Goals and Objectives: The lack of up-to-date pre-service curricula for clinical officers (CO), clinical assistants (CAs) and assistant medical officers (AMOs) is a significant obstacle to rapid scale up of quality HIV/AIDS programs. In FY2010 ITECH will finish the curriculum for CO/CAs and begin work on a revised curriculum for AMOs ensuring these curricula include prevention efforts such as infection prevention and control - injection safety and provider initiated testing and counseling (PITC). ITECH will also assist in the development of training materials as needed for the new laboratory curricula. This will include development of complementary teaching aids (e.g., facilitator guides, student handbooks, practicum guide, PowerPoint slides, and other resources). Based on an assessment of the current status of distance learning programs, ITECH will work to increase the quality of existing distance learning programs.

ITECH will also strengthen the capacity of tutors and clinical instructors at practicum sites in the CA, CO and AMO pre-service training institutions through the roll out of the basic teaching methods course and the HIV fundamentals course. ITECH will develop a package for more in-depth faculty development that includes further training on curriculum development and lesson planning. This will increase the capacity of faculty to provide high quality instruction in both pre- and in- service settings, as well as to adapt the curricula and lessons plans whenever new HIV/AIDS-related innovations and guidelines become available.

Regarding in-service training, ITECH will work to improve the Zonal Health Resource Centres' (ZHRCs) capacity to coordinate, implement, monitor, and evaluate HIV/AIDS training. ITECH will continue to equip ZHRC with basic training equipment, libraries, and staff, as well as build the ZHRCs' capacity in leadership and organizational development. ITECH will also work with the ZHRCs to pilot decentralized use of TrainSMART, a training information management system. ITECH will also provide support to the MOHSW to: create a new module on infection control and intensified TB case finding for the current TB/HIV training material; conduct a TB/HIV training evaluation; and develop training materials for pediatric TB. In addition, ITECH will continue supporting PITC in Morogoro by: providing training to create master trainers who will in turn train trainers at the hospital level; conduct sensitization meetings with council health management teams (CHMTs) and principals of health training institutions; work with respective CHMTs to develop the district PITC training plan; produce adequate PITC training materials in collaboration with other PITC partners and NACP; provide technical assistance to NACP in revising the couple counseling and testing training materials; and conduct refresher trainings for previously trained HCWs

Due to the fact that the existing pre-service institutions in the country are not readily able to absorb new numbers of students, help to identify schools where infrastructure investments will quickly yield increased enrollment capacity. As space becomes available ITECH will continue to provide scholarships to lab, CO, CA and nursing students.

ITECH will continue to provide support to the government's Workplace Intervention Program (WIP) ensuring existing training materials are of high quality and include adequate information on abstinence and other prevention.

Health System Strengthening: Tanzania continues to face an acute shortage of health professionals, severely hampering the scale up of HIV/AIDS-related services. Investing in the development of human resources for health lays the foundation upon which HIV/AIDS interventions are built and ultimately ensures the achievement of PEPFAR goals.

Cross-cutting: As an health systems strengthening partner I-TECH will work closely with various technical departments at the MOHSW such as the National AIDS Control Programme (NACP) and the National TB and Leprosy Program (NTLP) to ensure systems are build which supports service delivery.

Cost-efficiency: To date much of the PEPFAR funded training has been through in-service. Support for pre-service training will introduce greater sustainability by increasing knowledge among new health cadres during their routine training and credentialing. ITECH is also strategically decentralizing curriculum development and in-service training capacity to the MOHSW and ZHRCs to increase sustainability and cost efficiency.

Geographic: This is a nationwide program.

Partnership Framework (PF): This activity will contribute towards achievement of key component of the PF HRH Goal: increased production of health workers. These are also key objectives and high priorities in the GOT HRH Strategy.

M&E: ITECH has a comprehensive M&E plan to track progress against output, outcome, and impact indicators. Activity managers use a results-based framework and M&E plan for each area of activity to regularly review progress. Further technical support is provided from headquarters.

Continue support PITC Morogoro with the following activities:

Provide training to Morogoro region's training teams to become master trainers, who will in turn train trainers in PITC at the hospital level

Conduct sensitization meetings with council health management teams and principals of health training institutions within Morogoro region

Work with respective CHMTs in the development of the district PITC training plan

Produce adequate PITC training materials including job aids in collaboration with other PITC partners and NACP

Provide technical assistance to NACP in developing/ adapting the Couple Counseling and Testing training materials

Conduct refresher trainings to previously trained HCWs.

Support for pre-service training with an emphasis on ensuring counseling and testing content, including PITC, are fully integrated into the Zonal Health Resource Centers' work and into the pre-service curricula for health care workers. This funding will contribute to the following on-going activities: revision of curricula, development of training materials, orientating of teacher on the new curricula and materials.

Finalize the training materials for the revised CO and CA curriculum. Begin to revise the curricula for two additional cadres (AMOs and Laboratorians) as well as the curricula of the national distance learning center. Strengthen the capacity of tutors/clinical instructors in the CA, CO, and two new cadres pre-service training institutions working with JHPIEGO on AMOs as appropriate. Work to improve the ZTC's capacity to coordinate, implement, monitor, and evaluate training by providing ZTCs with basic training equipment, materials, and staff. Continue to work with the ZTCs and the national distance learning center to build their capacity in leadership and organizational development. Work with a minimum of six pre service training institutions to increase their throughput by providing supplies, tutors, scholarships, and other inputs. Support the zonal/district level pilot of Trainsmart, a system for tracking in service training.

Support for integration of IPC, including universal precautions and health care waste management, into pre-service training. This will include training of pre-service trainers and teachers on IPC and new/revised curricula including IPC contents. To-date training roll-out has largely occurred through in-service trainings; the IPC pre-service training support is introduced for greater sustainability by increasing knowledge and awareness about IPC among new health cadres and personnel.

Introduction of AB component to existing program for HIV-positive Health Care Workers.

Introduction of OP component to existing program for HIV-positive Health Care Workers.

Support the zonal/district level pilot of Trainsmart, a system for tracking in service training.

Provide the second year of tuition fees for 50 pre-service students currently in the lab schools who were first enrolled in Oct 2009. This includes: 27 lab assistant technicians; 15 diploma lab technicians; 5 advance degree students; and three lab BSc students. Support pre-service training related to the laboratory cadres. Activities will include: sponsorship for specialized lab and biomedical training outside of Tanzania to increase the number of laboratorians with advanced degrees qualified for teaching once they return to Tanzania; assistance with materials development as needed for the newly revised laboratory curricula.,

Provide support to MOHSW to revise/ update/intergrate new module (Infection control, Intensified TB case finding) into the current TB/HIV training material, conduct TB/HIV training evaluation; Develop training material for padiatric TB. Support will be provided at central (National) level