Browsing by Author "Mahonge, Christopher"

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Effects of decentralization on the functionality of health facility governing committees in lower and middle-income countries: a systematic literature review
(Taylor & Francis, 2022-05-02) Kesale, Anosisye M.; Mahonge, Christopher; Muhanga, Mikidadi
Background: Health facility governing committees (HFGCs) were established by lower and middle-income countries (LMICs) to facilitate community participation at the primary facility level to improve health system performance. However, empirical evidence on their effects under decentralization reform on the functionality of HFGCs is scant and inconclusive. Objective: This article reviews the effects of decentralization on the functionality of HFGCs in LMICs. Methods: A systematic literature review was conducted using various search engines to obtain a total number of 24 relevant articles from 14 countries published between 2000 and 2020. Inclusion criteria include studies must be on community health committees, carried out under decentralization, HFGCs operating at the individual facility, effects of HFGCs on health performance or health outcomes and peer-reviewed empirical studies conducted in LMICs. Results: The study has found varied functionality of HFGCs under a decentralization context. The study has found many HFGCs to have very low functionality, while a few HFGCs in other LMICs countries are performing very well. The context and decentralization type, members’ awareness of their roles, membership allowance and availability of resource to the facility in which HFGCs operate to produce the desired outcomes play a significant role in facilitating/ limiting them to effectively carry out the devolved duties and responsibilities. Conclusion: Fiscal decentralization has largely been seen as important in making health committees more autonomous, even though it does not guarantee the performance of HFGCs.
Knowledge, attitudes and practices related to taenia solium cysticercosis and taeniasis in Tanzania
(BMC, 2022) Nyangi, Chacha; Stelzle, Dominik; Mkupasi, Ernatus M; Ngowi, Helena A; Churi, Ayubu J; Schmidt, Veronika; Mahonge, Christopher; Winkler, Andrea S
Background: Taenia solium cysticercosis/taeniasis (TSCT) is reported to be endemic in pig producing areas around the world, causing significant disease burden and economic losses. Methods: This cross-sectional study aimed at assessing Knowledge, Attitudes and Practices (KAP) regarding TSCT in four districts, namely Mbulu, Mpwapwa, Mbinga, and Rungwe in Tanzania. Data on KAP were collected through questionnaire-based interviews and household infrastructure observations. Results: Knowledge about porcine cysticercosis was good, particularly among pig keepers across the districts. Many participants had heard about the pork tapeworm (T. solium taeniasis), and the knowledge about signs/symptoms and treatment was fair, but the means of transmission and prevention measures were often unknown. Whilst most participants were familiar with epilepsy, no one knew anything about human cysticercosis and the link between cysticercosis and epileptic seizures. A similar trend is reflected through the attitudes toward the low risk perception of cysticercosis infection. Not surprisingly, the risk perception of the infection with the pork tapeworm was low too. Many participants reported not washing their hands before eating or after using the toilet which highlights potential risks for the development of human cysticercosis. Albeit nearly every participant reported using the toilet always, household observations revealed that toilets were either lacking or had no complete walls. Generally, household observations revealed a discrepancy between questionnaire answers on the one hand and the availability of toilet and handwashing facilities and the confinement of pigs on the other hand. Conclusion: This study demonstrates knowledge gaps and adverse practices which may hinder and/or slow down the control/elimination of T. solium in endemic countries. The study results are also useful for appropriate designing of TSCT health interventions that need to be planned carefully, taking into account the local context and designing TSCT in partnership with the local communities from the beginning to the end applying a One Health approach to allow the possible sustained and best impacts. Keywords: Knowledge, Attitude, Practices, Smallholder pig farming, Taenia solium, Cysticercosis, Taeniasis, Epilepsy, Neurocysticercosis, Cross-sectional study
Smallholder Farmers’ Adaptation Strategies to Impact of Climate Change in Semi-arid Areas of Iringa District Tanzania
(International Institute for Science, Technology & Education (IISTE)) Kihupi, Mary L; Mahonge, Christopher; Chingonikaya, Emmanuel E.
Smallholder farmers’ levels of adaptive capacity to climate change and variability in Manyoni District, Tanzania
(International Journal of Research & Methodology in Social Science, 2016) Shirima, Andrew Omari; Mahonge, Christopher; Chingonikaya, Emmanuel
Smallholder farming households in developing countries are most vulnerable to climate change and variability as their livelihoods are climate-sensitive and they lack resources to invest on adaptation measures. To formulate appropriate measures to address this susceptibility, it is essential to understand smallholder farmers’ adaptive capacity. This study assessed the adaptive capacity to climate change of farming households in Manyoni District. The specific objectives were: to determine the levels of adaptive capacity of farming households to climate change and assess the impacts of households’ socio-demographic characteristics on adaptive capacity levels. A random sampling technique was adopted to obtain 240 households and data were collected using questionnaire and FGDs. Both descriptive and inferential statistical analyses were done using SPSS and excel. Ordinal logistic regression was adopted to determine influences of households’ socio-demographic characteristics on adaptive capacity. Majority had low adaptive capacity with financial resources ranking the highest in the resources that were required for adaptive capacity. Household size was the strongest predictor of adaptive capacity levels whereas age of the household head had a negative influence on adaptive capacity. Also majority belonged to low adaptive capacity levels. The study recommends strengthening of household farming labour for a more adaptive capacity through sensitization and strengthening farming subsidies. It also recommends creation of a more conducive financial access such as affordable credit conditions that will facilitate access to finances so as to sustain the adaptive capacities of the smallholder households under climate change variability.
The determinants of the performance of health facility governing committees (HFGC) in selected primary health facilities in Tanzania
(TAJOCODE and CODEPATA) Kesale, Anosisye; Mahonge, Christopher; Mikidadi, Muhanga