Maintain and strengthen provision of integrated high-quality HIV care and support aimed at extending and optimizing quality of life for PLHIV from the time of diagnosis throughout the continuum of illness. Being the main USG-funded technical advisor agency for facility-based positive prevention, with this funding ICAP will intergrate and expand positive prevention services (PHDP/PwP) in all supported facilities; additionally ICAP through this mechanism will provide TA to all other Facility-Based partners in intergrating PDHP activities into their programs. Ensure and strengthen adequate linkages between facility and community-based PHDP to optimize clients retention in care.Provide continued support (Technical Assistance), strengthen coordination and collaboration mechanisms between partners and Ministry of Health. The services will be provided in selected regions in Tanzania.

Focus on high quality HIV services at existing sites by reducing retention gap through identification of problems and strategies that will lead to increased retention of patients on ART. Continue capacity building and provide service delivery in an effort to take over ART sites from the international partner in the allocated regions. Focus more on clinical mentorship, supportive supervision and adhere to consolidation of in-service ART trainings in the zonal training centers. Partner works in 23 districts of Kigoma, Kagera, Pwani, Lindi and Zanzibar and currently covers 19053 patients.

Continue supporting HIV CT services (training of Health care workers, training of RHMT/CHMT, support for the supervision visits ) in Kagera, Kigoma, Coast, Lindi and Zanzibar; support HTC including community-based HTC as part of Prevention Combination in Pwani, the support will include training, awareness creation, support supervision.

These funds are proposed for the following activities: Scale up cotrimoxazole (CTX) prophylaxis for HIV-exposed and infected children; provide nutrition assessment, counseling and support; provide prevention, diagnosis and management of tuberculosis and other opportunistic infections (OI's); provide palliative care and psychosocial support. The funds will be used to improve linkages to Community Based Care including: under 5 child survival interventions and community HIV supported services. These activities will be achieved through training and on-site mentorship, establishment of coordinating committees with community-based organizations, advocacy and community mobilization. These activities will take place in Kigoma, Zanzibar, Pwani and Kagera.

These funds are proposed for the following activities: Implement updated WHO treatment guidelines to improve access to pediatric ART, including treatment of all HIV infected children <24 months;enhance the identification and diagnosis of HIV for infants and children through EID, PITC in in-patient and out-patient settings, immunization, OVC, and TB/HIV clinics; improve follow-up services for HIV-exposed infants and children and track and retain children in care and treatment; monitor response and adherence to treatment. These activities will be achieved through training, on-site mentorship, advocacy, community mobilization, and updating of tools for tracking and retention. These activities will take place in Kagera, Kigoma, Zanzibar and Pwani with the aim of enrolling 1348 new children on ART. $100,000 in additional funds have been added for strengthening referrals and linkages in Pwani region due to a high ANC prevalence.

Continuation of MC support in Kagera; Mobile MC services on Lake Victoria Islands off Kagera

Moved funding from Mechanism 9972 to Mechanism 83 in order to combine mechanisms for a single partner

Additional funding for AB component of combination prevention evaluation in Pwani region ($200,000).

Moved funding from Mechanism 9972 to Mechanism 83 in order to combine mechanisms for a single partner. HVAB was reduced from $250,000 to $200,000 and HVOP was increased from $200,000 to $250,000

Additional funding for the OP component of combination prevention evaluation in Pwani region ($200,000) and strengthened MSM outreach and services on Zanzibar ($50,000)

Funding was moved from Mechanism 9972 to Mechanism 83 in order to combine mechanisms for a single partner. HVAB was reduced from $250,000 to $200,000 and HVOP was increased from $200,000 to $250,000

IDU Outreach in Zanzibar, HTC, STI screening & treatment and NSP. Includes sub-grant to 3 local NGOs/CBOs for DU/MARPs outreach in Unguja & Pemba. Training health care providers for MARPs-friendly clinical HIV/AIDS services in Zanzibar. TA for national MARPs/DU M&E. Support MAT in Zanzibar. Increased funding this year to incude NSP for comprehensive IDU programing in Zanzibar and for baseline asessment and IDU outreach in Mwanza.

Implement PMTCT and improve MCH services (see PF package): The PF funds will support the implementing partner (IP) to meet the objective of scaling-up quality PMTCT services by:-

(1) Strengthening the linkages and referrals of HIV+ women and children to care and treatment services and other health and community programs

(2) Integrating PMTCT and ART

(3) Having the partner complement FP and Focused Antenatal Care (FANC)

(4) Having the PMTCT partner complement Emergency Obstetric Care (EmOC) package

(5) Having the partner complement Newborn Health package.

(6) Supporting EID transportation of samples including DBS and sending back the results to the clients.

(7) Improving infrastructure through construction and renovation (8) Improving the procurement of MCH-related equipment, drugs and supplies through a central procurement system

(9) Strengthening M&E systems to track and document the impact of the PMTCT program

(10) Providing training and improving retention rates of health care workers

(11) Strengthening and expanding interventions to improve maternal and child survival

(12) Supporting new activities such as Cervical cancer screening

(13) Creating community demand

a. Staffing NHLQATC (7 positions)

b. Support Mnazi Mmoja ISO accreditation

c. EID at national level (support 3 program officers) these positions will be transitioned to Ministry after FY 11

Maintain services related to implementation of the Three I's. It is estimated that around 20% of new patients enrolling into ART would present signs and symptoms of advanced HIV diseases and diagnosing TB among this group is difficult as the routine diagnostic tests (AFB smear microscopy and/or chest X ray) are neither very sensitive nor very specific and undiagnosed TB remains a major cause of mortality in this group. To enhance TB diagnosis in this group, there is a high need of investing in sophisticated TB diagnostic tests e.g. Liquid culture and Line Probe Assays. To increase access to this service, ICAP will coordinate transportation of sputum and/or blood samples to CTRL for Liquid culture and LPAs. ICAP should ensure TB screening and recording in the CTC2 is happening throughout the supported sites. ICAP will collaborate with the MOHSW and other stake holders to review, update, and develop guidelines/tools for management of TB among adults and the pediatric population. Services will continue being provided in 23 districts in 3 regions (Kagera, Kigoma, Pwani). This mechanism relates to mechanism system ID 83 Columbia.