Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012

Details for Mechanism ID: 10351
Country/Region: Tanzania
Year: 2012
Main Partner: Johns Hopkins University
Main Partner Program: JHPIEGO
Organizational Type: University
Funding Agency: USAID
Total Funding: $2,700,000

Jhpiegos UHAI program works with URT to scale up HTC for all Tanzanians, particularly those at high-risk for HIV infection. This is accomplished through the implementation of PITC in health facilities; HTC outreach activities through sub-grantees; training of providers in HTC and PITC; collaboration with district and regional authorities to ensure a whole district approach to training, quality assurance, and supervision; and strengthening links to prevention, care, and treatment services. The program aligns with the prevention and human resources goals in the Partnership Framework.

The program works in all districts of Iringa/Njombe, Tabora, Dodoma, Singida, Tanga, Mtwara, Kilimanjaro, and Manyara. For PITC, the general population is targeted. For outreach activities, MARPs (CSWs, MSM, IDUs, and mobile populations), couples, and under-served communities are targeted. UHAIs approach is to work with regional and district trainers and supervisors, particularly around M&E systems by strengthening the response capacity of local health authorities. As a result, many CHMTs in UHAI districts are incorporating PITC into their own budgets and plans. M&E systems for PITC and outreach HTC have been developed by URT and data reporting structures are followed and strengthened by UHAI.

Funding for Testing: HIV Testing and Counseling (HVCT): $2,700,000

UHAI's technical approach is guided by the principles of innovation, rapid expansion, appropriate diversity of strategies, quality, sustainability, strong links to HIV care and treatment, and cost effectiveness. UHAI uses a two-pronged approach. At the facility level, capacity in PITC, as per the national PITC guidelines, is enhanced. At the community level, a creative mix of community- based CITC outreach strategies focusing on key populations (MARPs) in high transmission areas and hot spots are utilized. These community-based interventions are also coupled with a gender approach and behavior change component.

The objectives of the project are: (1) To rapidly increase access to quality HTC for all Tanzanians, particularly those at high risk, through PITC (general population) and outreach HTC (MARPs, including CSWs, IDU, MSM, and mobile populations); (2) Develop providers skills for quality HTC services delivery by using a whole district approach for facility level services; (3) Strengthen links to prevention, care and treatment services, and establish community care and support for HIV-positive clients through close coordination with USG/T-supported care and treatment partners; and (4) Work with the NACP to strengthen supervision, quality, and data management systems.

These objectives align with the GHI Strategy as well as nearly all the goals set forth in the USG/T Partnership Framework. Last year, UHAI trained health providers in PITC, developed a new cadre of regional trainers, provided HTC services following the national testing algorithm to those in need, and supported implementing partners. Ten district councils used their own funding and resources to train an additional 383 providers and conduct orientations and supervisions with limited support. Specific training in reaching MARPs, BCC, VMMC counseling, couples counseling, and supporting PLHIV were held for CSO counselors.

In FY 2012, these activities will be enhanced, new sites will be added as district responses are strengthened, additional providers will be trained, and CSOs will receive additional mentoring, specifically in reaching MARPs, addressing GBV and couples counseling in PITC settings. Regional level small and mass media activities will take place to promote testing (and PITC specifically).

To date, the majority of PITC activities have taken place in facilities with CTCs, and therefore, easy referrals and links to care and treatment are available and clients are often escorted to the CTC to initiate services, which is tracked by facility PITC focal persons. In the case of outreach HTC, clients are referred to specific health facilities in their catchment areas and the CSOs follow up to see if clients have attended, and in some cases follow-up in the community. UHAI works hand-in-hand with the districts to ensure that their supervisors are capable of overseeing PITC, mentoring them in supervision and quality assurance activities. These systems will continue to be enhanced in the coming year using URTs own tools.

UHAI will also continue to strengthen data management and reporting systems at the district and regional levels and work with the national level, for example, through the STATUS PHE initiative.

Subpartners Total: $0
Africare: NA
Alpha Dancing Group: NA
Capacity-Building and Network Associates: NA
Cross Cutting Budget Categories and Known Amounts Total: $600,000
Gender: Reducing Violence and Coercion $100,000
Human Resources for Health $500,000
Key Issues Identified in Mechanism
Addressing male norms and behaviors
Increasing gender equity in HIV/AIDS activities and services
Increasing women's legal rights and protection
Mobile Populations