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BACKGROUND: Community violence has been found to be highly prevalent in Dar es Salaam, Tanzania. Increasing socioeconomic inequality has been outlined as one of the main causes of community violence. This controlled pilot trial aimed at evaluating the impact of beekeeping and entrepreneurship training on community violence exposure, financial and social capital generation, and employment structure. METHODS: Poisson regression was used to compare pre- and post-intervention risk ratios for community violence exposure. Linear regression was used to depict change in weekly income and utu scores. Employment rate structures were determined pre- and post-intervention. RESULTS: This study reports that compared to the Control arm beekeeping and entrepreneurship training appears to have protected young men in Dar es Salaam from exposure to community violence (All = 0.62 (0.40-0.96), Beekeeping = 0.57 (0.30-1.08), Entrepreneurship = 0.62 (0.33-1.17)), while increasing financial (All = 23,145 (- 27,155 - 73,444), Beekeeping = 29,310 (- 26,079 - 84,698), Entrepreneurship = 82,334 (12,274 - 152,293)) and partially also social capital (All = - 0.24 (- 1.35-0.87), Beekeeping = 0.85 (- 0.26-1.96), Entrepreneurship = 0.30 (- 1.16-1.77)). Financial dependency across all arms was reduced from 29.1 to 2.2%. CONCLUSIONS: Our study reports that beekeeping training and entrepreneurship seminars appear to have a protective effect against exposure to community violence among young men in Dar es Salaam, while partially also increasing financial and social capital, as well as reducing financial dependency. We recommend that these results should lay the foundation for an adequately powered randomized trial to confirm the study's efficacy. TRIAL REGISTRATION: retrospectively registered at ClinicalTrials.gov (Identifier: NCT04602416; October 26, 2020).
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Capital Social , Empleo , Humanos , Masculino , Proyectos Piloto , Tanzanía , Violencia/prevención & controlRESUMEN
BACKGROUND: Implementation of evidence-based guidelines (EBGs) related to VAP is an effective measure for the prevention of ventilator-associated pneumonia (VAP). While low knowledge regarding the EBGs related to VAP prevention among ICU nurses is still a major concern among nurses in ICUs globally, the situation in Tanzania is scarcely known. This study aimed to assess the ICU nurses' knowledge, compliance, and barriers toward evidence-based guidelines for the prevention of VAP in Tanzania. METHODS: A cross-sectional study, involving ICU nurses of major hospitals in Tanzania, was conducted. A structured questionnaire was administered among 116 ICU nurses. Data analysis included descriptive statistics and the independent sample t-test. RESULTS: The mean knowledge score was 3.86(SD = 1.56), based on ten questions (equivalent to 38.6%). Nurses with a degree or higher level of nursing education performed significantly better than the nurses with a diploma or lower level of nursing education (p = 0.004). The mean self-reported compliance score for EBGs for the prevention of VAP was 15.20 (SD = 0.93) which is equivalent to 60.8% based on 25 questions. The main barriers to the implementation of EBGs for VAP prevention were lack of skills (96.6%), lack of adequate staff (95.5%), and lack of knowledge (79.3%). CONCLUSION: Considering the severity and impact of VAP, and the higher risks of HAIs in resource-limited countries like Tanzania, the lower level of knowledge and compliance implies the need for ongoing educational interventions and evaluation of the implementation of the EBGs for VAP prevention by considering the local context.
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BACKGROUND: In low and middle-income countries (LMICs), laypersons play a significant role in providing initial care to injured victims of traffic accidents. Post-crash first aid (PFA) training programmes for laypersons have become an important response to addressing knowledge and skills gaps in pre-hospital care. However, little is known about factors influencing effective implementation of such programmes from stakeholders' point of view. Therefore, this study aimed to explore views of stakeholders on potential factors that may facilitate or hinder successful implementation of a PFA training programme for lay persons. METHODS: Twelve semi-structured qualitative interviews with leaders at a traffic police department and leaders of an association of city bus drivers, taxi drivers and motorcycle taxis in Tanzania were conducted. Interviews were audio-recorded and transcribed verbatim. A thematic analysis approach was used to identify themes and sub-themes. RESULTS: Three themes pertaining to implementation of a PFA training programme were identified: Motivation for engaging in training, Constrains for engaging in training and Training processes. They consisted of a total of six sub-themes: "perceived benefits of first aid training" and "availability of incentives" were considered as facilitators to PFA training. "Availability of time to attend training" and "accessibility of training" were reported as a potential barriers to successful training. Finally, they felt that "methods of training delivery" and "availability of first aid training materials and equipment" could either facilitate or impede delivery of PFA training. CONCLUSION: This study highlights potential facilitators and barriers to implementing a PFA training programme for lay persons from the perspectives of leaders from police department and associations of city bus drivers, taxi drivers, and motorcycle taxis. This may be useful information for other stakeholders, and may enable government-level leaders and persons higher up in the health service hierarchy to take action to meet WHO recommendations for emergency pre-hospital care.
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Accidentes de Tránsito , Servicios Médicos de Urgencia/organización & administración , Primeros Auxilios/métodos , Policia/educación , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , TanzaníaRESUMEN
BACKGROUND: The World Health Organisation (WHO) recommends involving lay people in prehospital care. Several training programmes have been implemented to build lay responder first aid skills. Findings show that most programmes significantly improved participants' first aid skills. However, there is a gap in knowledge of what factors influence the use of these skills in real situations. The current study aimed to describe police officers' views on and experiences of factors that facilitate or hinder their use of trained first aid skills at work. METHODS: Thirty-four police officers participated in five focus group discussions. A structured interview guide was used to collect data. Interviews were audio-recorded and transcribed verbatim. Data were analysed using qualitative content analysis. RESULTS: We identified five categories of facilitators or hindrances. Training exposure was considered a facilitator; work situation and hospital atmosphere were considered hindrances; and the physical and social environments and the resources available for providing first aid could be either facilitators or hindrances. CONCLUSION: Practical exposure during training is perceived to improve police officers' confidence in applying their first aid skills at work. However, contextual factors related to the working environment need to be addressed to promote this transfer of skills.
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Accidentes de Tránsito , Competencia Clínica , Medicina de Emergencia/educación , Primeros Auxilios , Policia/educación , Adulto , Femenino , Grupos Focales , Humanos , Masculino , Investigación Cualitativa , TanzaníaRESUMEN
BACKGROUND: An overwhelming proportion of road traffic deaths and injuries in low- and middle-income countries (LMICs) occur in prehospital environments. Lay first responders such as police officers play an important role in providing initial assistance to victims of road traffic injuries either alone or in collaboration with others. The present study evaluated a postcrash first aid (PFA) educational program developed for police officers in Tanzania. METHOD: A 16-h PFA educational program was conducted in Dar es Salaam, Tanzania, for 135 police officers. Participants completed training surveys before, immediately and 6 months after the training (before, N = 135; immediately after, N = 135; after 6 months, N = 102). The primary outcome measures were PFA knowledge, perceived skills confidence, and skills utilization. Parametric and nonparametric tests were used to analyse changes in outcome. RESULTS: The mean PFA knowledge score increased from 44.73% before training (SD = 20.70) to 72.92% 6 months after training (SD = 18.12), p < .001, N = 102. The mean PFA perceived skills confidence score (measured on a 1-5 Likert scale) increased from 1.96 before training (SD = 0.74) to 3.78 6 months after training (SD = 0.70), p < .001, N = 102. Following training, application of the recovery position skill (n = 42, 46%) and application of the bleeding control skill (n = 45, 49%) were reported by nearly half of the responding officers. Less than a quarter of officers reported applying head and neck immobilization skills (n = 20, 22%) following training. CONCLUSION: A PFA educational program has shown to improve police officers' knowledge and perceived skills confidence on provision of first aid. However qualitative research need to be conducted to shed more light regarding reasons for low utilization of trained first aid skills during follow-up.
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Accidentes de Tránsito , Primeros Auxilios/métodos , Conocimientos, Actitudes y Práctica en Salud , Policia/educación , Adulto , Países en Desarrollo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
In Tanzania, waste stabilization ponds (WSPs) are employed to treat wastewater, and effluents are used for urban agricultural activities. The use of untreated or partially treated wastewater poses risks of disease transmission, including parasitic and bacterial infections, to exposed communities. Little is known about the occurrence, concentration, and removal of parasites and fecal coliform (FC) bacteria in WSPs in Tanzania. This study evaluates the occurrence and concentration of parasites and FCs in wastewater, the efficiency of WSPs in removing parasites and FCs, and the validity of using FCs as an indicator of parasites. This was a cross-sectional study conducted between February and August 2018. Wastewater samples were collected from three WSPs located in the Morogoro, Mwanza, and Iringa regions. APHA methods were used to test physicochemical parameters. The modified Bailenger method and Ziehl-Neelsen stain were used to analyse parasites. Membrane filtration method was used to analyse FCs. Data were analysed using IBM SPSS version 20. Helminth egg removal ranged from 80.8% to 100%. Protozoan (oo)cyst removal ranged from 98.8% to 99.9%. The Mwanza WSP showed the highest FC reduction (3.8 log units (100 mL)-1). Both the parasites and FCs detected in the effluents of assessed WSPs were of higher concentrations than World Health Organization and Tanzania Bureau of Standards limits, except for helminths in the Morogoro WSP and FCs in the Mwanza WSP. FCs were significantly correlated with protozoa (p < 0.01) and predicted protozoa occurrence well (p=0.011). There were correlations between physicochemical parameters, parasites, and FC bacteria in the WSP systems. Inadequate performance of these systems may be due to lack of regular maintenance and/or systems operating beyond their capacity. FC indicators were observed to be a good alternative for protozoa monitoring, but not for helminths. Therefore, during wastewater quality monitoring, helminths should be surveyed independently.
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Heces/parasitología , Estanques/parasitología , Administración de Residuos , Aguas Residuales/parasitología , Animales , Fenómenos Químicos , Estudios Transversales , Carga de Parásitos , Tanzanía , Administración de Residuos/métodos , Aguas Residuales/análisis , Aguas Residuales/químicaRESUMEN
BACKGROUND: Recently, road traffic injuries (RTIs) have become a major health problem affecting health systems in many low- and middle-income countries. Regardless of whether an ambulance is available for evacuation, police officers have been shown to arrive at the crash scene first, becoming, in effect, the first responders to RTI victims. Therefore, the study aimed to explore the experiences of traffic police officers in regard to the provision of care to RTI victims in the prehospital environment, including the role of traffic police upon arriving at the crash scene, the challenges they face, and their opinions about how to improve care to RTI victims. METHOD: The study used a qualitative approach in which data were obtained from 10 individual interviews and three focus group discussions. There were 41 participants, 27 of them were male and 14 were female. About half (48.7%) of the study participants were aged between 30 to 39 years. Qualitative content analysis was used to analyse all the materials. RESULTS: Three themes emerged from the analysis. The theme "Maintain safety while saving injured victims' lives and facilitating access to a health facility" was comprised of safety, sorting, initial help, and assisting access to hospital care. "Overwhelmed working with limited resources and support" included limited care and transport resources, police fatigue, and little or no support. "Improving supportive system and empowering frontline personnel" included the need for an emergency care system, availability of resources and an emergency medical support system, and training for police and drivers regarding victims' first-aid care, and road safety. CONCLUSION: The study findings characterize an environment in which the police first responders have no knowledge or skills and no equipment and supplies to provide care to RTI victims at the scene before rushing them to definitive care. The results suggest a favorable climate for training and equipping officers so that they can deliver competent postcrash care at the scene while emergency medical services are yet to be established. However, more research will be needed to determine the efficacy of such training and its acceptability in the Tanzanian context.
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Accidentes de Tránsito , Servicios Médicos de Urgencia/organización & administración , Policia/psicología , Lugar de Trabajo/psicología , Heridas y Lesiones/epidemiología , Heridas y Lesiones/terapia , Adulto , Fatiga/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rol Profesional , Investigación Cualitativa , Seguridad , Tanzanía/epidemiologíaRESUMEN
BACKGROUND: The availability of prehospital trauma care is an important means of reducing serious injuries and fatalities associated with road traffic injuries (RTIs). Lay responders such as traffic police play an important role in the provision of prehospital trauma care to RTI victims, especially where there is no established prehospital care system. Therefore, the objective of the present study was to investigate knowledge, self-reported practice, and attitudes toward post-crash first aid among traffic police officers in Tanzania. METHOD: A cross-sectional survey was conducted in Dar es Salaam, Tanzania between July-September 2017 to investigate knowledge, self-reported practice and attitude among traffic police officers during provision of post-crash care. We used simple random technique to recruit 340 traffic police officers, self -administered questionnaires were used to collect data. The researchers used descriptive statistics and Pearson's chi-square tests to analyze the data. RESULTS: A total of 340 traffic police officers were surveyed. Nearly two thirds (65.3%) reported having had post-crash first aid on-the job training; a slightly larger proportion (70.9%) reported that they had cared for RTI victims in the previous year. The survey responses showed that, generally, traffic police officers' level of knowledge about post-crash first aid to RTI victims was low-about 3% of the surveyed officers possessed knowledge at a level considered good. Also, there was a statistically significant correlation between higher educational attainment and greater knowledgeability (p = 0.015). Almost all of the officers (96%) had a positive attitude toward providing post-crash first aid to RTI victims. CONCLUSIONS: Improved training of Tanzania traffic police officers, by means of an updated post-crash first aid curriculum and updated resources is recommended. Also, user-friendly post-crash first aid leaflets should be provided to traffic police for their reference.
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Accidentes de Tránsito , Primeros Auxilios , Policia , Adulto , Estudios Transversales , Atención a la Salud , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Tanzanía , Adulto JovenRESUMEN
BACKGROUND: Relapse in people with schizophrenia is a major challenge for mental health service providers in Tanzania and other countries. Approximately 10% of people with schizophrenia are re-admitted due to relapse at Muhimbili National Hospital (MNH) Psychiatric Unit each month. Relapse brings about negative effects and it results in a huge burden to patients, their families, the mental health sector and the country's economy. So far no study has been done to address relapse in Tanzania. The purpose of the study was to explore perspectives on risk and protective factors influencing relapse of people with schizophrenia and their caregivers attending Muhimbili National Hospital Psychiatric Out-patient Department, Dar es Salaam, Tanzania. METHODS: A qualitative study was conducted, involving in-depth interviews of seven people with schizophrenia who are out-patients and their seven family caregivers at MNH. Purposive sampling procedure was used to select participants for the study. Audio recorded in-depth interviews in Swahili language were conducted with all study participants. The recorded information was transcribed and analyzed using NVivo 9 computer assisted qualitative data analysis software. RESULTS: Personal risk and protective factors for relapse, environmental risk and protective factors for relapse and suggestions to reduce relapse were the main themes that emerged from this study. People with schizophrenia and their caregivers (all of whom were relatives) perceived non adherence to antipsychotic medication as a leading risk factor of relapse; other risks included poor family support, stressful life events and substance use. Family support, adherence to antipsychotic medication, employment and religion were viewed as protective factors. Participants suggested strengthening mental health psycho-education sessions and community home visits conducted by mental health nurses to help reduce relapse. Other suggestions included strengthening the nurse-patient therapeutic relationship in provision of mental health care. CONCLUSIONS: This study calls for improvement in mental health care service delivery to individuals with schizophrenia. Establishing a curricular in mental health nursing that aims to produce competent mental health nurse force would improve nursing practice in mental health care service delivery.
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Servicios de Salud Mental , Esquizofrenia/epidemiología , Esquizofrenia/terapia , Adulto , Anciano , Antipsicóticos/uso terapéutico , Cuidadores , Atención a la Salud , Femenino , Humanos , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , Pacientes Ambulatorios , Factores Protectores , Enfermería Psiquiátrica , Investigación Cualitativa , Recurrencia , Factores de Riesgo , Esquizofrenia/enfermería , Trastornos Relacionados con Sustancias/epidemiología , TanzaníaRESUMEN
OBJECTIVES: This study was performed to examine the potential contributions of sociocultural activities to reduce risks of death by homicide. METHODS: This study was designed as a case control study. Relatives of 90 adult homicide victims in Dar es Salaam Region, Tanzania, in 2005 were interviewed. As controls, 211 participants matched for sex and 5-year age group were randomly selected from the same region and interviewed regarding the same contents. RESULTS: Bivariate analysis revealed significant differences between victims and controls regarding educational status, occupation, family structure, frequent heavy drinking, hard drug use and religious attendance. Conditional logistic regression analysis indicated that the following factors were significantly related to not becoming victims of homicide: being in employment (unskilled labour: OR=0.04, skilled labour: OR=0.07, others: OR=0.04), higher educational status (OR=0.02), residence in Dar es Salaam after becoming an adult (compared with those who have resided in Dar es Salaam since birth: OR=3.95), living with another person (OR=0.07), not drinking alcohol frequently (OR=0.15) and frequent religious service attendance (OR=0.12). CONCLUSIONS: Frequent religious service attendance, living in the same place for a long time and living with another person were shown to be factors that contribute to preventing death by homicide, regardless of place of residence and neighbourhood environment. Existing non-structural community resources and social cohesive networks strengthen individual and community resilience against violence.
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Homicidio/estadística & datos numéricos , Medio Social , Adulto , Estudios de Casos y Controles , Escolaridad , Empleo , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Religión , Factores de Riesgo , Factores Socioeconómicos , Tanzanía/epidemiologíaRESUMEN
Snakebite envenoming causes more than 140,000 deaths annually and at least triple this number of disabilities. The World Health Organization classified snakebite as a Neglected Tropical Disease in 2017 and developed a strategy to halve death and disability from snakebite by 2030. To achieve this goal, snakebite victims need to receive safe and effective treatment. This descriptive, cross-sectional study surveyed student health professionals (N = 312) in Dar es Salaam, Tanzania, and was designed to identify major gaps in community practices and hospital resources for snakebite treatment. Participants reported using traditional community practices (44%, 95% confidence interval (CI) = 39-50%), allopathic practices (7%, 95% CI = 5-11%), or a combination of both (49%, 95% CI = 43-54%) to treat snakebite. Harmful practices included tight arterial tourniquets (46%, 95% CI = 41-52%) and wound incisions (15%, 95% CI = 11-19%). Many participants (35%, 95% CI = 29-40%) also turned to traditional healers. Students who treated snakebite injuries within the last 5 years (N = 69) also reported their general experiences with snakebite in hospitals. Hospitals often lacked essential resources to treat snakebite victims, and 44% (95% CI = 30-59%) of snakebite victims arrived at a hospital only three or more hours after the bite. A significant percentage of snakebite victims experienced lasting damage (32%, 95% CI = 20-47%) or death (14%, 95% CI = 7-25%). Snakebite outcomes could likely be improved if hospitals were universally and consistently equipped with the essential resources to treat snakebite victims, such as antivenoms. Educational interventions aimed at communities should focus on discouraging tourniquet use and tampering with the wound. Collaboration between the allopathic and traditional health system could further boost snakebite outcomes because traditional healers are often the first health workers to see snakebite victims.
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Mordeduras de Serpientes , Antivenenos/uso terapéutico , Estudios Transversales , Hospitales , Humanos , Enfermedades Desatendidas , Mordeduras de Serpientes/epidemiología , Mordeduras de Serpientes/terapia , Tanzanía/epidemiologíaRESUMEN
A foundational implementation of the WHO/CDC Injury Surveillance Guidelines was conducted in Dar es Salaam region of the United Republic of Tanzania in 2005. The Guidelines were adapted to gather qualitative as well as quantitative data about intentional injury mortality which were collected concurrently at the Muhimbili National Hospital Mortuary. An interview schedule of 12 quantitative variables and one open-ended question, participant observation and newspaper reports were used. Mixed methods allowed an understanding of intentional injury mortality to emerge, even for those with the least amount of data, the 22% of homicides whose bodies were never claimed. Mixed methods made it possible to quantify intentional injury mortality rates, describe subpopulations with scanty data, and learn how to embed ongoing injury mortality surveillance into daily practice.
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BACKGROUND: High unemployment rates and limited access to resources, services, and economic opportunities are associated with many types of violence. In Dar es Salaam, Tanzania, most violence is experienced by unemployed, poorly educated men between the ages of 20 and 35 years. It is expected that community violence will decrease as the incomes of those most at risk increase. However, economic opportunity through formal employment is rarely available to uneducated men in Dar es Salaam. Giving them access to economic independence through entrepreneurship training is therefore supported by the World Bank and the government of Tanzania. There has been little research on the effectiveness of programs to encourage entrepreneurship. METHODS: To evaluate the feasibility of providing entrepreneurial training programs to young men in Dar es Salaam, especially those without formal employment, a pretest-posttest pilot study was conducted drawing a sample of young men from neighborhood camps called vijiweni. There were four interventions, each implemented in a single camp: Health/Control, Entrepreneurship + Health, Beekeeping + Health, and Entrepreneurship + Beekeeping + Health. The four camps received 2, 6, 6, and 10 training sessions, respectively. No start-up capital was provided. The participants were interviewed at baseline and 3 months, 6 months, and 1 year after the sessions were completed. Data were collected on demographics, household assets, experience of violence, and income. RESULTS: Fifty-seven respondents attended the first session. At baseline, the camps were not meaningfully different from one another in educational attainment, number of dependents, daily income, assets, or individual members' roles as victims, perpetrators, or witnesses of violence. Differences were found in age, occupation, and weekly income. Over a period of 2.25 years (from baseline to the end of the project), the weekly income of the Health/Control camp, which had been earning the most, decreased by 37% in a reflection of worsening economic conditions at the time. All three intervention camps increased their income: Beekeeping by 43%, All by 50%, and Entrepreneurship by 146%, with the latter almost reaching the minimum wage level. The most persistently reported constraint was insufficient start-up capital. CONCLUSIONS: The feasibility and potential effectiveness of a short training program on entrepreneurship skills for unemployed, poorly educated young men in urban Tanzania were demonstrated in this study. It has set the stage for an intervention trial to test an updated hypothesis: A 5-7-day intervention about entrepreneurship and microfinance savings groups will lead to increased income and decreased violence. TRIAL REGISTRATION: ClinicalTrials.gov NCT04602416 . Registered on 24 October 2020. Retrospectively registered.
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PURPOSE: Administration of appropriate first aid immediately after a burn injury is crucial to averting further harm to the victim, physically and psychologically. The aim of this review is to enable the design of better interventions by describing what is known about prehospital care of burn victims in Africa. RESULTS: This review is based on 17 articles from 5 countries. For the purposes of the review, first responders are defined as those nearest the victim when a burn occurs. First responders include nonclinicians, most typically the mother of a young burn victim. Forty-five different substances, sometimes used in combination, are reported to have been applied to burn injuries: water, 15 food items (especially oils and egg), 14 pharmaceutical products, 9 traditional treatments, 5 minerals (petroleum products being the most common), and charcoal. Appropriate treatment, defined as the application of cool water for 10 min, was achieved about 0.5% of the time, most frequently in Cape Town, South Africa. Most victims do not have their wounds covered while they are transported to a health-care facility. Treatment delays are common. Pain management is hardly addressed. CONCLUSIONS: Appropriate prehospital care for burn injury generally is not practiced in Africa. Yet best practices for prehospital care are affordable, available, and easily understood. The greatest risk factor for poor care is first responders' lack of knowledge. Awareness and education campaigns focusing on the lay public, as well as educational institutions for health workers, are urgently needed throughout the continent.
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Quemaduras/terapia , Servicios Médicos de Urgencia/normas , África/epidemiología , Quemaduras/epidemiología , Servicios Médicos de Urgencia/métodos , Servicios Médicos de Urgencia/tendencias , Humanos , Manejo del Dolor/métodos , Manejo del Dolor/normasRESUMEN
As HIV/AIDS imposes an overwhelming pressure on the capacity of an already overburdened health care system in many African countries, families have increasingly been noted to supplement hospital care services for patients with AIDS. The aim of the present study is to generate knowledge on the experiences of family caregivers to the patients with AIDS at the household level in Dar es Salaam, Tanzania. Data were collected through in-depth interviews with 20 family caregivers and were analyzed using thematic content analysis. The article provides the reader increased insight on the obligations that AIDS caregiving has imposed on women within the close kin group of the patient. The study indicates that caregiving has increased the workload and in the same vein the economic marginality of women, who themselves are increasingly widowed heads of households. The study findings demonstrate strong gendered implications for community and policy makers.
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Síndrome de Inmunodeficiencia Adquirida , Cuidadores , Costo de Enfermedad , Identidad de Género , Salud de la Mujer , Adolescente , Adulto , Anciano , Antropología Cultural , Cuidadores/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pobreza , Tanzanía , Población UrbanaRESUMEN
Young adults face unemployment-related challenges, particularly in low- and middle-income countries. Self-employment is encouraged by the Tanzanian government and international institutions such as the World Bank. It has been found that young adults who are employed or self-employed show more functional independence and less inequality and social polarization, as well as a decrease in deviant behaviour. However, limited knowledge and skills related to entrepreneurial activities contribute to lack of motivation towards self-employment among young adults. In order to examine these behaviours, an intervention study implementing an entrepreneurship and beekeeping training in Dar es Salaam, Tanzania was conducted. After completion of the intervention, a qualitative study was conducted that used focus group discussions (FGDs) to explore the experiences and changes in behaviour of young adults following the intervention. A total of 36 of the original 57 young adults from four camps who fully participated in the four arms of interventions were recruited. Qualitative content analysis was used to analyze the FGD data. Three themes emerged from the findings: establishment and maintenance of an entrepreneurial business, changes in behaviour, and perceived challenges. Improved entrepreneurial skills, customer care, and financial management were expressed as positive changes the participants attained relating to business management. Similarly, changes in the participants' behaviours, attitudes, and lifestyle practices led to improved health and increased recognition and respect in their communities. Insufficient start-up capital and long intervals between sessions were the main challenges. The study showed an improvement in the ability of the participants to generate the human, social, and financial capital prerequisite to business development. Increase in customer care, social capital and financial management are key factors for successful microbusiness activities for stable self-employment.
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Apicultura/organización & administración , Empleo/organización & administración , Emprendimiento/organización & administración , Motivación/fisiología , Adolescente , Adulto , Actitud , Empleo/psicología , Administración Financiera/organización & administración , Grupos Focales , Humanos , Masculino , Investigación Cualitativa , Calidad de Vida , TanzaníaRESUMEN
Violence disproportionately affects low- and middle-income countries. Deeper understanding is needed in areas where little research has occurred. The objectives of the study were to: (a) ascertain rate of homicide death; (b) describe the victims and circumstances surrounding their deaths in Dar es Salaam, Tanzania in 2005. This study was developed by adapting the WHO/CDC Injury Surveillance Guidelines (Holder et al., 2001). Data on 12 variables were collected on all homicide deaths. Descriptive statistics and hypothesis tests were done when appropriate. Age standardised, age-specific and cause-specific mortality rates are presented. The overall homicide rate was 12.57 (males and females respectively: 22.26 and 2.64). Homicide deaths were 93.4% male, mostly unemployed, with a mean age of 28.2 years. Most deaths occurred in urban areas. Mob violence was the cause of 57% of deaths. The risk of homicide death for males was greater than the world average, but for females it was less. Most homicides were committed by community members policing against thieves.
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Homicidio/prevención & control , Homicidio/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Causas de Muerte , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Factores de Riesgo , Distribución por Sexo , Problemas Sociales , Tanzanía/epidemiologíaRESUMEN
The present study describes initial burn injury care in Tanzania-materials applied, sources of information, reasons for applying the materials, and time to a health centre-in order to suggest ways to optimize initial care. Eight small studies were conducted in which burn-injured patients were interviewed who had been admitted to referral hospitals in four regions in Tanzania. Most burn injuries in Tanzania occur in the home cooking area, and it was found that the first responders were family members, friends, and neighbours. A total of 710 burn victims were interviewed. Twenty-four different materials were applied to the patients' wounds. The most common application was honey. Only 14.3% of the victims received the recommended form of care: application of cool water. It was also found that nothing was applied to the wounds of 17.5% of these patients by first responders. Sources of information on burn treatment were family, friends and neighbours, and, less often, health workers or the media. Most of the burn victims' households had enough water to enable administration of recommended initial care. The main impediment to the provision of appropriate initial treatment of a burn appears to be lack of correct and useful knowledge about what to do immediately after the injury. A two-pronged educational approach should be used to improve care. A national mass media campaign should start immediately to inform ordinary citizens about proper initial treatment of burns. In addition, curricula of all schools that train health workers need to be reviewed for accuracy, and appropriate knowledge about initial care of burn victims should be added if necessary. Measures to improve burn first aid, are relatively easy, even in a low-income country such as Tanzania.
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BACKGROUND: Schistosoma haematobium and Schistosoma mansoni are endemic to East Africa. US Peace Corps volunteers (PCVs) serving in Tanzania were not experiencing symptoms of infection, but in 1998 when comprehensive testing was instituted, more than one-quarter were found to be infected with schistosomiasis at the close of their 27-month tour of service. METHODS: An education campaign was instituted by the in-country Peace Corps Medical Officers. At their close of service, all PCVs had a medical examination and blood, urine, and stool samples were tested for schistosomiasis. PCVs also answered a survey that included questions about their knowledge of the blood fluke and the disease, symptoms, where and how many times they had gone swimming, and what precautionary measures they had taken. RESULTS: PCVs in Tanzania are most susceptible to infection from recreational activities within the Lake Victoria ecosystem. After an education campaign, incident cases dropped quickly. Vigorous toweling after exposure may have decreased the risk of disease for those PCVs who went swimming in freshwater. Although schistosomiasis is common in Tanzania and PCVs are highly susceptible, it is possible for them to spend their entire tour without contracting the disease, even if they live by Lake Victoria. CONCLUSIONS: People should be encouraged not to swim in Lake Victoria. The possibility that vigorous toweling immediately after exposure to infected waters is a useful protective measure warrants further investigation.
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Agencias Gubernamentales/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Esquistosomiasis Urinaria/epidemiología , Esquistosomiasis mansoni/epidemiología , Voluntarios/estadística & datos numéricos , Adulto , Animales , Femenino , Educación en Salud/métodos , Humanos , Masculino , Schistosoma haematobium/aislamiento & purificación , Schistosoma mansoni/aislamiento & purificación , Esquistosomiasis Urinaria/diagnóstico , Esquistosomiasis Urinaria/prevención & control , Esquistosomiasis mansoni/diagnóstico , Esquistosomiasis mansoni/prevención & control , Autocuidado/métodos , Natación , Tanzanía , Viaje , Estados UnidosRESUMEN
Burn injuries in low and middle income countries still remain a significant health problem, even though numbers of burn injuries in high income countries have decreased showing that such events are not "accidents" but are usually preventable. WHO states that the vast majority (over 95%) of fire-related burns occur in low and middle income countries. Burn injuries are a major cause of prolonged hospital stays, disfigurement, disability, and death in Africa Region. Evidence shows that prevention strategies can work. However prevention strategies need to be tailored to the specific environment taking into account local risk factors and available resources. An examination of the patterns and causes of burns should allow site specific recommendations for interventions. This literature review, specific to the United Republic of Tanzania, was conducted by researching PubMed, SafetyLit, and African Journals on Line data bases for primary sources using key words