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At least 19 recordsLinked to original sources
PubMed1996

Professional nursing care in Tanzania: a descriptive study of nursing care in Ilembula Lutheran Hospital in Tanzania.

The purpose of this ethnonursing study is to find new knowledge of the professional nursing care practised in a Bantu cultural context in Tanzania. The main questions are: How do Bantu nurses describe nursing? What components are there in professional nursing care in Ilembula Lutheran Hospital? The data were collected through participant observation, interviews and personal working diaries in Ilembula Lutheran Hospital. Six Tanzanian nurses were interviewed. The findings indicated that nursing was based on formal training on one hand, and on a natural mother-child relationship on the other hand. The idea of respect towards life, which is central to the Bantu philosophy of life, guided nursing care. In professional nursing care there emerged curing and caring components. Protection, encouragement and comfort were distinguished as the main constructs of caring.

Attitude of Health Personnel↗
PubMed2005

Scaling up postabortion contraceptive service--results from a study conducted among women having unwanted pregnancies in urban and rural Tanzania.

INTRODUCTION: It is well recognized that unwanted pregnancies and unsafe abortion are significant public health problems in sub-Saharan Africa. At the International Conference on Population and Development held in Cairo in 1994, postabortion care was prioritized as a means to reduce maternal morbidity and mortality associated with unsafe abortion. However, only a few postabortion care programs have been implemented and most of them have been confined to urban settings. The present study describes the magnitude of the problem of unwanted pregnancies among women with incomplete abortion in urban and rural Tanzania and evaluates the outcome of a postabortion care intervention. METHODS: Data were collected among 781 women admitted with incomplete abortion in Dar es Salaam region (urban Tanzania) and 575 women in Kagera region (rural Tanzania). RESULTS: Sixty-seven percent of the women in urban Tanzania and 42% in rural Tanzania stated that their pregnancy was unwanted. Contraceptive acceptance among women with unwanted pregnancies was high; 93% in urban Tanzania and 71% in rural Tanzania left with a contraceptive method. CONCLUSION: The high proportion of women with unwanted pregnancies in urban and rural Tanzania underlines the need of scaling up postabortion contraceptive service.

Abortion, Illegal↗
PubMed2004

Infant feeding practices in western Tanzania and Uganda: implications for infant feeding recommendations for HIV-infected mothers.

Current infant feeding guidelines of UNICEF/UNAIDS/WHO for HIV-infected women recommend the avoidance of breastfeeding or to breastfeed exclusively. In the context of a prevention of HIV mother-to-child transmission programme we assessed the feeding practices in peripheral areas of Tanzania and Uganda. A total of 237 mothers in south-western Tanzania and 424 mothers in western Uganda attending urban and rural antenatal care services as well as village women were interviewed with regard to duration of breastfeeding, time of introduction of additional nutrients and type of solid and liquid nutrients. The average reported duration of breastfeeding was 24 months in Tanzania but 18 months in Uganda (P < 0.001). Solid nutrients were added on average at month 6 in both areas while liquids were given significantly earlier in Tanzania (month 4) than in Uganda (month 5; P < 0.001). A total of 19% and 48% of the study participants, respectively, stated to breastfeed their infants exclusively at the age of 4 months in Tanzania and Uganda. Age between 26 and 35 years, urban residence and ethnic group were the risk factors for earlier introduction of nutrients in Uganda. In Tanzania, solid maize porridge was the most frequent (94%) and often single nutrient given during breastfeeding, while in Uganda combinations of nutrients such as bananas, millet and beans were used. Milk was the most frequently added fluid in Uganda whereas in Tanzania various liquids such as liquid maize porridge, milk, juice or water were used. Feeding practices differed considerably in the two countries. According to the interviewees, exclusive breastfeeding was rarely practiced in Tanzania. Our findings underline the necessity to promote exclusive breastfeeding if infant feeding recommendations are to be realized and emphasize the need to assess the local situation in order to ensure that locally appropriate information and recommendations are given to the target groups.

Adolescent↗
PubMed1989

Health policy and implementations in Tanzania.

This paper describes the current health policy in Tanzania and its implementations. The present health policy in Tanzania originated from Arusha declaration of 1967, the country's most popular national policy after independence. Arusha declaration proclaims socialism and self-reliance, which has had important impact on the form and content of the present country's health policy in mainland Tanzania. Much of the wide-spread health care services infrastructure that is evident now in rural areas of Tanzania mainland is a result of the re-emphasis of the Arusha declaration in 1971. In Tanzania, the Ministry of Health has the responsibility for elaborating the health policy, ensuring that strategies and appropriate program are developed to give effect to the policy. In the present health policy discussed, the goal is seen to have shifted from having one dispensary in each village to one primary health unit in each village. One dispensary is intended to serve several villages together. In Tanzania, according to the present health policy, the village primary health care are mainly preventive oriented and only being managed by short term trained health staff. The candidate for training in each village is selected, among the village residents, by the villagers themselves. The primary health care system adopted by Tanzania is viewed as the only way through which it can achieve the social goal of health for everyone by the year 2000, provided the present political will which is evident continue, and enough availability of, human, financial and material resources.(ABSTRACT TRUNCATED AT 250 WORDS)

Delivery of Health Care↗
PubMed1990

Present health situation in Tanzania.

This article discusses the present health situation in Tanzania, however, health system before independence, the colonial health system, has been the foundation on which the present health services in Tanzania are built upon. The population growth in Tanzania is high (3.2% in 1986), and projected to be 3.7% by the year 2,000. This high growth explains why it is difficult to achieve health objectives on the long term basis. Compounded to this is the economical crisis in the country. Child population in Tanzania account for about 47% of the total population in 1986. Maternal and Child Health Care services (MCHC) are discussed, with much emphasis on the child health care problems, and different programmes involved in improving child health care in the country. Problems of poor environmental sanitation are discussed including possible solutions for Tanzania. Tanzania, in this article, is urged to strengthen the existing health services in terms of staff, drugs, other supplies and equipment in order to give adequate health care to its people. Tanzania should also balance the distribution of resources between urban and rural so as to comply with the objective of the national health policy of comprehensive basic health services equitably to all within the limited available resources and to be able to reach the ultimate goal of health for all the people in the country by the year 2,000.

Child↗
PubMed1994

The persistence of genetic homogeneity among Trypanosoma brucei rhodesiense isolates from patients in north-west Tanzania.

Trypanosomes isolated during 1991 from nine patients with Rhodesian sleeping sickness in north-west Tanzania were genetically characterized by electrophoresis of ten enzymes. Eight isolates were allocated to a known zymodeme (Z306); another had an enzyme profile (Z379) not previously encountered. An example of Z306 has been previously isolated in 1971, nearby in a part of Rwanda adjacent to the border with Tanzania; in addition, a closely related isolate, in Z307, was collected in 1959 from a patient in north-west Tanzania. The new zymodeme (Z379) was 94% similar to Z306, and both had a close similarity of 89% to Z307. All these isolates belonged to the zambezi strain group of related zymodemes, and evidence is presented that other examples of the group have been collected from man in Tanzania since 1959. Such apparent long term genetic stability is similar to circumstances further south in an endemic area of Zambia, where 12 examples of Z306 and two of Z307 were acquired over a period of 12 years from patients. The similar genetic homogeneity among trypanosomes in endemic parts of both Tanzania and Zambia contrasted markedly with the heterogeneity described to the north of Tanzania in that different strain groups circulate in epidemic areas of Kenya and Uganda.

Animals↗
PubMed2005

The molecular epidemiology of Mycobacterium bovis infections in Tanzania.

A molecular epidemiological study to determine the zoonotic importance of bovine tuberculosis was carried out in Tanzania. Specimens from human cases of tuberculosis as well as from slaughtered cattle were collected from regions with a high proportion of extrapulmonary tuberculosis. In order to determine the similarity of strains from the two sources, molecular typing techniques, namely RFLP and spoligotyping, were used to determine the genetic profile of the strains involved. The results of pTBN12 typing of M. bovis from cattle and man has shown a rather heterogeneous population of this species spread all over Tanzania, assuming that the present sample is representative. There were 13 different pTBN12 RFLP types encountered. The genetic relatedness between the pTBN12 RFLP patterns indicated a high degree of relatedness (86%) between the dominant pTBN12 genotypes existing in Tanzania. There were 13 different spoligotypes found in this study, whose genetic relatedness was also high (79%). DNA profiles were also confirmed by IS986 RFLP, which revealed that strains have 1-13 copies of IS986. Geographically, there was overlap between pTBN12 RFLP and spoligotypes amongst strains isolated from various parts of Tanzania. The diversity of the RFLP and spoligotype patterns observed in Tanzania probably reflects the extensive internal movements of cattle belonging to pastoralists. The evidence of overlap between DNA fingerprints of M. bovis from cattle and man has once more highlighted a need for synergy of veterinary and medical policies in the control of tuberculosis in Tanzania and probably in other developing countries.

Animals↗
PubMed1999

Neuropathology of human immunodeficiency virus 1 infection. Significance of studying in forensic autopsy cases at Dar es Salaam, Tanzania.

OBJECTIVE: In sub-Saharan Africa, only a few studies of neurologic complications of human immunodeficiency virus 1 (HIV-1) infection have been done. The authors studied neuropathology of HIV-1 infection in Tanzania. DESIGN: Forensic autopsy study at Dar es Salaam, Tanzania. SETTING: A joint research project between Dar es Salaam, Tanzania, and Kumamoto, Japan. PATIENTS: Thirty patients with risk factors for HIV-1 infection. MAIN OUTCOME MEASURES: Human immunodeficiency virus 1 infection was evaluated by HIV-1 antibody test on postmortem serum samples. The brains of HIV-1-infected persons were studied histopathologically. RESULTS: Infection with HIV-1 was identified on postmortem serum samples in 10 of 30 forensic autopsy cases. Neuropathologic changes of the brain were observed in 8 of the 10 HIV-1-infected persons; these changes consisted of lymphocytic meningitis, bacterial meningoencephalitis, cryptococcal meningoencephalitis, tuberculous meningitis with brain abscesses, and intracerebral hemorrhage. CONCLUSIONS: Because none of the persons studied was suspected to have had brain diseases before autopsy, the results suggest that brain diseases of HIV-1-infected patients are likely to go unrecognized in Tanzania. In addition, the high incidence of neuropathologic findings in HIV-1-infected persons indicates that HIV-1-related brain diseases are common in Tanzania, as they are in developed countries. Further forensic autopsy study will determine the range and prevalence of brain complications and have immediate impact on the management of HIV-1-infected patients in Tanzania and other developing countries.

AIDS Dementia Complex↗
PubMed1993

The current epidemiology and control of trypanosomiasis and other zoonoses in Tanzania.

The epidemiology and control strategies of African trypanosomiasis, plague, rabies, brucellosis, anthrax and hydatidosis, the most important and well documented zoonotic diseases in Tanzania, have been described. Bovine tuberculosis, tetanus, taeniosis, trichinosis and tungosis are also endemic in some parts of the country but records of their incidences are not available. Initial outbreaks of trypanosomiasis in Tanzania were caused by Trypanosoma gambiense which originated from West Africa and reached Tanzania via Zaire around 1902. T. rhodesiense which is currently responsible for human trypanosomiasis in Tanzania was introduced from Mozambique around 1910 and quickly spread to many parts of the country. The disease is currently prevalent in the western, north and northwestern parts, the southern highlands and southern regions. Over 6000 cases have reported since 1979. Control strategies against sleeping sickness in Tanzania include chemical control of vectors, treatment of patients with trypanocides and avoidance of humantsetse contact. Plague is mostly endemic in central, northern and north-eastern Tanzania. A total of 8161 cases with 1885 deaths have been recorded since 1890. The disease is currently prevalent in Lushoto district where outbreaks have been experienced since 1980, and in Singida district where it has been endemic since 1918. Integrated control measures are currently applied and were possibly responsible for the 1989 decline of outbreaks in the area. Financial constraints which led to deterioration of control activities from July 1989 probably accounted for the severe outbreaks in 1990/91 which spread to other parts of the country. Rabies is endemic country-wide except in Mtwara, Lindi and Zanzibar. Domestic dogs are the principal transmitters and prompt vaccination and destruction of unvaccinated stray dogs are the main control measures. Brucellosis is widely endemic in livestock and potentially so in humans. Destruction of infected animals, immunisation of susceptible ones, proper boiling of milk and its products and chemotherapy are the currently applied control measures against the disease. Anthrax and hydatidosis are sparsely endemic in the country, and they are mostly controlled by appropriate meat inspection and consequent condemnation and proper disposal of the affected meat. Vaccination and treatment of animals are also effective against anthrax.

Animals↗
PubMed2006

Mitogenomic analysis for coelacanths (Latimeria chalumnae) caught in Tanzania.

In recent years, a large number of individuals of the species Latimeria chalumnae, one of the living fossil coelacanths, have been landed off the coast of Tanzania. Although L. chalumnae specimens have also been landed at other localities in the western Indian Ocean, so far, viable populations of this species have been identified only at two localities, Comoros and South Africa. Therefore, the recent active catch off Tanzania suggests a new habitat for L. chalumnae. To examine the genetic background of the Tanzanian fish, we analyzed complete mtDNA sequences of two Tanzanian individuals (Kigombe-9 and Songo Mnara-1) collected from the north and south coasts of Tanzania. Using the recently reported criteria for six haplotypes established in a population genetic study for coelacanths living in the western Indian Ocean [Schartl, M., Hornung, U., Hissman, K., Schauer, J., Fricke, H., 2005. Relatedness among east African coelacanths. Nature 435, 901.], we characterized Songo Mnara-1 as haplotype 1 and Kigombe-9 as haplotype 5. We suggest that the Songo Mnara specimen is a member of the Comoran group, but was swept away by the South Equatorial current. The individual from Kigombe may be a member of an undiscovered population that exists near the boundary between Tanzania and Kenya. Further analysis using more than 19 individuals recently captured off the north coast of Tanzania will reveal whether a new population exists there. Our sequence data suggest additional variable sites in the mtDNA sequence that may define the population structure of coelacanths in the western Indian Ocean and also raise the possibility that the previously published Comoran coelacanth mtDNA sequence contains several critical errors including base changes and indels.

Animals↗
PubMed2000

Cost-effectiveness of voluntary HIV-1 counselling and testing in reducing sexual transmission of HIV-1 in Kenya and Tanzania.

BACKGROUND: Access to HIV-1 voluntary counselling and testing (VCT) is severely limited in less-developed countries. We undertook a multisite trial of HIV-1 VCT to assess its impact, cost, and cost-effectiveness in less-developed country settings. METHODS: The cost-effectiveness of HIV-1 VCT was estimated for a hypothetical cohort of 10000 people seeking VCT in urban east Africa. Outcomes were modelled based on results from a randomised controlled trial of HIV-1 VCT in Tanzania and Kenya. Our main outcome measures included programme cost, number of HIV-1 infections averted, cost per HIV-1 infection averted, and cost per disability-adjusted life-year (DALY) saved. We also modelled the impact of targeting VCT by HIV-1 prevalence of the client population, and the proportion of clients who receive VCT as a couple compared with as individuals. Sensitivity analysis was done on all model parameters. FINDINGS: HIV-1 VCT was estimated to avert 1104 HIV-1 infections in Kenya and 895 in Tanzania during the subsequent year. The cost per HIV-1 infection averted was US$249 and $346, respectively, and the cost per DALY saved was $12.77 and $17.78. The intervention was most cost-effective for HIV-1-infected people and those who received VCT as a couple. The cost-effectiveness of VCT was robust, with a range for the average cost per DALY saved of $5.16-27.36 in Kenya, and $6.58-45.03 in Tanzania. Analysis of targeting showed that increasing the proportion of couples to 70% reduces the cost per DALY saved to $10.71 in Kenya and $13.39 in Tanzania, and that targeting a population with HIV-1 prevalence of 45% decreased the cost per DALY saved to $8.36 in Kenya and $11.74 in Tanzania. INTERPRETATION: HIV-1 VCT is highly cost-effective in urban east African settings, but slightly less so than interventions such as improvement of sexually transmitted disease services and universal provision of nevirapine to pregnant women in high-prevalence settings. With the targeting of VCT to populations with high HIV-1 prevalence and couples the cost-effectiveness of VCT is improved significantly.

AIDS Serodiagnosis↗
PubMed2005

The impact of demand factors, quality of care and access to facilities on contraceptive use in Tanzania.

The low contraceptive prevalence rate and the existence of unmet demand for family planning services present a challenge for parties involved in family planning research in Tanzania. The observed situation has been explained by the demand-side variables such as socioeconomic characteristics and cultural values that maintain the demand for large families. A small, but growing body of research is examining the effect of supply-side factors such as quality of care of family planning services on the demand for contraceptives. This paper analyses the demand and supply factors determining contraceptive use in Tanzania using the Tanzania Service Availability Survey (1996) and the Tanzania Demographic and Health Survey (1996) data sets. The results show that access to family planning services and quality of care of services are important determinants of contraceptive use in Tanzania even after controlling for demand-side factors.

Adolescent↗
PubMed2000

Nutritional composition and micronutrient status of home made and commercial weaning foods consumed in Tanzania.

About 50% of young children in Tanzania suffer from protein-energy undernutrition (PEU) while more than 45% of children under the age of five suffer from various micronutrient deficiency disorders. The immediate cause of these conditions is inadequate intake and poor utilization of nutrients, which begins in the weaning period and amplifies in the subsequent years. This study was conducted to assess the potential of some home made and commercial weaning foods commonly consumed in Tanzania to supply adequate amounts of both macro- and micronutrients as recommended in the Tanzania and FAO/WHO Codex Alimentarius Standards for cereal/milk-based weaning foods. Six types of home made weaning foods, maize, cassava, millet, sorghum and millet-sardine-peanut composite gruels and plantain pap, and four types of commercial weaning foods, Cerelac- 1, Cerelac-2, Lactogen-1 and Lactogen-2, popularly consumed in Tanzania, were chemically assayed for proximate composition, energy and mineral density. Results of the study indicated that, both the home made and commercial weaning foods were good sources of macro- and micronutrients. When compared with the Codex Alimentarius and Tanzania Bureau of Standards specifications for weaning foods, both home made and commercial weaning foods had some shortcomings in terms of nutrient composition and energy balance. Many of the foods were low in fat. Fe, Ca, Zn and P but high in crude fiber, carbohydrate and magnesium. Ca, Fe and Zn were the most common deficient macro/micronutrients in the home made weaning foods. In spite of these shortcomings, most of the home made and commercial weaning foods were nutritionally sound since they could provide reasonable percentages of the recommended daily allowances for macro/micronutrients and energy. It is suggested that, more efforts must be directed towards increasing the concentration of Ca, Fe and Zn in the home made weaning foods through supplementation of the starchy staples with mineral rich foods. Meanwhile, the parents, caretakers and health workers should be educated on the selection and preparation of nutritious, balanced weaning foods and good weaning practices.

Animals↗
PubMed2005

Molecular biodiversity of cassava begomoviruses in Tanzania: evolution of cassava geminiviruses in Africa and evidence for East Africa being a center of diversity of cassava geminiviruses.

Cassava is infected by numerous geminiviruses in Africa and India that cause devastating losses to poor farmers. We here describe the molecular diversity of seven representative cassava mosaic geminiviruses (CMGs) infecting cassava from multiple locations in Tanzania. We report for the first time the presence of two isolates in East Africa: (EACMCV-[TZ1] and EACMCV-[TZ7]) of the species East African cassava mosaic Cameroon virus, originally described in West Africa. The complete nucleotide sequence of EACMCV-[TZ1] DNA-A and DNA-B components shared a high overall sequence identity to EACMCV-[CM] components (92% and 84%). The EACMCV-[TZ1] and -[TZ7] genomic components have recombinations in the same genome regions reported in EACMCV-[CM], but they also have additional recombinations in both components. Evidence from sequence analysis suggests that the two strains have the same ancient origin and are not recent introductions. EACMCV-[TZ1] occurred widely in the southern part of the country. Four other CMG isolates were identified: two were close to the EACMV-Kenya strain (named EACMV-[KE/TZT] and EACMV-[KE/TZM] with 96% sequence identity); one isolate, TZ10, had 98% homology to EACMV-UG2Svr and was named EACMV-UG2 [TZ10]; and finally one isolate was 95% identical to EACMV-[TZ] and named EACMV-[TZ/YV]. One isolate of African cassava mosaic virus with 97% sequence identity with other isolates of ACMV was named ACMV-[TZ]. It represents the first ACMV isolate from Tanzania to be sequenced. The molecular variability of CMGs was also evaluated using partial B component nucleotide sequences of 13 EACMV isolates from Tanzania. Using the sequences of all CMGs currently available, we have shown the presence of a number of putative recombination fragments that are more prominent in all components of EACMV than in ACMV. This new knowledge about the molecular CMG diversity in East Africa, and in Tanzania in particular, has led us to hypothesize about the probable importance of this part of Africa as a source of diversity and evolutionary change both during the early stages of the relationship between CMGs and cassava and in more recent times. The existence of multiple CMG isolates with high DNA genome diversity in Tanzania and the molecular forces behind this diversity pose a threat to cassava production throughout the African continent.

Base Sequence↗
PubMed2001

Incidence and characteristics of Myasthenia gravis in Dar Es Salaam, Tanzania.

OBJECTIVE: To ascertain the annual incidence and characterise the clinical features of Myasthenia gravis in Dar es Salaam, Tanzania during a ten-year period from 1st January 1988 to 31 December 1998. DESIGN: Prospective cumulative registration at a major urban hospital of all patients with newly diagnosed Myasthenia gravis who were resident in Dar es salaam. SETTING: Muhimbili Medical Centre Teaching Hospital, Dar es Salaam, Tanzania. SUBJECTS: Forty seven patients, twenty males, twenty seven females satisfied the criteria for the diagnosis of Myasthenia gravis (MG). RESULTS: The annual incidence of MG of both sexes was 3 per 1,000,000 population of all age groups (95% CI 2.0 to 3.6). The incidence per 1,000,000 population was lowest in those aged below ten years 2.2 (95% CI 1.4 to 3.4) which was statistically significant. The incidence per 1,000,000 per year was higher in females but this was not statistically significant. The clinical presentation of MG in Tanzania was localised disease accounting for 47% ocular type and 53% was mild to moderately severe generalised type MG. Twenty per cent of patients with generalised MG presented with bulbar features. Single fibre electromyography was the most sensitive test. CONCLUSION: Myasthenia gravis is fairly rare in Tanzania as is in other sub-Saharan countries and presents in similar way to European in terms of age, sex, and clinical features. Ocular Myasthenia gravis was more prevalent in Tanzania than in Europe.

Adolescent↗
PubMed1987

Prevalence of HIV infection in healthy subjects and groups of patients in Tanzania.

During 1986 sera from 2508 individuals representing various groups of healthy subjects and patients in Dar es Salaam (the capital city of Tanzania), Bukoba (the capital of Kagera region in the northwest corner of Tanzania), Arusha (in the northeast of Tanzania) and Mbeya (in the southwest of Tanzania) were screened for antibodies to HIV by enzyme-linked immunosorbent assay (ELISA). All ELISA-positive sera were also tested by Western blot analysis. In Dar es Salaam HIV antibodies were demonstrated in 3.6% of 192 pregnant women, 5.2% of 784 blood donors, 29.0% of 224 barmaids, 8.0% of 50 male bar workers, 9.25% of 400 male and 12.2% of 90 female patients attending a clinic for sexually transmitted diseases (STDs), 85.7% of 35 patients with herpes zoster and in 97.6% of 84 patients clinically suspected of AIDS. Among the barmaids the seropositivity rate was higher in younger women (45%) than in middle-aged women (11%). Only three (4.6%) out of 65 HIV-seropositive barmaids had HIV-related symptoms. The prevalence of HIV seropositivity among healthy low-risk subjects was highest in Bukoba, namely 16% of 100 pregnant women and 13.9% of 36 blood donors, while in Arusha only one (0.7%) of the 144 pregnant women and none of 41 bar workers, none of 42 blood donors and none of 61 patients with STD were positive. In Mbeya, 3.4% of 118 pregnant women and 11.8% of 34 men with STD were seropositive. Thus the prevalence of HIV infection differs considerably in various population groups and in various parts of Tanzania.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Human resources for emergency obstetric care in northern Tanzania: distribution of quantity or quality?

BACKGROUND: Health care agencies report that the major limiting factor for implementing effective health policies and reforms worldwide is a lack of qualified human resources. Although many agencies have adopted policy development and clinical practice guidelines, the human resources necessary to carry out these policies towards actual reform are not yet in place. OBJECTIVES: The goal of this article is to evaluate the current status of human resources quality, availability and distribution in Northern Tanzania in order to provide emergency obstetric care services to specific districts in this area. The article also discusses the usefulness of distribution indicators for describing equity in the decision-making process. METHODS: We conducted a quantitative facility survey in six districts of Northern Tanzania. We collected data from all 129 facilities that provide delivery services in the study area. The data includes information on the emergency obstetric care indicators, as described by the WHO/UNICEF/UFPA guidelines for monitoring the provision of obstetric care. The inventory also includes information on the numbers of qualified health personnel at the basic and comprehensive emergency obstetric care level. We analysed the distribution and workload of the available human resources in a wider policy context with a particular focus on equity, use and quality, by means of descriptive statistics and the Spearman's correlation test. RESULTS: We determined that there are adequate human resources allocated for health care provision in Tanzania, according to national standards. Compared to similar countries however, Tanzania has a very low availability of health care staff. Most qualified staff are concentrated in a few centralized locations, while those remaining are inequitably and inefficiently distributed in rural areas and lower-level services. Rural districts have restricted access to government-run health care, because these facilities are understaffed. In fact, voluntary agency facilities in these districts have more staff than the government facilities. There is a statistical correlation between availability of qualified human resources and use of services, but the availability of qualified human resources does not automatically translate into higher availability of qualified emergency obstetric care services. CONCLUSION: National guidelines for human resources for health care in Tanzania require focused revisions in order to reflect the quality indicators more adequately when monitoring and setting criteria for HR distribution. Availability of qualified personnel as well as institutional management and capacity determine the quality of emergency obstetric care services and personnel. The current wide distribution of staff of inadequate quality should be reconsidered. The use of distribution indicators alone is not useful to properly monitor equity. This article suggests increasing access to high-quality health care instead of distributing low-quality services widely.

Journal Article↗