Dissertations (Masters)-HME-SOPAM

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    Factors and challenges associated with loss of follow up visits among HIV/AIDS clients attending antiretroviral therapy in Ilala Municipal Council
    (Mzumbe University, 2015) Salema, Judith
    Background: The loss of follow up visits among HIV positive adults on antiretroviral therapy is a leading cause of morbidity and mortality in Tanzania. The loss of follow up visits brings a big challenge in Care and Treatment Centre (CTC) as many HIV clients are not attending clinics as scheduled. Broad Objective: To assess the factors and challenges associated with the loss of follow up visits among HIV positive adults attending CTC in Ilala Municipal Council. Methods: Cross sectional study design was conducted in Ilala Municipal Council involving HIV positive adults and health providers whereby data were extracted from CTC database and clients’ files. Data were obtained through structured questionnaires and were entered into Microsoft Excel and analyzed by using Stata version 13. Analysis for predictors was done using univariate and multivariate logistic regression where p value of <0.05 was considered as statistically significant. Results: 240 people were recruited in the study. 190 were patients, 50 were health workers, and most of the patients were females with the age ranging from 18-35 years amounting to 102 (54%). Lack of fare 72(60%), Stigma, shift from one clinic to another and use of traditional medicine found to be the factors contributing to the loss of follow up visits. However, lack of space (92%), shortage of health providers (94%), stigma and discrimination (90%), low motivation (94%) and work load (94%) were the challenges facing health providers during provision of services to HIV patients. Conclusion and Recommendations: The study found that the recording system of the patients’ information were poor, there were some clients who died, others were shifted to other clinics but the CTC term them as the loss of follow up visits therefore the data recording system should be strengthened.
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    Outcome evaluation of micro credit scheme saving and internal lending community intervention from people living with human immunodeficiency virus in Magu District
    (Mzumbe University, 2019) Iriya, Lucy C
    Background and rationale: HIV/AIDS has caused negative impacts on livelihoods including socio-economic problem, food insecurity and increased number of orphans in Sub-Saharan countries, including Tanzania. Following this, TAZAMA, the project operated under the Tanzania National Institute for Medical Research (NIMR) initiated the so called Microfinance schemes with the main objective to mitigate the negative impact of HIV/AIDS among People Living with Human Immunodeficiency Virus (PLHIV) and vulnerable populations in rural areas. Therefore the purpose of this study was to evaluate the contribution of microfinance Saving Internal Lending Community (SILC) intervention under TAZAMA project to the living standard of People Living with Human Immunodeficiency Virus (PLHIV) in Kisesa, Bujora and Bukandwe in Magu district within Mwanza city Tanzania Methods: Analytical cross-section study design was used which adapted mixed research methods; both quantitative and qualitative approaches were used. About 119 participants aged 18years old and above, PLHIV and beneficiaries of the SILC programme in Magu District suburb of Kisesa, Bujora and Bukandwe wards were enrolled for the study. Both self-administered questionnaires and interviews were used for data collection. STATA Statistical Software Package and ATLAS.ti V. 7 were used for data analysis. Inferential t-test and chi-squire test were used; also descriptive statistics such as frequency and percentage were presented in form of tables, figures and graphs. Results: The findings revealed that the majority of PLHIV had manage to save and receive credit through SILC groups, all beneficiaries of PLHIV manage to start entrepreneur activities after joining SILC groups such as horticulture, shops, transportation (bodaboda) and tailoring. Also, the findings show SILC members were able to increase meal intake and increased food stock. About success of SILC programme results shows PLHIV in improving their Living standard by owning assets and business. Statistically, there is significance difference on Ox-plough farm equipment before loan and after loan at P-value of 0.0095<0.05 which shows there is improvement in farming activities due to program intervention. Moreover, there is significance difference in type of wall materials used among the household of PLHIV before and after loan at P-value of 0.000<0.005. Conclusion: The scheme has been positively impacted to PLHIV through operational SILC groups by saving and receiving microcredit. It had improved lives of the PLHIV in the three wards in Magu district and therefore, the Government and other stakeholders should allocate resources to scale-up SILC initiatives to other areas of Magu District and beyond to cover unmet needs of PLHIV since the project did not cover the entire community of people who are living with HIV/AIDS.
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    Nutrition care and support services of people living with HIV/AIDS at care and treatment clinic: The case study of Kagera Region Referral Hospital
    (Mzumbe University, 2015) Tinkamwesigile, Nicolaus.T
    Introduction: A process evaluation on nutrition assessment counseling and support services of PLWHA at CTC conducted at Bukoba region referral hospital-Kagera region with the aim of ascertaining level of programme implementation. Methodology: Mixed methods were used to assess evaluation dimensions. The semi structure questionnaire, interview guide, observation checklists and documentary review were used to obtain information about programme context, implementation process, reach, fidelity, dose, adaptation and mechanisms of the impacts of the services provided to PLWHA. Evaluation findings: The evaluation findings revealed that programme was fairly implemented with overall 51% score of weighted factors. The evaluated factors show that implementation process was 42.8% and fidelity of the implementation is 43.5%. While dose and reach of the programme implementation show 38.64% and 79.64% respectively. Stakeholders were less engaging to the programme services as contextual limiting factors and integration of nutrition services to CTC services note as mediator of mechanisms of achieved reach. Using weight trend of PLWHA as nutrition status determination index seen as programme adaptation Conclusion: The CTC had inadequate implementation process that include limited number of staff to assist nutrition services, inadequate equipment, materials and supplies to better optimal programme implementation. Implementation components such as fidelity, dose and reach are imbalance implemented for optimal quality programme implementation. Recommendation: Hospital and regional health managements and ministry of health through TFNC and NACP with their nutrition stakeholders are urged to improve CTC capacity to better nutrition assessment, counseling and support services implementation for betterment of PLWHA.