How the Police and Prisons Healthcare Project Improved HIV and TB Services in Tanzania (2020–2025)

How the Police and Prisons Healthcare Project Improved HIV and TB Services in Tanzania (2020–2025) Police and prison health facilities play a critical role in Tanzania’s response to HIV and tuberculosis (TB). However, limited infrastructure, shortages of trained staff, weak diagnostic capacity, inefficient supply chain systems, and persistent stigma had long constrained access to quality HIV and TB services for police officers, prison staff, their families, inmates, and surrounding communities. From August 2020 to February 2025, Tanzania Health Promotion Support (THPS), in collaboration with the Ministry of Home Affairs, the Ministry of Health, and the President’s Office Regional Administration and Local Government (PO-RALG), and with support from the United States Government, implemented the Police and Prisons Healthcare Project to address these challenges. Over five years, the project strengthened HIV and TB prevention, care, and treatment services in 64 police and prison health facilities across 35 districts in Tanzania Mainland and Zanzibar, leaving behind stronger health systems and healthier communities. Closing a Critical Health Gap

Before the project, many police and prison facilities offered only limited services, frequently referring clients elsewhere for TB diagnosis or comprehensive HIV care. In overcrowded prison settings, delayed TB detection increased transmission risk, while concerns about confidentiality discouraged uniformed staff from seeking HIV services. “We used to refer many TB suspects outside the prison, and some never returned for results or treatment. Now diagnosis and treatment start much earlier.”— Prison Health Care Worker, Kigoma Region. The project was designed to address these gaps holistically, by simultaneously improving access, enhancing quality, and strengthening health systems. Expanding Access, Services Where People Live and Work The project expanded integrated HIV and TB services within police and prison facilities, reducing reliance on long-distance referrals and minimizing missed opportunities for care. Police officers, prison staff, inmates, their families, and nearby communities gained improved access to screening, testing, treatment initiation, and follow-up services closer to where they lived and worked. “I work long shifts, and before it was difficult to leave work to get services. Having care at the police clinic has helped me stay healthy and continue my duties.”— Police Officer receiving HIV care, Pwani Region. By integrating HIV testing with routine TB screening and other health services, the project strengthened early detection and timely linkage to care. Improving Quality, Care with Dignity and Reliability

Quality improvement was central to the project’s success. Healthcare workers received targeted training and continuous mentorship on HIV and TB management in line with national guidelines. Laboratory services were strengthened, enabling faster and more accurate TB diagnosis. Facility renovations improved privacy and confidentiality, critical for reducing stigma and building trust among clients. “The mentorship helped us follow guidelines correctly. Clients now trust us, and we feel proud of the services we provide.”— Nurse, Police Health Facility, Mwanza Region. Stronger Systems for Long-Term Impact Rather than creating parallel structures, the project focused on strengthening existing government systems. Facilities were renovated, essential equipment supplied, and health information systems improved to support routine reporting and data use. Referral linkages between police, prison, and civilian health facilities were strengthened, to ensure continuity of care when inmates were transferred or released. “When inmates are released now, we ensure they are properly referred to health facilities near their localities so treatment continues. This was a major challenge before.”— Medical Officer In-Charge, Shinyanga Prisons Dispensary Real Lives, Real Change The project’s impact is most visible in the lives it touched. Early TB diagnosis reduced illness and transmission in congested prisons, while continuous HIV care enabled police officers and prison staff to remain healthy and productive. “I was diagnosed with TB early and started treatment immediately inside the prison. I completed treatment and regained my strength.”— Former Prison Inmate, Singida Region. Healthcare workers also reported renewed motivation, stronger skills, and greater professional confidence. Results That Strengthened National Efforts By February 2025, the project had achieved significant milestones:

Introduced and optimized targeted HIV testing in all 64 supported facilities.
Expanded comprehensive HIV prevention, care, and treatment services from 49 to 58 Care and Treatment Centres (CTCs).
Improved early TB detection by upgrading 12 additional sites to TB diagnostic centres through the provision of 10 GeneXpert machines and 10 iLED microscopes.
Strengthened retention and continuity of HIV care.
Supported laboratories at Kilwa Road Police Regional Referral Hospital and Ukonga Chuo Hospital to attain three-star status under the WHO AFRO Strengthening Laboratory Management Toward Accreditation (SLMTA) framework, with Ukonga Chuo Hospital subsequently accredited by Southern African Development Accreditation Service (SADCAS).
Upgraded infrastructure and service readiness in all 64 supported facilities.
Strengthened virtual learning and mentorship for healthcare workers through 28 ECHO units installed across supported sites.

These achievements contributed directly to Tanzania’s national HIV and TB goals and reduced public health risks beyond police and prison walls. A Sustainable Legacy All gains from the Police and Prisons Healthcare Project were institutionalized within government systems. Trained healthcare workers remain in place, upgraded facilities continue to operate, and strengthened referral and reporting mechanisms are fully integrated into routine service delivery. “This project strengthened our systems in a sustainable way. The services will continue even after the project has ended.”— Tanga Regional Health Management Team Member. Another key achievement of the project is the introduction of peer education within prisons. In collaboration with the Ministries of Home Affairs and Health, a peer education curriculum was revised to align with prison rules and regulations, certified, and used to train selected inmates. These trained peer educators continue to serve their communities beyond the project’s lifespan. Protecting Those Who Protect the Nation By strengthening HIV and TB services for police and prison populations, the project protected not only uniformed personnel and inmates, but also their families and surrounding communities. Its legacy demonstrates that when health systems are strengthened from within, impact endures long after a project closes.