The SHOPS Project is a five-year cooperative agreement with a mandate to increase the role of the private sector in the sustainable provision and use of quality HIV/AIDS, family planning, and other health products and services. In Tanzania, SHOPS will support public and private sector organizations to initiate, implement, and scale up innovative, effective, and sustainable PPPs for health. These partnerships will leverage the private health sector to increase access to affordable treatment and prevention services that address the health goals outlined in both Tanzania' s Partnership Framework and GHI Strategy (e.g. preventing new HIV infections, improving HRH, scaling up delivery of quality health services to reduce morbidity and mortality from HIV/AIDS). Activities will address the capacity and willingness of stakeholders from the public and private sectors to identify and address opportunities to partner; the capacity of LGAs to contract the private for-profit health sector to deliver health services; and the ability of banks to develop innovative loan packages for medical education that will help address HRH shortages.

SHOPS will support local partners including but not limited to MOHSW, PPHFT, APHFTA, PRINMAT, and CSSC, to identify target populations for strategic interventions. By working through these local institutions, SHOPS will build local capacity to increase private sector participation in health. Key areas of focus will: 1) support evidenced-based advocacy and policy for health PPPs at the national level, 2) broker PPPs at the LGA level and 3) build capacity of private medical institutions to enhance human resources for health. A PMP will be developed in close collaboration with USAID, MOH and private sector partners.

This mechanism builds upon the 2012 private sector assessment conducted by SHOPS, which identified URT public private partnership capacity needs, particularly the PPP coordination units in the MOHSW, Tanzania Investment Center, and the Ministry of Finance and Economic Affairs. The project will demonstrate how these three units can work together to facilitate the development of PPPs in health. This will include establishing clear policies and procedures and establishing linkages with other departments within the MOHSW and building PPP unit capacity in feasibility analysis and due diligence approaches and costing of health services and other activities. With URT encouragement, a Public Private Health Forum in Tanzania (PPHFT) recently has been established and comprises representatives from private businesses, financial institutions, entrepreneurs, investors, philanthropists, foundations and other for- and not-for-profit non-governmental entities. This project will build the capacity of the PPHFT to engage in advocacy, policy analyses, and negotiations with the URT.

In addition to capacity building at national level, the project will build capacity at the local government level. For example, a barrier to increased private sector participation is government entering into service agreements with only faith-based facilities, thus excluding for-profit facilities. Given the MOHSW budgetary constraints, mobilizing private sector resource would be a significant contribution to improving health service delivery in the country. In addition, Comprehensive Council Health Plan guidance does not include tapping into private sector resources in the planning and budgeting processes of Local Government Authorities.

Another health systems barrier noted in the SHOPS assessment was the inability of medical students to acquire student loans for medical studies. The project will explore ways in which the Higher Education Students Loans Board (HESLB) can develop innovative loan packages for medical students. and ways in which commercial banks might be encouraged to enter the market. Furthermore, HESLB loans cannot be used for mid-level diploma or certificate programs, which is a significant limiting factor in building the base of the HRH system. Technical support for helping private banks to develop parent-student loans for students wishing to study medicine also will be pursued; this will increase financial access for pre-service training using domestic funding sources. In the FYCOP 2013, SHOPS will build the capacity of private medical institutions to raise revenue through consulting, research, alumni mobilization, and continuing education short-courses.

The VMMC Program is currently operating in ten priority regions in the country. While the selection of regions for this award have yet to be determined, the partner will likely support activities in three to four regions. The awardee will work in approximately 90 health facilities and is expected to circumcise 10,000 men. In the spirit of a public private partnership, on-site support supervision will be provided by a Chief Mentor and Project Officer from the Association of Private Health Facilities in Tanzania, in collaboration with the District Health Management Team. The facilities will be selected from private self-financing, government and faith-based facilities in these regions.

The project will ensure that private facility providers are trained in the provision of provider-initiated HIV testing and counseling as well as VMMC services. The trainings will be provided by URT regional staff following national procedures and guidelines. The partner will also coordinate closely with other PEPFAR-supported VMMC partners in demand creation activities. To ensure adequate demand, this award will engage in limited community outreach activities in an effort to sensitize communities about the option of seeking VMMC services in non-traditional settings (read: private health facilities). The service will be provided free of charge to the client, at least in the first year of implementation.

Since private facilities attract individuals with some level of disposable income, the project should be able to identify men over the age of 20 at equal or greater success than the national VMMC program. While older men remain the top priority, VMMC services will be offered to any eligible male, including neonates once the program has been initiated.

The award plans to train 180 healthcare providers from the facilities on VMMC and PITC (if not already trained). Each healthcare provider trained will be provided with a training manual for reference during their practice. Quality assurance standards would be adhered to as per the national program guidelines. All client data will be uploaded through the URT M&E VMMC database.