Financial constraints and risk taking are two well-established determinants of firm performance, however, no research analyzes how these variables are connected in the context of a high risk environment. Using data from microfinance clients in Tanzania, we derive a novel financial constraints measure and incorporate a psychometric risk taking scale. Results confirm the importance of access to finance and risk attitudes for business development. Also, we provide preliminary evidence for an interaction between financial constraints and risk taking. Financial constraints “throw sand in the wheels” and protect risk taking entrepreneurs from the negative impact of risk taking on microenterprise performance.
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Objective: In the context of a programme to improve people-centered care, launched by the Tanzanian Ministry of Health, an international project (HEALCARe) was initiated to enhance the health literacy (HL) and respectful compassionate care (RCC) competencies of Bachelor’s nursing and midwifery students. Part of the project involved exploring the perceptions of different stakeholders regarding what facilitates these students’ competencies. This paper specifically reports the perceptions of faculty lecturers and clinical instructors. Methods: We conducted nine focus groups with lecturers and instructors from three Tanzanian universities and their teaching hospitals, with a total of 65 participants. Results: Through thematic analysis, seven themes were identified: ‘knowledge of HL,’ ‘knowledge of RCC,’ ‘modules with clear key components in the curriculum,’ ‘expert teaching in the faculty classroom,’ ‘priority of supervision in the clinical setting,’ ‘learning methods, materials and resources,’ and ‘evaluation tools and monitoring the transfer from theory to practice.’ Conclusions: The findings show that students need to be supported in transferring the theory taught in class to clinical practice in patient care. The curricula of all universities and corresponding hospitals should specifically address the training of HL and RCC competencies. This will facilitate the improvement of students’ competencies, contributing to better health outcomes in Tanzania.
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This study investigates patients' access to surgical care for burns in a low- and middle-income setting by studying timeliness, surgical capacity, and affordability. A survey was conducted in a regional referral hospital in Manyara, Tanzania. In total, 67 patients were included. To obtain information on burn victims in need of surgical care, irrespective of time lapsed from the burn injury, both patients with burn wounds and patients with contractures were included. Information provided by patients and/or caregivers was supplemented with data from patient files and interviews with hospital administration and physicians. In the burn wound group, 50% reached a facility within 24 hours after the injury. Referrals from other health facilities to the regional referral hospital were made within 3 weeks for 74% in this group. Of contracture patients, 74% had sought healthcare after the acute burn injury. Of the same group, only 4% had been treated with skin grafts beforehand, and 70% never received surgical care or a referral. Together, both groups indicated that lack of trust, surgical capacity, and referral timeliness were important factors negatively affecting patient access to surgical care. Accounting for hospital fees indicated patients routinely exceeded the catastrophic expenditure threshold. It was determined that healthcare for burn victims is without financial risk protection. We recommend strengthening burn care and reconstructive surgical programs in similar settings, using a more comprehensive health systems approach to identify and address both medical and socioeconomic factors that determine patient mortality and disability.
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Training nurses and midwives to treat their patients well There are some specific factors facilitating the modification of the nursing and midwifery bachelor curriculum The development of health literacy and respectful and compassionate care competences among bachelor nursing and midwifery students in Tanzania
