Changes in exposure to information, communication and knowledge about AIDS among school children in Northern Tanzania, 1992-2005.

This article aims to investigate changes in primary school students' reported exposure to AIDS information and communication, and knowledge levels from 1992 to 2005. A repeated cross-sectional design was used. In 1992, a self-administered questionnaire was completed by 2,026 sixth and seventh grade students from 18 randomly selected primary schools in Arusha and Kilimanjaro regions, Tanzania. The same procedures were repeated in 2005 with a sample of 2,069 students. Mean values with 95% confidence intervals are reported. Chi-square was used to test for differences in proportions. Students in 2005 reported higher levels of exposure to information and communication from all sources than in 1992. Knowledge scores also increased, yet there was a significant decline in four variables, two of which are related to transmission and two of which are factual. An alarming decline in awareness of the condom as a preventative measure was found. Findings also indicate that myths related to transmission and infection persist. Salient sex differences remain, but the knowledge gap is narrowing. Interventions should aim to stimulate discussion in young people's social networks in order to increase overall exposure to AIDS information, communication and knowledge.

Status and Visions for the School Health Service as Reported by Local Health Care Workers in Northern Tanzania

Objective: The World Health Organization's (WHO) Global School Health Initiative provides a strategy to utilize schools to promote health and reduce the burden of diseases worldwide. The aim of this study was to investigate local school health work in Tanzania in relation to existing national guidelines and the WHO initiative. Methods: We intervie- wed 30 health care workers employed at 15 health institutions throughout Arusha and Kilimanjaro regions. Results: The results indicate a wide gap between the national and international guidelines for school health programs and the health workers' current practices. We found the main obstacles to providing adequate health care to be related to the burden of poverty that influences all levels of school health services; lack of clarity regarding the current official guidelines for school health services; and lack of appropriate offers for continuing education in the area of school health services. Conclusion: In order to successfully establish an integrated school health service; the working relationship between schools; health centres and the community clearly needs improvement

Use of health services and reported satisfaction among primary school adolescents in Arusha, Tanzania.

PURPOSE: To describe Tanzanian adolescents' utilization of health services, their satisfaction with the health services, and determinants of their satisfaction with these services. METHODS: A questionnaire was administered to 1279 seventh-grade school pupils, measuring use of health services in the past 2 years, reasons for seeking health services, and satisfaction with the health services provided during the last visit. Descriptive statistics were calculated on health service utilization and satisfaction variables, and univariate and multiple logistic regression analyses were performed to assess the factors associated with reported satisfaction with the health services. RESULTS: Seventy-five percent of the respondents reported using modern health services only, 1.2% used traditional services only, and 10% had used both during the past 2 years. Fever was the most common reason for seeking modern health services, followed by injury. The vast majority of the respondents reported being satisfied with the services provided during the last visit. Age was the only factor significantly associated with being very satisfied with traditional health services, whereas type of health facility and discussion of the issues of sexually transmitted diseases and AIDS were significantly associated with being very satisfied with modern health services during the last visit. CONCLUSION: Urban primary school adolescents report using modern health services, and the majority are satisfied with the services.

Health services utilisation among secondary school students in Arusha region, Tanzania.

OBJECTIVE: To investigate patterns and determinants of health services utilisation by secondary school students. DESIGN: A cross-sectional survey. SETTING: Twelve secondary schools located within seven districts of Arusha region Tanzania. PARTICIPANTS: Three thousand six hundred and three students proportionately selected from the twelve schools according to enrolment size. MAIN OUTCOME MEASURES: Self-reported use of modern and traditional health services within the past two years. RESULTS: The majority (77%) of the students used only modern health services while very few (1.3%) used only traditional services. Fever was the main reason for seeking health care during the last visit. Respondents who used traditional services expressed lower level of satisfaction with the services than those who used modern services. Living situation and socio-economic status of respondent's family predicted utilisation of modern health services whereas self-rated health status and perception that poverty was a threat against one's health predicted utilisation of traditional health services. CONCLUSIONS: Since most of secondary school students use modern health services, improvement of the modern health system is likely to benefit this population. Further work is needed to elucidate factors that facilitate or impede use of health services by young people in Tanzania.