Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014 2016

Details for Mechanism ID: 12247
Country/Region: Tanzania
Year: 2010
Main Partner: Harvard University
Main Partner Program: Harvard School of Public Health
Organizational Type: University
Funding Agency: HHS/CDC
Total Funding: $1,573,546

Harvard Mechanism 10048 has been split to make the management of the partner more efficient. The purpose of this funding mechanism is to support three key program areas including (a) Support provision of quality and sustainable adult and pediatrics HIV service (b) support provision of quality Laboratory services and (c) Support scale up for quality and comprehensive PMTCT services. (a) Support provisions of quality and sustainable adults and Pediatrics HIV services. Harvard will support maintenance of quality HIV services at existing sites, scaling up to previously underserved areas, expand adherence and psychosocial support services to PLHA and promoting PWP. Harvard will provide of Technical support, regular supportive supervision, clinical and nutrition mentoring, patient monitoring, development of SOPs and ensure uninterrupted supply of drugs and reagents. Capacity building of the DHMTs and CHMTs in financial accountability, HIV program oversight and M&E will be provided.

(b) Support provision of quality Laboratory services Harvard will continue to provide in-service training on Quality Assurance for HIV Rapid Testing, HIV disease staging and drug safety monitoring tests, opportunistic infection testing (e.g. Cryptococcus antigen test, syphilis test, etc.), and commodity and inventory management at facility level. To ensure standardization and maintenance of quality, trainings will only be conducted using the nationally approved modules and MoHSW approved trainers. To ensure quality assurance HARVARD will hire a Lab regional mentor for its sites in the region. The regional mentor will mentor staffs in its district laboratories. The mentors will visit each district lab four times per year to mentor lab staffs on 12 Quality System Elements (QSE) as per MOHSW local mentorship program. The goal is to assist the district laboratories to obtain accreditation through the WHO's 5-step SLMTA approach The zonal Laboratories will also be mentored to reach ISO 15189.

(c) Support scale up for quality and comprehensive PMTCT services.

MDH will scale-up PMTCT services from the current 75 sites to additional sites. By September 30, 2010, PMTCT services will be strengthened and expanded. Capacity of the ANC staff will be strengthened in clinical staging, CD4 determination and linkage to CTC. Harvard will support the following activities.

1. Carry out minor renovations of MCH and Labor wards, Procure machines, equipment, reagents, kits.CD4, Biochemistry, Hematology machines M&E tools.

2. Scale-up of EID to 50% of RCH clinics and offer PCR for early infant diagnosis HIV-testing to all HIV -exposed infants

3. Implement new innovation such as cervical cancer screening and screening for opportunistic including TB 4. Strengthen referral systems and integrate care and treatment clinic (CTC) 5. Increase male involvement in PMTCT 6. Recruit a PMTCT coordinator in each district to enhance supervision 7. Increase PMTCT uptake through community awareness-building activities 8. Engage more private facilities to engage in the provision of MCH. Cross cutting program and key issues. MDH works under the National AIDS Control Program following the national PMTCT and treatment guidelines. PMTCT services will be strongly linked with other HIV prevention, care, and treatment activities, including links to CTC and family planning (FP) programs. The MDH CTC intake form has been revised to allow for tracking of referrals and home-based care providers will track women who have been lost to follow-up. MDH will work with heath facility and district level management to support and link PMTCT and other related services. MDH will work with District Councils to include PMTCT activities in their Comprehensive Council Health Plans. MDH will also work with local NGOs and community leaders to support and link PMTCT and other related services for PLWHA, including linkages with OVC programs.

IM strategy to become more cost-efficient over time. MDH will engage regions/district in dialogue and program to retain staff: MDH has been closely working with the three Municipalities in order to be able to retain the trained and skilled staff at the HIV prevention, care and treatment services as much as possible and this effort will continue in future as well. Also MDH will use peer educators to conduct adherence counseling as well as non professional work such as cleaning at the facility.

How IM links to PF goals The program is linked to Goal 1 maintenance and scale-up services in Dar es Salaam, The prevention component of PMTCT program is directly linked to Goal 2 of the PF, PF Goal 4 procurement of commodities and supplies and Goal 6 of the PF through Public health Evaluation.

M&E MDH budget will continue to collaborate with the National AIDS Control Program (NACP) and support development/revision of ME tools for Adult and Pediatrics care and Treatment, Lab services and PMTCT so as to improvement data quality & reporting. MDH will promote data use culture in patient care and management. Feedback on tool performance will be provided to NACP and partners. Continuous quality improvement committees will be established at sites to manage and analyze data to measure quality and success of the program.

Funding for Treatment: Adult Treatment (HTXS): $1,200,000

Maintain Quality HIV services at existing sites and scaling up to cover private hospitals and previously underserved areas. This will be accomplished through regular supportive supervision, clinical and nutrition mentoring, patient monitoring, and ensuring uninterrupted supply of drugs and reagents through cental procurement mechanism,Capacity building to local partners in financial accountability, technical support, program oversight and M&E. Additional funds will be used for supplies and providing technical assistance to University and zonal institutions (UTAP). Partner works in 3 districts of Dar-es-Salaam and currently covers 26215 on treatment.

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $280,000

Implement PMTCT activities in Dar es Salaam has 3 districts and a HIV

Prevalence of 10.9. with a High HIV prevalence and high volume sites but less than 50% coverage, roll out MECR, implement M and E and Computerised M&E system. Implement PMTCT and improve MCH and PMTCT services (see PF package)

Funding for Laboratory Infrastructure (HLAB): $93,546

Support implementation of Lab quality system and accreditation process by ISO 15189 at Mnazi Mmoja hospital laboratory

Continue to support Early infant diagnosis at national level

support 3 program officers, (2 for EID program and 1 procurement officer ) at MOHSW,

Support funding for 7 technologists positions at NHLQATC. Mentorship at District levels

Subpartners Total: $0
Dar es Salaam City Council: NA
Muhimbili University of Health and Allied Sciences: NA
Key Issues Identified in Mechanism
Increasing gender equity in HIV/AIDS activities and services
Safe Motherhood
Family Planning