TITLE: SELIAN LUTHERAN HOSPITAL AIDS CONTROL PROGRAM - PMTCT PROJECT

NEED and COMPARATIVE ADVANTAGE: Selian and its clinics provide Antenatal Care (ANC) to over 3000

women annually. The current HIV prevalence in Arusha is 5.3% (as per the HIV indicator survey 2004)

THIS) and the current coverage does not avail access to all women in need of PMTCT services. Selian

aims to avail most women attending ANC to receive comprehensive PMTCT services. Selian plans to

provide PMTCT services to 1,105 women in FY 2008 and 2,200 in FY 2009

In addition, most Selian ANC clinics sites are need of repairs to improve the quality of reproductive health

(RH) services that is being provided, Health care workers needs retraining and closer supervision. The

program has additional needs to make follow up of exposed infants and provide services to pediatric clients.

ACCOMPLISHMENTS: As of July 2007, through Selian five sites: Selian Hospital, Kisongo, Bangata

dispensaries, the Arusha Town Clinic, and Kirurumo health centre at Mto wa mbu reached 1124 women

with PMTCT services including counseling, testing and receiving results. Of these, 50 pregnant women

were referred to CTC for ART treatment and their Infants provided with Nevirapine and cotrimoxazole

prophylaxis. Trainings for counselors to be done in August. Infant follow up and home visiting was carried

out to 80 infants and children.

ACTIVITIES: Testing will be opt out based on the new national algorithm, women will be tested in ANC,

labor ward (LW) and post natal, with rapid test and results given on same day. Based on capacity of the

facility, both SD Nevirapine and more complex regimen will be provided with a view of accessing more

women to more efficacious regimen as capacity of the facility allows.

Selian will increase access to PMTCT services so that more pregnant women at all Selian Sites in Arusha

and Simanjiro Regions can benefit from a full range of PMTCT services. New PMTCT services will be set

per NACP standard guidelines and regimens, renovations will be carried out, and improvements made to

ANC clinic environment, labor and delivery ward. Selian will ensure appropriate PMTCT commodities Test

kits, PMTCT drugs and other commodities.

Selian will ensure that clinical staging of HIV positive women is carried out and that appropriate referral for

all clients in need of ART to CTC for provision of HAART treatment and prophylaxis for their infants is

carried out. Cotrimoxazole and other necessary additional services will be provided.

Selian will ensure that appropriate feeding is carried out and supplementary feeding after BF for six months

is carried out after assessment and evaluation.

Selian will carry out capacity building in several fronts: Training service providers in PMTCT, infant nutrition

and infant feeding; Carrying out retaining session and seminars and attending conferences so that service

providers can be up to date with most recent information:; carrying out community mobilization to raise

awareness develop better involvement of the community; and work with the MOHSW and other USG

partners to use the information education and communication (IEC) materials developed at the national

level and ensure they are adopted/used in Selian sites.

This activity will carry out and link Infant diagnosis and follow-up including home visits and Follow Ups. It will

also ensuring that the PMTCT services are linked and integrated with other HIV related services such as,

Home based care, Care and Treatment, Family planning, Orphans and vulnerable Children etc.

LINKAGES: Linkage will be strengthened with, VCT, C&T, TB/HIV, Infant Diagnosis and OVC programs

supported by Selian and other USG programs. Linkage will also be improved with Reproductive and Child

Health (RCH) activities especially Malaria and Syphilis in Pregnancy program, Family planning and

nutritional and child survival program. Further more, linkages between facilities will be strengthened to

collaborate with facilities supported by the Global fund and other supporters.

To ensure continuum of care through relationships with Non - HIV programs , effective linkages have been

created with a number of organizations US government (USG), Ministry of health social welfare (MoHSW),

Ministry of Education (ME), Ministry of Community development (MCD), human resource development

(HR), Tanzania AIDS commission (TACAIDS) and local government (LG); also linkages with programs such

as Sexual transmitted infections (STI), Family planning (FP), orphans and vulnerable children (OVC), and

safe motherhood initiative (SMI).

AREAS OF EMPHASIS:

As a PMTCT component, this activity focuses almost entirely on Pregnant women. Increasingly, couples

are being counseled together but this activity mainly directed to the ANC which women primarily attend.

M&E: Selian will work with the MOHSW and USG partner such as EGPAF in rolling out the revised PMTCT

monitoring and evaluation and the commodity logistic (LMIS) tools to all of the sites it supports. It will

support the facilities teams collect and report PMTCT data based on the national protocol and provide

feedback on tool performance. Selian will work with these institutions to strengthen and implement PMTCT

quality framework and providing regular supervision. All sites of Selian monitoring & evaluation system are

done in an ongoing monthly, quarterly, semiannual and of year fashion in preparation of reports to all MOH,

NACP, USG and Selian ACP.

Selian will work with the Arumeru, Monduli, and Simanjiro District Councils to include PMTCT activities in

their Comprehensive Council Health Plans and increase funding from additional sources such as basket

funding, global fund (GF) and overtime districts own resources. The districts contribution to sustainability is

by fully integrating PMTCT in the reproductive child health (RCH), services, providing the health

infrastructure and staffing.

The project will build local ownership by working through government and building human capacity through

training, mentoring and supportive supervision.

Focus for sustainability is ensuring both technical and management capacity of Selian Hospital staff and

region and local authorities. The program will systematically review all programs to identify elements that

are not led by Selian staffs. At the sites level, criteria for transition to autonomy in services provided will be

finalized with MOH and USG.

TITLE: Selian Hospital Home-based Care/Palliative Care

NEED and COMPARATIVE ADVANTAGE: The number of chronically ill patients with HIV/AIDS in Tanzania

is increasing. The available health facilities cannot provide comprehensive care to patients; hence the need

for continuum of care at their homes. Home-based care (HBC) and palliative care can relieve the burden

currently allocated to the health system and families. The service operates through nurse supervisors,

outreach nurses, and trained community volunteers. However, as more people become aware of HBC and

stigma about HIV/AIDS is reduced, the demand for access to HBC has increased. In an effort to improve

the health and well-being of all Tanzanians with HIV/AIDS, Selian hospital has been providing HBC to

patients in its catchment area (Arusha municipal, Monduli, Arumeru and Simanjiro districts). The care

provided addresses the needs of the patient as a whole and includes physical, spiritual, emotional, and

psychological support. Selian hospital has a demonstrated record of providing patients with high-quality

HBC.

ACCOMPLISHMENTS: Selian offers holistic care to people with HIV/AIDS and their families: spiritual and

general counseling to patients and caregivers, treatment, nutritional support, pain control, linkage to

community volunteers and support groups, and referral to and from antiretroviral therapy (ART), TB, and

OVC services. Selian holds monthly meetings with its 150 volunteers to offer support and supervision.

Volunteers have conducted home visits to 1500 patients and provided them with medication and nursing

care. Selian has provided 36 respite day-care gatherings with average attendance of 40 clients and family

members per day care event. Selian has identified 1500 clients with poor nutritional status and distributed

nutritional supplements to approximately 700 patients. Fifty new volunteers were trained as of July 2007;

these volunteers were provided with bicycles and HBC kits which included safe water supplies, insecticide

treated nets and brings the total volunteers to 150. Selian recruited staff for HBC/PC. Community

mobilization has been conducted to raise awareness and reduce stigma. One staff member attended

clinical patrol education training at Kilimanjaro Christian Medical Center. One nurse and one clinical officer

attended palliative care training in Uganda.

ACTIVITIES: Using the National AIDS Control Programme (NACP) guidelines on HBC, Selian's activities

will focus on improving HBC services to clients in their target region; building the capacity of staff and

volunteers to better care for people living with HIV/AIDS (PLWHA); community sensitization to decrease

stigma and increase demand for HBC; and improving mechanisms for staff to share and learn from others.

Selian will scale up continuum of care services through additional HBC visits and facility-based services.

Through its network of trained providers and volunteers, Selian will provide patients with a basic care

package of services. This will address the physical, spiritual, emotional, and psychological well-being of

clients. They will also ensure the regular and constant supply of appropriate and sufficient pharmaceutical

and medical consumables. Selian will ensure adherence to treatment and improvement in the physical

condition of patients by providing nutritional support to qualified individuals using specific criteria for

eligibility, duration, and quantity. Selian will conduct interventions to improve prevention for positives which

will include provision of insecticide treated nets (ITNs) for malaria control, condoms, water purification

tablets and vessels for water safety, and cotrimoxazole for prophylaxis. Selian will provide respite day care

to approximately 50 families caring for PLWHA. Effective referral networks will be developed to link patients

to care and treatment services including ART, TB, counseling, and OVC services. Selian will also integrate

prevention with positives messages into HBC visits. Since the project's catchment area is large and patients

are often located in areas with difficult access, it is vital to ensure continuity and efficiency of HBC and

palliative care service by maintaining administrative functions (office supplies, computer, and furniture) as

well as fuelling vehicles.

Selian will work to increase the capacity of providers and volunteers through sending two staff for training

on palliative care at Nairobi Hospice in Nairobi, Kenya and a refresher course for approximately 200

volunteers to update skills and knowledge including counseling. Selian will ensure regular payment of

salaries and benefits to all staff in the service in order to retain competent, qualified, and motivated

personnel. Through the provision of support (bicycles for transport, monthly honorarium, meetings, etc) to

trained community HBC volunteers Selian will maintain motivation and activities. Staff will be trained in data

collection and management in order to improve reporting skills. Selian will maintain regular supervision

throughout the tier system.

Selian will work with communities to sensitize them to the need for and benefits of HBC in order in increase

demand and reduce stigma for PLWHA. Stigma reduction interventions will be conducted in communities to

enhance voluntary counseling and testing (VCT). Finally Selian will participate in meetings, seminars,

conferences, and other forums, as applicable, to share experiences and learn from other similar projects.

Selian will participate in a palliative care/ hospice team retreat to build organizational capacity and

efficiency.

LINKAGES: The program has been linking and collaborating with the District AIDS Control Coordinator

(DACC) for technical assistance and Council HIV/AIDS Coordinator (CHAC) for community mobilization and

sensitization as well as ward, village, and religious leaders in the four districts of operation. Other linkages

include community, faith, and non-governmental organizations working on HIV/AIDS and HBC, Ministry of

Health and Social Welfare, Tanzania AIDS Commission (TACAIDS), USAID, World Food Program and local

and international church ministries. The project links HBC with facility-based palliative care, and will also

strengthen linkages with providers of prevention of mother-to-child transmission (PMTCT), TB, VCT and

family planning services.

CHECK BOXES:The program covers both sexes of all ages and through its links with other Selian services,

also the specific groups mentioned. Capacity building of local organizations and human capacity building

are achieved through all the training activities. The HBC and facility-based palliative care program is closely

linked with TB program. Both programs identify and refer patients for TB diagnosis and treatment. Services

are particularly linked with ART services.

M&E: Five percent of Selian's budget will be dedicated to M&E. Monitoring and evaluation of HBC

activities will be completed using HBC national forms and other forms as applicable. Volunteers will be the

primary data collectors; they will send data to the supervisors for compilation. Selian will ensure that both

Activity Narrative: volunteers and supervisors are well trained in data collection. Data review will be undertaken by the Selian

HBC hospital team to analyze and finalize reports to be submitted to USAID, CHAC, DACC, and the social

welfare office. Data will also be accessible for official use in and outside Selian hospital (e.g. in forums,

meetings). The program will hold regular monitoring meetings to review progress, challenges, and solutions

with volunteers/ supervisors, CHAC, DAC, and others as applicable. All M&E activities will follow the

national guidelines on palliative care.

For FY 09 Selian's community based targets for individuals served is 1275 and for facility based palliative

care 3600. The de duplicated target is 3983.

SUSTAINAIBLITY: One of the priorities of the palliative care program is to support family care-givers by

increasing their knowledge and skills (which also improves the quality of care in the home). Community

HBC volunteers are also supported with motivational activities and psychosocial support. Both are

important for sustainability, as the program could not reach such high numbers of patients without their

collaboration. Regular meetings are held so that they can share experiences and challenges. The program

is fully integrated into a continuum of care with general medical, ART, PMTCT, TB, and OVC services which

also enhances sustainability. Community awareness and acceptance of HBC contributes to stigma

reduction and further sustainability.

TITLE: Selian OVC Program 2008

NEED and COMPARATIVE ADVANTAGE: As a faith-based organization (FBO), Selian has been working

in the Arusha region for several years supporting orphans and vulnerable children (OVC) through its

network of partners, which range from grass-roots church congregations to regional systems. The Selian

approach for OVC care is family-based support, focusing on empowering the extended families to be able to

care and support the OVC. Selian ensures a continuum of care through facilitating meaningful referral and

linkages to provide comprehensive support for OVC. Arusha is an area of particular need due to the

relatively high HIV/AIDS prevalence (5.3%).

ACCOMPLISHMENTS: As of June 2007, Selian provided direct support to 1,973 of the 5,054 identified and

registered OVC. The service area covered Arusha municipality, Monduli, and Arumeru districts in Arusha

region and Simanjiro district in Manyara region. Support provided included nutritional assistance to 750

OVC, school uniforms and school material to 296 children, medical treatment to 21 OVC, psychosocial

support (PSS) through three children, social clubs to 1,202 OVC, and economic strengthening for 20

households, which were provided with capital to start income-generating activities (IGA).

ACTIVITIES: 1. Use community involvement in identifying OVC, assessing their needs, prioritizing provision

of service support, and providing direct services. This will include activities such as: offering nutritional

support to 3000 OVC; providing school uniforms, and school materials to 400 OVC; providing medical

treatment to 60 OVC; provision of bedding to 50 OVC; provision of psychosocial support to 2,500 OVC

through six social clubs, three of which are existing, and three of which are slated to begin building;

conducting follow-up and monthly home visits per congregational recommendations.

2. Create three additional OVC social clubs for PSS and: provide children playing kits/materials; hold

quarterly ward level meetings; support OVC tours-travels to the nearby wildlife parks once a year as a

learning and entertainment trip.

3. Build capacity of the community and caregivers to care and support OVC in four districts by identifying

and training 1000 caregivers on caring and support of OVC; conducting seminars for 150 community

volunteers on OVC support, care, and protection; conducting community sensitization meetings in four

districts on care and support of OVC. The sensitization meeting will be rolled out to all villages with help of

trained volunteers. In addition: train 40 caregivers on how to run small income generating

businesses/projects; strengthen households through providing funds to 40 families to start IGAs; and

provide funds for overhead costs for running the project.

4. Build and support government capacity in the four district councils, which includes encouraging

complementary planning by the councils to support OVC; facilitating community sensitization for village

council and wards; and provide computers for entering OVC data into the national Data Management

System (DMS).

5. Provide food supplements through centrally purchased commodities, and the insecticide treated

mosquito nets (ITNs) available through the national voucher system.

LINKAGES: The program is linked to the National OVC Plan of Action (NPA), the national Implementing

Partner Group (IPG) network for OVC, and all USG-funded OVC programs. At the local level, Selian will

link with area organizations working on HIV/AIDS prevention, treatment, and care, such as UHAI Centre of

the Arusha RC church, along with several other church congregations providing OVC support. Local

government, along with agencies providing PMTCT, home-based care, and CTC will also participate in

collaboration. The program will also be linked to the national voucher system for the provision of ITNS.

CHECK BOXES: OVC programs serve children under 18 years, as well as provide wraparound assistance

in terms of nutrition, health care, and education.

M&E: Selian will monitor OVC care services using the national Data Management storage and reporting

System (DMS). Volunteers will work with MVCC to register OVC at the community level. CSOs will use

service providers' registry and referral forms to track services provided to OVC and they will enter the data

in their database and export it to the district. CSOs will analyze and report data to the regional office

according to services provided, age, and gender. All reports will be shared with relevant authorities for

decision making and planning. Monthly and quarterly reports will be prepared by both the OVC volunteers

and evangelists at the congregations and sent to the national DMS focal person in each district for

compilation. The data from the DMS will provide management reports that will assist in planning which

services are provided (including healthcare, nutritional support, financial support, emotional and

psychological support, school related assistance, and number of community based committees who

mobilized services for households with OVC). The allocated funding for M&E is 5%.

SUSTAINABILITY: Selian's OVC program aims to strengthen families and ensure involvement of the

community in supporting OVC. Church parishes are a primary and ongoing community entity where OVC

are cared for and supported irrespective of their denominations in the villages. Working through these

vested parish structures will enhance sustainability. This project will broaden parish activities and involve

the communities through awareness, care giving trainings, and identification of OVC. OVC caring programs

will be initiated in every church. This innovative approach will make church congregations centers for

prevention, care, and support for PLWHA and OVC. Selian will promote sustainability by supporting the

four district councils and encouraging complementary planning by the councils to support OVC. Selian will

also sensitize and work with community leaders and CBOs to mobilize resources to support OVC. Selian

will continue to solicit funds from different development partners for continuation of the program.

TITLE: Selian voluntary counselling and testing

NEED and COMPARATIVE ADVANTAGE: Voluntary Counseling and Testing (VCT) is integral to HIV

prevention, management, treatment, and support for HIV infected people., yet only 15% of Tanzanians have

been tested. Rural communities are even much more deprived of this service. The proposed activities

should scale -p numbers reached with VCT services from 11,000 to 25,000 annually by increasing PLWHA

involvement, mobile VCT services, and sites while improving their capacity. Selian has lengthy VCT

experience, wide coverage with a continuum of care where clients are referred for care, treatment, and

services like: post test clubs, HBC/palliative care, PMTCT, CTCs, and OVC support.

ACCOMPLISHMENTS: Selian provides VCT services in five fixed sites in Arumeru, Simanjiro, Monduli

Districts and Arusha Municipality. One site (Mererani) is not USAID funded. In 2006, 11,270 people were

reached with VCT services. Selian collaborates with AMREF at one center.

ACTIVITIES:

1) Continue with CT services, improve quality and scale-up within national guidelines and new testing

algorithm to reach 20,000 clients by September, 2008. (a) Discuss with USAID and AMREF running

Angaza services alone without AMREF support from January 2008 at Uzima VCT. (b) Include Mererani

youth center VCT services under USAID funding from January 2008.(c) Provide office equipment (d)

Provide administrative contribution for the AIDS Control Programme. (d) Discuss using Angaza logo on

contractual basis with AMREF or national logo, if available (e) Referral to CTC and PMTCT centers for HIV

positive clients.

2) Build capacity of six sites and increase access to VCT; improve environment so there are fewer clients

sent back without services. (a) Renovate, extend, and furnish two more counseling rooms at Uzima VCT

centre in Arusha to double clients. (b) Hire/train more counselors and staff (c) Renovate Uzima VCT centre

to create more opportunities to test. (d) Introduce provider initiated C and T in three sites within the health

provision centers according to the national guidelines on PICT. (e) Provide sufficient lab supplies, reagents

and test kits.

3) Promote accessibility of VCT services in rural areas to increase access to ART through mobile VCT (a)

Recruit/ train one staff specifically for that purpose (b) Purchase vehicle for reliable mobile VCT transport

and M&E (c) Provide public address system.

(4) Build capacity of staff for better provision of services (a) Retrain 22 counselors for quality service

provision (b) Provide counselor supervision.

(5) Demand creation to attract clients including children with parents/guardians to access VCT services. (a)

Access relevant IEC from NACP or other partners (b) Engage drama groups to sensitize public.

(c).Increase involvement of PLWHAs for psychological support and stigma reduction.(d) Support post test

clubs and use PLWHAs and voluntary adherence counselors to educate others.

LINKAGES: Selian has an integrated, comprehensive AIDS program emphasizing continuum of care. VCT

services are linked to PMTCT, ART, STI prevention, TB screening, RCH, FP, OVC care, nutrition, HBC and

palliative care, voluntary adherence counseling, World Food Program, faith-based organizations and NGOs

and other CTCs like St. Elizabeth, Mount Meru hospital and West Meru district hospital. Youth activities for

adolescent sexual and reproductive health are implemented in partnership with DSW, linking with UMATI

and WAMATA. Linkages with groups of people living positively will be strengthened to educate about

prevention for further infections.

CHECK BOXES: Human resource capacity building is crucial for counselors to provide quality services to

the client. In-depth counselor training will be done through NACP or AMREF or abroad. Medical personnel

should undergo HIV testing training according to government new testing algorithm and laboratory

procedures.

M&E: Selian VCT sites shall comply with the national CT monitoring and evaluation system, asses

operations, and improve practices and procedures in CT service delivery. Every CT site shall collect

information on CT activities using monitoring tools stipulated in the national guidelines including data

management, storage and completeness of forms. All CT centers will be monitored and evaluated by

counselor supervisors via district supervision. Staff training will be done using the national training

materials. Five percent of the budget will be used for monitoring and evaluation.

SUSTAINABILITY: Selian AIDS Control Program falls under the Evangelical Lutheran Church in the Arusha

Region. The program has grown in size and services rendered to the community. We anticipate leveraging

funds from different sources for VCT services. Selian is building the capacity of church congregations to

become centers for prevention, care, and support for PLWHs through a project called EVERY CHURCH IS

A CARING CHURCH. Since VCT is an entry point for care and treatment, the government is expected to

provide free universal VCT services to make them accessible to every citizen.

TITLE: Selian - ARV Services

NEED and COMPARATIVE ADVANTAGE:

There are an estimated 25,000 HIV+ people in need of comprehensive treatment services in the Arusha

area of northern Tanzania. Currently only 5,000 have been initiated. Selian AIDS Control Program care

and treatment services provide care and treatment to patients suffering from HIV/AIDS. Selian is a faith-

based initiative with a comprehensive and integrated spectrum of HIV/AIDS related services, including

counseling and testing, PMTCT, facility and home based palliative care, and services for OVC. Selian

provides ART through a network of three facilities: Selian Hospital, Arusha town clinic, and Kirurumo health

center at Mto wa Mbu. Selian "graduated" from sub-grantee status to being supported directly by the USG in

FY 2007.

ACCOMPLISHMENTS:

As of June 30 2007, Selian has expanded the number of patients enrolled to 3,062 in three CTCs. Of

these, 1,341 are on ART including 140 children, and 94 pregnant women and are receiving comprehensive

HIV/AIDS services. Selian has successfully expanded its referral linkages to other components of the AIDS

Control Project. All 1,245 newly enrolled patients have been provided with cotrimoxazole prophylaxis.

Regular referrals are made from the five VCT sites and the TB clinic. Selian also has increased the use of

the unique cadre of volunteer adherence counselors started last year.

ACTIVITIES:

1) Continue to provide and expand ART services at three CTCs which are following the national guidelines

for ART and which serve adults, children, and pregnant women. More HIV+ patients will be enrolled,

initiated on ART, and provided with comprehensive services. 1a) Increase number on treatment to 2400 in

2008 and 3100 by end of FY 2009.

The program will further increase the number on ART through recruitment in MCH settings, and the

introduction of PICT. The project will ensure continuous availability of pharmaceuticals, medical

consumables, laboratory reagents, test kits, equipment, and supplies.

1b) Improve quality of treatment services through innovative on-site continuing education programing of all

ART program staff; train 25 health care workers to deliver ARV services. 1c) Incorporate government

monitoring systems into hospital computerized health information management systems. 1d) Increase

voluntary adherence counselors (VACs) by 15 each year to 63 in FY 2008 and 78 in FY 2009 and promote

the use of expert clients. 1e) Share administrative costs for AIDS Control Programme

2) Initiate voluntary provider-initiated testing program for patients presenting to the hosting institutions of the

three CTCs. This will lead to more people knowing their status and initiating treatment. 2a) Provide training

for 30 clinicians in PICT. 2b) Carry out community sensitization to in three communities to improve

acceptance of voluntary PICT. 2c) Establish appropriate register and monitoring system for PICT.

3) Expand community outreach for awareness-raising concerning the successful treatments available with

ART and PICT. This will initiate greater community support and reduced stigma surrounding seeking

treatment for HIV/AIDS. 3a) Conduct seminars for 180 religious leaders. 3b) Continue promoting VACs as

community educators. 3c) Provide support for post test club.

LINKAGES:

Selian will ensure that it continues to provide services that support a continuum of care model by providing

several reproductive health (RH) and HIV related services within its sites and through its referral system

with palliative care, TB, OVC, and hospital to ART treatment. Relationships with other organizations will be

strengthened. Effective relationships have been established several organizations including: 1) World

Food Programme for food supplementation to ART patients. 2) Evangelical lutheran church in Tanzania for

provision of palliative care and hospice. 3) Other providers in the area including the CTC at St. Elizabeth's

Hospital in Arusha and the Mt. Meru Regional Hospital.

CHECK BOXES:

1) Selian is actively engaged in providing In-Service Training for its staff. 2) Selian provides food to ART

Clients which is from World Food Program. 3) As an ART component of the AIDS Control Program, the

target population is People with HIV, Pregnant Woman. 4) As a faith based organization Selian has

religious leaders as a target population.

M&E:

Selian uses the national ART monitoring system. All three sites use the national paper-based tools (CTC2

card and pre-ART and ART registers) to collect patient data. These are then entered into the NACP CTC2

database which in turn generates the required NACP and USG reports. Weekly and monthly data

summaries are provided to the ART team who utilize the data for patient management and for program

improvement. For data quality assurance, an external M&E consultant reviews the data from all three sites

on a quarterly basis and provides feedback to CTC staff. In FY 2008, the three CTCs will continue to utilize

paper and electronic systems to collect, manage, and analyze HIV care and treatment data. TA for M&E will

be provided for three organizations (CTCs) and 5% of the budget is attributed to M&E.

SUSTAINAIBLITY:

Selian is a Tanzanian faith-based organization providing ART services. The capacity building being done

through this project will remain within the organization. As an integrated component of health services, the

services are sustainable as long as there is direct support from the government of Tanzania.