Rose Mpembeni

This study aimed to assess the implementation of the MDSR system. The mixed cross-sectional study was conducted in 12 regions. The quantitative analysis used ordinal intervals: Excellent, Good, Satisfactory and Poor. Qualitative analysis developed themes to inform MDR system implementation. The findings showed that leaders were following up at the health facility, the community, and individual clients. The system implementation at the regional level was Satisfactory (75–84%), and at the district and health facility level was Poor (below 75%). Generally, responses to the action plan at all levels studied were rated Poor. The timeliness of notification to MD was found to be Satisfactory (75–84%) in three regions and Poor in Dar es Salaam and Mwanza. The daily notification of MDs was 57.3% of the 349 weekly reports. The completeness variables improved significantly to Excellent scores (above 95%) after a week, but not for notifications. Therefore, the system produces data that goes beyond numbers, thereby making it not inferior. The system generates MD data through timely notifications and weekly reporting, with the latter yielding twice as much.

Hypertension affects 15–25% of adults in Tanzania, yet fewer than 30% of treated patients achieve blood pressure control. Poor control contributes to stroke, heart failure, and renal disease. The National Standard Treatment Guidelines (NSTGs), 6th edition (2021), provide guidance for management, but healthcare provider adherence to the guidelines remains unclear. A mixed-methods cross-sectional study was conducted at five public district hospitals in Dar es Salaam, Tanzania between 1 ^st April and 31 ^st May 2025. Quantitative data from patient records assessed healthcare provider adherence to pharmacological treatment, complication monitoring, and comorbidity screening, categorized as complete, partial, or non-adherent. Modified Poisson regression identified associated patient and provider factors. Qualitative data from 11 in-depth interviews were thematically analysed to explore barriers and facilitators to adherence. The median age of the 397 patients was 55 years (IQR: 52–61), 79.1% were female, 40.0% had at least one comorbidity, and 65.2% were overweight. Only 26.2% were managed with complete adherence to NSTGs. Higher adherence was associated with follow-up visits (aPR = 5.81; 95% CI: 1.59–21.27), Grade 1 hypertension (aPR = 3.87; 95% CI: 1.99–7.53), Grade 2 hypertension (aPR = 5.06; 95% CI: 1.52–16.73), comorbidities (aPR = 2.35; 95% CI: 1.25–4.41), specialist cadre (aPR = 7.00; 95% CI: 1.05–46.55), and provider experience of 5–10 years (aPR = 3.25; 95% CI: 1.17–9.03) and >10 years (aPR = 3.91; 95% CI: 1.20–12.73). Barriers included outdated guidelines, limited resources, staffing shortages, and inadequate training, while facilitators included mentorship, peer collaboration, accessible guidelines, and continuing medical education. Healthcare provider adherence to NSTGs in management of hypertension was low. Strengthening guideline implementation through updated recommendations, provider training, improved resource availability, and supportive supervision may enhance adherence and improve patient outcomes.

This study aimed to assess the implementation of the MDSR system. The mixed cross-sectional study was conducted in 12 regions. The quantitative analysis used ordinal intervals: Excellent, Good, Satisfactory and Poor. Qualitative analysis developed themes to inform MDR system implementation. The findings showed that leaders were following up at the health facility, the community, and individual clients. The system implementation at the regional level was Satisfactory (75%-84%), and at the district and health facility level was Poor (below 75%). Generally, responses to the action plan at all levels studied were rated Poor. The timeliness of notification to MD was found to be Satisfactory (75%–84%) in three regions and Poor in Dar es Salaam and Mwanza. The daily notification of MDs was 57.3% of the 349 weekly reports. The completeness variables improved significantly to Excellent scores (above 95%) after a week, but not for notifications. Therefore, the system produces data that goes beyond numbers, thereby making it not inferior. The system generates MD data through timely notifications and weekly reporting, with the latter yielding twice as much.

Introduction: Newborn mortality is unacceptably high, especially in low- and middle-income countries. The Safer Births Bundle of Care (SBBC) was implemented in Tanzania, including training of healthcare workers on neonatal resuscitation by means of frequent in situ simulation training using improved training tools. We aimed to assess the acceptability of this training model among healthcare providers in selected health facilities under SBBC intervention. Methods: A cross-sectional study was conducted among healthcare workers in labor wards and obstetric theaters in selected facilities one year after the introduction of the SBBC model. The theoretical framework for assessment of the acceptability of healthcare interventions was used to assess the acceptability of the training model and accompanying tools. The chi-square test was used to assess the association between acceptability in specific constructs and average individual practice per month, while a modified Poisson regression analysis was used to assess factors associated with acceptability in specific framework constructs. Results: A total of 227 healthcare workers were enrolled in the study. Overall, 223 (98.2%) accepted the intervention. However, 207 (91.2%) reported that the intervention increased their work burden, while 39 (17.2%) reported that it interfered with other equally important activities. The level of health facility was independently associated with the reporting that engaging in simulation practice interfered with other equally important activities. Conclusions: In situ, low-dose, high-frequency facility-based simulation training for neonatal resuscitation was highly acceptable among healthcare providers. However, the perceived increased work burden of this intervention and interference with other equally important activities were identified as potential threats to successful implementation.

Micronutrient deficiencies can hurt the health of women of reproductive age (WRA), their pregnancy outcomes, and the growth and development of their offspring in sub-Saharan African countries. The present study aimed to estimate the dietary intake of non-pregnant and non-lactating (NPNL) WRA, residing in seven districts of the Mbeya region in Tanzania using a 24-hour dietary recall. A cross sectional study was conducted among 500 NPNL WRA. A two-stage sampling method was used, three enumeration areas (EAs) were chosen for each district using the probability proportional to size and, 24 eligible households were randomly selected from each chosen EA.The SAS macros (version 9.4) were used to analyse the quantities consumed and explore the usual intakes of three fortified food vehicles. The median intake of oil, wheat flour, and calories was 36.47g, 110.53g, and 2,169.9 kcal, respectively. The median protein intake was 63.5g, higher than the recommended value of 56.0g. Among the micronutrients, zinc had the highest prevalence of inadequate intake (91.2%), followed by iron (82.2%), and vitamin B12 (80.0%). Vitamin E had the highest nutrient gap (50.7%), while the nutrient gap in Q1 was relatively low (9.8%). There was a moderate prevalence of inadequate intake of vitamin C (46.5%) and riboflavin (54.8%), with a nutrient gap in Q1 (42%). Inadequate intake of vitamin A, thiamine, niacin, vitamin B6, and folate was moderate, ranging from 32.6% to 44.4%, with a nutrient gap at Q1 ranging from 16.2% to 34%. Our study has revealed a prevalent inadequate intake of micronutrients among NPNL WRA. Furthermore, our findings suggest that fortifying oil represents a promising intervention. However, fortified wheat flour had limited reach among NPNL WRA in the Mbeya region of Tanzania.

With 608 000 deaths annually in 2022, malaria remains a major public health challenge in sub-Saharan Africa over the past decade, despite worldwide efforts to eliminate it [1]. The burden of malaria has intensified, particularly in the aftermath of the COVID-19 pandemic and the expansion of mosquito habitats due to climate changes [2,3]. Malaria is mostly […]

Recent evidence suggests that 44.8% of women of reproductive age (WRA) in Tanzania suffer from anemia. Addressing this public health challenge calls for local evidence of its burden and determinants thereof for policy and tailored interventions. This secondary data analysis used Tanzania Demographic and Health Surveys (TDHS) 2004–2005 and 2015–2016 with a total of 23,203 WRA. Data were analyzed using descriptive statistics to characterize the burden of anemia, regression analyses to examine the adjusted change in the prevalence of anemia and remaining determinants thereof, and the Global Information System (GIS) to map the differences in the burden of anemia in Tanzania over the period of one decade. Considering the risk factors of anemia observed in our study, WRA in Tanzania should have been 15% less likely to suffer from anemia in 2015 compared to 2005. However, a small decline (3.6%) was not evenly distributed across the regions in Tanzania. Factors that remained significantly associated with anemia among WRA in the latest survey include age above 35 years (AOR = 1.564, p = 0.007), education level (AOR = 0.720, p = 0.001), pregnancy status (AOR = 1.973, p < 0.001), and use of contraception (AOR of 0.489, p < 0.001). Our findings suggest that WRA in Tanzania aged above 35 should be the target population to accept the more tailored interventions.

Many adolescent girls and young women (AGYW) experience gender-based violence (GBV) in Tanzania and only few seek GBV health services following violence. The objectives of our study are (1) to evaluate knowledge of gender-based violence among AGYW, (2) to explore their perceptions of and experiences with GBV health service quality and (3) to evaluate access to comprehensive GBV services. This study employed an explanatory, sequential mixed methods design in two districts of Dar es Salaam, Tanzania (Kinondoni and Temeke). A quantitative cross-sectional survey among AGYW (n = 403) between 15–24 years old was performed to assess their knowledge of GBV as well as perceptions of and experiences with GBV health services. The quantitative data was complemented by 20 semi-structured in-depth interviews with participants. Out of 403 study participants, more than three quarters (77.9%) had moderate to good knowledge of how GBV is defined and what constitutes gender-based violence. However, few participants (30.7%, n = 124) demonstrated knowledge of GBV health services offered at local health facilities. For example, only 10.7% (n = 43) of participants reported knowledge of forensic evidence collection. Additionally, of 374 participants (93% of total participants) who reported to have received GBV education sessions, only 66% accessed GBV health services (n = 247) and about half of these (52.7%, n = 130) were satisfied with these services. The study indicated that—despite good knowledge about what constituted GBV—knowledge about the roles and availability of GBV health services was limited and utilization of GBV health services remained low. Coordinated actions need to be strengthened to reach AGYW who remain unaware of GBV health services offered at health facilities by improving GBV service quality, bettering interventions aimed at reducing GBV among AGYW in Tanzania, and scaling-up integrated service models, such as GBV one-stop centers.

The burden of child anemia is on the decline globally but remains prevalent in low- and middle-income countries, including Tanzania. Evidence suggests regional variation and a slow pace of decline even in areas with high food production. The factors behind such decline and remaining challenges behind child anemia remain understudied in Tanzania. This secondary data analysis utilized data including 7361 and 7828 children from the Tanzania Demographic and Health Surveys (TDHS) conducted in 2004–2005 and 2015–2016 separately to examine the decline of child anemia and regional variation thereof. We used a geographic information system (GIS) to visualize the changes and differences between regions and the two study periods, and used regression analyses to examine the recent determinants of child anemia. Anemia has declined among children under five in Tanzania by 42% over a one-decade period, but remained high in relatively high food-producing regions. The risk of anemia is still higher among boys compared to girls (AOR = 1.39, p = 0.005), 41% higher among children lived in households with more than three under-five children compared to those households with only one child (p = 0.002); lower among children whose mothers were educated (p < 0.001) or had first given birth when aged over 25 (p = 0.033); and 34% less among children in the wealthiest households (p < 0.001). Efforts are needed to address social determinants of health, especially targeting women’s empowerment through decreasing the number of children and encouraging child spacing, and poverty reduction, particularly in high food producing regions.

Background: Tanzania has made a significant improvement in wasting and underweight indicators. However, stunting has remained persistently higher and varying between regions. We analyzed Tanzania Demographic and Health Survey (TDHS) datasets to examine (i) the trend of stunting over the period of 25 years in Tanzania and (ii) the remaining challenges and factors associated with stunting in the country. Methods: This secondary data analysis included six TDHS datasets with data of 37,409 under-five children spreading in 1991–1992(n = 6587), 1996(n = 5437), 1999(n = 2556), 2004–05(n = 7231), 2009–10(n = 6597), and 2015–16(n = 9001) conducted in all regions of Tanzania. Variables specific to children and their caregivers were analyzed using SPSS version 22. The variables considered include child anthropometric variables, caregiver’s demographic characteristics and household’s socio-economic factors. We used frequencies and percentages to compare stunting prevalence across the six surveys and chi-square test and three-level hierarchical logistic regression to examine the factors associated with stunting also applying sample weighting as advised by TDHS. Results: The prevalence of stunting has declined by 30% over the period of 25 years in Tanzania. However, one in three children aged below five years remains stunted with overweight and obesity more than doubled (from 11 to 25%) in the same period among women of reproductive age. The factors associated with stunting included children living in female-headed households (AOR = 1.16, P = 0.014), aged 24–35 months (AOR = 1.75, P = 0.019), born with low birth weight (AOR = 2.14, P < 0.001) and with inconsistent or without breastfeeding (AOR = 3.46, P < 0.001 and AOR = 4.29, P = 0.001) respectively. The risk of stunting among children living in urban area (AOR = 0.56, P < 0.001), with higher caregiver’s education (AOR = 0.56, P = 0.018), obese mother (AOR = 0.63, P < 0.001), households with highest wealth index (AOR = 0.42, P < 0.001), and among girls (AOR = 0.77, P < 0.001). Conclusions: The burden of stunting in Tanzania has declined by 30% in the past 25 years, but still affecting one in every three children. Efforts are needed to increase the pace of stunting decline especially among boys, children in rural areas, from poor, uneducated, and female-headed households, and through improving infant and young feeding practices. Effective and tailored nutrition-sensitive and specific interventions using multisectoral approaches should be considered to address these important determinants.