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

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Fig 1.7 : PRECEDE-PROCEED FOR HEALTH PROMOTION. (Source : L.Green and M. Krenter,1991) Administrative and policy diagnosis Health Health education education Components Components of of health health promotion promotion program program Policy Policy regulation regulation organisation organisation Direct Communication to public, youth, patients, students, employees Indirect communication througth staff training, supervision, consultation, feedback Training: community organization 44 |FINAL COMBINED-HSHSP 2008-2012: June 24 th 2007 Educational and organizational diagnosis Predisposing Predisposing factors factors Knowledge Knowledge Attitudes, Attitudes, Beliefs Beliefs Values, Values, Perceptions Perceptions Reinforcing Reinforcing factors: factors: Attitudes Attitudes and and behavior behavior of of health health and and other other personnel, personnel, peers, peers, parents parents employers, employers, etc. etc. Enabling Enabling Factors: Factors: availability availability of of resources, resources, acessibility, acessibility, referals, referals, skills, skills, Figure 5: Precede-Proceed Model for Health Promotion Behavioral and envirmental diagnoses Behavior Behavior (actions) (actions) of of individuals, individuals, groups, groups, or or communities communities Contextual Contextual factors factors (PEST) (PEST) Situation analysis Though the primary education net enrolment rate has improved to 90.5% in 2004 compared to 58.8% in 1990, illiteracy is a challenge especially among women. Overall, 25% of females and 20% of males have never been to school. Consequently the use of print media for sending HIV and AIDS messages to the general public will have a limited intended impact. Therefore, there is need to explore other innovative approaches in order to improve the impact of these messages on the target audiences including those who are unable to read and write. Below are the achievements and challenges in the implementation of 2003-2006 plans: Achievements 47% of men and 42% women used condoms in their last high risk sexual encounter Age at first sexual contact among female and male adolescent has increased by one year. Decline in proportion of people have sex with two or more partners (females from 8% to 5% and males from 27% to 20%) 15% of Tanzanians aged 16-49 years have ever been tested for HIV. Challenges Aspects Challenges with BCC Programming Availability • Non inclusion of BCC programming in HIV and AIDS interventions • Public awareness on some of the core interventions still low and many myths and misconceptions persist • Inadequate human resource in BCC programming at all levels Equitable • Current messages are not contextualised to local settings access Quality • IEC has often resulted in the production of discrete communication materials. • No monitoring tools are available to establish effectiveness of the BCC programs inadequate linkages and coordination at all levels
B. Information Education and Communication (IEC) Preamble IEC materials are extremely important in transmitting messages that are crucial for creating awareness on HIV/AIDS/STIs prevention, care and treatment in the general population. These materials are some of the strategies used to promote behavioural change. Achievements Awareness of HIV and AIDS in Tanzania is 99% Developed IEC materials o Print material: 100, 000 wall calendars, 200,000 brochures, 200,000 booklets, 100, 000 posters and 235,000 newsletters were produced. o Audio visual: TV and radio programs (film, spots & live talk shows) o There are some IEC materials produced by local NGOs. IEC materials produced and distributed through print materials, TV and Radio programs covered the following topics: • Stigma and discrimination • Nutrition • Anti retro viral treatment (ART) and Anti-retro-viral (ARV) Challenges • Home Based Care • Voluntary Counseling and Testing • Care and Treatment Centers (CTC) Aspects Challenges in IEC materials production 45 |FINAL COMBINED-HSHSP 2008-2012: June 24 th 2007 • Opportunistic infection • Tuberculosis and HIV • Adherence • Condom promotion HIV and AIDS situation in Tanzania • Eligibility criteria for ARV treatment and the WHO Criteria • Prevention and Mother To Child Transmission program • Sexual Transmission Infections Availability • No locally specific communication strategies • No evaluation done on impact of different types media used for channelling messages to the public Equitable • Centralized and inadequate production of IEC materials. access • Regional media and other communication channels are rarely used Quality • The IEC materials are not sensitive to gender, economic dimensions politicallegal context which influence sexual relations C. Stigma and Discrimination Preamble Stigma is a mark of shame or discredit on a person or group. Stigma can manifest itself in a variety of ways, from ignoring the needs of a person or group to psychologically or physically harming those who are stigmatized. Stigma is often felt by PLHIV, men who have sex with men (MSM), sex workers (SWs), IDUs, migrant populations and others. The importance of addressing stigma in the context of BCC campaigns has programmatic implications that go beyond compassion and humane treatment. Failure to address stigma jeopardizes BCC programs in prevention, quality of care and policy.
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 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: Emerging Issues Private for profit
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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