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Background: Antenatal care for pregnant and postnatal mothers is the main entry gate for maternal Tetanus Toxoid (TT) vaccination. In developing countries including Tanzania, pregnant and postnatal mothers especially in rural communities have been experiencing barriers to maternal vaccination. The study aimed to explore perspectives of pregnant and postnatal mothers on accessing TT vaccine in Hai District Kilimanjaro Region Tanzania. Methods: A descriptive qualitative study was conducted during baseline assessment from October 2020 to May 2021, in 10 remote villages. Pregnant and postnatal mothers attending antenatal and postnatal services were selected purposively based on their availability and convenience, A semi-structured interview guide relevant to the study objectives was used to guide the interviews. Focus Group Discussion (FGD) and In-depth interviews (IDIs) were conducted; and thematic analysis was used to obtain themes and subthemes. Results: A total of 15 mothers aged 18 to 40 years participated in the study. Most of the mothers were Christians, married with 1 to 5 children. Majority had completed primary level education engaged in small-scale farming. Main themes were extracted namely: Unreliable vaccine information, Healthcare workers attitude, Overworked with household activities, adherence of appointment dates for vaccination after delivery and role of Traditional medicine during pregnancy. Conclusion: The role of healthcare providers are critical component for the appropriate transfer of vaccine information to the mothers and their spouses during clinic visits, to eliminate vaccine misconceptions hence improving overall tetanus vaccine uptake. Quality of information from reliable sources could be an important factor to upgrade the awareness of pregnant mothers on maternal vaccination.

Background: Musculoskeletal (MSK) disorders account for 20% of all years lived with disability worldwide. There have been few prevalence studies of MSK disorders in Africa, and none published from Tanzania. Screening for MSK disorders is not routinely conducted in healthcare facilities and there are no registered rheumatology consultants in northern Tanzania. This pilot study aimed to provide an initial estimate of the community-based prevalence, and predictors, of MSK disorders and to assess the functional status and disability associated with MSK disorders. Methods: A cross-sectional pilot study was conducted in a single village in the Hai District Kilimanjaro region from March to June 2019, involving the administration of Gait, Arms, Legs, Spine (GALS) or paediatric GALS (pGALS) physical examinations during household and school visits. Individuals positive by GALS/pGALS screening were assessed by the regional examination of the musculoskeletal system (REMS) and the Modified Health Assessment Questionnaire (MHAQ) tools. Multivariable logistic regression analyses were used to understand the influence of demographic variables (age and sex), tribe and religion on GALS/pGALS, REMS and MHAQ outcomes. Results: A total of 1854 participants were enrolled. Of the 1172 individuals enrolled at the household level, 95 showed signs of MSK disorders during the GALS/pGALS examination (8.1%, 95% CI: 6.6 – 9.8) and 37 during the REMS examination (3.2%, 95% CI: 2.2 – 4.3), respectively. Among all 682 participants enrolled in schools, seven showed signs of MSK disorders during the GALS/pGALS examination (1.0%, 95% CI: 0.4 – 2.1) and three during the REMS examination (0.4%, 95% CI: 0.0 – 1.3), respectively. In the household enrolled population female gender and increasing age were significantly associated with GALS and REMS positive findings. Among the GALS positive individuals, increasing age was significantly associated with REMS positive status and increasing MHAQ scores, indicating worse function and greater disability. Conclusions: Our pilot study confirms the prevalence of MSK disorders in this study population and predictors of MSK disorders that are comparable to those seen elsewhere in the world. These pilot data can inform the design of future investigations of the determinants of MSK disorders and their impacts on health, livelihood, and well-being in Tanzania.