Background: Despite interventions improving maternal and newborn morbidity and mortality, progress has been sluggish, especially in hard-to-reach indigenous communities. Sociocultural beliefs in these communities more often influence the adoption of particular behaviors throughout pregnancy, childbirth, and postpartum. Therefore, this study identified sociocultural beliefs and practices during pregnancy, childbirth, and postpartum among indigenous pastoralist women of reproductive age in the Manyara region, Tanzania. Methods: The study was a descriptive qualitative design. We used purposive sampling to select twelve participants among community members who were indigenous women of Manyara who had ever experienced pregnancy. In-depth interviews were audio-recorded and transcribed verbatim, and organized manually. We used manual coding and inductive-deductive thematic analysis. Results: The study’s findings showed that sociocultural beliefs and practices are widespread, covering antenatal through childbirth to the postnatal period. Both harmful and harmless practices were identified. For example, the use of herbal preparations to augment labor was reported. Previously, most women preferred home delivery; however, the practice is changing because of increased knowledge of home delivery complications and the accessibility of the facilities. Nevertheless, women still practice hazardous behaviors like applying strange things in the birth canal after delivery, increasing the risk of puerperal infection. Conclusions: Sociocultural practices are predominant and widely applied throughout the peripartum period. These beliefs encourage adopting specific behaviors, most harmful to both mother and fetus. These sociocultural practices tend to affect the utilization of some essential maternal and child health practices. Eliminating unsafe peripartum practices will increase the use of medical services and ultimately improve outcomes for both mothers and their newborns. Public health interventions must recognize the cultural context informing these cultural practices in marginalized indigenous communities. Healthcare providers should routinely take the history of commonly traditional practices during the peripartum period to guide them in providing quality care to women by correcting all harmful practices.

Background: Antiretroviral therapy (ART) programs have expanded rapidly, and they are now accessible free of charge, yet "loss to follow-up, LTFU" is still a national public health issue. LTFU may result in treatment failure, hospitalization, increased risk of opportunistic infections and drug-resistant strains, and shortening the quality of life. This study described the rates and predictors of LTFU among adults living with human immunodeficiency virus (PLHIV) on ART in the Tanga region, Tanzania. Methods: A retrospective longitudinal cohort study was conducted between October 2018 and December 2020 in Tanga's care and treatment health services facilities. The participants were HIV adult PLHIV aged 15 years and above on ART and attended the clinic at least once after ART initiation. LTFU was defined as not taking ART refills for 3 months or beyond from the last attendance of a refill and not yet classified as dead or transferred out. Cox proportional hazard regression models were employed to identify risk factors for LTFU. P values were two-sided, and we considered a p < 0.05 statistically significant. Results: 57,173 adult PLHIV were on ART of them, 15,111 (26.43%) were LTFU, of whom 10,394 (68.78%) were females, and 4717 (31.22%) were males. Factors independently associated with LTFU involved age between 15 and 19 years (HR: 1.85, 95% CI 1.66–2.07), male sex (HR: 2.00 95% CI 1.51–2.62), divorce (HR: 1.35, 95% CI 1.24–1.48), second-line drug type (HR: 1.13, 95% CI 1.09–1.18), poor drug adherence (HR: 1.50, 95% CI 1.23–1.75), unsuppressed viral load (HR: 2.15, 95% CI 2.02–2.29), not on DTG-related drug (HR: 7.51, 95% CI 5.88–10.79), advanced HIV disease WHO stage III and IV (HR: 2.51, 95% CI 2.32–2.72). In contrast to cohabiting, ART duration < 1 year, and being pregnant showed a reduced likelihood of LTFU. Conclusion: A high prevalence of LTFU was observed in this study. Young age, not using DTG-based regimen, WHO clinical stage IV, poor drug adherence, male sex, unsuppressed viral load, divorcee, and second-line regime were independently associated with LTFU. To reduce LTFU, evidence-based interventions targeting the identified risk factors should be employed.

Background: Female genital mutilation (FGM) is one of the diehard cultures in the Mediterranean and sub-Saharan Africa. The act involves chopping off part of the female genitals in varying degrees depending on the society. The motive behind this practice includes reducing female sexual desire, a sign of maturation, and retaining the culture. The current study explored the roles of community members and leaders in the fight against FGM; and the reasons for continuing the practice in some societies. Method: We did an exploratory cross-sectional qualitative study between June – July 2020 in six purposively selected villages from Kilindi and Handeni districts in Tanga that were part of the five years implementation project. The project was named Alternative Right of Passage (APR) by Amref Health Africa Tanzania to eradicate FGM. The interventions were to sensitize the community on the effects of FGM on women’s health, educate and create demand for girl children to attend and complete school. Ethnic leaders and village members aged 19 years and above were purposively selected. Due to the sensitive nature of the study, FGDs were conducted separately between men and women. In addition, we did the inductive thematic analysis. Results: Four main themes emerged from the analysis; (1) the history of FGM and reasons behind persistent FGM practices, (2) Challenges to abandonment of FGM, (3) strategies to be used to eradicate FGM, and (4) Key change agents in ending FGM. It was reported that the FGM practice was inherited from elders years ago and is believed to reduce women’s sexual desire when the husband travels away for a long time. Some societies still practice FGM secretly because marrying an uncircumcised girl is a curse, as the husband and children will die. Some older women still practice FGM as they still hold the ancient culture. Constant communication with community leaders, seniors, and the young generation on complications of FGM will fasten efforts toward eradicating FGM practice. Conclusion: There are sporadic cases done secretly associated with FGM practice since the ant-FGM campaign, so this should be the reason to continue with the campaign. Winning the tribal/ethnic leaders can facilitate better achievement in the fight against FGM. In addition, social diffusion with inter-tribe marriages was also singled out as one of the factors that will make FGM practice unfamiliar to the communities in the future.

Purpose. This exploratory qualitative study aimed to analyze the experiences of healthcare providers (HCPs) in pharmacovigilance (PV) and ADR reporting in the southern highland zone of Tanzania. Methods. In 2022, an exploratory qualitative case study using in-depth interviews (IDIs) was conducted to explore the experiences of PV and ADR reporting among HCPs (doctors, nurses, and pharmacists). The study was carried out in a zonal referral hospital and a regional referral hospital of the Tanzanian southern highlands zone. Inductive-deductive thematic analysis was adopted for data analysis. Results. Participants demonstrated adequate knowledge of PV and its related activities including ADR reporting. Knowing the interactions and wrong medication dosage as sources of ADR, signs, and symptoms, stopping the drug, and treating the symptoms following ADR emerged as subthemes linked with adequate knowledge in identifying and managing ADR. Participants perceived reporting ADR as laborious, posing a subjective burden and that not all ADRs needed to be reported. The latter contributed to limited participation in ADR reporting despite that participants were conversant with both physical and online ADR reporting platforms. Conclusion. Although HCPs are well informed about PV and ADR reporting including the benefits to public health, their involvement in ADR reporting is low. In addition to the ongoing on-the-job training and regular supportive supervision for HCPs to improve the ADR practice, there is still a need to explore other strategies to be used as motives for HCPs to report ADR regularly.

The African Journal of Primary Health & Family Medicine welcomes submissions that encourage scholarly exchange between family medicine and primary health care researchers and practitioners across Africa and the developing world, whilst providing a contextual and holistic view of family medicine as practiced across the continent.