Many adolescent girls and young women (AGYW) experience gender-based violence (GBV) in Tanzania and only few seek GBV health services following violence. The objectives of our study are (1) to evaluate knowledge of gender-based violence among AGYW, (2) to explore their perceptions of and experiences with GBV health service quality and (3) to evaluate access to comprehensive GBV services. This study employed an explanatory, sequential mixed methods design in two districts of Dar es Salaam, Tanzania (Kinondoni and Temeke). A quantitative cross-sectional survey among AGYW (n = 403) between 15–24 years old was performed to assess their knowledge of GBV as well as perceptions of and experiences with GBV health services. The quantitative data was complemented by 20 semi-structured in-depth interviews with participants. Out of 403 study participants, more than three quarters (77.9%) had moderate to good knowledge of how GBV is defined and what constitutes gender-based violence. However, few participants (30.7%, n = 124) demonstrated knowledge of GBV health services offered at local health facilities. For example, only 10.7% (n = 43) of participants reported knowledge of forensic evidence collection. Additionally, of 374 participants (93% of total participants) who reported to have received GBV education sessions, only 66% accessed GBV health services (n = 247) and about half of these (52.7%, n = 130) were satisfied with these services. The study indicated that—despite good knowledge about what constituted GBV—knowledge about the roles and availability of GBV health services was limited and utilization of GBV health services remained low. Coordinated actions need to be strengthened to reach AGYW who remain unaware of GBV health services offered at health facilities by improving GBV service quality, bettering interventions aimed at reducing GBV among AGYW in Tanzania, and scaling-up integrated service models, such as GBV one-stop centers.

(1) Background: Gender-based violence (GBV) is widespread globally and has a myriad of adverse effects but is vastly under-reported. Health care workers are among the first responders in GBV. The objective of this study was to assess the knowledge of health workers with regard to GBV and related management guidelines and implementation. (2) Methods: The study employed a descriptive, sequential mix-method study, beginning with the quantitative part, followed by the qualitative component. Qualitative analysis was conducted using a content framework approach. (3) Results: More than two-thirds (71.79%) of health workers were found to be generally knowledgeable about gender-based violence; however, only 36.9% had good knowledge about gender-based violence management guidelines for gender-based violence and the mean value for all the items was less than 3 which indicates poor knowledge of the management guideline. Additionally, only 36.8% found the gender-based violence management guidelines useful and practical in clinical care for gender-based violence cases. (4) Conclusions: The finding of this study revealed that knowledge of gender-based violence management guideline was not adequate among health workers and rarely used during management of GBV cases. This calls for continuous training and specific refresher courses, including on-site practical sessions, professionals’ mentorship, and supervision.

BACKGROUND Hypertension remains a major public health challenge across Africa because of low control rates. In a global Lancet Non-Communicable Disease (NCD) Risk study, the national BP control in Ghana remains below 20%, underscoring critical gaps in detection, treatment, and long term management. To address these deficiencies, the Ghana Heart Initiative (GHI) implemented a comprehensive capacity-building programme aimed at strengthening hypertension and cardiovascular diseases management within primary, secondary and tertiary OBJECTIVE To evaluate the impact of the Ghana Heart Initiative capacity-building programme on BP levels and hypertension control among adults in the Greater Accra Region. METHODS We conducted a quasi-experimental study in Greater Accra between September 2020 and December 2023 involving 1,849 adults newly diagnosed with hypertension. BP was assessed at baseline, and at 3, 6, and 12 months. We compared the national BP control rate of 18.6% to the control after GHI intervention. The intervention comprised a multifaceted capacity building programme that included cardiovascular disease-focused clinical training, provision of equipment, mentorship program, digital health application, and call-centre support for clinicians. BP control was assessed using thresholds from JNC8, WHO, ESH and ACC/AHA criteria. Analyses included paired comparisons, McNemar tests, and difference-in-differences models. RESULTS Mean baseline systolic and diastolic BP were 162.1 and 94.6 mmHg, respectively, with no significant sex differences. By 12 months, systolic BP had declined by 16.6 and diastolic BP by 7.7 mmHg and BP control was 38.0% in men and 36.1% in women (mean 36.7%). Pre-GHI intervention survey of the facilities yielded control rate of 5% at 3 months, increasing to 29.2% (using 140/90 criteria) post-GHI intervention. Within-person improvements were significant (p<0.001). Difference-in-differences analysis demonstrated net improvements of 16.7 percentage points using 140/90 and 12.9 percentage points using 130/80 CONCLUSIONS The Ghana Heart Initiative capacity-building programme led to substantial and sustained improvements in BP control CLINICALTRIAL Ethical approval for the study was obtained from the Ghana Health Service Ethics Review Committee (GHS-ERC: 018/05/19)