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Article History

Received: 23 July 2021

Accepted: 1 September 2021

First Online: 23 September 2021

Declarations

:

: We received ethical approval from Harvard Medical School and Tanzania’s National Medical Research Institute (Ref. NIMR/HQ/R.8a/Vol. IX/2515). The study was also approved and endorsed by regional medical officers and district medical officers the regions and districts in which the study was conducted. Hospital administrators and staff were also briefed on the study and offered support to the data collectors during the study period. Verbal consent was obtained in Swahili from interviewees at the beginning of interviews and focus groups.

: No individual person’s data are presented in this article. In accordance with Tanzanian law, permission to publish this manuscript was sought and obtained from the National Institute for Medical Research.

: The Program in Global Surgery and Social Change, Dalberg Advisors, Jhpiego, and Assist International receive funding from the GE Foundation for the Safe Surgery 2020 project. Shehnaz Alidina, Sakshie Alreja, Danta Bien-Aime, Monica Cainer, Kevin Charles, Caroline Damian, Edwin Ernest, Joachim Eyembe, Laura Fitzgerald, Geofrey C. Giiti, Augustino Hellar, Furaha Kahindo, Bernard Kenemo, Albert Kihunrwa, Steve Kisakye, Innocent Kissima, Cheri Reynolds, Meaghan Sydlowski, Leopold Tibyehabwa, John Varallo, and Noor Zanial had financial support from GE Foundation for the submitted work. David Barash is employed by GE Foundation, which funded this work. Edwin Ernest, Augustino Hellar, Laura Fitzgerald, Leopold Tibyehabwa, and John Varallo declare financial support from ELMA Philanthropies., Ntuli A. Kapologwe, Yahaya Hussein, Steven J. Staffa, and John Meara have nothing to declare. The authors have had no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years and no other relationships or activities that could appear to have influenced the submitted work.