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Health Facilities Preparedness To Deliver Maternal And Newborn Health Care In Kilifi And Kisii Counties, Kenya, James Orwa, Marleen Temmerman, Lucy Nyaga, Kennedy Mulama, Stanley Luchters

Population Health, East Africa

Introduction: Health facility preparedness is essential for delivering quality maternal and newborn care, minimizing morbidity and mortality by addressing delays in seeking skilled care, reaching appropriate facilities, and receiving emergency care. A rapid assessment of 23 government health facilities in Kilifi and Kisii counties identified poor maternal and newborn indicators in 16 facilities. The Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project supported these facilities with training, equipment, and referral linkages. This study focuses on facility preparedness of the 16 facilities to deliver maternal and newborn health services, specifically delays two and three at the end …

A Health Systems Approach To Critical Care Delivery In Low-Resource Settings: A Narrative Review, Stephen A. Spencer, Faustina Excel Adipa, Tim Baker, Ana Maria Crawford, Paul Dark, Dingase Dula, Stephen B. Gordon, David Oliver Hamilton, Dawit Kebede Huluka, Wangari Siika

Anaesthesiology, East Africa

There is a high burden of critical illness in low-income countries (LICs), adding pressure to already strained health systems. Over the next decade, the need for critical care is expected to grow due to ageing populations with increasing medical complexity; limited access to primary care; climate change; natural disasters; and conflict. In 2019, the 72nd World Health Assembly emphasised that an essential part of universal health coverage is improved access to effective emergency and critical care and to “ensure the timely and effective delivery of life-saving health care services to those in need”. In this narrative review, we examine critical …

Improvement Of Community Health Worker Counseling Skills Through Early Childhood Development (Ecd) Videos, Supervision And Mentorship: A Mixed Methods Pre-Post Evaluation From Tanzania, Josephine Pascal Ferla, Michelle M. Gill, Teopista Komba, Amina Abubakar, Pieter Remes, Ola Jahanpour, Gretchen Antelman

Institute for Human Development, East Africa

Background: Community health workers (CHWs) play significant roles in improving health practices in under- resourced communities. This study evaluated an early childhood development (ECD) project in Tanzania assessing the effect of mobile video use, supervision and mentorship to improve quality of CHW counseling skills.

Methods: CHWs participating in the Malezi Project in Tabora Region were enrolled in a mixed methods pre-post evaluation. CHWs previously trained in UNICEF’s Care for Child Development package were further trained in counselling caregivers on nurturing care and father engagement using videos. Health providers were trained to provide ECD-focused supervision/mentorship of CHWs in facilities and …

Determinants Of First‐Ever Stroke Severity In West Africans: Evidence From The Siren Study, Oladimeji Adebayo, Onoja Akpa, Osahon J. Asowata, Adekunle Fakunle, Fred S. Sarfo, Albert Akpalu, Kolawole Wahab, Reginald Obiako, Morenikeji Komolafe, Philip Adebayo

Internal Medicine, East Africa

Background: Baseline stroke severity is probably partly responsible for poor stroke outcomes in sub-Saharan Africa. However, there is a paucity of information on determinants of stroke severity among indigenous Africans. We sought to identify the factors associated with stroke severity among West Africans in the SIREN (Stroke Investigative Research and Educational Networks) study.

Methods and Results: Stroke was diagnosed clinically and confirmed with brain neuroimaging. Severe stroke was defined as a Stroke Levity Scale score of ≤5. A multivariate logistic regression model was constructed to identify factors associated with stroke severity at 95% CI and a nominal cutoff of 5% …

Dengue Virus And Blood Safety: A Mini-Review Of Research Publications, Festus Mulakoli, George Gachara, Eric Ndombi, Samoel Khamadi

School of Nursing & Midwifery, East Africa

The growing demand for donated whole blood and blood products to save lives has both health benefits and health risks for blood recipients at the same time. Dengue virus, a re-emerging viral disease poses a threat to blood safety, and it has spread to over 128 countries in the world. Several studies have documented transfusion-transmitted (TT) dengue, with the first cases being reported in China in 2002 and Singapore in 2008. To understand the magnitude and broader picture of the dengue virus and blood safety, we conducted a mini-review of published literature from the Scopus database. The review focused on …

Highlights From The Second Choosing Wisely Africa Conference: A Roadmap To Value-Based Cancer Care In East Africa (9–10 February 2023, Dar Es Salaam, Tanzania), Rugengamanzi Eulade, Godwin Abdiel Nnko, Jerry Ndumbalo, Nazima Dharsee, Larry O. Akoko, Christian Ntizimira, Beda Likonda, Harrison Chuwa, Salum Lidenge, Verna Vanderpuye, Nazik Hammad, Sikudhani Muya, Rubagumya Rubagumya

Internal Medicine, East Africa

The ecancer Choosing Wisely conference was held for the second time in Africa in Dar es Salaam, Tanzania, from the 9th to 10th of February 2023. ecancer in collaboration with the Tanzania Oncology Society organised this conference which was attended by more than 150 local and international delegates. During the 2 days of the conference, more than ten speakers from different specialties in the field of oncology gave insights into Choosing Wisely in oncology. Topics from all fields linked to cancer care such as radiation oncology, medical oncology, prevention, oncological surgery, palliative care, patient advocacy, pathology, radiology, clinical trials, research …

Nurses' Preparedness For Disaster Response In Rural And Urban Primary Healthcare Settings In Tanzania, Kahabi Isangula, Mary Lyimo, Yudas Ndungile, Elisha Robert

School of Nursing & Midwifery, East Africa

Introduction: Nurses are often on the frontline of disaster management, providing care to patients with emerging physical, mental, and emotional turbulence, and acting as educators for health promotion and disaster prevention in both rural and urban contexts. However, the literature suggests that nurses are inadequately prepared for disaster response. This study examined preparedness for disaster response among nurses in rural and urban primary healthcare settings in Tanzania.

Methods: This qualitative descriptive study involved purposefully selected qualified nurses and nurse administrators working in rural (n=20) and urban (n=11) primary healthcare facilities in Tanzania. Telephone-based interviews were conducted to gather …

Functional Status Among Patients With Established Copd Attending Tertiary Hospitals In Dar Es Salaam, Tanzania, Peter M. Tumbo

Master of Medicine in Internal Medicine

Background Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable non communicable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases and influenced by host factors including abnormal lung development. It is associated with a lot of risk factors such as smoking, biomass fuel use for cooking and air pollutants in general. Objectives The primary objective of this research was to determine the functional status of patients with COPD. The secondary objectives were to determine the factors influencing …

Barriers Of Iucd Uptake Among Sexually Active Nulliparous University Students In Dar Es Salaam Tanzania, Fatma Shaib Mohamed

Master of Medicine in Family Medicine

Background Family planning contributes an important role in prevention of unintended pregnancy, unsafe abortion, maternal and child mortality. One of the methods used is an IUCD that help in preventing unintended pregnancy. Un intended pregnancy is a public he alth concern worldwide among younger women, resulting into unsafe abortion. Preventing unintended pregnancies in youth is crucial yet challenging. Few studies have addressed the problem of the low utilization of IUCD among university students. This group is overwhelmed with physiological, social, and economic issues in relation to reproductive health especially on family planning accessibility and use. Gap of knowledge and skills …

Breast Cancer Molecular Subtype Classification According To Immunohistochemistry Markers And Its Association With Pathological Characteristics Among Women Attending Tertiary Hospitals In Tanzania., Allyzain Ismail

Master of Surgery

Background: Breast cancer immunohistochemistry is a biological characteristic of the tumour which has a role to diagnose molecular subtype, prognosticate and guide treatment and categorised into 4 subtypes, Luminal A, Luminal B, Human Epidermal Growth Factor Receptor 2 (HER2) enriched and Triple Negative Breast Cancer (TNBC). Objectives: To determine the prevalence of each molecular subtype of breast cancer and determine their association with pathological and demographic characteristics. Methods: A retrospective cross-sectional study was carried out at two tertiary referral hospitals on participants who were recruited from the cancer registries from 2015-2022 and had a breast tissue biopsy confirming primary breast …

Experiences Of Diverse Health Care Workers’ Providing Maternal Care During The Covid-19 Pandemic: A Qualitative Study At Five Hospitals In Dar Es Salaam, Tanzania., Fatma Zahran

Master of Family Medicine

Background There are drastic changes in patient care with respect to maternity due to the COVID-19 pandemic with negative impact to health care workers. With Interruption of everyday basic services, arose the need to redistribute the scanty health care workers across health care facilities in sub-Saharan Africa. Its effects and involvement on maternity practice in Sub-Saharan Africa are nevertheless to be analyzed. This study aims to explore the likely ramifications for obstetrics and gynecologic practice in Tanzania. At present there are limited studies looking at impacts of COVID-19 in sub-Saharan Africa and Tanzania. No study has been carried out to …

An Assessment Of High-Performance Work System On The Survival Of The Print Media In Tanzania, Frank Sanga

Master of Arts in Digital Journalism

This study assessed the high-performance work system (HPWS) on the survival of print media in Tanzania. The study was guided by three specific objectives namely; (i) to assess the extent to which the high-performance work system is practised in Mwananchi and Nipashe newsrooms, (ii) to assess the correlation between the high-performance work system and the performance of Mwananchi and Nipashe newspapers, and (iii) to examine challenges of practicing HPWS in Mwananchi and Nipashe newspapers. The study was based on qualitative research approach. This approach was applied for the purpose of getting in-depth information from the sample of 24 respondents from …

Implementation Of Evidence-Based Multiple Focus Integrated Intensified Tb Screening To End Tb (Exit-Tb) Package In East Africa: A Qualitative Study, Kahabi Isangula, Doreen Philbert, Florence Ngari, Tigest Ajeme, Godfather Kimaro, Getnet Yimer, Nicholaus P. Mnyambwa, Winters Muttamba, Irene Najjingo, Aman Wilfred

School of Nursing & Midwifery, East Africa

Introduction Tuberculosis (TB) remains a major cause of morbidity and mortality, especially in sub-Saharan Africa. We qualitatively evaluated the implementation of an Evidence-Based Multiple Focus Integrated Intensified TB Screening package (EXIT-TB) in the East African region, aimed at increasing TB case detection and number of patients receiving care.

Objective We present the accounts of participants from Tanzania, Kenya, Uganda, and Ethiopia regarding the implementation of EXIT-TB, and suggestions for scaling up.

Methods A qualitative descriptive design was used to gather insights from purposefully selected healthcare workers, community health workers, and other stakeholders. A total of 27, 13, 14, and 19 …

Analysis Of Kenya’S Print Media Framing Of The Dusit D2 Terror Suspects, Ibrahim Galgalo Bocha

Master of Arts in Digital Journalism

The reporting of Terror Incidents (TIs) by the media in Kenya started when the first case was reported under the reign of President Jomo Kenyatta (1963-1978), with the first incident reported in 1980, when Palestinian militants staged an attack at Norfolk Hotel on New Year’s eve. Whereas the media has had to balance covering TIs in a timely, factual and objective manner, journalists also need to frame their narratives to reflect the event's social, economic and psychological dimensions. They strive to avoid sensationalism, bias and a presentation of facts that could be seen to fan militants’ propaganda. This study aimed …

Patient-Level And System-Level Determinants Of Stroke Fatality Across 16 Large Hospitals In Ghana And Nigeria: A Prospective Cohort Study, Fred S. Sarfo, Onoja M. Akpa, Bruce Ovbiagele, Albert Akpalu, Kolawole Wahab, Reginald Obiako, Morenikeji Komolafe, Lukman Owolabi, Godwin Ogbole, Philip Adebayo

Internal Medicine, East Africa

Background: Every minute, six indigenous Africans develop new strokes. Patient-level and system-level contributors to early stroke fatality in this region are yet to be delineated. We aimed to identify and quantify the contributions of patient-level and system-level determinants of inpatient stroke fatality across 16 hospitals in Ghana and Nigeria.

Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicentre study involving 16 sites in Ghana and Nigeria. Cases include adults (aged ≥18 years) with clinical and radiological evidence of an acute stroke. Data on stroke services and resources available at each study site were collected and analysed as …

Improving Nursing Education Curriculum As A Tool For Strengthening The Nurse–Client Relationships In Maternal And Child Healthcare: Insights From A Human-Centered Design Study In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Background. There are growing evidence of poor nurse–client relationships in maternal and child health (MCH). The nursing curriculum forms an important entry point for strengthening such relationships, consequently improving client satisfaction with nurses' competencies, confidence in the formal healthcare system, healthcare-seeking practices, continuity with care, and MCH outcomes.

Objective. MCH nurses and clients were invited to design an intervention package (prototype) to improve nurse–client relationships using a human-centered design (HCD) approach.

Methods. A multi-step HCD approach was employed to first examine the contributors of poor nurse–client relationships using nine focus group discussions with nurses and clients and 12 key informant …

The Efficacy Of Blended Learning In A Pediatric Spine Deformity Management Program In Sub-Saharan Africa, Alaaeldin Ahmad, Abdallah Abushehab, François Waterkeyn, Beverly Cheserem, Massimo Balsano, Christopher Bonfield, Hamisi Shabani, Juma Magogo, Bryson Mcharo, Costansia Bureta

General Surgery, East Africa

Introduction: Our study assessed the efficacy of blended learning, which combines in-person learning and e-learning, in a pediatric scoliosis training program through an international collaborative effort.

Methods: The course comprised two parts: the online portion, where participants reviewed educational materials for 3 weeks and met with faculty once/week for discussion, and the in-person session, where participants reviewed cases in a team-based approach and came to a consensus on treatment strategy, followed by discussion with an international expert. All participants completed a needs assessment (NA) and clinical quiz at three points: before the course, after the online session, and after the …

Trends Of Intra-Facility Births Outcomes Before And During Covid-19 Era In Dar Es Salaam, Tanzania, Willbroad Kyejo

Master of Medicine in Family Medicine

Background While substantial progress had been made in reducing maternal deaths, there was a risk that the COVID-19 pandemic might have reversed the progress made in maternal and newborn health in the last two decades. As such, maternal and newborn outcomes had been a topic of interest during the pandemic. Objectives This study aimed to compare the number of childbirths as an indicator of maternal health service utilization and to assess maternal and newborn outcomes before COVID-19 (2011-2019) and during the COVID-19 pandemic (2020/2021) in 22 health facilities in Dar es Salaam. Methodology A retrospective cohort study was conducted at …

Current Status And Priorities Of Paediatric Oncology Nursing In Africa: A Synthesis Of Perspectives From Siop Africa Nurses, Glenn M. Afungchwi, Elianeth Kiteni, Mariam Ndagire, Biemba Maliti, Julia M. Challinor, Rachel Hollis

School of Nursing & Midwifery, East Africa

Introduction. As African countries adopt the global goal of improving childhood cancer survival to 60% by 2030, intentional actions are required to improve nursing. This report aims to describe the current status of paediatric oncology nursing in Africa.

Methods. We report on nursing-related aspects of a survey to map paediatric oncology services in Africa (2018–2019), document perceived nursing strengths and weaknesses (2017) and share nurses’ research priorities (2019). Additionally, we report on a survey to identify topics for a foundation course (2019) and the expressed perspective of African nurses about the status of paediatric oncology nursing across the continent (2022). …

Investigating Students’ Conceptualization Of Linear Programming In Mathematics, A Case Of A Secondary School In Rachuonyo East Sub-County, Kenya, Opiyo Collince Oyaya

Master of Education

Mathematics is a compulsory subject in the Kenyan education system from pre-primary to secondary education. The ministry of education through the introduction of the 8-4-4 system of education in 1985 made Mathematics compulsory owing to its vast application in a wide range of spheres and professions. It is argued that proficiency in mathematics propels both economic and technological advancements. To further enhance delivery in this subject area, the ministry of education initiated SMASSE for science and mathematics teachers to help in simplifying the ‘high order’ concepts such as calculus, loci, and linear programming among others. Linear programming is applicable in …

Exploration Of Factors Contributing To Low Achievement Of Learners In Chemistry At Ordinary Secondary Level. A Case Study Of A Mixed Secondary School In Katrini Sub-County, Terego District, Uganda., Andrew Ababo

Master of Education

The performance of learners in the ordinary secondary section has been low over the years in Uganda. Many learners fail to pass chemistry at ordinary secondary level as such, very few students offer the subject at higher levels. The general purpose of this study was to explore factors contributing to low achievement of learners in chemistry at ordinary secondary section in a mixed secondary school in Katrini sub-county, Terego district, Uganda. A qualitative research approach with a case study design was applied. The sample size had twenty-two participants made up of ten females and twelve males in the following categories: …

Investigating The Role Of Play In Children’S Socio-Emotional And Cognitive Development: A Study In Three Public Preprimary Schools In Temeke Municipality., Farida Idd

Master of Education

Whilst play has been initiated by various philosophers and psychologists in early childhood education, the researcher sought to investigate the role of play in children’s socio-emotional and cognitive development in selected public pre-primary schools in Temeke Municipality and found out that teachers encourage a different kind of play to stimulate children’s development. This was a qualitative research approach whereby the researcher employed a case study design to get in-depth details from participants’ insights, expressions, and feelings based on their natural setting concerning the role of play in children’s development, and multiple ways of data collection were considered. The findings from …

Exploring The Use Of Digital Technologies In Early Childhood Teacher Education: A Case Of A Core Primary Teachers’ College In Uganda., Richard Anywar

Master of Education

This qualitative case study interrogated the use of digital technologies in Tera CPTC (pseudonym) in Northwestern Uganda under three research questions, namely: (1) What are the digital technologies teacher educators use to improve ECTE at Tera (pseudonym) CPTC? (2) How do teacher educators use digital technologies to improve Early Childhood Teacher Education? (3) What challenges do the ECE teacher educators face with the use of digital technologies to improve teaching and learning at Tera CPTC? Data was collected using classroom observation, focus group discussion, and semi-structured interviews. Three tutors and twenty-four teacher trainees participated in the study. Study findings revealed …

An Investigation On How Lower Primary School Teachers Are Developing Learners’ Digital Literacy Competencies: A Case Study Of A Primary School In Mtwapa, Kilifi County, Kenya, Judy Kinyanjui Wangui

Master of Education

Digital literacy has become a prerequisite in today’s learning due to the much-needed technological skills required in the 21st century for academic achievements, career development, and daily living. With the introduction of the Competency-Based Curriculum (CBC) in Kenya, studies have shown that teachers received limited in-service induction on CBC, raising questions on how teachers are developing learners’ digital literacy competencies (LDLC), yet little has been done to enhance teachers’ understanding of how this specific competence ‘digital literacy’ should be developed. This study investigated how primary school teachers are developing lower primary school LDLC. The study employed a qualitative approach that …

Factors That Influence Girl Child Performance In Science In Upper Primary Classes: A Case Of Two Selected Primary Schools In Arua District, Uganda., Ajuko Anna Grace

Master of Education

This study explored the factors that influence girl child performance in integrated science in upper primary classesin two primary schools in Arua district, Uganda. The findings are reflected in the themes; how girls perform in integrated science, factors that influence girls’ performance and strategies that can be used to improve girls’ performance in integrated science in primary schools. This study embraced a qualitative research approach and a case study design. The study sample comprised of thirty (30) participants which included two head teachers from the two selected primary schools, four teachers of science two from each school of study who …

An Analysis Of Tpd: Approaches, Challenges And Implication For The Transfer Of Knowledge And Skills To The Workplace, Baraka Mumo Kilonzo

Master of Education

This study explored transfer of knowledge and skills from teacher professional learning activities to the workplace. A concurrent mixed method was adopted. Data was collected using questionnaire, FGD and interview. The study was carried out among teachers in public secondary schools in Makueni county in Kenya. The respondents included classroom teachers, principal as well as TPD provider. Findings suggest that the transfer of training into the classroom is influenced by trainee characteristics, training design and work environment which were studied. In addition, findings revealed that while there is a sufficient supply of subject based TPL programs, the quality of these …

Exploring Head Teachers’ Support For Online Learning During The School Closure As A Result Of Covid-19: A Case Of Two Primary Schools In Mombasa County, Kenya, Juma Rashid Haji

Master of Education

The emergence and spread of COVID-19 in the world prompted most governments to close all educational institutions to halt the spread of the virus. Schools in Kenya were closed for nearly 7 months, resulting in a learning loss. The Kenyan government promoted online learning through mass media such as television and radio, while the Kenya Institute of Curriculum Development (KICD) uploaded learning resources to their i-cloud educational portal. However, students and teachers faced several challenges that made it difficult for such headteachers to provide effective support for online learning. The researcher selected two primary schools, two headteachers, two deputy headteachers, …

Examining The Status Of Professional Learning Communities In Private And Public Secondary Schools In Makindye Division, Kampala, Uganda, Bugembe Steven

Master of Education

The power of collective synergy while participating in professional learning communities is a relatively recent phenomenon in educational professional development. It has received a great deal of attention on the educational scene due to its roots in the majority of developed countries. Fortunately, professional learning communities are equated to what is referred to as site-based learning for teachers in Uganda's continuous professional development framework for teachers. This is a teacher-led initiative aimed at improving teacher quality and encouraging collaborative professional development. Since its introduction by the Education Ministry (MoES, 2017), the practice and implementation, as well as the rate of …

Effectiveness Of Teachers’ Continuous Professional Development (Cpd) In Enhancing Learners’ Achievement In Selected Primary Schools In Abim District, Akech Venty Obura

Master of Education

This qualitative study using case study design sought to explore the effectiveness of Teachers’ Continuous Professional Development (CPD) in enhancing learners’ achievement in primary schools of Abim district in Uganda. There are numerous CPDs in Abim district whose expected outcome is improved learners’ achievement but there is little evidence to authenticate that. A total sample of thirteen (13) respondents participated. The study used interviews and Focussed Group Discussion as methods of collecting data from sampled participants. Data collected, consisted of information about respondents’ understanding of CPD, organisation, implementation, and evaluation. The participants understood CPDs in many different ways. The study …

Exploring The Influence Of One-On-One Peer Support On Academic Performance And Career Pathway Choice For Students With Visual Impairment: A Case Of A Selected Secondary School In Kilimanjaro Region, Gerald John Kimaro

Master of Education

This study explored the influence of one-on-one peer support on the performance and career pathway choice of students with Visual Impairment (VI) in secondary school. The study adopted a qualitative research approach with a case study design. The sampling was purposive and the sample size comprises four teachers (One academic teacher, the head of the special need department, one teacher from STEM and one teacher from the social science department) and ten students (five pairs of one-on-one peer support from Form three class). The study employed an interview guide, focus group discussion guide and document analysis protocol as the instruments …