Browsing by Author "Ntwenya, Julius"

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    Adequacy of macro and micronutrients in infants and young children’s diets in Zanzibar, Tanzania
    (Makerere university medical school (Uganda), 2019) Kinabo, Joyce; Mamiro, Peter; Mwanri, Akwilina; Bundala, Nyamizi; Kulwa, Kissa; Picado, Janeth; Ntwenya, Julius; Nombo, Aneth; Mzimbiri, Rehema; Ally, Fatma; Salmini, Asha; Juma, Abuu; Macha, Elizabeth; Cheung, Edith; Msuya, John
    A study was conducted in Zanzibar using ProPAN software to assess nutrient adequacy of foods given to infants and children aged 6-23 months old in Zanzibar. The 24-hr dietary recall method embedded in ProPAN software was used to determine the adequacy of energy, protein, iron, calcium, zinc and vitamin A in foods consumed by children. Sample of 200 mothers/caretakers with children aged 6-23 months were interviewed. Most frequent foods given to infants and children were tea, bread, white rice and fish. Key nutrients such as iron, zinc and vitamin A were below the recommended levels except for vitamin C from the diets consumed by children aged 11-23 months. Energy and protein were considered to be adequate as more than 90% of the children received enough of these nutrients. Mean age of introduction of complementary foods was four months. Children diets were limited in fruits and vegetables that caused micronutrients of nutritional importance such as iron, zinc and vitamin A to be supplied below recommended level. Equally, fat intake was below recommended level. Nutrition education on appropriate complementary foods should be given to caregivers. Promotion of consumption of diversified diets and locally available nutrient dense foods should be emphasized so as to achieve adequate intake of nutrients to infants and young children. Keywords: ProPAN, children, nutrient adequacy, Zanzibar.
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    Adherence to standards of first-visit antenatal care among providers: A stratified analysis of Tanzanian facility-based survey for improving quality of antenatal care
    (PLoS ONE, 2019) Bintabara, Deogratius; Nakamura, Keiko; Ntwenya, Julius; Seino, Kaoruko; Mpondo, Bonaventura C. T.
    Introduction Despite the benefits of early antenatal care visits for early prevention, detection, and treatment of potential complications in pregnancy, a high level of provider adherence to first-visit antenatal care standards is needed. However, little information is available regarding provider adherence to antenatal care in Tanzania. This study was performed to assess provider adherence to first-visit antenatal care standards and to apply stratified analysis to identify associated factors in Tanzania. Methods Data from the 2014–2015 Tanzania Service Provision Assessment Survey were used in this study. Provider adherence to first-visit antenatal care standards was measured using 10 domains: client history; aspects of prior pregnancies; danger signs of the current pregnancy; physical examination; routine tests; HIV testing and counseling; maintaining a healthy pregnancy; iron/folate supplements; tetanus toxoid vaccination, and preparation for delivery. A composite score was then created in which the highest quantile (corresponding to �60.5%) considered to provider adhering to first-visit antenatal care standards. Initially, a series of unadjusted logistic regression analyses according to the type of facility and managing authority were performed separately at each level (i.e., facility, provider, and client). Thereafter, all variables with P < 0.2 were fitted into the respective stratified multivariable logistic regression analysis using a 5% significance level. Results A total of 1756 first-visit antenatal care consultations performed by 822 providers in 648 health facilities were analyzed. The overall median [Interquartile range, IQR] adherence to first-visit antenatal care was relatively low at 47.1% [35.7%–60.5%]. After adjusting for selected variables from each level in specific strata, at dispensary; female providers [AOR = 5.5; 95% CI, 1.8–16.4], at health centre; performance of quality assurance [AOR = 2.2; 95% CI, 1.3–3.9], at hospital; availability of routine tests [AOR = 2.5; 95% CI, 1.3–4.8] and basic medicine [AOR = 2.8; 95% CI, 1.4–5.7], at public facilities; availability of medicine [AOR = 1.8; 95% CI, 1.1–3.2] and receiving refresher training [AOR = 1.8; 95% CI, 1.1–3.1], and at private facility; receiving external fund from government [AOR = 3.0; 95% CI, 1.1–8.4] were significantly associated with better adherence to first-visit antenatal care standards. Conclusions The study highlighted the important factors, including the provision of refresher training, regular distribution of basic medicines, and diagnostics equipment which may influence provider adherence to first-visit ANC standards.
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    Client satisfaction with family planning services in the area of high unmet need:evidence from Tanzania service provision assessment survey, 2014-2015
    (BMC, 2018) Bintabara, Deogratius; Ntwenya, Julius; Maro, Isaac I.; Kibusi, Stephen; Gunda, Daniel W.; Mpondo, Bonaventura C. T.
    Client satisfaction has been found to be an important factor for the uptake and continuation of family planning services. This study aimed to examine the current status of and factors associated with clients satisfaction with family planning services in Tanzania, which has a high unmet need for family planning. Methods: The study used data from the Tanzania Service Provision Assessment survey of 2014–2015. A facility was classified as having high service readiness for FP if it scored at least 67.7% on a composite score based on three domains (staff training and guidelines, basic diagnostic equipment, and basic medicines), following criteria developed by the World Health Organization. The exit interview questionnaire was used to collect information from women about their level of satisfaction, whether very satisfied more or less satisfied, or not satisfied with the services received. The response was dichotomized into Yes if the woman reported being very satisfied with services received otherwise coded as No. Unadjusted and adjusted logistic regression models were used to assess the association between the client satisfaction and covariate variables; service readiness, facility type, managing authority, location, management meetings, supervision, providers sex, and working experience, clients age and education. All analyses were weighted to correct for non-response, disproportionate and complex sampling by using the SVY command in Stata 14. Out of the 1188 facilities included in the survey, 427 (35.9%) provided family planning services. A total of 1746 women participated in observations and exit interviews. Few (22%) facilities had a high readiness to provide family planning services. While most facilities had the recommended equipment available, only 42% stocked contraceptives (e.g. oral pills, injectable contraceptives and/or condoms). Further, trained staff and clinical guidelines were present in only 30% of services. Nevertheless, the majority (91%) of clients reported that they were satisfied with services. In the multivariate analysis, a high service readiness score [AOR=2.5, 95% CI; 1.1–6.0], receiving services from private facilities [AOR=2.3, 95% CI; 1.1–5.0], and being in the age group 20 to 29 years [AOR=0.3, 95% CI; 0.1–0.7] were all significantly associated with clients’ satisfaction with family planning services.
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    In-vitro bioavailability of selected minerals in dry and green shelled beans
    (Academic Journals, 2016) Mamiro, Peter; Mwanri, Akwilina; Mamiro, Delphina; Nyagaya, Martha; Ntwenya, Julius
    Mineral deficiency especially that of iron and zinc has continuously emerged as a public health issue in developing countries, probably due to the over dependence on plant food sources, which contain more than enough minerals to meet the daily requirement but have a low bioavailability for physiological purposes. Experiments on in-vitro bioavailability were carried out on dry and green shelled beans. Invitro bioavailability of iron and zinc in bean samples was determined by HCl-pepsin (HCl-P) and pepsin pancreatin (P-P) method. The amount of the proxy bioavailable minerals were obtained by atomic absorption spectrophotometry. In both minerals there was a small but significant (P=0.009) and (P=0.0003) increase in in-vitro bioavailability after cooking. The average increase for all the varieties was 3.2 to 3.4% for iron and 1.3 to 1.6% for zinc. The two minerals were more available in cooked green shelled beans compared to dry ones. The highest difference for iron bioavailability was observed in Maharagi soja (12.9%) while lowest was in TY 3396-12 (1.4%). The highest observed for zinc was 3% in G59/1-2. Vulnerable groups who suffer from iron and zinc deficiency should be encouraged to consume green shelled beans more often in comparison to dry beans to improve their mineral uptake.
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    Uptake of cervical cancer screening services and its association with cervical cancer awareness and knowledge among women of reproductive age in Dodoma, Tanzania: a cross-sectional study
    (East African Health Research Commission, 2019) Moshi, Fabiola V; Bago, Musa; Ntwenya, Julius; Mpondo, Bonaventura; Kibusi, Stephen M
    Background: There is a close link between an individual’s knowledge about a given disease and uptake of screening and ultimately treatment. This study aimed to determine the link between knowledge levels and awareness and uptake of cervical cancer screening among women of reproductive age (15 to 49 years) in Dodoma, Tanzania. Methods: A cross-sectional study of 1,587 women aged between 15 and 49 years was conducted in Dodoma City, Tanzania. A structured questionnaire, adapted from Montgomery and others, was pretested and used to collect data from March to April, 2016 via multistage sampling. Univariate and multiple regression analyses were used to determine factors associated with the level of knowledge about cervical cancer and the association between knowledge and uptake of cervical cancer screening. Results: The mean age of the participants was 26.99±8.026 years. Only 165 (10.4%) of the 1,587 participants were knowledgeable about cervical cancer; 1,051 (66.2%) were aware of cervical cancer screening, and only 125 (7.9%) had undergone cervical cancer screening. Predictors of knowledge about cervical cancer were education level (secondary education adjusted odds ratio [AOR] 2.23; 95% confidence interval [CI], 1.030-4.811; P<.05; university level AOR 2.59; 95% CI, 1.179 to 5.669; P<.05); residence (rural AOR 1.85; 95% CI, 1.282 to 2.679; P=.001); parity (multipara AOR 1.88; 95% CI, 1.125 to 3.142; P<.05). After adjusting for confounders, knowledge about cervical cancer significantly influenced both cervical cancer screening awareness (AOR 2.91; 95% CI, 1.821 to 4.640; P<.001) and uptake (AOR 2.065; 95% CI, 1.238 to 3.444; P=.005). Conclusion: The level of knowledge about cervical cancer was extremely low. Women with less knowledge about cervical cancer were those with less education, those living in rural areas, and those without children. A low level of knowledge was associated with poor uptake of screening services, highlighting the need for integrating health education pertaining to cervical cancer and screening when providing reproductive health care in Tanzania.