Prevalence of late antenatal care booking among pregnant women attending public health facilities of Kigamboni Municipality in Dar es Salaam region, Tanzania.

Background: Good care during pregnancy is important for the health of mothers and development of the unborn baby. The study determined the prevalence and factors associated with late ANC booking among pregnant women at health facilities in Kigamboni Municipality in Dar es Salaam, Tanzania. Methods: This was an analytical cross-sectional study among pregnant women attending ANC services during second and third trimester in the selected health facilities. The study recruited 204 through convenient sampling. Multi-stage cluster sampling was used to select health facilities. A Standardised questionnaire was used to collect information through face-to-face interviews. Data was analysed using SPSS version 25.0. Proportions were used to estimate the magnitude of late ANC booking while bivariate and multivariate analyses were performed to determine factors associated with the magnitude of late ANC booking. Results: Late ANC bookings were high 174 (85.3%) among pregnant women who attended clinic week 13 and later compared to those who attended earlier than 13 weeks 30 (14.7%). Factors associated with likelihood for late ANC booking during the initial visit included tertiary education [AOR= 10.174, 95%CI: 1.002-103.301] and primigravida [AOR=0.101, 95%CI: 0.170-0.605]. Conclusion: Majority of the pregnant women started ANC later than the recommended time. Health education provision at all community levels on the advantages and disadvantages of early and late ANC booking respectively should be strengthened.

A systems approach to implementation of eLearning in medical education: five MEPI schools' journeys.

How should eLearning be implemented in resource-constrained settings? The introduction of eLearning at four African medical schools and one school of pharmacy, all part of the Medical Education Partnership Initiative (MEPI) eLearning Technical Working Group, highlighted the need for five factors essential for successful and sustainable implementation: institutional support; faculty engagement; student engagement; technical expertise; and infrastructure and support systems. All five MEPI schools reported strengthening technical expertise, infrastructure, and support systems; four schools indicated that they were also successful in developing student engagement; and three reported making good progress in building institutional support. Faculty engagement was the one core component that all five schools needed to enhance.

Modernizing and transforming medical education at the Kilimanjaro Christian Medical University College.

The Kilimanjaro Christian Medical University (KCMU) College and the Medical Education Partnership Initiative (MEPI) are addressing the crisis in Tanzanian health care manpower by modernizing the college's medical education with new tools and techniques. With a $10 million MEPI grant and the participation of its partner, Duke University, KCMU is harnessing the power of information technology (IT) to upgrade tools for students and faculty. Initiatives in eLearning have included bringing fiber-optic connectivity to the campus, offering campus-wide wireless access, opening student and faculty computer laboratories, and providing computer tablets to all incoming medical students. Beyond IT, the college is also offering wet laboratory instruction for hands-on diagnostic skills, team-based learning, and clinical skills workshops. In addition, modern teaching tools and techniques address the challenges posed by increasing numbers of students. To provide incentives for instructors, a performance-based compensation plan and teaching awards have been established. Also for faculty, IT tools and training have been made available, and a medical education course management system is now being widely employed. Student and faculty responses have been favorable, and the rapid uptake of these interventions by students, faculty, and the college's administration suggests that the KCMU College MEPI approach has addressed unmet needs. This enabling environment has transformed the culture of learning and teaching at KCMU College, where a path to sustainability is now being pursued.