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One Health Approach (OHA) in Selected Urban Settings
in Tanzania: Knowledge, Attitudes, Awareness, and
Practices
Dr. Mikidadi .I. Muhanga
Department of Development Studies, College of Social Sciences and Humanities
Sokoine University of Agriculture, Morogoro, Tanzania
&
Prof. Jacob R.S. Malungo
Department of Population Studies, School of Humanities and Social Sciences
The University of Zambia
Presented on 28th November 2019 at
The Joint Conference for Tanzania One Health and 37th Tanzania Veterinary
Association (TVA) ,Arusha International Conference Center (AICC) in Arusha,
Tanzania , 27th to 29th November 2019.
In this presentation
Introduction and Problem Statement
Methodology
Measurement of Variables
Findings and Discussion
Conclusion and Recommendations
Ill-health and diseases pose barriers to
economic growth and subsequently to
national development worldwide
Apparently, attaining devpt goal calls
for improvement of health status of a
nation's population; however, there are
a number of challenges in attaining
good health
These challenges include the failure to recognize:- (i)
health as one, (ii) that there is no dividing line btn humans,
animals, & environmental health, (iii) lack of
understanding the consequences of humans, animals and
environment interactions on health, and (iv) need for
effective joint /collaborative efforts in control of infections
transmissible to man and animals.
In this context, there is an obvious need to empirically
document knowledge, attitudes, awareness, and practices
on the interactions of humans, animals and the
environment and its consequences on humans, animals and
environment health.
In cognisant of this, the Government of TZ introduced OH
Strategic Plan (2015–2020) (URT-PMO, 2015).
Despite pointing out to the issues related to consequences of interaction btn humans and animals (Kambarage et al., (2003), low awareness
(Scholz et al., 2008) and the the need for public health information awareness creation (Karimuribo, 2007) these studies have not
empirically studied KAPs.
Obviously there is a gap on knowledge & awareness on:-
human and animals’ interaction plus
its consequences and
lack of public health education
There is limited working cooperation between physicians and veterinarians
•Little is also empirically known on how One Health Strategic Plan has facilitated the enhancement of knowledge, awareness, and practices
(KAPs) under OHA
•Low awareness indicates apart from other factors lack of information on such interactions and its impact on health.
•This study was conducted in Morogoro region.
Morogoro is cited by The National One Health
Strategic Plan 2015 – 2020 under potential routes
of risks exposure due to the identification of
some incidences of zoonotic diseases in the area
(URT-PMO, 2015:16).
•Studies (Karimuribo, et al., 2005; Mgode et al.,
2014) have also identified health risks presence
in the area. This article analyses KAPs under
(OHA) in selected wards in Morogoro, Tanzania.
Theoretical Framework
•This study is guided by PEN-3 model under the Cultural
identity domain which recognizes the role of health
education in empowering People, Extended Family and
Neighborhood (PEN) to make informed health decisions.
•Also Relationships and Expectations domain which
encompasses Perceptions, Enablers, and Nurturers
(PEN). Perceptions contain the knowledge, attitudes,
values, and beliefs, within a cultural context, with the
potential to facilitate or obstruct personal, family, and
community motivation towards change (Airhihenbuwa,
1995:29-34; Yick and Oomen‐Early, 2009: 127-133).
Methodology
Study area: Morogoro municipality & Mvomero
districts , Morogoro, Tz region in Tanzania
Data: qualitative and quantitative
Research design: cross-sectional
Data collection tool: A structured questionnaire
population for the study : all households with
livestock species at Mvomero district. In Morogoro
district, the population included all the households
buying products from pastoralists from Mvomero
Sampling : multi-stage sampling procedure , four (4)
stages (in choosing districts, wards, villages/streets, and
HHs).
Purposive sampling: districts, wards and villages/streets
Simple random sampling : respondents.
Inclusion criteria for the wards at Mvomero: wards
pastoralists mostly residing, and for the HHs those having
animals being kept and selling livestock products to
Morogoro urban.
Wards included from Morogoro: areas products from
Mvomero districts were sold.
.
•Four wards were purposely selected, two from
each district after meeting the criterion. The
selected wards were Doma and Melela wards
in Mvomero districts also Mazimbu and
Kihonda Maghorofani in Morogoro
municipality. Thereafter two villages/streets
were purposively selected from the four wards
making a total of eight villages/streets.
For sample size estimation, a 95% confidence interval (CI), a
margin of error of 5%, and a design effect of 1.5 were
assumed. A minimum adequate sample size was calculated
based on the statistical estimation method of Kelsey et al.
(1996). A sample size of 1440 respondents was determined by
using the formulae:-
s=X2 NP (1- P) ÷d2 (N-1) + X2 P (1- P).
Where:-
s = required sample size.
X2 = the table value of chi-square for 1 degree of freedom at the desired confidence level
(3.841).
N = the population size.
P = the population proportion (assumed to be .50 since this would provide the maximum
sample size).
d = the degree of accuracy expressed as a proportion (.05).
.
Findings and Discussion
Socio-Demographic Characteristics of the Respondents
Table 1 presents the socio-demographic characteristics of
the respondents.
Knowledge on OHA
The results in Table 2 indicate that the minimum and maximum scores
on knowledge of OHA were 103.00 and 131.00 respectively with mean
score being 114.52 (95% CI: 114.2 to 114.9) with Standard Deviation
of 6.8 (95% CI: 6.5 to 7.1).
Table 2 present OHA knowledge into categories, the results indicate
that 37.8% (95% CI: 35.7 to 40.9) of the respondents had IOK, 29.9 %
(95% CI: 26.4 to 31.3) with MOK, and 32.3% (95% CI: 30.3 to 35.3)
had AOK.
Table 2: Knowledge on OHA
Awareness on the Concept and Practices
Related to OHA
The findings in Table 3 indicate that only 5% (CI 95%,
4.0 to 6.2) of the respondents who were interviewed were
aware of the concept of OHA.
Table 3: Awareness on on the Concept and Practices Related to OHA
Awareness on professionals collaboration
Table 4 reveal that only 3.8% (CI 95%, 2.8 to 4.8) of the
respondents were aware, with majority (91.3%: CI 95%,
89.7 to 92.7) were not aware on the ways in which these
professionals collaborated in the study area, other 5.0%
(CI 95%, 3.9 to 6.2) claimed that there were no any
collaborations observed within the specified period of
time.
Table 4: Awareness on professionals collaboration
Table 5 Awareness on Technical Collaboration on Diagnosis and Surveillance of Diseases (n=1440)
Awareness on Technical Collaboration on
Diagnosis and Surveillance of Diseases
The results in Table 5 indicate that only 2.5% (CI 95%, 1.7
to 3.3%) of the respondents are aware of some technical
collaboration on diagnosis and surveillance of zoonotic or
non-zoonotic diseases.
Table 5: Awareness on Technical Collaboration on Diagnosis and
Surveillance of Diseases (n=1440)
Responses Frequency Percent 95% Confidence Interval
Lower Bound Upper Bound
Not aware 1368 95.0 90.3 99.8
Aware 36 2.5 1.7 3.3
N/A 36 2.5 1.7 3.4
Total 1440 100.0 100.0 100.0
Attitudes towards OHA
Table 6 presents attitudes towards OHA into categories, whereas
30% (95% CI: 27.6 to 32.4) of respondents had negative
(unfavourable) attitude towards OHA, 38.5% (95% CI: 32.6 to 37.5)
had positive (favourable) attitude and 31.5% (95% CI: 32.5 to 37.4)
were undecided hence neutral attitude towards OHA.
Table 6: Attitudes towards OHA
Discussion
OHA is reported to be at its infancy in many areas
of the world (Millerand Olea-Popelka, 2013), no
wonder that people have little knowledge and
awareness on the concept and practices.
Low collaboration has similarly observed by
Mwinyi et al., (2015: 30) who claim that “One
Health in terms of collaboration, particularly
between human and animal health sectors to
prevent and control zoonoses has been low while
the sectors have a lot of things in common”.
•URT- Prime Minister’s Office (2015)
recognizes/acknowledges low awareness on
OHA, as it is revealed in One Health Strategic
Plan 2015 – 2020.
•Low collaboration on OHA is also partly
acknowledged by URT-MoHCDGEC (2017: 18)
as it reports that: “…..there is limited
coordination and collaboration between health
sector and other sectors as well as participation of
non-state actors in addressing emerging and re-
emerging diseases”.
•The findings from a study Mwinyi et al (2015) revealed that
respondents (98.5%) of the respondents would support
institutionalization of OH to a large extent.
During KII, it was observed that there has been a feeling that has
sometimes made it difficult for effective collaboration between
medical and veterinary professionals, as one participant claims:-
“It is just the way human health professionals have their views /perceptions on animals health
professionals that has always been a hindrance towards effective collaboration. Our colleagues
have always been considering themselves superior to us …..That has had a lot of negative
influence on collaboration …..”
•OH Strategic Plan is very important as it sets a
formal/institutionalised entry towards creating and maintaining
active collaboration.
•
Conclusion
Despite all these drawbacks, Tanzania has already put in
place enabling environment for the effective
collaboration between various professionals towards
attaining optimal health for humans, animals and the
environment. Through Tanzania’s 5-year One Health
Strategic Plan (2015–2020).
It, therefore, remains a necessary milestone for the
government to make an extra effort for what is in this
plan to translate into reality in terms of scaling up
collaboration of these professionals, through further
training, advocacy and research. Once this has been
effected, KAPs under OHA will be enhanced.
References
Listed in the main document
Acknowledgements
This study benefited from the support (financially
and technically) of INTRA-ACP Academic
mobility Scheme (EU-Funded consortium),
Sokoine University of Agriculture in Tanzania and
the University of Zambia