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

2.2. THEMATIC AREA: CARE AND TREATMENT
2.2.1. Introduction
Scaling up access to ART and decentralizing implementation to include primary health facilities and the
community so as to reach underserved populations is important. It is also critical that the challenges that
will be faced in ensuring quality, equitable access and overcoming stigmatization and discrimination are
addressed. .
This section addresses the continuum of care, treatment and support services at facility and in the
community .
Intervention Area 1: Facility Bases Services
Preamble
The plan focuses on scaling up activities, strengthening adherence to ART, integrating various HIV and
AIDS programs with other health programs, and linking facility based interventions to-and-from community
and home based care activities. The strategy is also mindful of low enrolment of children and males and
has designed activities which aim to increase enrolment of these populations, in addition to ensuring early
detection and follow up of children exposed to HIV.
Situational Analysis
Achievements
Infrastructure improvements, including purchase and installation of essential equipments and
supplies; 200 Care and Treatment Clinics (CTC) inclusive of referral, regional and district
hospitals, faith-based and some private hospitals were established.
A facility accreditation system was developed and implemented, services standards and
guidelines were developed and used in training health workers
1,427 HCWs from various cadres have been trained
Plan for gradual initiation of ART was implemented beginning with referral hospitals and
followed by regional and district hospitals.
162,922 patients were enrolled for general care and 79,181 were initiated into ART. Among
these 15, 505 (9.5%) were children.
Challenges
Aspects Challenges for Facility Based Services
Availability • The majority of rural population has no access to ART.
• Poor patients cannot afford paying for cost of treating OIs
• Only 19.4% and 12.8% of adults and children in need of ART receive this
treatment
• Lack of quality laboratory services to effectively support ART
• Inadequate laboratory services
• Limited infrastructure for CTC services
• Limited number of days for offering ART services
• Limited involvement by the private sector in care and treatment
Acceptability • Awareness of benefits of knowing one’s HIV status and accessing care and
treatment early is low
Quality of
services
• People do not know criteria for initiating ART
• Lack of integration of CTC clinics into routine care
• Poor linkage of vertical programs leading to inefficiency and at times artificial
shortages of drugs and other commodities which PLHIV cannot access, e.g.
34 |FINAL COMBINED-HSHSP 2008-2012: June 24 th 2007