APHFTA’S HIV/TB/MALARIA/RMNCAH/FP RELATED EXPERIENCE
APHFTA has successfully managed several donor-funded projects over the years and collaborated with the following in achieving national targets towards attaining the health Sustainable developments goals.:
- the Ministry of health
- Community Development, Gender, Elderly and Children (MoHCDGEC)
- President’s Office Regional Administration and Local Government (PO-RALG)
- Development Partners (DPs)
The DPs with whom APHFTA has collaborated to successfully implement health projects include:
- AMREF Health Africa
- Bienmoyo Foundation
- International Finance Corporation (IFC)
- PharmAccess International (PAI)
- Population Services International (PSI)
- World Diabetes Foundation (WDF)
- Danish International Development Agency (DANIDA)
- Strengthening Health Outcomes through the Private Sector (SHOPS)
- United States Agency for International Aid (USAID)
- Comic & GSK of the UK
- Program for Appropriate Technology in Health (PATH)
- Christian Social Services Commission (CSSC)
- Medical Credit Fund (MCF)
- Human Development Innovation Fund (HDIF)
- National Social Security Fund (NSSF), Development Cooperation of Ireland, among others.
To implement these projects APHFTA has worked with the Ministry of Education, Science and Technology (MoEST), President’s Office Regional Administration and Local Government (PO-RALG), CSO/CBO’s, District Accredited Drug Dispensing Outlets (ADDOs) Associations, Tanzania Diabetes Association (TDA) and Local Organization (SHED Foundation) among others.
Voluntary Medical Male Circumcision (VMMC) Project
APHFTA pioneered a facility-based VMMC project since 2013. The aim of the project was to establish effective and sustainable strategies for the prevention of HIV transmission through VMMC services in Tanzania. The project increased coverage of male circumcision for HIV/AIDS prevention in Rorya district, Mara Region.
APHFTA partnered with the Rorya District Council, SHED Foundation (a local CSO) to cover the whole district using a facility-based approach in twenty (20) private and public health facilities.
Currently, APHFTA is a Prime Recipient of the USAID SAFE VMMC project that is being implemented in Iringa, Njombe, Tabora, Singida and Morogoro regions in Tanzania. The Project’s goal is to contribute to the reduction of new HIV infections in Tanzania and the Project Purpose is to increase circumcision coverage to 95 percent among males 15-29 years old.
In this project, APHFTA will work with over 200 public and private health facilities in the targeted regions to deliver quality Male Circumcision services. Specifically, APHFTA as a contractor focuses on strengthening the capacity of service delivery teams to provide comprehensive, high quality and sustainable VMMC services aligned to National and PEPFAR guidelines and policies.
In addition, the project also creates demand for, and use of VMMC services through various approaches such as the use of Voluntary Community Advocates (VCAs), Community Health Workers (CHWs), local Community Social Organizations (CSOs), use of mass and social media, Information, Communication and Education materials among others.
APHFTA with the financial support from UKAID through Comic Relief and GSK implements a 4-year (2017-2020) Malaria control project worth approximately GBP 1.2 Million that aims at contributing to the reduction of Malaria prevalence in the six councils of the Geita region.
APHFTA works closely with MoHCDGEC, MoEST and PO – RALG. APHFTA partners with Afya Micro-Finance Company as a sub-recipient of the project to increase access to financing for anti-malaria drugs and commodities.
Key interventions being implemented include Facility-based Malaria Case Management by strengthening quality assurance and quality improvement of malaria diagnosis, treatment, and prevention services. The project also trains health care providers (Clinicians and Nurses) on National Guideline for Diagnosis and Treatment for Malaria, Trainings of Laboratory Personnel in Malaria testing (Microscopy and mRDT) Quality Assurance and Quality Control. The project also focuses on improving Private sector Case Management by an innovative PHFs financing model to ensure continuous availability of medical commodities in both private health facilities and ADDOs.
iii. Health Sector Support Program (HSSP)
APHFTA through the financial support of DANIDA has been implementing the Health Sector Support Programme in Tanzania that aims at promoting Public-Private Partnership for improved health outcomes. Through this support, APHFTA has been able to facilitate over 400 private health facilities to provide public health services across all regions in Tanzania.
These private health facilities have signed service level agreements (SLAs) with the respective councils for the provision of RCH, HIV/AIDS testing, care and treatment, Malaria services among other areas.
APHFTA has effectively and efficiently engaged the councils, regions and national level through the various PPP platforms by signing service/project agreements for various service provisions. APHFTA will use this experience gained to engage more private health facilities in the targeted regions to provide HIV and TB Testing, Care and Treatment services through the SLAs.
Public Private Mix for Tuberculosis
APHFTA through its network member facilities (district, regional and zonal level hospitals) are currently engaged in TB Screening, diagnosis and treatment interventions through the support of the Ministry of Health, Community Development, Gender, Elderly and Children.
Several private health facilities have been provided with Gene Expert Machines for TB diagnosis in order to increase the access points for TB diagnosis services. APHFTA has supported the training of health care workers in these private health facilities on TB diagnosis, treatment and referral.
APHFTA has also engaged several smaller health facilities in sample collection, transportation and referrals whereby facilities with no capacity for testing are collecting samples or referring patients to the other health facilities for diagnosis or treatment. APHFTA will use the experience gained through this project to lead the implementation of TB programme in Tanzania.
Quality Improvement Program
For the past ten years, APHFTA has been working hard to ensure that the quality of healthcare in the PHFs improves.
APHFTA has been implementing Quality Improvement Programs since 2009. Consequently, APHFTA established a designated Department for this purpose and collaborated with PharmAccess International to pioneer the use of the now internationally recognized Quality of Healthcare Improvement model – ‘SafeCare’.
APHFTA through the financial support of PharmAccess International rolled out a Quality Improvement program to over 450 private health facilities across the country. The project focus was to provide technical and financial support to private health facilities for overall quality improvement.
In addition, APHFTA has also established it own quality improvement system that it uses to support private health facilities to improve the quality of care provided from one level to another (AFYA STEPS). APHFTA uses this system as a training tool to mentor and coach facilities through their journey of quality improvement.
Diabetes/ NCD Project
For the past twelve years, APHFTA through the support of WDF has been implementing Diabetes/NCD project in 17 regions of Tanzania Mainland namely Dar Es Salaam, Mtwara, Singida, Morogoro, Dodoma, Mwanza, Shinyanga, Mara, Arusha, Kilimanjaro, Tanga, Mbeya, Iringa, Ruvuma, Lindi, Pwani, and Kagera.
This project focused on increasing access to quality diabetes care in the primary health facilities, capacity building of health care workers on Diabetes/NCD prevention, care and treatment. In addition, basic diagnostic equipment were donated to the private health facilities.
The equipment included Blood pressure machines, Glucometers, Weight and Height scales among others. The Project model involved primary school pupils, whereby school health teachers were trained on basic Diabetes/NCD prevention and care. The school health teachers cascaded the Diabetes/NCD information in class sessions daily.
The third phase of the Diabetes/NCD project aimed at mainstreaming the implementation of the school health program at national, regional and district levels. The goal of diabetes/NCD project is to improve access to Diabetes/NCD Primary Prevention and detection services by strengthening the National School Health Program in Tanzania.
The program targets school children, parents and communities at large. It also targets health staff and health facilities with support to strengthen their diabetes/NCD services.
The program intends to achieve the following results: Enhanced implementation of the national school health policy guideline; Increased knowledge of diabetes/NCDs prevention in schools and communities, and; improved capacity of primary health care facilities in primary diabetes prevention and detection through school health program.
APHFTA also implements Quality improvement in the delivery of Maternal Newborn and Child Health (MNCH). The project focuses on bridging the gap identified in the provision of quality MNCH services in the targeted areas.
The Health facilities involved are provided with capacity building of their clinicians and nurses on Basic Emergency Obstetric and Neonatal care (BEmONC), equipment for support during Labour and Delivery (Delivery kit, Delivery bed etc.), equipment for Newborn resuscitation, Weight and Height scales for Adult and Children among others.
Capacity Building project-HBB&HMS
APHFTA in collaboration with Last Day Saints (LDS) Charities conducts a capacity-building project for Private Health Facilities (PHFs) across the country with the aim of training health care providers working in Labour and Delivery rooms.
The project contributes to bridging the skills gap among health care workers in addressing the challenge of premature or rather preventable morbidity and morbidity associated with Pregnancy, Childbirth and early life.
The project specifically involves hands-on skills practices needed for Newborn resuscitation skills, active management of the third stage of Labour. Most importantly, HCWs are equipped with the necessary equipment for newborn resuscitation including Ambu bags, Penguin suckers and job aid handbook as reference materials and mannequins among others.
Since 2013 the project has reached more than Ninety (90) private health facilities and more than 200 health care providers have been engaged in this training. The regions covered include Dar Es Salaam, Mbeya, Iringa, Mtwara, Mwanza, Mara, Arusha and Kilimanjaro. The project is co-funded by DANIDA through APHFTA and LDS charities
APHFTA has implemented a Family Planning Project (referred to as Smart Filling Project) in selected 150 private health facilities in four zones of Tanzania Mainland.
The focus of the project is to build the capacity of health care workers to provide quality, integrated and sustainable family planning services, create linkages to other services and through CHWs create demand for and use of VMMC services in the APHFTA network facilities.
APHFTA Approaches for Service Delivery
School Health Approach for Social Behaviour Change Communication
At the core of APHFTA SBCC interventions is the use of the school health program model in disease prevention. The design focuses on empowering and using primary school pupils as change agents in the communities where they live.
It recognizes that most diseases’ risk factors do not respect age. They include habits that can start at a tender age, which need to be uprooted before they mature. Since prevention of most diseases requires a change of lifestyle, it is logical to engrain an appropriate lifestyle in the minds of these young ones so that it becomes part of their lifelong habits.
School going pupils can access their parents (and relatives) and have the potential to win their attention. APHFTA supported the review of the school health policy guidelines and training curriculum for TOTs for school health programs.
Service Level Agreements With Councils and Private Health Facilities
APHFTA in collaboration with the Ministry of Health Community Development, Gender, Elderly and Children (MoHCDGEC) has used Service Level Agreements (SLAs) as a Public-Private Partnership (PPP) tool for facilitating engagement of the Private Health Sector (PHS) in the implementation of National Health Programs such as National Essential Health Services Package interventions, Control of HIV/AIDS, Reproductive and Child Health (RCH) etc.
The use of SLAs is one of the ways of increasing access and availability of services as per the National Essential Health Services Package whereby control of HIV/AIDS is among the priority areas for SLAs. SLA is a national tool developed by the MOHCDGEC and PO-RALG with the aim of leveraging the available resources in the two sectors in response to the increasing need of quality services.
APHFTA in collaboration with MOHCDGEC has been facilitating the signing of SLAs for HIV/AIDS/TB, RCH, Malaria, Diagnostic, and Medical Waste Management among other services and to date over 400 SLAs between the councils and private health facilities have been signed-in the country.
APHFTA successfully implemented these projects using the Public-Private Partnership (PPP) approach.
The organization has thus gained remarkable experience in working with both the public and private health sectors in the provision of HIV/AIDS, VMMC, TB/Leprosy, MNCH, Malaria among other services in Tanzania.
APHFTA will continue to utilize these experiences to further strengthen and expand TB and Malaria services delivered by the private health sector and will strengthen linkages with the public sector through Public-Private Partnership initiatives in collaboration with Partners.