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

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Intervention area 3: Prevention of transmission in health-care settings A. Safe blood Preamble HIV transmission through blood-transfusion, contaminated blood-products and interventions / accidents happening in hospital settings as well as through traditional practices (skin piercing, genital mutilation etc.) account only for a relatively low percentage of the overall transmission. However, reduction of transmission risks in these settings is of importance to safeguard the health of the population in general and of the health workers / professionals in particular. The MOHSW has continued to ensure that blood is safe at all levels of health facilities by training laboratory staff in blood and injection safety, screening for HIV anti-bodies, hepatitis and syphilis. Situation analysis Achievements Though donor blood screening for HIV started in 1987 establishment of the National Blood Transfusion Service (NBTS). Was done in 2000 There are 6 zonal blood transfusion centers in Dar-es-salaam, Moshi, Mwanza, Mbeya, Tabora and Mtwara Efforts to establish a pool of low risk voluntary blood donors have started. NBTS has in place National Blood Transfusion Policy, Blood Donor Recruitment and Retention guidelines, Specific Blood Transfusion Practice guidelines and Guidelines on the Clinical use of Blood and Blood Products. Challenges Aspects Challenges for Blood Safety Availability • Limited numbers of blood donors Equitable • Weak distribution of donated blood and blood products by Zonal centers to regional access distribution points Quality • Lack of Quality Assurance scheme for NBTS at distribution points • Inadequate supervision of blood transfusion practices in private hospitals Equity, gender and sustainability considerations Currently the majority of blood donors are replacement donors (90%) out of whom majority are males (81.4%) ix . Half of blood recipients are children followed by pregnant women (30%). Strategic objective Reduce the risk of HIV transmission through blood and blood products Strategies Strengthen the distribution capacity of NBTS and regional distribution units Promote community awareness for blood donation Establish an efficient and appropriate M&E system and a Quality Assurance scheme for NBTS Target Increased low risk blood donations in public and private hospitals 28 |FINAL COMBINED-HSHSP 2008-2012: June 24 th 2007
Indicator % of blood units transfused that have been screened for HIV, syphilis and hepatitis according to National guidelines Key implementers MoHSW, Private hospitals, RHMTs, CHMTs B. Workplace interventions for HCW Preamble HCWs may acquire infection at places of work as an occupational risk or through sexual networking. In health care settings, universal bio-safety precautions and safe waste management is essential for prevention of nosocomial transmission of infectious agents. Situation analysis Achievements a) Universal precautions and medical waste management Guidelines for national hospital waste management have been developed and are being observed in most health facilities in the country. Facilities have ways of disposing waste such as incinerators and pits. There are satisfactory initiatives to intensify advocacy and sensitize health workers on issues related to HIV transmission risks at the workplace. b) Safe injections Safe disposal of needles and sharps is practiced in health facilities in special boxes or improvised alternatives. HCW are trained on the need to avoid recapping of syringes as part of the Infection Prevention Programme of the MOHSW c) Workplace interventions for HCWs The Occupational Unit of the MOHSW has developed a strategic plan for the control of HIV and AIDS for HCW at the workplace for the period 2006-2011. MOHSW developed National Infection Prevention and Control (IPC) Guidelines for health care services in Tanzania in 2004. Training of healthcare providers has been done in the zonal hospitals. d) Post-exposure prophylaxis (PEP) Despite MoHSW guidelines on PEP so far only facilities with Care and Treatment Clinics have PEP kits for needle stick injuries. Challenges Aspects Challenges for Workplace Interventions for HCW Availability • Limited awareness about risks of HIV transmission in hospital settings • Low rate of implementation of PEP. • Inadequate coverage of HIV work place interventions in health facilities Equitable • Inadequate knowledge and skills among healthcare providers on IPC. access Quality • Inadequate functioning of National Quality Improvement Committee (NQIC) on infection control • Lack of harmonized training materials on Infection IPC • No coordination forum for IPC 29 |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 and 24: Achievements Currently 659 sites (
Page 25 and 26: Indicators Number of health instit
Page 27: Key implementers Referral, regiona
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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