Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014 2015 2016

Details for Mechanism ID: 12246
Country/Region: Tanzania
Year: 2010
Main Partner: Columbia University
Main Partner Program: NA
Organizational Type: University
Funding Agency: HHS/CDC
Total Funding: $2,367,047

The Columbia Mechanism 9972 had been split into two separate mechanisms in order to better manage the partner. CU supports high quality comprehensive HIV Care and Treatment services for adults and children in Tanzania since 2004, and is well positioned to Maintain Quality HIV services at existing sites, scaling up to sites with high prevalence and previously underserved areas, expansion of adherence and psychosocial support services to PLHA and promoting PWP. Partner working in 23 districts in Kigoma, Kagera, Pwani, Lindi and Zanzibar.

FY 2010 funds will be used to focus on four key objectives: 1) Deepen quality and sustainability of adult and pediatric HIV care and treatment and laboratory programs; 2) Expand access to provide PMTCT services in 80% of RCH sites and improving quality and uptake of services for HIV infected women and their families; 3) Expand PMTCT portfolio to include a variety of supports for focused antenatal and postpartum care; and 5) include HIV testing services for male circumcision clients.

ICAP will widen the PMTCT package to incorporate essential reproductive health priorities to deliver a comprehensive package of quality and integrated RCH/PMTCT services to increase the uptake of PMTCT and impact maternal and newborn health in the region.

1) Deepen quality and sustainability of adult and pediatric HIV care and treatment and laboratory programs.

In 2009 ICAP TZ initiated a new program called the "District Mentoring Initiative" designed to build a network of qualified mentors to support clinical skills improvement in HIV care and treatment and PMTCT programs in Kagera Region. With the additional resources under the PF 2010 ICAP TZ will expand the DMI program to the Pwani and Kagera Regions, and to include laboratory personnel, targeting specialist and highly qualified health care workers from the regional and district hospitals to support a quality improvement and mentoring program.

2) Expand access to provide PMTCT services in 80% of RCH sites and improving quality and uptake of services for HIV infected women and their families.

In partnership with the district partners basic PMTCT services will be expanded to additional lower volume rural centers. In 2010 ICAP will achieve 80% coverage. In addition, will expand quality of services to assure all sites have access to the more efficacious regimen and also improve access to the baby dose and HIV exposed infant follow up, care and ART for HIV infected infants. HCWs will be trained on the revised national PMTCT curriculum merged with the EID curriculum at all new sites. The ICAP comprehensive model of care will be promoted and systems for linking clients for CD4 testing and follow up chronic care for the mother and baby will be implemented. This will include care for the HIV exposed infant, early infant diagnosis through DNA PCR testing via sample transportation of dried blood spot

3) Expand PMTCT portfolio to include a variety of supports for focused antenatal and post and intra partum care.

ICAP TZ will work closely with the regional authorities and other local and international partners to strengthen the intra and post partum component of PMTCT through multiple strategies, including advocacy at the regional district and community level and strengthening the obstetric skills of rural midwives. Regional trainers and national training package use will be promoted. Advocacy for wider promotion of cervical screening of eligible women in community will also be promoted.

4) HIV testing services for male circumcision clients. As part of the MC program in Kagera Region, ICAP will ensure all male clients receive full HIV testing, counseling and referral and will also encourage partner HCT.

Cross-cutting programs and key issues: ICAP will focus on improving access to and quality of 'family focused care'. A key focus is to leverage services to support entire families. Sustainability through use of the existing systems is a key strategy ensuring all support is included in the Council Comprehensive Health Plans annually. Work with PLHIV networks through direct grants for service delivery (managing the facility based peer educator programs, psychosocial family support groups and the mom to mom program for PMTCT).

ICAP currently maintains several other Implementing Mechanisms that align with the above objectives. The MCAP mechanism focuses on HIV/AIDS prevention, care and treatment programs; the UTAP mechanism currently provides support for male circumcision activities; and the URRAP mechanism supports harm reduction and outreach services linked to HIV services for Injecting Drug Users and Most At Risk Populations.

Geographic coverage & target populations: ICAP will focus on the three mainland regions of Kagera, Kigoma and Pwani Regions and the two islands of Zanzibar.

This Implementing Mechanism aligns directly with the partnership framework goals to improve health systems, improve monitoring, improve and deepen quality of services and expand access to prevention services/PMTCT services for HIV+ women and their families. ICAP works with the existing national system for planning, financing, implementing and monitoring the program.

M&E plans: ICAP aligns with the national indicators and tools for all programs.

Funding for Care: Adult Care and Support (HBHC): $300,000

Maintain and strengthen provision of integrated high-quality care and support for PLWHA aimed at extending and optimizing quality of life from the time of diagnosis throughout the continuum of illness. ICAP will intergrate Positive prevention services, supporting nutritional assessment and counseling in all supported facilities, build the capacity of local government and civil society for sustainable delivery of services for PLWHA. Strengtherning coordination and collaboration mechanisms between partners and Ministry of Health. The services will be provided in 23 districts in Kagera, Kigoma, Coast and Zanzibar

Funding for Treatment: Adult Treatment (HTXS): $50,000

Maintain Quality HIV services at existing sites, scaling up to sites with high prevalence and previously underserved areas, expansion of adherence and psychosocial support services to PLHA and promoting PWP. This will be accomplished through, provision of Technical support, regular supportive supervision, clinical and nutrition mentoring, patient monitoring, ensuring uninterrupted supply of drugs and reagents through central procurement mechanism,Capacity building to local partners in financial accountability, program oversight and M&E. Funds will also be used for facilities and community linkages. Partner works in 23 districts in Kigoma, Kagera, Pwani, Lindi and Zanzibar and currently covers 14457 patients on treatment .

Funding for Testing: HIV Testing and Counseling (HVCT): $450,000

Continue PITC, VCT and mobile CT support Kagera, Pwani, Kigoma; mobile CT for MARPs Znz started in '09; funding increase for increased coverage within these regions as well as balancing out inequalities between partners

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $1,350,000

Implement PMTCT activities to pregnant women in 4 regions (Kigoma , Kagera, Coast & Zanzibar). These regions have total number of 29 districts. the ANC HIV Prevalence: Kigoma 3.5, Kagera 4.7, Coast 7.3 and Zanzibar 0.8; Current coverage based on 2009 SAPR is 50% implement PMTCT package (see base package), include MECR, *Mother support groups, implement new M and E and computerise data system

Funding for Laboratory Infrastructure (HLAB): $217,047

Support implementation of Lab quality system and accreditation process by ISO 15189 at Mnazi Mmoja hospital laboratory

Continue to support Early infant diagnosis at national level

support 3 program officers, (2 for EID program and 1 procurement officer ) at MOHSW,

Support funding for 7 technologists positions at NHLQATC

Cross Cutting Budget Categories and Known Amounts Total: $200,000
Food and Nutrition: Commodities $50,000
Food and Nutrition: Policy, Tools, and Service Delivery $50,000
Human Resources for Health $50,000
Water $50,000
Key Issues Identified in Mechanism
Addressing male norms and behaviors
Increasing gender equity in HIV/AIDS activities and services
Increasing women's access to income and productive resources
Malaria
Child Survival Activities
Safe Motherhood
Family Planning