Browsing by Author "Kalabamu Florence S."

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    Acceptability Among Healthcare Providers of In Situ, Low-Dose, High-Frequency Neonatal Resuscitation Simulation Training Using Innovative Tools: Evidence from the Safer Births Bundle of Care
    (Children, 2025-07-02) Kalabamu Florence S.
    Introduction: Newborn mortality is unacceptably high, especially in low- and middle-income countries. The Safer Births Bundle of Care (SBBC) was implemented in Tanzania, including training of healthcare workers on neonatal resuscitation by means of frequent in situ simulation training using improved training tools. We aimed to assess the acceptability of this training model among healthcare providers in selected health facilities under SBBC intervention. Methods: A cross-sectional study was conducted among healthcare workers in labor wards and obstetric theaters in selected facilities one year after the introduction of the SBBC model. The theoretical framework for assessment of the acceptability of healthcare interventions was used to assess the acceptability of the training model and accompanying tools. The chi-square test was used to assess the association between acceptability in specific constructs and average individual practice per month, while a modified Poisson regression analysis was used to assess factors associated with acceptability in specific framework constructs. Results: A total of 227 healthcare workers were enrolled in the study. Overall, 223 (98.2%) accepted the intervention. However, 207 (91.2%) reported that the intervention increased their work burden, while 39 (17.2%) reported that it interfered with other equally important activities. The level of health facility was independently associated with the reporting that engaging in simulation practice interfered with other equally important activities. Conclusions: In situ, low-dose, high-frequency facility-based simulation training for neonatal resuscitation was highly acceptable among healthcare providers. However, the perceived increased work burden of this intervention and interference with other equally important activities were identified as potential threats to successful implementation. Keywords: acceptability; simulation; resuscitation; Neonatalie Live; NeoBeat
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    Availability and quality of vaccine cold chain equipment at healthcare facilities in Mtwara region, Tanzania: evidence from routine assessment of vaccine cold chain equipment
    (Tanzania Journal of Health Research, 2025-04-03) Kalabamu Florence S.
    The quality of vaccines is heavily dependent on maintaining proper cold chain equipment (CCE) throughout the supply chain. However, Tanzania faces significant challenges in this area. According to the Effective Vaccine Management Assessment (EVMA) of 2021, the country score was 73%, falling short of the 80% benchmark. The ongoing measles outbreak in several districts may be linked to the delivery of low-quality vaccines due to inadequate storage conditions. This study aimed to assess the availability and quality of CCE at healthcare facilities in the Mtwara region and identify areas for improvement. Methods: A descriptive cross-sectional study was conducted, utilizing an updated vaccine CCE inventory from 263 healthcare facilities (HFs) across nine councils in the Mtwara region. The updated inventory was compiled into a single Microsoft Excel dataset, which was then analyzed to determine the frequency and functionality of CCE. The findings were presented in tables for comparative analysis. Results: Routine immunization services were available at 263 out of 301 healthcare facilities (87.4%), with 234 (89%) of these being public facilities. Among them, 218 (82.9%) were dispensaries, and 209 (79.5%) were in rural areas. A total of 252 (95.8%) healthcare facilities had functional refrigerators, 115 (43.7%) of which were RCW 50EG models. Although all refrigerators met the World Health Organization's pre-qualification standards, 192 (76%) exhibited functional deficiencies. Additionally, 115 (43.7%) had been in use for over ten years, and 48 (19%) lacked temperature monitoring devices. While vaccine carriers were available, they showed deficiencies that made them unsuitable for effective vaccine storage. Conclusion: Most cold chain equipment (CCE) in the Mtwara region was in sub-optimal condition, potentially compromising vaccine quality and hindering immunization services. This could result in canceling immunization sessions, leading to low vaccination coverage and a failure to protect recipients. Urgent action is needed to repair or replace non-functional, outdated, and inefficient CCE. In addition, regular refresher training for healthcare providers on assessing and maintaining vaccine CCE is recommended, as well as the procurement of refrigerator models that are suitable for local conditions in alignment with manufacturer guidelines. Keywords: routine immunization, healthcare facility, cold chain equipment, vaccine refrigerator, vaccine quality, equipment inventory
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    Neonatal resuscitation skills acquisition among healthcare providers after Helping Babies Breathe simulation training using improved tools across two regions in Tanzania
    (Advances in Simulation, 2025-03-25) Kalabamu Florence S.
    Introduction Neonatal mortality is high in middle- and low-income countries, including Tanzania. Most of these deaths are preventable and linked to suboptimal quality of care. In this study, we assessed neonatal resuscitation skills acquisition after a 1-day Helping Babies Breathe (HBB) simulation training using improved tools and associated factors among healthcare providers in 12 facilities in Tanzania. Methods A cross-sectional study was conducted among healthcare providers working in the labor wards in selected health facilities. The training was conducted in situ using the HBB second edition curriculum with improved simulation tools (Neonatalie Live simulator, NeoBeat heart rate meter, and Upright resuscitator). After training, skills acquisition was evaluated using Objectively Structured Clinical Evaluation. Participants who scored an average of 75% or above were considered passing. Descriptive statistics were used to determine the proportion of staff who passed the evaluation by different demographic categories. One-way analysis of variance was used to compare mean scores among demographic categories. Factors associated with neonatal resuscitation skills acquisition were analyzed using modified Poisson regression. Results A total of 481 participants were enrolled in the study. Among these, 420 (87.3%) passed the skills evaluation on the first attempt. The overall mean skills score was 92.4%. In bivariable analysis, health facility level, region, age, and experience working in the labor ward were associated with passing skills evaluation on the first attempt. However, after controlling other variables in a multivariable model, none of the factors showed a statistically significant association. Conclusion In-situ, HBB simulation training using improved training tools effectively imparts neonatal resuscitation skills among healthcare providers. Participants learned skills similarly regardless of their different demographic characteristics, including level of education and working experience. Due to its potential to impart skills, frequent simulation training using improved tools may be considered for scaling up in other health facilities.
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    Practice, Experiences, and Facilitators of Simulation-Based Training During One Year of Implementation in 30 Hospitals in Tanzania
    (SAGE Open Nursing, 2025-01-03) Kalabamu Florence S.
    Introduction Enhancing the proficiency of healthcare workers (HCWs) in handling birth-related complications is crucial for reducing maternal and newborn morbidity and mortality. To achieve this, the Safer Births Bundle of Care offers a comprehensive set of innovative, simulation-based training interventions designed to strengthen the skills and competencies of HCWs working as skilled birth attendants. Objective To describe the use of in-situ low-dose, high-frequency simulation-based training, and the experiences of this usage among HCWs and stakeholders at facilities in Tanzania. Methods This mixed-methods study included quantitative and qualitative data collected between July 2021 and July 2022 across 30 health facilities in five regions of Tanzania. NeoNatalie Live (NNL) simulators were installed for independent skills and scenario training, and in-situ facilitator-led team simulations were introduced. The training frequency was analyzed using descriptive and analytical statistics, and mentorship and supervision reports were analyzed using qualitative content analysis. Results A large and sustained number of in-situ NNL skill-training sessions (n = 35,101) and facilitator-led team simulations (n = 266) were conducted during the first year. Clinical burden per HCW did not affect the frequency of NNL skills training at the health facility level (r = −0.16, p = .40) nor facilitator-led team simulations. There was a positive but weak correlation between the frequency of facilitator-led team simulations and NNL skills training (r = 0.34, p = .05). Qualitative data showed a high degree of motivation and participation among all stakeholders, and active use of hospital data, both clinical indicators and training data, was perceived as a success factor. Conclusion Facilitator-led in-situ simulation training was more likely to occur where individual skills-training sessions were recorded. Training sessions took place regardless of the increased workload.