Browsing by Author "Festo, Charles"

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Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania
(Hindawi, 2020-06-05) Lyoba, Winfrida B.; Mwakatoga, Joyce D.; Festo, Charles; Mrema, Jackline; Elisaria, Ester
Introduction. Pregnant women are at a high risk of anaemia, with iron-folate deficiency being the most common cause of anaemia among pregnant women. Despite the well-known importance of iron and folic acid supplementation (IFAS) during pregnancy, adherence to these supplements is relatively low and associated factors were not well identified in the study area. This study is aimed at investigating adherence to IFAS and associated factors among pregnant women in Kasulu district, north-western Tanzania. Methods. A health facility cross-sectional survey with a mixed-method approach was conducted in Kasulu district from March to April 2019. A structured questionnaire was given to 320 women with children aged 0-6 months to assess factors associated with adherence to IFAS among pregnant women. Data were entered into SPSS version 22.0 for analysis. Binary logistic regression was further employed to determine the factors associated with adherence to IFAS. Focus group discussions were done with 19 pregnant women and 15 mothers of children aged 0-6 months to obtain more clarifications on the factors associated with adherence to IFAS. Furthermore, in-depth interviews were done with six health care providers to explore their perceptions of IFAS. Results. Out of the 320 respondents of the survey, 20.3% (n = 65) adhered to IFAS. Factors associated with adherence to IFAS among pregnant women included time to start ANC (AOR = 3:72, 95% CI: 1.42, 9.79), knowledge of anaemia (AOR = 3:84, 95% CI: 1.335, 10.66), counseling on the importance of the iron-folic acid (AOR = 3:86, 95% CI: 1.42, 10.50), IFAS given during clinical visit (AOR = 15:72, 95% CI: 5.34, 46.31), number of meals consumed (AOR = 3:44, 95% CI: 1.28, 9.21), number of children (AOR = 3:462, 95% CI: 1.035, 11.58), and distance to health facility (AOR = 0:34, 95% CI: 0.131, 0.886). Qualitative findings revealed that delayed first ANC visit, lack of remainder for pregnant women to take IFAS, low awareness about the negative effects of anaemia, low of knowledge of IFAS and management of side effects, negative beliefs about the use of IFAS, and follow-up mechanism were major reasons for poor adherence. Conclusion. Adherence to iron-folic acid supplementation during pregnancy was low. Strengthening systems for creating reminding mechanism, raising community awareness through educational programs to pregnant women and health providers could improve adherence to IFAS.
A comparative analysis of determinants of low birth weight and stunting among under five children of adolescent and non-adolescent mothers using 2015/16 Tanzania Demographic and Health Survey (TDHS
(BMC Nutrition, 2021-11-21) Mtongwa, Ramadhani; Festo, Charles; Elisaria, Ester
Background: Tanzania is one of the Sub-Saharan African country with nearly 12 out of 60 million people being adolescent. The prevalence of child marriage is higher with one out of every three girls being married before reaching their 18th birthday, 5 % being married by the age of 15, and 31% by the age of 18 years. Literature shows early pregnancy is associated with Low Birth Weight (LBW) and stunting among children under 5 years. This paper explores variation and factors associated with low birth weight and stunting among children born by adolescent and non-adolescent mothers. Methods: Data from 13,266 women with children under 5 years collected as part of the 2015/2016 TDHS was re analyzed using STATA version 14 software while accounting for survey design. A total of 6385 women (of which 7.2% were adolescent) and 8852 women (of which 6.7% were adolescent) were involved in the analysis of child birth weight and stunting respectively. Descriptive statistics stratified by maternal age was conducted with LBW and stunting as outcome variables followed by logistic regressions models controlling for confounding variables. Results: The proportion of obese or overweight adolescent and non-adolescent mothers was 11.8 and 36.5% respectively. Antenatal care (ANC) attendance, areas of residence and social economic status were very similar in the two maternal age groups. Non- adolescent mothers had reduced odds of giving birth to LBW babies compared to adolescent mothers (Adjusted Odds Ratio (AOR) = 0.34; 95% CI: 0.22–0.50). Maternal undernutrition (AOR = 2.29; 95% CI: 1.43–3.67), being divorced, separated or widowed (AOR = 1.76; 95% CI: 1.24–2.50) and having at least four ANC visits (AOR = 0.64; 95% CI: 0.49–0.83) were significantly associated with reduced odds of having a LBW. Child stunting was not associated with maternal age. Maternal high socioeconomic status (AOR = 0.69; 95% CI: 0.57–0.84) and maternal obesity or overweight (AOR = 0.77; 95% CI: 0.64–0.92) were negatively associated with stunting. Child birth weight, sex, and age were significantly associated with stunting.
Determinants of Home Delivery among Women Aged 15-24 Years in Tanzania
(International Journal of Maternal and Child Health and AIDS, 2020-04-23) Kimario, Florence Focus; Festo, Charles; Shabani, Josephine; Mrisho, Mwifadhi
Background: The United Nation’s Sustainable Development Goal number 3 aims at reducing the maternal mortality rate by less than 70/100,000 live births globally and 216/100,000 live births in developing regions by 2030. Despite several interventions in Tanzania, maternal mortality has increased from 454/100,000 live births in 2010 to 556/100,000 live births in 2015. Home delivery and maternal young age contribute to maternal deaths. Reducing home deliveries among women aged 15-24 years may likely decrease the prevalence of maternal deaths in Tanzania. This study investigated the determinants of home delivery among women aged 15- 24 years in rural and mainland districts of Tanzania. Methods: This study uses a mixed-methods approach using data collected as part of the evaluation of government and UNICEF interventions in 13 districts of Tanzania mainland from October and November 2011. Results from the secondary analysis were supplemented by qualitative data collected between February and April 2019 from four rural districts: Bagamoyo, Tandahimba, Magu, and Moshi. Results: A total of 409 adolescents and young women who delivered one year before the quantitative data collection were included in the final analysis. A quarter of them gave birth at home. Having at least four antenatal care (ANC) visits (OR=0.23, 95% CI: 0.12-0.41, p<0.01), planning place of delivery (OR=0.22, 95%CI: 0.14-0.36 p<0.01), and knowledge of the danger signs during pregnancy (OR=0.36, 95% CI: 0.22- 0.57, p<0.01) were significantly associated with the place of delivery. Conclusion and Global Health Implications: Maternal level of education, number of ANC visits attended, planned place of delivery, and knowledge of danger signs during pregnancy were the determinants of the choice of place of delivery among women aged 15-24 years in Tanzania. Understanding these risk factors is important in designing programs and interventions to reduce maternal deaths from women of this age group which contributes about 18% of all maternal deaths in Tanzania.
Prevalence of Hypertension and Its Association with Tuberculosis, among HIV patients on ART in Bagamoyo District, Eastern Tanzania
(International Journal of AIDS, 2019-11-27) Nyangi, Getera Isack; Festo, Charles; Olotu, Ally
Background: Individuals living with HIV/AIDS have a higher risk of cardiovascular complications, including hypertension. We, therefore, assess the prevalence of hypertension and its association with Tuberculosis in HIV patients on ART in Bagamoyo district eastern Tanzania. Methods: This was a cross-sectional study involving HIV-infected individuals on ART, consecutively enrolled from two selected care and treatment clinics (CTC), between March and May 2019. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mm Hg, diastolic blood pressure (DBP) ≤ 90 mm Hg or being on-ant hypertensive medication regardless of blood pressure measurement on the day of the visit. Results: We investigated 328 HIV patients on ART, 64.6% were female, 92.68% on non-protease inhibitors, 0.61% had current TB and 14% had a history of Tuberculosis in the past 5 years. The overall prevalence of hypertension in HIV patients on ART was 29.3% and it was significant and positively associated with increasing age, obesity, family history of hypertension, and, current history of TB. However, having a history of Tuberculosis in the past 5 years was not associated with increased odds of having hypertension. Conclusion: The prevalence of hypertension in HIV patients on ART was higher and it was associated with traditional risk factors and the current history of tuberculosis and but not with a history of Tuberculosis in the past 5 years. Regular monitoring of blood pressure is crucial among HIV/AIDS patients attending HIV outpatient clinics.
The relationship between feeding practices and stunting among children under two years in Tanzania mainland: a mixed-method approach
(Springer Nature, 2024-10-28) Mandara, Faith; Festo, Charles; Killel, Erick; Lwambura, Samwel; Mrema, Jackline; Katunzi, Farida; Martin, Haikael; Elisaria, Ester
Background Proper infant and young child feeding practices have gained attention over the years as one of the interventions to reduce childhood stunting. However, there is still a gap in research to determine these relationships in children under two years and the reasons for improper feeding. Objective This study aimed to assess the relationship between feeding practices, stunting and barriers among children under two years. Methodology Utilizing a mixed-method approach, the study involved secondary analysis of 1806 records of children aged 6–23 month, from the Next Generation Nutrition Program conducted in Tanzania (2015–2019). Both quantitative and qualitative data analyses were employed. Frequency distribution tables were utilized to describe study participants stratified by their stunting status. Subsequently, modified Poisson regression models identified predictors of stunting. Qualitative analysis encompassed deductive and inductive approaches, to extract themes that address the behaviors contributing to inappropriate feeding practices. Results Stunting prevalence was 28.8% among children aged 6–23 months, with the majority (65%) of stunted children aged 1 year or older. Dietary diversity was low: 88.3% and 86.3% of stunted and non-stunted children, respectively, consumed less than 5 food groups. Surprisingly, early initiation of breastfeeding, time of stopping breastfeeding, and minimum dietary diversification were not significantly associated with child stunting (p-value > 0.05). Barriers to proper feeding practices identified were inadequate knowledge of feeding, maternal condition, economic hardship, cultural issues, and seasonality. Conclusion Early breastfeeding and minimum dietary diversity were not significant predictors of stunting. However, the mother’s age and height > 150 cm reduced stunting risk while child sex, age, birth weight, marital status, and place of delivery also influenced stunting risk. It is crucial for initiatives to emphasize good feeding practices while addressing the complex factors that may hinder optimal feeding practices in this age group to reduce childhood stunting effectively.