THIS IS AN ONGOING ACTIVITY FROM FY 2008. ACTIVITIES LISTED HAVE BEEN INITIATED AND

WILL PROCEED DURING FY 2009 AS IN THE PREVIOUS YEAR. ACCOMPLISHMENTS WILL BE

REPORTED IN THE FY 2008 APR. PLEASE NOTE THAT THE ACTIVITY NARRATIVE REMAINS

UNCHANGED FROM FY 2008.

The funding for this activity has changed from 1,300,000 to 1,104,321.

Cervical cancer screening activities will be funded in FY09 out of adult care services

*END ACTIVITY MODIFICATION*

TITLE: A Comprehensive Community Approach to Integrated PMTCT/FANC/PNC Services

NEED AND COMPARATIVE ADVANTAGE: This proposal addresses the need to support both HIV and

broader Reproductive health needs of HIV positive mothers and their children, and provides an example of

a wraparound program. The program supports PMTCT services through ensuring a more comprehensive

and integrated Maternal Neonatal and Child Health (MNCH) services for HIV+ pregnant women and their

infants. It covers unique needs from the antenatal care (ANC) period, through labor and delivery and

postpartum

period through a community approach.

JHPIEGO will mobilize and work with the community through community health workers (CHW) and

Community Own Resource Persons (CORPS) to mobilize moms and their family support units to create

demand and access to comprehensive reproductive health services that strengthens both PMTCT and

Reproductive health services at the community level.

ACCOMPLISHMENTS: Based on JHPIEGO's previous work in Tanzania in Focused antenatal care, Safe

Motherhood initiative in emergency obstetric care, and more recently Malaria through community health

workers , JHPIEGO intends to use the experience gained to strengthen community mobilization and

demand creation so that more women access PMTCT and RH services.

ACTIVITIES: In the proposed program, the strategy is to ensure that HIV+ pregnant women are linked to a

continuum of comprehensive MNCH care services through an integrated community/facility approach. This

proposed program will build on the CDC-funded community mobilization project and tools as well as the

USAID-funded FANC/PMTCT service provider orientation tools. JHPIEGO will train CHWs to transmit key

messages among pregnant women regarding PMTCT, FANC, preventing malaria, post natal care (PNC)

services, family planning (FP), and cervical cancer prevention. Using their FANC orientation package, the

program will complement and strengthen the skills of low-level providers working in health centers and

dispensaries serving as care and treatment centers refills/outreach sites. Providers will offer quality RH and

HIV services to women in their communities and ensure follow-up as indicated. The community component

will create demand for quality integrated health services, and will therefore complement HIV and RH

services at the health facility level to strengthen service provision.

Up to four districts that have the need/capacity for strengthening community outreach will be selected to

pilot this initiative, with a scale-up planned for subsequent years based on lessons learned.

ACTIVITIES: 1) Carry out advocacy and sensitization meetings: at national, regional, district and ward

levels with a focus on CHWs leadership to create awareness and to facilitate buy-in from stakeholders.

2) Initiate active FANC/PMTCT program for mothers and infants in the target districts through CHW: with

messages to improve ANC care, HIV screening, ARV prophylaxis, follow-up of infants and mothers, uptake

of intermittent presumptive therapy/prevention (IPTp), use of long-lasting ITNs (based on national PMTCT

and malarial guidelines), exclusive breastfeeding (AFASS as appropriate), transition to complementary

feeding, cotrimoxazole prophylaxis for infants, cervical cancer prevention and FP. 2a) Conduct assessment

of existing RH/PMTCT/FANC/PNC services. 2b) Develop strategic approach to support PMTCT/FANC and

PNC follow-up using assessment findings.

3) Improve PNC/safe delivery/cervical cancer prevention/FP services, including postpartum FP at up to four

district hospitals (that are also serving as care and treatment centers) and up to eight selected health

centers (two per district), where FANC/PMTCT services have already been established to improve

availability of quality, comprehensive RH/MNCH services for mothers and infants. 3a) Ensure training as

appropriate in PNC, safe delivery, cervical cancer prevention and/or FP for providers, based on existing

training materials and national standards. 3b)Conduct supervision quarterly.

4) Community mobilization for RH/FANC/PMTCT/PNC and follow-up through the first year: to support

norms for routine RH/FANC/PMTCT/PNC and follow-up of mothers and infants. CHWs will sensitize fellow

community members on the importance of ANC, PMTCT and other RH services for HIV+ pregnant women;

refer pregnant women in their communities to ANC and PMTCT services; refer women who recently

delivered for postpartum and newborn care; refer women for cervical cancer prevention and FP services;

and refer infants for treatment with cotrimoxazole. 4a) Identify needs in RH/FANC/PMTCT/PNC and

develop an action plan, including messages and information education and communication (IEC) materials

supportive of RH/FANC/PMTCT/PNC and follow-up care through the 1st year postpartum. 4b) Carry out

local sensitization meetings for community leaders in the importance of RH/FANC/PMTCT/PNC for women

and infants. 4c) Adapt previously developed training materials for CHW trainers, CHW supervisors, village

health committees (VHCs) and volunteers in RH/FANC/PMTCT/PNC. We will work with stakeholders to

revise the current FANC community mobilization training materials to include additional information on

PMTCT, HIV prevention and care, MIP, safe delivery, PNC, cervical cancer prevention, FP and other key

MNH areas that are not currently covered through existing community mobilization efforts and will ensure

that these are appropriate for the local context. 4d) Two trainers from each district will be oriented on

training and supervision manuals and reference guides for community mobilization for integrated

RH/PMTCT/FANC/PNC services

Activity Narrative: 4e) In each ward, four service providers will be selected and trained to provide supportive supervision to

CHWs. 4f) In each district, two CHWs will be trained from approximately four to six villages on how to

transmit key messages, conduct individual and group counseling and develop action plans. 4g) Support

CHWs, VHCs, and other advocates to carry out household visits to women in their communities and refer

for RH/FANC/PMTCT/PNC.

LINKAGES: We activities will be linked with existing RH, PMTCT, FANC and other MNCH services

implemented by the MOHSW and local partners at both the facility and community level. We will work with

the Ministry of Community Development, Gender and Children, and international NGOs training service

providers and CHWs on all topics to integrate RH/PMTCT/FANC/PNC messages. At the facility, we will

work in coordination with ACQUIRE, EGPAF and URC for PMTCT, with ACQUIRE and other partners for

FP, with national MOHSW initiatives for improving maternity care and current FANC activities. We will

collaborate closely with those organizations currently working to support CTCs. For example, our partner,

international medical association (IMA) World Health, has relationships with many such CTCs. In addition,

We will bring in new partners who are working in areas such as cervical cancer (from Ocean Road Cancer

Institute) to work with regional JHPIEGO experts on cervical cancer prevention training and service delivery.

CHECK BOXES: The program emphasizes a wraparound approach because activities will include

promotion of FANC (a malaria and child survival-focused activity), safe delivery, cervical cancer prevention

and PNC services including FP with special consideration for HIV+ women. We will work closely with the

RCHS to develop and implement this program.

Pregnant women, adult women, adolescent girls, and men were selected as target populations. Because

the median age at first birth in Tanzania is 19-years old, many female adolescents are pregnant and

subsequently may use PMTCT services. It is anticipated that the VCT and ARV FP counseling activities will

reach women who may be interested in becoming pregnant. Group education within the community will

focus on male involvement in MNCH.

M&E: Monitoring of community activities will be done mainly by immediate supervisors through monthly

meetings with CHWs and joint home visits to follow up clients. Immediate supervisors will compile the

reports and forward them to the district level where they will be sent to the RCHS and ACCESS-FP. RCHS

and ACCESS-FP, accompanied by district staff, will complete monitoring visits to selected sites once a

year. We will also evaluate increased use of RH/PMTCT/FANC/PNC services in the target facilities by

examining service statistics on PMTCT counseling and testing, early booking at ANC, intermittent

presumptive therapy (IPT) 1 & 2, attendance at PNC, uptake of post-partum FP, and cervical cancer

screening and treatment statistics. JHPIEGO uses an electronic system to monitor number of people trained

and ensure no duplication of training. M&E will account for 8% of the total budget.

SUSTAINABILITY: We will work closely with district health management teams and national level MOH

partners, including RCHS and NACP, to ensure sustainability. During advocacy meetings, We will support

district health teams to plan for continuation of facility support as well as CHW training and support by

including the program in Council Health Plans. Integrating with other ongoing service provider and CHW

training programs will also increase longevity of support for the program. In FY 2009, JHPIEGO/ACCESSFP

will also introduce a strategy of recognition of high-achieving facilities and CHWs as a further incentive

New/Continuing Activity: Continuing Activity

Continuing Activity: 16402

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

16402 16402.08 U.S. Agency for Access FP 9214 9214.08 $1,300,000

International

Development

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

Health-related Wraparound Programs

* Child Survival Activities

* Family Planning

* Malaria (PMI)

* Safe Motherhood

* TB

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $200,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $50,000

and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.01:

ACTIVITY NARRATIVE REMAINS UNCHANGED

TITLE: Strengthening Infection Prevention and Control (IPC) Injection Safety (IS) in Tanzania

Transmission of infection is a major problem in Tanzanian health care settings. Improper IPC practices,

including unsafe use of injections, continue to serve as a route for HIV transmission. The Ministry of Health

and Social Welfare (MOHSW) and other stakeholders in the health sector acknowledge that IPC-IS is one

of the pre-requisites for ensuring safe health care delivery as well as protecting the population from

infectious diseases including HIV/AIDS. Injection safety is essential to protecting the health workforce.

JHPIEGO is an international leader in implementing evidence-based IPC practices that protect both the

client and the health care worker and has developed successful IPC-IS initiatives through focused antenatal

care (FANC) and Reproductive and Child Health Services (RCHS) in over 40 countries.

ACCOMPLISHMENTS: This IPC-IS program builds upon efforts already being implemented by JHPIEGO in

partnership with the MOHSW health services inspectorate unit (HSIU), under the ACCESS program and

John Snow International, Inc (JSI). Utilizing FY 2005 PEPFAR funding, JHPIEGO/ACCESS assisted the

HSIU in developing national guidelines on IPC. During FY 2006, the guidelines were adapted into a

simplified pocket guide for health care providers, translated into Kiswahili, printed, and widely disseminated

to frontline health care workers. Currently, in FY 2007, JHPIEGO/ACCESS is assisting the HSIU in

developing an IPC orientation package for use in orienting district-level policymakers and training

institutions to the IPC guidelines. Approximately 60 tutors will be updated on IPC-IS and use of the

orientation package for updating others in the pre-service training institutions. These trainers will receive

support to implement the IPC-IS training. In addition, the IPC orientation package will serve as a tool for

advocacy with Council Health Management Teams (CHMT) to ensure that standard precautions are

featured in Council Comprehensive Health Plans (CCHP). JHPIEGO/ACCESS collaborated with the

MOHSW/HSIU to develop and introduce a formal quality improvement (QI) initiative at individual health

facilities. JHPIEGO/ACCESS, JSI, and HSIUwill develop nationally standardized performance standards for

IPC-IS and will adapt these standards into

checklists for both external assessments and internal QI work. This work has been discussed and solidified

by all key stakeholders, and suggested target districts have already been identified with HSIU input.

ACTIVITIES: JHPIEGO/ACCESS will introduce IPC-IS performance standards and a QI approach to 26

hospitals previously identified and trained on IPC-IS best practices by the MOHSW/HSIU and JSI.

JHPIEGO/ACCESS will work with 13 of these hospitals under the FY 2008 plus up funding to introduce the

IPC performance standards and the QI approach. This initiative will come to fruition when FY 2009 funding

becomes available for program introduction to the remaining 13 hospitals.

The program will include assembling advocacy meetings with regional and district health teams in the areas

where selected hospitals are located in order to introduce the program to local authorities and advocate for

IPC-IS training and equipment to be entered into council health plans. Additionally, up to five IPC-IS focal

persons from each facility will be trained on IPC QI process and tools through a modular approach.

Selected focal persons were chosen by the HSIU, updated on IPC best practices, and will form the core of

QI teams within the IPC-IS committee at their facilities. Furthermore, 13 hospitals will receive support to

conduct baseline assessments on IPC-IS. The QI team will subsequently review results, identify gaps, and

develop action plans to address these gaps.

The 13 hospitals will receive additional support in order to conduct quarterly follow up assessments on

IPCIS,

conduct onsite analysis, and share results with hospital staff and HSIU. Roughly three months following

baseline analysis, the first follow up assessment will be conducted by the QI team to evaluate progress and

identify larger gaps and arising issues. Results will feed into module two training where progress and

challenges will be shared. A subsequent follow up assessment will be conducted at a similar interval, with

results shared during module three training. Lessons learned at these trainings will allow QI teams to make

greater improvements in their facilities. After identifying gaps through the assessments, limited support will

be in place to address those shortcomings. These disparities could include support for onsite training,

technical assistance visits, and benchmarking visits.

Two national IPC quality improvement-sharing meetings will be supported by JHPIEGO. Following QI

modular training, program stakeholders from national, regional and district level, as well as facility

management, will convene bi-annually to review results to date, discuss common gaps, and suggest

solutions. Participation in these meetings will assist in advocacy with district and regional policymakers and

support for sustainability of the program.

Additionally, JHPIEGO will facilitate the development of a recognition mechanism/plan for high

scoring/achieving facilities to encourage productivity. JHPIEGO/ACCESS will collaborate with facilities and

the HSIU to develop a formal system of recognition for facilities who achieve at least 80% of standards.

This is a critical element in order to sustain motivation and maintain the QI process at the facilities.

JHPIEGO/ACCESS and HSIU will work with districts to develop local systems for recognizing staff and

funding them through their council health plans based on experiences with other QI work in UIanga District.

LINKAGES: JHPIEGO/ACCESS will collaborate with other organizations and local partners currently

working on IPC-IS. JHPIEGO/ACCESS has already established close working relationships with

MOHSW/HSIU and JSI/Making Medical Injections Safer as part of the IPC-IS thematic group. JHPIEGO

will also link the IPC programs with ongoing work in antenatal care (ANC), ensuring that FANC providers

are also implementing quality IPC-IS practices.

M&E: JHPIEGO will collaborate with HSIU, district health management teams, and other partners working in

IPC-IS in all data collection, evaluations, assessments, supervision tool development and quality

improvement initiatives undertaken as part of IS programs. The supervision and follow up tools that were

developed with FY 2007 funds in collaboration with the MOHSW will be used in the quality improvement

initiative form.

QI assessment results will provide a set of quantitative data for measuring facilities' improvements over time

Activity Narrative: in implementing infection prevention practices to standard guidelines. All work on the QI in the 26 facilities

will be closely coordinated with MOHSW and documented to ensure replication capability in other facilities

in future years. As part of the QI JHPIEGO will collect key service statistics from a sampling of sites to

evaluate translation of improved IPC-IS practices to reduced instances of infection transmission. PEPFAR

training indicators will be reported and other indicators adapted to assist MOHSW to better measure the

progress and potential impact of IS programs.

SUSTAINABILITY: As previously discussed, QI teams will be actively involved in advocacy efforts with all

districts. District allocation of resources to conduct orientation sessions on IPC and IS will ensure greater

coverage and effectiveness. Integrating recognition mechanisms into the program is another way to ensure

sustainability as facilities continuously strive to achieve at least 80% of standards or to maintain this level.

Finally, IPC focal persons will have the training and facilitation skills necessary to replicate this initiative in

other facilities

New/Continuing Activity: Continuing Activity

Continuing Activity: 13501

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

13501 3422.08 U.S. Agency for JHPIEGO 6528 1171.08 $393,016

International

Development

7730 3422.07 U.S. Agency for JHPIEGO 4546 1171.07 $400,000

International

Development

3422 3422.06 U.S. Agency for JHPIEGO 2848 1171.06 $200,000

International

Development

Table 3.3.05:

THIS IS A NEW ACTIVITY.

NEED and COMPARATIVE ADVANTAGE: Research conducted by technical experts and other credible

evidence indicates a higher correlation between HIV-positive women, the Human Papilloma Virus (HPV),

and the development of cervical cancer when compared with HIV-negative women. Because HIV-positive

women suffer from weakened immune systems, their resistance to sexually transmitted diseases, including

HPV, is extremely low. The link of HPV to cervical cancer is undeniable; a recent study found an HPV

prevalence of 94% in women with cervical cancer. Prevention of HPV is critical to cervical cancer

prevention, and identification and treatment are necessary steps to protect all women, especially those

living with HIV.

To respond to this evidence, PEPFAR plans to incorporate screening and treatment of cervical cancer into

the area of responsibility for implementing partners. Thus, in the context of HIV infection, cervical cancer is

defined as an opportunistic infection for HIV-positive women and will be included in Adult Care and Support

objectives. Ensuring that capacity and systems are in place for HIV-positive women to be screened and

referred for treatment for cervical cancer (once the program moves to implementation) will ensure that

existing programs can enhance the continuum of care for HIV-positive women in Tanzania.

JHPIEGO has been at the vanguard of global efforts to prevent , identify, and treat cervical cancer since

1997, when it conducted early clinical trials in Zimbabwe and developed an approach to see and treat

cervical cancer in one visit. JHPIEGO has worked to pioneer this unique, medically safe, acceptable, and

cost-effective approach to cervical cancer prevention for low-resource settings. This approach is a low-cost

intervention to identify and treat precancerous cervical lesions. It is a simple and practical procedure that

can be scaled up nationally to significantly reduce rates of invasive cervical cancer. Currently, JHPIEGO is

translating these research results into practice by bringing the single visit approach into routine health

services. JHPIEGO works with ministries of health and national stakeholders to implement a sustainable

and comprehensive approach to cervical cancer prevention.

ACTIVITIES:

1) Assess current legislation, programs, epidemiology, and existing information relevant to HPV and cervical

cancer to determine best practices recommended for implementation of a nationwide screening and

treatment program for HIV-positive women in Tanzania.

JHPIEGO will review existing policies and efforts regarding screening for and treatment of cervical cancer

and current availability of treatment for cervical cancer and precancerous lesions. JHPIEGO will also collect

and monitor relevant epidemiological data as it relates to HPV, cervical cancer, and HIV/AIDS.

2) Develop linkages with the Government of Tanzania (GOT), treatment implementing partners, existing

facility-based care programs, and other key stakeholders to ensure sustainable and collaborative initiatives.

JHPIEGO will also meet with various stakeholders and implementing treatment partners who can help to

combat cervical cancer in HIV-positive women. In addition, JHPIEGO will assist the Ministry of Health and

Social Welfare (MOHSW) with the development of a forum for coordination of these efforts, as appropriate.

JHPIEGO will work with the MOHSW to design a pilot for the integration of cervical cancer screening with

low cost and practical methods (e.g., visual inspection) into service protocols, and establish appropriate

referral mechanisms and systems for treatment of cervical cancer.

Options for treatment would be shared with the GOT so that the appropriate options would be included in

national policy and practice. Presently, GOT has policies in place that require cytology-based screening of

all women for cervical cancer; however, current rates of compliance are unclear. JHPIEGO will review the

existing guidelines for cervical cancer screening and treatment systematically and explore current

implementation of these guidelines and other practical and available treatment options. These

assessments will determine capability and identify existing infrastructure for cytology-based screening, and

alternative methods of screening and treatment will be explored for areas lacking resources. In addition to

national considerations and input from implementing partners, successful programs from other African

countries (e.g., Zambia) will be considered for adaptation into the Tanzanian context. It is likely that a

simple, low-tech approach will be adopted, using visual inspection and acetic acid to detect HPV and

precancerous lesions.

3) Expand the continuum of care to include cervical cancer screening and treatment for HIV-positive women

in Tanzania; services delivered by trained nurses, midwives, clinical officers, assistant medical officers, and

medical officers.

The USG/Tanzania Clinical Services team will work with the Cervical Cancer Taskforce to ensure that

proposed programs are compliant with PEPFAR guidance, as well as with existing and procedures.

Additionally, JHPIEGO will assist the MOHSW in updating guidance as appropriate, and develop plans for

the piloting and implementation of cervical cancer screening efforts among HIV-positive women, including

plans for funding, evaluation, and sustainability. Since this a new area of focus, major groundwork will take

place to assess and develop infrastructure to support future programs, which will be larger in scope in

subsequent years. If possible, the program will be piloted with USG treatment partners in a limited number

of sites.

LINKAGES: In compliance and in conjunction with GOT (particularly the reproductive health unit at the

MOHSW), JHPIEGO will ensure linkages and coordination with existing implementing partners who already

provide facility-based HIV/AIDS care and support. These implementing partners include Harvard, Deloitte,

EGPAF, Mbeya Referral Hospital, Mbeya Regional Hospital, AIDSRelief, PharmAccess, Columbia, Selian,

and PASADA. The linkages will also include collaboration with other stakeholders, both US Government

(USG) and non-USG-funded activities currently supporting efforts relating to screening and treatment of

cervical cancer, other women's health issues, and HIV care and treatment.

TARGET POPULATION: Screening and treatment programs for HPV and cervical cancer will be directed

solely toward HIV-positive women, in compliance with Country Operation Plan (COP) guidance for these

initiatives.

Activity Narrative: M&E: JHPIEGO will collaborate with implementing partners to develop a Monitoring and Evaluation (M&E)

system to monitor feasibility, scalability, potential for impact, and cost-effectiveness of potential cervical

cancer programs. Evaluation data will ensure ongoing program improvements in addition to securing and

facilitating future replication, expansion, and national scale-up of programs. Evaluation components will

include qualitative and quantitative measures, and use cost data analysis to monitor program activities,

including monitoring the number of HIV-positive women screened and treated for HPV and cervical cancer.

JHPIEGO will work with implementing partners to develop appropriate tools and necessary systems to

collect and report relevant data. Data will be shared on a quarterly basis to ensure the effective partnership

between implementing agencies in meeting goals and objectives.

SUSTAINABILITY: In order to develop sustainable and effective programs, FY 2009 funds will be allocated

toward developing protocols, reviewing and refining standard guidelines for programs and procedures,

training for human resources, and creating job aids for screening and treatment of cervical cancer.

Sustainability will occur through knowledge and information sharing among partners and key stakeholders,

in addition to linking with already existing HIV care and treatment initiatives. By ensuring that implementing

partners collaborate within existing public and private mechanisms, using national guidelines, and

complementing an already existing continuum of care for HIV-positive women, sustainable services that

build upon existing systems will be ensured.

New/Continuing Activity: New Activity

Continuing Activity:

Program Budget Code: 09 - HTXS Treatment: Adult Treatment

Total Planned Funding for Program Budget Code: $74,974,303

Total Planned Funding for Program Budget Code: $0

Table 3.3.09:

ACTIVITY NARRATIVE REMAINS UNCHANGED FROM FY 2008.

The funding for this activity has changed from clinical services (HTXS) to Health Systems Strengthening

(OHSS), as a result the targets have also changed to reflect their contribution to OHSS targets. In FY 2008

this activity did not contribute to HTXS targets.

TITLE: Strengthening Pre-service Education for Medical Institutions

NEED and COMPARATIVE ADVANTAGE:

National medical institutions and university teaching hospitals play a critical role in the training and

development of new health workers. Such sites are often used for clinical training aspects of many health

worker cadres, not just medical students. Furthermore, medical institutions and physicians hold a great deal

of influence in Tanzania. To this end, it is critical that such institutions and their personnel exhibit and

support quality care for HIV/AIDS according to evidence-based best practices as a model for the entire

country.

ACCOMPLISHMENTS:

JHPIEGO has a long history to working with pre-service educational institutions throughout the world. With

USAID funding, JHPIEGO/ACCESS has been working to improve teaching of PMTCT in pre-service

nursemidwifery

schools, both certificate and diploma levels. This work was building on previously-established

relationships with pre-service schools for integrating focused antenatal care (FANC) into their curricula. In

FY 2008, ACCESS plans to expand the FANC work to medical schools with funding from the Presidential

Malaria Initiative. This will enable ACCESS to develop a strong relationship with medical schools.

ACTIVITIES:

ACCESS will work with the MOHSW of Tanzania, the National AIDS Control Program (NACP), and the

Human Resources Development Directorate, to strengthen medical training institutions such as Muhimbili

University College of Health Sciences (MUHAS), Kilimanjaro Christian Medical College (KCMC), and

others. Specifically, ACCESS will supply equipment for state-of-the-art teaching. ACCESS will supply at

least five schools with educational equipment such as LCD projectors and laptop computers in order to aid

them in delivering high quality lectures and lessons. Representatives from recipient institutions will also be

trained on the use of such equipment.

LINKAGES:

JHPIEGO/ACCESS will collaborate closely with other organizations, local partners and health care

providers currently working with medical institutions and national teaching hospitals. JHPIEGO will also

ensure synergies between its own pre-service activities to avoid re-inventing the wheel.

CHECK BOXES:

The area of emphasis for this program is Human Capacity Development through pre-service training for

medical professionals and educators.

M&E:

JHPIEGO will use the TIMS database to capture names and numbers of persons trained. M&E will account

for five percent of the total budget.

SUSTAINAIBLITY: The sustainability of all pre-service programs is long-term in that by ensuring that new

graduates have updated skills in evidence-based best practices, there is less need for in-service training.

Furthermore, this program will improve pre-service facilities and this will allow more students to enter to

training and will ensure that new providers graduate with the necessary skills to provide adequate care to

HIV+ women.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16978

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

16978 16978.08 U.S. Agency for JHPIEGO 6528 1171.08 $150,000

International

Development

Emphasis Areas

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $150,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.18: