scholarly journals Policies, Multi-Stakeholder Approaches and Home-Grown School Feeding Programs for Improving Quality, Equity and Sustainability of School Meals in Northern Tanzania

2021 ◽  
Vol 5 ◽  
Author(s):  
Ralph Roothaert ◽  
Hosea Mpogole ◽  
Danny Hunter ◽  
Justus Ochieng ◽  
Dyness Kejo

Malnutrition among children of school-going age is a challenge of serious concern in developing countries especially Sub-Saharan Africa. Many programs focus on mothers and under-5-year-old children, leaving the school going age unattended. It has been shown that school meals can reduce school absenteeism, improve concentration in class and reduce early dropouts. In Tanzania, successful home-grown school feeding programs are localized in few areas but have not been scaled-out. The objective of this study was to analyze the policy and organizational environment which enables or promotes home-grown school feeding approaches. The study consisted of a systematic review, key informant interviews and focus group discussions in Arumeru and Babati Districts, Tanzania. In total, 21 key informant interviews with 27 participants and 27 focus group discussions with 217 participants were conducted. The results show that Tanzania lacks a clear policy on school feeding; there are no guidelines for school meal quality, participation in school feeding programs is not mandatory, leading to many students being left out and going hungry. Students in private schools tend to be better off than those in public schools in terms of provision and quality of school meals. We recommend that policies and practices are developed based on positive experiences of home-grown school feeding programs implemented in Tanzania by the World Food Programme and Project Concern International and emphasize that these policies need to be developed in a multi-sectoral manner. A conceptual framework for improving home-grown school feeding in public schools in Tanzania highlights four critical components: leadership and public awareness; operational modalities; contributions from parents; and meal diversity and nutrition. The home-grown school feeding model provides mechanisms to improve diversity of meals and their nutritional value, increase participation of communities and inclusion of students. Parents will still be responsible for the largest part of food supplies, but the model also requires participation of multiple stakeholders, and provision of natural resources such as land and water by the local government for production of nutritious food for young students. Minimum levels of social protection are recommended to ensure that no student is denied school meals.

2014 ◽  
Vol 47 (4) ◽  
pp. 505-520 ◽  
Author(s):  
SIMON MUHUMUZA ◽  
ANNETTE OLSEN ◽  
FRED NUWAHA ◽  
ANNE KATAHOIRE

SummaryDespite attempts to control intestinal schistosomiasis through school-based mass drug administration (MDA) with praziquantel using school teachers in Uganda, less than 30% of the school children take the treatment in some areas. The aim of the study was to understand why the uptake of praziquantel among school children is low and to suggest strategies for improved uptake. This was a cross-sectional qualitative study in which 24 focus group discussions and 15 key informant interviews were conducted 2 months after MDA. The focus group discussions were held with school children in twelve primary schools and the key informant interviews were held with school teachers, sub-county health assistants and the District Vector Control Officer. The study shows that the low uptake of praziquantel among school children is a result of a complex interplay between individual, interpersonal, institutional, community and public policy factors. The individual and interpersonal factors underpinning the low uptake include inadequate information about schistosomiasis prevention, beliefs and attitudes in the community about treatment of schistosomiasis and shared concerns among children and teachers about the side-effects of praziquantel, especially when the drug is taken on an empty stomach. The institutional, policy and community factors include inadequate preparation and facilitation of teachers and the school feeding policy, which requires parents to take responsibility for providing their children with food while at school, yet many parents cannot meet the cost of a daily meal due to the prevailing poverty in the area. It is concluded that strategies to improve uptake of praziquantel among school children need to be multi-pronged addressing not only the preparation and motivation of teachers and health education for children, but also the economic and political aspects of drug distribution, including the school feeding policy.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mulugeta Dile Worke ◽  
Zewdie Birhanu Koricha ◽  
Gurmesa Tura Debelew

Abstract Background Workplace sexual harassment is a public health problem that depends on gender, context, and perceived ideology. Although studies have documented the prevalence and consequences of workplace sexual harassment worldwide, victims’ perceptions and experiences are still poorly understood in low and middle-income countries, particularly Ethiopia. Female workers in the hospitality industry, including hotels, bars, restaurants, fast-food restaurants, and cafeterias, are particularly affected. Hence, this study aimed to explore sexual harassment perceptions and experiences among women working in these workplaces. Methods An exploratory qualitative study was conducted from 1 January to 30 August 2019. Data were collected from female employees and key informants from several hospitality workplaces in Bahir Dar City. Data were collected through focus group discussions, in-depth interviews, and key-informant interviews. Women who experienced sexual harassment were selected using the snowball method, and key informants were recruited purposefully. Six focus group discussions, ten in-depth interviews, and thirteen key informant interviews were conducted. Data were analysed using the ATLAS ti version 8.4.24. Results In this study, most participants perceived that sexual harassment is pressuring, threatening, touching, abducting sexual advances, and experiencing verbal, physical, and non-verbal types. Similarly, the perceived risk factors were related to the organisations, the customers, and the victims, with the consequences being work-related, health-related, financial-related, and family-related. Conclusions Workplace sexual harassment in hospitality workplaces is poorly understood, but many women experience it. A variety of factors also caused it, and it influenced both organisations and people. Public awareness programs, pre-service preparation, in-service training, prevention, and psychosocial support are needed. Similarly, policies and strategies for the organisations should be developed and implemented.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patience A. Muwanguzi ◽  
Robert C. Bollinger ◽  
Stuart C. Ray ◽  
LaRon E. Nelson ◽  
Noah Kiwanuka ◽  
...  

Abstract Background Men in Sub-Saharan Africa are less engaged than women in accessing HIV testing and treatment and, consequently, experience higher HIV-related mortality. Reaching men with HIV testing services is challenging, thus, increasing the need for innovative ways to engage men with low access and those at higher risk. In this study, we explore men’s perceptions of drivers and barriers of workplace-based HIV self-testing in Uganda. Methods An exploratory study involving men working in private security companies employing more than 50 men in two districts, in central and western Uganda. Focus group discussions and key informant interviews were conducted. Data were analyzed using inductive content analysis. Results Forty-eight (48) men from eight private security companies participated in 5 focus group discussions and 17 key informant interviews. Of the 48 men, 14(29.2%) were ages 26–35 years. The majority 31(64.6%) were security guards. The drivers reported for workplace-based HIV self-testing included convenience, autonomy, positive influence from work colleagues, the need for alternative access for HIV testing services, incentives, and involvement of employers. The barriers reported were the prohibitive cost of HIV tests, stigma, lack of testing support, the fear of discrimination and isolation, and concerns around decreased work productivity in the event of a reactive self-test. Conclusions We recommend the involvement of employers in workplace-based HIV self-testing to encourage participation by employees. There is need for HIV self-testing support both during and after the testing process. Both employers and employees recommend the use of non-monetary incentives, and regular training about HIV self-testing to increase the uptake and acceptability of HIV testing services at the workplace.


2015 ◽  
Vol 15 (2) ◽  
pp. 51-56
Author(s):  
Dinesh Ghimire ◽  
Jagannath Shrestha ◽  
Anup K.C

This study presents the potentiality of biogas plants and their role for the conservation of environment. It is basedon primary data collected from 84 household surveys, 6 key informant interviews and two focus group discussions. It was observed that more than 95% of the people residing in the VDCs were using firewood as a main source ofenergy. The total amount of firewood consumed was 510.570 ton/year which emits 775.052tCO2e/year. Due to the presence of agriculture based livestock holding population, there is a great potential of biogas technology. Thestudy showed that biogas technology could saved 34.40% of firewood which conserves 5.415 ha of forests area. There is a potentiality of 58 biogas plants of size 6 cu.m which will reduce 440.800 tCO2e/year.DOI: http://dx.doi.org/njst.v15i2.12114Nepal Journal of Science and Technology Vol. 15, No.2 (2014) 51-56


2021 ◽  
Author(s):  
Aliya Karim ◽  
Don de Savigny ◽  
Serge Ngaima ◽  
Daniel Mäusezahl ◽  
Daniel Cobos Muñoz ◽  
...  

BACKGROUND Integrated community case management (iCCM) is a child health program designed to provide integrated, community-based care for pneumonia, malaria and diarrhea for children in hard-to-reach areas of low- and middle-income countries (LMICs). The foundation of the intervention is service-delivery by community health workers (CHWs) who depend on reliable provision of drugs and supplies, consistent supervision, comprehensive training, and community acceptance and participation to perform optimally. The effectiveness of the program may also depend on a number of other elements, including an enabling policy environment, financing mechanisms from the national to the local level, data transmission systems, and appropriate monitoring and evaluation. The extent to which these factors act upon each other to influence the effectiveness and viability of iCCM is both variable and challenging to assess, especially across different implementation contexts. OBJECTIVE In this paper, we describe a mixed-methods systems-based study protocol to assess the programmatic components of iCCM which are associated with intervention effectiveness, and report preliminary results of data collection. METHODS This protocol employs a mixed qualitative and quantitative study design based on a Systems Thinking approach within four iCCM programs in Malawi, Democratic Republic of the Congo, Niger State, and Abia State, Nigeria. Routine monitoring data is collected to determine intervention effectiveness, namely testing, treatment and referral outcomes. Surveys with CHWs, supervisors, and caregivers are performed to collect quantitative data on their demographics, activities, and experiences within the program, and how these relate to the areas of intervention effectiveness. Focus group discussions are conducted with these stakeholders as well as local traditional leaders to contextualize this data. Key informant interviews are undertaken with national and district-level program stakeholders and officers knowledgeable in critical program processes. RESULTS We performed 3,836 surveys and 45 focus group discussions with CHWs, supervisors, and caregivers, and traditional leaders; 120 key informant interviews with district and national-level program managers, health officers, and ministry officials. Policy and program documents were additionally collected for review. CONCLUSIONS Evidence from this study will inform child health programs and practice in low- and middle-income settings, and future policy development within the iCCM intervention.


2018 ◽  
Vol 10 (3) ◽  
pp. 261-273
Author(s):  
M. I. Khan ◽  
M. M. Islam ◽  
G. K. Kundu ◽  
M. S. Akter

The Padma is the second longest and one of the trans-boundary rivers of Bangladesh that significantly contributes to fisheries production and supports the fishers’ livelihoods. This study assesses the livelihood characteristics of the Padma river-dependent migratory and non-migratory fishers, employing household interviews, focus group discussions (FGDs), and key informant interviews from July to October, 2015. All migratory fishers were full-time fishers, whereas, non-migratory fishers included full time (88.89%), part-time and occasional fishers (11.11%). Maximum fishers were belonging to the age group of 31 to 50 years of which 94.74% were migratory and 57.4% were non-migratory fishers. Half of the migratory and non-migratory fishers were illiterate. 89.47% migratory fishers used river water for drinking and other purposes, whereas, 94.44% non-migratory fishers used tube-well water. Average annual incomes of both migratory (58%) and non-migratory (65%) fishers ranged from Tk. 30,000 to 60,000, whereas 26% migratory and 5% non-migratory fishers had average annual incomes above Tk. 60,000. The overall livelihood status of the migratory and non-migratory fishers was not satisfactory as they have faced problems like conflicts with elite groups for resources, lack of fish preservation facilities. Effective initiatives and their proper implementations are very crucial to develop the Padma river fisher’s livelihood conditions.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e034668
Author(s):  
Helen M Nabwera ◽  
Jemma L Wright ◽  
Manasi Patil ◽  
Fiona Dickinson ◽  
Pamela Godia ◽  
...  

​ObjectiveTo explore the experiences of using continuous positive airway pressure (CPAP) in newborn care among healthcare workers in Kenya, and to identify factors that would promote successful scale-up.​Design and settingA qualitative study using key informant interviews and focus group discussions, based at secondary and tertiary level hospitals in Kenya.​ParticipantsHealthcare workers in the newborn units providing CPAP.​Primary and secondary outcome measureFacilitators and barriers of CPAP use in newborn care in Kenya.​Results16 key informant interviews and 15 focus group discussions were conducted across 19 hospitals from September 2017 to February 2018. Main barriers reported were: (1) inadequate infrastructure to support the effective delivery of CPAP, (2) shortage of skilled staff rendering it difficult for the available staff to initiate or monitor infants on CPAP and (3) inadequate knowledge and training of staff that inhibited the safe care of infants on CPAP. Key facilitators reported were positive patient outcomes after CPAP use that increased staff confidence and partnership with caregivers in the management of newborns on CPAP. Healthcare workers in private/mission hospitals had more positive experiences of using CPAP in newborn care as the relevant support and infrastructure were available.​ConclusionCPAP use in newborn care is valued by healthcare workers in Kenya. However, we identified key challenges that threaten its safe use and sustainability. Further scale-up of CPAP in newborn care should ensure that staff members have ready access to optimal training on CPAP and that there are enough resources and infrastructure to support its use.EthicsThis study was approved through the appropriate ethics committees in Kenya and the UK (see in text) with written informed consent for each participant.


2000 ◽  
Vol 13 (1) ◽  
pp. 6-15 ◽  
Author(s):  
J. Gupta ◽  
H. Gupta

Mortality associated with complications of pregnancy and childbirth remains disproportionately high in the developing world. This paper reports on a study into the reasons for the poor uptake of referrals to specialist medical units in a group of 276 women in a rural area in the state of Rajasthan, India. Of the 276 cases that were referred, 242 (88%) of the women failed to attend for specialist consultation. In-depth personal interviews were conducted and a series of focus group discussions was held with the women and with their spouses and spouses' mothers. A range of geographic, cultural, socio–economic and medico–administrative factors was identified as influencing decisions to attend referral units. Recommendations for improving uptake include improving facilities at referral units, providing additional training for healthcare staff (covering technical, managerial and behavioural aspects) and in counselling techniques, a better defined role for traditional birth attendants, improved understanding of the mother's needs by her family (particularly the spouse and his mother) and increasing public awareness of the importance of referral. Finally, there is the requirement that women are encouraged to realize and understand their own needs.


2021 ◽  
Vol 3 (5) ◽  
pp. 26-30
Author(s):  
Annet Aromo Khachula ◽  
Lucy Mandillah ◽  
Bernard Angatia Mudogo

Languages have different concepts for conveying meanings; hence there is a problem in finding equivalents between the source language (SL) and the target language (TL) in the process of interpreting. The transfer of meaning is identified as one of the basic problems in interpreting due to the absence of equivalence between two languages. This paper identifies levels of equivalence in the interpretation of selected sermons from English into Luhya varieties. Data was collected through key-informant interviews of interpreters, Focus Group Discussions by the congregants, and the researcher’s non-participant observation during church services. An audio recorder was used to collect the corpus for analysis which was later transcribed and translated for analysis. Relevance Theory by Sperber and Wilson (1986) provided the background for the discussion of the data. The findings revealed the following levels of equivalence in the interpretation of English sermons into Luhya varieties; one to many, one to part-of-one and nil equivalence. Further, it was also revealed that interpreters need to identify these three levels of equivalence in interpreting English sermons into Luhya varieties to determine the appropriate measures to counteract the situation.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245289
Author(s):  
Aiggan Tamene ◽  
Abel Afework

Background Even though evidence shows that access to and use of improved latrines is related to healthful families and the public, obstacles to the adoption and use of improved latrine facilities remain. Globally, not many inquiries appear to have been carried out to satisfactorily inform us regarding the multi-level barriers influencing the adoption and utilization of improved latrines facilities. Related studies in Ethiopia are even fewer. Methods Two qualitative data gathering methods, viz., key informant interviews and focus group discussions, were employed to collect data for this study. A total of fifteen focus group discussions were conducted with members of the community in the rural Wonago district of Ethiopia. Similarly, ten key informant interviews were conducted with water, sanitation, and hygiene officers, and health extension workers responsible for coordinating sanitation and hygiene activities. Open code software 4.03 was used for thematic analysis. Result Barriers to adoption and use of improved latrine facilities were categorized into Contextual factors (e.g. Gender, educational status, personal preference for using the field, limited space, population density, the status of land ownership), Psychosocial factors (Culture, beliefs, attitudes, and perceptions of minimal health threat from children's feces), and Technological factors (inconveniences in acquiring materials and cost of constructing a latrine). Conclusion There are a series of multi-leveled barriers to the sustained adoption and use of latrines. Providing funding opportunities for the underprivileged and offering training on the engineering skills of latrine construction at the community level based on the contextual soil circumstances could expand the latrine coverage and use. Similarly, taking into account the variability in motivations for adopting and using latrines among our study in Ethiopia and other studies, we implore public health experts to recognize behaviors and norms in their target communities in advance of implementing sanitation interventions.


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