DOCSLIB.ORG

Type 2 Diabetes Mellitus in the Arumeru District of Northern

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Type 2 Diabetes Mellitus in the Arumeru District of Northern TYPE 2 DIABETES MELLITUS IN THE ARUMERU DISTRICT OF NORTHERN TANZANIA: EVALUATION OF THE PREVALENCE AND ASSOCIATED RISK FACTORS IN RURAL COMMUNITIES By BENJAMIN JOHN MILLER A dissertation submitted in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY WASHINGTON STATE UNIVERSITY College of Nursing May 2013 © Copyright by Benjamin J Miller, 2013 All Rights Reserved © Copyright by Benjamin J Miller, 2013 All Rights Reserved ii To the Faculty of Washington State University: The members of the Committee appointed to examine the dissertation of BENJAMIN JOHN MILLER find it satisfactory and recommend it be accepted. ________________________________________ Lorna L Schumann, Ph.D., Chair ________________________________________ John Roll, Ph.D. ________________________________________ Robert Short Ph.D. ________________________________________ Cynthia Corbett, Ph.D. iii Acknowledgement I would like to thank my family for their continued support. Spending summers in Tanzania, learning about the community and culture has required patience and understanding. To my wife, thank you for everything. To my children, the times I was not home, the sacrifices you have made, helped this dream to come true. I wish to thank my committee members for the endless time spent reading and offering insight and wisdom into this dissertation. Dr. Leonard Mboera, with the National Institute for Medical Research in Dar es Salaam. Thank you for working with me these past several years. Your role as my local collaborator on this research project was invaluable. Your patience in helping me navigate the research regulations cannot really be acknowledged by words alone. During the summer of 2012, I could not have tested 709 people in Tanzania without the help of Tyler Ellis, Summer Carney, and Sarah Berg. Taking time out of your life helped me accomplish this goal. Because of your commitment and the work of the other members of our group, this project came to life. The information we collected will make a difference in the lives in this region. This could not have occurred without your help. Asante Sana! Askofu Eliud Issangya: Asante sana kwa urafiki na mchango wenu mkubwa. Ushirikiano mlionipa umewezesha kukamilisha utafiti huu katika muda uliokusudiwa. Maneno yangu hayawezi kuonesha hisia za shukrani nilizonazo kwa watu wote wa Sakila na Arumeru kwa ujumla. Shukrani zangu za kipekee ni kwa International Evangelism Centre na wafanyakazi wake wote ambao wamenisaidia kufanikisha utafiti huu. iv TYPE 2 DIABETES MELLITUS IN THE ARUMERU DISTRICT OF NORTHERN TANZANIA: EVALUATION OF THE PREVALENCE AND ASSOCIATED RISK FACTORS IN RURAL COMMUNITIES Abstract by Benjamin John Miller, Ph.D. Washington State University May 2013 Chair: Lorna L. Schumann Purpose: Describe the prevalence of diabetes in rural northern Tanzania and the association between biometric markers and lifestyle indicators with diabetes, hypertension, and obesity. Background: Diabetes in sub-Sahara Africa is expected to increase by 161% in the next 15 years. Estimates suggest the prevalence of diabetes is 4.8% in east Africa and 1.4% in rural Tanzania. The cost of health care is high when compared to average household income. Understanding prevalence rates as well as increased risk factors will help develop preventative interventions. Methods: Cross-sectional observational study was used to estimate the indirect the age-adjusted prevalence rates of pre-diabetes and diabetes in rural Tanzania. Data regarding socioeconomic status (SES), past medical history, behavioral lifestyle factors, and anthropometric measurements described the association and odds ratio for the development of impaired glucose metabolism (IGM), hypertension (HTN) and excessive adiposity. Findings: The age adjusted rates for pre-diabetes and T2DM are 2.55% (95% CI [0.06; 0.1]) and 2.81% (95% CI [0.07; 0.12]), respectively. Impaired glucose metabolism (IGM) was associated with excessive adiposity (p=.003) and hypertension (p=.001). Advancing age was significantly associated with IGM (p=.004), HTN (p=.001) and excess adiposity (p<.001). Higher glucose v levels were associated with an increased risk of developing hypertension (p=.001) and excessive adiposity (p=.006). Factors associated with excess adiposity included advancing age, female gender (p<.001) and wooden or concrete household flooring (p=.001). When regressed, higher frequency of sweet drink consumption was associated with higher fasting plasma glucose levels (p=.012). Significance: The prevalence of pre-diabetes and diabetes has been established in the rural AruMeru district Tanzania. Socioeconomic development increased the risk of developing hypertension, diabetes, and adiposity. Understanding the prevalence rates for diabetes and factors with IGM will guide in the planning intervention strategies and health policy. vi Table of Contents Acknowledgement ......................................................................................................................... iii Abstract .......................................................................................................................................... iv Table of Contents ........................................................................................................................... vi List of Tables .................................................................................................................................. x List of Figures ............................................................................................................................... xii Chapter 1 ......................................................................................................................................... 1 Background ................................................................................................................................. 2 Globalization and urbanization. .............................................................................................. 2 Type 2 diabetes mellitus. ........................................................................................................ 3 Economics. .............................................................................................................................. 5 Complications. ........................................................................................................................ 7 Tanzania ...................................................................................................................................... 7 Research Questions ................................................................................................................... 10 Specific aims. ........................................................................................................................ 10 Theoretical Model ..................................................................................................................... 10 Conclusions ............................................................................................................................... 11 Chapter 2 ....................................................................................................................................... 12 Diagnosis of Type 2 Diabetes Mellitus ..................................................................................... 14 Type 2 Diabetes in Sub-Sahara Africa and Tanzania ............................................................... 16 Diabetes in Tanzania. ............................................................................................................ 22 Type I diabetes in sub-Sahara Africa. ................................................................................... 24 Tropical diabetes. .................................................................................................................. 25 vii Risk Factors for Diabetes in Tanzania ...................................................................................... 25 Wealth. .................................................................................................................................. 27 Body Mass Index. ................................................................................................................. 28 Obesity in Sub-Sahara Africa. .............................................................................................. 29 Conclusions ............................................................................................................................... 30 Chapter 3 ....................................................................................................................................... 31 Research Design........................................................................................................................ 31 Participants ................................................................................................................................ 33 Participant recruitment. ......................................................................................................... 33 Inclusion criteria. .................................................................................................................. 34 Exclusion criteria. ................................................................................................................. 35 Human Subjects Protection. .................................................................................................
Load more

Recommended publications
  • Assessment of Water Scarcity and Distribution in Arumeru District -Tanzania
    ASSESSMENT OF WATER SCARCITY AND DISTRIBUTION IN ARUMERU DISTRICT -TANZANIA BY MESHACK ELPHACE BAE/12064/61/DF A DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF THE DEGREE OF BACHELOR OF ARTS WITH EDUCATION OF KAMPALA INTERNATIONAL UNIVERSITY JANUARY 2009 DECLARATION I Meshack Elphace, Registration number BAE/12064/61/DF declare that the work presented in this dissertation is my own and has never been presented in any university or institution. N\ta ttfteb( j:=k,P A-Cf; Name ---------- ------- ------------ -----------rt-- ----------- Signature ----.---------~~-------------- i l 1 <l o.,o o 7 . Date --- -------------------~~ -or-------- --------------------- 11 APPROVAL FOR SUBMISSION This is to acknowledge that, this dissertation entitled "ASSESSMENT OF WATER SCARCITY AND DISTRIBUTION IN ARUMERU DISTRICT TANZANIA" has been approved under my supervision and ready for submission for the award of the degree of Bachelor of Arts with education of Kampala International University. ~ Signatar eC -::::::::::::.. _- ------------- ----------- -------- Date --~~ _Jg~J~j ___ -------------------- -- -- -- --- ---- lll DEDICATION This research is dedicated to my wife Elizabeth Meshack, my child Shadrack Meshack, my parents Elphace Lembalai and Bertha Elphace, my brothers Lazaro Elphace, Micheal, Petro Elphace and my sisters Anne, Lilly, Joyce, Einoth Ndavu and Rizick. All you are a great aspiration to my life. Special thanks go to them for their moral and financial support they offered me through out the three years that finally made this research successful. IV ACKNOWLEDGEMENT I wish to express my thanks to the almighty God for granting me health and all those who assisted me materially and morally to be able to complete this research successfully. Special thanks to my supervisor Mr.
    [Show full text]
  • Arumeru District Catherine W
    Conservation agriculture as practised in Tanzania Conservation agriculture in Africa series Series editors Bernard Triomphe Josef Kienzle Martin Bwalya Soren Damgaard-Larsen Titles Conservation agriculture as practised in Ghana Philip Boahen, Benjamin Addo Dartey, Genevieve Delali Dogbe, E. Asare Boadi, Bernard Triomphe, Soren Daamgard-Larsen, John Ashburner Conservation agriculture: a Uganda case study Paul Nyende, Anthony Nyakuni, John Peter Opio, Wilfred Odogola Conservation agriculture in Zambia: a case study of Southern Province Frédéric Baudron, Herbert M. Mwanza, Bernard Triomphe, Martin Bwalya Conservation agriculture as practised in Kenya: two case studies Pascal Kaumbutho, Josef Kienzle, editors Laikipia District Tom Apina, Paul Wamai, Philip Mwangi Siaya District Philip K. Mwangi, Kennedy O. Okelo, Tom Apina Conservation agriculture as practised in Tanzania: three case studies Richard Shetto, Marietha Owenya, editors Arumeru District Catherine W. Maguzu, Dominick E. Ringo, Wilfred Mariki, Marietha Owenya, Flora Kola, Charles Leseyo Karatu District Dominick E. Ringo, Catherine W. Maguzu, Wilfred Mariki, Marietha Owenya, Njumbo, Frank Swai Mbeya District Saidi Mkomwa, Ahaz Mussei, Remmy Mwakimbwala, Ndabhemeye Mulengera, Elimpaa Kiranga Conservation agriculture as practised in Tanzania: three case studies Richard Shetto, Marietha Owenya, editors Arumeru District Karatu District Mbeya District Publishers African Conservation Tillage Network (ACT) PO Box 14733, Westlands Nairobi 00800, Kenya tel and fax: +254 20 445 1391 website:
    [Show full text]
  • 1. Arumeru District Council
    1. Arumeru District Council P.1.1 : RR_SI and RR_PM Gombe Estate Mmbogo and P 1.1 : RR_SI and RR_PM Gombe Estate‐Mmbogo and Mlalua‐Nduruma‐Bwawani Mlalua‐Nduruma‐Bwawani P 1. 3 : Construction of Materninty Ward at Oltrumet P 1.2 : Construction of Materninty Ward at Oltrumet Health Centre Health Centre P 1.5 : Construction of Materninty Ward at Oltrumet Health Centre P 1. 4 : Construction of Sekei Bridge P.1. 5 : Construction of Sekei Bridge P 1. 6 : Construction of Boundary Fence around ADC 2. BAHI DISTRICT COUNCIL P 2.1: Aditors at contractor's site office reviewing P2.2: Uncompacted fill and poor concrete drawings workmanship on Kongogo Dam P 2.3: Un‐cemented Riprap at Kongogo Dam P 2.4: Poorly trimmed borrow pit at Kongogo P 2.5: Auditors checking dimensions compliance at Bahi DC P 2.6: Completed Kigwe Mnadani Drift Servant Quarters P 2.7: Auditors confirming a borehole at Mchito P 2.8: Auditors discussing with village leader at Borehole Mundemu on the way forward - dry borehole 3. Bukoba District Council P. 3.1: Cracks can be seen on the floor and walls of a newly constructed Agricultural Centre at Kikomelo P. 3.2: A newly constructed small bridge P 3.3: Oversize, dirty, sand stone coarse aggregates used for bridges/box culverts along Kalebe- Nyakibimbili road P 3.4: A bridge whose width was increased a day after casting without engineer’s approval along Kalebe- Nyakibimbili road 4. Geita District Council P 4.1: Poorly constructed pavement at the New Geita Bus Stand P 4.2: An auditor and PE Technician carrying out P 4.3: Well constructed headwalls and wingwalls and measurements at the New Geita Bus Stand poorly compacted approaches along Geita Town – Katoma Area Roads P 4.4 Poor workmanship on constructed headwall P 4.5 One of the existing “Bridges” along Sungusira and wing walls along Sungusira – Nyakaduha Road Road 5.
    [Show full text]
  • Tackling the Dangerous Drift
    TACKLING THE DANGEROUS DRIFT ASSESSMENT OF CRIME AND VIOLENCE IN TANZANIA & RECOMMENDATIONS FOR VIOLENCE PREVENTION AND REDUCTION June 2013 Open Society Foundations Crime and Violence Prevention Initiative (OSF CVPI) & Open Society Initiative for Eastern Africa (OSIEA) Prepared by Lainie Reisman, Kennedy Mkutu, Samwel Lyimo, and Monica Moshi with support from the Tanzanian Police Force (TPF) TABLE OF CONTENTS TABLE OF CONTENTS ........................................................................................................................................... 2 ACRONYMS ............................................................................................................................................................... 8 1. INTRODUCTION AND METHODOLOGY ................................................................................................... 11 BACKGROUND ON CVPI AND OSIEA ...................................................................................................................... 11 JUSTIFICATION FOR TANZANIA ............................................................................................................................... 11 ASSESSMENT PURPOSES/OBJECTIVES .................................................................................................................... 12 METHODOLOGY ........................................................................................................................................................ 12 2. BACKGROUND AND CONTEXT .................................................................................................................
    [Show full text]
  • Recapping the Meru Land Case, Tanzania by Dr
    Global Journal of HUMAN SOCIAL SCIENCES Economics Volume 13 Issue 1 Version 1.0 Year 2013 Type: Double Blind Peer Reviewed International Research Journal Publisher: Global Journals Inc. (USA) Online ISSN: 2249-460x & Print ISSN: 0975-587X Recapping the Meru Land Case, Tanzania By Dr. Simeon Mesaki University of Dodoma, Tanzania Abstract - Mt Meru dominates the scenery and economy of the people living on its slopes. The lower slopes of the mountain provided fertile, well-watered land for the Meru and Arusha people for several centuries. Here they have developed "moral economies," innovative and well- managed mixed farming and agro-pastoral systems. The earliest Meru were Chaga speakers from western Kilimanjaro who expanded across the Sanya plains sometimes in the 17th century. They were traditionally organised through “big men” known as vashili (singular nshili who supervised all important matters including traditional prayers, land conflicts, inheritance, farm boundaries, ceremonies and punishment. There were chiefs and elders who met under a large sacred tree, the mringaringa. Colonial occupation since the late 19th century caused the closing of the land frontier on Meru and alienation of most of their land to white settlers. The Meru Land Case was a protest by Meru people, living in the Eastern part of what is now Arumeru District, against the allocation of their land to Europeans for development purposes. It is a tale of the Meru united to demand in an international forum the restitution of their rights to land. It is the story of Kirilo Japhet the first Tanzania to speak at the United Nations and in Kiswahili at that.
    [Show full text]
  • Arusha District Council
    ARUSHA DISTRICT COUNCIL INVESTMENT PROFILE DISCLOSE THE POTENTIAL OF ARUSHA DISTRICT COUNCIL February, 2017 FOREWORD I would like to welcome all esteemed investors to explore the irresistible opportunities provided by the Arusha District Council. Arusha District Council was established in 2007, the Council has a vision of to be a leading transformed Council that provides high quality services for Sustainable Development of the Community by 2025. In order to increase competitiveness in attracting investors to our District Council, effort and initiative to identify, expose and promote investment opportunities available in Arusha District Council is going on. We are indeed determined to utilize potential areas owned by the Council, Communities and those own by private developer. In this Investment Profile, we give you opportunities to realize your entrepreneurial ambitions and explore them. We believe in supporting our investors’ aspirations as the Council. As we want to be one among the leading investment avenues in Tanzania. In Arusha District Council investors are favoured with presence of suitable investment climate that will help you capitalize on untapped opportunities in Arusha and Tanzania as a whole. Whereby investment can be done to the following areas of interests include tourism, processing industries, livestock and agricultural sector, beekeeping, sports and recreation centre, modern market, real estate, socio-economic services. Investment climate is characterised by peace and stability, availability of raw materials, market, abundant natural resources, road and transportation network, electricity services and the strategic geographical location will support establishment and success of investments. It is because of the above mention few facts we are proud to say that Arusha District Council is the best investment destination of your choice.
    [Show full text]
  • Contribution of Local Leaders Towards Land Conflict Management in Tanzania: a Case of Farming Communities in Monduli District
    International Journal of Science and Research (IJSR) ISSN (Online): 2319-7064 Index Copernicus Value (2016): 79.57 | Impact Factor (2017): 7.296 Contribution of Local Leaders towards Land Conflict Management in Tanzania: A Case of Farming Communities in Monduli District Nsia Humphrey1, Peter A. Kopoka. PHD2 1, 2Jomo Kenyatta University of Agriculture and Technology, Kenya Abstract: The purpose of this paper is to assess the contribution of local leaders towards land conflict management. The paper is based on a study conducted in MonduliJuu ward in Monduli District in Arusha region. The study aimed at identifying sources of land conflicts, identifying the role of local leaders towards land conflicts management and examining the effectiveness of local leaders towards land conflicts management among farmers and pastoralists in MonduliJuu ward. The study adopted both quantitative and qualitative research approaches, the data were collected by using questionnaires and interview. The study employed a descriptive survey research design while the respondents were selected by using purposive sampling techniques and simple random sampling. The study involved 100 respondents which include 10 local leaders, 45 farmers and 45 pastoralists from MonduliJuu ward in Monduli District. The findings revealed that sources of land conflicts among farmers and pastoralists were poor land planning, scarcity of land and scramble for pasture. Furthermore,the findings discovered that local leaders play a leading role in solving land conflicts among farmers and pastoralists communities but during conflicts some of the local leaders favor their owncommunities andeven some of them take bribes when solving herders-farmers conflicts which creates dispute among the communities. Thus, the study recommends that in order to solve land conflicts, local leaders should be at the forefront to control and manage land conflict in time and should avoid taking bribe and put aside theirself-interest.
    [Show full text]
  • ARUMERU: Project and Evaluation Edited from an Evaluation Report by Tamara Kwarteng, Tim O’Shaughnessy and Florence Ghamuga September 1999
    Appendix 3 ARUMERU: Project and Evaluation Edited from an evaluation report by Tamara Kwarteng, Tim O’Shaughnessy and Florence Ghamuga September 1999 Précis Arumeru is a “classic” HIV/AIDS prevention project in the best sense of the word. Prevention is the chief intervention and largely relies on counselling and education activities carried out by community volunteers. Dependence on volunteers, when combined with fervent community acceptance and participation, gives the Arumeru Project a high probability that it will be sustainable. Strong governmental approval of the project’s performance adds to the likelihood that HIV/AIDS prevention measures will continue after World Vision funding stops. Arumeru is more than prevention, however. The project also engaged communities in ways to care for AIDS orphans and people living with AIDS (PLWA). While not the main thrust of the Arumeru Project, care became an important intervention, as did ways to improve people’s livelihoods. Enterprise development grew out of a concern that poor women have few assets to sell except their bodies, a risky endeavour where HIV is epidemic. Loans to start businesses were also extended to youth in an effort to turn “loitering” into something more productive. Contents Summary 128 Introduction 129 Arumeru District HIV/AIDS Project 129 Evaluation Process and Methods 131 Planning the evaluation 131 Arumeru Project Activities and Coverage 133 Project coverage 133 Project Impact 135 Knowledge about HIV/AIDS 135 Behavioural changes 139 Strengths and Challenges of the Project
    [Show full text]
  • Tanzania Seeway Expedition Information Pack 2018-19 Contacts
    Tanzania Seeway Expedition Information Pack 2018-19 Contacts David Wall Mark Orrow-Whiting Assistant Director: Head of Expeditions Director of Curriculum and Student Performance [email protected] [email protected] Mobile: +44 7423 467753 Mobile: +44 7425 621025 Office: +44 1235 355835 Office: +44 1235 355835 Michael Napier Angi Richards Expedition Programme Officer Expedition Logistics and Travel Coordinator [email protected] [email protected] Office: +44 1235 355846 Office: +44 1235 355832 [email protected] Table of Contents 5 Introduction 18 Travel and documentation 6 Tanzanian expedition package and fees 19 What to bring 7 Accommodation - Shamba Kipara Camp 22 Where to buy your kit 8 Typical expedition itinerary 23 Electronics 10 Community service 24 Health on expedition 12 A message from Seeway Tanzania 29 Expedition staff 13 Safari experience 31 Gifts and Donations 14 Preparing for the expedition 32 Language, Currency, Weather, Emergencies 17 Fundraising 35 Useful websites 2 3 Introduction The Tanzania Seeway Expedition is a life changing experience and an opportunity to make a lasting impact on the local communities and villages around Maji ya Chai, in the Arusha region of Tanzania. The eight days our students will spend in Tanzania will see them travel around the Arusha region, participating in a highly rewarding programme of community service, learning about sustainable development and exploring the Tarangire National Park where they will discover the diverse range of Tanzanian flora and fauna. This is a fantastic opportunity for your child to be ambitious and challenge themself through a unique and highly enjoyable programme, designed to enable them to grow personally and emotionally.
    [Show full text]
  • List of Petrol Stations As of 30Th Sept 2019 S/No. Name Address District
    List of Petrol Stations as of 30th Sept 2019 LIST OF PETROL STATIONS AS OF 30th SEPTEMBER 2019 S/No. Name Address District Region 1 Saiteru Petroleum Company Limited Plot No.32 Block “BB”, Ngulelo Area Arusha Arumeru Arusha City P. O. Box 11809 Arusha 2 Lake Oil Limited - Olosiva Petrol Station Plot No. 1330, Olosiva Village Arumeru District Arumeru Arusha Arusha Region, P.O.Box 5055 Dar es Salaam 3 Munio Petrol Station – Maji ya Chai Farm No. 039, Kitefu Village , Maji ya Chai Arumeru Arusha Ward, Meru District, Arusha Region, P.O Box 160 Himo - Moshi 4 Panone and Company Ltd – Kisongo Filling Plot No. 3, Olasiti Area, Arumeru District Arumeru Arusha Station of P.O. Box 33285, Dar es salaam 5 Gapco Tanzania Ltd - Gapco Maji Farm No 1118 Imbaseni Village Arumeru Arusha Ya Chai Filling Station, P. O. Box 9103 Dar es Arumeru District in Arusha Region Salaam 6 Olasiti Investment Co. Ltd - Olasiti Plot no 46 Olasiti Area Arumeru Arumeru Arusha Filling Station, P.O.Box 10275 Arusha District, Arusha Region 7 Hass Petroleum Ltd – Kwa Idd Petrol Station Plot No. 832, Arumeru District, Arusha Region Arumeru Arusha of P. O. Box 78341 Dar es Salaam 8 Gapco Tanzania Ltd - Trans Highway Service Plot No. 116, Ngorbob Village, Kisongo Area, Arumeru Arusha Station of P.O Box 7370 Arusha Arumeru Arusha 9 Panone King’ori Filling Station- Arumeru of Farm No.1411, King’ori Area, Malula Village - Arumeru Arusha P. O. Box 33285 Arumeru District 10 Engen Petroleum (T) Ltd- Makumira Station Plot No. 797, Ndato Village, Makumira Area, Arumeru Arusha of P.
    [Show full text]
  • Improving Accessibility of Safe and Clean Water In
    IMPROVING ACCESSIBILITY OF SAFE AND CLEAN WATER IN MARORONI WARD IN MERU DISTRICT, ARUSHA NEEMA JOSIAH SAMBO A DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT FOR THE REQUIREMENTS FOR THE DEGREE OF MASTERS IN COMMUNITY ECONOMIC DEVELOPMENT OF THE OPEN UNIVERSITY OF TANZANIA 2014 ii CERTIFICATION This is to certify that I have read this project paper and I’m satisfied that it can be submitted to the Senate of the Open University of Tanzania in partial fulfillment of the requirements for the award of Master’s degree in Community Economic Development (M. CED). ……………………………... Dr. Felician Mutasa (Supervisor) ……………………….. Date iii COPYRIGHT No part of this project paper may be reproduced, stored in any retrieval system, or transmitted in any form by any means, electronic, mechanical, photocopying, recording or otherwise without prior written permission of the author or the Open University of Tanzania. iv DECLARATION I, Neema Sambo, do hereby declare that this is my own original work and it has not in part or wholly been presented for a degree of Masters in Community Economic Development or any other degree at any University. ……………………………. Signature ……………………….. Date v DEDICATION To my husband, and our dear children Joshua and Amon, who patiently endured my absence while I was busy with the study. vi ACKNOWLEDGEMENTS I would like to acknowledge the support of family, friends, faculty and institutions, who have stood with me in my efforts to complete this stage of my academic journey. I will certainly not be able to name them individually, by doing so would make me vulnerable to the accusation of not being grateful to some.
    [Show full text]
  • Mapping of Community Home-Based Care Services in Five Regions of the Tanzania Mainland
    PATHFINDER INTERNATIONAL Mapping of Community Home-Based Care Services in Five Regions of the Tanzania Mainland June 2006 Table of Contents Acknowledgements 2 Executive Summary 3 Background 6 Objectives and Methodology 8 Findings 11 Findings from Focus Group Discussions: Cross-Cutting Themes 11 Focus Group Discussions with People Living with HIV/AIDS 18 Focus Group Discussions with Community Health Workers 20 Focus Group Discussions with Primary Care Providers 23 Consultations with CMAC members and Key Informants 25 Discussion 29 Overall Recommendations 31 List of Acronyms AIDS Acquired Immune Deficiency Syndrome ARV Antiretroviral CBOs Community-Based Organizations CMACs Council Multisectoral AIDS Committees CHWs Community Health Workers CHBC Community Home-Based Care DCCO District AIDS Control Coordinator FBO Faith-Based Organization FGD Focus Group Discussion HBC Home-Based Care PASADA Pastoral Activities and Services for People with AIDS Dar es Salaam Archdiocese PMTCT Prevention of Mother-to-Child Transmission PLWHA People Living with HIV/AIDS TACAIDS Tanzania Commission for AIDS TIS Tanzania HIV Indicator Survey VCT Voluntary Counseling and Testing PATHFINDER INTERNATIONAL Mapping of Community Home-Based Care Services in Five Regions of the Tanzania Mainland June 2006 1 Acknowledgements We wish to thank many institutions and individuals who have contributed information collected in this report or extended support in the gathering of the information. First and foremost, we wish to recognize the United States government, through the Centers for Disease Control and Prevention, for providing the financial support for the Home-Based Care Project. Our words of gratitude are extended to the National Institute for Medical Research for reviewing the study protocol and granting research clearance, and to the National AIDS Control Program for facilitating research clearance.
    [Show full text]