Background Delivery of quality reproductive health services has been documented to depend on the availability of healthcare workers who are adequately supported with appropriate training. However, unmet training needs among healthcare workers in reproductive, maternal, and newborn health (RMNH) in low-income countries remain disproportionately high. This study investigated the effectiveness of training with onsite clinical mentorship towards self-reported performance in RMNH among healthcare workers in Mwanza Region, Tanzania. Methods The study used a quasi-experimental design with pre-and post-intervention evaluation strategy. The baseline was compared with two endline groups: those with intervention (training and onsite mentorship) and those without. The differences among the three groups in the sociodemographic characteristics were analyzed by using chi-square test for categorical variables, independent-sample t-test for continuous variables and Mann–Whitney U test for ordinal or skewed continuous data. The independent sample t-test was used to determine the effect of the intervention by comparing the computed self-reported performance on RMNH services between the intervention and control groups. The paired-samples t-test was used to measure the differences between before and after intervention groups. Significance was set at a 95% confidence interval with p ≤ 0.05. Results The study included a sample of 216 participants with before and after intervention groups comprising of 95 (44.0%) and 121 (56.0%) in the control group. The comparison between before and after intervention groups revealed a statistically significant difference (p ≤ 0.05) in all the dimensions of the self-reported performance scores. However, the comparison between intervention groups and controls indicated a statistical significant difference on intra-operative care (t = 3.10, df = 216, p = 0.002), leadership skills (t = 1.85, df = 216, p = 0.050), Comprehensive emergency obstetric and newborn care (CEMONC) (t = 34.35, df = 216, p ≤ 0.001), and overall self-reported performance in RMNH (t = 3.15, df = 216, p = 0.002). Conclusions This study revealed that the training and onsite clinical mentorship to have significant positive changes in self-reported performance in a wide range of RMNH services especially on intra-operative care, leadership skills and CEMONC. However, further studies with rigorous designs are warranted to evaluate the long-term effect of such training programs on RMNH outcomes.

Background: Generally, diarrhea is still a second major reason of death and illness in children below the age of five years. It holds breathes of around half a million under five children’s every year and causes million more to be admitted. Every year diarrhea kills around 525000 children of under five years.Although few study have been done in Tanzania to determine factors associated with diarrhea among under five children, but environment factors have not yet well addressed. Therefore, this study seeks to address environmental factors associated with diarrhoea among under-five children attending at Muhimbili National Hospital, in Tanzania. Methods: A quantitative descriptive cross sectional study design of 100 simple randomly participants were selected. Questionnaires were used to collect data form key informants who were mothers/ carers with a child of under-five suffering from diarrhoea admitted at Muhimbili National Hospital, Tanzania. Data were analysed using SPSS. Statistical tests used were mean, median, proportions and chi square. Environmental risk factors associated with diarrhoea were determined with a p value of less than 0.05. Ethical approval and permission to collect data were obtained from relevant authorities.Results: Unsuitable infrastructure for grey water disposal, improper hand washing before feeding the baby and hand washing without using clean water and soap had strongly association with the occurrence of diarrhoea in under-five children attending at Muhimbili National Hospital (MNH) with P-value of 0.00, 0.00, and 0.01 respectively.Conclusion: Childhood diarrhoea is contributed by various environmental risk factors including unimproved sanitation, lack of hand washing facilities and poor knowledge among caregivers. This calls for the importance of providing health education to the caregivers on the cause, prevention and treatment of diarrhoea among under-five children.

BackgroundDelivery of quality reproductive health services has been documented to depend on the availability of healthcare workers who are adequately supported with appropriate training. However, unmet training needs among healthcare workers in reproductive, maternal, and newborn health (RMNH) in low-income countries remain disproportionately high. This study investigated the effectiveness of trainings with onsite clinical mentorship towards perceived importance and performance in RMNH among healthcare workers in Mwanza Region of Tanzania.MethodsThe study used a quasi-experimental design using single group pre-and post-intervention evaluation strategy. The training needs of healthcare workers from the selected health facilities were assessed, skills gaps identified and ranked according to priority. Training courses that addressed skills gaps were developed and delivered with adaptations of the national guidelines followed by onsite clinical mentorship for one year. The baseline and endline survey were conducted at 3 years interval to assess change in HCWs on their perceived importance and performance on different aspects of RMNH care. Independent samples t-tests were used to compare differences in perceived performance in selected training areas between baseline and endline. Significance was set at p < 0.05.ResultsTNA was administered to 152 and 216 healthcare workers at baseline and endline respectively. In total, 141 (65%) of the 216 end line survey participants had received at least one IMPACT project training course and at least three mentorship visits. Participants were matched on their age and duration in RMNH services, but differed in age and duration of employment. Comparison between baseline and endline by using the training needs analysis questionnaire scores showed statistically significant positive changes (p ≤ .05) in most training needs analysis items, except for some items including those related to research capacity and provision of health education for cancer.ConclusionsThe findings revealed that the training and onsite clinical mentorship program that address the actual needs of healthcare workers to have significant positive changes in perceived performance in a wide range of RMNH services. However, further studies with rigorous designs are warranted to evaluate the long-term effect of such training programs on RMNH outcomes.

BACKGROUNDIn Tanzania, cesarean section (CS) rates have been steadily increasing, yet little is known about mothers' understanding of the medical rationale for their CSs.AIMTo identify mothers' cultural understandings of the rationale for their CSs.METHODSDesign: A qualitative descriptive design was employed.Setting: A government hospital in the western region in Tanzania.Participants: A total of 117 mothers were interviewed using convenience sampling post CS.FINDINGSForty percent of the mothers were younger than 18 years, with more than 50% having had five or more live babies. Among multigravida women, 40.2% had had one or more previous CSs.The emergent themes were lack of dietary knowledge, use of local herbs, delays in coming to hospital, avoiding stressful labor pains and no ability to exercise, and no personal preferences of “push or go for an operation.”CONCLUSIONPregnant women in Tanzania need improved health education to make informed choices about childbirth and be involved all processes of antepartum care decision making to achieve optimal birth outcomes.

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