Browsing by Author "Kessy, A. T."

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    Is decentralization still recentralization? The local government reform programme in Tanzania
    (Taylor & Francis, 2010) Kessy, A. T.; McCourt, W.
    Many governments have promoted decentralization, but opinion is divided on whether real devolution of authority from the centre to the local level has occurred. This article uses a study of the Local Government Reform Program (LGRP) in Tanzania to explore whether decentralization is realizing its objectives. Our findings are that LGRP has led to a significant devolution of authority and resources. However, persisting capacity deficits, increased financial dependence on the central government, and political and institutional constraints mean that the achievements have fallen short of the reformers' intentions. The study suggests that even where political will to decentralize exists, it has to translate into identifying and dealing with stubborn and subtle constraints such as, in this case, the contradiction between a new devolved structure and a persisting deconcentrated structure in order for decentralization to reach the logical conclusion that the reformers intended.
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    Risk sexual behaviors and consistent condom use among adults living with HIV/AIDS in Mtwara urban district, Tanzania
    (East African Public Health Association, 2018) Kessy, A. T.; Moshiro, C. S.; Semali, I. A.; Mtenjela, S. A.
    Objective: People living with HIV/AIDS, aware or unaware of their sero-status, form the main source of HIV transmission. Risk sexual behaviors among HIV infected persons have been studied in different parts of the world, with considerable variations and contexts. Regular efforts to study their behaviors are imperative in the struggle to mitigate the HIV/AIDS epidemic. We set out to determine risk behaviors and condom use among people living with HIV/AIDS in Mtwara urban district in Tanzania. Methods: Through a systematic sampling method, we selected 240 adults living with HIV/AIDS attending care and treatment centres in Mtwara urban district. We used an interview schedule to collect data from the respondents after individual verbal consent. Multivariate logistic regression models were employed to assess correlates of condom use. Results: The mean age of respondents was 40.9 (±10.3 SD) years, and 164 (68.4%) were female. Majority were married or cohabiting and had primary education. Sexual debut was generally early, with 43.3% and 42.1% of female and male respondents respectively reporting sexual debut before 18 years. All respondents had multiple sexual partners prior to HIV diagnosis, while only 6.7% of female and 15.8% of male reported having multiple sex partnerships post diagnosis. Consistent condom use increased significantly post HIV diagnosis, from 9.2% to 35.4% (p< 0.0001) among female and from 8.1% to 25.8% (p=0.013) among male. Having post primary education increased the odds of using condom in the last sex (aOR 4.3, 95% CI: 1.1–17.5). Conclusion: People living with HIV/AIDS in Mtwara reduced number of sex partners significantly post HIV testing. Although the proportion using condom consistently post HIV diagnosis increased significantly, findings suggest that condom use in this population is not a common practice, leading to an increased risk of re-infection and infecting their partners. We therefore recommend for more research to document motivational factors for using condom especially among people diagnosed with HIV infection.