Attainment of optimal health calls for collaboration between animals, humans, and environmental health professionals together with understanding the consequences of animals, humans, and environment interactions on health. In cognizant of this, the government in Tanzania introduced One Health Strategic Plan (2015–2020), little is empirically known on how this plan has facilitated the enhancement of knowledge, awareness, attitudes, and practices (KAPs) under One Health Approach (OHA). This article analyses KAPs under OHA from a cross-sectional study conducted in Morogoro, Tanzania. Data were collected by a questionnaire from 1440 respondents obtained through a multistage sampling procedure, 80 Focus Group discussions (FGDs) participants and 16 key informant interviewees. IBM-SPSS v.20 analysed quantitative data while qualitative data were organised into themes on specific objectives. Results revealed that only 32.3% (95% CI:30.3 to 35.3) had adequate OH knowledge. Only 5% (95% CI:4.0 to 6.1) were aware of OHA concept and practices; 3.8% (CI 95%, 2.8 to 4.8) managed to identify collaborative efforts and strategies, and 2.5% (CI 95%, 1.7 to 3.4) correctly explained/ described OHA. Whereas, 38.5% (95% CI:32.6 to 37.5) had a positive (favourable) attitude towards OHA. Despite the efforts outlined in the OH Strategic Plan to promote OHA, there is little awareness and knowledge on OHA. This indicates that the One Health Strategic Plan (2015–2020) and other initiatives have not significantly facilitated the enhancement of KAPs. This study recommends strengthening efforts towards OHA information dissemination to enhance awareness and knowledge on the concept and practices.

BackgroundPublic-Private-Partnership-supported health facilities have been operational in Tanzania, and specifically, in Kilimanjaro since 1990s. This study provides a snapshot of the contribution of PPP-supported health facilities’ operations towards attainment of Universal Health Coverage (UHC) in Kilimanjaro region.MethodsAdopting a cross-sectional research design, samples of 384 households and 30 health facilities were selected through a multi-stage and purposive sampling approaches, respectively. Questionnaires and key informant interviews (KIIs) were administered (June 2020 - February 2021). Using IBM-SPSS v.23, chi-square was used to compare PPP-supported and government health facilities’ service delivery quality and affordability. Content analysis was done on KIIs.ResultsWith PPP-support unweighted mean index score for service availability (SA) was 46.59% and 29.14% without PPP-supported health facilities. With PPP-support, the GSR index score was 87% while it was 82% without PPP-support. This implies, with PPP-support, progress towards UHC attainment can be accelerated. There was no significant association between accessing services in PPP-supported or government health facilities by perceived service delivery quality and service affordability.ConclusionPPP-supported and government health facilities co-existence is essential at hastening the progress towards UHC in the study area. The government should strengthen policies and regulations to promote more PPPs in improving health facilities’ operations.Rwanda J Med Health Sci 2022;5(2):216-232

Attainment of optimal health calls for collaboration between animals, humans, and environmental health professionals together with understanding the consequences of animals, humans, and environment interactions on health. In cognizant of this, the government in Tanzania introduced One Health Strategic Plan (2015–2020), little is empirically known on how this plan has facilitated the enhancement of knowledge, awareness, attitudes, and practices (KAPs) under One Health Approach (OHA). This article analyses KAPs under OHA from a cross-sectional study conducted in Morogoro, Tanzania. Data were collected by a questionnaire from 1440 respondents obtained through a multistage sampling procedure, 80 Focus Group discussions (FGDs) participants and 16 key informant interviewees. IBM-SPSS v.20 analysed quantitative data while qualitative data were organised into themes on specific objectives. Results revealed that only 32.3% (95% CI:30.3 to 35.3) had adequate OH knowledge. Only 5% (95% CI:4.0 to 6.1) were aware of OHA concept and practices; 3.8% (CI 95%, 2.8 to 4.8) managed to identify collaborative efforts and strategies, and 2.5% (CI 95%, 1.7 to 3.4) correctly explained/ described OHA. Whereas, 38.5% (95% CI:32.6 to 37.5) had a positive (favourable) attitude towards OHA. Despite the efforts outlined in the OH Strategic Plan to promote OHA, there is little awareness and knowledge on OHA. This indicates that the One Health Strategic Plan (2015–2020) and other initiatives have not significantly facilitated the enhancement of KAPs. This study recommends strengthening efforts towards OHA information dissemination to enhance awareness and knowledge on the concept and practices.

Universal Health Coverage (UHC) attainment has been associated with households’ socio-demographic characteristics. Empirical findings have hardly dwelt on assessing the association between household socio-demographic characteristics and UHC attainment. This article assessed the association between socio-demographic features and attainment of UHC in Kilimanjaro Region, Tanzania. Specifically, the article: (i) analysed the perceptions on households’ socio-demographic characteristics in relation to UHC factors; (ii) determined the association between socio-demographic characteristics and UHC attainment; and (iii) estimated the level of UHC service coverage in the study area. The study employed a cross-sectional research design in which 384 households were selected through a multi-stage sampling approach and interviewed using a questionnaire. The Kruskal Wallis H test and Mann Whitney U test were used as tests for association of socio-demographic variables and UHC factors. Geometric mean computation was used to estimate the level of UHC attainment. Results indicate; the level of UHC service coverage score of 69.9%, which is fairly good in relation to the WHO recommendation of 80%. Occupation (p = 0.012), general household health condition (GHHC) (p=0.039), health insurance membership (HIM) (p=0.039), and presence of non-communicable disease (p=0.032) were significantly associated with health services delivery quality. GHHC (p=0.041) was significantly associated with service accessibility. Income (p=0.000), occupation (p=0.000), education (p=0.004), health check-up frequency (p=0.001), and HIM (p=0.000) were significantly associated with health services affordability. Health services accessibility was not of great concern to most of the households. Some households could easily afford the cost of health services and others could not. Service providers, LGAs, and MoH should promote affordability and accessibility of health services by the population regardless of their socio-demographic characteristics. The promotion of a single universal health insurance fund is essential for improved progress to UHC attainment.