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

Intervention Area 2: HIV Testing and Counselling (HTC) services
Preamble
The National Guidelines for Voluntary Counselling and Testing (2005) clearly state that HTC provides an
opportunity to access accurate and comprehensive information on HIV, AIDS and STIs. It serves as an
entry point to prevention, care, support and treatment programs and enables persons to confidently
understand their HIV status and learn about supportive behaviours for protecting and preventing further
spread of HIV.
It has been noted that the demand for counselling is high suggesting a need to provide a wide variety of
models of HTC including PITC. The existing public system cannot handle the high demand for this service.
However the opportunities for support for HTC service provision from a number of partners exists.
Situation analysis
Below are the achievements and challenges in implementing HSS 2003-2006:
Achievements
Trainings have been conducted as follows
o 2,739 counsellors, 96 national VCT trainers and 62 regional and district VCT supervisors
had been trained.
o Sixty members of CHMT were oriented on managerial skills on the supervision of VCT
and other HIV and AIDS-related interventions.
The National Counsellor Training Curriculum was reviewed to equip counsellor with necessary
skills to provide services of recommended quality.
National guidelines were developed
o VCT
o PITC
1,027 VCT sites had been established and some have been accredited.
Challenges
Aspects Challenges for HIV Testing and Counseling
Availability • Irregular supply of HIV test kits
• Lack of appropriate infrastructure for HTC
Equitable access • 10.5% of people aged 15 to 49 in urban areas had been tested in the past year
against 3.4% in rural areas
• A few trained counselors are in place compared to need,
• Lack of skills to provide counselling to special groups, for example, the deaf and
the children,
Acceptability • Patients and clients visiting the health facilities might not ask for an HIV test
because of fear and stigma
• VCT services are often provided in small and poorly furnished rooms, which
compromise privacy and confidentiality.
• VCT being a part time activity and hospital-based, lack of recognition as a
career path (counsellor is not a cadre in the health system)
Quality Programme management
• VCT services being partially included in the Council Comprehensive Health
Plans (CCHPs),
• Inadequate coordination of VCT services at all levels,
• A weak referral and networking system
• Inadequate supervision and support to counsellors,
• Existence of different HTC standards
Quality improvement (M&E and supportive supervision)
• Poor/lack or incomplete and inconsistent reporting
• Poor/lack of motivation
• Heavy workload (some counsellors attending between 30 and 50 clients a day),
42 |FINAL COMBINED-HSHSP 2008-2012: June 24 th 2007