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The novel Coronavirus disease 2019 (COVID-19) presents a major threat to public health but can be prevented by safe and effective COVID-19 vaccines. Vaccine acceptance among healthcare workers (HCWs) is essential to promote uptake. This study, aimed to determine the COVID-19 vaccination uptake and hesitancy and its associated factors among HCWs in Tanzania. We employed a convergent-parallel mixed-methods design among 1368 HCWs across health facilities in seven geographical zones in Tanzania in 2021. We collected quantitative data by using an interviewer-administered questionnaire and qualitative data, using in-depth interviews and focus group discussions. Participants in the quantitative aspect were conveniently selected whereas those in the qualitative aspect were purposively selected based on their role in patient care, management, and vaccine provision. Stata software version 16.1 was used in the analysis of quantitative data and thematic analysis for the qualitative data. Multiple logistic regression was used to assess the determinants of COVID-19 vaccine uptake. The median age of 1368 HCWs was 33, and the interquartile range was 28-43 years; 65.6% were aged 30+ years, and 60.1% were females. Over half (53.4%) of all HCWs received the COVID-19 vaccine, 33.6% completely refused, and 13% chose to wait. HCWs aged 40+ years, from lower-level facilities (district hospitals and health centers), who worked 6+ years, and with perceived high/very high risk of COVID-19 infection had significantly higher odds of vaccine uptake. The qualitative data revealed misinformation and inadequate knowledge about COVID-19 vaccine safety and efficacy as the key barriers to uptake. Nearly half of all HCWs in Tanzania are still unvaccinated against COVID-19. The predominance of contextual influence on COVID-19 vaccine uptake calls for interventions to focus on addressing contextual determinants, focusing on younger HCWs' population, short working duration, those working at different fac

The novel Coronavirus disease 2019 (COVID-19) presents a major threat to public health but can be prevented by safe and effective COVID-19 vaccines. Vaccine acceptance among healthcare workers (HCWs) is essential to promote uptake. This study, aimed to determine the COVID-19 vaccination uptake and hesitancy and its associated factors among HCWs in Tanzania. We employed a convergent-parallel mixed-methods design among 1368 HCWs across health facilities in seven geographical zones in Tanzania in 2021. We collected quantitative data by using an interviewer-administered questionnaire and qualitative data, using in-depth interviews and focus group discussions. Participants in the quantitative aspect were conveniently selected whereas those in the qualitative aspect were purposively selected based on their role in patient care, management, and vaccine provision. Stata software version 16.1 was used in the analysis of quantitative data and thematic analysis for the qualitative data. Multiple logistic regression was used to assess the determinants of COVID-19 vaccine uptake. The median age of 1368 HCWs was 33, and the interquartile range was 28-43 years; 65.6% were aged 30+ years, and 60.1% were females. Over half (53.4%) of all HCWs received the COVID-19 vaccine, 33.6% completely refused, and 13% chose to wait. HCWs aged 40+ years, from lower-level facilities (district hospitals and health centers), who worked 6+ years, and with perceived high/very high risk of COVID-19 infection had significantly higher odds of vaccine uptake. The qualitative data revealed misinformation and inadequate knowledge about COVID-19 vaccine safety and efficacy as the key barriers to uptake. Nearly half of all HCWs in Tanzania are still unvaccinated against COVID-19. The predominance of contextual influence on COVID-19 vaccine uptake calls for interventions to focus on addressing contextual determinants, focusing on younger HCWs' population, short working duration, those working at different fac

The novel Coronavirus disease 2019 (COVID-19) presents a major threat to public health but can be prevented by safe and effective COVID-19 vaccines. Vaccine acceptance among healthcare workers (HCWs) is essential to promote uptake. This study, aimed to determine the COVID-19 vaccination uptake and hesitancy and its associated factors among HCWs in Tanzania. We employed a convergent-parallel mixed-methods design among 1368 HCWs across health facilities in seven geographical zones in Tanzania in 2021. We collected quantitative data by using an interviewer-administered questionnaire and qualitative data, using in-depth interviews and focus group discussions. Participants in the quantitative aspect were conveniently selected whereas those in the qualitative aspect were purposively selected based on their role in patient care, management, and vaccine provision. Stata software version 16.1 was used in the analysis of quantitative data and thematic analysis for the qualitative data. Multiple logistic regression was used to assess the determinants of COVID-19 vaccine uptake. The median age of 1368 HCWs was 33, and the interquartile range was 28-43 years; 65.6% were aged 30+ years, and 60.1% were females. Over half (53.4%) of all HCWs received the COVID-19 vaccine, 33.6% completely refused, and 13% chose to wait. HCWs aged 40+ years, from lower-level facilities (district hospitals and health centers), who worked 6+ years, and with perceived high/very high risk of COVID-19 infection had significantly higher odds of vaccine uptake. The qualitative data revealed misinformation and inadequate knowledge about COVID-19 vaccine safety and efficacy as the key barriers to uptake. Nearly half of all HCWs in Tanzania are still unvaccinated against COVID-19. The predominance of contextual influence on COVID-19 vaccine uptake calls for interventions to focus on addressing contextual determinants, focusing on younger HCWs' population, short working duration, those working at different fac

The novel Coronavirus disease 2019 (COVID-19) presents a major threat to public health but can be prevented by safe and effective COVID-19 vaccines. Vaccine acceptance among healthcare workers (HCWs) is essential to promote uptake. This study, aimed to determine the COVID-19 vaccination uptake and hesitancy and its associated factors among HCWs in Tanzania. We employed a convergent-parallel mixed-methods design among 1368 HCWs across health facilities in seven geographical zones in Tanzania in 2021. We collected quantitative data by using an interviewer-administered questionnaire and qualitative data, using in-depth interviews and focus group discussions. Participants in the quantitative aspect were conveniently selected whereas those in the qualitative aspect were purposively selected based on their role in patient care, management, and vaccine provision. Stata software version 16.1 was used in the analysis of quantitative data and thematic analysis for the qualitative data. Multiple logistic regression was used to assess the determinants of COVID-19 vaccine uptake. The median age of 1368 HCWs was 33, and the interquartile range was 28-43 years; 65.6% were aged 30+ years, and 60.1% were females. Over half (53.4%) of all HCWs received the COVID-19 vaccine, 33.6% completely refused, and 13% chose to wait. HCWs aged 40+ years, from lower-level facilities (district hospitals and health centers), who worked 6+ years, and with perceived high/very high risk of COVID-19 infection had significantly higher odds of vaccine uptake. The qualitative data revealed misinformation and inadequate knowledge about COVID-19 vaccine safety and efficacy as the key barriers to uptake. Nearly half of all HCWs in Tanzania are still unvaccinated against COVID-19. The predominance of contextual influence on COVID-19 vaccine uptake calls for interventions to focus on addressing contextual determinants, focusing on younger HCWs' population, short working duration, those working at different fac

Background: Many evidence-based health interventions, particularly in low-income settings, have failed to deliver the expected impact. We designed an Adaptive Diseases Control Expert Programme in Tanzania (ADEPT) to address systemic challenges in health care delivery and examined the feasibility, acceptability and effectiveness of the model using tuberculosis (TB) and diabetes mellitus (DM) as a prototype. Methods: This was an effectiveness-implementation hybrid type-3 design that was implemented in Dar es Salaam, Iringa and Kilimanjaro regions. The strategy included a stepwise training approach with web-based platforms adapting the Gibbs' reflective cycle. Health facilities with TB services were supplemented with DM diagnostics, including glycated haemoglobin A1c (HbA1c). The clinical audit was deployed as a measure of fidelity. Retrospective and cross-sectional designs were used to assess the fidelity, acceptability and feasibility of the model. Results: From 2019-2021, the clinical audit showed that ADEPT intervention health facilities more often identified median 8 (IQR 6-19) individuals with dual TB and DM, compared with control health facilities, median of 1 (IQR 0-3) ( p = 0.02). Likewise, the clinical utility of HbA1c on intervention sites was 63% (IQR:35-75%) in TB/DM individuals compared to none in the control sites at all levels, whereas other components of the standard of clinical management of patients with dual TB and DM did not significantly differ. The health facilities showed no difference in screening for additional comorbidities such as hypertension and malnutrition. The stepwise training enrolled a total of 46 nurse officers and medical doctors/specialists for web-based training and 40 (87%) attended the workshop. Thirty-one (67%), 18 nurse officers and 13 medical doctors/specialists, implemented the second step of training others and yielded a total of 519 additional front-line health care workers trained: 371 nurses and 148 clinicians. Over

Background: Many evidence-based health interventions, particularly in low-income settings, have failed to deliver the expected impact. We designed an Adaptive Diseases Control Expert Programme in Tanzania (ADEPT) to address systemic challenges in health care delivery and examined the feasibility, acceptability and effectiveness of the model using tuberculosis (TB) and diabetes mellitus (DM) as a prototype. Methods: This was an effectiveness-implementation hybrid type-3 design that was implemented in Dar es Salaam, Iringa and Kilimanjaro regions. The strategy included a stepwise training approach with web-based platforms adapting the Gibbs' reflective cycle. Health facilities with TB services were supplemented with DM diagnostics, including glycated haemoglobin A1c (HbA1c). The clinical audit was deployed as a measure of fidelity. Retrospective and cross-sectional designs were used to assess the fidelity, acceptability and feasibility of the model. Results: From 2019-2021, the clinical audit showed that ADEPT intervention health facilities more often identified median 8 (IQR 6-19) individuals with dual TB and DM, compared with control health facilities, median of 1 (IQR 0-3) ( p = 0.02). Likewise, the clinical utility of HbA1c on intervention sites was 63% (IQR:35-75%) in TB/DM individuals compared to none in the control sites at all levels, whereas other components of the standard of clinical management of patients with dual TB and DM did not significantly differ. The health facilities showed no difference in screening for additional comorbidities such as hypertension and malnutrition. The stepwise training enrolled a total of 46 nurse officers and medical doctors/specialists for web-based training and 40 (87%) attended the workshop. Thirty-one (67%), 18 nurse officers and 13 medical doctors/specialists, implemented the second step of training others and yielded a total of 519 additional front-line health care workers trained: 371 nurses and 148 clinicians. Over

The novel Coronavirus disease 2019 (COVID-19) presents a major threat to public health but can be prevented by safe and effective COVID-19 vaccines. Vaccine acceptance among healthcare workers (HCWs) is essential to promote uptake. This study, aimed to determine the COVID-19 vaccination uptake and hesitancy and its associated factors among HCWs in Tanzania. We employed a convergent-parallel mixed-methods design among 1368 HCWs across health facilities in seven geographical zones in Tanzania in 2021. We collected quantitative data by using an interviewer-administered questionnaire and qualitative data, using in-depth interviews and focus group discussions. Participants in the quantitative aspect were conveniently selected whereas those in the qualitative aspect were purposively selected based on their role in patient care, management, and vaccine provision. Stata software version 16.1 was used in the analysis of quantitative data and thematic analysis for the qualitative data. Multiple logistic regression was used to assess the determinants of COVID-19 vaccine uptake. The median age of 1368 HCWs was 33, and the interquartile range was 28-43 years; 65.6% were aged 30+ years, and 60.1% were females. Over half (53.4%) of all HCWs received the COVID-19 vaccine, 33.6% completely refused, and 13% chose to wait. HCWs aged 40+ years, from lower-level facilities (district hospitals and health centers), who worked 6+ years, and with perceived high/very high risk of COVID-19 infection had significantly higher odds of vaccine uptake. The qualitative data revealed misinformation and inadequate knowledge about COVID-19 vaccine safety and efficacy as the key barriers to uptake. Nearly half of all HCWs in Tanzania are still unvaccinated against COVID-19. The predominance of contextual influence on COVID-19 vaccine uptake calls for interventions to focus on addressing contextual determinants, focusing on younger HCWs' population, short working duration, those working at different fac

BACKGROUND: Infrastructure development and upgrading to support safe surgical services in primary health care facilities is an important step in the journey towards achieving Universal Health Coverage (UHC). Quality health service provision together with equitable geographic access and service delivery are important components that constitute UHC. Tanzania has been investing in infrastructure development to offer essential safe surgery close to communities at affordable costs while ensuring better outcomes. This study aimed to understand the public sector's efforts to improve the infrastructure of primary health facilities between 2005 and 2019. We assessed the construction rates, geographic coverage, and physical status of each facility, surgical safety and services rendered in public primary health facilities. METHODS: Data was collected from existing policy reports, the Services Availability and Readiness Assessment (SARA) tool (physical status), the Health Facility Registry (HFR), implementation reports on infrastructure development from the 26 regions and 185 district councils across the country (covering assessment of physical infrastructure, waste management systems and inventories for ambulances) and Comprehensive Emergence Obstetric Care (CEMONC) signal functions assessment tool. Data was descriptively analyzed so as to understand the distribution of primary health care facilities and their status (old, new, upgraded, under construction, renovated and equipped), and the service provided, including essential surgical services. RESULTS: Of 5072 (518 are Health Centers and 4554 are Dispensaries) existing public primary health care facilities, the majority (46%) had a physical status of A (good state), 33% (1693) had physical status of B (minor renovation needed) and the remaining facilities had physical status of C up to F (needing major renovation). About 33% (1673) of all health facilities had piped water and 5.1% had landline telecommunication system. Betwe

The development of interest and engagement in science studies among junior learners is shaped by many factors within their learning environment, one of them being the social influence. However, in practice it has not been clear how such influence shapes learners’ interests and engagement in science studies. This study examined the social influences and their impact on students’ interest and engagement in science. The study was mainly a qualitative research involving teachers, parents, and students. The findings revealed that students’ interests and engagement in science studies were mainly shaped by multi-influences from different social groups including: peers, family members, senior students, subject teachers, and career advisors/counsellors. The findings suggest that there is a need to monitor and control the available social influences on leaners’ interests in science because not all influences seemed to be positive, as some of them are negatively influencing the learners’ interests, persistence, and engagement in science.

The development of interest and engagement in science studies among junior learners is shaped by many factors within their learning environment, one of them being the social influence. However, in practice it has not been clear how such influence shapes learners’ interests and engagement in science studies. This study examined the social influences and their impact on students’ interest and engagement in science. The study was mainly a qualitative research involving teachers, parents, and students. The findings revealed that students’ interests and engagement in science studies were mainly shaped by multi-influences from different social groups including: peers, family members, senior students, subject teachers, and career advisors/counsellors. The findings suggest that there is a need to monitor and control the available social influences on leaners’ interests in science because not all influences seemed to be positive, as some of them are negatively influencing the learners’ interests, persistence, and engagement in science.

The development of interest and engagement in science studies among junior learners is shaped by many factors within their learning environment, one of them being the social influence. However, in practice it has not been clear how such influence shapes learners’ interests and engagement in science studies. This study examined the social influences and their impact on students’ interest and engagement in science. The study was mainly a qualitative research involving teachers, parents, and students. The findings revealed that students’ interests and engagement in science studies were mainly shaped by multi-influences from different social groups including: peers, family members, senior students, subject teachers, and career advisors/counsellors. The findings suggest that there is a need to monitor and control the available social influences on leaners’ interests in science because not all influences seemed to be positive, as some of them are negatively influencing the learners’ interests, persistence, and engagement in science.

The development of interest and engagement in science studies among junior learners is shaped by many factors within their learning environment, one of them being the social influence. However, in practice it has not been clear how such influence shapes learners’ interests and engagement in science studies. This study examined the social influences and their impact on students’ interest and engagement in science. The study was mainly a qualitative research involving teachers, parents, and students. The findings revealed that students’ interests and engagement in science studies were mainly shaped by multi-influences from different social groups including: peers, family members, senior students, subject teachers, and career advisors/counsellors. The findings suggest that there is a need to monitor and control the available social influences on leaners’ interests in science because not all influences seemed to be positive, as some of them are negatively influencing the learners’ interests, persistence, and engagement in science.

The development of interest and engagement in science studies among junior learners is shaped by many factors within their learning environment, one of them being the social influence. However, in practice it has not been clear how such influence shapes learners’ interests and engagement in science studies. This study examined the social influences and their impact on students’ interest and engagement in science. The study was mainly a qualitative research involving teachers, parents, and students. The findings revealed that students’ interests and engagement in science studies were mainly shaped by multi-influences from different social groups including: peers, family members, senior students, subject teachers, and career advisors/counsellors. The findings suggest that there is a need to monitor and control the available social influences on leaners’ interests in science because not all influences seemed to be positive, as some of them are negatively influencing the learners’ interests, persistence, and engagement in science.

Improving quality science education (SE) in many countries across the world has been a focus of international inquiry. Though Tanzania, like many other countries, has placed an increasing focus on improving the quality of SE experiences in its schools, little has been made to achieve this goal. This means the process of providing quality SE remains problematic and challenging. This study explores promising practices for improving the quality of SE in Tanzanian junior secondary schools (JSS) from the perspectives of 67 key SE stakeholders involving: educators, policy makers, parents, students, science alumni and selected education officers. In order to address the issue, the study used a mixed method approach involving interviews and questionnaires (with all respondents except students); document review, and focus group discussions (with students). A pragmatic perspective, with an emphasis on creating a more relevant, contextual, responsive and functional SE experiences in schools, was used as a lens. The study was conducted in two concurrent (embedded) phases within two regions in Tanzania beginning with in-depth interviews with policy makers and followed by intensive study of schools. All phases of data collection generated qualitative and quantitative data sets, which were then analysed using thematic analysis and descriptive statistics respectively. The findings of this research identified that despite policy articulation, the understanding and delivery of quality SE in Tanzanian JSS has remained debatable, divisive and antagonistic controversy over its meaning, value, nature, features and measures. As such, a comprehensive framework is needed to harmonise the existing and diverse conceptions of what quality SE is among different stakeholders. The findings also revealed that there are several contextual challenges rooted in the processes of planning, delivery, assessment and monitoring of quality SE practices in schools. Respondents identified these challenges as

Improving quality science education (SE) in many countries across the world has been a focus of international inquiry. Though Tanzania, like many other countries, has placed an increasing focus on improving the quality of SE experiences in its schools, little has been made to achieve this goal. This means the process of providing quality SE remains problematic and challenging. This study explores promising practices for improving the quality of SE in Tanzanian junior secondary schools (JSS) from the perspectives of 67 key SE stakeholders involving: educators, policy makers, parents, students, science alumni and selected education officers. In order to address the issue, the study used a mixed method approach involving interviews and questionnaires (with all respondents except students); document review, and focus group discussions (with students). A pragmatic perspective, with an emphasis on creating a more relevant, contextual, responsive and functional SE experiences in schools, was used as a lens. The study was conducted in two concurrent (embedded) phases within two regions in Tanzania beginning with in-depth interviews with policy makers and followed by intensive study of schools. All phases of data collection generated qualitative and quantitative data sets, which were then analysed using thematic analysis and descriptive statistics respectively. The findings of this research identified that despite policy articulation, the understanding and delivery of quality SE in Tanzanian JSS has remained debatable, divisive and antagonistic controversy over its meaning, value, nature, features and measures. As such, a comprehensive framework is needed to harmonise the existing and diverse conceptions of what quality SE is among different stakeholders. The findings also revealed that there are several contextual challenges rooted in the processes of planning, delivery, assessment and monitoring of quality SE practices in schools. Respondents identified these challenges as

Improving quality science education (SE) in many countries across the world has been a focus of international inquiry. Though Tanzania, like many other countries, has placed an increasing focus on improving the quality of SE experiences in its schools, little has been made to achieve this goal. This means the process of providing quality SE remains problematic and challenging. This study explores promising practices for improving the quality of SE in Tanzanian junior secondary schools (JSS) from the perspectives of 67 key SE stakeholders involving: educators, policy makers, parents, students, science alumni and selected education officers. In order to address the issue, the study used a mixed method approach involving interviews and questionnaires (with all respondents except students); document review, and focus group discussions (with students). A pragmatic perspective, with an emphasis on creating a more relevant, contextual, responsive and functional SE experiences in schools, was used as a lens. The study was conducted in two concurrent (embedded) phases within two regions in Tanzania beginning with in-depth interviews with policy makers and followed by intensive study of schools. All phases of data collection generated qualitative and quantitative data sets, which were then analysed using thematic analysis and descriptive statistics respectively. The findings of this research identified that despite policy articulation, the understanding and delivery of quality SE in Tanzanian JSS has remained debatable, divisive and antagonistic controversy over its meaning, value, nature, features and measures. As such, a comprehensive framework is needed to harmonise the existing and diverse conceptions of what quality SE is among different stakeholders. The findings also revealed that there are several contextual challenges rooted in the processes of planning, delivery, assessment and monitoring of quality SE practices in schools. Respondents identified these challenges as

Te Hakalo Kelihiano (right) and Takina Tiu (left).

From left: Teve Kalolo, Taulaga Matetu, ??, Hamu Titaia.

Village islet at left.

At left: Valele Temo, at right:??.

From left: Peni Teaku, ??, Teloloma Paulo.

At back: Stan Feleti, at right: Tile Elia.

In the background is little Lootala filled with women and at left is new Lootala. From left: Nouata Tufoua, Lokeni Malaki and Kaleti Pita.

The outrigger (ama) side.

large catch of reef fish is being arrange in inati piles

Looking through this traditional style house are the concrete and corrugated iron of recent building.

See image 189973

Tehakalo Keli

Paulo Patea--Pulenuku. In the background Te ulugagie and islets across lagoon.

Prone are sisters Tagivale and Taunehe.

See image 189973

If they weren't racing they wouldn't be paddling.

A small cooking fire at back.

It's Tehakalo who does not yet know better.

The fish are all laid out in their inati piles--53 of them.

From left: Teve Kalolo and Taulaga Matetuu

The new, modern Lootala is in the background.

Little Lootala under the aegis of women is of traditional construction while Big Lootala is the communal meeting house for the elders and all communal events.