Rural Tanzania Research Articles

No association between fertility desire and HIV infections among men and women: Findings from community-based studies before and after implementation of an early antiretroviral therapy (ART) initiation program in the rural district of North-western Tanzania.

Background: Fertility is associated with the desire to have children. The impacts of HIV and antiretroviral therapy (ART) on fertility are well known, but their impacts on the desire for children are less well known in Tanzania. We used data from two studies carried out at different periods of ART coverage in rural Tanzania to explore the relationship between HIV infection and fertility desires in men and women. Methods: We conducted secondary data analysis of the two community-based studies conducted in 2012 and 2017 in the Magu Health and Demographic system site, in Tanzania. Information on fertility desires, HIV status, and social-economic and demographic variables were analyzed.Fertility desire was defined as whether or not the participant wanted to bear a child in the next two years. The main analysis used log-binomial regression to assess the association between fertility desire and HIV infection. Results: In the 2012 study, 43% (95% CI 40.7-45.3) of men and 33.3% (95% CI 31.8 - 35.0) women wanted another child in the next two years. In 2017 the percentage rose to 55.7% (95% CI 53.6 - 57.8) in men and 41.5% (95% CI 39.8 - 43.1) in women. Although fertility desire in men and women were higher in HIV uninfected compared to HIV infected, age-adjusted analysis did not show a statistical significance difference in both studies (2012: PR=1.02, 95%CI 0.835 - 1.174, p<0.915 and 2017: PR = 0.90 95%CI 0.743 - 1.084 p= 0.262). Discussion: One-third of women and forty percent of men desired for fertility in 2012, while forty percent of women and nearly half of men desired for fertility in 2017. The data showed fertility desire, in 2012 and 2017 were not related to HIV infection in both periods of ART coverage.

Savings Groups for Social Health Protection: A Social Resilience Study in Rural Tanzania.

Global health experts use a health system perspective for research on social health protection. This article argues for a complementary actor perspective, informed by the social resilience framework. It presents a Saving4Health initiative with women groups in rural Tanzania. The participatory qualitative research design yielded new insights into the lived experience of social health protection. The study shows how participation in saving groups increased women’s collective and individual capacities to access, combine and transform five capitals. The groups offered a mechanism to save for the annual insurance premium and to obtain health loans for costs not covered by insurance (economic capital). The groups organized around aspirations of mutual support and protection, fostered social responsibility and widened women’s interaction arena to peers, government and NGO representatives (social capital). The groups expanded women’s horizon by exposing them to new ways of managing financial health risk (cultural capital). The groups strengthened women’s social recognition in their family, community and beyond and enabled them to initiate transformative change through advocacy for health insurance (symbolic capital). Savings groups shape the evolving field of social health protection in interaction with governmental and other powerful actors and have further potential for mobilization and transformative change.

Factors shaping good and poor nurse-client relationships in maternal and child care: a qualitative study in rural Tanzania

BackgroundEvidence indicates that poor nurse-client relationships within maternal and child health (MCH) continues to impact trust in formal healthcare systems, service uptake, continuity with care and MCH outcomes. This necessitates contextualized innovative solutions that places both nurses and clients at the forefront as agents of change in optimizing intervention designs and implementation. This study explored nurses and clients’ perspectives on the factors shaping nurse-client relationships in MCH care to generate evidence to guide subsequent steps of human centered design (HCD) that involve designing effective strategies for improving therapeutic relationships in Shinyanga, Tanzania.MethodsQualitative descriptive design was employed. About 9 Focus Group Discussions (FGDs) and 12 Key Informant Interviews (KIIs) with purposefully selected nurses and midwives, women attending MCH services and administrators were conducted using semi-structured interview guides in Swahili language. Data were transcribed and translated simultaneously, managed using Nvivo Software and analyzed thematically.ResultsFactors shaping nurse-client relationships were heuristically categorized into nurse, client and health system factors. Nurse contributors of poor relationship ranged from poor reception and hospitality, not expressing care and concern, poor communication and negative attitudes, poor quality of services, job dissatisfaction and unstable mental health. Client contributors of poor relationship include being ‘much know’, late attendance, non-adherence to procedures and instructions, negative attitudes, poor communication, inadequate education and awareness, poverty, dissatisfaction with care, faith in traditional healers and unstable mental health. Health system contributors were inadequate resources, poor management practices, inadequate policy implementation and absence of an independent department or agency for gathering and management of complaints. Suggestions for improving nurse-client relationship included awards and recognition of good nurses, improving complaints mechanisms, continued professional development, peer to peer learning and mentorship, education and sensitization to clients, improving service quality and working conditions, improving renumeration and incentives, strengthening nursing school’s student screening and nursing curriculum and improving mental health for both nurses and clients.ConclusionsThe factors shaping poor nurse- client relationships appear to extend beyond nurses to both clients and healthcare facilities and system. Implementation of effective interventions for addressing identified factors considering feasibility and acceptance to both nurses and clients using novel strategies such as HCD could pave the way for employing good nurse-client relationships as a tool for improving performance indicators and health outcomes within MCH care.

Social participation of individuals with spinal injury using wheelchairs in rural Tanzania after peer training and entrepreneurial skills training

Background: Individuals with spinal cord injury (SCI) in less-resourced settings reported barriers to community integration, including inaccessible rehabilitation services, restricted environments and limited social integration. Peer training and entrepreneurial skills training are provided by Motivation, a nonprofit organisation, and Moshi Cooperative University to enhance occupational engagement of individuals with SCI in less-resourced settings. Objective: This study aimed to explore the impact of peer training and entrepreneurial skills training on the social participation of individuals with SCI living in Tanzania. Method: Using a qualitative photovoice approach, 10 participants captured meaningful photos and provided captions according to five standardised questions (PHOTO technique) to convey their messages. Participants selected up to 34 photos that best illustrated their experiences in the community. A mixed inductive–deductive thematic analysis was guided by the International Classification of Functioning, Disability and Health. Results: Two interrelated themes emerged: (1) ‘influencing factors’, which revealed how participants’ inclusion in the community was influenced by their activities and personal and environmental factors and (2) ‘empowerment’, which highlighted participants’ desire to advocate and promote awareness of needs and hopes. Conclusion: Participants emphasised the importance of accessibility and equal opportunities. Whilst some were able to overcome obstacles, others experienced continued inaccessibility that inhibited meaningful occupations. Daily participation challenges of individuals with SCI in rural Tanzania were highlighted. Although the Motivation programmes were perceived to have powerful impacts on social participation, continued efforts and advocacy are needed to overcome accessibility issues and to meet the physical, psychological and social needs of Tanzanians living with SCI. Contribution: This article highlights the importance of accessibility and equal opportunities for individuals with disability living in rural Tanzania. Peer-training and entrepreneurial programs offer community-based rehabilitation services that were perceived by people with disabilities to have a powerful impact on social participation and vocation. However, continued efforts and advocacy are needed to meet the needs of Tanzanians living with spinal cord injury.

Improving access to emergency obstetric care in underserved rural Tanzania: a prospective cohort study

BackgroundOne of the key strategies to reducing maternal mortality is provision of emergency obstetric care services. This paper describes the results of improving availability of, and access to emergency obstetric care services in underserved rural Tanzania using associate clinicians.MethodsA prospective cohort study of emergency obstetric care was implemented in seven health centres in Morogoro region, Tanzania from July 2016 to June 2019. In early 2016, forty-two associate clinicians from five health centres were trained in teams for three months in emergency obstetric care, newborn care and anaesthesia. Two health centres were unexposed to the intervention and served as controls. Following training, virtual teleconsultation, quarterly on-site supportive supervision and continuous mentorship were implemented to reinforce skills and knowledge.ResultsThe met need for emergency obstetric care increased significantly from 45% (459/1025) at baseline (July 2014 – June 2016) to 119% (2010/1691) during the intervention period (Jul 2016 – June 2019). The met need for emergency obstetric care in the control group also increased from 53% (95% CI 49–58%) to 77% (95% CI 74–80%). Forty maternal deaths occurred during the baseline and intervention periods in the control and intervention health centres. The direct obstetric case fatality rate decreased slightly from 1.5% (95% CI 0.6–3.1%) to 1.1% (95% CI 0.7–1.6%) in the intervention group and from 3.3% (95% CI 1.2–7.0%) to 0.8% (95% CI 0.2–1.7%) in the control group.ConclusionsWhen emergency obstetric care services are made available the proportion of obstetric complications treated in the facilities increases. However, the effort to scale up emergency obstetric care services in underserved rural areas should be accompanied by strategies to reinforce skills and the referral system.

Stigma-directed services (Stig2Health) to improve 'linkage to care' for people living with HIV in rural Tanzania: study protocol for a nested pre-post implementation study within the Kilombero and Ulanga Antiretroviral Cohort.

Background: HIV-related stigma is a major barrier to the timely linkage and retention of patients in HIV care in sub-Saharan Africa, where most people living with HIV/AIDS reside. In this implementation study we aim to evaluate the effect of stigma-directed services on linkage to care and other health outcomes in newly diagnosed HIV-positive patients. Methods: In a nested project of the Kilombero and Ulanga Antiretroviral Cohort in rural Tanzania, we conduct a prospective observational pre-post study to assess the impact of a bundle of stigma-directed services for newly diagnosed HIV positive patients. Stigma-directed services, delivered by a lay person living with HIV, are i) post-test counseling, ii) post-test video-assisted teaching, iii) group support therapy and group health education, and iv) mobile health. Patients receiving stigma services (enrolled from 1 st February 2020 to 31 st August 2021) are compared to a historical control receiving the standard of care (enrolled from 1 st July 2017 to 1 st February 2019). The primary outcome is 'linkage to care'. Secondary endpoints are retention in care, viral suppression, death and clinical failure at 6-12 months (up to 31 st August 2022). Self-reported stigma and depression are assessed using the Berger Stigma scale and the PHQ-9 questionnaire, respectively. The sample size calculation was based on cohort data from 2018. Assuming a pre-intervention cohort of 511 newly diagnosed adults of whom 346 (68%) were in care and on antiretroviral treatment (ART) at 2 months, a 10% increase in linkage (from 70 to 80%), a two-sided type I error rate of 5%, and 90% power, 321 adults are required for the post-implementation group. Discussion: We expect that integration of stigma-directed services leads to an increase of proportions of patients in care and on ART. The findings will provide guidance on how to integrate stigma-directed services into routine care in rural sub-Saharan Africa.

Enhancing community participation for environmental health improvement in rural Tanzania: Evidence from Bukombe district

Community participation has become a dominant approach in environmental health-related projects, yet, its enhancement has remained a challenge. This study examines ways of enhancing community participation in environmental health-related initiatives in rural areas of Tanzania. A total of one hundred people (n = 100) were engaged in this study. An embedded case study design was employed, in which multiple methods such as household questionnaires, in-depth interviews, focus group discussions, and document analysis were used in collecting empirical data. Findings show that integration of the community into the development agenda and facilitating communities to access required equipment and tools is vital for enabling participation in environmental health-related matters. Effective and efficient leadership, mobilisation, and sensitisation of communities are operational and functioning strategies to improve environmental health through community participation, while retribution measures may prevent environmental pollution. There is a definite need for the integration of community participation as a key aspect of environmental-related projects and programs in the development policy aiming at improving the environmental health of communities.

Intra-Household Resource Allocation in Rural Tanzania: Why Women Care about Disclosure

How resources from development or social programs are allocated within the household is important for household welfare. Intra-household resource allocation does not only depend on who receives and allocates the resources, but also on whether the resources are disclosed to other household members. In patrilineal societies in rural Tanzania, like the one we selected for this study, we expect disclosure of the available resources to have a stronger effect on women’s allocation decisions than on their husbands’. To test this, we use a choice experiment with 664 couples in rural Tanzania. Each spouse allocates a hypothetical sum of money between themselves, their spouse, and their children. We randomize whether they are told to assume that these resources are disclosed to their spouse. We find that women respond more strongly to disclosure than their husbands. Disclosure of the resources makes women increase the share allocated to their spouse and reduce the share kept to themselves but does not change the share allocated to their children. This disclosure effect is stronger among women with a controlling husband and women who receive transfers from their husband but gets weaker with higher spousal trust.

Equal goods, but inequitable capabilities? A gender-differentiated study of off-grid solar energy in rural Tanzania

Women and low-income households experience a disproportionate burden of energy poverty and have different capabilities to utilize access to energy. Despite this, many electrification plans insufficiently address gender and low-income households. Off-grid solar has and will continue to play a role in expanding access to electricity in rural Sub-Saharan Africa; however, off-grid solar is rarely examined across gender. We draw on a quantitative survey and qualitative interviews from a case study in rural Tanzania to investigate the energy justice implications of off-grid solar. We are the first article to evaluate and compare the primary goods approach and the capabilities approach for off-grid solar. We ask how the distributional benefits of off-grid solar are mediated by gender and class, filling a key gap in the literature of off-grid solar's impact. We find little evidence of gender differentiation from a primary goods approach, suggesting equality within off-grid solar usage, but inequity through a capabilities approach lens. Solar home systems remain out of reach for the lowest-income households. In our case study, off-grid solar is used both as a primary source for low-and-middle-income households, and as a back-up source for middle-and higher-income households. We find that solar energy is under-used as a means of income generation and that payment schemes may not be the key to achieving energy justice. We provide concrete recommendations for rural energy policy and global tracking frameworks to ensure that women and low-income households have not only equal, but equitable access to obtain the capability benefits of off-grid solar.

Strengthening Interpersonal Relationships in Maternal and Child Health Care in Rural Tanzania: Protocol for a Human-Centered Design Intervention.

BackgroundEvidence indicates that clients’ dissatisfaction with providers’ competencies within maternal and child health (MCH) continues to impact trust in formal health care systems, service uptake, continuity with care, and MCH outcomes. A major problem with existing interventions is the failure to address all the complexities of provider-client relationships necessitating targeted, contextualized, innovative solutions that place providers and clients at the forefront as agents of change in optimizing intervention design and implementation. To improve the provider-client relationship, the Aga Khan University is piloting a human-centered design (HCD) intervention where MCH nurses and clients are invited to partner with researchers in the intervention design and evaluation process.ObjectiveThe objective of this research is to co-design an intervention package (prototype) for improving nurse-client relationships in the rural Shinyanga region of Tanzania using a series of iterative HCD steps, involving key stakeholders to tailor solutions for complex problems impacting provider-client interactions in MCH care.MethodsThe following 5-step HCD approach will be implemented: (1) community-driven discovery through qualitative descriptive research methods using focus group discussions and key informant interviews; (2) co-design of an intervention package through consultative ideation and cocreation meetings with nurses, clients, and other stakeholders; (3) prototype validation through qualitative insight gathering using focus group discussions; (4) refinement and adaptation meeting; and (5) documentation and sharing of lessons learned before the final prototype is tested and validated in a broader community.ResultsA prototype characterized by a package of interventions for improving nurse-client relationships in MCH care in rural contexts is expected to be developed from the co-design process.ConclusionsAn HCD approach provides a novel entry point for strengthening provider-client relationships, where clients are invited to partner with providers in the design of acceptable and feasible interventions.International Registered Report Identifier (IRRID)DERR1-10.2196/37947

The banana project: a qualitative study of caregivers’ and teachers’ experiences of preschool children participating in a free banana school fruit scheme in rural Tanzania

IntroductionGood nutrition is the foundation of sustainable growth and development among children. The United Nations aims to achieve food security and improve nutrition through its Sustainable Development Goal 2 -...

Varieties of Necessity Entrepreneurship – New Insights From Sub Saharan Africa

Necessity entrepreneurship (NE) describes the process of venturing a business out of need when alternative options are seemingly absent. Whereas prior research typically understands NE to be a homogenous construct, recent theorizing suggests the possibility of NE heterogeneity. In this paper we employ Sen’s capability approach to elicit NE variety. Using data gathered from 820 households in rural Tanzania, our cluster analysis generates four distinct types of NE that vary significantly regarding their entrepreneurial activities, determinants and outcomes. Our findings demonstrate the relevance of life satisfaction and reveal the role of choice in NE. Our study thereby advances a nuanced perspective of NE.

Missed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural Tanzania: a cross-sectional survey

ObjectiveThe study aimed to identify the missed opportunity for detection and management of alcohol use disorder by primary health care workers.DesignA cross-sectional surveySettingOutpatient services in the six governmental primary health care facilities in Moshi district council in Tanzania.ParticipantsA total of 1604 adults were screened for alcohol use disorder (AUD) using the Alcohol Use Disorder Identification Test (AUDIT). Participants scoring 8 or above then provided details about their help-seeking behavior and barriers to seeking care. Participants’ records were reviewed to assess the screening and management of AUD.ResultsIn the last 12 months, 60.7% reported alcohol use, and heavy episodic drinking (HED) was reported by 37.3%. AUD (AUDIT ≥ 8) was present in 23.9%. Males were more likely to have HED (aPR = 1.43;95% CI:1.3 to 1.4) or AUD (aPR = 2.9; 95% CI 1.9 to 4.2). Both HED and AUD increased with age. Only one participant (0.3%) had documented AUD screening and management. Only 5% of participants screening positive for AUD had sought help. Reasons for not seeking care were thinking that the problem would get better by itself (55.0%), wanting to handle the problem alone (42.0%), or not being bothered by the problem (40.0%).ConclusionWhile reported alcohol use, HED, and AUD are common among patients presenting to primary healthcare facilities in northern Tanzania, help-seeking behavior and detection are very low. Not screening for AUD in primary health care is a missed opportunity for early detection and management. There is an urgent need to develop interventions to increase the detection of AUD by health care providers, while also addressing help-seeking behavior and barriers to seeking care.

“Many women use contraceptives in secret”: a qualitative study of health provider perspectives regarding barriers and enablers to reproductive health and antenatal care services in rural Tanzania

Background Women in sub-Saharan Africa face numerous barriers to reproductive health and antenatal care (ANC) services. The objective of this study was to identify health provider perspectives regarding the barriers and enablers to reproductive health, ANC, and postnatal care (PNC) services in rural Tanzania. Methods A qualitative study was conducted in four districts of Tanzania and utilized key informant interviews (KIIs) and focus group discussions (FGDs). An interview guide was developed, focusing on individual and community-based factors (barriers and enablers) to accessing ANC and PNC services. Data were collected during December 2017 and May 2018 and analyzed using a thematic approach. Results Two major themes were identified as barriers to women accessing ANC and PNC services. First, factors related to women in the context of their family and community, for example (i) lack of autonomy in a patriarchal society, (ii) lack of knowledge and education regarding healthy pregnancy and pregnancy complications, (iii) lack of financial resources or control over financial resources, (iv) use of traditional birth attendants, (v) lack of male involvement, (vi) cultural beliefs as barriers to accessing family planning and ANC and PNC services. Second, factors present in the health system, for example (i) lack of infrastructure, equipment and health provider resources at health facilities, and (ii) lack of confidentiality and feelings of stigmatization when receiving health services. Reduced stigmatization against women with Human Immunodeficiency Virus (HIV) served as an enabler. Conclusions Overall, this study highlights the need to implement more initiatives in these rural districts to improve ANC and PNC services uptake. It also indicates the need to find strategies to improve male involvement and family support in the local context.

Children’s work in environmental chores: ‘says who?’

ABSTRACT The standard approach for collecting sociodemographic data about children in developing countries is to elicit information from adults. While using proxy respondents is appropriate for very young children or for questions likely beyond children’s knowledge, it is less clear that it is better for older children and topics within their experience. Several arguments can be made that children could provide better or equally valid information on their activities than proxy respondents. We explore this question in the context of children’s work on environmental chores in rural Tanzania, using data that include parallel questions to children ages 10–17 and to proxy respondents about those children. Given the paucity of research on this issue, we offer exploratory evidence suggesting that efforts to collect data directly from children are fruitful and should be vigorously pursued, in keeping with Article 12 of the United Nations Convention on the Rights of the Child

Working or not Working in Commercial Farms and Uptake of Agricultural Technologies in Rural Tanzania

Commercial farms investment plays important role in agricultural technology spillovers but less is known on specific channels influencing neighboring farmer’s uptake of agricultural technologies. This study analyzed the effect of farmer’s working in commercial farms on agricultural technologies uptake intensity. Multiphased study design was used to randomly and proportionately to collect a sample of 1,203 farmers from three independent samples in Karatu, Iringa and Njombe. Nearest neighbor matching estimator was used to estimate the effect of working in commercial farms after testing for a balanced matching and control samples. In Karatu the intensity of agricultural technology uptake of farmer worked in commercial farm was 0.28 larger but not statistically significant. But if the farmer had not worked uptake intensity is reduced to 0.27 which was statistically significant at 5% p-value. In Iringa the intensity of agricultural technology uptake to farmer working in commercial farm on average is 0.45(P&lt; 0.05) significantly large. In Njombe, on average agricultural uptake intensity is 0.20 not statistically significant compared to uptake intensity of 0.23 which is statistically significant at 5% p-value had he/she not worked in commercial farms. It implies in areas where commercial farm producing different crops to neighboring farmers uptake of technologies is more on soil conservation than growing new crop or seed varieties. But in areas without landscarcity and investor’s crop being similar to crops produced by small-holder farmer, it was found farmers grow new crops or new seed varieties, use soil conservation practices, tractor and ox-plough. It was concluded that commercial farms should be promoted while considering crops produced by neighboring smallholder farms and land availability to farmers, if uptake of agricultural technologies to neighboring farmers is the policy expectation. Keywords: employment, commercial farms, uptake of agricultural technology, matching estimation DOI: 10.7176/JESD/13-14-08 Publication date: July 31 st 2022

Association Between Nutrition Social Behavior Change Communication and Improved Caregiver Health and Nutrition Knowledge and Practices in Rural Tanzania.

BackgroundEfforts to improve infant and young child feeding practices include the use of nutrition behavior change communication among caregivers of children under 5 years. We assessed the association between monthly participation in community-level nutrition group meetings on caregiver health and nutrition knowledge and practices (KPs).MethodsData from a community-based cross-sectional survey conducted in the Eastern and Southern Highland Zones of Tanzania were used. Indices were developed for caregivers' knowledge of nutrition, health and childcare, household (HDD) and young child dietary diversity (CDD), and vitamin A (VA) intakes. The comparison of means and proportions was assessed using Student's t-test and the Chi-square test, respectively, between the caregivers participating in nutrition group meetings and non-participants. The impact of the number of nutrition meeting attendance on caregiver KPs scores was examined using multiple regression.ResultsOf 547 caregivers surveyed, 49.7% attended nutrition group meetings and received information on nutrition social behavior change communication (SBCC). Overall, 28% of participating women had a moderate level of nutrition knowledge, 62% had a high level of VA knowledge, and 57% had a high level of health and childcare knowledge. Participation in nutrition group meetings was significantly associated with the health and childcare knowledge score (HKS), HDD and CDD scores, and household and young child VA intake; the magnitude of the associations was greater for caregivers who attended at least four meetings.ConclusionThe findings emphasize the need for programs that seek to address the issues present in the use of nutrition SBCC at the community level to improve maternal or caregiver KPs and subsequently the nutrition status of infants and young children.

Women’s use of family planning services: An experiment on the husband’s involvement

Despite the increased availability of family planning services (FPS) in low-income countries, their use remains low, especially in rural sub-Saharan Africa. To investigate to what extent this is explained by the husband’s involvement in the decision process, we use an experiment in rural Tanzania in which couples choose between two payments, one being conditional on attending a family planning meeting at a health center. Experimentally varying the husband’s involvement, we find that FPS are more likely chosen in treatments that involve the husband. Exploring potential mechanisms, we show that this is driven by couples where the wife (incorrectly) believes that the husband disapproves of contraceptives. We also find that involving the husband increases the wife’s expectation that the family planning meeting will be attended. Both findings suggest that initiating communication between spouses could reduce demand constraints.

Rural electricity system reliability: Do outages exacerbate spending on backup fuel in rural Tanzania?

Most rural Tanzanians have had no access to electricity. But efforts have been made to remedy this, including an extension of the national grid and the establishment of independent power plants in rural areas. The result is a recordable increase of people with access to electricity; however, the realization of reliable power for both consumers and suppliers has remained a puzzle. This paper out to examine the reliability of rural electricity systems based on consumer measures; to find out determinants for system reliability; and examine how outage incidences exacerbate households’ expenditure on backup fuels. Reliability was assessed through a stepwise approach, where a general system reliability index and trend analysis were used. It was found that system reliability was enhanced because consumers only spent 6–15 days per year without electricity due to outages. These are tolerable outages, given the volatility of the rural system. Further, weather, fire outbreaks in bushes, and lightning, significantly determined system reliability. Nonetheless, despite the reasonable reliability, some outage incidences had dragged consumers into unplanned expenditure on backup fuel. It is recommended that there should be a continuous inspection of the system, and the use of supervisory control and data acquisition device on the distribution line for accurate monitoring is imperative.

Agroecological practices increase farmers’ well-being in an agricultural growth corridor in Tanzania

Millions of people rely on nature-rich farming systems for their subsistence and income. The contributions of nature to these systems are varied and key to their sustainability in the long term. Yet, agricultural stakeholders are often unaware or undervalue the relevance of those contributions, which can affect decisions concerning land management. There is limited knowledge on how farming practices and especially those that build more strongly on nature, including agroecological practices, may shape farmers’ livelihoods and well-being. We aim to determine the effect that farmer perception of contributions from nature, socioeconomic conditions, and farming practices, have on outcomes related to food security and human well-being. We conducted 467 household surveys in an agricultural growth corridor in rural Tanzania, which is also essential for nature conservation due to its high biodiversity and its strategic location between several protected areas encompassing wetland, forest, and grassland habitats. Results show that implementing more agroecological practices at farm scale has a positive effect on farmer well-being in the study landscape. Results also indicate that higher awareness of benefits from nature, as well as engagement with agricultural extension services, are associated with higher number of agroecological practices applied in the farm. This research confirms the relevance of capacity-building initiatives to scale up the uptake of agroecological practices in the tropics. It also shows, using empirical evidence, that farming practices taking advantage of nature’s contributions to people can positively affect food security and human well-being, even when those practices complement conventional ones, such as the use of synthetic inputs. Understanding the impact of agroecological farming on the well-being of smallholder farmers in the tropics paves the way for policy and program development that ensures global food demands are met in a sustainable way without compromising the well-being of some of the world’s most vulnerable people.