the united republic of tanzania health sector hiv and aids strategic plan

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Only a few women (17%) and men (19%) know that there are special drugs that can be given to pregnant women infected with HIV to reduce the risk of transmitting the virus to the baby vi . Low uptake of maternal and infant ARV prophylaxis Limited access of pregnant women and children to a comprehensive package of Reproductive Health and HIV prevention, care and treatment services Inadequate staffing (number and skills) in the health facilities Weak coordination of implementing partners NACP PMTCT Unit engaged in implementing instead of coordination Equity, gender and sustainability considerations Women confront a number of gender-based obstacles in accessing PMTCT services such as, utilizing HIV testing and counseling services in RCH, using ARV prophylaxis or engaging in alternative infant feeding practices. The role of men in facilitating and supporting women in preventing HIV, fighting stigma and discrimination at home and at the community level is of crucial importance and needs to be addressed. Strategic objective Reduce the transmission of HIV from mothers to their children and ensure entry into care and treatment for mothers, families and babies. Strategies Advocate for and increase awareness and communication to addressing PMTCT and paediatric HIV prevention, care, treatment and support among key stakeholders at all levels Strengthen the provision of PMTCT in all sectors and to all levels of health facilities o Decentralize responsibility of PMTCT planning and implementation to the Zonal, Regional and District levels o Ensure the continuous availability of good quality medicines, diagnostics and other medical supplies for PMTCT Improve delivery of community PMTCT and referral of HIV-infected women, their children and families Improve programme management, coordination and supervision for PMTCT programme activities at all levels o Operationalize the linkage between the delivery of PMTCT and reproductive health and other health services o Improve the monitoring and evaluation of PMTCT including surveillance and research o Mobilize resources to implement the 2008-12 Strategic Plan Targets At least 80% of women living with HIV enrolled in PMTCT and care and treatment services receive family planning services (either on site or through referrals) HIV positive pregnant women who receive ARVs prophylaxis increased to at least 80% At least 60% of infants born to women living with HIV receive co-trimoxazole prophylaxis for 24 months At least 96% of pregnant women living with HIV receive continuous and sustained infant feeding counselling by a trained counsellor At least 80% of infants born to women with unknown HIV status are screened for HIV exposure at age of 6-8 weeks. All referral, regional, district hospitals and at least 76% of health centres and 44% of dispensaries with RHC services provide integrated PMTCT services according to national guidelines 24 |FINAL COMBINED-HSHSP 2008-2012: June 24 th 2007
Indicators Number of health institutions offering PMTCT Proportion of identified+ women receiving ARV prophylaxis (stratified by single dose Nevirapine (sdN) versus more efficacious regimes) Proportion of identified exposed babies receiving ARV prophylaxis Proportion of exposed infants and children receiving cotrimoxazole prophylaxis Proportion of HIV exposed babies tested for HIV at 18 months or earlier Number/percentage of clinically eligible HIV infected pregnant women starting ART during pregnancy Key implementers Referral, regional and district hospitals), Health centres and dispensaries, MOHSW, RHMTs and CHMTs Intervention area 2: Prevention of Sexual Transmission of HIV A. STI prevention and management Preamble Adequate treatment of patients with STIs and their partners can reduce the rate of transmission of HIV in the population, as has been demonstrated in a community based STI intervention study done in Mwanza, Tanzania. Furthermore, it reduces the reproductive – tract and obstetric complications associated with STIs. Interventions for STIs have therefore been considered essential in HIV prevention programmes. However, people in general, particularly young people, tend to be ill-informed about STIs. The surveillance of HIV and Syphilis Infection among antenatal mothers in the RCH, 2005/2006 indicates the overall syphilis sero-prevalence of 6.9% (Surveillance of HIV and Syphilis Infections among antenatal clinic attendee 2005/2006). Situation analysis The following achievements and challenges were encountered during the implementation of 2003-2006 strategic plan: Achievements All public hospitals including Referral, Regional, District hospitals and DDH, health centers and 60% of the dispensaries provide STI syndromic case management services. To achieve the goal of the STI control programme, the NACP in the period 2003-2006 continued to work in collaboration with the government structures, communities and a number of nongovernmental agencies. Some FBOs and NGOs including private health facilities also provided STIs services. 7,926 Health care providers have been trained in STI syndromic case management. Developed National Guidelines for the Management of STI/Reproductive Tract Infections Over 484 Health Care workers from Antenatal Clinics trained in management of syphilis in pregnancy under NACP coordination. Development, production and distribution of varieties of educational materials (posters, leaflets and video tapes) on STI prevention and control About 67.2% of service providers make correct choice of drugs, dosage and duration of treatment for their clients Counseling aimed at safer sex options and risk reduction strategies is routinely done in VCT centers and in the course of management of STI and HIV/AIDS. 25 |FINAL COMBINED-HSHSP 2008-2012: June 24 th 2007
Page 1 and 2: FINAL DRAFT 24 th JUNE 2007 THE UNI
Page 3 and 4: TABLE OF CONTENT Abbreviations and
Page 5 and 6: ACKNOWLEDGEMENTS 5 |FINAL COMBINED-
Page 7 and 8: National HIV and AIDS Priority Inte
Page 9 and 10: 3.3. IEC and BCC and Stigma reducti
Page 11 and 12: Financing the Health sector respons
Page 13 and 14: 1.1.3. Geographic and administrativ
Page 15 and 16: 1.1.6.2. Gender and HIV and AIDS It
Page 17 and 18: Human resource The country is facin
Page 19 and 20: 1.2.3.2. Financial Contributions to
Page 21 and 22: Decentralisation: Devolution of key
Page 23: Achievements Currently 659 sites (
Page 27 and 28: Key implementers Referral, regiona
Page 29 and 30: Indicator % of blood units transfu
Page 31 and 32: etween older males and girls. On th
Page 33 and 34: Challenges Aspects Challenges for p
Page 35 and 36: Aspects Challenges for Facility Bas
Page 37 and 38: Key implementers MoHSW, Private ho
Page 39 and 40: ased care services Establish mecha
Page 41 and 42: Challenges Aspects Challenges for L
Page 43 and 44: Emerging Issues Private for profit
Page 45 and 46: B. Information Education and Commun
Page 47 and 48: Challenges Aspects Challenges in Co
Page 49 and 50: delivery of all health programmes-
Page 51 and 52: o Coordinate partnerships between e
Page 53 and 54: Pharmacovigilance and quality assur
Page 55 and 56: o The tendency of recruitment of st
Page 57 and 58: Availability of annual, midterm and
Page 59 and 60: Key Implementers MoHSW, Academic I
Page 61 and 62: 3.0. SECTION THREE IMPLEMENTATION F
Page 63 and 64: plan for districts. Rather the acti
Page 65 and 66: The Table 14 below shows the trend
Page 67 and 68: Given the findings discussed above
Page 69 and 70: Monitoring Depending on the type an
Page 71 and 72: “Mkukuta Based MDGs Costings for
Page 73 and 74: ANNEX 2: FRAMEWORK FOR TARGET SETTI
Page 75 and 76:
ANNEX 3: ORGANOGRAM OF MINSTRY OF H
Page 77 and 78:
Strategy 4: Improve programme manag
Page 79 and 80:
Intervention Area 3a: Prevention of
Page 81 and 82:
Intervention Area 4a: Vulnerable Po
Page 83 and 84:
Intervention Area 5: Positive Preve
Page 85 and 86:
Strategy 3: Increase access to and
Page 87 and 88:
Strategy 4: To reduce the burden of
Page 89 and 90:
Intervention area 2: Community base
Page 91 and 92:
Strategy 3: Develop and implement c
Page 93 and 94:
Strategy 3: Develop effective strat
Page 95 and 96:
Strategy 1: To ensure nation-wide a
Page 97 and 98:
Strategy 3: Implement and strengthe
Page 99 and 100:
Strategy 1: Strengthen existing and
Page 101 and 102:
Intervention area 3: Promote BCC pr
Page 103 and 104:
103 |FINAL COMBINED-HSHSP 2008-2012
Page 105 and 106:
Intervention area 3: Human Resource
Page 107 and 108:
Intervention area 4: Strategic info
Page 109 and 110:
Strategic Objectives 3: To strength
Page 111:
ANNEX 5: REFERENCE AND NOTES i TACA
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