I-TECHs goal is to build the necessary HR and infrastructure capacity for training HCWs to provide quality health services, including HIV. The objectives include strengthening ZHRC systems capacity to manage in-service trainings; supporting MOHSW to increase the number of qualified HCWs; strengthening MOHSW and other partners capacity to use TrainSMART; strengthening pre-service schools to produce competent HCWs; building capacity of regional and district health teams to train HCWs in PITC; and strengthening distance education. I-TECHs goal and objectives contribute to all six goals of the Partnership Framework, with emphasis on Goal 2 with (prevention); Goal 3 (leadership, management, accountability, and governance); and Goal 5 (human resources).

Due to I-TECHs support of MOHSW at national and zonal levels, coverage of projects is national. I-TECH collaborates with MOHSW staff at the national, zonal, and regional levels in planning and implementation of its activities. M&E is done through site visits, supportive supervision, regular progress reports, and assessments in collaboration with MOHSW counterparts. This ensures local ownership and facilitates transition of programs. Transition of activities is underway in ZHRC, pre-service and PITC programs; transition plans for all programs will be included in COP 12.

While continuing its emphasis on high-impact, sustainable programs focusing on pre-service education, I-TECH will also develop innovative approaches to in-service trainings, including training staff at district level, exploring e-learning modalities, and emphasizing on-site training through supportive supervision and mentoring.

The TB/HIV program aims to increase the capacity of health care workers to provide quality TB/HIV care and treatment services. In FY 2012, I-TECH will disseminate the results of a TB/HIV training evaluation expected to take place in FY 2011. Based on the results, I-TECH will collaborate with NTLP, PATH, ICAP, USAID, and other partners to revise the TB/HIV training and develop refresher TOT training materials.

I-TECH will also support the MOHSW-NTLP efforts in the on-going 3Is pilot by developing and printing 500 copies of TB/HIV and 3Is Standard Operating Procedures (SOP). In collaboration with NTLP, NACP, and other TB/HIV partners, I-TECH will draft the SOP outline based on the national approved TB/HIV and 3Is guidelines and training packages. Several TWG meetings will be organized to review the outline and content of the SOP. The team will also support MOHSW to train 25 pre-existing national, regional, and district TB/HIV trainers on the TB 3Is package. I-TECH will work with NTLP to follow up the 3Is trainers to assess effectiveness of teaching skills in the delivery of the 3Is course.

In FY 2011, the project was able to develop the TB 3Is training package for health care workers and trained 20 tutors from health training institutions on the TB/HIV content and drafted TB/HIV training evaluation protocol. This project is aligned with the MOHSW policy (revised in 2007) and the Health Sector Strategic Plan III (July 2009 - June 2015), the Five-Year Partnership Framework in Support of the Tanzania National Response to HIV and AIDS (2009 - 2013), the National TB and Leprosy Program Strategic Plan (2009 - 2015), and the National TB/HIV Policy Guidelines (2007). The Policy guidelines clearly demonstrate the need to fight the dual epidemics and provide the basis for action in collaborative TB/HIV activities by the National TB and Leprosy Program (NTLP), the National AIDS Control Program (NACP), and other stakeholders to work synergistically to reduce the burden of TB/HIV co-infection by strengthening the capacity of health care workers to provide quality TB/HIV care and treatment services.

In FY 2012, I-TECH, in collaboration with MOHSW, medical laboratory universities, and medical laboratory health training institutions in Tanzania, will continue to strengthen laboratory training for faculty and pre-service students who have an interest in becoming laboratory tutors. These efforts will contribute to creating skilled laboratory tutor graduates who in turn will train laboratory health workers at health training institutions. I-TECH will continue to support 17 medical laboratory students (15 Bsc and two Msc ) at KCMC, Bugando, IMTU and Makerere Universities. Of the 17 students, 10 BSc and two MSc students will graduate in FY 2012. I-TECH will also support two full-time tutors to teach at laboratory training institutions.

I-TECH supports MOHSW to build human resources capacity and infrastructure for HCWs to provide quality HIV services through pre-service training (PST), human resource for health scale-up (HRHS), zonal health resource centers (ZHRCs), distance learning (DL), and TrainSMART (TS) programs. I-TECH has made significant contributions in the finalization of the standardized training materials for clinical assistants and clinical officers (CA/COs), hiring of tutors to support PST scale up, strengthening ZHRCs, development of DL bridging courses for CAs to upgrade to COs, and in piloting TrainSMART in two ZHRCs.

The program will work with MOHSW and partners to build ZHRCs capacity to coordinate, implement, monitor, and evaluate pre- and in-service training. I-TECH will work with ZHRCs to support pre-service health training institutions (HTIs) by training some tutors on teaching methods and others on training coordination and logistics. A few tutors will also be trained on supportive supervision (SS) and mentoring key ZHRC/HTI staff on leadership and management, including financial and library management. I-TECH will also support ZHRCs to conduct stakeholders and annual ZHRC coordinators meetings and, while also building their capacity in M&E. Three PC volunteers and two zonal field officers will be supported to help strengthen ZHRCs.

The pre-service program works with MOHSW to develop and strengthen pre-service curricula and build tutor capacity in classroom and clinical teaching. Support will be provided to MOHSW to develop harmonized faculty development packages. M&E activities will receive high priority to ensure quality classroom and practical teaching. In FY 2012, I-TECH will develop the curricula for upgrading AMOs/COs to a Bachelor in Clinical Medicine (BCM) and strengthen the capacity of tutors and clinical instructors in collaboration with JHPIEGO.

I-TECH will collaborate with MOHSW to develop standardized DE training materials and orient tutors to the new materials. Support will be provided to build the capacity of tutors in DE teaching and student assessment skills, whereas options to pilot e-learning materials will also be explored.

In FY 2012, TS will expand to more USG partners, regions, and districts. New users will be trained on registration forms with online and offline database versions. I-TECH will build capacity of the ZHRC staff and regional and district continuing education officers to use TS data for decision-making, while the ICT officers will be trained to provide technical support. I-TECH will also work with USG partners who train community health workers on TS. I-TECH will mentor selected RMOs and DMOs to use TS for reporting, budgeting, and participant selection.

I-TECHs HRHS program will collaborate with MOHSW and partners to develop a plan for mainstreaming up to 49 full-time tutors at nursing and CA/CO schools into the government service. CDC and I-TECH will work together, with a minimum of three pre-service training institutions, to increase their throughput by providing furniture, supplies, and student aid. I-TECH will also collaborate with MOHSW and CDC to prioritize HTIs for infrastructure development to scale-up enrollment. Support will be provided to a few I-TECH-hired tutors to earn a diploma in health personnel education at CEDHA. In addition, support will be directed to MOHSW to harmonize curricula of the three tutor training institutions (Bugando, Muhimbili, and CEDHA).

In collaboration with NACP, Morogoro Health Authority, and FHI, I-TECH will continue to provide technical assistance to Morogoro region on PITC in health care facilities. Morogoro region has an HIV prevalence rate of 5.1% and targets to test about 25,000 clients. Since 2008, I-TECH has trained 804 out of 2,055 HCWs in Morogoro region with a long-term objective of continuing to transition training activities to the districts. In FY 2012, I-TECH will provide financial and technical support to two districts to train 60 HCWs. Technical assistance will be provided to the remaining four districts for training HCWs that expect to get funds from the Basket Fund. I-TECH will also support the NACP on strengthening HIV couples testing and counseling (HCTC) by enhancing or developing relevant HCTC materials, including training and job aid materials. In addition, I-TECH will collaborate with NACP to provide support to the districts for on-site training of 20 HIV counselors and PITC trainers on HCTC. I-TECH expects that by the end of FY 2012, PITC services to 22,880 clients will have been provided.

I-TECH will support districts in preparing for transition and sustainability of PITC activities. Twenty district health managers will be trained on coordination and logistics as provided by I-TECH and NACP. Moreover, 20 HCWs selected by the districts will be trained on HIV/AIDS mentoring and supportive supervision. These HCWs will be used by the region and districts to support effective implementation of PITC training.

Financial support will also be provided to RHMTs and CHMTs to conduct supportive supervision to monitor the quality of services. I-TECH will support an annual review meeting where selected PITC implementers and managers will come together to share experiences and challenges. Districts will be encourged to budget for training and supportive supervision activities. In addition, I-TECH will compile PITC overview reports and share them with CDC and MOHSW. Capacity of CHMTs in PITC data management using national tools and protocols will continue to be built.

In collaboration with NACP, John Hopkins University, Stradcom, and other media groups, I-TECH will develop various targeted HIV messages. I-TECH will also support Morogoro region to participate in the commemoration of World AIDS Day.

In its efforts to coordinate and manage trainings, ITECH has introduced a web-based tool for monitoring and reporting training activities, called TrainSMART. The tool helps to strengthen coordination and management of in-service training. Currently, ITECH is working with MOHSW and its institutions including National Aids Control Program, National TB and Leprosy Program, RCH, and PMTCT programs as well as USG training partners (particularly Track 1 partners) and Zonal Health Resource Centers to input their training data into the system.

In FY 2011, ITECH introduced the tool to partners by assessing each partners' need, which was followed by customizing their needs into the system and training them on how to use the system. All partners were able to enter and report training information into the system as well as export the data from TrainSMART into the PEPFAR PROMIS system. Trainsmart has enabled the MOHSW to have a standardized tool to report on the national- approved HIV/AIDS in-service training.

For COP 2012, I-TECH will build the capacity of approximately 25 PMTCT staff from the POHSW and USG-funded PMTCT partners to enter data online and generate training reports using the new version of TrainSMART. I-TECH will also provide technical assistance and refresher trainings to address TrainSMART new releases, and to introduce an offline version to NACP and PMTCT. These trainings will help the vertical programs to collect and enter training data in the database at training sites, which are often in areas with limited internet access.

I-TECH will conduct "data for decision makers" capacity building on TrainSMART to 10 MOHSW vertical program staff. This capacity will be offered to selected high profile individuals at each of the vertical programs using TrainSMART. Finally, I-TECH will conduct quarterly follow up visits to the vertical programs to address any issues or difficulties encountered with the new version.

As part of the efforts to support the decentralization of ART trainings to districts during FY 2012, I-TECH will collaborate with ZHRCs, NACP, FHI, ICAP, MDH, and other ART training implementing partners to provide technical assistance to Central and Eastern ZHRCs to conduct TOTs to 20 district-level trainers. The partners, in collaboration with the District Health Authority, will identify the trainers. In addition, to strengthen decentralization of ART training and improve the implementation of effective ART services, I-TECH will collaborate with the previously mentioned partners to provide TA to Central and Eastern Zones by training 40 health care workers on HIV health services (including ART), supportive supervision, and clinical mentoring. Trained HCWs will in turn support training, supportive supervision, and clinical mentoring activities in the districts, which will be specified in the Comprehensive Council Health Plans for each respective district/council.

To promote transition, local ownership, and sustainability, ZHRCs will take a leading role in training coordination and logistics. ZHRCs will also be encouraged to use the existing resources within their zones, including health system structures and inventory of human resources, for improved efficiency and cost effectiveness.