Search

Background: Low birth weight (LBW) is a significant public health concern given its association with early-life mortality and other adverse health consequences that can impact the entire life cycle. In many countries, accurate estimates of LBW prevalence are lacking due to inaccuracies in collection and gaps in available data. Our study aimed to determine LBW prevalence among facility-born infants in selected areas of Kenya and Tanzania and to assess whether the introduction of an intervention to improve the accuracy of birth weight measurement would result in a meaningfully different estimate of LBW prevalence than current practice. Methods: We carried out a historically controlled intervention study in 22 health facilities in Kenya and three health facilities in Tanzania. The intervention included: provision of high-quality digital scales, training of nursing staff on accurate birth weight measurement, recording and scale calibration practices, and quality maintenance support that consisted of enhanced supervision and feedback (prospective arm). The historically controlled data were birth weights from the same facilities recorded in maternity registers for the same calendar months from the previous year measured using routine practices and manual scales. We calculated mean birth weight (95% confidence interval CI), mean difference in LBW prevalence, and respective risk ratio (95% CI) between study arms. Results: Between October 2019 and February 2020, we prospectively collected birth weights from 8441 newborns in Kenya and 4294 in Tanzania. Historical data were available from 9318 newborns in Kenya and 12,007 in Tanzania. In the prospective sample, the prevalence of LBW was 12.6% (95% confidence intervals [CI]: 10.9%–14.4%) in Kenya and 18.2% (12.2%–24.2%) in Tanzania. In the historical sample, the corresponding prevalence estimates were 7.8% (6.5%–9.2%) and 10.0% (8.6%–11.4%). Compared to the retrospective sample, the LBW prevalence in the prospective sample was 4.8% points (3.2%–6.4%) higher in Kenya and 8.2% points (2.3%–14.0%) higher in Tanzania, corresponding to a risk ratio of 1.61 (1.38–1.88) in Kenya and 1.81 (1.30–2.52) in Tanzania. Conclusion: Routine birth weight records underestimate the risk of LBW among facility-born infants in Kenya and Tanzania. The quality of birth weight data can be improved by a simple intervention consisting of provision of digital scales and supportive training. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to identify and assess the regulatory and institutional constraints in managing procurement records in Tanzania’s procuring entities.Design/methodology/approach This study used a mixed study design. There were explorative case study and questionnaire survey study methods used sequentially. In total, 15 procuring entities were used for exploratory case study, while 200 respondents were administered with questionnaires. A 75 per cent response rate was realised.Findings Results indicated that management and care of procurement records is constrained by regulatory and institutional constraints. The identified and assessed constraints were inter alia: incapacity of institutional actors, inadequate regulatory and institutional arrangements, inadequacy of storage space, equipment and facilities and insufficiency of security and safety measures.Research limitations/implications This research focussed on the procuring entities found in Dar es Salaam, which accounts for 40.72 per cent of the total procuring entities in Tanzania. Based on this, the generalisation of research findings can be sought in that particular context.Practical implications Findings imply that procurement records management and care is highly influenced by the constraining factors that hinder efficient records keeping in most procuring entities in Tanzania.Social implications Majority of procurement management units and user departments’ staff were found to possess inadequate knowledge, skills and competences in management and care of procurement records. The procuring entities should ensure that procurement staffs are trained in records and archives management practices.Originality/value This study contributes towards adding knowledge to the existing body of knowledge on the procurement records and archives management systems. [ABSTRACT FROM AUTHOR]