Browsing by Author "Ngowi, Agatha Fabian"

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    Determinants of enrollment in the improved Community Health Fund among household members in Manyara region, Tanzania
    (National Institute for Medical Research, 2023) Ngowi, Agatha Fabian; Nuru, Shamira
    Background: The improved community health fund (iCHF) concept was developed to increase access and utilization of health services while achieving financial protection against financial hardship. This study aimed to assess determinants of enrollment to the iCHF among household members in the Manyara region, Tanzania. Method: A cross-sectional study design was employed to collect quantitative data in the two selected districts of the Manyara region from January to March 2021. Data were collected using a structured questionnaire. The multivariable logistic regression model was employed to determine the predictors of enrollment to the iCHF. Results: Out of 403 participants sampled for this study, 157 (39%) were enrolled in the iCHF. After controlling for the potential confounder in the multivariate analysis results showed that, marital status (aOR=3.79; P=0.04), average income (aOR=3.01; P<0.001), chronic disease or disability (aOR=1.93; P=0.04), family size (aOR=4.55; P=0.009)and awareness of iCHF (aOR=5.89; P<0.0001) were predictors of enrollment in the scheme. Conclusion: Enrollment in the iCHF among community members is still low and the predictors for enrolment include marital status, average income, family size, chronic diseases or disabilities, and awareness of the scheme. The iCHF can be a pathway to universal health coverage through continuous health education on the importance of enolment in the scheme
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    Enrollment status and determinants of improved community health fund among households in Dodoma Tanzania
    (International Journal of Innovative Science and Research Technology, 2021) Modest, Andrea R.; Ngowi, Agatha Fabian; Katalambula, Leonard
    Community Health Funds (CHFs) is a promising means for enhancing social economic security to low socio-economic households. In 2015 the government of Tanzania set a goal of achieving 30% of CHF enrolment amongst households, however only 16.4% was achieved. The government of Tanzania is continually reforming the Health Fund and the most recent reform started implementation on 2018 which changed the name to Improved Community Health Fund (ICHF). There is a need of knowing if the changes have affected enrolment status and what could be the driving factors. Therefore, this study aimed to establish enrolment status of ICHF and its determinants among households in Dodoma region. This study was a cross sectional study design which employed multi stage sampling technique Structured questionnaire was used to obtain information from a total number of 424 head of the HH; Descriptive statistics were used to determine status of enrolment while chi square test and logistic regression were used to determine factors. This study found that, of all 424 respondents only 19.1% were enrolled in ICHF. Wealthiest households were 2.224 (AOR); p-value (0.034) at CI of 95% (1.063, 4.657) more likely to be enrolled to the ICHF as compared to poor households. Households with more than two elders with 60 years old and above, were 2.986 (AOR); p-value 0.006 at the CI of 95% (1.373, 6.496) more likely to be enrolled in ICHF compared to households with no elderly. And there were statistical significance between motivational benefits and availability of health care services with the enrollment status, household who perceived to receive motivational benefits once visit health facility were more enrolled as compared to those who do not and household who perceive health care service to be available were more enrolled as compared to who do not, they had chi-square of 16.017a and 64.084, p-value of 0.00 and 0.00 at CI of 95% respectively. Wealth status, presence of elders above 60 years old, motivational benefits and availability of the HCs were the determining factors for HH to be enrolled in ICHF. The government should consider poor households by helping them to pay ICHF enrollment fees.
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    Enrollment status and determinants of improved Community Health Fund among households in Dodoma Tanzania
    (Hemant, 2021) Ngowi, Agatha Fabian; Katalambula, Leonard; Modest, Andrea R.
    Community Health Funds (CHFs) is a promising means for enhancing social economic security to low socioeconomic households. In 2015 the government of Tanzania set a goal of achieving 30% of CHF enrolment amongst households, however only 16.4% was achieved. The government of Tanzania is continually reforming the Health Fund and the most recent reform started implementation on 2018 which changed the name to Improved Community Health Fund (ICHF). There is a need of knowing if the changes have affected enrolment status and what could be the driving factors. Therefore, this study aimed to establish enrolment status of ICHF and its determinants among households in Dodoma region. This study was across sectional study design which employed multi stage sampling technique Structured questionnaire was used to obtain information from a total number of 424 head of the HH; Descriptive statistics were used to determine status of enrollment while chi square test and logistic regression were used to determine factors. This study found that, of all 424 respondents only 19.1% were enrolled in ICHF. Wealthiest households were 2.224 (AOR); p-value (0.034) at CI of 95% (1.063, 4.657) more likely to be enrolled to the ICHF as compared to poor households. Households with more than two elders with 60 years old and above, were 2.986 (AOR); p-value 0.006 at the CI of 95% (1.373, 6.496) more likely to be enrolled in ICHF compared to households with no elderly. And there were statistical significance between motivational benefits and availability of health care services with the enrollment status, household who perceived to receive motivational benefits once visit health facility were more enrolled as compared to those who do not and household who perceive health care service to be available were more enrolled as compared to who do not, they had chi-square of 16.017aand 64.084, p-value of 0.00 and 0.00 at CI of 95% respectively. Wealth status, presence of elders above 60 years old, motivational benefits and availability of the HCs were the determining factors for HH to be enrolled in ICHF. The government should consider poor households by helping them to pay ICHF enrollment fees.
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    Mothers’ willingness to deliver at health facilities in Dodoma region, Tanzania
    (Kenya Medical Research Institute, 2022) Ngowi, Agatha Fabian; Bali, Theodora; Kamazima, Switbert Rwechungura; Gibore, Nyasiro Sophia
    Introduction: Maternal morbidity and mortality are a public health concern in most developing countries. It has been shown that skilled attendance at birth can be the single most effective intervention in preventing maternal death. However, limited studies have updated current knowledge on why some women prefer to deliver at health facilities and others do not. The study was aimed to explore mother’s willingness to deliver at the health facilities and attitudes toward service providers in Dodoma Region, Tanzania Methods and Materials: This was a qualitative cross-sectional study design conducted in four districts of the Dodoma region. The study population was women of reproductive age with their (spouses) who had children aged less than two years, health care providers, TBAs, and community leaders. We conducted eight focused group discussions (FGDs) and fourteen In-depth interviews (IDIs) using interview guides and an IDI checklist respectively. Data were transcribed and translated from Kiswahili to English. The transcribed documents were then exported into NVivo 10 software to facilitate the coding process and analyzed through a thematic approach. Results: The study participants reported that the majority of women were willing to deliver at health facilities but some still preferred home delivery due to different reasons including positive or negative attitudes toward service provided by nurses and traditional birth attendants. Conclusions: Our findings suggest for health care providers customize respectful maternity care to all women. This may encourage all women to deliver at the health facilities; hence, decreasing the risk of maternal morbidity and mortality.
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    Parents’ practices and barriers in reducing aflatoxins contamination in complementary foods for children in central regions of Tanzania
    (Science Publishing Group, 2020) Ngoma, Selestin Joseph; Tiisekwa, Bendantukuka; Ngowi, Agatha Fabian; Ngwashemi, Secilia Kapalata; Katalambula, Leonard Kamanga
    Contamination of complementary foods by aflatoxin is a serious public health threat that requires attention to ensure that proper actions are taken to limit its health effects. A cross-sectional study was conducted to assess parents’ practices and barriers associated with reducing aflatoxins contamination in complementary foods among parents with children aged 6-23 months in central regions of Tanzania. Semi-structured questionnaire (364) respondents and focus group discussion (FGD) with (121) respondents were used to collect data. The information collected included socio-demographic variables, parents’ barriers, and actions to mitigate aflatoxin contamination and its reduction strategies. The results of the fitted model revealed that among proposed predictors of barriers for proper processing of grains/nuts to reduce spoilage/aflatoxin/ mould contamination at home, only a number of children that a participant had was statistically significant. The family with 3-7 children, the estimated odds that the barrier is time consuming rather than costly, was 0.305 times the estimated odds for the family with 1-2 children. This means that parents with 3-7 children were less likely to report that time consumed was the barrier rather than the costs involved in comparison to parents with 1-2 children. On the other hand, the estimated odds for parents with 3-7 children that the barrier reduces food quantity instead of costs, was equal to 2.389 times the estimated odds for parents with 1-2 children. The results of multiple logistic regression model for applying traditional fungicides/pesticides for storing crops showed that respondents aged above 34 years (OR=0.576, 95% CI: 0.342-0.969) were significantly few in applying traditional fungicides/pesticides for storing crops than those respondents aged less or equal to 34 years old. The respondents with no/incomplete primary education (OR=2.872, 95% CI: 1.283-6.427) and primary education (OR=2.256, 95% CI: 1.194-4.264) were significantly more in applying traditional fungicides/pesticides for storing crops than never been to school respondents. FGDs revealed that drying crops before taking them for storage, use of traditional herbs for example ash and mud applied/smeared/sprayed on the grain before and during storage was used to preserve crops/grain against fungi. It was revealed that no any formal or informal education had been provided about fungi contamination, and even control, rather, the respondents were generally preventing (mould) aflatoxins through experience. Therefore, there is a need to educate the community on good agricultural practices for the better food safety and health of the community in general.
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    Women’s determinant factors for preferred place of delivery in Dodoma region Tanzania: a cross sectional study
    (Springer, 2017) Ngowi, Agatha Fabian; Kamazima, Switbert R.; Kibusi, Steven; Gesase, Ainory; Bali, Theodora
    Background: Skilled birth attendance is one of the key factors in improving maternal health but less than 50% of women in sub-Saharan African countries do not have the opportunity to be attended to by skilled personnel during childbirth. The aim of the study was to assess the factors determining women’s preference for a place to give birth in Dodoma Region, Tanzania. Methods: This study employed a cross-sectional survey design using quantitative data collection and analysis methods. Data were collected using structured questionnaire administered to 800 women obtained through multistage random sampling. Multivariable logistic regression model was applied to determine the predictors of place of delivery. Results: More than three quarters 629(78.6%) respondents had their last delivery in the health facilities while 171(21.4%) had their last delivery at home/on the way to hospital. Reasons for delivering at home include: abrupt occurrence of labour pain, long distance to the health facilities, lack of money to pay for transport and unfriendly experience with the health care providers. Simple logistic regression model indicate that mothers’ education level, number of children, cost of transport the estimated distance to the nearby health facility and occupation were strong predictors of the preferred place of delivery. However, after controlling the potential confounder, the multivariable logistic regression model demonstrated a significant association between delivery at the health facility and the number of children and transport cost. Conclusion: Our findings suggest a need for health care providers to enhance health education to women and their spouses about birth preparedness and the importance of delivering at the health facility. There is also a need for the government to increase the number of health facilities including maternity waiting homes and well trained health workers in both rural and urban areas.