Equity in water, sanitation, hygiene, and waste management services in healthcare facilities in Tanzania.

Objectives: To determine coverage and the reliability of water, sanitation, hygiene (WASH) and healthcare waste management (HCWM) services in healthcare facilities (HCFs) in Tanzania. Study design: Cross-sectional study design. Methods: Data of 1066 HCFs in Tanzania from the 2014-15 Tanzania Service Provision Assessment (TSPA) survey were analyzed. The availability of WASH and HCWM services was examined across facility locations, types, and managing authorities. Descriptive statistics, and bivariate and multivariate logistic regression analyses were performed. Results: HCFs with improved water sources, with functional improved latrines for patients, and using the incineration method to treat sharps waste before final disposal were 81.2%, 70.6%, and 41.3%, respectively. Among the HCFs with improved water sources and with functional improved latrines for patients, 50.9% and 50.6% respectively experienced water outages. Rural HCFs were less likely to have water sources on-site within 500 m (AOR 0.41; 95%CI 0.24-0.68), and soap, running water or alcohol-based hand rub (AOR 0.54; 95%CI 0.37-0.80). Rural HCFs were 0.25 times less likely to have functioning improved latrines for patients than urban HCFs (p < 0.001). Public HCFs were 0.5 times less likely to have an incineration method for sharps waste treatment than private HCFs (p < 0.001). Conclusion: Access inequity in WASH and HCWM was observed in HCFs in rural areas and those under public management. To attain equity and sustainability, investing in improving WASH and HCWM services for both new and renovations projects, must consider the circumstance status of the marginalized society.

Commercial motorcyclists and road safety measures compliance. A case study of Dodoma city, central Tanzania.

Objective: Road traffic accidents have been reported to contribute a greater proportion of deaths. Motorcyclists are among the high-risk group within road users to succumb to road traffic accidents. Road traffic accidents reflect the co-occurrence of multiple causes that involve road infrastructure, vehicle, and people. Understanding the level of compliance with road safety measures and their associated factors among commercial motorcyclists is important approach in the steps towards road traffic accident prevention. Study design: A cross-sectional study of commercial motorcyclists from two districts in Dodoma region was conducted in 2020. Methods: Multistage sampling method was used to recruit motorcyclists from registered parking stations. At first stage, purposive sampling was used to select the two districts, while in the second stage simple random sampling by lottery method was employed in the selection of wards and parking stations. Descriptive and Chi-square test analyses determined the compliance level. Bivariate and multivariate logistic regression analyses were performed to determine the associated factors. Results: A total of 378 male commercial motorcyclists participated in the study. Majority (87.8%) were within the age range of 18-29 years. A significant proportion of participants (61.9%) had adequate knowledge and 59.5% showed positive attitude towards road safety measures. Only 39.7% reported to have good level of compliance with road safety measures. Married motorcyclists and those with good road safety practice regarding road safety measures were more likely to comply with road safety measures than their counterpart. Conclusion: Good road safety practices and marital status were predictors of good compliance with road safety measures. Coordinated approaches, including continuing provision of road safety education and enforcement of road safety measures are needed to control the way motorcyclist behave on the road.

Consumer awareness and production practices of farmers on antimicrobial residues in chicken eggs and Chinese cabbage in Dodoma, Central Tanzania.

BACKGROUND: Antimicrobial residues (ABs) in foods contribute to the development of antimicrobial resistance, which is becoming a major public health concern around the world. Understanding food production practices concerning antimicrobial use and consumer awareness on the possibility of ABs in foods is necessary for developing mitigation strategies. Therefore, this study was conducted to assess the production practices and awareness among eggs and Chinese cabbage consumers in Dodoma city. METHODS: A cross-sectional study was conducted using a structured questionnaire and checklist to collect data on awareness and production practices from 420 consumers, 30 chicken egg farmers, and 30 Chinese cabbage farmers in eight city wards. FINDINGS: About 42% of consumers of eggs and Chinese cabbages were not aware of the likelihood of antimicrobial residues in these foods. The awareness was significantly influenced by the consumer's educational level (p = 0.001) and geographical location (p = 0.045), with educated and urban consumers being 7.7 and 1.6 times more informed than their uneducated and peri-urban counterparts. Furthermore, the majority of chicken farmers raised more layers than broilers, and they all used antimicrobial drugs, mainly tetracycline and its variants, to treat and prevent diseases. The findings also revealed that many vegetable producers utilized wastes from animals treated with antimicrobials as manure to amend the soil. CONCLUSION: In a view of the findings, a considerable number of egg and Chinese cabbage consumers in Dodoma city were unaware on the likelihood of antimicrobial residues in these foods from their production practices. All chicken farmers utilized antimicrobial drugs mainly tetracycline and its derivatives, for the treatment and prevention of diseases while vegetable producers used wastes from animals treated with antimicrobials as soil manure. Therefore, initiatives to inform farmers and consumers about the possibility of antimicrobial residues in these foods and their related public health risks upon long-term consumption are strongly advised.

Biolarviciding implementation in southern Tanzania: Scalability opportunities and challenges.

BACKGROUND: The resistance to insecticides among malaria vectors poses a global challenge in the efforts towards malaria elimination. This calls for an addition of larval control methods such as biolarviciding. However, the implementation of biolarviciding in Tanzania has been very low. Therefore, this study explored factors affecting the implementation of biolarviciding in the councils of Southern Tanzania. METHODS: A mixed method descriptive qualitative, cross-sectional study design was used to collect data from 32 community leaders through key informant interviews and 12 Vectors Control Coordinators through in-depth interviews and questionnaire interviews and document review of implementation reports in 12 councils. Data were analysed using ATLAS.ti version 8, where content analysis was performed and SPSS for the quantitative data. RESULTS: The study found low implementation of biolarviciding intervention in 9 out of 12 (75%) surveyed councils. All Vector Control Coordinators reported a shortage of at least one type of resources: funds, trained personnel, transport, supply of biolarvicide, and equipment; low community involvement (50%) and low level of community participation 83.3% (10/12). CONCLUSION: This study highlights resource inadequacy and low community participation as main barriers to the implementation of biolarviciding. Availing adequate resources and strengthening community participation through involvement in all stages of implementation is crucial for successful and sustainable implementation.

Biolarviciding for malaria vector control: Acceptance and associated factors in southern Tanzania.

In the struggle towards malaria elimination, the government of Tanzania scaled up nationwide biolarviciding to supplement existing vector control measures. As with any community-based intervention, success of biolarviciding depends on acceptability to the community. This study sought to ascertain acceptance of biolarviciding among communities in southern Tanzania. A mixed-method study involved administration of questionnaires to 400 community members, with 32 key informant interviews and five in-depth interviews also held in selected councils of southern Tanzania. A multistage sampling method was employed in selecting community members, with purposive sampling used in selecting key informant and in-depth interviewees. The study found high community acceptance (80.3%) despite very low (19.3%) knowledge on biolarviciding. Community perception that biolarvicide is effective in reducing malaria infection was found to be a significant predictor of community acceptance to biolarviciding: those who perceived biolarvicide as effective in reducing malaria were five times more likely to accept biolarviciding compared to those with a negative perception (odds ratio = 4.67, 95% CI: 1.89-11.50, P = 0.001). We conclude that biolarviciding received high acceptance among community members in southern Tanzania and therefore the implementation is likely to get strong support from community members. To enhance and make community acceptance sustainable, heath education to enhance the level of community knowledge on biolarviciding is recommended.