PharmAccess will continue the work with the police, immigration department and prison with work place community care services. This program is also linking with others on PMTCT, prevention, care and treatment, pediatric care, TB/HIV and care for OVC. PharmAccess will continue to target employees of their institutions as well as the surrounding civilian population. This activity is implemented in Police barracks, Immigration departments and Prisons facilities and surrounding communities, with a major role for HBC trained women of police officers living in the barracks surrounding the health facilities.

1) Leverage resources to complement provided funds 2) Support OVC access health service through establishing of the Heath Insurance fund. 3).Link with other OVC IPs to identify the beneficiaries and ensure comprehensive services. 1).Implement strategy developed for Police and Prisons to work with children to ensure the supporting of the developed "Interactive Services for Children" guideline integration in the daily police job descriptions, trainings, and routines 2). Roll out the piloted child friendly police program to another station .

3.)Train more 100 police, prison personnel, and available community team members in appropriate "handling" of OVC, abused children, street children, and other vulnerable children during detention and in the streets using the developed guidelines.

Maintain quality HIV services at eight Police and Prison Hospitals in the country that will be accomplished through regular supportive supervision, clinical and nutrition mentoring, patient monitoring, and ensuring uninterrupted supply of drugs and reagents through central procurement mechanism, supplemented by capacity building in financial accountability and M&E. Funds will also be used for facilities and community linkages. Provide AIDS care and treatment in least one police and one prison health facility in every region of Tanzania. Most health facilities need extensive refurbishment and training of staff. PharmAccess will establish private health insurance to low income African workers in Dar es Salaam and Arusha

Continue to provide HCT services to prison and immigration officials and police and surrounding communities. Program aims to include at least one police and one prison health facility in every region of Tanzania. Most health facilities need extensive refurbishment and training of staff.

Maintain and improve quality of existing pediatric HIV Care services. This will be achieved through provision of CTX, Screening and Treatment for OIs, Nutritional Assessment and support and Linkages with other programs such as OVC and HBC, PMTC, TB/HIV. The services will be provided at Kilwa Road Hospital, the National Referral Hospital for the Police and at Ukonga Hospital, the National Referrral Hospital for Prisons.

Maintain and improve quality of existing Pediatric HIV services. This will be achieved through support supervision visits, inservice training including on site mentorship, infrastructure development and supplies of essential commodities including drugs. The work will occur within two Police health facilities in Dar es Salaam and Moshi and in four Prison health facilities: Dar es Salaam, Mwanza, Mbeya and Moshi.

Maintain comprehensive prevention activities for police, prison and immigration authorities and the surrounding communities. The AB component is focused on gender issues, which is integrated in the peer educators training program. The 'life skills' trainings for recruits and HIV awareness campaigns for commanders include assertiveness skill-building for females and awareness raising for male commanders.

Expand comprehensive prevention activities for police, prison and immigration authorities and the surrounding communities. This will be accomplished through expansion of comprehensive HIV prevention activities, linkages with health services/CT, and workplace programs. National roll-out planned through peer educators programs, life-skills trainings for recruits, HIV awareness campaigns for commanders (who are powerful message-senders), trainings on safety measures and condom distribution.

PAI works in Police and Prision facilities (18) across several regions (with corresponding HIV prevalence). The program will scale up PMTCT and implement PMTCT package. Activities to be supported using base funding

The program will scale-up PMTCT services to cover 80% of the facilities providing RCH services in prison and immigration facilities. PAI will provide support to respective facilities and these services will include but not be limited to: HIV testing (in ANC, L&D), including partner testing, Counseling on infant feeding options (IF), Strengthen counseling on FP methods to HIV+ mothers during postpartum visits, offer HIV testing at the FP clinic and offer referrals to CTC and vice versa, Clinical staging of the HIV+ pregnant women at the RCH clinic by the PMTCT service providers with linkages to CTC, Rolling out of more efficacious regimen to facilities with the capacities, Provision of ART prophylaxis to HIV+ pregnant women who are not eligible for HAART, Provision of Cotrimoxazole to all eligible pregnant women and exposed infants, Conduct PMTCT outreach services in hard to reach areas, Quarterly supportive supervision by the RHMT to ensure quality of services. In collaboration with health department, bi-annual supportive supervision will also be done to facilities.

PAI will collaborate with community support groups including M2M program to form psychosocial support groups, which will provide psychosocial support and increase adherence and retention to care. Expert patients will carry out non-medic chores in the facilities. In addition, mother to mother program and other partners within the regions will follow up mother-infant pairs in the community.

The programs will Renovations, procurement and materials as follows:

Renovate and equip facilities to provide space for offering integrated PMTCT services. PAI will ensure availability of HIV test kits by procuring to fill gaps, ensure adequate supply of drugs for more efficacious regimen, based on needs, support printing and distribution of IEC materials and job aids.

The program will also train nurses, nurse midwives and other cadres in PMTCT, IF, drug monitoring and stock outs, including WHO staging.

The program will carry out Mentoring of HCW and support use of retired nurses to provide integrated PMTCT services in the region

It will ensure guidelines and M & E tools are available, improve data collection systems, and train service providers on filling of the PMTCT monitoring tool.

The program will strengthen and facilitate RHMT annual review meetings, formation and integration of regional PMTCT task forces into Reproductive and child health. Support regional quarterly partners meeting and strengthening linkages and referrals. PAI will implement PMTCT and improve MCH and PMTCT services (see PF package) Activities to be supported using PF Funding

PAI will work with Reproductive health partners and with the respective districts and facilities, to carry out facility infrastructure improvement after carrying out facility audit; subsequently they will renovate and equip facilities to provide space for offering integrated PMTCT services at RCHC and L&D, FP, FANC and BEmoc

PAI will Improve conditions in the maternity wards so as to attract more women to deliver at the facilities by procuring appropriate equipments such as delivery beds/kits, suction machines, weighing scales, protective gears etc.

PAI will strengthen PMTCT-ART Integration by supporting Hospitals, Health Centers and Dispensaries to develop capacity to provide more efficacious PMTCT regimen, training PMTCT HCP at RCH on ART so that they can refill ARV drugs at the RCH; Ensure availability of PMTCT guidelines and job aids; Support transportation of CD4 samples of HIV+ pregnant women; Ensure availability of PMTCT M&E tools and Integrate HIV counseling and testing in all the RCH services, including Pediatric wards

PAI will focus on community and demand creation activities that include: sensitize the community through different media on the improved MCHC/RCHC services with emphasis on PMTCT, EID services and FP), Engage men through different avenues to participate in RCH services (use of invitation letters, priority treatment, through involvement of village authorities etc), Collaborate with Mother to Mother program to establish psychosocial support groups in the8 facilities they work in. PAI will also integrate its FP program and link with partners supporting Emergency obstetrics, new born and pediatric health and cervical cancer screening services.

PAI will ensure program ownership and sustainability by working with districts to ensure that PMTCT/pediatric AIDS activities are planned and prioritized and funding allocated through the facility Health Plans.

Continue implementing activities to reduce burden of TB and HIV among patients infected by both diseases. This will be achieved by Improving collaboration, referrals and linkages with partners working in the regions where these institutions are located, training, mentoring and regular supportive supervision. Services will continue being provided in two Police (Dar es Salaam and Moshi) and eight Prison health facilities (Dar es Salaam, Arusha, Dodoma, Mbeya, Morogoro, Kilimanjaro, Tabora and Zanzibar).