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Background: The Tanzanian health sector receives large amounts of funding from multiple international development partners to support a broad range of population-health interventions. However, little is known about the partners’ level of commitment to sustain funding, and the implications of uncertainties created by these funding mechanisms. This study had the following objectives: 1) To present a theoretical model for assessing funding commitments by health development partners in a specified region; 2) to describe development partner funding commitments against this framework, using a case study example of Morogoro Region, Tanzania; and 3) to discuss policy considerations using this framework for district, regional and national level.Methods: Qualitative case study methodology was used to assess funding commitments of health-related development partners in Morogoro Region, Tanzania. Using qualitative data, collected as part of an evaluation of maternal and child health programs in Morogoro Region, key informants from all development partners were interviewed and thematic analysis was conducted for the assessment. Results: Our findings show that decisions made on where to commit and direct funds were based on recipient government and development partner priorities. These decisions were based on government directives, such as the need to provide health services to vulnerable populations; the need to contribute towards alleviation of disease burden and development partner interests, including humanitarian concerns. Poor coordination of partner organizations and their funding priorities may undermine benefits to target populations. This weakness poses a major challenge on development partner investments in health, leading to duplication of efforts and resulting in stagnant disease burden levels.Conclusion: Effective coordination mechanisms between all stakeholders at each level should be advocated to provide a forum to discuss interests and priorities, so as to harmonize them and facilitate the implementation of development partner funded activities in the recipient countries.

Background: Developing countries with increasing service needs and shortage of skilled health workers, governments are investing in community health worker (CHW) programs to address rural health needs. With current renewed interest in CHWs in Tanzania, questions have arisen surrounding the age group composition of this health worker cadre. This study investigated age differences in characteristics, knowledge, and service delivery among CHWs working on maternal, newborn, and child health (MNCH) in rural Tanzania.Methods: A quantitative survey was administered to all CHWs that received training from December 2012 to July 2013 in five administrative districts of Morogoro Region, Tanzania where the community integrated MNCH program is being implemented. Program monitoring and evaluation forms provided detailed records of service delivery during CHW home visits. Data on CHW socio-demographic characteristics, knowledge, and service delivery was analyzed through bi- and multivariate analyses. Composite scores were generated across ten knowledge domains: pregnancy, postpartum, newborn, and child care, family planning, injury and infection prevention, malaria, nutrition, and HIV. Ordered logit models were used to estimate relationships between knowledge scores and predictor variables.Results: Among ninety seven percent of the eligible 238 Community Health Workers interviewed, the highest percentage (37%) was in the age group above 35 years. A variation in gender was not significant among different age groups. However there was a statistically significant difference (p

Background: While the prevalence of HIV in adults has slightly decreased in recent years, the variations in prevalence and risks to infection among men and women persist. These variations are partly explained by the social and structural conditions that predispose both sexes to HIV infection. Due to psychological and physiological conditions, literature indicates that HIV and gender based violence including intimate violence are related. This study aimed to assess how attitudes and beliefs respond to the spread of HIV and gender-based violence (GBV) in Tanzania.Methods: We conducted a quasi-experimental study with a sample of 1,620 adult women and men; with an approximate ratio of 1:2. A Gender Equitable Men’s scale was slightly modified to capture various psychometric domains on HIV related gender norms and attitudes among women and men.Results: We found a substantial higher proportion of men having positive gender equitable norms and consistently positive attitudes in all four domains (GBV, reproductive health and disease prevention, sexuality and domestic life and child care) we assessed on.Conclusion: Results from this study may probably imply that now men are taking positive roles in issues of domestic violence, reproductive health and disease prevention, sexuality and in domestic life and child care.

Overview of Integrated Program MNCH CHW rollout per district. Figure S2. Mean composite scores for CHW knowledge and reported service provision on maternal and child health care across the continuum of care and for specific services. Figure S3. Observed use of job aids during pregnancy home visits (nâ =â 37). Table S1. Ordered logistic regression models for composite scores for overall CHW knowledge and specific sub-domains of pregnancy, postpartum, newborn care, and child health controlling for gender, date of training, education, age, and assets. Table S2. Ordered logistic regression models for composite scores for family planning, infection/injury prevention, malaria, HIV transmission, and nutrition controlling for gender, date of training, education, age, and assets.

Includes bibliographical references (leaves 95-103)., Most low-income countries have not been able to fulfill the health care needs of the poor, and especially the rural population. Budgetary and other resource constraints in the health sector have been the major causes of this failure. Tanzania, like any other poor country is faced with challenges in health care financing, such that it cannot provide adequate cushion against health care costs for the majority of its population. One response to this situation was the health care financing reforms which among others saw the introduction of voluntary Community Health Fund (CHF) in 1996. The aim of the CHF was to mobilize resources through collection prepayments from households on a voluntary basis to fund primary health care for people in the informal sector operating in rural areas. However, CHF membership (enrollment) has been reported to be below the targeted coverage of 85% of the population living in rural areas. The percentage of households joining CHF has been ranging from 4% to 18% in various districts. This low enrolment prompted the need to study the predictors of and barriers to enrolment in CHF.

While the prevalence of HIV in adults has slightly decreased in recent years, the variations in prevalence and risks to infection among men and women persist. These variations are partly explained by the social and structural conditions that predispose both sexes to HIV infection. Due to psychological and physiological conditons, literature indicates that HIV and gender based violence including intimate violence are related. This study aimed to ases how atitudes and beliefs respond to the spread of HIV and gender-based violence (GBV) in Tanzania. We conducted a quasi-experimental study with a sample of 1,620 adult women and men; with an aproximate ratio of 1:2. A Gender Equitable Men’s scale was slightly modifed to capture various psychometric domains on HIV related gender norms and atitudes among women and men. We found a substantial higher proportion of men having positve gender equitable norms and consistently positive atitudes in al four domains (GBV, reproductive health and disease prevention, sexuality and domestic life and child care) we asesed on. Results from this study may probably imply that now men are taking positive roles in isues of domestic violence, reproductive health and disease prevention, sexuality and in domestic life and child care.