Dissertations (Masters)-HME-SOPAM

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    Assessment of the quality of postnatal care services: A case study of Mbeya District Council
    (Mzumbe University, 2015) Lotto, Theopista, David
    Background: Postnatal care services consists of care given to the mother and her new- born for the first six weeks following birth, which enable health care providers identify post delivery problems and provide treatments promptly. This evaluation was conducted to assess the quality of postnatal care services following the unpublished report from Health Management Information System of the District which showed an increase in the number of maternal and infant death within six weeks post delivery. Methods: The evaluation used descriptive cross sectional study design in which quantitative approach was employed to collect and analyze evaluation data. The study was also guided by Donabedian conceptual framework based on structural and process components. A total of 355 clients attending postnatal care services in five selected facilities participated in an exit interview. Observational checklist adopted from the WHO implementation guideline was used for assessing resource availability. Data was analyzed using STATA version 13.0. Results: The findings established that health facilities that were involved in the study had basic resources to render quality postnatal care, however, there were some deficiencies in both structure and process components for provision of Post Natal Care (PNC) services. None of the five facilities had separate PNC room equipped with facilities for provision of quality services. Discussion and policy implications: The evaluated health facilities scored below 90%, based on agreed standard as set by World Health Organization which implies PNC services offered was sub-standard. Mbalizi Hospital and Inyala Health Centre had the average score of 77%, Santilya dispensary scored the third (75%) followed by Ilembo Health Centre 70% and the last was Igoma dispensary which scored 68% which is equal to partial quality. There is a need for the management of Mbeya District Council to plan for improvement of health facility infrastructures by constructing separate rooms for PNC to be able to provide quality health services and reduce neonatal and maternal death and ensure privacy to patients and clients.
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    Process evaluation on the implementation of mwanzo bora nutrition program on the reduction of childhood stunting: A case of Kilolo District in Tanzania
    (Mzumbe University, 2018) Chisanga, Helen, J
    Nutritional status of children is an important ending measure of their health status. Thus, child care and feeding practices has been recommended as a major solution to improve under-five survivals and promote healthy growth and development. This evaluation aimed to assess the implementation process of Mwanzo Bora Nutrition Program (MBNP) in reduction of childhood stunting at Kilolo district council in Iringa, Tanzania. The evaluation employed formative approach guided by a cross-sectional design. The evaluation enrolled a total sample size of 161 respondents. The sample included mothers of children/caregivers between 0-23 months enrolled in MBNP, community health workers and CHMT officials who were purposely and randomly selected. Data were obtained by using questionnaires, interviews and focus group discussions. Quantitative data were entered and analyzed by using SPSS software version 20 whilst simultaneously qualitative data were analyzed manually. Data were collected by using structured questionnaire, focus group discussion and in depth interview. Descriptive statistics were carried out, Chi – test was done to determine relationship between variables by using IBM SPSS version 20. The results revealed that 98% of mothers had knowledge about infant and young child feeding. There was no significance difference between knowledge of infant and young child feeding and practices especially on complementary food practice and breast feeding. However, significance difference was reported on the initiation of breastfeeding at (p≤0.05). Likewise, there was significance difference (p≤0.05) between knowledge of Mwanzo Bora Nutrition Program and its practices. Finally majority of the respondents (80%) had reported to have hand-washing equipment's; and among them 51% reported to have started using the equipment's after implementation of the program. The study concludes that use of hand-washing facilities improve hygienic condition and ultimately results on the reduction of childhood illness. Challenges associated with insufficient funds, shortage of human resources and poor community participation to some extent limited the implementation process