DSD Scale-up in Tanzania

Dr Mastidia Rutaihwa National AIDS Control Program

Ministry of Health, Community Development, Gender, Elderly and Children 7 November, 2018

Addis Ababa Ethiopia

Outline

•  CQUINDashboardresults•  Successesandchallenges•  Targetsandmonitoring•  Nextsteps

Tanzania Dashboard Results – 1

PreliminaryDashboardResults,October2018

Tanzania Dashboard Results – 2

Tanzania Dashboard Results – 3

Outline

•  CQUINDashboardresults•  Successesandchallenges•  Targetsandmonitoring•  Nextsteps

DSD Scale-up Success

PresenceofpolicyguidelinesacrosstheHIVcarecascade(HTS,ART,LINKAGE&HVLsuppression),SOP’s,sensiAzaAonandorientaAonpackagessupporAngeasyimplementaAonandreachingdiversityofPLHIV•  DSDincorporatedintoNaEonalHIVguidelinesinclude:

–  mulE-monthprescripEonextendedto3months–  Blockappointment–  DecentralizaEontothelowfacilitylevelatthecommunity–  IntegraEonofservices–  ARTRefill:Fasttrackrefill/Familyandtreatmentsupporterrefill/CommunitybasedindividualARTdeliverythroughmobileoutreachbyHCW/FacilitybasedHCWmanagedgroupse.g.teenclubs,Youthclubsandadultgroups

DSD Scale-up Success

(conAnuaAon)– DSDOperaEonalManualandJobAids(EnglishandSwahiliversion)– RevisedCTC2CardwithsomeDSDvariables– Standardtrainingpackagedeveloped

•  SensiEzaEon:targeEngregional,districtandfacilityleaders•  OrientaEon:targeEnghealthcareworkers(HCWs)•  Regional,DistrictandfacilitylevelAcEonPlans:on-sitefollow-upandTAtosupportimplementaEonofplans

– Dra]NaEonalImplementaEonplandeveloped

DSD Scale-up Challenge

VerylowhealthfacilityandpaAentcoveragewithnodatabase/toolstocaptureinformaAononDSDimplementaAon

– Trainingcoverage:reachingHCWsinallfaciliEesforrapidscale-upofDSDmodelsandtrackingofthosetrained

– UnavailabilityofallDSDvariablesinM&ErecordingandreporEngtools–  LackoftargetsandrouEnemonitoringofDSDindicators

Outline

•  CQUINDashboardresults•  Successesandchallenges•  Targetsandmonitoring•  Nextsteps

DSD Targets and Monitoring

•  WhatarethenaEonalDSDtargets,withregardstoDSDcoverageforstablepaEents?– DSDtargetsforcoverageofstableclientsnotdetermined

•  Howisperformancemonitored?– Whatdataarecollected?

•  ClientcategoryonART,ARTtypeofvisit,NumberofdaysdispensedARVs(mulEmonthprescripEon)usingCTC2cardanddatabase

– Howo]enaretheyanalyzed?•  AllHIVdata(apartfromDSD)inCTC2Databaseanalyzed:monthlyatfacilitylevel;quarterlyatnaEonallevel

•  NoreporEngtooltocaptureDSDImplementaEon

Outline

•  CQUINDashboardresults•  Successesandchallenges•  Targetsandmonitoring•  NextSteps

Next Steps

WhataretheprioriAesfor2019relatedtoDSDscale-up?•  FinalizerevisionofM&EtoolsandElectronicDataBasetocaptureallinformaEonrelaEngtoDSD

•  Setupthecountrytargets&finalizeindicatorsforDSD•  FinalizeNaEonalDSDImplementaEonPlantoincludetargets,indicatorsandM&Eplan

•  IntegrateDSDinConEnuousQualityImprovement(CQI)iniEaEves•  ConEnuerolloutandscaleupofDSDimplementaEon

Next Steps

WhataretheprioriAesfor2019relatedtoDSDscale-up?•  StrengthentrackingofHCWstrainedonDSDatalllevelsusingTranSMARTDatabase

•  StrengthenuseofdatafordecisionmakingatR/CHMTandFacilitylevels•  StrengthendemandcreaEonandARTliteracyatcommunitylevel•  StrengthensupporEvesupervisionandmentoringonDSDatfacilitylevel

Acknowledgement

ASANTESANA አመሰግናለሁ