Mark Urassa
Dados Biográficos
| ID | 158764 |
|---|---|
| NOME | Mark Urassa |
| PRENOMES | Mark |
| SOBRENOME | Urassa |
| ASSINATURA | URASSA M |
| AFILIAÇÕES | National Institute for Medical Research |
| ORCID | 0000-0003-0257-6938 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 52 |
| TOTAL DE CITAÇÕES | 148 |
| TOTAL COMO AUTOR | 52 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2003 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 7 |
Childcare in Transition
Highlights This study uses novel data on multiple childcare types from both kin and nonkin in two culturally similar communities with varying market integration. It tests the hypothesis that market integration is associated with reduced kin support. Who provides support and the type of support vary by level of market integration. Market integration disrupts childcare support from paternal but not maternal kin. Distant kin and nonkin substitute fo…
Cause-specific mortality transition among women of reproductive age with special reference to maternal mortality
BACKGROUND: Limited population data exist on mortality and causes of death among women of reproductive age, including maternal mortality. OBJECTIVE: To present trends from 1995 to 2022 in mortality, cause of death, maternal mortality ratio and place of death from the rural Magu health and demographic surveillance site in north-west Tanzania. METHODS: Data on residency, fertility, and verbal autopsy were analysed to compute trends in all-cause and…
Trends in Median Age at First Sex and Age at First Marriage Among Youth in Tanzania
Understanding trends in age of first sex and first marriage is vital for interventions addressing sexually transmitted infections (STIs/HIV) and youth sexual behavior. Shifts in these milestones affect fertility, contraceptive use, and STI/HIV dynamics. Traditional descriptive statistics often overlook younger populations, leading to inaccurate trend assessments. This study analyzed trends in median age at first sex and first marriage using survi…
Children's Caregiving and Growth in Northwestern Tanzania
Receiving care from individuals other than one's mother (i.e., allomothering) is a universal aspect of raising children, but whether and how such care impacts children's health remains subject to debate. Existing studies in low‐income societies largely use broad proxies for caregiving behaviors rather than measuring childcare activities, which may mask variation in allomothering and, thus, its impact on children's health. Using data collected to …
A snake with no teeth
In this urbanizing Tanzanian community, supportive men may face reputational harm, social exclusion, and even physical violence—particularly from other men and elders. • Supportive men’s marriage prospects, sexuality, and reproductive capabilities are often subject to scrutiny. • Urbanization appears to introduce new incentives for men to support women’s empowerment, including social prestige, access to novel employment, and increased adaptabilit…
Prestige and gender role ideology
With the objective of informing theoretical accounts of social learning and gendered conflict, we explore the role of prestige in the formation of men’s beliefs about gender in a semi-rural but fast urbanizing community in north-western Tanzania. Using focus groups and participant observation, we contrast the extent to which young men view elders and men from the neighbouring city as prestigious, and the beliefs they ascribe to each category. Eld…
You are Married by the Woman
Engaging men in women's empowerment is a global priority, yet there is still limited understanding of how men's support for women's empowerment is conceptualized across diverse demographic groups, particularly within communities undergoing change. This gap is especially critical in rural-urbanizing contexts, representative of many contemporary Global South settings, where individuals navigate tensions between respecting tradition while responding…
Levels, trends and inequalities in mortality among 5–19-year-olds in Tanzania
Background: For the past two decades, health priorities in Tanzania have focussed on children under-five, leaving behind the older children and adolescents (5-19 years). Understanding mortality patterns beyond 5 years is important in bridging a healthy gap between childhood to adulthood. We aimed to estimate mortality levels, trends, and inequalities among 5-19-year-olds using population data from the Magu Health and Demographic Surveillance Site…
Causes of death among older children and adolescents (5–19 years) in the Magu Health and Demographic Surveillance Study, Tanzania, 1995–2022
BACKGROUND: Population data on mortality and causes of death among 5-19-year-olds are limited. OBJECTIVES: To assess levels, trends, and risk factors of cause-specific mortality and place at death among 5-19-year-olds in Tanzania (1995-2022). METHODS: Using longitudinal data from the Magu Health and Demographic Surveillance System in northwest Tanzania, we identified leading causes of death among 5-19-year-olds from verbal autopsy interviews, usi…
Misperception of peer beliefs reinforces inequitable gender norms among Tanzanian men
Gender role ideology, i.e. beliefs about how genders should behave, is shaped by social learning. Accordingly, if perceptions about the beliefs of others are inaccurate this may impact trajectories of cultural change. Consistent with this premise, recent studies report evidence of a tendency to overestimate peer support for inequitable gender norms, especially among men, and that correcting apparent ‘norm misperception’ promotes transitions to re…
What do other men think? Understanding (mis)perceptions of peer gender role ideology among young Tanzanian men
Peer influence in adolescence and early adulthood is critical to the formation of beliefs about appropriate behaviour for each gender. Complicating matters, recent studies suggest that men overestimate peer support for inequitable gender norms. Combined with social conformity, this susceptibility to 'norm misperception' may represent a barrier to women's empowerment. However, why men misperceive peer beliefs remains unclear. Working in an urbaniz…
The impacts of Covid-19 and its policy response on access and utilization of maternal and child health services in Tanzania
The SARS-Cov-2 virus (COVID-19) has had a global social and economic impact. Despite the growing evidence, its effects on access and delivery of maternal and child health services in low-income countries are still unclear. This cross-sectional case study was conducted in Mjini Magharibi, Chake Chake, and Ilala districts in Tanzania to help fill this gap. The study combined qualitative and quantitative data collection methods, providing an account…
Why marry early? Parental influence, agency and gendered conflict in Tanzanian marriages
Global health interventions increasingly target the abolishment of ‘child marriage’ (marriage under 18 years, hereafter referred to as ‘early marriage’). Guided by human behavioural ecology theory, and drawing on focus groups and in-depth interviews in an urbanising Tanzanian community where female early marriage is normative, we examine the common assumption that it is driven by the interests and coercive actions of parents and/or men. We find l…
Shared interests or sexual conflict? Spousal age gap, women's wellbeing and fertility in rural Tanzania
He for she? Variation and exaggeration in men's support for women's empowerment in northern Tanzania
Cross-cultural research must prioritize equitable collaboration
Research centres in low- and middle-income countries are routinely circumvented in the production of cross-cultural research on human behaviour. Where local contributions are made, collaboration is rarely equitable and often uncredited in co-authorship. Efforts to decolonize the social sciences will remain inadequate until these norms are overturned
Characterizing a Leak in the HIV Care Cascade
Background. In Tanzania, HIV testing data are reported aggregately for national surveillance, making it difficult to accurately measure the extent to which newly diagnosed persons are entering care, which is a critical step of the HIV care cascade. We assess, at the individual level, linkage of newly diagnosed persons to HIV care. Methods. An expanded two-part referral form was developed to include additional variables and unique identifiers. The…
Lockdown measures in response to Covid-19 in nine sub-Saharan African countries
Lockdown measures have been introduced worldwide to contain the transmission of COVID-19. However, the term ‘lockdown’ is not well-defined. Indeed, WHO’s reference to ‘so-called lockdown measures’ indicates the absence of a clear and universally accepted definition of the term ‘lockdown’. We propose a definition of ‘lockdown’ based on a two-by-two matrix that categorises different communicable disease measures based on whether they are compulsory…
Cascade of care for HIV-seroconverters in rural Tanzania
We examined the HIV care cascade in a community-based cohort study in Kisesa, Magu, Tanzania. We analyzed the proportion achieving each stage of the cascade - Seroconversion, Awareness of HIV status, Enrollment in Care and Antiretroviral therapy (ART) initiation - and estimated the median and interquartile range for the time for progression to the next stage. Modified Poisson regression was used to estimate prevalence risk ratios for enrollment i…
When marriage is the best available option
Global health studies typically characterise adolescent marriage as a fundamental risk to female wellbeing. In contrast, ethnographic research among communities 'at risk' identifies that early marriage is often viewed as an opportunity weighed against locally feasible alternatives. Addressing this contradiction, we document perceived risks and opportunities of marriage, positioning them among wider concerns facing female adolescents in north-west…
Sharing the Load
Economic and evolutionary models of parental investment often predict education biases toward earlier-born children, resulting from either household resource dilution or parental preference. Previous research, however, has not always found these predicted biases—perhaps because in societies where children work, older children are more efficient at household tasks and substitute for younger children, whose time can then be allocated to school. The…
Fathers favour sons, mothers don't discriminate
Parent-offspring conflict unlikely to explain 'child marriage' in northwestern Tanzania
Earning their keep? Fostering, children's education, and work in north-western Tanzania
Fostering, raising children that are not oneâ s biological children, is common in many societies worldwide. Despite predicted lower investment in nonbiological offspring, numerous studies report no obvious well-being penalty for fostered children. Building
Non-disclosure of HIV testing history in population-based surveys
Background: HIV/AIDS programmes and organisations around the world use routinely updated estimates of the UNAIDS 90-90-90 targets to track progress and prioritise further programme implementation. Any bias in these estimates has the potential to mislead organisations on where gaps exist in HIV testing and treatment programmes. Objective: To measure the extent of undisclosed HIV testing history and its impact on estimating the proportion of people…
Secretive females or swaggering males
Women’s Bodies are Shops”
Trade-Offs in Children's Time Allocation
Embodied capital theory (ECT) argues that socioeconomic "modernization" leads to high-cost, high-return parental investments in education, in turn incentivizing demographic transitions to low fertility. However, few studies have directly investigated the proposed opportunity costs of schooling in contemporary developing populations undergoing socioeconomic change. We present a study of children's time use in two communities in Mwanza, Tanzania, r…
Earning their keep? Fostering, children's education, and work in north-western Tanzania
Fostering, raising children that are not oneâ s biological children, is common in many societies worldwide. Despite predicted lower investment in nonbiological offspring, numerous studies report no obvious well-being penalty for fostered children. Building
Why marry early? Parental influence, agency and gendered conflict in Tanzanian marriages
Global health interventions increasingly target the abolishment of ‘child marriage’ (marriage under 18 years, hereafter referred to as ‘early marriage’). Guided by human behavioural ecology theory, and drawing on focus groups and in-depth interviews in an urbanising Tanzanian community where female early marriage is normative, we examine the common assumption that it is driven by the interests and coercive actions of parents and/or men. We find l…
He for she? Variation and exaggeration in men's support for women's empowerment in northern Tanzania
Cross-cultural research must prioritize equitable collaboration
Research centres in low- and middle-income countries are routinely circumvented in the production of cross-cultural research on human behaviour. Where local contributions are made, collaboration is rarely equitable and often uncredited in co-authorship. Efforts to decolonize the social sciences will remain inadequate until these norms are overturned
Fathers favour sons, mothers don't discriminate
Misperception of peer beliefs reinforces inequitable gender norms among Tanzanian men
Gender role ideology, i.e. beliefs about how genders should behave, is shaped by social learning. Accordingly, if perceptions about the beliefs of others are inaccurate this may impact trajectories of cultural change. Consistent with this premise, recent studies report evidence of a tendency to overestimate peer support for inequitable gender norms, especially among men, and that correcting apparent ‘norm misperception’ promotes transitions to re…
Postpartum Contraception in Northern Tanzania
In Tanzania, unmet need for contraception is high, particularly in the postpartum period. Contraceptive counseling during routine antenatal HIV testing could reach 97 percent of pregnant women with much‐needed information, but requires an understanding of postpartum contraceptive use and its relationship to antenatal intentions. We conducted a baseline survey of reproductive behavior among 5,284 antenatal clients in Northern Tanzania, followed by…
Parent-offspring conflict unlikely to explain 'child marriage' in northwestern Tanzania
What do other men think? Understanding (mis)perceptions of peer gender role ideology among young Tanzanian men
Peer influence in adolescence and early adulthood is critical to the formation of beliefs about appropriate behaviour for each gender. Complicating matters, recent studies suggest that men overestimate peer support for inequitable gender norms. Combined with social conformity, this susceptibility to 'norm misperception' may represent a barrier to women's empowerment. However, why men misperceive peer beliefs remains unclear. Working in an urbaniz…
Sharing the Load
Economic and evolutionary models of parental investment often predict education biases toward earlier-born children, resulting from either household resource dilution or parental preference. Previous research, however, has not always found these predicted biases—perhaps because in societies where children work, older children are more efficient at household tasks and substitute for younger children, whose time can then be allocated to school. The…
You are Married by the Woman
Engaging men in women's empowerment is a global priority, yet there is still limited understanding of how men's support for women's empowerment is conceptualized across diverse demographic groups, particularly within communities undergoing change. This gap is especially critical in rural-urbanizing contexts, representative of many contemporary Global South settings, where individuals navigate tensions between respecting tradition while responding…
The impact of antenatal HIV diagnosis on postpartum childbearing desires in northern Tanzania
With the expansion of routine antenatal HIV testing, women are increasingly discovering they are HIV-positive during pregnancy. While several studies have examined the impact of HIV on childbearing in Africa, few have focused on the antenatal/postpartum period. Addressing this research gap will help tailor contraceptive counseling to HIV-positive women’s needs. Our study measures how antenatal HIV diagnosis affects postpartum childbearing desires…
The Association Between Hiv and Fertility in a Cohort Study in Rural Tanzania
Recent studies in sub-Saharan Africa have shown that fertility is reduced among HIV-infected women compared with uninfected women. The size and pattern of this fertility reduction has important implications for antenatal clinic-based surveillance of the epidemic and also for estimates and projections of the demographic impact of the epidemic. This paper examines the association between HIV and fertility in Kisesa, a rural area in Tanzania, where …
Secretive females or swaggering males
Scaling up stigma? The effects of antiretroviral roll-out on stigma and HIV testing. Early evidence from rural Tanzania
OBJECTIVE: To investigate the interplay between antiretroviral therapy (ART) scale-up, different types of stigma and Voluntary Counselling and Testing (VCT) uptake 2 years after the introduction of free ART in a rural ward of Tanzania. METHODS: Qualitative study using in-depth interviews and group activities with a purposive sample of 91 community leaders, 77 ART clients and 16 health providers. Data were analysed for recurrent themes using NVIVO…
"Just like fever"
BACKGROUND: Once effective therapy for a previously untreatable condition is made available, a normalisation of the disease often occurs. As part of a broader initiative to monitor the implementation of the national antiretroviral therapy (ART) programme, this qualitative study investigated the impact of ART availability on perceptions of HIV in a rural ward of North Tanzania and its implications for prevention. METHODS: A mix of qualitative meth…
Doubts, denial and divine intervention
Irregular or delayed attendance at HIV treatment clinics among HIV-positive individuals can have negative implications for clinical outcomes and may ultimately undermine the effectiveness of national treatment programmes. This study explores factors influencing attendance at HIV clinic appointments among patients in a rural ward in north-west Tanzania. Forty-two in-depth interviews (IDI) and four focus group discussions were conducted with HIV-in…
Parent-child communication about sexual and reproductive health in rural Tanzania
BACKGROUND: Many programmes on young people and HIV/AIDS prevention have focused on the in-school and channeled sexual and reproductive health messages through schools with limited activities for the young people's families. The assumption has been that parents in African families do not talk about sexual and reproductive health (SRH) with their children. These approach has had limited success because of failure to factor in the young person's fa…
"Driving the devil away"
The roll-out of ART is taking place in a context in which the new drugs are competing with a diversity of existing options. As long as the complementarities of prayers and ART are not clearly and explicitly stated by FLs, spiritual options may be interpreted as a superior alternative and contribute to hampering adherence to ART. In contexts where ambivalent attitudes towards the new drugs prevail, enhancing FLs understanding of ART's strengths an…
Trends in HIV & syphilis prevalence and correlates of HIV infection
HIV prevalence trends concur with results from a community-based cohort in the region. Correlates of HIV infection have also changed and more proximate, individual level factors are now more important, in line with the changing epidemiology of infection in this population
Verbal autopsy can consistently measure Aids mortality
BACKGROUND: Verbal autopsy is currently the only option for obtaining cause of death information in most populations with a widespread HIV/AIDS epidemic. METHODS: With the use of a data-driven algorithm, a set of criteria for classifying AIDS mortality was trained. Data from two longitudinal community studies in Tanzania and Zimbabwe were used, both of which have collected information on the HIV status of the population over a prolonged period an…
Evaluation of knowledge levels amongst village Aids committees after undergoing HIV educational sessions
BACKGROUND: Village AIDS committees (VAC) were formed by the Tanzanian government in 2003 to provide HIV education to their communities. However, their potential has not been realised due to their limited knowledge and misconceptions surrounding HIV, which could be addressed through training of VAC members. In an attempt to increase HIV knowledge levels and address common misconceptions amongst the VACs, an HIV curriculum was delivered to members…
Parental control and monitoring of young people's sexual behaviour in rural North-Western Tanzania
Despite parents making efforts to control and monitor their young people's sexual behaviour, they are faced with several challenges (e.g. little time spent with their children) which make it difficult for them to effectively monitor them. There is a need for interventions such as parenting skills building that might enable parents to improve their relationships with children. This would equip parents with the appropriate skills for positive guida…
Socio-economic change and parent-child relationships
This paper examines how socio-economic changes in Tanzania have impacted on parent-child relationships, in particular parental behavioural control over their children and parental influence on young people's sexual behaviour. Data came from participant observation, focus group discussions and in-depth interviews with young people (14-24 years) and their parents. Socio-economic changes (education, changes in values, material needs provision) affec…
Women’s Bodies are Shops”
The impact of antenatal HIV diagnosis on postpartum childbearing desires in northern Tanzania
With the expansion of routine antenatal HIV testing, women are increasingly discovering they are HIV-positive during pregnancy. While several studies have examined the impact of HIV on childbearing in Africa, few have focused on the antenatal/postpartum period. Addressing this research gap will help tailor contraceptive counseling to HIV-positive women’s needs. Our study measures how antenatal HIV diagnosis affects postpartum childbearing desires…
Do accurate HIV and antiretroviral therapy knowledge, and previous testing experiences increase the uptake of HIV voluntary counselling and testing? Results from a cohort study in rural Tanzania
Two years after the introduction of free ART in this setting, misconceptions regarding HIV transmission remain rife and knowledge regarding treatment is worryingly poor, especially among women and HIV-positive people. Further HIV-related information, education and communication activities are urgently needed to improve VCT uptake in rural Tanzania
Retracted
INTRODUCTION: Spectrum epidemiological models are used by UNAIDS to provide global, regional and national HIV estimates and projections, which are then used for evidence-based health planning for HIV services. However, there are no validations of the Spectrum model against empirical serological and mortality data from populations in sub-Saharan Africa. METHODS: Serologic, demographic and verbal autopsy data have been regularly collected among ove…
Using HIV-attributable mortality to assess the impact of antiretroviral therapy on adult mortality in rural Tanzania
BACKGROUND: The Tanzanian national HIV care and treatment programme has provided free antiretroviral therapy (ART) to HIV-positive persons since 2004. ART has been available to participants of the Kisesa open cohort study since 2005, but data to 2007 showed a slow uptake of ART and a modest impact on mortality. Additional data from the 2010 HIV serological survey provide an opportunity to update the estimated impact of ART in this setting. METHOD…
The INDEPTH standard population for low- and middle-income countries, 2013
Crude rates such as the crude death rate are functions of both the age-specific rates and the age composition of a population. However, differences in the age structure between two populations or two time periods can result in specious differences in the corresponding crude rates making direct comparisons between populations or across time inappropriate. Therefore, when comparing crude rates between populations, it is desirable to eliminate or mi…
Challenges with routine data sources for PMTCT programme monitoring in East Africa
Routinely collected clinic data have the potential to provide much needed information on the uptake of services to prevent mother-to-child transmission (PMTCT) of HIV, and to measure HIV prevalence in pregnant women. This article describes the methodological challenges associated with using such data, based on the experiences of researchers and programme implementers in Tanzania and drawing from other examples from East Africa. PMTCT data are rou…
Postpartum Contraception in Northern Tanzania
In Tanzania, unmet need for contraception is high, particularly in the postpartum period. Contraceptive counseling during routine antenatal HIV testing could reach 97 percent of pregnant women with much‐needed information, but requires an understanding of postpartum contraceptive use and its relationship to antenatal intentions. We conducted a baseline survey of reproductive behavior among 5,284 antenatal clients in Northern Tanzania, followed by…
Exploring the relationship between population mobility and HIV risk
Migration and population mobility has long been regarded as an important structural driver of HIV. Following initial concerns regarding the spatial spread of the disease, mobile populations are viewed to engage in higher levels of risky sexual behaviours than non-mobile groups. However, beyond the case studies of mineworkers and truck drivers, the statistical evidence is inconclusive, suggesting that the relationship between mobility and risk is …
It is just the way it was in the past before I went to test’
Within the broader social context of a rural African setting, HIV prevention counselling based on a Western model of individual-level agency seems unlikely to make a significant contribution to sexual behaviour change until there is greater recognition by counsellors of the ways in which power dynamics within many relationships influence behaviour change. More culturally relevant counselling strategies and messages and infrastructural improvement…
Prevalence,awareness and factors associated with hypertension in North West Tanzania
BACKGROUND: Hypertension is a public health problem, and yet few people are aware of it and even fewer access effective treatment. With the ongoing demographic transition in many parts of Sub-Saharan Africa, people are changing from rural, manual work to urban lifestyles, hence the risk of hypertension increases. OBJECTIVE: This study aimed at determining the prevalence, awareness and risk factors associated with hypertension in North West Tanzan…
Gender and youth migration for empowerment
Migration remains a central concern in urbanisation, especially in Africa. With mobility, and migration, articulated as norms of the twenty-first century this paper introduces a focus on trending realities. The paper describes the migration to and from the rural hinterland of a medium-sized African city in Tanzania. By asking questions on migration trends within livelihoods, this project identifies the emerging demographic patterns, and geographi…
Physical activity and associated factors from a cross-sectional survey among adults in northern Tanzania
The prevalence of PA in this population was high. However, there is need for PA programs to maintain the high level of compliance during and following the transition to a more urban-based culture
Tanzania (45 obras) · Medicine (36 obras) · Sociology (27 obras) · Population (25 obras) · Demography (24 obras) · Psychology (24 obras) · Socioeconomics (24 obras) · Environmental health (23 obras) · HIV/AIDS Research and Interventions (23 obras) · Adolescent Sexual and Reproductive Health (22 obras)