COP 2012 funds will be going to support multiple programs of the Ministry of Health and Social Welfare (MOHSW), all of which contribute to health systems strengthening specifically in the areas of human resources and strategic information, respectively Goals 5 and 6 of the Partnership Framework. Working closely with government employees and structures, this mechanism seeks to build up local talent and systems

The goal of Field Epidemiology and Laboratory Training Program (FELTP) is to strengthen capacity of public health workforce in Tanzania to collect and use surveillance data and manage programs including national HIV/AIDS/TB/Malaria and strengthen laboratory support for surveillance, diagnosis, treatment, and HIV screening for blood safety. Activities cover all of Tanzania and target in-service health professionals. Local staff will be recruited to keep personnel costs down. This program maintains a close partnership with the MOHSW who leads biannual steering committee. Monitoring and evaluation takes place through the EPITRACK software.

The goal of Health Management Information System (HMIS) program is to improve and strengthen HMIS and information usage at all levels of healthcare delivery system. HMIS monitoring indicators are used to monitor progress and achievements.

The goal of the Infection Prevention and Control - Injection Safety Program (IPC-IS) is to prevent infection transmission through exposure to blood and other body fluids and other infections in healthcare services provision settings. The program covers 32 council health management teams from six regions to ensure sustainability, monitored primarily through supportive supervision.

MOHSW M&E section, along with the HMIS section in particular, is working together to strengthen the national health monitoring and evaluation systems and processes to improve evidence based decision making across the sector. The HIV program in Tanzania, the work of all PEPFAR partners, and their combined ability to evaluate and monitor the effective implementation of programs is dependent on a strong national M&E system for the health sector.

To coordinate a wide range of investments, MOHSW has created an M&E Strengthening Initiative. This initiative brings together a wide range of funding and implementing partners under the leadership of MOHSW to strengthen M&E within the sector. This initiative includes substantial inputs from Global Fund, the Netherlands, and PEPFAR through CDC.Other PEPFAR partners also contribute to this initiative. Research Triangle Institute (RTI) is contributing technical assistance to MOHSW, which will help improve MOHSWs ability to implement the activities described in the initiative. CDC Foundation is working closely with MOHSW under the M&E Strengthening Initiative to leverage m-health potential to improve the M&E systems in Tanzania. NIMR GIS/WAN activities and IHI SAVVY activities also support the M&E Strengthening Initiative.The HVSI activities implemented within this mechanism support goal number 5 of the Tanzania PEPFAR five-year implementation framework. More specifically, the PEPFAR funding will support the MOHSW capacity to coordinate and manage the M&E TWG, the P4H project, the NIMR GIS and master facility list, the data warehouse technical support, SAVVY, and the National Sentinel Surveillance System.

In FY 2012, MOHSW HMIS team will make use of the PEPFAR funds to support the following deliverables and milestones:(1) $75,000 to be programmed by the MOHSW ICT team to procure equipment and support the expansion of ICT services in regional hospitals. This includes the initiation of internet connectivity, capacity building, and creation of local area networks for regional hospitals. This funding is a continuation of the activities that were previously implemented through NIMR;(2) $110,000 for the MOHSW HMIS team to coordinate and manage M&E TWG, m-health project, SAVVY, and the National M&E Strengthening Initiative, while building the management and coordination capacity within MOHSW M&E team to manage a wide range of priorities and objectives; and(3) $40, 000 will be allocated for activities to be implemented by both the MOHSW epidemiology and disease control section and the HMIS section to expand the use of the IDSR system, prepare routine data dissemination products with information from the IDSR system, and initiate steps towards transition of ownership, management, and sustaining costs associated with the IDSR system to the MOHSW.

Tanzania is faced with the challenge of inadequate human resources for health services. The lack of adequately trained personnel is often the most significant rate-limiting step in providing quality health and clinical services. MOHSW has also identified a need at the national, regional, and district levels to develop a cadre of competent field epidemiologists and public health laboratory managers and technologists who will help to strengthen surveillance and the public health response of priority communicable diseases, especially HIV/AIDS. To address this need, MOHSW established a short course on Field Epidemiology and Laboratory Training Program (FELTP) in Tanzania which complements the FELTP two year graduate course that strengthens integrated disease surveillance systems (IDSR) in Tanzania.

The two week short course has been a very successful program, which allows for a three month field study of participants in their working places after the course. Over the last two years, the FELTP short course, has successfully built the capacity of the ministry health personnel in areas of epidemiology, biostatics, disease surveillance, TB, HIV, M&E, quality assurance, and outbreak management. In addition, it has strengthened the capacity of regions and districts to respond to public health emergencies, such as outbreaks, natural disasters, and other unusual public health events, including those that could be a result of chemical or biological pollution. A number of health personnel (clinicians, laboratory technologists, and health officers) from various districts have also been trained.

In FY 2012, the program will continue to conduct short courses for selected health personnel from the districts who are not covered by the graduate course in areas of epidemiology, biostatistics, disease surveillance, TB, HIV, M&E, quality assurance, and outbreak management. The focus will also be implementation of the newly developed five-year strategic plan for short courses, which has been finalized in FY 2011. This will include improving quality of the supervision to trained cohorts while continuing to strengthen linkages with the graduate course and other various departments within MOHSW as a way to promote sustainability.

The goal and objectives of the IPC program is to prevent transmission of HIV and other blood borne pathogens through exposure of blood and other body fluids as well as other infections. The key program objectives include capacity building of Regional Health Management Teams (RHMT), Council Health Management Teams (CHMT), Health Management Teams (HMT), and Quality Improvement Teams (QIT) to implement policy guidelines and standards for Infection Prevention and Control Injection safety (IPC-IS); Train health care workers (HCWs) who are involved in phlebotomy activities; improve and strengthening quality assurance and quality improvement (QA/QI) activities; ensure the availability of commodities and supplies; advocate for IPC-IS program support with key stakeholders; promote HCWs safety in all public and private health facilities; and ensure safe and appropriate health care waste management (HCWM) and sharps management in all health care settings.

For COP 2012, the Ministry of Health (MoHSW) in collaboration with other Implementing partners in IPC-IS will develop and disseminate IPC related policies, guidelines, standards and packages at national level (including PEP, HCWM and safe phlebotomy as content areas). The coverage and scope of capacity building activities for COP 2012 will focus on strengthening a total of 32 health management teams in six regions of Tanzania Mainland. These teams will include RHMTs and CHMTs, as well as QITs. The plan is to ensure that all facilities have a functional QIT that will coordinate IPC-IS issues as well. MOHSW will put more emphasis on integration of all programs that have quality components.

The MOHSW, will support HCWM systems at selected health facilities with high volume of HIV patients enrolled in HIV care and treatment services, including PMTCT, HTC and MC. In collaboration with partners the MOHSW will facilitate the development of a recognition mechanism/plan for high scoring/achieving facilities through a formal system of recognition for facilities that achieve at least 80% of standards. This is a critical element in order to sustain motivation and maintain the QI process at the facilities.

The HSIU will continue strengthening the PEP M&E system in collaboration with the HMIS unit. The emphasis will be to create a reporting system for PEP and other health care associated infections from facilities to the national level. The program will provide technical assistance to RHMTs and CHMTs for effective supervision of IPC-IS and HCWM activities at facility levels.

In order to ensure the availability of the commodities and supplies for IPC-IS, the MOHSW will establish the technical working group (TWG) comprised of HSIU, Tanzania Food and Drug Authority (TFDA), Medical Stores Department (MSD), PSU, and environmental health unit. The TWG will work to support the systems and logistic for procurement and supply.

The MOHSW, will focus on integrating IPC-IS trainings into the existing pre-service training curriculum for health training institutions and advocate for inclusion of IPC-IS activities in Medium Term Expenditure Framework (MTEF), regional health plans (RHP), and the Comprehensive Council Health Plans (CCHP) to ensure sustainability.