Experience Of Tanzania Research Articles

Between Fatigue and Silence: The Challenges of Conducting Research on Sexual Violence in Conflict

This paper discusses the meanings of research fatigue and silences in conflict-related sexual violence research. Drawing on field experiences in Liberia, Tanzania, Bosnia and Herzegovina, and Peru, we discuss some of the unintended consequences of persistent focus on victim-survivors’ narratives and argue for a reflexive feminist perspective that allows us to question the need and context of interviewing survivors and the associated insistence on disclosure.

Efficacy of an Intensive, Ultrasound-Guided Fine-Needle Aspiration Biopsy Training Workshop in Tanzania.

BackgroundFine-needle aspiration biopsy (FNAB) is a minimally invasive, cost-effective diagnostic tool that can be used in low-resource settings. However, adequacy and accuracy of FNAB is highly dependent on the skills of the operator and requires specialized training. Poor technique can preclude definitive diagnoses because of insufficient quality or quantity of FNAB samples. We evaluated the efficacy of an intensive training experience in Tanzania on improving ultrasound-guided FNAB techniques.MethodsA 2-day workshop offered didactic lectures, demonstrations, and hands-on practicum on fundamentals of ultrasound imaging and FNAB technique. A prospective interventional study design was used with pre- and postintervention surveys and assessments to measure the effect of the workshop on specific skills related to slide smearing and ultrasound-guidance among participants.ResultsTwenty-six pathologists and radiologists, including trainees in each specialty, participated in the workshop. Pre- and postworkshop assessments demonstrated that most participants improved significantly in nearly all technical skills for slide smearing and ultrasound-guided FNAB. After the workshop, most participants demonstrated substantial improvements in ability to prepare the ultrasound equipment, measure the lesion in three dimensions by ultrasound, target lesions in one pass using both parallel and perpendicular approaches, and prepare high-quality aspirate smears.ConclusionAn in-country 2-day workshop in Tanzania was efficacious in transferring basic skills in FNAB smear preparation and ultrasound-guided FNAB, resulting in skills enhancement among participating pathologists and radiologists. Although mastery of skills was not the goal of this short workshop, participants demonstrated proficiency in most technical elements after workshop completion, and the workshop generated interest among select participants to pursue additional intensive training in cytopathology.

From Stumbling Block to Enabler: The Role of Public Financial Management in Health Service Delivery in Tanzania and Zambia

The way governments manage resources through the budget cycle has important implications for health policy and whether governments achieve societal objectives such as efficiency, equity, quality, and accountability. Studies found a positive association between health service delivery outcomes and good governance of public finance; however, the mechanisms through which public financial management affects service delivery remain underexplored. This article maps the three stages of the budget cycle to common performance criteria used in health service delivery. It applies this approach to experiences in Tanzania and Zambia. The findings point to a number of stumbling blocks, including the lack of flexibility to provide additional resources for unexpected demand for care, misalignment between budgeting and planning, fragmented funding sources, rigid internal controls, insufficient budget provision leading to arrears, and a budget evaluation system that is excessively compliance driven and gives inadequate attention to issues of equity, quality, and efficiency in service delivery.

Difficulties in Establishing Liability in Online Defamation; Tanzania Experience

This paper is devoted to uncover difficulties in establishing liability in online defamation in Tanzania. The focus is on the effectiveness of the current laws and regulations relating to online defamation; and the lack of awareness on the part of the general public on legal and practical challenges in establishing liability over defamatory comments occurring on the internet. The investigator discovered that, the existing legal framework in Tanzania cover issues of establishing liability in online defamation suffers from a number of inadequacies. Moreover the legal and practical challenges includes, the weakness of some law and regulations covering online defamation, limitation periods, jurisdiction and choice of law issues, investigation and admissibility of electronic evidence and its authenticity, identifying anonymous defendant and the rights to privacy. The author recommends that the government has to consider amending its law by taking on board the forgotten stakeholders opinions that would address by dealing with specific issues of liability in online defamation to internet users, Internet Service providers(ISP’s) and intermediary for their defamatory comments.

Teachers’ Perspectives Regarding the Impacts of the Secondary Education Expansion Policy on Students’ Self-Regulatory Learning Experiences in Tanzania

Since 2004, the Tanzania secondary education sector has witnessed a significant increase in the number of new schools and enrolment rates. At the same time, academic results have indicated an increase in poor student performance. The assumption has been that the expansion policy brought about devastating consequences for student learning. The purpose of this study, therefore, was to investigate the perceptions of teachers in relation to the impacts of the government’s secondary education expansion policy on students, especially their self-regulatory learning. A qualitative case study approach was employed, and interviews were used as data gathering tools. Thirty respondents were purposively drawn from two highly and two poorly performing community secondary schools in Tanzania. Findings revealed that false policy promises in relation to school libraries, students’ housing and students’ learning spaces were obstacles to students in developing their self-regulatory learning habits. For the sake of fostering students’ self-regulatory learning, this paper recommends that it is the responsibility of the government, among other stakeholders, to address all issues pertaining to school infrastructure. The limitation of this study provides a chance to suggest areas which need further investigation.

Ultrasound curriculum taught by first-year medical students: A four-year experience in Tanzania.

Diagnostic imaging is an integral aspect of care that is often insufficient, if not altogether absent, in rural and remote regions of low to middle income countries (LMICs) such as Tanzania. The introduction of ultrasound can significantly impact treatment in these countries due to its portability, low cost, safety, and usefulness in various medical assessments. This study reviews the implementation of a four-week ultrasound course administered annually from 2013-2016 in a healthcare professional school in Mwanza, Tanzania by first-year allopathic US medical students. Participants (n=582, over 4 years) were recruited from the Tandabui Institute of Health Sciences and Technology to take the ultrasound course. Subjects were predominantly clinical officer students, but other participants included other healthcare professional students, practicing healthcare professionals, and school employees. Data collected includes pre-course examination scores, post-course examination scores, course quiz scores, demographic surveys, and post-course feedback surveys. Data was analyzed using two-tailed t-tests and the single factor analysis of variance (ANOVA). For all participants who completed both the pre- and post-course examinations (n=229, 39.1% of the total recruited), there was a significant mean improvement in their ultrasound knowledge of 42.5%, P<0.01. Our data suggests that trained first-year medical students can effectively teach a point of care ultrasound course to healthcare professional students within four weeks in Tanzania. Future investigation into the level of long-term knowledge retention, impact of ultrasound training on knowledge of human anatomy and diagnostic capabilities, and how expansion of an ultrasound curriculum has impacted access to care in rural Tanzania is warranted.

The African Renaissance and Struggles for the Third Phase of Nation-Building in Africa: The Experience of Tanzania

Since independence most countries in Africa have experienced two phases of nation-building. These include the nationalist phase and the neo-liberal phase. The third phase entails struggling for neo-nationalism and democratic developmental societies. The movement of struggles for a neo-nationalist approach, entailing independent democratic socio-economic development, has been viewed by some African historians and other scholars as an African Renaissance. Historically, renaissance is conceptualized as a movement and struggle for changing political, socio-economic and cultural system of a society. The struggle for change in Tanzania, which started during the first two phases and continues through the current third phase, provides a typical example of African renaissance in the context of nation building.

Learning from the other: Benefit sharing lessons for REDD+ implementation based on CBFM experience in Northern Tanzania

A key challenge facing interventions in forestry sector is how to ensure that benefit-sharing arrangements meet the needs and aspirations of poor rural people. In particular, as interest and effort builds around REDD+, it is important to remember that it, and any other intervention, are likely to be shaped by the history of Tanzania’s forestry sector, especially community based forest management. This paper examines benefit lessons for REDD+ from a well-known Tanzanian Forest Reserve which has begun to participate in selling carbon. The example is particularly important as it is one of the oldest cases of village-based forest management in the country. To explore this case a total of 101 households from two reserve-adjacent villages were randomly interviewed along with key informant interviews, transect walks, participant observation, and focus group discussions. Findings of the study revealed that majority of respondents felt benefits are concentrated on an elite due to weak governance mechanisms. We argue that local governance and central oversight will enhance good benefit sharing under REDD+ and future interventions in the forest sector.

Theoretical Perspectives on Critical Thinking Teaching: Reflections from Field Experiences from a Norwegian Lower Secondary School in Comparison to Tanzanian Secondary School Teaching Practices

This paper presents the theoretical perspectives relevant to critical thinking as my topic of research during my teaching practice period which was conducted from 12th -28th October 2015 at Eidsvag secondary school in Bergen, Norway. As a requirement for Masters’ degree in social science education, all master students were required to engage in teaching practice in different Norwegian primary and secondary schools. Importantly, every student teacher was given a topic of concentration as a mini-research for the whole teaching practice period. My topic of research focused at exploring and gaining the theoretical and practical perspectives on critical thinking teaching by drawing some experiences from a Norwegian lower secondary school (Eidsvag skole) in reflection to secondary school teaching practice experiences in Tanzania. Therefore, in this paper, my reflections with regard to the conditions favoring the possibility for critical thinking teaching and how it was enhanced by teachers at my practice school will be discussed. Further to that, I will also present the observed challenges of which, in my view, in way or another intervened the possibility for effective critical thinking teaching to take place.

Community-based field implementation scenarios of a short message service reporting tool for lymphatic filariasis case estimates in Africa and Asia.

Lymphatic filariasis (LF) is a neglected tropical disease (NTD) targeted for global elimination by 2020. Currently there is considerable international effort to scale-up morbidity management activities in endemic countries, however there remains a need for rapid, cost-effective methods and adaptable tools for obtaining estimates of people presenting with clinical manifestations of LF, namely lymphoedema and hydrocele. The mHealth tool 'MeasureSMS-Morbidity' allows health workers in endemic areas to use their own mobile phones to send clinical information in a simple format using short message service (SMS). The experience gained through programmatic use of the tool in five endemic countries across a diversity of settings in Africa and Asia is used here to present implementation scenarios that are suitable for adapting the tool for use in a range of different programmatic, endemic, demographic and health system settings. A checklist of five key factors and sub-questions was used to determine and define specific community-based field implementation scenarios for using the MeasureSMS-Morbidity tool in a range of settings. These factors included: (I) tool feasibility (acceptability; community access and ownership); (II) LF endemicity (high; low prevalence); (III) population demography (urban; rural); (IV) health system structure (human resources; community access); and (V) integration with other diseases (co-endemicity). Based on experiences in Bangladesh, Ethiopia, Malawi, Nepal and Tanzania, four implementation scenarios were identified as suitable for using the MeasureSMS-Morbidity tool for searching and reporting LF clinical case data across a range of programmatic, endemic, demographic and health system settings. These include: (I) urban, high endemic setting with two-tier reporting; (II) rural, high endemic setting with one-tier reporting; (III) rural, high endemic setting with two-tier reporting; and (IV) low-endemic, urban and rural setting with one-tier reporting. A decision-making framework built from the key factors and questions, and the resulting four implementation scenarios is proposed as a means of using the MeasureSMS-Morbidity tool. This framework will help national LF programmes consider appropriate methods to implement a survey using this tool to improve estimates of the clinical burden of LF. Obtaining LF case estimates is a vital step towards the elimination of LF as a public health problem in endemic countries.

Implementation of "Helping Babies Breathe": A 3-Year Experience in Tanzania.

This first-ever country-level study assesses the implementation of the Helping Babies Breathe (HBB) program in 15 of Tanzania's mainland regions by measuring coverage, adoption and retention of provider skills, acceptability among providers, and barriers and challenges to at-scale implementation. Longitudinal facility-level follow-up visits assessed provider resuscitation knowledge and skills in using objective structured clinical examinations and readiness of facilities to resuscitate newborns, in terms of birth attendants trained and essential equipment available and functional. Focus group discussions were held with providers to determine the acceptability, challenges, and barriers to implementation of the HBB program. Immediately after HBB training, 87.1% of providers passed the objective structured clinical examination. This number dropped to 79.4% at 4 to 6 weeks and 55.8% at 4 to 6 months (P < .001). Noting this fall-off in skills, the program implemented structured on-the-job training and supportive supervisory visits, which were associated with an improvement in skill retention. At long-term follow-up, >90% of facilities had bag-mask devices available to all beds in the labor and delivery ward, and 96% were functional. Overall, providers were highly satisfied with the HBB program but thought that the 1-day training used in Tanzania was too short, so they would welcome additional training and follow-up visits to reinforce skills. The HBB program in Tanzania has gained acceptability and shown success in equipping providers with neonatal resuscitation knowledge, skills, and supplies. However, assessing the program's impact on neonatal mortality has proven challenging.

The "Evolution" of Regulation in Uganda’s Mobile Money Sector

Uganda’s mobile money sector has grown rapidly since its introduction in 2009. As at the last quarter of 2015, there were 21.1 million registered mobile money users in the country, representing a penetration of about 54%. As well as providing a convenient, cheap and safe means of money transfer, mobile money has spurred increased financial inclusion, which grew from 28% in 2009 to 54% in 2013. The rapid growth has happened under conditions of “light touch” regulation of the sector, which allows the first mover to reap the rewards of investments made, but raises potential competition issues. The mobile money sector, much like the telecommunications sector, is characterised by network externalities, lock-in effects and high barriers to entry that can give rise to a concentrated sector with a single dominant player. This article considers the effect of light touch regulation on the competitive dynamics in the mobile money market in Uganda and contrasts this with the experience in Tanzania, where regulation evolved from a light touch style to a more comprehensive framework as the sector grew.

Child malnutrition – from Hospital to clinical practice – the experience of Tanzania and Uganda

Child malnutrition – from Hospital to clinical practice – the experience of Tanzania and Uganda

The inescapable question of fairness in Pay-for-performance bonus distribution: a qualitative study of health workers' experiences in Tanzania.

BackgroundDuring the last decade there has been a growing concern about the lack of results in the health sectors of many low income countries. Progress has been particularly slow in maternal- and child health. Prompted by the need to accelerate progress towards these health outcomes, pay-for- performance (P4P) schemes have been initiated in a number of countries. This paper explores the perceptions and experiences of health workers with P4P bonus distribution in the health system context of rural Tanzania.MethodsThis qualitative study was based on the P4P pilot in Pwani Region of Tanzania. The study took place in 11 health care facilities in Rufiji District. The study informants and participants were different cadres of health workers assigned to different outpatient and inpatient departments at the health facilities, and local administrators of the P4P bonus distribution. Thirty two in-depth interviews (IDIs) with administrators and health care workers, and six focus group discussions (FGDs with Reproductive and Child Health (RCH) staff, non-RCH staff and non-medical staff were conducted. Collected data was analyzed through qualitative content analysis.ResultsThe study found that the bonus distribution modality employed in the P4P programme was experienced as fundamentally unjust. The bonuses were calculated according to the centrality of the health worker position in meeting targeted indicators, drawn from the reproductive and child health (RCH) section. Both RCH staff and non-RCH perceived the P4P bonus as unfair. Non-RCH objected to getting less bonus than RCH staff, and RCH staff running the targeted RCH services, objected to not getting more P4P bonus. Non-RCH staff and health administrators suggested a flat-rate across board as the fairest way of distributing P4P bonuses. The perceived unfairness affected work motivation, undermined teamwork across departments and created tensions in the social relations at health facilities.ConclusionOur results suggest that the experience of unfairness in the way bonuses are distributed and administered at the health facility level undermines the legitimacy of the P4P scheme. More importantly, long term tensions and conflicts at the workplace may impact negatively on the quality of care which P4P was intended to improve. We argue that fairness is a critical factor to the success of a P4P scheme and that particular attention should be paid to aspects of workplace justice in the design of P4P bonus structures.

ICT Use, Innovation, and Productivity: Evidence from Sub-Saharan Africa

This paper examines empirically the links between adoption of information and communications technology (ICT), defined as usage by firms, innovation, and productivity using firm-level data for a sample of six Sub-Saharan African countries: the Democratic Republic of Congo (DRC), Ghana, Kenya, Tanzania, Uganda, and Zambia. Although adoption of information and communications technology in these countries is still lagging behind OECD countries, there is significant heterogeneity on adoption rates across the countries. Kenya has the largest adoption rate of computer, software, and Internet usage. The Democratic Republic of Congo and Tanzania experience lower adoption rates. The degree of internationalization of the firm, use of technology, and extent of competition are important factors explaining firm-level use of ICT. The results of the estimates suggest that ICT use is an important and robust enabler of product, process, and organization innovation across all six countries. However, the final impact on productivity depends on the degree of novelty of the innovation introduced by the firm.

Practical Considerations with Using Mobile Phone Survey Incentives: Experiences in Ghana and Tanzania

As mobile phone surveys are gaining popularity among researchers and practitioners in international development, one primary challenge is improving survey response and completion rates. A common solution is to provide monetary compensation to respondents. This paper reports on our experience with using incentives with a mobile phone survey conducted in Ghana and Tanzania in June 2015. We find that extrinsic incentives – transfers of airtime – improve survey completion rates by roughly 6 to 8 percentage points. We also find that an SMS notification, aimed at increasing intrinsic motivation to complete the survey, has a comparable positive effect. Considering three levels of compensation (airtime transfers), we find that the supply curve of completed surveys appears to be fairly inelastic. In other words, small amounts of incentives have a similar effect as larger incentives. We also find little evidence of the extrinsic incentives skewing the demographics of the completed samples. However, we do find some evidence that the SMS treatment may have skewed the sample toward wealthier and more educated respondents. Finally, we found that the cost per completed response is not substantially less for every incentive or combination of incentives, compared to the group that did not receive any incentives. Considering these results, we would recommend the consideration of modest monetary compensation as a way of increasing response and completion rates. Nonetheless, a complete lack of extrinsic incentives may remain the most cost effective way to gather completed responses without any associated risk of skewing the survey sample. However, if higher completion rates are desired, a small monetary compensation would be most cost effective with lower risks of biasing the completed sample.

Transdisciplinary Project Communication and Knowledge Sharing Experiences in Tanzania and Zambia through a One Health Lens.

The project “Strengthening food and nutrition security through family poultry and crop integration in Tanzania and Zambia” brings together animal, crop, and human health specialists, economists, ecologists, social scientists, and practitioners to work with participating communities. It aims to increase poultry value chain, crop farming systems efficiency, and household food and nutrition security and thus requires understanding of, and ability to work effectively within, complex systems. In this context, communication knowledge sharing and synthesis between stakeholders from diverse backgrounds and a range of experiences, perspectives, agendas, and knowledge is a challenge. To address this situation, communication is conceived as a dialog and a participatory process bringing together all stakeholders. This process results in unanticipated and unexpected results that require a high degree of flexibility and adaptability from team members. The paper analyses the approach and aim of the communication strategy developed for the project and the challenges faced.

Access to land reconsidered: The land grab, polycentric governance and Tanzania’s new wave land reform

Inspired by Ostrom’s concept of polycentric governance, this article aims to refine the analytical framework through which contemporary access to land is analysed. By drawing on extensive fieldwork and conducting a review of the existing literature on the making and implementation of Tanzania’s 1999 land reform, it challenges some of the main assumptions behind the land access and land grabbing literatures about the level at which agency is placed. Processes governing access to land are more contingent than they are most often depicted, involving actors at the local, national and international levels. National and local level actors are often more important than, in particular, the land grab literature tends to suggest. This implies that the state should be seen not merely as a site of ‘legitimate theft’, but also as one in which rights may be upheld. Based on the experience of Tanzania, the article suggests that analytical a priori assumptions about where agency is placed should be abandoned and replaced with empirical research into the relations between actors at all levels.

Child malnutrition – from Hospital to clinical practice – the experience of Tanzania and Uganda

Child malnutrition – from Hospital to clinical practice – the experience of Tanzania and Uganda

Science, Technology and Sustainable Food Production in Africa: An Assessment

This paper examines the impact of science and technology on sustainable food security in Africa, particularly on the contribution of Biodiversity, Biotechnology, and Biosafety. The researchers adopted a descriptive survey of wide range of literature drawn from the experience of South Africa, Zimbabwe, Uganda, Kenya, Cameroon, Tanzania and Nigeria. The centrality of the role of science and technology in sustainable food security in these countries is highlighted. Challenges of achieving sustainable food security is also identified. The study concludes that to achieve sustainable food security Africa must lay a solid foundation for African science and technology by investing more on education, research and development (R&D) as well as initiate public policies aimed at sharing adaptive and practical innovations and breakthroughs in science, technology and sustainability of food in the African continent among African States. Furthermore, African countries as a matter of urgency should invest on agricultural development with a view to achieving sustainable food production. DOI: 10.5901/mjss.2015.v6n6s4p285