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  1. Article ; Online: Low engagement of key populations in HIV health services in Tanzania: analysis of community, legal and policy factors.

    Kigombola, Andrew / Lyimo, Johnson / Mizinduko, Mucho / Mkembela, Deogratias / Maziku, Evelyne / Kafura, William / Maghimbi, Abubakar / Musanhu, Christine / Nsubuga, Peter / Yoti, Zablon

    The Pan African medical journal

    2023  Volume 45, Issue Suppl 1, Page(s) 8

    Abstract: Introduction: key populations (KP) often face legal and social challenges that increase their vulnerability to HIV. These experiences include criminalization, higher levels of stigma and discrimination which negatively affect access to HIV services. ... ...

    Abstract Introduction: key populations (KP) often face legal and social challenges that increase their vulnerability to HIV. These experiences include criminalization, higher levels of stigma and discrimination which negatively affect access to HIV services. This study aims to understand legal, community and policy factors affecting engagement of KP in HIV health interventions.
    Methods: qualitative research key populations design involving a desk review and stakeholder's engagement. We reviewed program data from NACP on how KP access health services and then conducted three stakeholders' engagement meetings. Factors affecting access to health services by KP were documented. Data were organized using socio-ecological model (SEM).
    Results: program data showed only 49% of the estimated KP accessed health services. Barriers to accessing health services at the interpersonal level included lack of social support and high-risk networks linked with risk behaviours. At the community, stigma and discrimination, limited engagement of influential leaders were noted. In health facilities, lack of trained staff to provide KP friendly services affected utilization of health services. At structural level, despite improvements, still various laws negated engagement of KP such criminalizing drug use, same sex, and sex work. Harassments and arrests further marginalize KP and makes access to health intervention harder.
    Conclusion: engagement of key population into HIV health interventions was limited at multiple levels. The study recommends building capacity on KP friendly services for communities, law enforcement and health care providers, further engagement of communities including religious leaders on KP issues and implementing differentiated service delivery models for KP.
    MeSH term(s) Humans ; HIV Infections/therapy ; HIV Infections/epidemiology ; Tanzania ; Health Services Accessibility ; Health Services ; Social Stigma ; Policy
    Language English
    Publishing date 2023-06-20
    Publishing country Uganda
    Document type Review ; Journal Article
    ZDB-ID 2514347-5
    ISSN 1937-8688 ; 1937-8688
    ISSN (online) 1937-8688
    ISSN 1937-8688
    DOI 10.11604/pamj.supp.2023.45.1.39591
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania.

    Mwita, Stanley / Konje, Eveline / Kamala, Benjamin / Izina, Angelina / Kilonzo, Semvua / Kigombola, Andrew / Marwa, Karol J / Jande, Mary / Dewey, Deborah

    PloS one

    2021  Volume 16, Issue 7, Page(s) e0254916

    Abstract: Objectives: The primary aims of this study were to investigate if exposure to antenatal corticosteroids (ACS) was associated with lower rates of perinatal mortality (primary outcome) and other adverse perinatal outcomes (i.e., stillbirth, early neonatal ...

    Abstract Objectives: The primary aims of this study were to investigate if exposure to antenatal corticosteroids (ACS) was associated with lower rates of perinatal mortality (primary outcome) and other adverse perinatal outcomes (i.e., stillbirth, early neonatal mortality, APGAR score of < 7 at 5 mins, neonatal sepsis and respiratory distress syndrome) in preterm infants in hospitals in Tanzania. We also examine factors associated with administration of ACS among women at risk of preterm delivery.
    Methods: A hospital-based prospective chart review study was undertaken in four hospitals located in Nyamagana and Sengerema districts, Tanzania. The study population included all stillborn and live born preterm infants delivered between 24 to 34 weeks of gestation between July 2019 to February 2020. A total 1125 preterm infants were delivered by 1008 women (895 singletons, 230 multiple). Sociodemographic and medical data were recorded from participants' medical records.
    Results: Three hundred and fifty-six (35.3%) women were administered at least one dose of ACS between 24 to 34 weeks' gestation and 385 (34.2%) infants were exposed to ACS. Infants exposed to ACS had a lower rate of perinatal mortality (13.77%) compared to those who were not exposed (28.38%). Multivariate analysis indicated that infants exposed to ACS were less likely to die during perinatal period, aRR 0.34 (95%CI 0.26-0.44). Only one-third of the sample was provided with ACS. Administration of ACS was associated with maternal education, attending antenatal care more than 3 times, method used to assess gestational age, maternal infection, exposure to maternal antibiotics, delivery mode and level of health facility.
    Conclusion: ACS significantly reduced the risk in perinatal mortality among infants born preterm in a limited resource setting. However, only about one-third of eligible women were provided with ACS, indicating low usage of ACS. Numerous factors were associated with low usage of ACS in this setting.
    MeSH term(s) Adrenal Cortex Hormones/administration & dosage ; Adult ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Perinatal Mortality ; Premature Birth/drug therapy ; Premature Birth/mortality ; Prospective Studies ; Respiratory Distress Syndrome, Newborn/drug therapy ; Respiratory Distress Syndrome, Newborn/mortality ; Sepsis/drug therapy ; Sepsis/mortality ; Stillbirth ; Tanzania/epidemiology
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2021-07-22
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Multicenter Study
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0254916
    Database MEDical Literature Analysis and Retrieval System OnLINE

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