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Background. The Catholic University of Health and Allied Health Sciences, Kilimanjaro Christian Medical University College and Muhimbili University of Health and Allied Sciences teamed up to address gaps in the training curricula for medical doctors and nurses with the aim of developing harmonised curricular templates that would be comprehensive and suit national objectives. Objectives. To share experiences and lessons learned in engaging stakeholders using social media as an additional method to collect information on curricular gaps and ideas to develop harmonised medical and nursing curricula. Methods. Pictures, newsprint extracts, and videos of face-to-face events in the curriculum development process and project and a curriculum advert were posted on Facebook, Twitter and YouTube and used to engage stakeholders, including regulatory bodies, health professional councils, graduates, students, practitioners, health training institutions, private and public employers, internship supervisors, faculty and the public. Reactions, comments and post insights from stakeholder postings, in both Swahili and English, were analysed manually and categorised into four types of messages: congratulatory, comments on the process and expected outcomes, curricular gaps, and faculty development needs to implement new curricula. Results. A total of 69 290 stakeholders were engaged via Facebook and 229 via Twitter. A total of 13 553 (19.6%) Facebook and 179 (78.2%) Twitter comments were directly related to gaps in current curricula and graduate competencies. Other inputs received through social media were on faculty development needs to implement harmonised curricula and the project in general. Conclusion. This was the first attempt to engage curriculum stakeholders using social media for the development of harmonised curricula in Tanzania. The impact of social media in providing relevant inputs for curriculum development was significant. Use of social media, with multiple language options, is an economical and efficient way to reach a large number of stakeholders for curriculum quality improvement. [ABSTRACT FROM AUTHOR]

Background: The search for an efficacious HIV vaccine is a global priority. To date only one HIV vaccine trial (RV144) has shown modest efficacy in a phase III trial. With existing different HIV-1 subtypes and frequent mutations, multiple trials are needed from different geographical sites particularly in sub-Saharan Africa where most HIV infections occur. Thus, motivations to participate in HIV vaccine trials among Tanzanians need to be assessed. This paper describes the motives of Police Officers who showed great interest to volunteer in HIVIS-03 in Dar es Salaam, Tanzania.Methods: A descriptive cross-sectional study was conducted among Police Officers who showed interest to participate in the HIVIS-03, a phase I/II HIV vaccine trial in Dar es Salaam. Prior to detailed training sessions about HIV vaccine trials, the potential participants narrated their individual motives to participate in the trial on a piece of paper. Descriptive analysis using content approach and frequency distributions were performed.Results: Of the 265 respondents, 242 (91.3%) provided their socio-demographic characteristics as well as reasons that would make them take part in the proposed trial. Majority, (39.7%), cited altruism as the main motive. Women were more likely to volunteer due to altruism compared to men (P < 0.01). Researchers' explanations about HIV/AIDS vaccine studies motivated 15.3%. More men (19.6%) than women (1.7%) were motivated to volunteer due to researchers' explanations (P < 0.001). Also, compared to other groups, those unmarried and educated up to secondary level of education were motivated to volunteer due to researchers' explanation (P < 0.05). Other reasons were: desire to become a role model (18.6%); to get knowledge for educating others (14.0%); to cooperate with researchers in developing an HIV vaccine (9.5%); to get protection against HIV infection (7.0%), and severity of the disease within families (6.2%). These results were supported by testimonies from both men and women.Conclusions: Participation in an HIV vaccine trial in a Tanzanian context is likely to be influenced by altruism and comprehensive education about the trial. Gender differences, marital status and education level need to be considered to enhance participation in future HIV vaccine trials. [ABSTRACT FROM AUTHOR]

While interest in social disparities in health within affluent nations has been growing, discussion of equity in health with regard to low- and middle-income countries has generally focused on north-south and between-country differences, rather than on gaps between social groups within the countries where most of the world's population lives. This paper aims to articulate a rationale for focusing on within- as well as between-country health disparities in nations of all per capita income levels, and to suggest relevant reference material, particularly for developing country researchers. Routine health information can obscure large inter-group disparities within a country. While appropriately disaggregated routine information is lacking, evidence from special studies reveals significant and in many cases widening disparities in health among more and less privileged social groups within low- and middle- as well as high-income countries: avoidable disparities are observed not only across socioeconomic groups but also by gender, ethnicity, and other markers of underlying social disadvantage. Globally, economic inequalities are widening and, where relevant information is available, generally accompanied by widening or stagnant health inequalities. Related global economic trends, including pressures to cut social spending and compete in global markets, are making it especially difficult for lower-income countries to implement and sustain equitable policies. For all of these reasons, explicit concerns about equity in health and its determinants need to be placed higher on the policy and research agendas of both international and national organizations in low-, middle-, and high-income countries. International agencies can strengthen or undermine national efforts to achieve greater equity. The Primary Health Care strategy is at least as relevant today as it was two decades ago: but equity needs to move from being largely implicit to becoming an explicit component of the strategy, and progress toward greater equity must be carefully monitored in countries of all per capita income levels. Particularly in the context of an increasingly globalized world, improvements in health for privileged groups should suggest what could, with political will, be possible for all. [ABSTRACT FROM AUTHOR]

Given the worldwide epidemiologic transition and the lure of technology aggressively promoted by those profiting from it, policy-makers in developing as well as industrialized countries now frequently face decisions on the introduction of screening into routine health services. Concerns regarding development and equity raise issues that may not arise within the scientific, technical, or individually-focused ethical frameworks used in prior work on screening policy. Screening can divert attention from primary prevention of a society's most important threats to health, especially when primary prevention faces political challenges and screening costs are viewed in isolation from the overall strategy required to make it useful. For secondary prevention of diseases with easily recognizable symptoms, public education promoting timely self-referral to accessible medical services is preferable to "screening" unselected populations. In any country, but perhaps especially in developing countries, screening may waste scarce resources: it could also lead to widened inequities. [ABSTRACT FROM AUTHOR]