School of Public Administration and Management (SOPAM)

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    Factors affecting implementation of electronic logistics management information system (eLMIS) towards availability of essential medicine in selected primary health facilities in Karagwe District, Tanzania
    (Mzumbe University, 2025) Nozobona,Emmanuel D.
    Access to essential medicine is a global concern to heath of the population. In Tanzania it remains a significant challenge in strengthening primary health care services. Despite government efforts to strengthen primary health services including the implementation of electronic Logistic Management Information System (e-LIMS) to solve medicine challenges, many facilities still face shortage of essential medicine despite using a logistic system. However, there is limited data on the factors affecting its implementation. The study had three objectives: to assess the perceived availability of medicines, to identify institutional and individual factors affecting its implementation. The study adopted the Technology Acceptance Model (TAM), to carry out the study. A cross-sectional design was employed, utilizing both descriptive and inferential statistics specifically bivariate (OR) and multivariate logistic regression (AOR) for institutional and individual factors affecting implementation. Data were collected using questionnaires administered to 51 respondents from dispensaries to the district hospital. Stratified random sampling was used to sample primary health care facilities involved in the study and simple random sampling was used to select individual involved in the study from the selected facilities from each level On the availability of essential medicine, the study revealed that, 61% facilities frequently experienced medicine stock-outs, 65% often borrow medicine from other facilities to manage shortages. About 75% reported insufficient medicine to meet operational needs. On the institutional factors, the findings reviled that, facilities with logistics policies, standard operating procedures, (OR = 0.05, p = 0.021), facility dedicated budgets for logistics (OR = 0.4, p = 0.052). and adequate staff incentives (OR = 0.18, p = 0.043) were less likely to experience stock-outs. In the individual factors the study found that, facilities with staff who perceived eLMIS implementation as increasing their workload were more likely to experience shortages (OR = 2.28, p = 0.026). This study concludes that, primary healthcare facilities continue to experience frequent stock outs and drug expirations despite the implementation of the e-LMIS. The study recommends to address both institutional and individual factors to optimize e-LMIS implementation, thereby improving the consistent availability of essential medicines in primary healthcare settings.
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    Implementation evaluation of direct health facility financing at lower health facilities in Tanzania: A case study of Dodoma city council
    (Mzumbe University, 2019) Bura, Joseph M.
    Introduction: The Direct Health Facility Financing meant to ensure directly disbursing funds to the lower level health facilities and enabling them together with communities set their own health priorities so as to improve delivery of health services to achieve Universal Health Coverage (UHC). The main focus of the evaluation was implementation of Direct health facility financing in lower facilities in Tanzania, specifically it looked at Disbursement of funds,human resources availability and their capacity in implementation of DHFF, community participation and how social demographic affect the implementation ot DHFF. Methodology: This process evaluation study was conducted in Dodoma City Council and applied the descriptive cross-sectional design. There were 99 Questionnaires, 12 in-depth interviews, 6 focused group discussions, and documentary review. A total of 22 health managers and 32 HFGC participated in an in-depth interview and Focused Group Discussions. Quantitative Data were imported to STATA 13 to run test statistics such as the logistic regression statistical test and chi-square statistical test that was used to assess the relationship and association between the dependent and independent variable respectively. While for qualitative data were transcribed read and re-read for completeness, and then uploaded in Atlas ti 7 to assist the data analysis process. The analysis was assisted by quere tool report. Results: It was found that DHFF funds were disbursed very late from Central Government to facility account. Human resources for health number and their attitude is negatively affecting implementation of DHFF by 74 Percent and 96 Percent respectively, so there is critical shortage of health care providers and unpleasant attitude with insufficient capacity toward users of services. There is observed improvement in motivation due to autonomies in managing facilities funds by health care providers and improved financial fast-tracking of payments due DHFF programme being free from higher-level bureaucracies. Community participation is very low, only 14 Percent of the general population is aware on participation in the planning. It was found that social demographic factors like education, for example, none educated community 75 Percent attend tradition healing compared to the remaining 25 Percent who first attend facility services when they fall sick. Poverty, distance to the facility and local belief were important factor that is affecting implementation DHFF. Conclusion: DHFF Funds are disbursed into the facility account untimely so resulting in an occasional shortage of essential commodities. There is critical of human resources shortage for health that affect implementation of DHFF. There is low community involvement in the implementation of DHFF and social demographic factors such as literacy, economy and distance to facilities is negatively vii affecting implementation of DHFF. We recommend the government to timely disburse funds, recruit human resources for health in the required number, sensitise community participation by preparing simple to understand manuals and advocate health promotion to enhance care seeking behaviours to the communities. Conclusion: Unreliable funds, lack of awareness on SWASH project, poor sectorial coordination and non-consideration of MHHM issues as vital are major challenges impinging smooth implementation of SWASH project. Considerable measures are to viii be taken by government and project designers in areas of scale up, implementation and progress monitoring so as to ensure achievement of envisioned outcomes. recording and data reporting tools in the health facilities, despite that tools are available but still the quality of data remained doubtful due to data disparities observed in the documentary review across different level of response. Family planning data quality assessment is only performed at the District and in the Region level but rarely and improperly conducted at facility levels due to some observed challenges like inadequate knowledge for FP DQA, lack of skilled team, lack of standardized data quality assessment tools, mistrust of data collectors at different levels, data manipulation to fulfil donors requirements, parallel reporting and report overburden at the health facilities.
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    Outcome evaluation of voluntary medical male circumcision project on changes in knowledge, attitude and practices in Njombe town council
    (Mzumbe University, 2018) Mhagama, Boniface
    Despite of the Voluntary Medical Male Circumcision (VMMC) project to meet its target of scaling the coverage of male circumcision to 80%, there is no clear indication to whether this achievement is parallel to changes in knowledge, attitude and practices of community members of Njombe Town council. Therefore, this study evaluated outcomes of VMMC project on knowledge, attitude and practices towards Medical Male Circumcision (MMC) among community members of Njombe Town council. The study was conducted at Njombe Town Council in Tanzania, using descriptive cross sectional study design involving 156 respondents who were randomly selected from the study population. This study employed self-administered questionnaire method to collect data from respondents. Both inferential and descriptive analysis were applied to analyze study data using SPSS V.20. Study findings revealed that majority of respondents possess knowledge on MMC as one of the prevention methods of HIV, penile cancer and STIs. When attitudes of respondents towards MMC were assessed, many showed to have positive attitude. Moreover, the researcher found male circumcision is practiced in Njombe Town council. Knowledge, attitude and practices of community members towards MMC has been positively impacted by VMMC project, though it is not to the entire community. Hence more initiatives should be carried out by the government and other stakeholders to advocate MMC to community members of Njombe Town council.
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    Evaluation of the effect of pneumococcal conjugate vaccine 13 (PCV 13) and rotavirus vaccine on under five children hospitalisation and mortality: A case study of Maswa district
    (Mzumbe University, 2018) Galishi, Anthony N.
    Pneumococcal and Rotavirus infection continues to cause high level of hospitalisation and mortality in under-fives. In January 2013, Maswa district introduced PCV13 and Rotavirus vaccines in its immunisation programme to prevent children against pneumococcal and Rotavirus infection. This evaluation study investigated the effect of PCV13 and Rotavirus vaccines in under-five hospitalisation and mortality in Maswa district. The study adopted a case study design drawing a sample of 20 respondents who provided detailed information until the saturation level was met. Data were collected through in-depth interview, documentary review and observation. Some of the study participants were purposively selected due to their roles in IVD programme while others were conveniently selected at the facilities. Content analysis was used to analyse the data from in-depth interviews. Documentary data were analysed using SPSS computer software where descriptive statistics such as frequencies and percentages were deployed. The IVD programme was implemented following the national guideline. There was a decreased under-five hospitalisation and mortality due to pneumonia and diarrhoea diseases in Maswa district following introduction of PCV13 and Rotavirus vaccines.
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    Process evaluation of community led total sanitation programme in Njombe district council
    (Mzumbe University, 2017) Msemwa, Boniface
    Most of the diseases which affect the community are caused by poor sanitation. Improper hand washing or not washing hands after using a latrine, open defecation are the factors which contribute to the transmission of diarrhoea diseases. In order to prevent diseases resulting from unimproved sanitation, in 2011, the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDEC) introduced the programme to assist the community to increase the coverage of improved latrine and hand washing facilities by 50%. This evaluation study was conducted to assess the implementation of community led total sanitation programme in Njombe district council under the dimensions of knowledge of the community on Sanitation programme, identifying the households with improved latrine after the implementation of the CLTS programme, implementation of Sanitation programme and examining the progress, shortcomings, challenges and the lesson learnt of Sanitation programme. The evaluation adopted cross-sectional study design. Both quantitative and qualitative data were collected from 272 households in three wards using questionnaire, observational checklist and interview guide. The study revealed that CLTS programme has successively scaled up the coverage of improved latrine from 3% before implementation to 98.7% after implementing the programme. Moreover, the findings showed that households with functional hand washing facilities has increased up to 68% compared with the previous during baseline survey which was 3%. This study showed that implementation of CLTS programme in Njombe district council has brought high coverage of improved latrine and hand washing facilities among the community. Community led total Sanitation can be well implemented using available resources found in the programme area taking into consideration that proper triggering is well conducted. Njombe district council should continue to strengthen CLTS programme so that to attain the declaration of open defecation free (ODF).
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    Process evaluation on the contribution of emergency obstetric and neonatal care services on maternal mortality reduction: A case of Chamwino district.
    (Mzumbe University, 2018) Mahava, Gatete Y.
    Objective: This study examined evaluation of the contribution of emergency obstetric and neonatal care services on maternal mortality reduction. Specifically, to determine the magnitude of Maternal Mortality rate before and after introduction of EmONC, to examine implementation process of EmONC in Chamwino District, to examine factors facilitating or impinging the implementation of EMONC. Methods: The studyused a case study design, drawing all health workers implementing EMONC in Chamwino district these include Heath workers implementing EMONC programme in the dispensary who were 75, in health centers were 12 and in hospitals were 16 which made a population of 103 employees. The population was manageable and therefore the researchers did not find any need to do sampling hence all the employees were used for data collection. Purposive sampling was used to select respondents. Primary data were collected through questionnaire data were analysed using Stata computer software where descriptive statistics such as frequencies and percentages were deployed. Results: The study reported adequate availability of CEmONC and BEmONC in Chamwino district, in compliance with the international and national standards. Poor distribution was noticed as all CEmONC were concentrated at Chamwino and Mvumi villages, there was a decrease in the mortalities between 2005/2008 and 20013/2017. The study reported variations in shortage of lifesaving supplies, lack skills, training and guidelines. As most of BEmONC facilities provide parenteral antibiotics, parenteral anticonvulsants, and parenteral oxytocin drugs. The study recommend that for better implementation of CEmONC and BEmONC more health workers should be trained and tools such as antibiotics, parenteral anticonvulsants, and parenteral oxytocin drugs should be supplied to the dispensaries.
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    Evaluation of SWASH: Has it addressed menstrual health and management challenges facing school girls in Muheza district?
    (Mzumbe University, 2019) Mwaisengela, Mwantimwa S
    Introduction: Many countries especially in Africa and Asia lack menstrual hygienic facilities in public places especially in schools where it is needed the most. At least 500 million” females, both women and young girls, do not have access to adequate facilities as part of managing menstrual hygiene (World Bank, 2018). This goes in hand to low level of MHHM understanding among both girls and boys. Hence this evaluation study aimed at ascertaining MHHM awareness among girls, schools’ adherence to SWASH MHHM guidelines, school boys peer support, availability of funds for implementation, implementers’ commitment and responsiveness to challenges and socio demographic and geographic factors affecting MHHM knowledge among school girls. Methodology: The study was a concurrent mixed method with analytical cross sectional study design where a formative evaluation approach was employed to ascertain contribution of SWASH project in addressing MHHM related challenges facing school girls in Muheza district. 8 private and government secondary schools were purposely selected where 503 respondents were involved out of which, 458 girls were used as quantitative sample while 42 girls students were selected for in depth interviews out of quantitative sample, 5 FGD’s each comprised 8 girls’ students, 3 FGD’s for boys each comprised 8 students, 16 teachers and 5 District Managers were used in this study as a part of qualitative sample. Data were quantitatively analyzed with the help of Stata 13, Python and QGIS for geospatial analyses. Qualitative analysis involved content analysis technique with the help of Atlas ti. Results: it was found that none of 8 schools has met 100% MHHM requirements as envisaged, mean students ratio per pit hole were observed to be 52 with the worst situation in government schools (>100 for some schools). Operations and maintenance was another challenge where non availability of soaps, emergency pads, water and dilapidated infrastructure were prevalent in government schools. Age were observed to have a weak positive relationship to students’ performance (r=0.35) while menstrual experience years modrate (r=0.52). “Form II”, “Form III” and “Form IV” are 1.04, 1.36 and 1.39 respectively times likely to have desirable awareness level (>= 50%) compared to “Form I” (p>0.05). primary and secondary level educated mothers are 10% and 6% less likely to have desirable MHHM understanding compared to university educated mothers (p=0.732 and 0.33 respectively) whereas Mothers who have not gone to school are 80% less likely to have a good understanding level than University/College mothers (p=0.033). Conclusion: Unreliable funds, lack of awareness on SWASH project, poor sectorial coordination and non-consideration of MHHM issues as vital are major challenges impinging smooth implementation of SWASH project. Considerable measures are to viii be taken by government and project designers in areas of scale up, implementation and progress monitoring so as to ensure achievement of envisioned outcomes. recording and data reporting tools in the health facilities, despite that tools are available but still the quality of data remained doubtful due to data disparities observed in the documentary review across different level of response. Family planning data quality assessment is only performed at the District and in the Region level but rarely and improperly conducted at facility levels due to some observed challenges like inadequate knowledge for FP DQA, lack of skilled team, lack of standardized data quality assessment tools, mistrust of data collectors at different levels, data manipulation to fulfil donors requirements, parallel reporting and report overburden at the health facilities.
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    Outcome evaluation of differentiated HIV testing services in improving linkage of newly diagnosed clients to care and treatment in selected health facilities in Morogoro Region
    (Mzumbe University, 2025) Centa,Boniface G.
    Background: Linkage to HIV care and treatment following diagnosis is essential for the prompt initiation of antiretroviral therapy and for effective epidemic control. The NASHCoP 2022-2026 Strategic Plan aims to achieve 100% linkage rate. This evaluation assessed the effectiveness of Differentiated HIV Testing Services and contextual factors influencing linkage to care and treatment among newly HIV clients in Morogoro region from January 2024 to February 2025. Methods: A sequential explanatory mixed-methods was used. Quantitatively, a multistage sample of 392 newly diagnosed clients was drawn from facility records. Data on the linkage proportion, timeliness, and associated factors were analysed using descriptive statistics and a logistic regression in STATA v17.0. Qualitatively purposively selected 6 healthcare providers who provide HTS at various testing points were interviewed in-depth; transcripts underwent phenomenological analysis in ATLAS.ti v9 to identify facilitators and barriers of linkage to care. Results: Of the newly diagnosed clients, 90.05% were successfully linked to care, with 95% of those linked being enrolled on the same day of diagnosis. Higher odds of successful linkage were observed among females (AOR=7.19; P=0.014), and those diagnosed at dispensaries (AOR=2.10; P=0.017). Qualitative findings identified key facilitators including high quality pre and post-test counseling, positive provider-client relationships, active phone follow-up, support from expert clients and mentor mothers, and weekly departmental meetings. Major barriers included cultural denial among Maasai pastoralist communities, religious beliefs, unavailability of CTC services on weekends, stigma and distance to CTC. Conclusion: Linkage to HIV care was high but below universal targets, with same day enrolment common. Success was influenced by gender, marital status, distance, and contact availability, proper counseling, and peer support. Persistent cultural, religious, and stigma-related barriers require targeted interventions
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    Determinants of youth participation in sports betting: A case study of Mzumbe Ward, Mvomero District, Morogoro, Tanzania
    (Mzumbe University, 2025) Wilson, Elinami
    The growing involvement of youth in sports betting activities presents serious social and economic challenges, especially in developing countries like Tanzania, where unemployment and limited recreational options are common. This study aimed to examine the determinants of youth participation in sports betting in Mzumbe Ward, Mvomero District, Tanzania. Guided by three specific objectives, the research explored youth perceptions of the risks and benefits of sports betting and analyzed the economic and social determinants contributing to their engagement. A cross sectional design was adopted, employing a mixed-methods approach that combined quantitative data from 362 survey respondents with qualitative insights from interviews and focus group discussions. Descriptive statistics, content analysis, and binary logistic regression (using SPSS v25) were utilized for data analysis. The results showed that while some youth view sports betting as a source of entertainment and potential income, the majority (74.6%) believe that risks such as strained relationships, financial loss, addiction, and mental health issues outweigh the benefits. Economic determinants, including financial pressure (p = 0.016), income levels (p = 0.024), and employment status (p = 0.030), were found to significantly influence betting behavior. Youth under financial stress were more likely to participate, whereas employed individuals were less likely to engage. Furthermore, social determinants such as peer influence (p = 0.001), family background (p = 0.002), gender (p = 0.006), and education level (p = 0.011) also had significant effects. In conclusion, both economic and social determinants have a significant impact on youth involvement in sports betting. The study recommends multi-sectoral measures for the Gaming Board of Tanzania (GBT), social service organizations, and educational institutions, including public awareness campaigns, economic empowerment initiatives, stricter gambling regulations, and the provision of alternative recreational activities to foster positive youth development.
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    Healthcare services delivery to elders in Tanzania: Analysis of challenges and enablers in Songea Municipal Council, Tanzania
    (Mzumbe University, 2025) Mtega, Victoria
    Quality health care service delivery to elders is important for social economic development of any country. Despite this recognition, the provision of quality healthcare services to elders in Tanzania, particularly in upgraded health centers, remains a significant challenge despite improvements in infrastructure and service availability. This study examined enablers and challenges of healthcare delivery to elderly patients. The mixed research approach with explanatory sequential research design was employed. The study began with a survey questionnaire which was administered to 220 healthcare providers selected through simple random sampling. This was followed with 20 -depth interviews with geriatrics selected purposively from the upgraded health center in Songea Municipal Council. SPSS version 23 was employed to perform descriptive statistics, logistic regression and variable of p-value of less than 0.05 was statistically significant. Results showed that 69.5% of healthcare provider delivered sub-optimal healthcare services to elders. Factors like leadership support, staff training, and effective policies were important enablers while, challenges were shortages of resources and staff, as well as poor coordination between service units, hindered effective service delivery. Qualitative insights from elders highlighted both strengths and weaknesses, including challenges like drug stock-outs, long waiting times, and delays in emergency care, alongside positive experiences with trained providers offering proper diagnosis and treatment. The study concluded that heath care service delivery to elders in some areas, remain largely inadequate. The study recommends strengthening facility leadership, providing ongoing geriatric training, developing and implementing elder-specific policies, ensuring adequate staffing and medical supplies, and enhancing coordination through clear referral systems and integrated health records. Collaboration among government, healthcare providers, and communities is vital for sustainable improvement. Policy implications include prioritizing leadership development, standardized geriatric training, equitable staffing, and integrated service delivery models. Establishing shared care plans and efficient referral systems will promote continuity and quality of elder care. These measures are essential for creating a responsive, inclusive healthcare system to meet Tanzania’s growing elderly population’s needs