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      Mitigating the Rising Burden of Non-Communicable Diseases through Locally Generated Evidence-Lessons from Tanzania

      research-article
      , MD 1 , , MD 1 , , MD 1 , , MD 1 , , BPharm 1 , , MD 1 , , PhD 1 , , MMed 1 , , PhD 1 , , PhD 1 , 2 , , MMed 1 , , MD 1 , , PhD 3 , , PhD 3 , , MPH 2 , , MMed 2 , , MPH 3 , , PhD 1 , , MMed 4 , 5 , 6 , , PhD 1
      Annals of Global Health
      Ubiquity Press
      Non-communicable diseases (NCDs), epidemiological transition, advocacy, multi-stakeholders, Tanzania

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          Abstract

          Background:

          The burden of Non-Communicable Diseases (NCDs) is rapidly increasing globally, and low- and middle-income countries (LMICs) bear the brunt of it. Tanzania is no exception. Addressing the rising burden of NCDs in this context calls for renewed efforts and commitment by various stakeholders. This paper highlights local initiatives and strategies to combat NCDs in Tanzania and provides lessons for countries with similar contexts.

          Methods:

          We reviewed published and grey literature and conducted policy analysis on NCDs in Tanzania to examine the burden of NCDs and the national response addressing it. The documents included National NCD strategic plans, NCD research agenda, and reports from the World Diabetes Foundation and the World Health Organization. Moreover, a scoping review of ongoing NCD activities and programs in other countries was also conducted to supplement the evidence gathered.

          Results:

          The rising burden of NCDs as a result of the epidemiological transition in Tanzania called for the launching of a dedicated National NCD Control and Prevention Program. The Ministry of Health collaborates with local, national, and international partners on NCD prevention and curative strategies. This led to the development of important guidelines and policies on NCDs, including strengthening the capacity of health facilities and healthcare workers, increased community engagement and awareness of NCDs, and increased advocacy for more resources in NCD initiatives. Strong governmental commitment has been vital; this is demonstrated by a renewed commitment to the fight through national NCD week and related advocacy activities conducted annually. To ensure multi-stakeholders’ engagement and political commitment, all these activities are coordinated at the Prime Minister’s office and provide strong lessons for countries with contexts similar to Tanzania.

          Conclusion:

          Multi-stakeholders’ engagement, innovative approaches, and coordinated governmental efforts to address NCDs have shone a light on addressing the burden of NCDs and may be sustainable if aligned with locally available resources. Such initiatives are recommended for adoption by other nations to address the burdens of NCDs.

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          Most cited references26

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          Burden of non-communicable diseases in sub-Saharan Africa, 1990–2017: results from the Global Burden of Disease Study 2017

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            Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors

            Non-communicable diseases (NCDs) are of increasing concern for society and national governments, as well as globally due to their high mortality rate. The main risk factors of NCDs can be classified into the categories of self-management, genetic factors, environmental factors, factors of medical conditions, and socio-demographic factors. The main focus is on the elements of self-management and to reach a consensus about the influence of food on risk management and actions toward the prevention of NCDs at all stages of life. Nutrition interventions are essential in managing the risk of NCDs. As they are of the utmost importance, this review highlights NCDs and their risk factors and outlines several common prevention strategies. We foresee that the best prevention management strategy will include individual (lifestyle management), societal (awareness management), national (health policy decisions), and global (health strategy) elements, with target actions, such as multi-sectoral partnership, knowledge and information management, and innovations. The most effective preventative strategy is the one that leads to changes in lifestyle with respect to diet, physical activities, cessation of smoking, and the control of metabolic disorders.
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              Human resources for health care delivery in Tanzania: a multifaceted problem

              Background Recent years have seen an unprecedented increase in funds for procurement of health commodities in developing countries. A major challenge now is the efficient delivery of commodities and services to improve population health. With this in mind, we documented staffing levels and productivity in peripheral health facilities in southern Tanzania. Method A health facility survey was conducted to collect data on staff employed, their main tasks, availability on the day of the survey, reasons for absenteeism, and experience of supervisory visits from District Health Teams. In-depth interview with health workers was done to explore their perception of work load. A time and motion study of nurses in the Reproductive and Child Health (RCH) clinics documented their time use by task. Results We found that only 14% (122/854) of the recommended number of nurses and 20% (90/441) of the clinical staff had been employed at the facilities. Furthermore, 44% of clinical staff was not available on the day of the survey. Various reasons were given for this. Amongst the clinical staff, 38% were absent because of attendance to seminar sessions, 8% because of long-training, 25% were on official travel and 20% were on leave. RCH clinic nurses were present for 7 hours a day, but only worked productively for 57% of time present at facility. Almost two-third of facilities had received less than 3 visits from district health teams during the 6 months preceding the survey. Conclusion This study documented inadequate staffing of health facilities, a high degree of absenteeism, low productivity of the staff who were present and inadequate supervision in peripheral Tanzanian health facilities. The implications of these findings are discussed in the context of decentralized health care in Tanzania.
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                Author and article information

                Contributors
                Journal
                Ann Glob Health
                Ann Glob Health
                2214-9996
                Annals of Global Health
                Ubiquity Press
                2214-9996
                17 November 2023
                2023
                : 89
                : 1
                : 77
                Affiliations
                [1 ]Muhimbili University of Health and Allied Sciences, 9 United Nations Road, Upanga West P O Box 65001, Dar es salaam, Tanzania
                [2 ]Ministry of Health, P O Box 743, Dodoma, Tanzania
                [3 ]President’s Office Regional Administration and Local Government, P O Box, 1923 Dodoma, Tanzania
                [4 ]Tanzania Non-Communicable Diseases Alliance, P O Box 65201, Dar es salaam, Tanzania
                [5 ]Tanzania Diabetes Association, P O Box 65201, Dar es salaam, Tanzania
                [6 ]Shree Hindu Mandal Hospital, P O Box 581, Dar es salaam, Tanzania
                Author notes
                CORRESPONDING AUTHOR: Harrieth P. Ndumwa, MD Muhimbili University of Health and Allied Sciences, 9 United Nations Road, Upanga West P O Box 65001, Dar es Salaam, Tanzania harrieth.peter@ 123456gmail.com
                Author information
                https://orcid.org/0000-0003-0681-880X
                https://orcid.org/0000-0003-0563-8188
                https://orcid.org/0000-0002-2540-615X
                https://orcid.org/0000-0002-8312-0643
                https://orcid.org/0000-0002-3100-3066
                https://orcid.org/0000-0002-7300-1958
                https://orcid.org/0000-0002-1130-9279
                https://orcid.org/0000-0002-6693-2834
                https://orcid.org/0000-0003-0900-2937
                https://orcid.org/0000-0002-2384-4586
                https://orcid.org/0000-0002-5985-054X
                https://orcid.org/0000-0001-6895-9187
                https://orcid.org/0000-0003-3309-5395
                https://orcid.org/0000-0003-3625-0725
                Article
                10.5334/aogh.4111
                10655751
                38025921
                c1584f3c-49eb-4355-bfe9-e74bd10825d7
                Copyright: © 2023 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.

                History
                : 16 March 2023
                : 26 June 2023
                Categories
                Policy Paper

                non-communicable diseases (ncds),epidemiological transition,advocacy,multi-stakeholders,tanzania

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