Perceptions of School Management on the Relationship between School Nutrition and Development of Non-Communicable Diseases in a Rural South African District: A Qualitative Study

Globally, noncommunicable diseases (NCDs) were responsible for 41 million deaths in 2016, with the majority of these occurring in low- and middle-income countries. These diseases are on the rise as a result of unhealthy, low-quality, and unbalanced diets, which have resulted in overweight and obesity. The National School Nutrition Program (NSNP) was created to regulate the foods sold to schoolchildren. The aim of this study was to ascertain school management teams’ perspectives on the relationship between the NSNP and the development of lifestyle diseases. A phenomenological qualitative study using focus group discussions among 16 purposively selected members of the school management teams were conducted in Mt Frere, Eastern Cape in 2016. The narrative data were analyzed using Tesch’s eight-phase thematic analysis approach. The data analysis revealed two themes (NSNP and the vendor system) and six sub-themes. The NSNP was viewed as making a significant contribution to children’s food security, thereby improving academic output. However, reengineering of the NSNP was needed through improved budgeting and inclusion of breakfast in the menu to control NCDs risk factors. The current implementation of the vendor system did not support reduction of NCDs risk factors. Improved implementation of the guide to the vendor system is needed.

Perceptions of School Management on the Relationship between School Nutrition and Development of Non-communicable Diseases in a Rural South African District: A Qualitative Study

Globally, noncommunicable diseases (NCDs) were responsible for 41 million deaths in 2016, with the majority of these occurring in low and middle-income countries. These diseases were on the rise as a result of unhealthy, low-quality, and unbalanced diets, which resulted in overweight and obesity. The National School Nutrition Programme (NSNP) was created to regulate the foods sold to schoolchildren. To ascertain school management teams' perspectives on the relationship between the NSNP and the development of lifestyle diseases. A phenomenological qualitative study using Focus Group Discussions among 16 purposively selected members of the School Management Teams were conducted in Mt Frere, Eastern Cape in 2016. The narrative data was analyzed using Tesch's eight-phase thematic analysis approach. The data analysis revealed two themes (NSNP and the vendor system) and six sub-themes. The NSNP was viewed as making a significant contribution to children's food security, thereby improving academic output. However, reengineering of the NSNP was need through improved budgeting and inclusion of breakfast in the menu to control NCDs risk factors. The current implementation of the vendor system did not support reduction of NCDs risk factors. Improved implementation of the guide to vendor system is needed.

Cost and cost drivers associated with setting-up a prime vendor system to complement the national medicines supply chain in Tanzania

IntroductionEconomic analysis of supply chain management interventions to improve the availability of healthcare commodities at healthcare facilities is important in generating evidence for decision-makers. The current study assesses the cost and cost drivers for setting-up a public-private partnership programme in Tanzania in which all public healthcare facility orders for complementary medicines are pooled at the district level, and then purchased from one contracted supplier, the prime vendor (referred to as ‘Jazia Prime Vendor System’ (Jazia PVS)).MethodsFinancial and economic costs of Jazia PVS were collected retrospectively and using the ingredients approach. The financial costs were spread over the implementation period of January 2014–July 2019. In addition, we estimated the financial rollout costs of Jazia PVS to the other 23 regions in the country over 2 years (2018–2019). A multivariate sensitivity analysis was conducted on the estimates.ResultsJazia PVS start-up and recurrent financial costs amounted to US$2 170 989.74 and US$709 302.32, respectively. The main cost drivers were costs for short-term experts, training of staff and healthcare workers and the Jazia PVS technical and board management activities. The start-up financial cost per facility was US$2819.47 and cost per capita was US$0.37.ConclusionIn conclusion, the study provides useful information on the cost and cost drivers for setting-up a complementary pharmaceutical supply system to complement an existing system in low-income settings. Despite the substantial costs incurred in the initial investment and operations of the Jazia PVS, the new framework is effective in achieving the desired purpose of improving availability of healthcare commodities.

Acceptability of a Prime Vendor System in Public Healthcare Facilities in Tanzania

Background: Pharmaceutical supply chain management in low- and middle-income countries has received substantial attention to address the shortage of medicines at peripheral facilities. The focus has been on health system interventions, including the establishment of public-private partnerships (PPPs). In 2014, the United Republic of Tanzania began implementing the Jazia prime vendor system (Jazia PVS) with a contracted private wholesale supplier to complement the national medicines supply chain in public facilities. Few studies have investigated the acceptability of such a prime vendor system. This study analyses factors that contributed to the acceptability of Jazia PVS introduced in Tanzania. We used qualitative analytical methods to study experiences of Jazia PVS implementers in 4 districts in mid-2018. Methods: Data were drawn from 14 focus group discussions (FGDs), 7 group discussions (GDs) and 30 in-depth interviews (IDIs) with a range of actors involved in Jazia PVS. The study analysed 7 acceptability dimensions as defined in the acceptability framework by Sekhon et al. Framework analysis was adopted to summarise the results using a deductive and an inductive approach. Results: The findings show that participants’ acceptability of Jazia PVS was influenced by the increased availability of essential medicines at the facilities, higher order fulfilment rates, and timely delivery of the consignment. Furthermore, acceptability was also influenced by the good reputation of the prime vendor, close collaboration with district managers, and participants’ understanding that the prime vendor was meant to complement the existing supply chain. Intervention coherence, experienced opportunity cost and intervention burden, affective attitude and self-efficacy were also important in explaining the acceptability of the Jazia PVS. Conclusion: In conclusion, the most critical factor contributing to the acceptability of the Jazia PVS was the perceived effectiveness of the system in achieving its intended purpose. Districts purchasing directly from the prime vendor have a policy based on the possibility to increase availability of essential medicines at peripheral facilities in a low income setting; however, it is crucial to select a reputable and competent vendor, as well as to abide by the contractual agreements.

A Monitoring System for Integrated Management of IoT-based Home Network

Recently, the society is rapidly becoming highly integrated with the convergence of smart devices, SNS, big data, cloud, and IoT. This phenomenon is being spread more swiftly based on the wired and wireless communication infrastructure provided to most homes, as terminal devices for communication have more various functions and are being supplied to homes through a multi-vendor system and as several terminal devices are installed in each home to provide services. Particularly, various IoT terminal devices and services are being introduced to facilitate functions such as home crime prevention, gas valve control, control of electric apparatus and temperature-humidity sensors, and door control based on facial recognition, and integrated IoT-based management monitoring is required for TVs, washing machines, refrigerators, etc. Hence, in this study, a monitoring system for integrated home network management and data collection management, which solves problems of existing home network systems by connecting API Adaptor connection technology, message technology for integrated management of universal communications terminal devices and IoT devices, and data modelling technology to individual network platforms, was proposed.