Urban Tanzania Research Articles

Institutional work: how lenders transform land titles into collateral in urban Tanzania

Abstract We examine the ‘institutional configuration’ that makes land titles work as collateral in Tanzania’s nascent credit market, through the ‘institutional work’ of local lenders. This work is effective and precarious: while lenders seek out and create institutional complementarities across diverse domains, they also require higher-level regulation to help stabilise land titles’ fungibility as collateral. Our results contribute to knowledge on path-dependency, contingency and uneven trajectories in the property-credit nexus development, and advance understandings of institutional interdependencies and coevolution in the situated economy. By combining deep contextualisation and institutional analysis, we progress an empirical engagement with institutional research in economic geography.

The Dynamics of Faith-based Organisations’ Healthcare Interventions in Urban Tanzania: An Ethnographic Inquiry of Direct Aid and Bethel Revival Temple

The study examines the ways the new generation of Christian and Muslim Faith-based Organisations (FBOs) have become engaged in the healthcare interventions in Urban Tanzania in recent decades. The study examines character and content of their healthcare interventions as well as religious and professional motivations for their healthcare workers, followers, beneficiaries and management. The study employs the concept of religion as a model for, and model of lived reality by Geertz (1973); and the concept of development as holistic by Bornstein (2005). Ethnographically, the study examines how religious discourses were embodied in social practices, how social and historical processes led to this particular embodiment, and how religion itself defined the discourses and practices of FBOs Healthcare Interventions in the context of changing socio-economic, and political circumstances since 1990s to 2020. Findings showed that FBOs healthcare activities were designed as alternatives for their beneficiaries and the general public access healthcare services, particularly for those coming from weak socioeconomic backgrounds and in the absence of sufficient community and family support. Religious ideas, practices and meanings motivated FBOs healthcare workers, followers and the management to engage in healthcare interventions and express for the same using spaces created by social, economic, and political changes since the mid-1990s.Keywords:

Hypertension and traditional risk factors for cardiovascular diseases among treatment naïve HIV- infected adults initiating antiretroviral therapy in Urban Tanzania

BackgroundCardiovascular diseases (CVDs) have become an important cause of ill health and death among people living with HIV and/or AIDS (PLHIV) in the antiretroviral therapy (ART) era. There is scarce data on the burden of hypertension (HTN) and risk factors for CVDs among PLHIV in developing countries, including Tanzania during the ART era.Objective(s)To determine the prevalence of HTN and risk factors for CVDs among ART naïve PLHIV initiating ART.MethodsWe analysed baseline data of 430 clinical trial participants on the effect of low-dose aspirin on HIV disease progression among HIV-infected individuals initiating ART. HTN was the outcome CVD. Traditional risk factors for CVDs studied were age, alcohol consumption, cigarette smoking, individual and family history of CVDs, diabetes mellitus (DM), obesity/overweight, and dyslipidaemia. A generalized linear model (robust Poisson regression) was used to determine the predictors for HTN.ResultsThe median (IQR) age was 37 (28, 45) years. Females were the majority contributing 64.9% of all participants. The prevalence of HTN was 24.8%. The most prevalent risk factors for CVDs were dyslipidaemia (88.3%), alcohol consumption (49.3%), and overweight or obesity (29.1%). Being overweight or obese predicted the occurrence of HTN, aPR 1.60 (95% CI 1.16–2.21) while WHO HIV clinical stage 3 was protective against HTN, aPR 0.42(95% CI 0.18–0.97).ConclusionThe prevalence of HTN and traditional risk factors for CVDs in the treatment naïve PLHIV initiating ART are significant. Identifying these risk factors and managing them at the time of ART initiation may lower future CVDs among PLHIV.

Social-political and vaccine related determinants of COVID-19 vaccine hesitancy in Tanzania: A qualitative inquiry.

Vaccines have played a critical role in the response to the COVID-19 pandemic globally, and Tanzania has made significant efforts to make them available to the public in addition to sensitizing them on its benefit. However, vaccine hesitancy remains a concern. It may prevent optimal uptake of this promising tool in many communities. This study aims to explore opinions and perceptions on vaccine hesitancy to better understand local attitudes towards vaccine hesitancy in both rural and urban Tanzania. The study employed cross-sectional semi-structured interviews with 42 participants. The data were collected in October 2021. Men and women aged between 18 and 70 years were purposefully sampled from Dar es Salaam and Tabora regions. Thematic content analysis was used to categorize data inductively and deductively. We found that COVID-19 vaccine hesitancy exists and is shaped by multiple socio-political and vaccine related factors. Vaccine related factors included worries over vaccine safety (e.g., death, infertility, and zombie), limited knowledge about the vaccines and fear of the vaccine's impact on pre-existing conditions. Participants also found it paradoxical that mask and hygiene mandates are expected even after vaccination, which further exacerbated their doubts about vaccine efficacy and their hesitancy. Participants possessed a range of questions regarding COVID-19 vaccines that they wanted answered by the government. Social factors included preference for traditional and home remedies and influence from others. Political factors included inconsistent messages on COVID-19 from the community and political leaders; and doubts about the existence of COVID-19 and the vaccine. Our findings suggest that the COVID-19 vaccine is beyond a medical intervention, it carries with it a variety of expectations and myths that need to be addressed in order to build trust and acceptance within communities. Health promotion messages need to respond to heterogeneous questions, misinformation, doubts, and concerns over safety issues. An understanding of country-specific perspectives toward COVID-19 vaccines can greatly inform the development of localized strategies for meaningful uptake in Tanzania.

High prevalence of self-reported sexually transmitted infections among older adults in Tanzania: results from a list experiment in a population-representative survey

PurposeSelf-report of sensitive or stigmatized health states is often subject to social desirability and interviewer biases. To reduce such biases, we estimated the rate of sexually transmitted infections (STIs) using a list experiment. MethodsThis population-representative study was nested within the Dar es Salaam Urban Cohort Study, a Health and Demographic Surveillance System (HDSS) in the Ukonga ward of Dar es Salaam, Tanzania. Men and women aged ≥40years were randomly assigned to receive a list of either four control items (i.e., the control group) or four control items plus an additional item on having had a disease through sexual contacts in the past 12months (i.e., the treatment group). We calculated the mean difference in the total number of items to which respondents answered “yes” in the treatment versus control group and compared this prevalence estimate to the one measured by the direct question. ResultsA total of 2310 adults aged ≥40years were enrolled in the study: 32% were male and 48% were aged 40–49years. The estimated prevalence of having STIs in the past 12months was 17.8% (95% confidence interval [CI] 12.3–23.3) in the list experiment, almost 10 times higher than the estimated prevalence of 1.8% (95%CI 1.3–2.4) based on the direct question (P < .001). STI prevalence remained high after adjusting for age, the number of lifetime sex partners, alcohol consumption and smoking in multivariate linear regression (15.6%; 95% CI 7.3–23.9). ConclusionsWe found a substantially higher prevalence of STIs among older adults in urban Tanzania when we based our estimation on a list experiment rather than a direct question in a population-representative survey. List experiments should be considered to elimnate social desirability and interviewer biases in surveys of sensitive or stigmatized health states. The very high prevalence of STIs highlights the need for improved access to STI screening, prevention and treatment for older adults in urban Africa.

Institutional pluralism and pro-poor land registration: Lessons on interim property rights from urban Tanzania

While interim property rights are thought to achieve incremental improvements of tenure security and rights for the urban poor, there is surprisingly little research into the provision of starter documents in sub-Saharan Africa. Namely, how effective are interim property rights in responding to local demands for tenure security and rights in the long run and vis-à-vis other de facto and de jure tenure options? Drawing on an institutional analytic approach and mixed-method research, we study the Residential Licence programme of Tanzania, which offers short-term leases to around 220,000 plots in Dar es Salaam. This interim property right has undergone substantial institutional drift, with decreasing uptake rates, low renewal rates and poor updating of records. Today, landholders value other de facto and de jure proofs of ownership over and above the Residential Licence, which is now less perceived as pro-poor and fit-for-purpose. These results illustrate that interim property rights need maintenance and recalibration, or they will ‘come adrift’ amidst other institutional layers. Reflecting on the effects of institutional layering in property rights, this paper contributes to literatures on incremental land reform and demand for land titles, and it provides important policy recommendations relevant to urban Tanzania and wider contexts.

Phylogeographic Patterns of the Greater Cane Rat (Thryonomys Swinderianus) Populations from Eastern, Western and Southern Africa and Implications for Wildlife Conservation

Background and aim: African Greater Cane (ACG) rat populations are widely distributed across Africa but the ancestral origin of populations inhabiting different geographical regions is unknown. There is currently no information available on the genetic differentiation of these populations resulting from long-time geographical isolation, environmental and anthropogenic pressures they face in each region. This limits our ability to understand potential speciation processes in AGC and their implications for their conservation and of other small wild mammals exposed to similar ecological conditions in the savannah biomes in Africa. Methods: We analyzed mitochondrial genes targeting the D-loop region of AGC samples from two blocks of the Eastern Arc Mountains in Tanzania (eastern), three agro-ecological zones in Ghana (western) and four sites in South Africa (southern) to characterize the phylogeographical patterns of the species. Results: AGC populations from Tanzania revealed higher haplotype diversity than those from the two other régions. Analysis of variance (AMOVA) revealed higher genetic variations within than between populations in all geographic regions. Demographic history analysis revealed a negative and significant Tajima’s D for a single southern African population as well as close relatedness with the Eastern Africa populations, suggesting a common ancestral origin. Conclusion: This is the first study to compare maternal lineages of AGC populations from eastern, western and southern Africa and provides a basis for future genetic studies of the species, its evolutionary ecology and the conservation of these populations across their range. Conservation implications: Evidence of recent population size expansion underpinned by high genetic diversity observed in the Uluguru urban (Tanzania) Guinea savannah (Ghana) and Kwazulu Natal (South Africa) populations suggest that the AGC populations are not currently threatened, consistent with the current IUCN status. Also, the distinct haplotypes observed in each region suggest that the populations can be managed as meta-populations, thus providing opportunities for potential local game-farming programs.

INCOME POVERTY AND CHILD STREETISM IN DODOMA AND DAR ES SALAAM, TANZANIA

Tanzania has been implementing several initiatives to address the challenge of street children in the country. Despite such efforts, the child streetism has become the daily reality and has shown the sign of increasing. This article explores the influence of income poverty on child streetism in urban Tanzania. Specifically, the article focused on analysing the live experiences of street children; and describing the influence of income poverty on streetism of children. The article adopted the descriptive cross-sectional design and involved a total of 56 informants who were purposively selected while the snowballing sampling technique was used in accessing street children. Semi-structured interview, documentary review and observation method were used to collect data. Through thematic and content data analysis techniques this article revealed that street children experienced difficulties in getting their basic needs and did not easily access health services when they fell sick. Further, child streetism has been largely influenced by income poverty. Hence, the study recommends that; develop a formal and functional support system to facilitate children on the street to access the educational services. Regarding coping strategies as an emerged issue, street children engaged into begging, unsafe sex and petty income-generating activities such as car wash and bottle collection. They also used self-medication to treat themselves when they fell sick or being left at the hospital buildings or on the street by their fellow street children when the condition got worse. Additionally, they did not have any coping strategy to enroll themselves into the school.

Feasibility of a mobile phone training on autism spectrum disorders for teachers in Tanzania

ABSTRACT Despite the rising global prevalence of autism spectrum disorders (ASD), significant disparities in ASD knowledge persist worldwide. Professional development trainings are effective in increasing teacher knowledge of ASD; however, in-person trainings pose accessibility concerns for teachers in low- and middle-income countries. In sub-Saharan Africa, few teacher development opportunities exist and logistical barriers limit attendance, highlighting the need for a more accessible training modality. The present study used a pre-post-test methodology among general and special education teachers in urban Tanzania to evaluate the feasibility of a mobile phone-delivered training on ASD. Results indicated a robust 84% participation rate and high quiz scores across training modules. The benefits of using mobile phone technology in a low-resource setting are presented. As the first asynchronous ASD training developed and implemented among teachers in Tanzania, this study can guide future research that explores how best to increase ASD knowledge among community members using technology.

Prevalence and factors associated with potential substance use disorders among police officers in urban Tanzania: a cross-sectional study

BackgroundSubstance Use Disorders (SUDs) among Police Officers has been a concern to many professionals in the field of health, research and criminal justice since their work is subjected to higher levels of stress and hence more likely to use alcohol or tobacco as a coping mechanism. However, little is known about SUDs among Police Officers in Tanzania. Therefore, we assessed the prevalence and factors associated with SUDs among Police Officers in urban Tanzania.Materials and methodsA cross-sectional study was conducted between April and October 2019 among Police Officers in Dar es Salaam. Multistage cluster sampling technique was used to recruit study participants. The WHO-Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) version 3.0 was used to measure potential SUDs. Bivariate and multivariate analyses were performed to establish associations between potential SUDs and predictors of interest, and an alpha of 5% was used in sample size calculation.ResultsA total of 497 participants were enrolled, of these, 76.6% (376/491) were males, the median age (years) and IQR was 37.0 (30.0, 47.0). The prevalence of past three months use of alcohol and tobacco were 31.3% and 6.3%, respectively. About 13.3% (62/468) and 6.2% (29/468) of Police Officers met criteria for potential Alcohol Use Disorder (AUD) and potential Tobacco Use Disorder (TUD) respectively. In adjusted analysis, participants with depression had about two times increased odds for potential AUD (aOR: 2.27, 95% CI; 1.12 – 4.58, p = 0.023) than those with no depression. Potential AUD and depression were associated with about eight times (aOR: 8.03, 95% CI; 3.52 – 18.28, p < 0.01) and more than twice (aOR: 2.63, 95% CI; 1.12 – 6.15, p = 0.026) higher odds for potential TUD respectively.ConclusionSubstance use and potential substance use disorders particularly AUD and TUD are common among Police Officers in urban Tanzania. Depression was found to be an important factor for potential AUD and TUD among Police Officers and, a significant co-occurrence of potential AUD with potential TUD was observed. Findings from this study call for interventions, for example, the need to routinize the brief motivational interview services for alcohol and tobacco use among Police Officers.

Institutional hybrids through meso-level bricolage: The governance of formal property in urban Tanzania

Drawing on a case-study from Dar es Salaam, Tanzania, we explore who governs formal property in African cities, how they make formal property legitimate and functional, and the consequences of these processes. Through the analytic lenses of institutional hybridity and ‘meso-level’ bricolage, we study the implementation of the Residential Licence programme, which offered a relatively affordable interim property right to the urban poor. We illustrate that formal property is constructed and managed by a hybrid governance of actors within and at the interface of the state – municipalities and community leaders. Some eighteen years after the programme began, the mtaa chairperson – an unpaid political figure and community representative, typically associated with informal land institutions – is still central to the governance of formal property. Both municipalities and mtaa chairpersons engage in practices of bricolage, which transform the RL into a hybrid institution, anchored to both existing and newly proposed sources of authority and knowledge on property relations. On one side, these practices lend legitimacy and functionality to the ‘new’ property right system. On the other, they open up grey areas for discretion and power relations. Therefore, we argue that this hybrid governance be supported by the state through adequate resources and political support. By offering a rare analysis of institutional bricolage within and at the interface of the state, our findings are important to advance current understandings on land reform implementation, land governance and land institutions in African cities.

Influence of Poverty on Streetism of Children in Dar Es Salaam and Dodoma Cities

Purpose: Tanzania has been implementing several initiatives to address the challenge of street children in the country. Despite such efforts, the child streetism has become the daily reality and has shown the sign of increasing. This dissertation is a study on the influence of poverty and family support on child streetism in urban Tanzania. Specifically, the study focused on analysing the lived experiences of street children; describing the influence of income poverty on streetism of children.&#x0D; Methodology: The study adopted interpretivism research paradigm using descriptive cross-sectional design and inductive research approach. It involved a total of 38 informants who were purposively selected while the snowballing sampling technique was used in accessing street children. Semi-structured interview, documentary review and observation method were conducted.&#x0D; Findings: Through thematic and content data analysis techniques, this study reveals that street children experienced difficulties in getting their basic needs and did not easily access health services when they fell sick. They also engaged into intra-violence among themselves. Further, child streetism has been largely influenced by income poverty. Regarding coping strategies, street children engaged into begging, unsafe sex and petty income-generating activities such as car wash and bottle collection. They also used self-medication to treat themselves when they fell sick or being left at the hospital buildings or on the street by their fellow street children when the condition got worse.&#x0D; Unique Contribution to Theory, Practice and Policy: Additionally, they did not have any coping strategy to enroll themselves into the school. The study also revealed that vulnerability and rational choice perspectives must be used in exploring the lived experienced of street children instead of using the vulnerability perspective alone. The rational choice perspective explains, among others, why street children sustain street life hardships and difficulties instead of going back to their families.

Contribution of Family Support in Addressing Children Streetism in Dar Es Salaam and Dodoma Cities

Purpose: Tanzania has been implementing several initiatives to address the challenge of street children in the country. Despite such efforts, the child streetism has become the daily reality and has shown the sign of increasing. This dissertation is a study on the influence of poverty and family support on child streetism in urban Tanzania. Specifically, the paper focused on analysing the lived experiences of street children; describing the influence of the family support on children streetism.&#x0D; Methodology: The paper adopted interpretivism research paradigm using descriptive cross-sectional design and inductive research approach. It involved a total of 38 informants who were purposively selected while the snowballing sampling technique was used in accessing street children. Semi-structured interview, documentary review and observation method were conducted.&#x0D; Findings: Through thematic and content data analysis techniques, this study reveals that street children experienced difficulties in getting their basic needs and did not easily access health services when they fell sick. They also engaged into intra-violence among themselves. Further, child streetism has been largely influenced by lack of family support. Lack of family support included unwillingness of parents and guardians to carter for the needs of their children, single parenting and poor orphaned families with limited economic opportunities, abusive parenting and, absence of love and care to children i.e. child neglect. &#x0D; Unique Contribution to Theory, Practice and Policy: These negative consequences of inadequate family support were attributed by substance abuse and use by parents and guardians, family violence incidences including gender-based violence, death of one or all parents, relatives’ thirsty in confiscating family properties when the death of male parent occurs.

Exploring the Effects of Out-of-Pocket Payments on Healthcare Utilization in Rural and Urban Tanzania: A Gender Perspective

Exploring the Effects of Out-of-Pocket Payments on Healthcare Utilization in Rural and Urban Tanzania: A Gender Perspective

Vertical HIV transmission within 18 months post partum among women on lifelong antiretroviral therapy for HIV in Dar es Salaam, Tanzania: a prospective cohort study

The UNAIDS estimate of vertical HIV transmission in Tanzania is high (11%), despite 84% uptake of antiretroviral therapy (ART) among pregnant women with HIV. We aimed to evaluate vertical transmission and its determinants by 18 months post partum among women on lifelong ART in routine health-care settings in Tanzania. We conducted a prospective cohort study in 226 health facitilies across Dar-es-Salaam, Tanzania. Eligible participants were pregnant women of any age with HIV, and later their infants, who enrolled in routine health-care services for the prevention of vertical transmission. We prospectively followed up mother-infant pairs at routine monthly visits until 18 months post partum and extracted data from the care and treatment clinic (CTC2) database, a national electronic database that stores patient-level HIV care and treatment clinic data. The primary outcome was time from birth to HIV diagnosis, defined as a positive infant HIV DNA PCR or antibody test from age 18 months. We used the Kaplan-Meier method to estimate cumulative risk of vertical transmission by 18 months post partum and Cox proportional hazards regression with shared frailties to account for potential clustering in health facilities to evaluate predictors of transmission. Between Jan 1, 2015, and Dec 31, 2017, 22 930 pregnant women with HIV (median age 30 years, IQR 25-34) enrolled on a care programme. After excluding 9140 (39·9%) women and 539 (2·4%) infants with missing outcome data, 13 251 (59·0%) mother-infant pairs were analysed, of whom 6072 (45·8%) women were already on ART before pregnancy. By 18 months post partum, 159 (1·2%) of 13 251 infants were diagnosed with HIV, equivalent to a risk of vertical transmission of 1·4% (95% CI 1·2-1·6). In the complete case analysis, the rates of vertical transmission were higher among women who enrolled in the third trimester of pregnancy than among those who enrolled in the first trimester (adjusted hazard ratio 3·01, 95% CI 1·59-5·70; p=0·0003), among women with advanced HIV disease than among those with early-stage disease (1·89, 1·22-2·93; p=0·0046), and among women who were on a second-line ART regimen than among those on a first-line regimen (3·58, 1·08-11·82; p=0·037). By contrast, the rate of vertical transmission was lower among women who were already on ART at enrolment than among those starting ART at enrolment (0·39, 0·25-0·60; p<0·0001) as well as among women in high-volume clinics than among those in low-volume clinics (0·46 (0·24-0·90; p<0·0097). Provision of ART for life (WHO's option B+ recommendation) has reduced the risk of vertical transmission to less than 2% among pregnant women with HIV in routine care settings in urban Tanzania. There is still a need to improve timely HIV diagnosis and ART uptake, and to optimise follow-up for the prevention of vertical transmission and the uptake of infant HIV testing. Swedish International Development Cooperation Agency.

Local knowledge and derived practices of safety during pregnancy, childbirth and postpartum: a qualitative study among nurse-midwives in urban eastern Tanzania

BackgroundMaternal and newborn mortality are still high in low-income and middle-income countries despite global efforts to improve the quality of care by prioritising evidence-based practices and increasing the number of...

Digital Communication for Civic Engagement Opportunity in Urban Tanzania

Purpose: This study examined the use of digital smartphone interaction for civic and public communication in the public sphere. It focuses on how policymakers perceive digital public communication among youths who constitute the majority of smartphone users in Tanzania.&#x0D; Design/ Methodology/ Approach: It is designed as a case study involving a qualitative data collection method. Semi-structured interviews were conducted with policy experts in Dar es Salaam city in Tanzania.&#x0D; Findings: Outcomes show that policy experts mainly focus on digital economic capacity building and less on the opportunities for developing civic and public communication as an important component of societal development.&#x0D; Research Limitation: The study is designed as a case study thus limiting the generalisation of findings.&#x0D; Practical implications: The study suggests policy guidelines for facilitating youths’ participation in the public sphere as a strategy to guide the utilisation of smartphones to promote engagement in civic and public life specifically for youths as a trajectory towards societal development. &#x0D; Social implications: The study creates awareness among youths to use smartphone interaction to participate in civic and public communication as an emerging crucial aspect of societal development in the digital era.&#x0D; Originality/ Value: The study will contribute to improving citizens’ knowledge of civic and public engagement via new media for achieving development.

Higher Dietary Intake of Animal Protein Foods in Pregnancy Is Associated with Lower Risk of Adverse Birth Outcomes

The prevalence of adverse birth outcomes is highest in resource-limited settings such as sub-Saharan Africa. Maternal consumption of diets with adequate nutrients during pregnancy may protect against these adverse outcomes. The objective was to determine the association between maternal dietary consumption of animal source foods (ASFs) and the risk of adverse birth outcomes among HIV-negative pregnant women in Tanzania. Using dietary intake data from 7564 HIV-negative pregnant women, we used Poisson regression with the empirical variance (generalized estimating equation) to estimate the RR of adverse birth outcomes-preterm birth, very preterm birth, small for gestational age (SGA), low birth weight (LBW), stillbirth, and neonatal death-for higher and lower frequency of ASF intake. Median daily dietary intake of animal protein was 17 g (IQR: 1-48 g). Higher frequency of ASF protein intake was associated with lower risk of neonatal death (quartile 4 compared with quartile 1; RR: 0.59; 95% CI: 0.38, 0.90; P-trend = 0.01). Higher fish intake was associated with lower risk of very preterm birth (high tertile compared with low; RR: 0.76; 95% CI: 0.58, 0.99; P-trend = 0.02). Any meat intake was protective of preterm birth (RR: 0.73; 95% CI: 0.65, 0.82; P < 0.001), very preterm birth (P < 0.001), LBW (P < 0.001), and neonatal death (P = 0.01) but was associated with increased risk of SGA (RR:1.19; 95% CI: 1.01, 1.36; P = 0.04). Any egg intake was protective of very preterm birth (RR: 0.50; 95% CI: 0.31, 0.83; P = 0.01) as compared with no egg intake. Finally, any dairy intake was associated with lower risk of preterm birth (RR: 0.82; 95% CI: 0.68, 0.98; P = 0.03) and very preterm birth (RR: 0.53; 95% CI: 0.34, 0.84; P = 0.01). Higher frequency of dietary intake of ASF is associated with lower risk of adverse birth outcomes in urban Tanzania. Promoting prenatal dietary intake of ASF may improve birth outcomes in this region and similar resource-limited settings.

The Entrepreneurship Potential of Rural Areas: Soap Production as a Side Business for Tanzanian Rice Farmers

Purpose: This study examines soap production’s entrepreneurship potential and profitability as a supplementary business for rural rice farmers in Tanzania to promote their economic independence.&#x0D; Design/ Methodology/ Approach: We randomly sampled and interviewed about ten small-scale soap manufacturers in urban Tanzania gathered from 2019-2021 to develop a soap production business strategy for rural farmers at a similar scale. Considering the Voronoi theory, we calculated the distance from the rural areas to urban centres to determine the transportation costs, which particularly burden rural farmers. Soap production costs and profitability were determined based on transportation costs and raw material prices.&#x0D; Findings: Rural farmers would incur high transportation costs, given the high average distance to the nearest urban centre (sometimes &gt; 100 km). Nevertheless, producing their rice bran oil, valuable raw material for soap production, would give them a competitive advantage over urban producers.&#x0D; Research Limitation: The study’s proposed strategy can be applied to similar contexts to reduce the urban-rural entrepreneurship divide.&#x0D; Practical Implication: Soaps made using rice bran oil help farmers reuse agricultural waste. Their active ingredients also increase their marketability as high-end cosmetic products, providing farmers with additional income.&#x0D; Social Implication: Commercializing agricultural residues such as rice bran increases farmers’ revenues and reduces CO2 emissions by preventing the residues’ incineration; this creates a virtuous cycle in society.&#x0D; Originality/ Value: This study presents a more realistic business strategy for rural Tanzanian farmers, as, unlike previous studies, it considers not only direct costs but also transportation costs.

Ideal Cardiovascular Health: Distribution, Determinants and Relationship with Health Status among People Living with HIV in Urban Tanzania.

Ageing adults living with HIV (ALHIV) have increased risk of cardiovascular diseases as a result of HIV-infection-related chronic immune activation and inflammatory responses. Cardiovascular health index (CVHI) is a valid and relatively simple index for assessing the cardiovascular health (CVH) of the general population. Use of this index among ALHIV in Sub Saharan Africa, a resource-restricted setting where it could be mostly beneficial, remains limited. Understanding of the distribution and associated factors may inform the design of optimal interventions to improve CVH of ALHIV. We aimed to assess the distribution and factors associated with CVHI scores among ALHIV in an urban setting in Tanzania. A cross-sectional study was conducted among ALHIV on antiretroviral therapy at six HIV clinics in Dar-es-Salaam, Tanzania. We summed the score of each of the seven CVHI metric to obtain the overall CVHI score and assessed the distribution of the score by sex. We then categorized the overall score into ideal (5-7), intermediate (3-4) and poor (<3) CVH categories and performed ordinal regression to identify CVHI score associated factors. In all, 629 ALHIV [mean age of 43.5(SD ± 11.2) years] were enrolled. Most had ideal levels of blood glucose (96.2%) and smoking status (83.4%) while less than half had ideal BMI (48.1%), blood pressure (BP) (43.9%) and dietary intake (7.8%). Less than half (47.6%) showed ideal CVH, while less than 1% had all seven metrics at ideal level. Older age (0.96(95%CI:0.95-0.97), p-value < 0.001), being retired/unemployed (0.59(95%CI:0.43-0.81), p-value < 0.01), being employed (0.76(95%CI:0.62-0.94), p-value = 0.01) alcohol use (0.41(95%CI:0.21-0.80), p-value = 0.01) and presence of non-communicable disease comorbidities (0.68(95%CI:0.48-0.97), p-value = 0.04) had significant lower odds of ideal CVH. Based on our findings, interventions to improve CVH of ALHIV should target BP management, health education on diet for BMI control and reduction in alcohol consumption, particularly among ageing ALHIV with comorbidities.