eajahme

Multilevel Modelling of the Factors Associated with Stunting among Under-five Children in Tanzania: A Bayesian Approach

Edwin Musheiguza — 2026-09-06

Introduction: In Tanzania, prevalence exceeds 30% and is unevenly distributed across geographical areas. The observed distribution may reflect unobserved contextual factors; however, little literature applies Bayesian multilevel generalised linear mixed (B-MGLM) models, which can account for them. This study aimed to model the determinants of stunting, controlling for contextual factors at both the region and enumeration area levels.

Methods: This was a secondary data analysis using four recent Tanzania Demographic and Health Surveys (TDHS) datasets. We studied 7,492, 6,806, 8,929, and 4,797 under-five children in TDHS 2004/5, 2010, 2015/16, and 2022, respectively. We used B-MGLM models to evaluate the determinants of stunting. We used the deviance information criterion to compare the models.

Results: About 41.4%, 34.1%, and 28.96% of under-five children were stunted in 2010, 2015/16, and 2022, respectively. Controlling for other factors in the model, a unit increase in MPI increased the odds of stunting by 10% [AOR = 1.1; 95% CI: 1.1, 1.2], while a unit increase in WAMI reduced the odds of stunting by 64% [AOR=0.36; 95% CI: 0.3, 0.4] in 2015/16 and 2010, respectively. Other interesting results were that children with multiple births had 17% [AOR=0.83; 95% CI: 0.7, 0.9] lower odds and 68% [AOR=1.68; 95% CI: 1.5, 1.9] higher odds of stunting in 2004/5 and 2010, respectively.

Conclusion: Stunting is associated with individual and contextual factors. Critical efforts should focus on the availability of items that form WAMI and MPI, with greater emphasis on elements that form WAMI because of its consistent negative relationship with stunting across the two surveys. Nutrition education should target working mothers and households with food insecurity.

Unlocking the Door to Improved Sanitation: Exploring Factors Influencing Adoption of Improved Latrines in a Coastal Rural Area of Tanzania

Isabellah Sambo Luhanga — 2026-09-06

Introduction: Access to safe sanitation is a recognised human right, yet many rural communities in Tanzania continue to experience low adoption of improved latrines. This study explored factors influencing adoption of improved latrines in rural coastal households of Tanzania.

Methods: A phenomenological qualitative study in Mkubiru village, Mtwara, explored factors influencing adoption of improved latrines. Purposive sampling recruited 38 adults and community leaders, including latrine owners and non-owners. Data were collected through 14 interviews and four focus groups in Kiswahili during July–August 2023. Thematic analysis combined deductive and inductive coding in Atlas.ti. Trustworthiness was enhanced through triangulation, reflexivity, audit trails, and thick description. The study obtained ethical approval and informed consent.

Results: Participants identified interrelated barriers and facilitators of improved-latrine adoption. Normalised open defecation was the leading barrier, compounded by sandy soils, high water tables, and rainfall that increased construction difficulty and costs. Competing household priorities, limited technical knowledge, and perceptions that improved latrines were for wealthier households further constrained adoption. Incremental construction, peer examples, local enforcement, health-worker engagement, and anticipated privacy, convenience, dignity, and safety promoted uptake.

Conclusion: Adoption of improved latrines in rural coastal communities is shaped by entrenched social norms, environmental constraints, and affordability challenges. Interventions should prioritise culturally sensitive strategies that address social norms and promote feasible latrine construction options suited to the coastal environment.

Experiences of Youth and Service Providers with Internet-Based Approaches for Delivering Sexual and Reproductive Health Information in Kinondoni Municipal Council, Dar es Salaam, Tanzania

Mangi J. Ezekiel — 2026-07-07

Introduction: Youth in low- and middle-income countries (LMICs) face limited access to sexual and reproductive health (SRH) information and services, and internet-based approaches are increasingly used to address this gap. This study explored the experiences of youth and service providers in Kinondoni Municipal Council, Dar es Salaam, regarding internet-based delivery of SRH information.

Methods: A phenomenological qualitative design was employed, including 12 in-depth interviews (IDIs) with youth, 4 IDIs with healthcare workers, 3 IDIs with NGO staff, and 2 focus group discussions (FGDs) with 6 participants each (one male, one female). Data were analyzed thematically using NVivo version 14.

Results: Findings are organized into two main themes: (1) service providers’ perspectives on internet-based approaches, including perceived benefits, limitations, and preferred platforms; and (2) youths’ views on accessibility, effectiveness, and challenges, including preferred digital platforms and content formats, barriers such as cost and misinformation, trust in online sources, and linkage to physical SRH services. Youth emphasized accessibility and interactivity as key enablers, while providers highlighted scalability and confidentiality.

Conclusion: Well-designed internet-based SRH interventions can enhance engagement, complement facility-based services, and support strategies to improve youth access to SRH information and services in Tanzania