Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 4554
Country/Region: Tanzania
Year: 2007
Main Partner: Management Sciences for Health
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $900,000

Funding for Health Systems Strengthening (OHSS): $900,000

This activity relates to OPSS activity #7729.

Management Sciences for Health (MSH) has been the lead agency providing support and technical assistance (TA) to build management and leadership capacity among key institutions involved in Tanzania's multi-sectoral response to HIV/AIDS. MSH assistance is channeled through the Leadership, Management and Sustainability Project (LMS). The main LMS partner in Tanzania is the Eastern and Southern Africa Management Institute (ESAMI) based in Arusha.

MSH has worked extensively with the two national coordination bodies for HIV/AIDS; the Tanzania Commission for AIDS (TACAIDS) and the Zanzibar AIDS Commission (ZAC). Key areas include strengthening national leadership, accountability, coordination, planning, and resource mobilization. MSH TA has been critical in helping Tanzania and Zanzibar develop, submit, and negotiate large Global Fund proposals. This has included extensive TA to the Tanzania National Coordinating Mechanism (TNCM) and the Zanzibar Country Coordinating Mechanism (CCM), Global Fund Principal Recipients, and other major players.

The significant Global Fund resources awarded to Tanzania are matched with major implementation challenges and the need for a more effective TNCM and CCM, greater accountability, and higher expectations for results. Global Fund projects should not function in isolation from activities funded by other means, such as the President's Emergency Fund for AIDS Relief (PEPFAR) or the World Bank MAP project. MSH has secured additional, non-mission funds to build capacity in Tanzania and Zanzibar to improve performance of Global Fund projects. TA teams fielded by MSH will support Global Fund structures and processes in the areas of governance, flow of funds, monitoring and evaluation, and reporting. Monitoring tools and comprehensive reporting practices will be developed to enable timely intervention when projects need attention. Governance will be improved through structured agreements on the roles and responsibilities of all partners, leading to a revised Operations Manual. MSH will support the preparation of strong and locally developed implementation plans for existing or new awards. The local MSH team in Tanzania will help define and guide the work of the external TA teams and provide follow-up to maximize the benefits of the TA. MSH will liaise with all Global Fund partners to ensure effective planning, coordination, technical consistency and appropriate geographic balance. The LMS team will also assist TACAIDS in its role of TNCM Secretariat and the Zanzibar CCM in the preparation of phase two applications as they become due.

Severe human resource constraints prevent Tanzania from providing comprehensive health and HIV/AIDS services to its rapidly growing population. Low wages, outdated policies and poor work conditions help fuel a steady exodus of health workers, and the Ministry of Health (MOH) is increasingly motivated to address this crisis. MSH collaborates with the Capacity Project to engage different divisions of the MOH (mainland and Zanzibar) in a structured assessment of needs and to formulate a comprehensive framework for intervention. This includes conducting human resource management assessments in FY 2006 that targeted the Human Resources Department of the MOH in Zanzibar and the Human Resources and Personnel Administration divisions of the MOH on the mainland. In FY 2007, MSH will continue to collaborate with Capacity to deliver technical assistance to the MOH and Department of Social Welfare on both Zanzibar and the mainland.

TACAIDS and ZAC are relatively young commissions and MSH will continue to invest in their organizational development. MSH has strong relationships with TACAIDS and ZAC based on years of effective collaboration. Over time, MSH has helped build the institutional capacity of TACAIDS and, to a lesser extent, ZAC, through the provision of TA and training in such areas as planning, budgeting, resource mobilization, advocacy, and reporting. With the growth of institutional capacity the role of MSH is evolving. MSH will help TACAIDS identify and articulate its needs for short-term TA, and work with TACAIDS managers and donors to identify sources of external TA. MSH will help TACAIDS and ZAC develop tools and approaches for sourcing, procuring and monitoring effective TA making use of all available resources. To identify and prioritize continued needs within ZAC, where organizational development lags behind TACAIDS, MSH will conduct a workshop with ZAC using the Management and Organizational Sustainability Tool (MOST). One output will be an agreed action plan for organizational strengthening to be supported by MSH and other donors.

In addition to helping TACAIDS and ZAC procure short-term TA, MSH/LMS will offer direct TA in a number of key areas. The need for line ministries to mainstream HIV/AIDS requires that MSH provide support to TACAIDS, ZAC and the ministries, including working with senior civil servants on policies/procedures to identify the impact of HIV/AIDS on their respective ministries. The MSH team will be engaged with TACAIDS and other donors to help revise the National Multi-Sectoral Strategic Framework for HIV/AIDS as well as periodic reviews of progress against work plans.

MSH will work with TACAIDS to ensure that Regional Facilitating Agencies (RFAs), set up with funding from the World Bank MAP program, operate effectively. The RFAs oversee the Community AIDS Response Fund, and serve as TACAIDS' agents to support civil society to address HIV/AIDS, especially building the capacity of local government, the Community Multi-sectoral AIDS Committees, and community-based organizations that provide HIV/AIDS services. In Zanzibar, district HIV/AIDS coordination rests with the District AIDS Coordination Committees (DACCOMS) and MSH and its partner, ESAMI, are carrying out a leadership development program (LDP) with the DACCOMS to improve performance. ZAC has expressed interest in applying the LDP to ministries to help build consensus for the national strategic framework and to improve mainstreaming of HIV/AIDS.

A proven success in addressing HIV/AIDS in Tanzania has been the Rapid Funding Envelope (RFE) governed by TACAIDS and ZAC, managed by Deloitte, with MSH TA. The USG provides funding for management support to leverage funds from nine other donors. Through FY 2006, about 88 civil society organizations (CSOs) have received RFE grants at a cumulative award value of approximately $ 9.7 million. MSH will support resource mobilization, assist CSOs to apply for RFE funding, review applications for technical content, and conduct monitoring and evaluation. MSH will help draft the technical specifications for an external review of the RFE in FY 2007 or early FY 2008. MSH takes a lead role in disseminating lessons learned and success stories via the RFE website, national and international conferences, and other means.

Outputs for FY 2007 include: revised monitoring tools and reports for GFATM TA; training materials for the above; an executive dashboard for project review; a TNCM governance manual; action plans to address HR constraints; a rolling work plan for short-term TA to TACAIDS and ZAC; a consultant database for TACAIDS; an orgainzational development plan for ZAC; DACCOm action plans for revitalization; an updated grants operation manual for the RFE; and a results conference for RFE grantees.

Subpartners Total: $0
Ministry of Health - Zanzibar, Tanzania: NA
Tanzania Commission for AIDS: NA
Ministry of Health and Social Welfare - Tanzania: NA