Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014 2015 2016

Details for Mechanism ID: 9616
Country/Region: Tanzania
Year: 2010
Main Partner: IntraHealth International, Inc.
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $2,690,000

Project Title: Strengthening and Expanding Routine HIV Counseling and Testing and Integrating Prevention and Care Interventions, including Male Circumcision and PDA-Based Patient Screening for HIV/AIDS Care and Treatment

The Project has three technical areas: HIV testing and counseling (HTC), Male circumcision (MC), and PDA-based patient screening for HIV/AIDS care and treatment (D-Tree)

Goals and objectives: 1) HIV testing and counseling: The program goal is to support the Ministry of Health and Social Welfare (MOHSW) in strengthening and expanding Provider Initiated Testing and Counseling (PITC) services and strengthening referral systems and processes. Program objectives are to: a) Strengthen the capacity of MOHSW and private facilities to provide sustainable, quality PITC services in selected health facilities, b) Create an enabling policy and physical environment to support sustainable, quality PITC, c) Strengthen confidential facility-based HIV/AIDS care and treatment referral networks in target districts. 2) Male circumcision: The program goal is to support the MOHSW in scaling up MC services in one region, Shinyanga , with high HIV prevalence and low MC rates (HIV Prevalence 7.4%, MC rate 20.9%, # of uncircumcised adult men: 891,709). Program objectives are to a) Strengthen the capacity of regional/district/facility-based MOHSW staff to provide sustainable, quality MC services b) Develop an enabling policy and physical environment at selected sites in Shinyanga to support sustainable, quality MC services. 3) Personal digital assistant (PDA)-Based Patient Screening for HIV/AIDS Care and Treatment: This activity is implemented in collaboration with sub-grantee D-Tree. The program goal is to improve efficiency and quality of HIV patient screening and to increase the client capacity in HIV Care and Treatment Centers (CTC). Program objectives are to: a) Adapt and validate HIV patient screening protocols and software via PDA for use in Tanzania; b) Pilot use of the PDA and evaluate its ability to deliver standardized HIV patient screening in CTC; c) Advocate for the adoption of guidelines or policy supporting HIV PDA patient screening protocols.

Contributions to Health Systems Strengthening

The project will train in-service clinical health workers in the delivery of PITC and MC. The D-Tree activity will help ensure quality of care, especially as Tanzania considers task shifting as an intervention to address the HRH crisis. The project will also renovate sites, and procure equipment and supplies for MC services.

Cross cutting programs and key issues

Mobile populations The project will reach mobile/nomadic populations with HTC services, condom promotion and distribution, and linkages/referral to other RH and HIV services in Ngorongoro district (Maasai communities) and fishing communities around Lake Victoria. Wrap around programs The project integrates PITC into family planning services. Gender - The project will address male norms and behaviors during the implementation of the MC and HTC programs, including the strengthening of couples counseling and testing.

Strategy to become more cost-efficient

The project will work with Regional/Council Health Management Teams (R/CHMT) to ensure that HTC and MC services are included and budgeted for in comprehensive council health plans. The project will continue to use district-based trainers to facilitate training sessions.

Geographic coverage & target populations

The project will cover 30 districts in five regions (Arusha, Kigoma, Mara, Mwanza, and Shinyanga) for HTC and one region (Shinyanga) for MC. Kibaha district, coast region, will be covered by the D-Tree program.

Target populations For PITC services the target population will be any person visiting a health facility in the district covered. Nomadic populations with be reached through mobile/outreach HTC services. For prevention with positives, the target population will be HIV infected persons. The priority target population for MC services will be all males aged 15-24 years. However, even men and older than 24 years will be offered services. The target population for the D-Tree program will be all persons enrolled into care and treatment at the pilot clinic in Kibaha district.

Links to PF goals

The project will contribute towards the achievement of 1) Service maintenance and scale-up goals through the development and strengthening of quality assurance systems for HTC and MC services; 2)Prevention goals through scaling up of HTC, prevention with positives, HIV couples counseling and testing, and MC services in supported regions, 2) Human resources goals through in-service training of R/CHMT and clinical health workers in PITC, and MC,as well as address the shortage of health care workers, 3) Evidence-based and strategic decision-making through the introduction of hand-held PDAs for the screening of patients attending care and treatment centers.

M&E plans

The project will use MOHSW data collection and reporting tools across all its program areas. The project will provide technical assistance to R/CHMT so that they can effectively and efficiently supervise HTC, prevention with positives, and MC services as an integral of the coordinated district HIV and AIDS response. The project will support regular data quality assessments to ensure that district and program level decisions are based on valid and reliable data. The D-Tree program will be monitored per the CDC and NIMR approved protocol.

Funding for Testing: HIV Testing and Counseling (HVCT): $2,340,000

Continue and expansion PITC, VCT and mobile CT in Arusha, Kigoma, Mwanza, Mara, Shinyanga; Technical Assistance for CT Quality Assurance for NACP; integrate Positive Prevention & Gender Based Violence

Funding for Health Systems Strengthening (OHSS): $200,000

Develop a fully functional PDA based set of clinical standards that can be rolled out more widely. Adapt and pilot system for delivering standardized care in CTC clinics on PDAs to help screen clients and make better use of limited clinical staff. This will provide a tool for use throughout Tanzania and an assessment of its feasibility and its ability to improve quality of care for a rapid rollout.

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $150,000

Expansion of MC support in Shinyanga region

Subpartners Total: $0
D-Tree International: NA