Browsing by Author "Maluka, Stephen O"

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    The Effect of Elderly Exemption Policy on Access to and Utilization of Health Care Services in Tanzania
    (Tanzania Journal of Development Studies, 2021) Edward, Joshua; Maluka, Stephen O
    Exemption from and waiver of social service cost for elderly people have been implemented in Tanzania for the past three decades. In order to facilitate the exemption of the elderly from paying for health services, the then Ministry of Health directed all districts in Tanzania to issue identify cards (IDs) to the elderly in order to address the challenges already observed in the implementation of the exemption and waiver policy. Despite an increase in demand and popularity of the IDs among elderly people, it was not clear whether this new mechanism offered the elderly access to health services. This paper examines the implementation of this policy in Mbarali and Ubungo districts in Tanzania. The study adopted a mixed method approach using surveys (n=879) and semi-structured interviews (n=23). Quantitative data were analysed descriptively and qualitative data were analysed thematically. It was found that elderly identity cards have only improved physical access to health facilities through simplification of identification. Shortage of health care services, particularly medicines and medical supplies, long waiting time due to shortage of staff and the use of unfriendly language by the health care workers, have caused negative perceptions of the elderly towards the exemption policy. The use of elderly IDs has not solved the earlier observed challenges facing the exemption policy for the elderly population. It is recommended that the government needs to work more to improve the quality of health care services for the elderly in public health facilities.
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    The Effect of Elderly Exemption Policy on Access to and Utilization of Health Care Services in Tanzania
    (Tanzania Journal of Development Studies, 2021) Edward, Joshua; Maluka, Stephen O
    Exemption from and waiver of social service cost for elderly people have been implemented in Tanzania for the past three decades. In order to facilitate the exemption of the elderly from paying for health services, the then Ministry of Health directed all districts in Tanzania to issue identify cards (IDs) to the elderly in order to address the challenges already observed in the implementation of the exemption and waiver policy. Despite an increase in demand and popularity of the IDs among elderly people, it was not clear whether this new mechanism offered the elderly access to health services. This paper examines the implementation of this policy in Mbarali and Ubungo districts in Tanzania. The study adopted a mixed method approach using surveys (n=879) and semi-structured interviews (n=23). Quantitative data were analysed descriptively and qualitative data were analysed thematically. It was found that elderly identity cards have only improved physical access to health facilities through simplification of identification. Shortage of health care services, particularly medicines and medical supplies, long waiting time due to shortage of staff and the use of unfriendly language by the health care workers, have caused negative perceptions of the elderly towards the exemption policy. The use of elderly IDs has not solved the earlier observed challenges facing the exemption policy for the elderly population. It is recommended that the government needs to work more to improve the quality of health care services for the elderly in public health facilities.
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    Effects of Male Engagement Interventions on Women’s Autonomy in Decision Making in Iringa Region, Tanzania
    (Tanzania Journal of Development Studies, 2021) Japhet, Paul; Maluka, Stephen O
    Maternal and neonatal mortality are largely caused by delays in attending to obstetric complications and this is attributed to limited women’s power in making decisions regarding household resources and utilisation of health care services. This requires effective implementation of male engagement interventions to improve women’s autonomy in making decisions and hence reduce delays in attending to obstetric complications. This study examines the contribution of male engagement interventions in promoting women’s autonomy in decision making within households and society. A structured questionnaire was used to collect data on socio-demographic and household characteristics, women’s practices concerning prenatal care, childbirth, postnatal care, and related decision-making power. Descriptive statistics and inferential analysis were used to analyse the data. The findings show a significant difference in decision making autonomy regarding family planning methods among respondents who had received male engagement education versus those who had not received such education (p-0.001<1%). Again, there was significant participation of women in household purchases for daily needs (p-0.057<10%) and in decisions to work out of homes (p-0.015<5%). This trend was noted among respondents who had received male engagement education as compared to those who had not received such education. There was also greater engagement of women in decision making concerning major household purchases and their health care, although their engagement was not statistically significant (p- 0.397>10% and p-0.293>10% respectively). Effective implementation of male engagement interventions may leverage men’s power within households and promote women’s autonomy in decision making, thereby improving healthcare- seeking behaviour.
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    Factors Facilitating and Challenges Facing Community-based Interventions in Improving Antenatal Care in Rural Tanzania
    (Journal of Education, Humanities and Sciences, 2021) Maluka, Stephen O; Joseph, Chakupewa
    The improvement of antenatal care has remained a topical global concern as signalled by maternal deaths, which have remained unacceptably high, especially in low- and middle- income countries. In response to this concern, community-based interventions through women’s groups have been implemented to improve antenatal care; and have shown promising results in rural settings. However, factors contributing to the success or failure of these interventions vary across geographical settings, thereby necessitating area- specific considerations. This paper sets out to unveil significant facilitators and barriers to the implementation of women’s group interventions in Tanzania. A qualitative case study design was employed involving interviews, focus group discussions, and documentary review in Kilolo and Mufindi districts. Eighty-six participants were interviewed and six small focus group discussions were conducted. Findings show that several factors facilitated the implementation of community-based interventions. These included recruitment and selection of the women’s groups, readiness among the women’s groups, support of the local administrative systems, and inclusive monitoring and evaluation process. On the other hand, the implementation process was constrained by insufficient logistical supplies, multiple workloads, and the desire for allowances. It is concluded that increased uptake and sustainability of antenatal care can potentially be attained through an understanding of both facilitators and barriers during the planning, development and implementation of the interventions of women’s groups.
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    Knowledge, Attitude and Practices on Non-Communicable Diseases among Students and Staff at the Dar es Salaam University College of Education in Tanzania.
    (Journal of Humanities and Social Sciences, 2022) Maluka, Stephen O; Sangeti, Saningo
    Non-Communicable Diseases (NCDs) are among the major public health problems facing the world today. Despite contributing to over half of all deaths worldwide, and being a major challenge in low- and middle-income countries, NCDs have received less attention. In Tanzania, studies focusing on the assessment of comprehensive knowledge of NCDs are lacking. This study aims to assess knowledge, attitudes and behaviour of the Dar es Salaam University College of Education (DUCE) community on selected NCDs. A cross- sectional study was conducted to assess knowledge, attitudes and practices on selected NCDs. The study involved both students and staff at the DUCE. A descriptive analysis was adopted for the quantitative data collected through structured questionnaires. The study findings show that the general knowledge of the DUCE community about some selected NCDs was generally high. However, there was a very low level of knowledge about risk factors, early symptoms and preventive measures. Regarding risk factors, a very small proportion of students (1.6%) and staff (3.1%) consumed tobacco products. Only 75 (13.1%) of students and 70 (36.5%) of staff consumed alcohol. The intake of fruits and vegetables among the community was insufficient. About 493 (86%) of the students and 135 (70.3%) of the staff added salt or salty sauce to their meals. As for physical activities, 234 (40.8%) of the students and 99 (51.6%) of the staff reported that they ran or participated in games and sports for at least one day in a week. The study concludes that while generally there is a high level of knowledge about NCDs, there is a very low level of knowledge about risk factors, early symptoms and preventive measures. The study underlines the need to increase the awareness of the DUCE population on risk factors associated with NCDs, early signs and preventive measures that people should take to prevent NCDs in the future. Keywords: higher education, public health, diseases, HIV/AIDS, Tanzania