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Using Discussion As A Teaching Technique To Improve Learners Oral Communication Skills In English Language Lessons: A Case Of A Rural Public School In Homa Bay County, Kenya, Linet Adhiambo Agele

Master of Education

This qualitative research study focused on the use of discussion as a teaching pedagogy to improve learners‟ oral communication in the elementary English language classrooms. The data was gathered from interviews with teachers and learners, lesson observations, various documents‟ analysis, oral tests and general observations and conversations. The findings indicated teachers‟ use of traditional methods of teaching, lack of immersion environment together with inadequate use of discussion, hindered the development of learners‟ oral communication skills in English. Other negative factors that emerged from the study were a lot of syllabus content and the use of written exercises in the English …

How The Politics Of Teacher Unions Affect Teacher Benefits, Derrick Okumu Odhiambo

Master of Education

This study investigated how the politics of teacher unions affect teacher benefits. The study sought to investigate the political strategies that teacher unions employ in order to fight for the benefits of teachers and the teachers’ awareness of these union activities. The study was carried out among teachers in public primary and secondary schools in Western Kenya in a county pseudonymized as New County. The respondents included classroom teachers in primary and secondary schools, school heads and principals as well as a teacher union official. This study adopted Dewey’s Pragmatic paradigm where workable methods are used for problem solving. A …

Systematic Review Of Doppler For Detecting Intrapartum Fetal Heart Abnormalities And Measuring Perinatal Mortality In Low‐ And Middle‐Income Countries, Marya Plotkin, Benjamin Kamala, Jim Ricca, Linda Fogarty, Sheena Currie, Hussein Kidanto, Stephanie B. Wheeler

Obstetrics and Gynaecology, East Africa

Background: Using Doppler to improve detection of intrapartum fetal heart rate (FHR) abnormalities coupled with appropriate, timely intrapartum care in low-and middle-income countries (LMIC) can save lives.

Objective: To review studies using Doppler to improve detection of intrapartum FHR abnormalities and intrapartum care quality in LMIC health facilities.

Search strategy: PubMed, Web of Science, Embase, Global Health, and Scopus were searched from inception to October 2018 by combining terms for Doppler, perinatal outcomes, and FHR monitoring.

Selection criteria: Selected studies compared Doppler and Pinard stethoscope for detecting/monitoring intrapartum FHR, or described provider and maternal preferences for FHR monitoring in LMIC …

Potential Causes Of Early Death Among Admitted Newborns In A Rural Tanzanian Hospital, Robert Moshiro, Jeffrey M. Perlman, Paschal Mdoe, Hussein Kidanto, Jan Terje Kvaløy, Hege L. Ersdal

Obstetrics and Gynaecology, East Africa

Background: Approximately 40,000 newborns die each year in Tanzania. Regional differences in outcome are common. Reviewing current local data, as well as defining potential causal pathways leading to death are urgently needed, before targeted interventions can be implemented

Objective: To describe the clinical characteristics and potential causal pathways contributing to newborn death and determine the presumed causes of newborn mortality within seven days, in a rural hospital setting.

Methods: Prospective observational study of admitted newborns born October 2014–July 2017. Information about labour/delivery and newborn management/care were recorded on data collection forms. Causes of deaths were predominantly based on clinical diagnosis. …

Predictors For Expired Co2 In Neonatal Bag-Mask Ventilation At Birth: Observational Study, Kari Holte, Hege Langli Ersdal, Joar Eilevstjønn, Monica Thallinger, Jørgen Linde, Claus Klingenberg, Rene Holst, Samwel Jatosh, Hussein Kidanto, Ketil Stordal

Obstetrics and Gynaecology, East Africa

Background: Expired carbon dioxide (ECO2) indicates degree of lung aeration immediately after birth. Favourable ventilation techniques may be associated with higher ECO2 and a faster increase. Clinical condition will however also affect measured values. The aim of this study was to explore the relative impact of ventilation factors and clinical factors on ECO2 during bag-mask ventilation of near-term newborns.

Methods: Observational study performed in a Tanzanian rural hospital. Side-stream measures of ECO2, ventilation data, heart rate and clinical information were recorded in 434 bag-mask ventilated newborns with initial heart rate <120 beats per minute. We studied ECO2 by clinical factors (birth weight, Apgar scores and initial heart rate) and ventilation factors (expired tidal volume, ventilation frequency, mask leak and inflation pressure) in random intercept models and Cox regression for time to ECO2 >2%.

Results: ECO2 rose non-linearly with increasing expired tidal volume …

Frequent Refresher Training On Newborn Resuscitation And Potential Impact On Perinatal Outcome Over Time In A Rural Tanzanian Hospital: An Observational Study, Estomih Mduma, Jan Terje Kvaløy, Eldar Soreide, Erling Svensen, Paschal Mdoe, Jeffrey Perlman, Caroline Johnson, Hussein Kidanto, Hege Langli Ersdal

Obstetrics and Gynaecology, East Africa

Objectives: Globally, perinatal mortality remains high, especially in sub-Saharan countries, mainly because of inadequate obstetric and newborn care. Helping Babies Breathe (HBB) resuscitation training as part of a continuous quality improvement (CQI) programme may improve outcomes. The aim of this study was to describe observed changes in perinatal survival during a 6-year period, while adjusting for relevant perinatal risk factors.

Setting: Delivery rooms and operating theatre in a rural referral hospital in northern-central Tanzania providing comprehensive obstetric and basic newborn care 24 hours a day. The hospital serves approximately 2 million people comprising low social-economic status.

Participants: …

Health Professionals' Experiences And Views On Obstetric Ultrasound In Vietnam: A Regional, Cross-Sectional Study, Sophia Holmlund, Pham Thi Lan, Kristina Edvardsson, Ho Dang Phuc, Joseph Ntaganira, Rhonda Small, Hussein Kidanto, Matilda Ngarina, Ingrid Mogren

Obstetrics and Gynaecology, East Africa

Objectives: Obstetric ultrasound is an important part of antenatal care in Vietnam, although there are great differences in access to antenatal care and ultrasound services across the country. The aim of this study was to explore Vietnamese health professionals' experiences and views of obstetric ultrasound in relation to clinical management, resources and skills.

Design: A cross-sectional questionnaire study was performed as part of the CROss Country UltraSound study.

Setting: Health facilities (n=29) in urban, semiurban and rural areas of Hanoi region in Vietnam.

Participants: Participants were 289 obstetricians/gynaecologists and 535 midwives.

Results: A majority (88%) …

Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C. Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Rabia Hussain, Najeeha Talat Iqbal

Department of Pathology and Laboratory Medicine

Background: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.
Methods and Findings: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. …

Reasons For Delay In Seeking Treatment Among Women With Obstetric Fistula In Tanzania: A Qualitative Study, Mary Lyimo, Idda H. Mosha

School of Nursing & Midwifery, East Africa

Background: Obstetric fistula is among the serious and distressing maternal morbidities in Tanzania. Obstetric fistula is a childbirth-related injury caused by prolonged and obstructed labor which has a devastating impact on affected women and their families. The aim of this study was to explore reasons why women with obstetric fistula admitted to the Comprehensive Community- Based Rehabilitation in Tanzania (CCBRT) hospital delayed seeking fistula treatment.

Methods: This exploratory study incorporated qualitative approach. In-depth interviews were used to collect data from 18 women with obstetric fistula admitted to CCBRT hospital. The interviews were conducted in Kiswahili and lasted for 40–45 min. …

Clinical Emergency Care Research In Low-Income And Middle-Income Countries: Opportunities And Challenges, Adam R. Aluisio, Shahan Waheed, Peter Cameron, Jermey Hess, Shevin Jacob, Niranjan Kissoon, Adam C. Levine, Asad Mian, Shammi Ramlakhan, Hendry R. Sawe, Junaid Razzak

Department of Emergency Medicine

Disease processes that frequently require emergency care constitute approximately 50% of the total disease burden in low-income and middle-income countries (LMICs). Many LMICs continue to deal with emergencies caused by communicable disease states such as pneumonia, diarrhoea, malaria and meningitis, while also experiencing a marked increase in non-communicable diseases, such as cardiovascular diseases, diabetes mellitus and trauma. For many of these states, emergency care interventions have been developed through research in high-income countries (HICs) and advances in care have been achieved. However, in LMICs, clinical research, especially interventional trials, in emergency care are rare. Furthermore, there exists minimal research on …

Position Statement:Emerging Genetic Therapies For Rare Disorders, Pauline Samia, Adam Kirton, Russell Dale, Silvia Tenembaum, Chahnez Charfi Triki, Anaita Hegde, Richard Idro, Jo M. Wilmshurst, Ingrid Tein, Haluk Topaloğlu

Paediatrics and Child Health, East Africa

Emerging genetic therapies for rare disorders at high cost, cannot realistically address the global burden of disease. Stakeholders must develop new pathways to ensure safe, fair and sustainable provision of such therapies.

Research Strategy 2019-2023 : Medical College And School Of Nursing & Midwifery - East Africa, Office Of The Research

Office of Research and Graduate Studies

Content

- Background

- AKU Medical College and School of Nursing & Midwifery in East Africa

- AKU MC/SONAM East Africa Academic Plan

- Research and Graduate Programs

- SWOT Analysis of AKU-MC/SONAM

- Vision, Mission and Core Values

- Strategic Objectives

- Monitoring and Evaluation

The Validation Of Swahili Version Of The International Prostate Symptom Score Questionnaire, Miten Ramesh Patel

Master of Surgery

Background: Benign prostatic hyperplasia is a common condition encountered in men who are 50 years and above, presenting in hospitals for evaluation of lower urinary tract symptoms. The International Prostate Symptom Score is one of the questionnaires used to assess these symptoms. However, this questionnaire has not yet been validated among patients with Benign Prostate Hypertrophy in the Tanzanian setting. Objectives: The primary objective of this study was to assess the validity of the Swahili version of the IPSS questionnaire among patients with benign prostatic hyperplasia. Methods: We employed a cross-sectional study design in patients that presented at the Aga …

Pick’S Disease And Subdural Haematoma: A Diagnostic Red Herring, Philip Adebayo, Funmilola Taiwo, Fatma Bakshi, Sunham Nur

Internal Medicine, East Africa

Frontotemporal dementia (FTD), otherwise known as Pick’s disease, is a clinically heterogeneous group of sporadic and familial neurodegenerative diseases. These conditions are characterized by dementia, behavioural and language dysfunction and loss of executive skills resulting from the degeneration of the frontal and temporal lobes. Although reversible causes of dementia are always sought during the evaluation of patients with progressive cognitive decline, the occurrence of a reversible aetiology may distract from evaluating for neurodegenerative causes of dementia. This report is about a 66-year old man with features of FTD and superimposed chronic subdural haematoma.

Negative Appendectomy Rate And Associated Factors In Urban Referral Hospitals In Tanzania, Masawa Klint Nyamuryekung’E

Master of Medicine in General Surgery

Background: Acute appendicitis is a common surgical emergency. In atypical presentation, making a clinical diagnosis is difficult leading to delays with high perforation rate or misdiagnoses and high negative appendectomy rates. In the urban referral hospitals in Tanzania the baseline perforation rate, negative appendectomy rate, and factors that drive it are unknown. These could serve as measures of performance, and as evaluation parameters of future interventions aimed at improving acute appendicitis case management in Tanzania. Objectives: The aim of this study was to establish the negative appendectomy rate and associated factors among patients undergoing emergency appendectomy for suspected acute appendicitis …

Prevalence And Outcome Of Asymptomatic Cryptococcal Antigenemia In Art Naive And Art Experienced Hiv Patients In Dar Es Salaam, Tanzania, Charles Mandela Makakala

Master of Medicine in Internal Medicine

Introduction: Cryptococcal meningitis (CM) is a highly fatal disease and contributes to about 20% of all-cause mortality in HIV/AIDS. Sub-Saharan Africa is facing substantial challenges in the treatment of the disease; the focus has been shifted towards prevention of the condition in ART-naive patients with CD4 counts of less than 100 cells/μL. Most studies and interventions have been conducted on ART-naive HIV patients despite there being cases and deaths due to cryptococcal meningitis among ART-experienced patients. Recent studies have shown that although there is an increase in ART coverage among HIV patients, this has not affected the incidence of cryptococcal …

Perceptions And Experiences Of Skilled Birth Attendants On Using A Newly Developed Strap-On Electronic Fetal Heart Rate Monitor In Tanzania, Sara Rivenes Lafontan, Hussein Kidanto, Hege L. Ersdal, Columba Mbekenga, Johanne Sundby

School of Nursing & Midwifery, East Africa

Background: Regular fetal heart rate monitoring during labor can drastically reduce fresh stillbirths and neonatal mortality through early detection and management of fetal distress. Fetal monitoring in low-resource settings is often inadequate. An electronic strap-on fetal heart rate monitor called Moyo was introduced in Tanzania to improve intrapartum fetal heart rate monitoring. There is limited knowledge about how skilled birth attendants in low-resource settings perceive using new technology in routine labor care. This study aimed to explore the attitude and perceptions of skilled birth attendants using Moyo in Dar es Salaam, Tanzania.

Methods: A qualitative design was used to collect …

Magnitude Of Screening For Gestational Diabetes Mellitus In An Urban Setting In Tanzania, Akampa Mukuve

Master of Medicine in Family Medicine

Background: Medical screening detects risk factors for disease or presence of disease in otherwise well persons in order to intervene early and reduce morbidity and mortality. During pregnancy it is important to detect conditions which may harm the mother and fetus during antenatal care (ANC). Gestational diabetes mellitus (GDM) is one such condition which causes adverse effects during pregnancy, acutely and in the long term. There is lack of consensus on uniform screening and diagnostic guidelines for GDM both internationally and locally. Furthermore, there is evidence that recommendations in antenatal care guidelines are not routinely performed by health care providers …

Complementary Feeding Practices And Their Determinants In Infants And Young Children On Follow Up At A Private Tertiary Hospital In Nairobi, Catherine Muthoni

Master of Medicine in Paediatrics and Child Health

Background: More than a third of all deaths in children under five years of age worldwide, are linked to maternal and child under-nutrition. Appropriate complementary feeding is one of the interventions with the greatest potential for reduction of nutrition-related diseases and mortalities, yet uptake of the recommended World Health Organisation (WHO) infant and young child feeding practices in Kenya remains low. Despite provision of nutrition education at Aga Khan University Hospital- Nairobi (AKUH-N), both growth faltering and over-weight trends have been observed, pointing to both under- and over-nutrition. Objectives: This study investigated caregivers' knowledge , attitude and practice (KAP) of …

My Husband Will Love Me More If I Give Birth To More Children: Rural Women’S Perceptions And Beliefs On Family Planning Services Utilization In A Low Resource Setting, Agnes Msoka, Eunice Pallangyo, Sharon Brownie, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

Introduction: Responsibility for family planning in low resource settings is almost solely delegated to women, with very low male involvement. This study investigated rural Tanzanian women’s perceptions and cultural beliefs of the barriers to family planning services utilization.

Methods: This study used a qualitative descriptive approach drawing on four group discussions with 20 purposively selected married women with two or more children. The study followed COREQ guidelines for reporting qualitative studies. Data were collected from participants at four health facilities in Bagamoyo and Kisarawe districts in Pwani, Tanzania.

Results: Participants’ occupations included housewives, small-scale farmers, and entrepreneurs. Most women were …

Contextual Design Choices And Partnerships For Scaling Early Child Development Programmes, Kate M. Milner, Raquel Bernal Salazar, Sunil Bhopal, Alexandra Brentani, Pia Rebello Britto, Tarun Dua, Melissa Gladstone, Esther Goh, Jena Hamadani, Muneera Rasheed

Department of Paediatrics and Child Health

Translating the Nurturing Care Framework and unprecedented global policy support for early child development (ECD) into action requires evidence-informed guidance about how to implement ECD programmes at national and regional scale. We completed a literature review and participatory mixed-method evaluation of projects in Saving Brains®, Grand Challenges Canada® funded ECD portfolio across 23 low- and middle-income countries (LMIC). Using an adapted programme cycle, findings from evaluation related to partnerships and leadership, situational analyses, and design for scaling ECD were considered. 39 projects (5 'Transition to Scale' and 34 'Seed') were evaluated. 63% were delivered through health and 84% focused on …

Early Neonatal Vitamin A Supplementation And Infant Mortality: An Individual Participant Data Meta-Analysis Of Randomised Controlled Trials, Rajiv Bahl, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Biannual vitamin A supplementation is a well-established survival tool for preschool children 6 months and older in vitamin A deficient populations but this schedule misses the opportunity to intervene on most young infant deaths. Randomised trials of neonatal vitamin A supplementation (NVAS) in the first few days of life to assess its impact on under 6-month mortality in low/middle-income countries have had varying results.
Methods: Investigators of 11 published randomised placebo-controlled NVAS trials (n=163 567 children) reanalysed their data according to an agreed plan and pooled the primary outcomes of mortality from supplementation through 6 and 12 months of …

National Policies And Care Provision In Pregnancy And Childbirth For Twins In Eastern And Southern Africa: A Mixed-Methods Multi-Country Study, Claudia Hanson, Stephen Munjanja, Agnes Binagwaho, Bellington Vwalika, Andrea B. Pembe, Elsa Jacinto, George K. Chilinda, Kateri B. Donahoe, Sikolia Wanyonyi, Peter Waiswa, Muchabayiwa F. Gidiri, Lenka Benova

Obstetrics and Gynaecology, East Africa

Background: High-risk pregnancies, such as twin pregnancies, deserve particular attention as mortality is very high in this group. With a view to inform policy and national guidelines development for the Sustainable Development Goals, we reviewed national training materials, guidelines, and policies underpinning the provision of care in relation to twin pregnancies and assessed care provided to twins in 8 Eastern and Southern African countries: Kenya, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe.

Methods and findings: We located policies and guidelines by reviewing national repositories and by contacting experts to systematically map country-level maternal and newborn training materials, guidelines, and …

Structured On-The-Job Training To Improve Retention Of Newborn Resuscitation Skills: A National Cohort Helping Babies Breathe Study In Tanzania, Mary Drake, Dunstan R. Bishanga, Akwila Temu, Mustafa Njozi, Erica Thomas, Victor Mponzi, Lauren Arlington, Georgina Msemo, Mary Azayo, Allan Kairuki, Amunga R. Meda, Kahabi Isangula, Brett D. Nelson

School of Nursing & Midwifery, East Africa

Background: Newborn resuscitation is a life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Improving provider newborn resuscitation skills is critical for delivering quality care, but the retention of these skills has been a challenge. Tanzania implemented a national newborn resuscitation using the Helping Babies Breathe (HBB) training program to help address this problem. Our objective was to evaluate the effectiveness of two training approaches to newborn resuscitation skills retention implemented across 16 regions of Tanzania.

Methods: An initial training approach implemented included verbal instructions for participating providers to replicate the training back at their service delivery site …

Exploration Of Teachers’ Perceptions Of Teacher Leadership: A Case Of One Secondary School In Monduli District., Fredrick John Seiyai

Master of Education

While it is known that teacher leadership is significant for school improvement, yet, little has been done in Tanzania context to understand how teachers perceive teacher leadership. The purpose of this study was to investigate the perceptions of teachers on teacher leadership in Monduli District in one public secondary school in Tanzania. The study employed a qualitative case study design with thirteen participants who were purposively selected. used and a case study design. The study participants were purposely selected. The sample included thirteen teachers, out of whom six were teacher leaders and seven were teachers who did not have teacher …

Exploring Teachers’ Integration Of Information Communication Technology (Ict) In Teaching Young Learners In Tanzania: A Case Study Of A Public Primary School In Temeke, Humphrey Frank Elias

Master of Education

The aim of this study was to explore how teachers integrate the use of ICT in teaching young learners (0 to 8 years) in Tanzania; a case study of one public primary school in Temeke Municipality. The study used a qualitative approach with a case study design of one primary school in Temeke municipal. The collection of data was through interviews, document analysis and observation. This study will be important to the teachers, the government, young leaners, and other stakeholders to take initiatives for improving teacher’s integration of ICT in teaching early years children. ICT Policy for Basic Education 0f …

The Effects Of English As Language Of Instruction On Teaching History In Two Schools In Monduli District, Agness Dominick

Master of Education

The use of English as a foreign language in Education system in Tanzania has been an issue of concern, and maybe blamed for the gaps in the quality of education. Research shows that, despite the fact that education standard is deteriorating the measures that have been taken to address the problem have not achieved the intended outcomes. This current study aimed to the effects of using English language in teaching and learning of history subject in Tanzania’s public secondary schools. The study applied a descriptive qualitative research approach where purposive sampling was used to choose two public secondary schools to …

Exploring The Role Of Schools In Supporting Professional Development For Pre-Primary Teachers: A Case Of Two Public Primary Schools In Moshi Municipality, Frank A. Christian

Master of Education

This study anticipated to explore the role of schools in supporting professional development for pre-primary teachers at the school level. The literature shows that professional development is an integral part of the strategies and efforts to improve the quality of pre-primary education. It was also clear that professional development is mostly associated with training offered from outside the school setting but little has been said of how professional development is being carried out within the school setting. Therefore this study concentrated on looking for the structures and opportunities at school which support professional development (PD) for pre-primary teachers. This study …

The Rural Livelihood Impacts Of East Africa’S New Development Corridors, Charis Enns, Brock Bersaglio, Ramson Karmushu, Masalu Luhula, Alex Awiti

East Africa Institute

Background and rationale: Africa is experiencing a surge of investment in new development corridors, which are networks of transport infrastructure intended to open isolated parts of the continent for investment and socio-economic development. Proponents of development corridors – including governments, bilateral development agencies and multilateral development banks – present these massive infrastructure projects as a solution to the obstacles created by uneven development. Development corridors are promoted as a way of correcting the spatial disparities that exist between different regions as they are promised to intensify agricultural and industrial production, increase economic diversification, create new employment opportunities and improve access …

Tanzanian Mothers’ Cultural Beliefs And Misinformation Regarding The Reasons For Their Cesarean Sections, Victor Mathias, Eleanor Holroyd, Grace Edwards

School of Nursing & Midwifery, East Africa

Background: In Tanzania, cesarean section (CS) rates have been steadily increasing, yet little is known about mothers’ understanding of the medical rationale for their CSs.

Aim: To identify mothers’ cultural understandings of the rationale for their CSs.

Methods: Design: A qualitative descriptive design was employed.

Setting: A government hospital in the western region in Tanzania.

Participants: A total of 117 mothers were interviewed using convenience sampling post CS.

Findings: Forty percent of the mothers were younger than 18 years, with more than 50% having had five or more live babies. Among multigravida women, 40.2% had had one or more previous …