Afya Kwanza/PEPFAR Program

PEPFAR CDC AFYA KWANZA PROGRAM (Sept 2018 – Sept 2021)

The Project goal is to implement quality facility-based HIV care and treatment services to achieve PEPFAR and Government of Tanzania’s National Multi-sectoral Strategic Framework. THPS, as a subgrantee to MDH through Afya Kwanza Project in collaboration with MOHCDGEC, and PORALG, provides HIV care and treatment services to 122 health facilities (49 in Kigoma and 73 in Pwani region). 

THPS, as a subgrantee to Management and Development for Health (MDH) through Afya Kwanza Project in collaboration with MOHCDGEC, PORALG, Regional Health Management Teams, District Health Management Teams and Health care providers in health facilities provides HIV care and treatment services to122 health facilities (49 in Kigoma and 73 in Pwani region). 

Program Strategies and Objectives

Strategy 1

Implement Comprehensive Facility based HIV care along clinical cascade for general population, key and vulnerable population (KVP), adolescent girls and young women (AGYW), young adults (<30 yrs.), older men, pregnant & breast-feeding women and TB/HIV patients at 114 health facilities (HFs).

Program area 1: Identification and linkage of HIV-positive individuals to care at all 122 health facilities

Objectives

  • Develop and implement innovative evidence-based testing strategies to identify HIV positive individuals in 122 HFs
  • Work with HFs and community implementing partners (IPs) to develop a functional and sustainable linkage system for HIV positive individuals to CTCs
  • Train and certify relevant health facility staff to perform targeted quality rapid HIV testing at supported 122 HFs

Program area 2: Treatment initiation and clinical care services at 122HFs

Objectives

  • Work with HF staff to effectively implement the ‘test and start’ strategy for all people living with HIV (PLHIV) at all 122 supported sites in Pwani and Kigoma regions
  • Work with facility staff at 122 HFs in Pwani and Kigoma to provide the PEPFAR basic service package for all PLHIV which includes screening and management of opportunistic infections (OIs) including TB, STIs, cryptococci meningitis, cervical cancer, post exposure prophylaxis (PEP), and post gender-based violence care.
  • Scaleup IPT and infection control practices at all supported CTC, TB-HIV clinics and reproductive and child health (RCH)/PMTCT sites

Program area 3: Adherence, Viral Load (VL) Monitoring, Retention and Community Linkages at all 122 supported HFs

Objectives

  • Strengthen ART adherence counselling and expand viral load mentoring capacity for PLHIV on treatment in supported health facilities
  • Work with 122 facilities to strengthen and fully use the established national sample referral system and transport networks for viral load, early infant diagnosis and dried blood spot testing in all supported sites.
  • Implement standardized council and partner- level retention cascade analysis by gender and age in 122 health facilities in five supported regions
  • Increase knowledge and skills of laboratory staff at 122 HFs to implement quality assurance (QA) per SLMTA/SLIPTA standards
  • Work with health facility staff to implement internal and external HIV testing QA programs through HIV rapid test continuous quality improvement initiative (RT CQII) at 122 health facilities in Pwani and Kigoma.
  • Work with Health facilities to increase access to viral load& EID results, and maximize use of results for patient management.
  • Work with all HFS and National HIV Laboratory Support (NHLS) project to expand the use of laboratory information system (LIS) and ensure quality of data in all laboratories.
  • Build capacity of R/CHMT to collect quality data, routinely analyze program data and use data for program improvement in supported regions.
Strategy 2

Mentorship and supportive supervision on M&E activities to inform program planning and improve data quality and service delivery at 122 HFs

Program area 4: Quality Assurance/Quality Insurance (Strengthening M&E Data)

Objective

  • Build capacity of R/CHMT to collect quality data, routinely analyse program data and use data for program improvement in supported regions
  • Project Management of Afya Kwanza project
Strategy 3

 Partner with district and facility to strengthen, design and implement innovative SDM per national guideline and ensure CQI activities.

Program area 5: Service Delivery Model (SDM), Quality Assurance/Quality Improvement) (QA/QI) Strengthening at all supported 122 HFs

Objectives

  • Work with HFs to implement differentiated care and SDMs at 122 HFs in the two regions
  • Monitor and track implementation of test and start, differentiated care models and SDMs for stable patients at 122 supported HFs.
  • Strengthen facility QI team competency to effectively implement and document QI activities using evidence CQI approaches and methodologies that will enable HFs to improve the quality of clinical services across the continuum.
  • Conduct QI collaborative forums with 122 HF teams to increase shared experiences and effective monitoring of quality data and use.

Program Achievements

As of October-December 2020, THPS through Afya Kwanza program managed to reach 31,152 (30% of the annual DSD target of 104,550) clients who were counselled, tested and received their HIV results. Among them 1732 (5.5%) were found to be HIV infected and 2,333 (135%) were initiated on ART.

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