Caregiver perspectives on TB case-finding and HIV clinical services for children diagnosed with TB in Tanzania.

Caregivers of children with tuberculosis (TB) and HIV play a critical role in seeking healthcare for their children. To assess the perspectives of caregivers of pediatric TB patients, we conducted 76 in-depth interviews at 10 TB clinics in 5 districts of Tanzania in March 2016. We assessed how the child received their TB diagnosis, the decision-making process around testing the child for HIV, and the process of linking the child to HIV treatment in the event of an HIV diagnosis. Caregivers suspected TB due to cases in their family, or the child being ill and not improving. Most caregivers noted delays before confirmation of a TB diagnosis and having to visit multiple facilities before a diagnosis. Once diagnosed, some caregivers reported challenges administering TB medications due to lack of pediatric formulations. Reasons for accepting HIV testing included recurrent illness and HIV symptoms, history of HIV in the family, and recommendation of the clinical provider. Caregivers described a relatively seamless process for linking their child to HIV treatment, highlighting the success of TB/HIV integration efforts. The multiple clinic visits required prior to TB diagnosis suggests the need for additional training and sensitization of healthcare workers and better TB diagnostic tools.

Evaluating feasibility, reach and potential impact of a text message family planning information service in Tanzania.

BACKGROUND: The objective of this research was to evaluate the feasibility, reach and potential behavioral impact of providing automated family planning information via mobile phones to the general public in Tanzania. STUDY DESIGN: Data from users of the Mobile for Reproductive Health (m4RH) program were collected during the 10-month pilot period. First, contraceptive methods queried by each user were electronically logged by the mobile phone system. Second, four text questions assessing gender, age, promotion point and potential family planning impact were sent to every user. RESULTS: During the pilot period, 2870 unique users accessed m4RH in Tanzania, resulting in 4813 queries about specific contraceptive methods. Among those responding to text questions, 56% were female and approximately 60% were 29 or younger years in age. A variety of changes in family planning use were mentioned after using m4RH, with reported changes consistent with where users are in their reproductive life cycle. CONCLUSIONS: Reaching younger people, women and men of reproductive age with family planning information delivered via mobile phone is recommended.