have sex with men, healthcare workers described six different ideas. One was that restrictive and punitive measures ought to be taken to prevent HIV transmission through same-sex sex. The remaining five promoted understanding of and support for same-sex attracted men. They prescribed more healthcare education, measures to improve attitudes among healthcare workers, healthcare delivery with user involvement, and political action to achieve law reform. Finally, some study participants raised concerns about the implementation of the national comprehensive package for key populations. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Rare cancer originating from parathyroid parenchymal cells. Preoperative diagnosis is often difficult. Presents with normal serum levels of calcium and parathyroid hormone. Treated by en bloc resection. Benefits of adjuvant therapy are unclear. Parathyroid carcinoma is an uncommon endocrine tumor. Its typical presentation is that of primary hyperparathyroidism with elevated serum calcium and parathormone levels. Nonfunctioning carcinoma of the parathyroid gland with normal serum calcium levels is extremely rare. This paper describes a case of nonfunctioning parathyroid carcinoma and brief literature review thereof. [ABSTRACT FROM AUTHOR]

Background : A key factor driving the development and maintenance of antibacterial resistance (ABR) is individuals' use of antibiotics (ABs) to treat illness. To better understand motivations and context for antibiotic use we use the concept of a patient treatment-seeking pathway: a treatment journey encompassing where patients go when they are unwell, what motivates their choices, and how they obtain antibiotics. This paper investigates patterns and determinants of patient treatment-seeking pathways, and how they intersect with AB use in East Africa, a region where ABR-attributable deaths are exceptionally high. Methods: The Holistic Approach to Unravelling Antibacterial Resistance (HATUA) Consortium collected quantitative data from 6,827 adult outpatients presenting with urinary tract infection (UTI) symptoms in Kenya, Tanzania, and Uganda between February 2019- September 2020, and conducted qualitative in-depth patient interviews with a subset (n = 116). We described patterns of treatment-seeking visually using Sankey plots and explored explanations and motivations using mixed-methods. Using Bayesian hierarchical regression modelling, we investigated the associations between socio-demographic, economic, healthcare, and attitudinal factors and three factors related to ABR: self-treatment as a first step, having a multi-step treatment pathway, and consuming ABs. Results: Although most patients (86%) sought help from medical facilities in the first instance, many (56%) described multi-step, repetitive treatment-seeking pathways, which further increased the likelihood of consuming ABs. Higher socio-economic status patients were more likely to consume ABs and have multi-step pathways. Reasons for choosing providers (e.g., cost, location, time) were conditioned by wider structural factors such as hybrid healthcare systems and AB availability. Conclusion: There is likely to be a reinforcing cycle between complex, repetitive treatment pathways, AB consumption and ABR. A focus on individual antibiotic use as the key intervention point in this cycle ignores the contextual challenges patients face when treatment seeking, which include inadequate access to diagnostics, perceived inefficient public healthcare and ease of purchasing antibiotics without prescription. Pluralistic healthcare landscapes may promote more complex treatment seeking and therefore inappropriate AB use. We recommend further attention to healthcare system factors, focussing on medical facilities (e.g., accessible diagnostics, patient-doctor interactions, information flows), and community AB access points (e.g., drug sellers). [ABSTRACT FROM AUTHOR]

We carry out a time series analysis on the yearly crop yield data in six east African countries (Burundi, Kenya, Somalia, Tanzania, Uganda and Rwanda) using the autoregressive integrated moving average (ARIMA) model. We describe the upper tail of the yearly crop yield data in those countries using the power law, lognormal, Fréchet and stretched exponential distributions. The forecast of the fitted ARIMA models suggests that the majority of the crops in different countries will experience neither an increase nor a decrease in yield from 2019 to 2028. A few exceptional cases correspond to significant increase in the yield of sorghum and coffee in Burundi and Rwanda, respectively, and significant decrease in the yield of beans in Burundi, Kenya and Rwanda. Based on Vuong's similarity test p–value, we find that the power law distribution captured the upper tails of yield distribution better than other distributions with just one exceptional case in Uganda, suggesting that these crops have the tendency for producing high yield. We find that only sugar cane in Somalia and sweet potato in Tanzania have the potential of producing extremely high yield. We describe the yield behaviour of these two crops as black swan, where the "rich getting richer" or the "preferential attachment" could be the underlying generating process. Other crops in Burundi, Kenya, Somalia, Tanzania, Uganda and Rwanda can only produce high but not extremely high yields. Various climate adaptation/smart strategies (use of short-duration pigeon pea varieties, use of cassava mosaic disease resistant cassava varieties, use of improved maize varieties, intensive manuring with a combination of green and poultry manure, early planting, etc) that could be adapted to increase yields in east Africa are suggested. The paper could be useful for future agricultural planning and rates calibration in crop risk insurance. [ABSTRACT FROM AUTHOR]

This paper is primarily based on collections in Tanzania and Ghana in 1990-1991 and 1991-1994, respectively. In all, 46 species of Chimarra were collected, 31 of them new species. All these species are illustrated or re-illustrated and described in the paper. Additionally, five species from Africa from collections in Illinois and Minnesota, four of them new, are included. This provided the incentive to review the species of Chimarra from the African subregion and assign the majority of them to species groups and subgroups. In the process, several species were synonymized. In all 147 valid species are recognized, of which 51 are treated in this paper. Two major species groups are recognized for Africa, the marginata Group and the georgensis Group. The former is based on the type species for the genus; this is the first formal characterization of this group, as distinct from other species groups in the subgenus. Mainland African species in the marginata Group mostly fall into four large species-diverse subgroups, but a number of smaller subgroups are also recognized. Membership in these subgroups is specified for the majority of African species and characters defining the subgroups informally discussed. The georgensis Group includes a single Asian species and nine previously described African species. They are assigned to two subgroups, one newly recognized in this paper. Several additional species were considered unassigned to subgroup within the georgensis Group. The majority of the new species described in this paper belong to the georgensis Group. [ABSTRACT FROM AUTHOR]

Over the last two decades, scholars and organizations across the world have carried out research projects and promoted dissemination tools aimed at promoting food and food-related elements embedded in local and traditional foodways. In this regard, the documentation of food and biocultural heritage has been seen as the starting point of processes directed toward their safeguarding and promotion. Drawing from this premise, the paper presents an original methodological approach, designed within the framework of the Ark of Taste project, to map, inventory, and document food and food-related resources to produce a comprehensive dissemination tool for the promotion of local food and biocultural heritage. To this end, the paper discusses the case study of the Atlas of the Ark of Taste in Tanzania, looking at the approach used, and the challenges faced, in undertaking field and desk activities aimed at inventorying Tanzanian food products and in the creating of the gastronomic atlas of this country. Drawing from this experience, the paper highlights the potentially crucial role that food and gastronomic inventories may have in achieving UN Sustainable Development Goals from a grassroots perspective. Acknowledging the limitations and possible unintended effects of these initiatives on the protection of food and biocultural resources, the authors recognize the promising role that these tools could have in fostering the achievement of environmental (SDGs 13, 14, 15) and social sustainability (SDGs 1, 2, 3, 10) objectives. [ABSTRACT FROM AUTHOR]

Reliable and accurate flood prediction in poorly gauged basins is challenging due to data scarcity, especially in developing countries where many rivers remain insufficiently monitored. This hinders the design and development of advanced flood prediction models and early warning systems. This paper introduces a multi-modal, sensor-based, near-real-time river monitoring system that produces a multi-feature data set for the Kikuletwa River in Northern Tanzania, an area frequently affected by floods. The system improves upon existing literature by collecting six parameters relevant to weather and river flood detection: current hour rainfall (mm), previous hour rainfall (mm/h), previous day rainfall (mm/day), river level (cm), wind speed (km/h), and wind direction. These data complement the existing local weather station functionalities and can be used for river monitoring and extreme weather prediction. Tanzanian river basins currently lack reliable mechanisms for accurately establishing river thresholds for anomaly detection, which is essential for flood prediction models. The proposed monitoring system addresses this issue by gathering information about river depth levels and weather conditions at multiple locations. This broadens the ground truth of river characteristics, ultimately improving the accuracy of flood predictions. We provide details on the monitoring system used to gather the data, as well as report on the methodology and the nature of the data. The discussion then focuses on the relevance of the data set in the context of flood prediction, the most suitable AI/ML-based forecasting approaches, and highlights potential applications beyond flood warning systems. [ABSTRACT FROM AUTHOR]

The focus of this study is the implications of structural transformation for gender equality, specifically equal pay, in Sub-Saharan Africa. While structural transformation affects key development outcomes, including growth, poverty, and access to decent work, its effect on the gender pay gap is not clear ex-ante. Evidence on the gender pay gap in sub-Saharan Africa is limited, and often excludes rural areas and informal (self-)employment. This paper provides evidence on the extent and drivers of the gender pay gap in non-farm wage- and self-employment activities across three countries at different stages of structural transformation (Malawi, Tanzania and Nigeria). The analysis leverages nationally-representative survey data and decomposition methods, and is conducted separately among individuals residing in rural versus urban areas in each country. The results show that women earn 40 to 46 percent less than men in urban areas, which is substantially less than in high-income countries. The gender pay gap in rural areas ranges from (a statistically insignificant) 12 percent in Tanzania to 77 percent in Nigeria. In all rural areas, a major share of the gender pay gap (81 percent in Malawi, 83 percent in Tanzania and 70 percent in Nigeria) is explained by differences in workers' characteristics, including education, occupation and sector. This suggests that if rural men and women had similar characteristics, most of the gender pay gap would disappear. Country-differences are larger across urban areas, where differences in characteristics account for only 32 percent of the pay gap in Tanzania, 50 percent in Malawi and 81 percent in Nigeria. Our detailed decomposition results suggest that structural transformation does not consistently help bridge the gender pay gap. Gender-sensitive policies are required to ensure equal pay for men and women. [ABSTRACT FROM AUTHOR]

In Morogoro Region of south-central Tanzania, loss of crops and safety concerns due to elephants compromises livelihoods in many rural communities relying on subsistence agriculture. Using a social-ecological system framework to examine conflict-coexistence between people and elephants, this paper explores drivers that influence human-elephant interaction and subsistence farmer attitudes towards elephants in 10 villages from three different districts. Surveys and interviews document experiences interacting with elephants along with direct and indirect costs incurred in sharing the landscape, revealing different tolerance levels by residents of subject communities towards elephants that have important implications for elephant conservation. Rather than uniformly negative beliefs about elephants, analyses reveal that over the past decade a shift has occurred from largely favorable to unfavorable. The variables influencing attitudes included amounts of crops lost to elephants, perceived benefits from elephants, amounts of crops lost to other causes, perceived trend of human-elephant conflict (HEC) in the past three decades and level of education. Villager tolerance varied by level of income, perception on how the community coexists with elephants, amounts of crops lost to elephants and compensation. The study contributes to understanding how HEC is affecting the relationship between people and elephants, revealing a shift in the conflict-coexistence continuum from positive to broadly negative and identifying characteristics underlying varying tolerance towards elephants in different communities. Rather than a static condition, HEC emerges under specific conditions at particular times and places through varying, uneven interactions between rural villagers and elephants. In communities vulnerable to food insecurity, such conflict exacerbates existing problems of poverty, social inequality, and feelings of oppression. Addressing the causes of HEC, when possible, will be essential to elephant conservation as well as to improving the wellbeing of rural villagers. [ABSTRACT FROM AUTHOR]

Sickle cell disease (SCD) is a common genetic disorder in Africa. Some ongoing work in SCD research includes the analysis and comparisons of variation in phenotypic presentations and disease outcomes with the genotypic signatures. This has contributed to the observed growth of molecular and genetic data in SCD. However, while the "omics" data continues to pile, the capacity to interpret and turn the genetic findings into clinical practice is still underdeveloped, especially in the developing region. Building bioinformatics infrastructure and capacity in the region is key to bridging the gap. This paper seeks to illustrate how the Sickle Cell Programme (SCP) at the Muhimbili University of Health and Allied Sciences (MUHAS) in Tanzania, modeled the integration of infrastructure for bioinformatics and clinical research while running day-to-day clinical care for SCD in Tanzania. [ABSTRACT FROM AUTHOR]

Essential Emergency and Critical Care (EECC) is a novel approach to the care of critically ill patients, focusing on first-tier, effective, low-cost, life-saving care and designed to be feasible even in low-resourced and low-staffed settings. This is distinct from advanced critical care, usually conducted in ICUs with specialised staff, facilities and technologies. This paper estimates the incremental cost of EECC and advanced critical care for the planning of care for critically ill patients in Tanzania and Kenya. The incremental costing took a health systems perspective. A normative approach based on the ingredients defined through the recently published global consensus on EECC was used. The setting was a district hospital in which the patient is provided with the definitive care typically provided at that level for their condition. Quantification of resource use was based on COVID-19 as a tracer condition using clinical expertise. Local prices were used where available, and all costs were converted to USD2020. The costs per patient day of EECC is estimated to be 1 USD, 11 USD and 33 USD in Tanzania and 2 USD, 14 USD and 37 USD in Kenya, for moderate, severe and critical COVID-19 patients respectively. The cost per patient day of advanced critical care is estimated to be 13 USD and 294 USD in Tanzania and USD 17 USD and 345 USD in Kenya for severe and critical COVID-19 patients, respectively. EECC is a novel approach for providing the essential care to all critically ill patients. The low costs and lower tech approach inherent in delivering EECC mean that EECC could be provided to many and suggests that prioritizing EECC over ACC may be a rational approach when resources are limited. [ABSTRACT FROM AUTHOR]

Mainstreaming land use planning for tenure security in rural areas is a key issue to both scholars, academia and policymakers as well as governments in most developing countries. Land use planning as the land management interventions aims to allocate land to individuals and groups for improved tenure security. Goal and Objectives This paper focuses on examining the challenges and opportunities for land use planning on tenure security in rural Tanzania, taking a case study of three villages in Kilombero district, south-western of Tanzania. In particular, the study proposes the model for implementing land use planning in the future. Methodology Both secondary and primary data were gathered to explore the challenges and opportunities of the land use planning project in the case study areas. The secondary data refers to documents review1 sources of data. However, documents review whether published or not published were based on its relevance to provide critical analysis of land use planning process in most developing countries including Tanzania. Data from secondary sources "were analyzed to extract meaning and develop knowledge regarding" land use planning practices from an engagement perspective. Results The research findings indicate less benefits for the local people over the existing rural land use planning process. The main causes of drawbacks were ineffective participation of the local actors in the land use planning process, lack of transparency, effective communication and inadequate procedures to planning and decision-making processes. Taking these drawbacks into account, the paper suggests the conceptual framework for comprehensive land use planning that strive to strengthen actor's interaction in the land use decision-making process, searching informal means of communication and consultations as well as providing education to village residents on daily basis regarding land use planning process and outcomes. [ABSTRACT FROM AUTHOR]

Effective, low-cost clinical interventions to improve facility-based care during childbirth are critical to reduce maternal and perinatal mortality and morbidity in low-resource settings. While health interventions for low- and lower-middle-income countries are often developed and implemented top-down, needs and circumstances vary greatly across locations. Our pilot study in Zanzibar improved care through locally co-created intrapartum clinical practice guidelines (CPGs) and associated training (the PartoMa intervention). This intervention was context-tailored with health-care providers in Zanzibar and now scaled up within five maternity units in Dar es Salaam, Tanzania. This PartoMa Scale-up Study thereby provides an opportunity to explore the co-creation process and modification of the intervention in another context and how scale-up might be successfully achieved. The overall protocol is presented in a separate paper. The aim of the present paper is to account for the Scale-up Study's programme theory and qualitative methodology. We introduce social practice theory and argue for its value within the programme theory and towards qualitative explorations of shifts in clinical practice. The theory recognizes that the practice we aim to strengthen – safe and respectful clinical childbirth care – is not practiced in a vacuum but embedded within a socio-material context and intertwined with other practices. Methodologically, the project draws on ethnographic and participatory methodologies to explore current childbirth care practices. In line with our programme theory, explorations will focus on meanings of childbirth care, material tools and competencies that are being drawn upon, birth attendants' motivations and relational contexts, as well as other everyday practices of childbirth care. Insights generated from this study will not only elucidate active ingredients that make the PartoMa intervention feasible (or not) but develop the knowledge foundation for scaling-up and replicability of future interventions based on the principles of co-creation and contextualisation. [ABSTRACT FROM AUTHOR]

Productivity growth emanating from scientific advances offered by biotechnology and other plant breeding initiatives offers great promise for meeting the growing food demand worldwide. This justifies investments in agricultural research and development that have led to the development of stress‐tolerant maize varieties (STMVs) in Africa. While most literature has documented the average impacts of STMVs on productivity, this paper is premised on the fact that benefits from technology adoption are not the same across household. The paper addresses this information gap by examining potential heterogeneity in yield, income, and food security benefits from of adopting STMVs using a sample of 720 maize‐producing households from Tanzania. The dose‐response continuous treatment effect method supported by an endogenous switching probit model was used to estimate the heterogenous impact of STMV adoption on the three outcomes of interest. Results show that, overall, the adoption of stress‐tolerant maize varieties increased maize grain yield by about 1 ton/ha, maize income by about $62/ha. The adoption of STMVs also reduced the propensity to report mild, moderate, and severe food insecurity by 34%, 17%, and 6%, respectively. There are substantial idiosyncratic variations in the productivity, income, and food security effects depending on the scale of adoption, with a higher impact at lower dose levels of adoption. The heterogenous and pro‐poor nature of STMV adoption is also revealed through nonparametric results showing higher productivity benefits among households that are less endowed with wealth and knowledge. These findings underscore the need for further scaling of stress‐tolerant maize varieties for greater impact on the livelihoods of poor small‐scale farmers in Tanzania. [ABSTRACT FROM AUTHOR]

Background: Data entry at the point of collection using mobile electronic devices may make data-handling processes more efficient and cost-effective, but there is little literature to document and quantify gains, especially for longitudinal surveillance systems. Objective: To examine the potential of mobile electronic devices compared with paper-based tools in health data collection. Methods: Using data from 961 households from the Rufiji Household and Demographic Survey in Tanzania, the quality and costs of data collected on paper forms and electronic devices were compared. We also documented, using qualitative approaches, field workers, whom we called ‘enumerators’, and households’ members on the use of both methods. Existing administrative records were combined with logistics expenditure measured directly from comparison households to approximate annual costs per 1,000 households surveyed. Results: Errors were detected in 17% (166) of households for the paper records and 2% (15) for the electronic records (p < 0.001). There were differences in the types of errors (p = 0.03). Of the errors occurring, a higher proportion were due to accuracy in paper surveys (79%, 95% CI: 72%, 86%) compared with electronic surveys (58%, 95% CI: 29%, 87%). Errors in electronic surveys were more likely to be related to completeness (32%, 95% CI 12%, 56%) than in paper surveys (11%, 95% CI: 7%, 17%).The median duration of the interviews (‘enumeration’), per household was 9.4 minutes (90% central range 6.4, 12.2) for paper and 8.3 (6.1, 12.0) for electronic surveys (p = 0.001). Surveys using electronic tools, compared with paper-based tools, were less costly by 28% for recurrent and 19% for total costs. Although there were technical problems with electronic devices, there was good acceptance of both methods by enumerators and members of the community. Conclusions: Our findings support the use of mobile electronic devices for large-scale longitudinal surveys in resource-limited settings. [ABSTRACT FROM PUBLISHER]

Contract farming (CF) is often seen as a system that enhances production efficiency leading to increased agricultural productivity and improved farmer livelihoods. However, there is a conflict in the literature on its impact on young farmers who are involved in farming in Sub-Saharan Africa. This paper evaluates the impacts of CF on crop yield, crop and household income among the youth farmers involved in French bean farming in Tanzania using cross-sectional data of 273 households. The study employs an endogenous switching regression (ESR) model that accounts for observed and unobserved factors to estimate the impact of CF. Further, the propensity score matching (PSM) model is used to check the robustness of ESR results. The results indicate that 162 farmers had contracts and French bean yields and incomes significantly increased with CF. Specifically, the empirical results reveal that CF leads to a gain of 17%, 34% and 37.5% in the yield, crop income and household income. Participation and impact of contract farming differed according to different socio-economic/institutional variables, such as access to extension services. [ABSTRACT FROM AUTHOR]

A sufficient supply of ecosystem services (ESs) in agriculture provides the basis for human sustainable development. Intensified large-scale farming has changed wetland ecosystems extensively by reducing both the resilience and capacity to support production of many ESs. Small-scale farming may also affect the generation of ESs where the impact often reflects the differences in farming practices. This paper explores the supply and demand of the ESs between management practices, irrigated and rainfed, of smallholder farmers in Kilombero wetland, Tanzania. We conducted interviews involving 30 households and two focus groups with five discussants for each practice, rainfed and irrigation. Generally, we found that the need for ES, especially food, water and flood control, in both farming practices, were exceeding the capacity to supply. In general, irrigation farming compared to rainfed farming was associated with higher levels of food production, increasing flood regulation and erosion control. However, the ES delivery and need were not uniform depending on the river discharge. The differences in supply and demand of ESs between farming practices suggest that society would benefit from investing in irrigation and regulatory infrastructures to minimize flooding risk and to build up the ecosystem's natural capacity to produce services. Such practical policy-relevant measures could balance the gap between supply and demand of ESs in smallholder farming systems in Tanzanian wetland. [ABSTRACT FROM AUTHOR]