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Objective: Our objective was to assess clinical governance and the quality of health services in public primary health facilities in three councils of Arusha Region. Participants: We conducted a study involving 270 clients from 19 primary health facilities in three councils in Arusha Region. Methods: We conducted a cross-sectional study. The clients were selected using multistage-cluster sampling. Data were collected using exit interview and observation. A descriptive statistical method was used to analyse data. Results: We found that health facilities had the key policies and structures for quality improvement and limited governance for quality of health services. In total,109(43%) of the clients reported receiving all the prescribed medicines and 230 (85%) of the clients had a positive experience with care processes. Also, 181(72%) of the clients were satisfied with the health services and 230 (85%) of clients had confidence and trust in public primary health facilities. Conclusion: This research has generated valuable evidence on governance and the quality of health services offered in public primary health facilities in three councils of the Arusha Region. Our research has indicated that: facilities had limited governance for quality of health services and clients had limited access to essential medicines; the majority of clients had a positive experience with the processes of health care; the majority of clients were satisfied with health services offered and had confidence and trust in public primary health facilities. The empirical evidence of this study should inform quality improvement efforts in the studied councils and Tanzania. [ABSTRACT FROM AUTHOR]

Health-care technology is central to boosting the productivity and quality of health-care systems. In many sub-Saharan African countries, however, medical device management systems are weak or absent. The aim of this article is to illustrate, using a case study, how policy reforms can help ensure policy on health-care technology is translated into everyday practice and how an integrated systems approach can enhance the operation of medical device management. Between 2011 and 2023, a plan to improve medical device management systems in the United Republic of Tanzania was developed and implemented through Swiss-Tanzanian cooperation within the Health Promotion and System Strengthening Project. The availability of biomedical engineers was increased through new training courses and the creation of permanent positions in government. Moreover, additional district and regional maintenance and repair workshops were built, and a National Centre for Calibration and Training was established to ensure the correct functioning of medical devices. The introduction of an electronic medical device management system provided health facilities and the health ministry with data on the operational status of medical devices and the need for repairs and spare parts. Every level of government was encouraged to allocate more human and financial resources to medical device management. Following this decade-long effort, the percentage of functioning equipment increased substantially, and costs were reduced by repairing rather than replacing equipment. The project also demonstrated the value of an integrated, system-strengthening approach that considered personnel, maintenance and repair facilities, documentation and management, and government policy and budgeting., ((c) 2024 The authors; licensee World Health Organization.)

Background: Urogenital schistosomiasis (UGS) caused by Schistosoma haematobium is endemic in Southern Tanzania. The disease has significant implications for both socioeconomic and public health. Because infections with S. haematobium usually peak in childhood, the majority of studies have concentrated on school-aged children leaving other groups such as males which might be continuous reservoir of infection transmission. However, despite its chronic consequences in the male population, the disease has received insufficient attention, especially in sub-Saharan Africa. This study was conducted to describe the previous and current schistosomiasis status among adult males living in high-endemic areas of southern Tanzania DESIGN, SETTING AND PARTICIPANTS: A descriptive cross-sectional study was employed to gather data on the prevalence of UGS among adult men residing at schistosomiasis endemic in the Mtama District Council. Quantitative methods of data collection which included questionnaire and laboratory procedures were used., Results: Out of 245 participants, macrohaematuria and microhaematuria were found in 12 (4.9%, 95% CI 2.4% to 7.8%) and 66 (26.9%, 95% CI 21.6% to 32.7%) participants, respectively. S. haematobium ova were recovered from the urine samples of 54 (22.0%, 95% CI 16.7% to 27.3%) participants. The median intensity of infection was 20 eggs per 10 mL of urine ranging from 1 to 201 eggs per 10 mL of urine (IQR) 60.5). Out of 245 participants 33 (13.5% 95% CI 9.0% to 17.6%) had light intensity of infection and 21 (38.9%, 95% CI; 25.0% to 52.5%) had heavy intensity of infection. Overall, the prevalence of heavy intensity of infection was 8.6% (95% CI 4.9% to 12.6%). The prevalence and intensity of UGS varied significantly by age, marital status and village of residence., Conclusion: This study sheds light on the prevalence of UGS among adult males in endemic areas of southern Tanzania. The results highlight the urgent need for comprehensive intervention strategies to address the burden of the disease., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Male genital schistosomiasis (MGS) is a significantly neglected condition, and its consequences often receive inadequate attention. The disease is suggested to cause schistosomiasis-induced sexual and reproductive health problems among males. The study was conducted to investigate the prevalence of MGS, sexual and reproductive health problems that could be caused by MGS among adult males in Mtama district. A community-based cross-sectional study using quantitative methods was carried out among males aged ≥ 18 years in selected households. Semen and urine samples were collected from each participant to establish the prevalence of MGS and urogenital schistosomiasis respectively. Semen quality was macroscopically and microscopically assessed. Urine samples were analyzed using filtration technique. A structured questionnaire interview was carried out to collect socio-demographic data, sexual and reproductive health information. Descriptive statistics were used to provide a summary of each variable. The prevalence (proportions) were presented in percentages and their respective 95% confidence intervals. A total of 223 adult males participated in this study. The prevalence of MGS and urogenital schistosomiasis were 5.8% (95% CI; 3.1%-9.0%) and 22.4% (95% CI; 16.6%-27.8%) respectively. The prevalence of Schistosoma haematobium eggs in semen was found high among young adults 12/129 (9.3%, 95% CI; 4.9%-15.7%), who never attended to school 6/35 (17.1%, 95% CI; 6.6%-33.6%), petty traders 4/26 (15.4%, 95% CI; 4.4%-34.9%), never impregnated woman 9/70 (12.9%, 95% CI: 6.6%-33.6%), experienced pain during ejaculation 4/17 (23.5%, 95% CI; 4.9%-15.7%), and with brownish semen 2/5 (40%, 95% CI; 4.9%-15.7%). According to the findings, MGS, like urogenital schistosomiasis, is prevalent in southern Tanzania. The disease is prevalent among males with some reproductive and sexual issues. This highlight the need for more research to investigate the association of MGS and male reproductive and sexual health for improved health services among males., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Makene et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Tuberculosis (TB) disproportionally affects persons and families who are economically and socially disadvantaged. Therefore, a patient cost survey was conducted in Tanzania to evaluate the costs incurred by patients and their households before and after the diagnosis of TB. It was the first survey in Tanzania to ascertain baseline information and experience for subsequent surveys. This paper aims to share the experience encountered during the survey to ensure a standardized approach and elimination of potential barriers for the implementation of future surveys. A total of 777 TB patients from 30 clusters selected based on probability proportional to the size were interviewed during the study period. As the sample size was calculated based on notification data from the previous year, some health facilities experienced an inadequate number of TB patients during the study to meet the allocated cluster size for the survey. Most facilities had poor recording and recordkeeping in TB registers where deaths were not registered, and some patients had not been assigned district identification numbers. Fixed days for TB drug refills in health facilities affected the routine implementation of the survey as the interviews were conducted when patients visited the facility to pick up the drugs. Tablets used to collect data failed to capture the geographic location in some areas. The households of TB patients lost to follow-up and those who had died during TB treatment were not included in the survey. When planning and preparing for patient costs surveys, it is important to consider unforeseen factors which may affect planned activities and findings. During the survey in Tanzania, the identified challenges included survey logistics, communications, patient enrollment, and data management issues. To improve the quality of the findings of future surveys, it may be reasonable to revise survey procedures to include households of TB patients who were lost to follow-up and those who died during TB treatment; the households of such patients may have incurred higher direct and indirect costs than households whose patient was cured as a result of receiving TB treatment., (© 2022. The Author(s).)

Background: Although tuberculosis (TB) care is free in Tanzania, TB-associated costs may compromise access to services and treatment adherence resulting in poor outcomes and increased risk of transmission in the community. TB can impact economically patients and their households. We assessed the economic burden of TB on patients and their households in Tanzania and identified cost drivers to inform policies and programs for potential interventions to mitigate costs., Methods: We conducted a nationally representative cross-sectional survey using a standard methodology recommended by World Health Organization. TB patients of all ages and with all types of TB from 30 clusters across Tanzania were interviewed during July - September 2019. We used the human capital approach to assess the indirect costs and a threshold of 20% of the household annual expenditure to determine the proportion of TB-affected households experiencing catastrophic cost. We descriptively analyzed the cost data and fitted multivariable logistic regression models to identify potential predictors of catastrophic costs., Results: Of the 777 TB-affected households, 44.9% faced catastrophic costs due to TB. This proportion was higher (80.0%) among households of patients with multi-drug resistant TB (MDR-TB). Overall, cost was driven by income loss while accessing TB services (33.7%), nutritional supplements (32.6%), and medical costs (15.1%). Most income loss was associated with hospitalization and time for picking up TB drugs. Most TB patients (85.9%) reported worsening financial situations due to TB, and over fifty percent (53.0%) borrowed money or sold assets to finance TB treatment. In multivariable analysis, the factors associated with catastrophic costs included hospitalization (adjusted odds ratio [aOR] = 34.9; 95% confidence interval (CI):12.5-146.17), living in semi-urban (aOR = 1.6; 95% CI:1.0-2.5) or rural areas (aOR = 2.6; 95% CI:1.8-3.7), having MDR-TB (aOR = 3.4; 95% CI:1.2-10.9), and facility-based directly-observed treatment (DOT) (aOR = 7.2; 95% CI:2.4-26.6)., Conclusion: We found that the cost of TB care is catastrophic for almost half of the TB-affected households in Tanzania; our findings support the results from other surveys recently conducted in sub-Saharan Africa. Collaborative efforts across health, employment and social welfare sectors are imperative to minimize household costs due to TB disease and improve access to care, patient adherence and outcomes., (© 2022. The Author(s).)