Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013

Details for Mechanism ID: 12193
Country/Region: Tanzania
Year: 2012
Main Partner: Africare
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $1,649,607

KAYA Community Care Initiatives goal is to link PLHIV with continuum of care services through HBC supervisors (CHBCSs) and providers (CHBCPs). Adherence support is central to the program, ensuring patients are linked to HCT, enrolled at CTCs, and maintained on treatment. The projects strategic objectives are: (1) Strengthen capacity of regional and district authorities to coordinate, plan, and fund HBC activities; (2) Strengthen the capacity of CSOs, FBOs, and PLHIV support groups to coordinate, plan, and fund HBC activities in collaboration with R/CHMTs; (3) Support HBC program quality improvement and data management through technical assistance to District Councils and CSOs; and (4) Strengthen dual referral networks between households and health units to decrease barriers to accessing health services.

Under the PF, KAYA CCI furthers the goals by expanding prioritized care, treatment, and support services to 35% more patients reaching 9,064 PLHIV and chronically ill clients; ensuring existing and additional care, treatment, and support services adhere to a minimum quality standard and package of services by working with 14 District Councils; and ensuring HBC services are offered per MoHSW guidelines and documented using HBC RRS.

KAYA CCI works within the three regions of Mara, Manyara, and Kagera, targeting PLHIV and chronically ill patients in 103 wards. Increased cost efficiencies will be leveraged through funding from CHMT budgets and providing HBC RRS training to providers trained by district councils. Direct service scale up by district councils will facilitate transition of the project to URT. Monitoring and evaluation of project activities will be done using the four national HBC RRS tools and HBC database (to be initiated in FY 2012).

Funding for Care: Adult Care and Support (HBHC): $1,649,607

KAYA CCIs network of community HBC providers and supervisors (509 HBC providers; 103 health facility-based HBC supervisors) implement the MOHSW HBC service package, which includes nursing care, psychological support, nutrition education, socioeconomic support by establishing VSL groups, and legal support. Prevention services are included within the Positive Health Dignity and Prevention package, including water purification and sanitation interventions whereby KAYA CCI has established household hand-washing stations for diarrheal disease prevention. Targeted beneficiaries include PLHIV and other chronically ill patients. Special focus has been given to HBC enrollment and retention for HIV positive pregnant women since this group has been documented with high lost to follow up (LTFU) rates. HBC services are focused on home-based service delivery. Community-based interventions support recruitment and retention of HBC clients, PHDP services, and economic strengthening activities, by linking clients and caregivers to PLHIV support groups.

Under the USG Tanzania country strategy, HBC coverage is regionalized to limit duplication while focusing priority to areas of high HIV prevalence and incidence. Africares KAYA CCI works in 103 wards in the three regions of Mara, Manyara, and Kagera. In FY 2012, KAYA CCI will serve 9,064 clients in six districts of Manyara Region, 6 districts of Mara region, and 2 districts of Kagera region. Within the fourteen districts, a total of 103 wards have been covered by the project in FY 2011.

The program addresses various HHS/CDC program areas including the expansion of confidential counseling and testing; building programs to reduce mother-to-child transmission by decreasing PMTCT lost-to-follow ups; and improving the care and treatment of HIV/AIDS and related opportunistic infections. The project initiated the provider linkage and referral strategy to ensure HIV continuum of care services, linking HBC providers to 73 health facilities. This work has been central in addressing the high rates of missed appointments and lost to follow up patients at CTCs. Patients are tracked monthly by HBC volunteers, which has accounted for a 60-70% return rate for those that are located. Referrals to health facilities are captured using the national HBC Recording and Reporting System. Africare facilitates joint annual review meetings with HBC cluster leaders and health facility staff to identify gaps in the dual referral system and proposes measures to address these gaps.

Africares program is linked to care, treatment, and prevention facilities in its regions of operation focusing on the CTC as the primary point of service delivery for PLHIV. AIDS Relief (Mara and Manyara), ICAP (Kagera), and EngenderHealth are included in planning sessions related to HBC strategy development, per region, covering continuum of care and PMTCT services, respectively.

In the upcoming year, Africare is proposing to undertake joint planning with the Kagera RHMT and ICAP to ensure newly trained HBC providers are linked to 13 health facilities and mobilized to increase CTC coverage and increase ART retention rates, which are now as low as 50%. Supportive supervision and mentoring are the primary means for program quality improvement. In FY 2012, district action plans will be developed to ensure joint targets are established with local government authorities to improve HBC services and coordination mechanisms.

Subpartners Total: $0
Evangelical Lutheran Church in Tanzania (Various Dioceses): NA
Cross Cutting Budget Categories and Known Amounts Total: $290,443
Economic Strengthening $25,800
Food and Nutrition: Policy, Tools, and Service Delivery $16,200
Human Resources for Health $248,443
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
Increasing women's legal rights and protection
enumerations.Malaria (PMI)
Safe Motherhood
Family Planning