School of Public Administration and Management (SOPAM)
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Item Evaluation of the implementation process of health system strengthening program towards improving emergency obstetric and newborn care services: A case of selected health facilities in Kisarawe District(Mzumbe University, 2018) Mwandiki, Martin FelicianBackground: In this 21st century with well advanced technology on medical treatment we still lose a number of women and childrenn during childbirth in Tanzania. Emergency obstetric care is one of the strategies for reducing death during childbirth. Objectives: The aim of this study was to evaluate the implementation process of health system strengthening program towards improving emergency obstetric and newborn care services specifically, ability of the health facilities on providing EmONC services after health system strengthening. The goal of the project has been to improve EmONC services by ensuring availability of funds for training of health staff, procurement of medical equipment and supplies to the health facilities of Kisarawe district. Methodology: A cross-sectional descriptive study was conducted to 15 health facilities in the period of 2015-2017. The methods of data collection employed were mixed methods of data collection whereby the data was collected through face to face questionnaires to coordinators of the program, structured questionnaire administered to health staff, observation checklist and documentary review of the facilities` records. Descriptive analyses such as bar charts, histograms, line charts and percentages were employed. Results: The amount of support was not adequate since the program managed to support just four facilities out of 35. Merely 19%-20% of staff were trained for EmONC services, and almost all were from the district hospital. There was a shortage of medical equipment by 39.1-56.5% and medical supplies by 40-65% for EmONC services to all selected health facilities except the district hospital.The dispensaries and health centers could provide EmONC services at rate of 22.2-44.4% except the district hospital which had 100 percent. Conclusions: The implementation process of health system strengthening towards improving EmONC services at selected health facilities is not implemented successfully. Recommendations: There is a need of more funds, and the district should see to it that the program is implemented more effectively to realise set objectives and the Government of Tanzania should also increase its stewardship.Item People's perception on mosquito net performance: A cross-sectional study in the north-western part of the Lake Zone in Tanzania(Mzumbe University, 2015) Lukole, Eliud AndreaThe main aim of this study was to assess People’s Perception of Mosquito Net Performance in Muleba District in the North-Western Part of the Lake Zone of Tanzania. A cross-sectional survey and KAP survey were conducted a month apart. It was found that the sole reasons for not using bed nets in the study area were having not enough nets and bed nets being too old or poor condition. Half of the respondents continued to sleep under bed nets with poor conditions since they had no other alternatives. The attrition, survivorship and fabric integrity (LLIN with holes) rates were 36.85%, 57.76% and 60.15% respectively. Moreover, over 3 years more than 3 nets for every 10 nets distributed were lost because of wearing and tear, 5 nets survived out of 10 nets after 3 years and 4 nets sustained field condition for every net used. A proportionate hole index (pHI) was developed so that the integrity of net structure could be categorized. The pHI, IQR(Inter-quartile Range), median and standard deviation for HI were 3382.74, 2594.47, 3310.58 and 2551.50 respectively. There is wider dispersion of data on holes, and this is due to cluster geographical differences and differences in household composition between and within clusters. Based on study findings, mosquito nets are the main preventive measure against malaria used in Muleba. The population highly associates nets with malaria prevention. Nets with too many holes and more than three years old were perceived to be poorly performing in malaria prevention. Moreover,net attrition and survivorship and fabric integrity as elements of net durability showed significance difference between clusters because of geographical difference and the within cluster variation was due SES led by household composition. It is recommended that intensive and robust community-specific communication programmes should be devised by the government and/or other private institutions. Nets accessibility ought to be increased 3 years after free universal distribution through supply of subsidized nets in private shops so that families can at any time have access to them at lower costs. Pro- poor exemption policies can help the poorer group on equity bases.Item Patients’ satisfaction under National Health Insurance Fund (MHIF):The case of Bugando Referral Hospital(Mzumbe University, 2015) Mtwe, Joseph NyamhangaPatients’ satisfaction under National Health Insurance Fund (NHIF):The case of Bugando Referral Hospital Introduction: The National Health Insurance Fund (NHIF), scheme was initiated in 2003 by the government, with the aim of making health care services accessible to the formal sector employees. Objective: The main objective of this study was to assess the patients’ level of satisfaction under NHIF and factors influencing their satisfaction. Methods: The study employed a cross sectional study design involving 82 NHIF outpatients. Qualitative and quantitative approaches were employed; the data collection methods used includes questionnaire administration, focus group discussions and documentary review. Results: It emerged from the study that, insured patients had good expectation towards health services as well as good attitude with health service at the OPD, except poor attitude was noted on patients’ comfort ability towards health service. 37 (52.9%) respondents expressed poor attitude. Also 38 (54.2%) respondents indicated dissatisfaction on accessibility of the health services, especially enough space and seats. Furthermore, up to 36(51.4 %) respondents were dissatisfied with too long consultation time; and 34 (48.6%) respondents were dissatisfied with the service area at OPD, being inconvenient for the provision of health care to the insured patients.. It however emerged from the study that respondents were moderately satisfied with the availability of health services at the OPD and were satisfied with the quality of health services at the OPD. Conclusion: The study recommends action to be taken by NHIF scheme together with the hospital administration on addressing patients’ concerns for the purpose of improving the provision of health services. They should also include patient satisfaction strategies in their strategic plan for monitoring and evaluation of patient satisfaction under NHIFItem An assessment of family planning program data quality: A case of Tarime District(Mzumbe University, 2018) Sufian, Magetta S.BACKGROUND: Family planning encompasses the accessibility of services, policies, information, attitudes, practices and commodities, that gives women, men, couples, and adolescents the ability to avoid unintended pregnancy and choose whether and or when to have a child and the preferable number of children. It is a cross-sectoral intervention that can hasten progress across the sustainable development goals (Starbird, 2016). Inadequate information and poor data quality on family planning intervention program seems to affect contraceptives uptake records across different level of response. Investing on family planning program data quality assessment can bridge up the gap between the observed differences. OBJECTIVES: The aim of this evaluation study was to determine the tools used by health care providers in recording and reporting family planning data at facility levels, to assess how data collected at different levels with different organisation have similarities, and exploring how different organizations assess family planning data quality collected at different levels. METHODS: The study was conducted at Tarime district in the DMO’s office, 19 health facilities, RMO’s office and Program’s office. Qualitative research design was used in this study, purposive sampling methods applied, the researcher used both primary and secondary data through questionnaires and documentary review respectively, and lastly data analysed by excel and Atlas.ti software. RESULTS: Family planning data recording and data reporting tools was available in all public health facilities visited, however, there were data disparity between health facility and district level, as well as District and Regional office. Though data similarities were observed between District office and program office. Data quality assessment was not vii done in the health facilities for almost 90% but seems to be done at the District and in the Regional levels in collaboration with partners. CONCLUSSION: The findings concluding that Family planning program use MTUHA book no 8 which consist of three books namely registers, tally sheet and summary report books as a data 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.Item Pastoralism reorganised: Maasai resilience and governance in the shadow of mega-infrastructure in Tanzania(Cogent Social Sciences- Taylor &Francis, 2026) Chambo, Makulangwa Jeremiah; Massoi, lucy WillyMega-infrastructure projects are widely promoted as engines of modernisation in Africa, yet their implications for pastoralist societies remain contested. this article examines how Tanzania’s Standard Gauge railway (SGr) has reshaped livelihoods, governance, and spatial practices among the Ilparakuyo Maasai in Kilosa District. using interviews, focus group discussions, and field observations, the study draws on lefebvre’s notion of the production of space and resilience theory to analyze community responses. the findings show that the SGr has not displaced pastoralists but reorganised their practices through adaptation rather than transformation. Stations and adjacent settlements became economic hubs appropriated by women traders and youth entrepreneurs, with profits often reinvested in livestock, reinforcing pastoral continuity. resilience emerged through livelihood diversification, though unevenly distributed across households. Governance appeared as a contested arena, where elders mediated disputes, women pressed for inclusion, and state regulations reshaped authority. the study argues that the SGR generates hybrid socio-spatial realities in which pastoralists assert agency, reorganise livelihoods, and renegotiate authority. By moving beyond binary narratives of disruption versus modernisation, it extends debates on infrastructure, resilience, and governance in African rangelands.Item Assessment of factors influencing community health fund member’s satisfaction with treatment services offered through community health fund(Mzumbe University, 2015) Swai, Denis F.Background: In Tanzania, Community Health Fund (CHF) was initiated in 1996 with the aim of implementing a community Based Health Financing Scheme through volunteer membership contribution as additional income to improve access to quality health care service for marginalized rural community. The evaluation was conducted to assess factors that influencing Community Health Fund member‟s satisfaction with treatment services offered through Community Health Fund membership. Methods: A cross sectional study design was employed that involved 153 respondents for which allowed collection of data that provided a descriptive estimates of the population parameters. The study was guided by Donabedian conceptual framework where by questionnaires were designed to assess structures, process of service delivery and treatment outcome as attributes of satisfaction. A sample size of 153 respondents was calculated by statalcl 13 (64-bit) within the effect size of 0.7– 0.8 one sample (Alpha = CI=95%, α=0.05, two-sided). Two health facilities were involved in the exit interview where by respondents were selected and interviewed based on their inclusion criteria. Results: A bigger proportional of female 55(60%) and 40(60%) in Likombe and Mikindani compared to male 37(40%) and 21(34%). A big proportional of respondents revealed that structures of health facility include availability of adequate Health Care Providers (HCPs) and medicines influence their satisfaction (p=0.05). Most of respondents were happy with the quality of available medical supplies and it was statistically significant at satisfaction level (p=0.02). The process of service delivery indicate that CHF members spend more than one hour to receive treatment service in health facility from their first contact and there was significant association between time spent and satisfaction(p=0.02). However, significance association was found between happiness with treatment and overall satisfaction level with services (p=0.03) though members do not feel much difference from being a CHF member and other patients. Conclusions: All three attributes - Structure of the health facility, process and treatment outcomes significantly influence CHF members satisfaction of treatment services provided through CHF membership. However, the availability of medicines and qualified HCPs have great influence in the Satisfaction with structures, while there is a significant influence of time in satisfaction with process of services provision and treatment results have significant association with service provided.Item Factors influencing the level of women participation in community development projects: A case of Kahama Town Council(Mzumbe University, 2019) Lugendo, Vailet N.This study intended to investigate the factors influencing the level of woman participation in community development projects. It was carried out in Kahama Town council. The emphasis was put on the bypass of women in execution of development projects through devolved participatory approach to development. Four specific objectives of the study were: to determine level of participation of women in community development projects at Kagongwa ward, examine socio cultural factors influencing the participation of women in community development projects, identify economic factors influencing the participation of women in community development projects and to establish the role of media in influencing women participation in community development project. The study utilized a case study design, with a sample size of 100 respondents where by mixed methods of research approach were used in data collection, data analysis and data interpretation. Questionnaire survey and interview methods were used to collect data. Two data analysis methods were employed; the content analysis for qualitative data and descriptive statistical analysis using a statistical package for the social sciences computer programmed (SPSS) version 20.0 for quantitative data. The finding of the study reveals that the level of women participation in community development projects at Kagongwa ward is medium. Social cultural factors such as social norms and values, gender roles and stereotyping, and attitude influence negatively on women participation in community development projects. Level of education has positive significance influence on women participation in community development projects. Furthermore, the study reveals that economic factors like income level and pre occupation of women affected the level of women participation in community development project. Media was observed to influence the level of women participation in community development projects. The study recommends that there should be improvements on gender awareness for men and women; capacity building for women training for both men and women and dissemination of information through media should be given priority.Item The role of health sector basket fund on improvement of health services provision: A case of Nachingwea District Council, Lindi Region(Mzumbe University, 2019) Mbago, Ngoma, T.The study examined the implementation of Health Sector Basket Fund on improvement of health services provision in Nachingwea District Council. The study specifically, examined the trend of Health Sector Basket Fund disbursement for financial years, 2015/2016, 2016/2017 and 2017/2018, determined the activities supported by Health Sector Basket Fund implementation as planned in the Comprehensive Council Health Planning, and determined the perceived challenges of Health Sector Basket Fund implementation in the Nachingwea District Council. The study employed a single descriptive study design comprising the sample size of sixty (60) respondents including council health management team, health facilities in charges and their assistants. Moreover, simple random samplings were used as selection technique of the study. A quantitative research approach was employed in this study to collect information from the respondents easily and timely. The data collection tool used was a questionnaire which involved both closed and open ended questions. The descriptive statistics analyses were done with the aid of Statistical Package for Social Science (SPSS) version 21. The major findings of the study showed that, the trend of HSBF disbursement in three financial years 2015/16, 2016/17 and 2017/18 were Tsh. 401,727,651.87,Tsh. 503,277,000.00 and Tsh.428,394,800.00 respectively. The amounts were disbursed in two phases that is a half in every two quarters until the amount was finished and the results indicate that the council did not receive the Health Sector Basket Funds (HSBF) timely, and that the fund was sent to the council on quarterly system. That means, half of the budget needed for two quarters and another half of the amounts was received for the other last two quarters. The results also show that, the activities supported by Health Sector Basket Funds (HSBF) were implemented as planned in the Comprehensive Council Health Planning (CCHP). It also shows that, the major challenge in the implementation of Health Sector Basket Funds (HSBF) were delay in disbursement of funds and transport system. The study recommends that, the Health Sector Basket Fund (HSBF) improve the health services provision in Nachingwea Ditsrict Council. The government should insist the partners and donors who support the fund to disburse timely in order to rescue the consequences of health services provision in all councils.Item Assessing factors influencing reporting of weekly diseases data from regions to Ministry of Health and Social Welfare in Tanzania Mainland(Mzumbe University, 2015) Moshi, Frank SolomonBackground: Reporting weekly diseases data from regions to Ministry of Health and Social Welfare is one of method which is used to submit weekly diseases information from regions to the Ministry according to number of weeks in a year from 1st to 52th week. This method is a paper based, that enables diseases information to be available at the national level on time to allow for quick and important public health action. This is an evaluation study designed to assess factors which tended to influence weekly diseases data from regions to Ministry of Health and Social Welfare, to determine technical challenges and determine measures to improving the reporting design. Methodology: The quantitative study design was conducted in Tanzania mainland which consist all regions. A primary data type was collected through structured closed questionnaire which was administered to a total of 25 respondents’ samples size that was 100% countrywide, since each region was represented by single reporter. Data was processed and analyzed by using Microsoft Excel 2010. Results: Findings showed that there was higher understanding of factors which influenced reporting. Findings indicate that 100% of the participants were Health officers, 68% were regional IDSR focal person who understood well the system of reporting weekly disease data. The evaluation also revealed technical challenges associated with reporting; whereas 88% of participants acknowledged to have incurred cost during reporting, 71% viewed that approving weekly diseases data contributed to untimely reporting. Finally, there were measures identified for improving reporting; these include feedback report, supportive supervision and availability of IDSR guidelines. Conclusions: The evaluation concludes that, the ineffectiveness of reporting weekly diseases data was due to several reasons which include weekly reporter having many responsibilities, approving and signing weekly diseases by RMO before submission, costs of reporting incurred by reporters and weak or no supportive supervision and feedback.. So the evaluation recommends that government through its ministry must take responsibilities of making sure that reporting forms are available. The Ministry and its development partners should take responsibilities to elevating the costs incurred by IDSR focal person.The study also recommends to the Ministry and RMHT to strategize on how to speed up reporting, and that weekly disease data should not be approved only by RMO but other RHMT members. Lastly, the study recommends that the Ministry set aside some fund and schedule a time table to enable them to conduct supportive supervision from National level to Regional levels.Item Implementation of inclusive education programme in public primary schools in Uvinza District Council in Tanzania(Mzumbe University, 2019) Kayagula, BThe implementation of inclusive education programmed in some areas has been reported very challenging. This has caused some of public primary schools to have low enrolment of children with disabilities (CWDs). With this regard, this study aimed at examining the extent to which inclusive education programmed has been implemented in Public primary schools to ensure that children with disabilities are enrolled and have access to education in Uvinza District Council. The study was designed to; ascertain the presence of infrastructures and facilities, determine the level of teachers’ preparedness, identify the approaches used by schools to identify and enroll children with disabilities and assess parents’ attitude on inclusion of children with disabilities in public primary schools. Mixed Methods Research approach and descriptive research design was used to guide this study. A sample size of 121 respondents from teachers, head teachers, parents and district education officer for special needs education was used. Interview, questionnaire and observation methods were used to collect primary data while documentary review was used for secondary data. The study found that amongst the selected public primary schools had no improved infrastructures and facilities to accommodate children with disabilities. Majority of teachers (88.1%) had no professional skills and lacked trainings to respond to CWDs. The approaches used by schools to identify and enrolls children with disabilities varied from one school to another. Most of parents are aware that children with disabilities are supposed to be placed in inclusive schools although they still doubt if CWDs can learn effectively with non-disabled children. Therefore, the study recommends that; Central government should prepare a special budget for supporting implementation of IEP. LEAs should seriously take into account in supporting those schools to have improved infrastructures, facilities, well trained teachers and mobilized community members, and build special canters for children with severe disabilities.