Dissertations (Masters)-HSM-SOPAM

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Assessment of energy efficient rocket stoves contribution on deforestation control in Tanzania: A case study of Chamwino District in Dodoma Region
(Mzumbe university, 2015) Annamaria Cornelius Gerome
Deforestation is undeniable fact that it is a worldwide environmental concern. This study assessed contribution of energy efficient rocket stoves technology in deforestation control at household level in Chamwino District whereby it specifically examined adoption and adaptive use of energy efficient rocket stoves technology. It also explored the impact of energy efficient rocket stoves technology in rate of deforestation and identified challenges in adoption and use of energy efficient rocket stoves technology in the study area. The study involved 114 respondents including randomly selected 100 households and 14 purposely selected key informants such as WEO, VEO, DEMO, FO and STT Officers. The data were collected using structured questionnaires, interviews, focus group discussions, participant observation and documentary review. Quantitative data were analysed using descriptive statistics while qualitative data were analysed through content analysis based on emerging themes. Moreover, forest cover change was assessed using ERDAS IMAGINE 2014, ArcGIS 10.2.2, Google Earth and Microsoft Office Excel. Findings showed that, even though the majority (60%) revealed the fact that rocket stoves are efficient in terms of firewood, adoption was only high initially due to promotion by STT project and perceived benefit, later as the project phased out, adoption decreased due to loss of hope and socioeconomic barriers. Even those who adopted the stoves, only few (27%) had adaptive use as the majority turned into use of traditional stoves because the majority (84%) faced challenges in use of the stoves. Among the challenges were easy breaking of the stove, costs of running the stove when broken and cutting of wood into small pieces. Moreover, it was revealed that the rate of deforestation is still increasing despite the introduced stoves. It was therefore concluded that rocket stoves have not helped in control of deforestation. Hence, it was recommended that, people should respond positively towards such projects so that forests are sustained for both present and future generations. Also, the implementers should continue to visit the areas and work on the existing challenges so as to ensure effective adoption as well as use of the stoves even after the phase is off.
Assessment of medical waste management in health facilities: A case study of Makambako health centre
(2017) Mwakanyamale, Nuru
INTRODUCTION: Healthcare wastes pose health problems to the people and affect environment in general. Since the WHO set rules and principles of handling medical wastes but in health facilities health workers lack awareness and knowledge on how to handle those medical wastes whereby there are no training sessions and seminars to them. OBJECTIVES: The objectives of this study were to determine the practices of medical waste management at Makambako Health Centre, examining awareness to health workers and assessing the factors affecting adherence to the MWM at Makambako Health Centre (MHC) to avoid occurrence of health hazards to those interacted with those medical wastes including patients and environment around the area. METHODS: The researcher made use of both primary and secondary data. The study also employed the use of cross section method to describe the BWM since it involve 60 of Health workers included in the study from Health facility using purposive sampling technique. A semi structured questionnaire and observational check list were used to collect data. Data were entered and analyzed using SPSS. FINDINGS: The study has revealed the following key findings it indicates that generally level of awareness of health workers in government strategies to address medical waste was 65.4% and only 34.6% were not aware. Also 82.7% said the practices are satisfactory and 19.3% said the practices are not satisfactory since are encountering different challenges in the medical waste handling practices including getting injuries when handling wastes. RECOMMENDATIONS: From the research findings study recommend that there is a need of having regular training programs to all workers in order to help them to know the risks associated with poor management of medical wastes also the notification of quantity of wastes generated to enable the proper allocation of resources in medical waste management.
Assessment of outreach immunization services as a strategy to increase immunization coverage to reach Zanzibar national target of ninety Percent. A case study y - north “A” district of Unguja
(2015) Mize, Shah Abushir
Reaching the whole target population is one among the five essential components of the WHO/RED Strategy, and an operational approach to achieve immunization coverage. Different approaches for reaching target population enhance delivering of the health services to a large proportion of the population, that is Outreach (fixed site or mobile), Mass campaign and Village Health Day and Nutrition,The study was conducted to assess the outreach immunization service as a strategy to increase immunization coverage to reach Zanzibar national target of ninety percent. The study was carried out as quantitative and qualitative descriptive case study design involving 100 respondents including 80 community members from 5 selected Shehia in North “A “District of Unguja (Bandamaji, Kinyasini, Kandwi, Fukuchani and Kigongoni); 13 service providers from Chaani Kubwa, Kidoti and Pwani Mchangani health facilities and 7 supervisors from the District Health Management Teams. The information was obtained using guided interview questions, documentary review, and checklist/ observation. Data analysis was done by manual sorting, tallying, tabulation on master sheet through electronic software, and the results are presented in figures, tables and percentage (both qualitative and quantitative). The study findings revealed that the majority 46.15% of service providers interviewed were unskilled personnel (auxiliary worker) who execute outreach immunization services, with no reliable transport to track and follow up the outreach services, (23.75) % of the respondents agreed that outreach settings were not conducive to perform outreach services, and (16.25%) respondents were not satisfied with the services they received at the outreach setting. The study concluded that, factors limiting reaching unreached population include: weak supportive supervision (30%), weak male involvement (20%), and shortage of qualified staff (50%) to execute outreach immunization services and to reach all target population viii.Moreover, community suggested that to increase the number of resources, outreach services should be comprehensive and integrated as well as construction of health facility at every outreach setting to be put into consideration.The study recommended that the need to increase the demand for and supply of qualified staff so as to improve the utilization of health services and performance of the providers; to intensify community education on the use of the health services and to effectively provide supportive supervisions at regularly (at least monthly or quarterly) to improve staff performance.
Assessment of outreach immunization services as a strategy to increase immunization coverage to reach Zanzibar National target of ninety percent: A case study - North “A” District of Unguja
(Mzumbe university, 2015)
Reaching the whole target population is one among the five essential components of the WHO/RED Strategy, and an operational approach to achieve immunization coverage. Different approaches for reaching target population enhance delivering of the health services to a large proportion of the population, that is Outreach (fixed site or mobile), Mass campaign and Village Health Day and Nutrition, The study was conducted to assess the outreach immunization service as a strategy to increase immunization coverage to reach Zanzibar national target of ninety percent. The study was carried out as quantitative and qualitative descriptive case study design involving 100 respondents including 80 community members from 5 selected Shehia in North “A “District of Unguja (Bandamaji, Kinyasini, Kandwi, Fukuchani and Kigongoni); 13 service providers from Chaani Kubwa, Kidoti and Pwani Mchangani health facilities and; 7 supervisors from the District Health Management Teams. The information was obtained using guided interview questions, documentary review, and checklist/ observation. Data analysis was done by manual sorting, tallying, tabulation on master sheet through electronic software, and the results are presented in figures, tables and percentage (both qualitative and quantitative). The study findings revealed that the majority 46.15% of service providers interviewed were unskilled personnel (auxiliary worker) who execute outreach immunization services, with no reliable transport to track and follow up the outreach services, (23.75) % of the respondents agreed that outreach settings were not conducive to perform outreach services, and (16.25%) respondents were not satisfied with the services they received at the outreach setting. The study concluded that, factors limiting reaching unreached population include: weak supportive supervision (30%), weak male involvement (20%), and shortage of qualified staff (50%) to execute outreach immunization services and to reach all target population viii .Moreover, community suggested that to increase the number of resources, outreach services should be comprehensive and integrated as well as construction of health facility at every outreach setting to be put into consideration. The study recommended that the need to increase the demand for and supply of qualified staff so as to improve the utilization of health services and performance of the providers; to intensify community education on the use of the health services and to effectively provide supportive supervisions at regularly (at least monthly or quarterly) to improve staff performance
Determinants of obesity among rural men aged 18 years and above: A case of Bagamoyo district hospital
(Mzumbe University, 2015) Lugendo, Pendo Eva
Introduction: In Tanzania, obesity is regarded as a town problem; but currently the problem is facing the rural community as well. However, the magnitude and determinants of this problem in rural areas are not well known. This study aimed to explore determinants of obesity among rural men aged 18 years and above in Bagamoyo district. Methodology: A cross sectional study design was employed; data were collected from selected health facilities in Bagamoyo district. A Hundred and twenty men patients aged 18 years and above who visited health facilities during the study period were recruited. A semi-structured questionnaire was used to collect primary data. Secondary data were obtained from reviewing patient’s registers and files from CTC and Diabetes clinics in Bagamoyo district hospital. Data were entered and analyzed using Microsoft Excel applications. Results: The findings showed that 41.5% and 31.7% of the obese men were of the age group 40 or above and between 29-39 years respectively. Majority of the obese men were married and cohabiting by 37% and 27% respectively. Over 70% of the obese men earned a monthly incomes ranging from TZS 201,000/= to TZS 300,000/=. Furthermore, 56% of the obese men reported to eat 3 times a day and 24% more than 3 times a day eat starch food like ugali and beans, rice and beans in as lunch and dinner while during morning they eat fried doughnuts or cassava. Beer and soda were highly preferred by obese men by 43.9% and 35% respectively while 34% had drinking habit after working hours. More than 70% of the obese men did not participate in physical activities, 56% reported that they did not have recreational places and 65.9% did not engage in any recreation clubs. In addition, the findings from CTC and Diabetes clinics revealed that overweight and obesity is an indicative of being at risk of co-morbidities. Recommendations: This study strongly recommends that education should be given on how to prevent and control obesity, for example education on eating balanced diet as well education on physical activities.
Efficacy of Azadirachta indica plant leaves extract against “Bulinus globosus” snails under laboratory setting
(Mzumbe University, 2018) Badran, Issa S.
Niclosamide is the only chemical compound recommended for fresh- water snail control worldwide. Unfortunately, this compound has genotoxicity and carcinogenic effects. Besides, this compound is expensive and unaffordable to low income community members and developing countries like Tanzania. This study had the aim of testing the Azadirachta indica (neem) plant leaves extract against Bulinus globosus snails under laboratory setting so as to come up with alternative product to be used in the control of snails. The objectives of this study included determination of the lethal dose at LD50 and LD95 of grinded leaves of Azadirachta indica plant against field collected Bulinus globosus and determination of effectiveness of lethal time at LT50 and LT95 of grinded leaves of Azadirachta indica plant against field collected Bulinus globosus. Study population was snails and study design employed was experimental, which consists of two comparable groups which were an exposure and non-exposure groups containing 10 snails per batch with 266 total sample size for each group of hours. The study revealed that Azadirachta indica has a molluscicidal effect against Bulinus globosus although at all doses no LD50 and LD95 were recorded during the 6 hours exposure despite of recorded snail mortalities. The LD50 of 28.81g/L with a 95% Confidence Interval (CI) of 39.8-54.8 was recorded at 12 hours exposure where LD95 could not be recorded at this same time. The LD95 was recorded after 24 hours of snail exposure and this was 42.99g/L with a 95% Confidence Interval of 73.9-89.7. However, the Analysis of Variance (ANOVA) showed that no statistical significance different between the mortality exerted by the three groups for 6, 12 and 24 hours (P>0.05). On the hand, LT50 was recorded at the dosage of 28.81g/L and LT95 at the dosage of 42.99g/L. These findings therefore show that Azadirachta indica leaves extract has poison to kill Bulinus globosus snails because at laboratory setting experiment this was obvious. The important things noted are that to obtain high rate of mortality higher dose and longer time are needed. Furthermore, it is recommended to do the same vii experiment to these snail‟s species using other parts of the plant such as bark and seeds so as to make full utilization of the plant.
Factors affecting continuity in attending antenatal care services among pregnant women in Chemba district
(Mzumbe University, 2019) Hamisi, Aziza
Background: Maternal mortality has remained to be the leading cause of death among women of reproductive age. In developing countries like Tanzania, the occurrence of maternal deaths has been linked with low level of attendance and utilization of skilled maternal health services like Antenatal Care (ANC) services. This is because some deaths among pregnant mothers could have been prevented if women early utilize skilled maternal health services especially ANC services. Objective: This study aimed to determine the factors affecting continuity in attending antenatal care services among pregnant women. Methodology: The study adopted a cross-sectional design. Data were collected from 384 conveniently selected respondents enrolled in 7 health facilities of Chemba. Questionnaire was used during data collection. SPSS version 17 was used for data analysis. Findings: The findings of this study indicated that description of ANC services from health care workers (HCW) (Harsh or irrelevant description of ANC by HCW to clients), awareness on the day to start ANC and awareness on the frequency in which a pregnant mother is supposed to attend ANC services are the client related hindrances for continuity of ANC attendance. Service providers related factors that hinder continuity of attendance to ANC include long waiting hours of ANC services, modality of counseling for HIV test and STI test, provision of ANC services by male health providers, provision of ANC services by younger health providers, and shortage of medicines and medical equipment. The socio-economic factors that hinder continuity of ANC attendance include low family monthly income, religion objections, lack of spouse’s escort to ANC, lack of spouse’s financial support, family responsibilities, existence of traditional birth attendants and long distance from ANC clinics. Conclusion: In respect to the findings of this study, planners and implementers should consider multiple factors such as client related factors, service providers’ related factors and socio-economic factors in order to enhance continuity of ANC attendance among pregnant mothers.
Human health effects of exposure to wastewater among residents nearby river Msimbazi in Kigogo ward, Dar es Salaam
(Mzumbe University, 2017) Mwalilei, Gladsone
Objective: This study was designed to investigate human health effects of exposure to wastewater among residents nearby river Msimbazi in Kigogo ward, Dar es Salaam, particularly on skin diseases, respiratory conditions and reproductive problems. Methodology: This case control study recruited 200 respondents, among them 100 were exposed in 500 metres from river Msimbazi and 100 were non exposed 2000 metres far from river Msimbazi. Data were collected using administered questionnaires and analysis was made by Statistical Package for Social Sciences (SPSS) version 21.0. Findings: The present study reports findings from 100 (50%) male and 100 (50%) female respondents. A minimum year of the respondents spent in occupation was 1 year and maximum was 22 years. Among of 200 respondents, 47 (23.5%) had history of skin diseases and 20 (10%) respiratory conditions while 37 (18.5%) reported to have reproductive problems. The skin diseases reported were skin itching and rashes 29 (14.5%), black spots on the skin 12 (6.0%) and scabies 6 (3.0%). The reported respiratory conditions included pneumonia 13 (6.5%), asthma 6 (3%) and wheezing 1 (0.5). The reproductive problems were miscarriage 27 (13.5%), low birth weight 5 (2.5%), preterm birth 3 (1.5%) and prolonged time to pregnancy 2 (1%). The factors that were associated with exposure status were existence of source of pollutants that pollutes river Msimbazi (p=0.010), number of years that respondents spent in occupation (p=0.016), ignorance of respondents on the use of personal protective equipments such that apron was (p=0.013), overall (p=0.043) and sunglasses (p=0.013). Variables such as age less than 35 years (p=0.034), distance less than 0.5 kms in proximity from river Msimbazi (p=0.005) were significantly associated with skin diseases. Female respondents (p=0.005), nature of respondents occupational for survival (p=0.048) were significantly associated with respiratory conditions while respondents education level (p=0.000), existence of source of pollutants that pollutes river Msimbazi (p=0.002) were significantly associated with reproductive problems. Conclusion: Exposure to wastewater was associated with skin diseases, respiratory conditions and reproductive problems more too exposed residents nearby river Msimbazi compared to non-exposed.
Implementation of subsidy ITNs vouchers scheme: The experience from Chunya District
(Mzumbe University, 2015) Lumuliko, Yohana N.
The study main objective was to explore the implementation of subsidy ITNs vouchers scheme, the experience from Chunya District, specific objectives was on examining malaria incidence, investigating subsidy insecticide treated nets (ITNs) vouchers coverage and identifying challenges faced by subsidy ITNs vouchers program actors and beneficiaries during the implementation. This study was descriptive cross-sectional, applied a triangulation of quantitative and qualitative methods. Information’s on malaria incidence and subsidy ITNs vouchers coverage was obtained from soft and hard copies archived records and reports by using checklist extracted from the District Medical Office. Information on challenges experienced during the implementation was obtained through an in-depth interview by involving three key participants, who were malaria focal person, community leader and selected woman rearing a child as program beneficiary were involved. Data analysis involved summarization and import in micro-soft excel for quantitative data for table and figure. For qualitative data atlas.ti was used for grounded theory and content analysis. Overall findings indicated the decline in malaria incidence as DMO‟s report depicted from 34% in 2012 to 9.2% for outpatient department (OPD) and 10% for in patient in the year 2013. Further findings revealed that, 9,380 pregnant women were identified in 2013, only 2,915 received subsidy ITNs vouchers equal to 31%. Also, findings revealed a total 5,163 of subsidy ITNs vouchers distributed to pregnant women in 2014, but a report was blank for the number of pregnant women received. Furthermore, majority of participants have knowledge about subsidy voucher. Also, findings observed that, some community members missed their share. Challenges identified were poor communication and coordination between actors. Subsidy ITNs vouchers scheme has shown to contribute in reducing malaria incidence despite some setbacks those emerged. It is necessary for the health sector management to rectify weaknesses observed for improvement during future intervention of the same nature.
Influence of religious beliefs on family planning and contraceptive utilization: A cross-sectional study of Morogoro Municipality
(Mzumbe University, 2018) Semwaiko, Jennifer Julius
The main objective of this study was to examine the influence of religion on FP and contraceptive utilization. This cross-sectional study was conducted in Morogoro Municipality, which employed questionnaires and interviews to collected data from 220 respondents. The study population included 200 respondents who are religious followers and 20 respondents were religious leaders. Qualitative data was analyzed using context analysis and quantitative data was analyzed by using SPSS version 21.0 to examine the influence of religion and other factors on family planning and contraceptive utilization in Morogoro Municipality. Findings of this study have shown that, family planning and contraceptive utilization differ across religions and denominations. For instance, it was revealed that 31.7% of Muslims used withdrawal method, 10% use condom, 6.7% use Standard Days Method, 5% use pills while 46.6% do not use any method, compared to Christians 25% of whom uses Standard Days Method, 18% uses pills, 18% uses condoms, 7% uses withdrawal method while the remaining 32% do not use any method of family planning. The findings indicated that religion has no significant influence on FP and contraceptive utilization as p-value was 0.070, above the alpha level of 0.05. Hence, in ranking, other factors has more influence than religion because they have shown statistical significance in influencing family planning and contraceptive utilization. In particular, these factors include sex (OR=5.0, 95% CI 2.053-12.427) with p-value=0.000, age (OR=0.3, 95% CI 0.111-1.080) with p-value=0.058, distance (OR=0.05, 95% CI 0.020-0.0127) with p-value=0.000, availability of FP commodities (OR=2.9, 95% CI 1.245-6.997) with p-value=0.011, friendliness of health providers (OR=3.0, 95% CI 1.344-6.734) with p-value=0.006 and side effects of contraceptives (OR=0.2, 95% CI 0.074-0.390) with p-value=0.000. However, in interpreting these findings, factors like sex, availability of family planning commodities and friendliness of health providers significantly increase the use of family planning and contraceptives, however, distance and side effects of contraceptives significantly decrease the use of family planning and contraceptives. In addition, as the age of people increase above 39 years old, the use of family planning and contraceptives fall.
Perception, practice and risk factors for self- medication among residents of Kakonko District council
(Mzumbe University, 2017) Lusinge, Marcely S.
This study was about perception, practice and risk factors for self-medication. Specific objectives of this study were; to determine the perception of Kakonko District residents towards self- medication, to identify risk factors that influence them to practice self-medication, to identify medicines which are commonly used for self- medication as well as to determine sources of medicines information among those who self- medicate. This study was carried out at Kakonko District council in which 6 wards were randomly selected from the available 11 wards in which in each ward 2 villages were selected. The study area was chosen due to limited health care and increased population as a result of influx of Burundian refugee which jeopardize health services delivery. This study covered 90 respondents with different backgrounds and experiences. Information from respondents were collected through questionnaires and interviews. Results show that out of 90 respondents, only 28% were aware of the concept of self-medication while 88% of all respondents practiced self-medication. Risk factors for self-medication mentioned were as; lack of basic education 64%, dishonorable behaviors of service providers 30%, limited health services 71%, low income 51%, long waiting hours at the facility 61%, knowledge of local medicines 33%, past experience 44% and lastly fear to seek medical care was mentioned by 14% of all respondents. On the other hand, common medicines used were found to be; 14 (25%) respondents said that they usually use ALU for self-medication, 13 (23%) respondents paracetamol, metakelfin was used by 10 (17%), local medicines by 6 (11%) respondents, ciprofloxacin by 3 (5%) respondents, amoxicillin by 7 (12%) while fragyl used by 4 (7%) respondents. Source of medicines information mentioned are individual themselves, friends, family members, parents and other relatives. Given the extent of the study findings, there is a need of concerted efforts to deliver basic factual information to the society on health and social-economic effects of self-medication.
Role of cultural orientation towards risk sexual behaviors among school children: A case of selected secondary schools in Morogoro Urban
(Mzumbe university, 2015) Goodluck Patrice Nombo
The study was conducted in Morogoro urban in Tanzania to explore the relationship between the cultural orientation and students risky sexual behaviors and examine whether and how modern intervention including modern contraception influence these behaviors to secondary and primary schools students. The main concern was to find out if traditional intervention through cultural orientation could be a proper strategy for risky sexual behaviors by determining the cultural orientation negative roles in students‟ sexual behaviors and also whether and how modern intervention programs for risky sexual behaviors had succeeded to reduce the problem. The study employed cross-sectional design: structured and unstructured questionnaires were used to collect both primary and secondary data. It involved 300 respondents from five secondary schools that were purposively selected while convenience sampling was used in choosing 1 education officer, 1 health officer and 3 indigenous aged people. Findings: 85% of students in secondary schools had sex before 19 years in which 68.33% of them did not use condoms completely as a result of cultural orientation factors; initiation ceremonies fostered the problem by 74.57% for males and 79.81% for females; having multiple sexual partners by 78.18% for males and 60.67% for females; Religion fostered the risky sexual behaviours by 61.42%; the orientation to use calendar or safe days method than modern contraceptives to females by 64.67%; social taboos caused 28% of males and 41.33% females not to use condoms. The parents‟ use of strokes to punish their children had led to the increase of risky behaviors among 19% of male students‟ while for females it decreased. Cultural orientation factors had impact on failure or success of the modern strategies including contraceptives on controlling risky sexual behaviours, thus there was a call for improvement of sexual health education via reviewing the cultural orientation factors in efforts to combat the

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