Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 9564
Country/Region: Tanzania
Year: 2008
Main Partner: Management Sciences for Health
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $200,000

Funding for Care: Adult Care and Support (HBHC): $200,000

This activity will be related to the newly awarded program for Basic Care and Support that will be

implemented by a consortium led by Deloitte Touche Tohmatsu (#8706), and also the AED T-Marc Social

Marketing Program (#7667).

The duka la dawa baridis (DLDBs) outlets provide an essential service in Tanzania. They are small outlets,

originally set up to provide non-prescription drugs in the private sector. DLDBs constitute the largest

network of licensed retail outlets for basic essential drugs in Tanzania. They are found in all districts in the

country. For many common medical problems, such as diarrhea, fungal infections, malaria, etc., a variety of

factors encourage people to self-diagnose and medicate before going to a health facility. Because nearly

80% of the population of Tanzania is rural, DLDBs are often the most convenient retail outlet from which to

buy drugs.

Evidence has demonstrated that DLDBs are not operating as had been originally intended. Prescription

drugs that are prohibited for sale by the Tanzania Food and Drug Authority (TFDA) are invariably for sale,

quality cannot be assured, and the majority of dispensing staff lack basic qualifications, training, and skills.

Regulation and supervision are also poor. To address this, Management Sciences for Health (MSH)

initiated a program (originally funded under the Gates funded SEAM program) to build the skills of the

DLDBs and transform them into Accredited Drug Dispensing Outlets (ADDOs).

In the past two years, MSH's Rational Pharmaceutical Plus program has laid the groundwork in Morogoro to

develop ADDOs and prepare them to support palliative care programs for HIV/AIDS. Elements of their work

to date have included accreditation based on Ministry of Health and Social Welfare/TFDA-instituted

standards and regulations governing ADDOs; business skills training, pharmaceutical training, education,

and supervision; commercial assistance; marketing and public education; and regulation and inspection.

The work done to date has been primarily focused on ensuring accreditation, but has not yet been linked

with home-based care activities. Beginning in FY07, the ADDO work will be linked with the newly awarded

Tunajali home-basesd care/orphan and vulnerable children activity in Morogoro, Iringa, and Dodoma.

ADDOs, in collaboration with community-based organizations and NGOs, may provide HBC services to

remote and rural areas through the provision of HBC kits and services that might no otherwise be available

in rural areas. Selected ADDOs would be assigned a catchment area where they could provide HBC

services to volunteers and possibly HIV patients identified by local NGOs and/or clinical facilities. If this

linkage works well, the USG would propose the expansion of the network of ADDOS to another region

covered by Tunajali, e.g., Iringa. The ADDOS could also support referrals of patients for counseling/testing

and for clinical services at the closest HIV/AIDS Care and Treatment Clinic.

The proposed role of ADDOs in community-based HIV/AIDS prevention and care would also include

dissemination of HIV/AIDS information whereby ADDOs would become centers for providing basic

HIV/AIDS information to the public. This way, information on HIV prevention, treatment, and the fight

against stigma can be provided using available IEC materials and social marketing techniques in

collaboration with other partners (e.g. PSI, T-Marc) would reach groups and areas that might not otherwise

be reached.

It is expected that through this program, additional beficiaries will be reached, but the first focus will be on

providing quality and accessible goods to existing NGOs whose beneficiaries are counted under the

Tunajali program. In future years, the program could reach more persons in remote areas who are

unduplicated. Consequently, no targets are set.

Cross Cutting Budget Categories and Known Amounts Total: $0
Food and Nutrition: Commodities $0