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

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Indicators Existence of an innovative management system Number of integrated plans done collaboratively Quality assurance scheme institutionalised Key implementers MoHSW, PORALG, POSMS Intervention area 2: Procurement and supply management Systems for HIV and AIDS medicines, laboratory supplies and other reagents Preamble Procurement and supply management of commodities, reagents and drugs is an important element for the HIV and AIDS response. The Medical Stores Department was established to offer a centralized procurement, storage and distribution system for all health commodities. The MSD is the main stockists and distributor of all medicines and laboratory supplies. Due to emerging demands of major public health diseases including HIV and AIDS, the ability of MSD coping with the demands is constrained. Most HIV and AIDS medicines have been developed in the recent years and hence their long term safety in large populations have not been well established. TFDA has in place a pharmacovigilance system for all medicines whereby health workers voluntarily report adverse drug reactions occurring in their places of work. Pharmacovigilance is a terminology used to indicate the process of detection, assessment, understanding and prevention of adverse effects, particularly long term and short term side effect of medicines. The long term and short term side effects are termed Adverse Drug Reactions (ADR) on patients that are using a pharmaceutical product. Situation analysis Achievements General health reform activities at all levels Procurement and supply management Systems for HIV and AIDS medicines, laboratory supplies and other reagents • Presence of infrastructure for procurement, storage, supply and distribution • Established computerized inventory system covering the whole country Indent and Integrated Logistics Management (ILS) system for ordering supplies is in place • The system of allocating funds at MSD and HFs drawing supplies against them has worked relatively well over the years. • Mechanisms of selecting and reviewing medicines for the management of HIV and AIDS are in place through the National Essential Medicine List (NEMLIT). Medicines Registration System • Existence of mechanisms for fast tracking registration of HIV and AIDS medicines (ART) • Some of the registered ART are manufactured in country 52 |FINAL COMBINED-HSHSP 2008-2012: June 24 th 2007
Pharmacovigilance and quality assurance • Monitoring Adverse Drug Reaction (ADR) for HIV and AIDS medicines has been established. • A system for monitoring the quality of medicines from the ports of entry as well as those circulating in the market exists in the country. Challenges Procurement and supply management Systems for HIV and AIDS medicines, diagnostic supplies and laboratory reagents • Two competing systems (Push and Pull) for acquisition of supplies from the same source to the end users is a problem • Erratic supplies especially of HIV diagnostics tests and laboratory commodities • Improper utilization of maximum-minimum ordering concept leading adhoc order placement. • Inefficient fall back opportunities at facility level to use alternative methods of acquiring supplies when MSD has stock outs. • No central tool for commodity forecasting for HIV and AIDS commodities • No regular consumption feedback of HIV and AIDS commodities from end users • Poor coordination and communication about available stocks and demands from end users Pharmacovigilance • There is gross under reporting of ADR. • Poor coordination of the dissemination of ADR in terms of onward transmission of information and feedback Equity, Gender and sustainability considerations Rural areas have few supplies and other commodities. Procurement of supplies for HIV and AIDS is heavily donor dependent and so alternative funding sources should be sought. Strategic objective To have secure and functional procurement and supply management systems for HIV and AIDS medicines, diagnostics and other commodities Key Implementers Strategies Strengthen procurement and supply management systems for HIV and AIDS medicines, diagnostics and other commodities Facilitate regular revision of NEMLIT and ensure availability of HIV and AIDS, STI and OIs related medicines. Strengthen a mechanism for tracking and providing feedback on ADR associated with HIV and AIDS, STI and OIs medication. Targets Uninterrupted supply of STI, OIs, HIV and AIDS medicines, diagnostics and other commodities Indicators Availability of supplies Revised NEMLIT Number of ADR reported MoHSW, MSD, TFDA, Health facilities 53 |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 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: o Coordinate partnerships between e
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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