Access and Challenges of Health Facilities amongst Agro-pastoralist Communities in Handeni District, Tanzania
Main Article Content
Abstract
This study examines high incidence of under-five mortality among agro-pastoralists resulting from lack of access to healthcare facilities. A proportional sampling method was adopted, and descriptive statistics and binary logistic regression were used in data analysis. The results revealed low dependence of agro-pastoralists on formal healthcare facilities, which could be explained by prevalence of informal healthcare facilities in villages where they reside. Education, income, accessibility, and duration of stay in a particular area accounted for the choice of healthcare facilities. Level of education and income determined preference for formal health facilities, possibly due to influence of education on understanding benefits of treatment in formal health facilities and income to meet associated costs. Accessibility of health facility influenced the decision to patronize formal health facilities. This was evident in villages which were connected to reliable road networks. Additionally, the length of time one resides in a particular area played a role in adhering to traditional values influencing the choice of informal healthcare facilities. The government and private sector should invest in rural road networks and promote education among agro-pastoralists on importance of using formal healthcare facilities and rational use of household income to improve accessibility to formal health facilities.
Article Details
References
• Acacio, S., Verani, J.R., Lanaspa, M., Fairlie, T.A., Nhampossa, T., Rupere, Z., & Sigauque, B. (2015). Under treatment of pneumonia among children under 5 years of age in amalaria-endemic area: Population-based surveillance study conducted in Manhica district- rural, Mozambique. International Journal of Infectious Diseases, 36, 39 – 45.
• Acharya, D.R., Bell, J.S., Simkhada, P., Teijlingen, E.R., & Regmi, P.R. (2010). Women’s autonomy in household decision making: A demographic study in Nepal. Journal of Reproductive Health, 7(15), 1 – 12.
• American Diabetes Association. (2015). Standards of medical care in diabetes. Journal of Clinical and Applied Research and Education, 38, 1 – 99.
• Atwine, F., Hultsjö, S., Albin, B., & Hjelm, K. (2015). Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews. Retrieved from http://www.ncbi.nlm.gov/pmc/articles/PMC 4450037/ Site visited on 12/07/2016
• Babbie, E.R. (1990). Survey research methods. Wadsworth Publishing Co, Belmount, California.
• Bailey, K.D. (1994). Methods of social research. (4th ed.). the Free Press, New York.
• Bailey, K.D. (1998). Methods of social research. (4th ed.). The Free Press, New York.
• Bee, F.K., Diyamett, M.L.N., & Towo, E.N. (2002). Challenges to traditional livelihoods and newly emerging employment patterns of pastoralists in Tanzania. International Labour Office, Geneva.
• Boex, J., Fuller, L., & Malik, A. (2015). decentralized local health services in Tanzania are health resources reaching primary health facilities, or are they getting stuck at the district level? Urban Institute Elevate Debate, Washington DC.
• Boureima, A., & Flury, M. (2016). Land and development of pastoral areas in Sub - Saharan Africa. Capex in supporting pastoral development. Swiss Agency for Development and Cooperation, Switzerland.
• Botterli, A. (2015). Adopting to climate change through villagization? The context of sedentary vulnerability in Afar region Ethiopia. Dissertation for Award of MSc Degree at Norwegian University of Life Sciences, Norway.
• Bryman, J. (2004). Social research methods Bureau of Statistics, Dar es Salaam. Bulleting Ankel Niehof, 20(2), 1 – 7.
• Caulfield, T., Onyo, P., Byrne, A., Nduba, J., Nyagero, J., Morgan, A., & Kermode, M. (2016). Factors influencing place of delivery for pastoralist women in Kenya: a qualitative study. BioMed Central Women's Health, 16(52), 1 – 11.
• Charlton, K.E., & Rose, D. (2001). Nutrition among older adults in Africa: The situation at the beginning of the millennium, nutrition and aging in the developing world. Retrieved November 8, 2016 from http://jn.nutrition.org/content/131/9/2424S.full.pdf+html
• Chauhan, R.C., Manikandan., Purty, A.J., Samuel, A., & Singh, Z. (2015). Determinants of health care seeking behaviour among rural population of a coastal area in South India, International Journal of Scientific Reports, 1(2), 118-122
• Cheikhyoussef, A., Shapi, M., Matengu, K., & Ashekele, H.M. (2011). Ethnobotanical study of indigenous knowledge on medicinal plant use by traditional healers in Oshikoto region, Namibia. Journal of Ethnobiology and Ethno Medicine, 7(10), 1 – 11.
• Christina, M., Surawicz, M.D., Lawrence, J., Brandt, M.D., David, G., Binion, M.D., & Zuckerbraun, M.D. (2013). Guidelines for diagnosis, treatment, and prevention of clostridium difficile infections. The American Journal of Gastroenterology, 108, 478 – 498.
• Dawood, O.T., Hassali, M.A., & Saleem, F. (2017). Factors affecting knowledge and practice of medicine use among the general public in the State of Penang, Malaysia. Journal of Pharmaceutical Health Services Research, 8(1) 51-57.
• Delice, A. (2010). The sampling issues in quantitative research, Turkey.
• Downie, R. (2012). The road to recovery: A report of the CSIS global health policy centre. Centre for Strategic and International Studies, Washington DC.
• Duba, H.H., Mur-Veema, I.M., & Van Raak, A. (2001). Pastoralist health care in Kenya. International Journal of Integrated Care, 1, 1 – 12.
• Enwerem, N.Y., Obirieze, A.C., & Bishai, D.M. (2014). Estimating the influence of maternal
height on under five mortality in Nigeria. African Journal of Reproductive Health,
(1), 54 – 60.
• English, M., Reyburn, H., Goodman, C., & Snow, R.W. (2009). Abandoning presumptive antimalarial Treatment for febrile children aged less than Five years-A Case of Running before We Can walk? PLoS Medicine, 6(1), 1-3. Retrieved June 04, 2016 from www.plosmedicine.org
• Eshete, M.A., Kelbessa, E., & Dale, G. (2016). Ethnobotanical study of medicinal plants in Guji Agro-pastoralists, Blue Hora District of Borana Zone, Oromia Region, Ethiopia. Journal of Medicinal Plants Studies, 4(2), 170-184.
• Gray, D.E. (2014). Doing research in the real World. Sage Publications, UK.
• Ibrahim, F., & Ibrahim, B. (1998). The Maasai herbalists in Arusha Town, Tanzania. Geo Journal, 46, 141–154.
• Kadobera, D., Sartorius, B., Masanja, H., Mathew, A., & Waiswa, P. (2012). The effect of distance to formal health facility on childhood mortality in rural Tanzania, 2005 2007. Makerere University, Uganda.
• Kayombo, E.J. (2013). Impact of training traditional birth attendants on maternal mortality and
morbidity in Sub Saharan African countries. Tanzania Journal of Health Research, 15(2), 1 – 11.
• Kónya, V., Matić, D., & Pavlović, J. (2016). The influence of demographics job characteristics and characteristics of organizations on employee commitment. Acta Polytechnica Hungarica, 13(3), 119 – 138.
• Lemire, J., & Lemire, J. (2016). An interdisciplinary clinic in rural Tanzania – observations on chiropractic care in a developing nation. Journal of Canadian Chiropractic Association, 60(2), 131 – 136.
• Minstry, N., Rangan, S., Dholakia, Y., Lobo, E., Shah, S., & Patil, A. (2016). Durations and delays in care seeking, diagnosis and treatment initiation in uncomplicated pulmonary tuberculosis patients in Mumbai, India. Plos One, 10(1371), 1 – 17.
• Mrisho, M., Obrist, B., Schellenberg, J.A., Haws, R.A., Mushi, A.K., Mshinda, H., … Schellenberg, D. (2009). The use of antenatal and postnatal care: Perspectives and experiences of women and health care providers in rural southern Tanzania. BioMed Central Pregnancy and Childbirth, 9(10), 1 – 12.
• Muiya, B.M., & Kamau, A. (2013). Universal health care in Kenya: Opportunities and challenges for the informal sector workers. International Journal of Education and Research, 1(11), 1-10.
• Montenegro, H., Holder, R., Ramagem, C., Urrutia, S., Ricardo, F., Tasca & Gomes, A.M. (2011). Combating health care fragmentation through integrated health service delivery networks in the Americas: Lesson Learned. Journal of Integrated Care, 19(5), 1 – 11.
• Mwamfupe, D. (2015). Persistence of farmer header conflicts in Tanzania. International
Journal of Scientific and Research Publications, 5(2), 2250 – 3153.
• Pallant, J. (2007). SPSS Survival manual, A step by step guide to data analysis using SPSS for Windows, third edition. Open University Press, England.
• Rufino, M.C., Thornton, P.K., Ng’ang’a, S.K., Mutie, I., Jones, P.G., Van Wijk, M.T., & Herrero, M. (2013). Transitions in agro-pastoralist systems of East Africa: Impacts on food security and poverty. Agriculture, Ecosystems and Environment, 179, 215– 230.
• Shehu, C.E., Ibrahim, M.T.O., Oche, M.O., & Nwobodo, E.I. (2016). Determinants of place of delivery: A comparison between an urban and a rural community in Nigeria. Journal of Public Health and Epidemiology, 8(6), 9 – 101.
• Shidhaye, R., Lund, C., & Chisholm, D. (2015). Closing the treatment gap for mental, neurological and substance use disorders by strengthening existing health care platforms: Strategies for delivery and integration of evidence-based interventions. International Journal of Mental Health Systems, 9(40), 1 – 11.
• Simon, T.D. (2007). Health care accessibility and Socio-economic groups. Theoretical Framework and review of literature, A study of Kerala.
• Tanga City Council Report. (2012). Tanga region investment profile report.
• Tsegaye, D., Vedeld, P., & Moe, S.R. (2013). Pastoralists and livelihoods: A case study from northern Afar, Ethiopia. Journal of Arid Environments, 91, 138 – 146.
• UNICEF (2016). A fair chance for every child: The state of the world's children. UNICEF, New York, USA.
• URT (2010). Tanzania demographic and health survey. National Bureau Statistics, Dar es salaam, Tanzania.
• URT (2012). Population distribution by administrative units. population and housing census. National Bureau of Statistics Ministry of Finance, Dar es Salaam.
• URT (2013). Basic data for livestock and fisheries sectors. Ministry of Livestock and Fisheries Development.
• URT (2015). Mortality and healthy. National Bureau of Statistics, Ministry of Finance Dares Salaam and Office of Chief Government Statistician Ministry of State, President Office, Dar es Salaam, Tanzania.
• Yaya S., Bishwajit, G., & Ekholuenetale, M. (2017). Factors associated with the Utilization of Institutional Delivery Services in Bangladesh. PLoS ONE, 12(2), 1-14. doi: 10.1371/journal. pone.0171573