UDOM IR :: Browsing by Author "Kibusi, Stephen M."

Browsing by Author "Kibusi, Stephen M."

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Acceptability of the direct health facility financing (DHFF) initiative in Tanzania: a mixed methods process evaluation of the moderating factors
(John Wiley & Sons, Inc, 2021) Kalolo, Albino; Kapologwe, Ntuli A.; Samky, Hendry; Kibusi, Stephen M.
Despite wide agreement that stakeholder acceptability plays a critical role in an intervention's effectiveness, gaps remain on understanding acceptability of complex health financing interventions. We aimed to understand the moderators of acceptability of the Direct Health Facility Financing (DHFF) initiative across primary health facilities in Tanzania. Employing a mixed methods approach and guided by the theoretical framework for acceptability (TFA), we collected data from implementers and their supervisors using a structured questionnaire and semi-structured interview guides. We analysed data using a chi square test, logistic regression, and thematic analysis. We recruited 238 participants, of whom 71% were females and 54% were below 37 years old. Acceptability was found to be 63% and received high rating in qualitative interviews. Moderators of acceptability included sex (AOR = 1.93, p = 006), work experience (AOR = 3.47, p = 0.001), knowledge (13.8, p = 0.00), supportive work environment (AOR = 2.28, p = 0.019), and capability to implement the programme (AOR = 0.12, p = 0.00). Moderators reported in qualitative interviews related to individual and contextual factors. This study suggests that the DHFF initiative is acceptable and influenced by factors operating at the individual level and beyond. Addressing moderators of acceptability as programs are designed and implemented is the holy grail of acceptability of complex interventions.
Assessing health system responsiveness in primary health care facilities in Tanzania
(BioMed Central, 2020) Kapologwe, Ntuli A.; Kibusi, Stephen M.; Borghi, Josephine; Gwajima, Dorothy O.; Kalolo, Albino
Background: Health system performance is one of the important components of health care delivery; its achievement depends on the quality of services rendered and the health system responsiveness of its beneficiaries. Health system responsiveness is a multi-dimensional concept and is usually measured through several domains. Health system responsiveness (HSR) remains to be a key indicator for the evaluation of health system performance in any settings. This study aimed at assessing the situation of health system responsiveness in primary health facilities in Tanzania prior to the introduction of the Direct Health Facility Financing (DHFF) program. Methods: This was a cross-sectional study conducted between January and February 2018. We collected data from 42 primary health facilities (14 health centres and 28 dispensaries) where a questionnaire was administered to a total of 422 participants. The questionnaire collected information on attention, respect to dignity, clear communication, autonomy, access to care, respect to confidentiality and basic amenities. Descriptive analysis was done to determine the distribution of the variables whereas ANOVA and linear regression analysis was employed to discern the association between variables. Results: More than 67% of participants had visited the same health facility more than 5 times. Sixty-seven percent of the patients were residing within 5kms from the public primary health care facilities. The geographical access to health care scored the lowest (43.5% for Dispensaries and 36% for Health centre) mean as compared to other domains of health system responsiveness. The highest score was with respect to confidentiality (86.7%) followed by respect to dignity (81.4%). Linear regression analysis revealed no statistical association between any of the social demographic features with the overall HSR performances. However, in post hoc analysis, Pwani and Shinyanga regions didn’t differ significantly in terms of their performances whereas those two regions differ from all other regions. Conclusion: Based on the study findings health system responsiveness domains has performed relatively poor in many regions except for respect of dignity and confidentiality scored high of all the domains. Shinyanga and Pwani regions scored relatively well in all domains this could have been due to the effect of Results Based Financing (RBF) in the respective regions. All in all the Government and other stakeholders in the health sector they should deliberately invest in the access to care domain as seem to be a challenge as compared to others.
Clinical characteristics and health care received among patients with type 2 diabetes attending secondary and tertiary healthcare facilities in Mwanza region,Tanzania: a cross-sectional study
(Springer Nature, 2020) Munyogwa, Mariam J.; William, Reuben; Kibusi, Stephen M.; Gibore, Nyasiro S.
Background: Tanzania is among the sub-Saharan African countries facing a tremendous increase in the burden of type 2 diabetes mellitus. In order to provide diabetes health care services, the government has established diabetes care clinics in secondary and tertiary healthcare facilities. However, previous studies have demonstrated a disparity in the availability of supplies and equipment for the provision of diabetes health care services at these healthcare facilities. This study aims to assess the clinical characteristics and health care received among patients with type 2 diabetes attending secondary and tertiary healthcare facilities in Mwanza Region, Tanzania. Methods: A cross-sectional study was conducted in Mwanza Region from June to September 2018. Three hundred and thirty patients were selected by systematic random sampling from three healthcare facilities. A structured questionnaire was utilized to collect information on patient characteristics, health care received and patient perception of care. Patient blood pressure, blood glucose, weight and height were measured during the study. Percentages, chi-square tests and multivariable analyses were conducted to obtain the proportions, make comparisons and determining the correlates of a tertiary-level healthcare facility. Results: Approximately half of the respondents (54.5%) were from secondary healthcare facilities. The prevalence of hypertension (63.3%), hyperglycemia (95.8%) and obesity (93.3%) were high. The prevalence of hyperglycemia was slightly higher at a secondary-level healthcare facility (p= 0.005). The proportion of respondents recently diagnosed with diabetes (≤10 years) was significantly higher at a tertiary-level healthcare facility (p= 0.000). The prevalence of diabetes-related complications was higher at a tertiary-level healthcare facility (80.7% versus 53.3%,p= 0.000). Assessments of body weight, blood pressure, blood glucose, feet and eye examination were conducted on a monthly basis at all facilities. None of the respondents had undergone lipid profile testing. All of the respondents(100%) received care from a nurse during diabetes clinic visits and half of the respondents (49.7%) also received care from a clinician. Relatively young patients, married and recently diagnosed patients were more likely to attend the clinic at tertiary facilities. Tertiary-level healthcare facilities were more likely to have patients with complications and to have a dietitian available at the clinic.
Determinants of men’s involvement in maternity care in Dodoma region, Central Tanzania
(Hindawi, 2019) Gibore, Nyasiro S.; Ezekiel, Mangi J.; Meremo, Alfred; Kibusi, Stephen M.; Munyogwa, Mariam J.
Background: Men’s involvement in maternity care is recognized as a key strategy in improving maternal health and accelerating reduction of maternal mortality. This study investigated the factors determining men’s involvement in maternity care in Dodoma Region, Central Tanzania.Methods. This cross-sectional survey used multistage sampling in four districts of Dodoma Region to select 966 married men participants aged 18 years and above. Data were collected using a structured questionnaire. Multivariate logistic regression analysis was carried out in SPSS version 21.0 to measure the determinants of men’s involvement in maternity care. Results. The study found that only 1 in 5 men were involved in maternity care of their partners. Factors found to determine men’s involvement in maternity care were having>4 children (AOR=1.658, 95%CI=1.134 to 2.422), urban area of residence (AOR=0.510,95%CI=0.354 to 0.735), waiting time>1 hour at the health care facility (AOR=0.685, 95%CI=0.479 to 0.978), limited access to information (AOR=0.491, 95%CI=0.322 to 0.747), and limited spousal communication (AOR=0.3, 95%CI=0.155 to 0.327). Conclusions: Long waiting time to receive the service and limited access to information regarding men’s involvement are associated with low men's involvement in maternity care. Male friendly maternity care should recognize men's preferences on timely access to services and provide them with relevant information on their roles in maternity care. Spousal communication is important;mothers must be empowered with relevant information to communicate to their male partners regarding fertility preferences and maternity care in general.
Effect of integrated reproductive health lesson materials in a problem-based pedagogy on soft skills for safe sexual behaviour among adolescents: A school based randomized controlled trial in Tanzania
(Public Library of Science (PLOS), 2022) Millanzi, Walter C.; Kibusi, Stephen M.; Osaki, Kalafunja M.
Background Adolescents are currently becoming sexually active before their 18th birthday during which they have to battle with unsafe sexual behaviours, teenage pregnancies, sexually transmitted infections (STIs), and school dropouts. The trend is linked with low soft skills (self-esteem and assertiveness skills) for them to make informed, reasoned, and responsible decisions over sexual activities. This study designed and tested the effect of integrated reproductive health (RH) lesson materials in a problem-based pedagogy (PBP) to enhance soft skills for safe sexual behaviour among adolescents in Tanzania. Methods A double-blinded clustered randomized controlled trial was conducted between September 2019 and September 2020 among 660 randomly selected adolescents. A Sexual-risk Behaviour Beliefs and Self-esteem Scale adopted from previous studies measured soft skills for safe sexual behaviour. A descriptive statistical analysis was performed by using the statistical analysis software programme version 9.4. The effect of the intervention was determined using Linear Mixed Model set at α error probability = 5% significance level (95% confidence interval) and a β error probability = 0.80. Findings Adolescents’ mean age was 15±1.869 with 57.5% females. The end-line findings indicated that the coefficient of soft skills was significantly higher among adolescents in the hybrid PBP (β=9.0986, p<0.01; 95%CI: 4.7772, 14.2311) and pure PBP (β =8.7114, p<0.01; 95%CI: 3.9990, 10.1208) than in the control group. The retention rate of soft skills was still significantly higher at 3-months follow-up (β=2.0044; p<0.01; 95%CI: 1.0234, 4.1182) and at 6-months follow-up (β=1.9803; p<0.01; 95%CI: 0.8399, 3.1099) compared to the baseline and immediate post-intervention assessments. Conclusion The intervention substantially enhanced soft skills for safe sexual behaviour among adolescents of both sex. Despite the fact that scores for soft skills varied across the study timelines, adolescents demonstrated significant intentions to abstain from sexual intercourse, delay sexual relationships, negotiate condom use, and withstand sexual coercions. The PBP may need to be incorporated in ordinary level secondary school curricula as a formal guide to teachers and or health workers to optimally prepare adolescents for their healthy adulthood.
The effectiveness of community-based continuous training on promoting positive behaviors towards birth preparedness, male involvement, and maternal services utilization among expecting couples in Rukwa, Tanzania: a theory of planned behavior quasi-experimental study
(Hindawi Limited, 2018) Moshi, Fabiola V.; Kibusi, Stephen M.; Fabian, Flora
Rukwa Region has the highest maternal mortality ratio, 860 deaths per 100,000 live births in Tanzania. The region has neonatal mortality rate of 38 deaths per 1,000 live births. Previous interventions to promote maternal and neonatal health targeted access to maternal services by removing financial barriers and increasing the number of health facilities. However, maternal service utilization remains very low, especially facility delivery. The proposed intervention was sought to address deep-rooted behavioral beliefs, normative beliefs, control beliefs, and knowledge empowerment to determine their effect on improving birth preparedness, male involvement, and maternal services utilization. The study tested the effectiveness of a Community-Based Continuous Training (CBCT) intervention that was based upon the theory of planned behavior and was sought to promote positive behaviors. The study used a quasi-experimental design. The design consisted of pre- and postintervention assessments of two non equivalent groups. Two districts were selected conveniently using criteria of high home birth. A district to hold intervention was picked randomly. Study participants were expecting couples at gestation age of 24 weeks and below. After obtaining informed consents, participants were subjected to baseline assessment. Expecting couples in the intervention group had two training sessions and two encounter discussions. The three primary outcomes of the study were changes in the level of knowledge about birth preparedness, male involvement, and use of maternal services. Data were collected at preintervention, mid intervention, and postintervention. Policy Implications of the Results. The aim of this paper was to describe the study protocol of a quasi-experimental study design to test the effectiveness of an interventional program on promoting positive behaviors on birth preparedness, male involvement, and maternal services utilization among expecting couples. This study has a potential to address the challenge of low birth preparedness, male involvement, and use of maternal health services in Rukwa Region
Exploring factors influencing pregnant Women’s attitudes, perceived subjective norms and perceived behavior control towards male involvement in maternal services utilization: a baseline findings from a community based interventional study from Rukwa, rural Tanzania
(BMC, 2020) Moshi, Fabiola V.; Kibusi, Stephen M.; Fabian, Flora
Although male involvement enhances obstetric care-seeking behaviour, the practice of male involvement in developing countries remains unacceptably low. Male involvement in maternal services utilization can be influenced by the attitude, subjective norm, and perceived behaviour control of their female partners. Little is known about factors influencing pregnant women’s attitudes, perceived subjective norms, and perceived behaviour control towards male involvement in maternal services utilization. A baseline community-based cross-sectional study whose target was pregnant women were performed from 1st June until 30th October 2017. A three-stage probability sampling technique was employed to obtain a sample of 546 pregnant women. A structured questionnaire that hinged the Theory of Planned Behavior was used. The questionnaire explored three main determinants of male involvement, which were: attitudes towards male involvement, perceived subjective norms towards male involvement, and perceived behaviour control towards male involvement. After adjusting for the confounders, factors influencing positive attitude towards male involvement were age at marriage [19 to 24 yrs.,(AOR = 1.568 at 95% CI =1.044–2.353), more than 24 yrs. (AOR = 2.15 at 95% CI = 1.150–1.159)]; education status [primary school (AOR = 1.713 at 95% CI = 1.137–2.58)] and economic status [earning more than one dollar per day (AOR = 1.547 at 95% CI = 1.026–2.332)]. Factors influencing perceived subjective norms was only age at marriage [19 to 24 yrs., (AOR = 1.447 at 95% CI = 0.970–2.159), more than 24 years, (AOR = 2.331 at 95% CI = 1.261–4.308)]; factors influencing perceived behaviour control were age at marriage [more than 24 years (AOR = 2.331 at 95%CI = 1.261–4.308)], and the intention to be accompanied by their male partners (AOR = 1.827 at 95%CI = 1.171–2.849). The study revealed that women who were married at an older age were more likely to have a positive attitude, subjective norms, and perceived behaviour control towards male involvement in maternal services utilization than those who were married at a young age. Pregnant women who had primary education and earn more than a dollar per day were more likely to have positive attitudes towards male involvement than poor and uneducated pregnant women. The study recommends an interventional study to evaluate the influence of attitude, subjective norms, and perceived behaviour control on male involvement in maternal services utilization.
Exploring the effect of problem-based facilitatory teaching approach on metacognition in nursing education: a quasi-experimental study of nurse students in Tanzania
(John Wiley & Sons, Inc., 2020) Millanzi, Walter C.; Kibusi, Stephen M.
Currently, there has been a progressive shortage of not only the number of frontline healthcare providers but also a decline in the quality of nursing care. There is a growing concern to rethink the approaches on how nurses are prepared, explore and test novel approaches for delivering the nursing curricula. This study tested the effect of the problem-based facilitatory teaching approach on metacognition among nursing students in Tanzania, higher learning institutions. A controlled pre-/post-test quasi-experimental study design with a quantitative research approach was employed in this study. The study was conducted between February–June 2019 including two purposively selected higher learning institutions in the Dodoma region, the central zone of Tanzania. The 401 randomly selected undergraduate nursing students (interventional = 134 and control = 267) were involved. The auditing inventory developed by the researcher measured the intervention, and the questionnaire titled Metacognition Strategies in Nursing was adopted to measure the metacognition, respectively. Statistical analysis was performed using the Statistical Package for the Social Solution (SPSS) software program version 23.Findings indicated that 65.8% of the study participants were males. The post-test findings revealed a significant gain in metacognition scores among participants in an intervention group between (M = 23.27; SD = 1.716) at baseline and (M = 66.31; SD = 6.204) post-intervention. 63.4% of the total sample in an intervention group demonstrated a high level of knowledge about the regulation of cognition compared to their counterpart control group. However, 69.1% (N = 85) participants in the control group performed better for the knowledge about cognition. With the control of other factors, the intervention was found to be more times likely to influence metacognition among nurse students (AOR = 1.603, p < 0.05, 95% CI: 1.023, 2.513). In conclusion, the intervention had the potential to positively effect the levels of metacognition among nurse students. Hence, it was closely linked to professional competency and it would change the spectrum of nursing competency and quality of care among nurse students.
Factors influencing men’s involvement in antenatal care services: a cross-sectional study in a low resource setting, Central Tanzania
(Springer Nature, 2019) Gibore, Nyasiro S.; Bali, Theodora A. L.; Kibusi, Stephen M.
Background: Men’s involvement can impact the delays in the decision to seek health care and in reaching a health facility, which are contributing causes for increased maternal mortality. Despite of the call to involve men in antenatal care, their participation is not well understood. This study aimed to determine the level of men’s involvement in antenatal care and the factors influencing their involvement in these services. Methods:A cross sectional study of 966 randomly selected men aged 18 years or older was conducted in Dodoma Region, from June 2014 to November 2015. Face to face interviews were conducted using a pretested structured questionnaire. The outcome variable was men’s involvement and was constructed from four dichotomized items which were scored zero to two for low involvement and three to four for high involvement. A multiple logistic model was used to measure the factors influencing men’s involvement in antenatal care services. Results: The level of men’s involvement in antenatal care was high (53.9%). Majority 89% of respondents made joint decisions on seeking antenatal care. More than half (63.4%) of respondents accompanied their partners to the antenatal clinic at least once. Less than a quarter (23.5%) of men was able to discuss issues related to pregnancy with their partner’s health care providers. About 77.3% of respondents provided physical support to their partners during the antenatal period. Factors influencing men’s involvement in antenatal care were occupation (AOR = 0.692, 95% CI = 0.511–0.936),ethnicity (AOR = 1.495, 95% CI = 1.066–2.097), religion (AOR = 1.826, 95% CI = 1.245–2.677), waiting time (AOR = 1.444, 95%CI = 1.094–1.906), information regarding men’s involvement in antenatal care (AOR = 3.077, 95% CI = 2.076–4.562) and men’s perception about the attitude of health care providers (AOR = 1.548, 95%CI = 1.090–2.199). Conclusion: Overall, more than half of respondents reported high involvement in antenatal care services. Access to information on men’s involvement, religion, occupation, ethnicity, waiting time and men’s perception about the attitude of care providers were significant factors influencing men’s involvement in antenatal care services in this study. Health promotion is needed to empower men with essential information for meaningful involvement in antenatal care services
Health insurance is important in improving maternal health service utilization in Tanzania—analysis of the 2011/2012 Tanzania HIV/AIDS and malaria indicator survey
(BioMed Central, 2018) Kibusi, Stephen M.; Sunguya, Bruno Fokas; Kimunai, Eunice; Hines, Courtney S.
Maternal mortality rates vary significantly from region to region. Interventions such as early and planned antenatal care attendance and facility delivery with skilled health workers can potentially reduce maternal mortality rates. Several factors can be attributed to antenatal care attendance, or lack thereof, including the cost of health care services. The aim of this study was to examine the role of health insurance coverage in utilization of maternal health services in Tanzania. Secondary data analysis was conducted on the nationally representative sample of men and women aged 15–49 years using the 2011/12 Tanzania HIV and Malaria Indicator Survey. It included 4513 women who had one or more live births within three years before the survey. The independent variable was health insurance coverage. Outcome variables included proper timing of the first antenatal care visit, completing the recommended number of antenatal care (ANC) visits, and giving birth under skilled worker. Data were analyzed both descriptively and using regression analyses to examine independent association of health insurance and maternal health services. Of 4513 women, only 281 (6.2%) had health insurance. Among all participants, only 16.9%, 7.1%, and 56.5%, respectively, made their first ANC visit as per recommendation, completed the recommended number of ANC visits, and had skilled birth assistance at delivery. A higher proportion of women with health insurance had a proper timing of 1st ANC attendance compared to their counterparts (27.0% vs. 16.0%, p < 0.001). Similar trend was for skilled birth attendance (77.6% vs. 55.1%, p < 0.001). After adjusting for other confounders and covariates, having health insurance was associated with proper timing of 1st ANC attendance (AOR = 1.89, p < 0.001) and skilled birth attendance (AOR = 2.01, p < 0.01). Health insurance coverage and maternal health services were low in this nationally representative sample in Tanzania. Women covered by health insurance were more likely to have proper timing of the first antenatal visit and receive skilled birth assistance at delivery. To improve maternal health, health insurance alone is however not enough. It is important to improve other pillars of health system to attain and sustain better maternal health in Tanzania and areas with similar contexts.
Healthcare managers' managerial competency in enabling and managing changes: evidence from primary healthcare managers in Tanzania
(Sapientiae, 2024) Kingu, Ukende A.; Ismail, Ismail J.; Kibusi, Stephen M.
This research article examined the primary healthcare managers' managerial competency in enabling and managing changes. The study was conducted in Tanzania. This study used a cross-sectional research approach. A census sampling approach was used to gather data from one hundred and two healthcare managers. Utilizing SPSS version 25, statistical product and service solutions were used to analyze the data that had been gathered. Results show that, about the indicators within the preparation for change, implementation of change, evaluation of change, and leadership qualities concerning lead changes constructs, respectively, (73.53%), (65.69%), and (76.47%) of the healthcare managers are competent, and (26.47%), (34.31%), and (23.53%) are less competent. The study concludes that primary healthcare managers in Tanzania have shown both levels of competence and less competent practices in facilitating and managing changes.
Healthcare managers' managerial competency in enabling and managing changes: evidence from primary healthcare managers in Tanzania
(SAPIENTIAE, 2024-10) Kingu, Ukende A.; Ismail, Ismail J.; Kibusi, Stephen M.
This research article examined the primary healthcare managers' managerial competency in enabling and managing changes. The study was conducted in Tanzania. This study used a cross-sectional research approach. A census sampling approach was used to gather data from one hundred and two healthcare managers. Utilizing SPSS version 25, statistical product and service solutions were used to analyze the data that had been gathered. Results show that, about the indicators within the preparation for change, implementation of change, evaluation of change, and leadership qualities concerning lead changes constructs, respectively, (73.53%), (65.69%), and (76.47%) of the healthcare managers are competent, and (26.47%), (34.31%), and (23.53%) are less competent. The study concludes that primary healthcare managers in Tanzania have shown both levels of competence and less competent practices in facilitating and managing changes.
Healthcare managers' managerial competency in enabling and managing changes: evidence from primary healthcare managers in Tanzania
(2024) Kingu, Ukende A.; Ismail, Ismail J.; Kibusi, Stephen M.
This research article examined the primary healthcare managers' managerial competency in enabling and managing changes. The study was conducted in Tanzania. This study used a cross-sectional research approach. A census sampling approach was used to gather data from one hundred and two healthcare managers. Utilizing SPSS version 25, statistical product and service solutions were used to analyze the data that had been gathered. Results show that, about the indicators within the preparation for change, implementation of change, evaluation of change, and leadership qualities concerning lead changes constructs, respectively,(73.53%),(65.69%), and (76.47%) of the healthcare managers are competent, and (26.47%),(34.31%), and (23.53%) are less competent. The study concludes that primary healthcare managers in Tanzania have shown both levels of competence and less competent practices in facilitating and managing changes.
How do Tanzanian nursing students experience an elective exchange programme – A qualitative
(Elsevier, 2020) Nielsen, Dorthe S.; Tarimo, Edith A.M.; Kibusi, Stephen M.; Jansen, Mette Bro; Mkoka, Dickson Ally
Experiences from the Peace Corps and President's Emergency Plan for AIDS Relief programs show that exchange of nurses can strengthen the breadth and quality of nursing care delivery in places with shortages of health professionals. The objective of this study was to capture the perspectives and experiences of Tanzanian students participating in an international elective in a Scandinavian country. With a phenomenological hermeneutical approach, qualitative interviews were conducted with 16 student nurses from Tanzania. The interviews were guided by a qualitative thematic interview guide. The international placement in Scandinavia had significance to all students. Most students underlined that it had changed their professional and private life to the better, providing them with new competences, new awareness, and job opportunities.
The impact of community based continuous training project on improving couples’ knowledge on birth preparedness and complication readiness in rural setting Tanzania;:A controlled quasi-experimental study
(PLOS, 2021) Moshi, Fabiola V.; Kibusi, Stephen M.; Fabian, Flora Masumbuo
It is widely accepted that community-based interventions are vital strategies towards reduction of maternal and neonatal mortalities in developing counties. This study aimed at finding the impact a Community Based Continuous Training (CBCT) project in improving couples’ knowledge on birth preparedness and complication readiness in rural Tanzania.The quasi-experimental study design with control was adopted to determine the impact of CBCT in improving knowledge on birth preparedness and complication readiness. The study was conducted from June 2017 until March 2018. A multi-stage sampling technique was employed to obtain 561couples. Pre-test and post-training intervention information were collected using semi-structured questionnaires. The impact of CBCT was determined using both independent t-test and paired t-test. Linear regression analysis was used to establish the association between the project and the change in knowledge mean scores. The effect size was calculated using Cohen’s d. At post-test assessment, knowledge mean scores were significantly higher in the intervention group among both pregnant women (m = 14.47±5.49) and their male partners (m = 14.1 ±5.76) as compared to control group among both pregnant women (m = 9.09±6.44) and their male partners (m = 9.98±6.65) with large effect size of 0.9 among pregnant women and medium effect size of 0.66 among male respondents. When the mean scores were compared within groups among both pregnant women and male partners in the intervention group, there were a significant increase in knowledge mean scores at post-test assessment as compared to pre-test assessment with large effect size of Cohen’s d = 1.4 among pregnant women and 1.5 among male partners. After adjusting for the confounders, the predictors of change in knowledge among pregnant women were the CBCT project (β= 0.346, p<0.000) and ethnic group [Mambwe (β= -0.524, p = 0.001)] and the predictors of change in knowledge among male partners were the CBCT project (β= 1.058, p<0.001) and walking distance [more than five kilometers (β= -0.55, p<0.05)]. This interventional study which focused on knowledge empowerment and behavior change among expecting couples was both feasible and effective on improving knowledge about birth preparedness and complication readiness in rural settings of Tanzania.
Improving pregnant women’s knowledgeon danger signs and birth preparedness practices using an interactive mobile messaging alert system in Dodoma region,Tanzania: a controlled quasi experimental study
(BioMed Central, 2019) Masoi, Theresia J.; Kibusi, Stephen M.
Background: Unacceptably high maternal and perinatal mortality remains a major challenge in many low-income countries. Early detection and management of danger signs through improved access to maternal services is highly needed for better maternal and infant outcomes. The aim of this study was to test the effectiveness of an interactive mobile messaging alert system on improving knowledge on danger signs, birth preparedness and complication readiness practices among pregnant women in Dodoma region, Tanzania. Methods: A controlled quasi-experimental study of 450 randomly selected pregnant women attending antenatal care was carried in Dodoma municipal. Participants were recruited at less than 20 weeks of gestation during the first visit where 150 were assigned to the intervention and 300 to the control group. The intervention groups were enrolled in an interactive mobile messaging system and received health education messages and were also able to send and receive individualized responses on a need basis. The control group continued receiving usual antenatal care services offered at the ANC centers. Pregnant women were followed from their initial visit to the point of delivery. Level of knowledge on danger signs and birth preparedness were assessed at baseline and a post-test was again given after delivery for both groups. Analyses of covariance, linear regression were employed to test the effectiveness of the intervention. Results: The mean age of participants was 25.6 years ranging from 16 to 48 years. There was significant mean scores differences for both knowledge and birth preparedness between the intervention and the control group after the intervention (p< .001). The mean knowledge score was (M = 9.531,SD = 2.666 in the intervention compared to M =6.518,SD = 4.304 in the control, equivalent to an effect size of 85% of the intervention. Meanwhile, the mean score for IBPACR was M = 4.165,SD = 1.365 for the intervention compared to M = 2.631,SD = 1.775 in the control group with an effect size of 90% A multivariate linear regression showed a positive association between the intervention (p<0.001)and level of knowledge (B = 2.910,95%CI = 2.199–3.621) and birth preparedness (B = 1.463,95%CI = 1.185–1.740).
Intimate partner violence victimization increases the risk of under-five morbidity: a stratified multilevel analysis of pooled Tanzania demographic health surveys, 2010-2016
(Public Library of Science (PLoS), 2018) Bintabara, Deogratius; Kibusi, Stephen M.
A hidden determinant such as intimate partner violence victimization has been associated with under-five morbidity and mortality. However, there is lack of information regarding which exactly age group of under-five is more vulnerable to morbidity when their mothers exposed to intimate partner violence victimization. This study aimed to determine the effect of mothers’ exposure to intimate partner violence victimization on age groups specific under-five morbidity that could lead to mortality. The current study pooled and analyzed data from 2010 and 2016 Tanzania Demographic Health Survey datasets. We used a stratified multilevel modeling to assess the association between under-five morbidity and intimate partner violence victimization according to age groups. The Statistical approach using Stata 14 was used to adjust for clustering effect and weighted the estimates to correct for non-responses and disproportionate sampling employed during designing of the surveys. A total of 13,639 singleton live-births babies within three years prior to interview dates from the ever-married women were included in the analysis. We found a significant reduction of the three main symptoms of under-five morbidity namely; a cough with difficult or fast breathing from 21.7 to 15.7%, fever from 22.5 to 18.3%, and diarrhoea from 15.5 to 12.7% for the survey years from 2010 to 2016 respectively (P<0.05). Overall, about 40% of mothers reported experiencing any forms of intimate partner violence victimization. After adjusting for individual and cluster variables, we found that under-five in post-neonatal period (Adjusted odds ratios = 1.50; 95%CI, 1.21–1.86) and childhood period (Adjusted odds ratios = 1.40; 95%CI, 1.24–1.57) were significantly affected with morbidity when their mothers exposed to any form of intimate partner violence victimization. This analysis revealed that intimate partner violence victimization is still a major and public health problem in Tanzania that threatens child health during the period of post-neonatal and childhood. There is a need to introduce screening for intimate partner violence victimization in maternal and child care for effective monitoring and prevention of the problem.
Knowledge on birth preparedness and complication readiness among expecting couples in rural Tanzania: differences by sex cross-sectional study
(PLOS, 2018) Moshi, Fabiola V.; Kibusi, Stephen M.; Ernest, Alex; Fabian, Flora
Inadequate knowledge of birth preparedness and complication readiness (BPCR) among expecting couples delays timely access to maternal emergency services. The aim of this study was to assess knowledge on birth preparedness and complication readiness and how men and women differ" among expecting couples in a rural setting of Rukwa Region, Tanzania.A community-based cross-sectional study targeting pregnant women and their partners was performed from June 2017 to October 2017. A total of 546 couples were sampled using three-stage probability sampling techniques and then interviewed using a structured questionnaire. The mean score difference was sought using independent t-test. Multiple linear regressions were performed to determine the predictors of knowledge.There was a significant difference in mean knowledge scores between pregnant women (M = 5.58, SD = 4.591) and male partners (M = 4.37, SD = 4.285); t (1085) = -4.525; p<0.001. Among women, BPCR levels were positively influenced by age (β = 0.236; p<0.01), having ever heard about birth preparedness (β = 0.176;p<0.001), being of Mambwe ethnicity (β = 0.187; p<0.001), living near a health center rather than a dispensary (β = 0.101;p<0.05) and having had a prior preterm delivery (β = 0.086;p<0.05). Access to media through radio ownership negatively influenced BPCR levels among both women (β-.119; p<0.01) and men (β = -0.168; p<0.0001). Among men, the BPCR knowledge was only positively influenced by having ever heard about birth preparedness (β = 0.169;p<0.001), age at marriage (β = -0.103; p<0.05), and having completed either primary (β = 0.157;p<0.001) or secondary education (β = 0.131;p<0.01).Some important predictors of knowledge were revealed among women and men, but overall knowledge about birth preparedness and complication readiness was low. This study demonstrates inadequate knowledge and understanding at the community level about key elements of birth preparedness and complication readiness. In order to improve access to life-saving care for women and neonates, there is a pressing need for innovative community strategies to increase knowledge about birth preparedness and complication readiness. Such strategies are essential in order to reduce maternal and neonatal mortality in rural Tanzania.
Knowledge on prevention and management of preeclampsia and eclampsia among nurses in primary health settings: baseline findings from an interventional study in Dodoma Region, Tanzania
(East African Health Research Commission, 2020) Mwampagatwa, Ipyana; Ernest, Alex; Angelina, Joho A.; Kibusi, Stephen M.
Preeclampsia and eclampsia are conditions which increase maternal and foetal morbidity and mortality worldwide. These conditions are ranked as the second leading cause of maternal deaths. Nurses have a critical role in preventing and managing preeclampsia. However, their knowledge has not been evaluated particularly among those working in primary health facilities, where opportunities for continue education is limited. To assess knowledge on prevention and management of preeclampsia and eclampsia among nurses working in the primary health care settings. Analysis of baseline data from an intervention study which test the effectiveness of simulation-based training on obstetric and neonatal emergencies among nurses in managing maternal and newborn emergencies in primary health care settings. A total of 39 primary health centres within 7 districts in Dodoma Region were selected to take part in the interventional study. Individual participants were nurses working in maternity units were involved. 172 nurses were selected using a simple random method. Nurses’ knowledge on prevention and management of PEE and its predictors were assessed using a self-administered questionnaire. Descriptive statistics analysis was done to determine the distribution of the background characteristics of nurses and logistic regression analysis was performed to explore predictors of nurses’ knowledge Overall knowledge on preeclampsia and eclampsia was 88 (51.2%). Professional qualification was a predictor associated with a nurse’s knowledge about preeclampsia and eclampsia. Registered nurses were more knowledgeable compared to enrolled nurses (AOR3.311; CI, 1.62 to 6.768; P value =.001), years of working experience showed no association with knowledge on preeclampsia and eclampsia (AOR 0.98; CI: 0.39-2.47; P values = 0.970). This study showed there is a critical knowledge deficiency in the prevention and management of preeclampsia and eclampsia among nurses working in maternal units of primary health care setting. Effective regular training on prevention and man agement of preeclampsia and eclampsia for frontline nurses is required in order to improve maternal and neonatal survival.
Managerial competency of primary healthcare facility managers in the selected district councils in Tanzania
(Achour University of Djelfa, 2023) Kingu, Ukende Apollo; Ismail, Ismail J.; Kibusi, Stephen M.
Understanding the managerial competency of healthcare managers is very important. However, more evidence is needed on the managerial competency of primary healthcare facility managers in low- and middle income countries. This research examined the managerial competency of primary healthcare facility managers in the selected District Councils in Tanzania. This research is grounded on positivism philosophy, a cross-sectional survey descriptive research design, a complete enumeration sampling strategy, and a survey used to collect primary data from 102 public primary healthcare facility managers located in Kondoa, Iramba, and Sumbawanga District Councils in Tanzania. The study used version 25 of SPSS to analyze the data and adopted the MCAP framework to examine the managerial competency of primary healthcare facility managers. For the communication and relationship management domain, 74.5% were competent, while 25.5% were less than fully competent. Likewise, 65.68% of them were competent, while 34.32% needed to be more competent in the knowledge of the healthcare environment domain. 62.74% and 37.26% of the primary healthcare facility managers were competent and less than competent in operations, administration, and resources management. Correspondingly, 67.65% and 32.35% of primary healthcare facility managers needed to be more competent in evidence-informed decision-making. Similarly, 74.55% and 25.45% were competent and less competent in enabling and managing change. The study used primary data and contributed recently well-worth and highly demanded knowledge on the managerial competency of healthcare managers in the LMICs.

Browsing by Author "Kibusi, Stephen M."

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