The <em>Afya Jijini</em> program targeted improved access to and quality of health services in Nairobi City County through the strengthening of local health systems. The program took a systems thinking app...The <em>Afya Jijini</em> program targeted improved access to and quality of health services in Nairobi City County through the strengthening of local health systems. The program took a systems thinking approach recognizing that strong, coordinated commitments and contributions from various levels of multiple sectors such as health, public works, and education would be essential to the program’s success. Consistent with the World Health Organization’s proclamation that the provision of safe water, sanitation, and hygiene (WASH) are prerequisites for all public health endeavors, WASH-related efforts were woven into nearly all facets of the <em>Afya Jijini </em>program. IRC is a nonprofit located in the Netherlands focused on systems thinking approaches for sustainable WASH improvements. IRC’s 9 building blocks are tools to assist in breaking down the complexities of systems, identifying key actors and factors that contribute to sustainable improvements, and setting clear program indicators and targets for success. This conceptual manuscript seeks to explore the <em>Afya Jijini </em>program through the lens of the IRC’s building block approach to systems thinking. Examples of<em> Afya Jijini</em> programming aligned with each building block are presented to assist program planners and guide future interventions. <em>Afya Jijini</em> could have benefited from increased attention to several key building blocks, including<em> institutions</em>, <em>finance</em>, and <em>learning and adaptation</em>.展开更多
Stunting remains a particular challenge in Sub-Saharan Africa. Despite encouraging declines in Tanzania over the past 25 years, one-third of Tanzanian children under the age of five years are stunted. Diarrhea remains...Stunting remains a particular challenge in Sub-Saharan Africa. Despite encouraging declines in Tanzania over the past 25 years, one-third of Tanzanian children under the age of five years are stunted. Diarrhea remains one of the greatest causes of childhood stunting worldwide. Mass media has been used to improve the uptake of behaviors associated with reductions in diarrhea. This study evaluates the effectiveness of a mass media campaign in the Lake Zone region of Tanzania from 2015-2020 and positive changes in caregiver health-seeking behaviors related to diarrhea in children. Approximately 5000 households participated in a cross-sectional survey after a communications campaign. Exposure variables included hearing and seeing radio and TV spots and participating in a variety of interpersonal communication approaches. Study results indicated primary caregivers (mothers) exposed to media messages only (OR 1.66, CI 1.05 - 2.62), and to media messages and interpersonal communication (OR 2.51, CI 1.48 - 4.26), were more likely to seek advice or treatment for diarrhea from a health facility. Primary caregivers exposed to both media messages and interpersonal communication were more likely to give oral rehydration salts (OR 2.56, CI 1.72 - 3.79), zinc tablets/syrup (OR 1.74, CI 1.18 - 2.57), and homemade fluids (OR 2.02, CI 1.15 - 3.55) when their children had diarrhea. Male heads of household (fathers) exposure to mass media was not associated with care-seeking for diarrhea treatment.展开更多
文摘The <em>Afya Jijini</em> program targeted improved access to and quality of health services in Nairobi City County through the strengthening of local health systems. The program took a systems thinking approach recognizing that strong, coordinated commitments and contributions from various levels of multiple sectors such as health, public works, and education would be essential to the program’s success. Consistent with the World Health Organization’s proclamation that the provision of safe water, sanitation, and hygiene (WASH) are prerequisites for all public health endeavors, WASH-related efforts were woven into nearly all facets of the <em>Afya Jijini </em>program. IRC is a nonprofit located in the Netherlands focused on systems thinking approaches for sustainable WASH improvements. IRC’s 9 building blocks are tools to assist in breaking down the complexities of systems, identifying key actors and factors that contribute to sustainable improvements, and setting clear program indicators and targets for success. This conceptual manuscript seeks to explore the <em>Afya Jijini </em>program through the lens of the IRC’s building block approach to systems thinking. Examples of<em> Afya Jijini</em> programming aligned with each building block are presented to assist program planners and guide future interventions. <em>Afya Jijini</em> could have benefited from increased attention to several key building blocks, including<em> institutions</em>, <em>finance</em>, and <em>learning and adaptation</em>.
文摘Stunting remains a particular challenge in Sub-Saharan Africa. Despite encouraging declines in Tanzania over the past 25 years, one-third of Tanzanian children under the age of five years are stunted. Diarrhea remains one of the greatest causes of childhood stunting worldwide. Mass media has been used to improve the uptake of behaviors associated with reductions in diarrhea. This study evaluates the effectiveness of a mass media campaign in the Lake Zone region of Tanzania from 2015-2020 and positive changes in caregiver health-seeking behaviors related to diarrhea in children. Approximately 5000 households participated in a cross-sectional survey after a communications campaign. Exposure variables included hearing and seeing radio and TV spots and participating in a variety of interpersonal communication approaches. Study results indicated primary caregivers (mothers) exposed to media messages only (OR 1.66, CI 1.05 - 2.62), and to media messages and interpersonal communication (OR 2.51, CI 1.48 - 4.26), were more likely to seek advice or treatment for diarrhea from a health facility. Primary caregivers exposed to both media messages and interpersonal communication were more likely to give oral rehydration salts (OR 2.56, CI 1.72 - 3.79), zinc tablets/syrup (OR 1.74, CI 1.18 - 2.57), and homemade fluids (OR 2.02, CI 1.15 - 3.55) when their children had diarrhea. Male heads of household (fathers) exposure to mass media was not associated with care-seeking for diarrhea treatment.
