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

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Executive summary Introduction This Health Sector HIV and AIDS Strategic Plan (“HSHSP-2008-2012” ) is the contribution of the Health sector to the overall National Multisectoral Strategic Framework (NMSF-2008-2012). The theme of the HSHSP is “universal access to preventive, care, treatment and support services”… The plan has been prepared at the time when the country and, in particular, the health sector, is facing significant challenges such as serious human resource crisis, inadequate funds to immediately deal with the health problems and geographical imbalances in the distribution of the available resources within the country. Background Health Sector Performance and Disease Burden Over the past five years, the overall performance of the health sector has shown some improvements and there is government commitment to allocate resources. The country has recorded successes in key HIV and AIDS interventions, such as: increased coverage for PMTCT, introduced and expanded care and treatment, increased availability of condoms, increased counseling and testing services, expansion of services to communities and household levels. Lastly measures to monitor the epidemic are in place. Despite these improvements, the biggest challenge is that the epidemic is far from being contained. Currently, the majority of people in need of services cannot access them especially the vulnerable groups and rural areas. The challenges of assuring quality of services being provided remains an area of great concern. Although resources are being allocated to the epidemic by the government, sustainability still remains a formidable task. In order to successfully implement this strategic plan, the following assumptions are made: Continued peace and political stability in the country; There will be adequate numbers of appropriately trained and well motivated health workers; Macroeconomic stability and sustainable economic growth will continue; Increased Government prioritisation and funding to the health sector; Increased Partners support to other programmes within the health sector; and Timely and appropriate attention to implementation of all health priority areas. Vision, Mission, Goals and Key Principles Vision: “A country united in its efforts to reduce the spread of HIV and to provide the best available care for those infected and affected by the virus.” Mission Working in partnership with other public sectors, private sector, civil society and communities to play a leading role in the prevention of further spread of HIV/AIDS and mitigate its impacts by providing essential interventions and quality care. Goals: To scale up the health sector response to HIV and AIDS and strengthen the health system capacity to support HI and AIDS interventions, To promote access and utilization of affordable and essential interventions and commodities for HIV and AIDS, and To improve the quality of HIV and AIDS interventions to the general public, PLHIV, health care providers and other vulnerable populations. Key Principles Equity of access, Ethical conduct and human rights, Quality, Accountability, Partnerships Decentralisation, Leadership: Gender 6 |FINAL COMBINED-HSHSP 2008-2012: June 24 th 2007
National HIV and AIDS Priority Interventions Though the lesson of prioritization in terms of focusing on few interventions has been acknowledged, this strategic plan has included some illustrative activities to serve as a menu that accommodates the interests of various stakeholders involved in the health sector response. There are four themes including the health system strengthening. The health system interventions represent support services which facilitate the efficient and effective management of the health sector HIV and AIDS response, and without which implementation of the HIV and AIDS priorities would be seriously compromised. Thematic area Key Challenges Strategic objective Targets 1. 1. PMTCT 1.2. Prevention of sexual transmission of HIV a) STI b) Male circumcision 1.3. Prevention of HIV in Health care settings a) Safe blood b) Workplace programmes 1.4. Prevention of HIV transmission in vulnerable groups 1. Prevention 12% of HIV positive pregnant women are receiving ARV prophylaxis 38% of identified HIV positive pregnant women received Nevirapine (NVP). 54% of HIV+ exposed infants receive ARV prophylaxis after birth 6.9% HIV infected women opt for replacement feeding. Inadequate screening for syphilis in RCH services Few youth friendly reproductive health services STI services addressing high risk population groups are limited. Weak monitoring of aetiologies and antimicrobial susceptibility patterns of STI pathogens Poor contact tracing (21-35%) Male circumcision has not been integrated in HIV prevention services currently in the country Limited numbers of blood donors Weak distribution of donated blood and blood products by Zonal centers to regional distribution points Inadequate functioning of National Quality Improvement Committee (NQIC) on infection control Low rate of implementation of PEP. Inadequate coverage of HIV work place interventions in health facilities a) Youth b) CSW, MSM, IDU Inadequate data on the characteristics, risk taking behaviours, magnitude, socialeconomic- situation of vulnerable populations 1.5. Positive prevention Adolescent sexual and reproductive health (ASRH) not mainstreamed into HIV and AIDS at all levels Lack of policy issues for the VP Inadequate meaningful engagement and involvement of PLHIV for Positive Prevention Several PHLA groups are poorly organized and weak 7 |FINAL COMBINED-HSHSP 2008-2012: June 24 th 2007 To reduce the transmission of HIV from mothers to their children and ensure entry into care and treatment for mothers and babies. To expand quality STI services and enhance appropriate utilization of services To promote safe, socio-culturally accepted male circumcision as a preventive measure against HIV transmission To reduce the risk of HIV transmission through blood and blood products To implement comprehensive workplace interventions in the health sector focused on the prevention, care, treatment and support of employees and their families To develop effective interventions to reduce HIV infection among youth To contribute to the reduction of risk of HIV infection among vulnerable population groups including IDUs. To reduce the risk of PLHIV getting re-infection or infecting others with HIV HIV positive pregnant women who receive ARVs prophylaxis increased to at least 80% % of patients with STIs at selected health care facilities who are appropriately diagnosed and treated according to national guidelines increased from 67% in 2005 (NACP) to over 75% Promote awareness of male circumcision where traditionally this is not done Increased low risk blood donations in public and private hospitals Comprehensive Health Sector Workplace HIV intervention implemented at all levels Joint planning and implementation of ASRH and HIV interventions targeting young people with key stakeholders at all levels Harm reduction for injecting drug users, focusing on risk reduction information and education National guidelines for meaningful involvement of PLHIV (MIPA) developed Public disclosure of HIV serostatus by champions of change
Page 1 and 2: FINAL DRAFT 24 th JUNE 2007 THE UNI
Page 3 and 4: TABLE OF CONTENT Abbreviations and
Page 5: ACKNOWLEDGEMENTS 5 |FINAL COMBINED-
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 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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