Healthcare-seeking behaviours among mother's having under-five children with severe wasting in Dodoma and Mbeya regions of Tanzania-A qualitative study.

Maternal healthcare-seeking behaviour affects the health and well-being of under-five children. Drawing from the concepts of the health belief model, this study seeks to understand the determinants of health-seeking behaviours among mothers or caregivers of under-five-year-old children having severe wasting in Tanzania. A qualitative study employing the ethnography method conducted 32 semi-structured and narrative interviews with healthcare workers, community health workers, traditional healers, religious and village leaders, and mothers or caregivers of children who had acute malnutrition. The analysis of transcripts was done by qualitative content analysis. Further, the thematic analysis was carried out by assigning data into relevant codes to generate categories based on study objectives. Severe wasting among under-five-year-old children was not observed as a serious disease by the majority of mothers or caregivers. The study established that the health systems parameters such as the availability of the community health workers or healthcare providers and the availability of medicines and supplies to the health facility impact on mothers' or caregivers' healthcare-seeking behaviours. The findings also show that long distances to the health facility, behavioural parameters such as lack of awareness, negative perception of the management of severe wasting at the health facility, superstitious beliefs, women's workload, household food insecurity, and gender issues have a significant role in seeking healthcare. The results reaffirm how a programme on integrated management of severe wasting in Tanzania should encompass sociocultural factors that negatively influence mothers or caregivers of children with acute malnutrition. The programme should focus on engaging community structures including traditional healers, religious and village leaders to address prevailing local beliefs and sociocultural factors.

The association between social networks and self-rated risk of HIV infection among secondary school students in Moshi Municipality, Tanzania.

This study describes the social networks of secondary school students in Moshi Municipality, and their association with self-rated risk of human immunodeficiency virus (HIV) infection. A cross-sectional analytical study was conducted among 300 students aged 15-24 years in 5 secondary schools in Moshi, Tanzania. Bonding networks were defined as social groupings of students participating in activities within the school, while bridging networks were groups that included students participating in social groupings from outside of the school environs. A structured questionnaire was used to ask about participation in bonding and bridging social networks and self-rated HIV risk behavior. More participants participated in bonding networks (72%) than in bridging networks (29%). Participation in bridging networks was greater among females (25%) than males (12%, p<.005). Of 300 participants, 88 (29%) were sexually experienced, and of these 62 (70%) considered themselves to be at low risk of HIV infection. Factors associated with self-rated risk of HIV included: type of school (p<.003), family structure (p<.008), being sexually experienced (p<.004), having had sex in the past three months (p<.009), having an extra sexual partner (p<.054) and non-condom use in last sexual intercourse (p<.001), but not the presence or type of social capital. The study found no association between bonding and bridging social networks on self-rated risk of HIV among study participants. However, sexually experienced participants rated themselves at low risk of HIV infection despite practicing unsafe sex. Efforts to raise adolescents' self-awareness of risk of HIV infection through life skills education and HIV/acquired immunodeficiency syndrome risk reduction strategies may be beneficial to students in this at-risk group.