Tanzania and Zanzibar

Our Global Strategic Information (GSI) group provides training, mentoring and technical assistance to build capacity in epidemiologic surveillance, monitoring and evaluation, data science, and applied public health research among health ministries and local partners in Tanzania and Zanzibar. GSI’s partners in Tanzania and Zanzibar include the Centers for Disease Control and Prevention (CDC) – Tanzania; the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR); the Ministry of Health, Community Development, Gender, Elderly, and Children (MoHCDGEC); the National AIDS Control Programme (NACP); the Zanzibar Integrated HIV/TB Leprosy Programme (ZIHTLP); and the Tanzania Commission for AIDS (TACAIDS). GSI has operated in Tanzania since 2008 and has worked out of the the Global Programs Office in Tanzania since its launch in 2012.

Surveillance

Integrated Biological and Behavioral Surveillance Surveys

GSI provides technical assistance to the NACP and the ZIHTLP in planning and implementing integrated biological and behavioral surveillance surveys (IBBSS), which are designed to improve understanding of the disease burden and unique service needs among key populations at risk for HIV. GSI has supported four IBBSS studies in Tanzania from protocol development through report writing and dissemination. Results from these studies have been the basis for developing and improving programmatic interventions.

Drug Mapping Assessment

GSI provided technical assistance to the Drug Control Commission of Tanzania in planning, implementing and analyzing data for a mixed-method assessment to better understand the scope of drug use in Tanzania, estimate population size, and map the geographic distribution of people who use and inject drugs along the coast and in other regions of the country. Findings from this study were shared with key stakeholders and used to target and plan interventions for people who inject drugs.

Hot Spot Surveillance

GSI is working with the NACP to conduct a study to identify and characterize high-risk populations at areas of high transmission along major transit corridors in Tanzania using innovative surveillance techniques, such as starfish sampling. The study will assess HIV prevalence and incidence measures, linkage to HIV services, sexual networks, high-risk behaviors and other drivers of the epidemic.

Antenatal Care Surveillance

GSI and NACP developed the protocol for HIV sentinel surveillance among pregnant women attending antenatal care in Tanzania based on routine PMTCT data within a quality monitoring and strengthening framework.

Research & Evaluation

DREAMS Program Evaluation

GSI is conducting an evaluation of DREAMS, a global partnership between PEPFAR, Girl Effect, and the Bill & Melinda Gates Foundation to reduce new HIV infections in vulnerable adolescent girls and young women. This evaluation uses innovative technology platforms and mixed methods including a longitudinal cohort, time-location sampling (TLS), and qualitative interviews to assess intervention effect and reach, program acceptability within target communities and fidelity of implementation.

DREAMS Evaluation Report

Home-Based Care (HBC) Assessment

In conjunction with the National Alliance of State and Territorial AIDS (NASTAD), GSI conducted a qualitative assessment of home-based care services in three regions to inform the revision of the national home-based care guidelines.

Data Driven Science

Building Capacity in Data Triangulation and Use

GSI collaborates with TACAIDS to coordinate triangulation workshops with regional-, district- and facility-level HIV/AIDS providers. Workshops include training in Microsoft Excel, DHIS2 and mapping software to produce visual data displays; building local capacity to analyze and use sub-national data for program improvement; and developing HIV triangulation reports to assess and address challenges affecting service provision. GSI has coordinated 21 workshops covering 24 regions of Tanzania in an effort to promote a culture of data use and encourage evidence-based decision making.

GSI also worked with RTI and the National Malaria Control Programme on a data triangulation for malaria program data.

Data Quality Assessment

GSI supported the MoHCDGEC to develop and roll out national data-quality assessment guidelines. The guidelines use the data-quality applications within the national HMIS (DHIS2) and routinize the assessment of routinely reported data within the national health system. GSI also supported NACP to develop and roll out the National Data Quality Guidelines for Care and Treatment. GSI also will conduct a data-quality assessment of PEPFAR-required indicators for ART, HTC, and PMTCT to inform partner- and facility-level data quality improvement systems.

Strategic Planning and Mapping Workshops

GSI supported the NACP in the development of the M&E section of the third national Health Sector HIV Strategic Plan as well as ZIHTLP in developing the M&E section of the second Zanzibar Health Sector HIV Strategic Plan. These strategic plans set targets and guided national HIV/AIDS programming for five years. GSI also supported CDC in conducting HIV counseling and testing (HTC) strategic mapping workshops to inform strategic thinking around increasing yield in the HTC program.

Training and Education

Mentorship on Development, Submission, and Review Process for Scientific Manuscripts

GSI has conducted four scientific writing workshops to support the CDC, NACP and ZIHTLP staff to develop scientific manuscripts and guide participants through the manuscript submission and review process. GSI also supported the launch of the East African Journal of Applied Health Monitoring and Evaluation, which is housed at Mzumbe University’s Centre of Excellence in Health Monitoring and Evaluation. As one measure to ensure sustainability of the journal, GSI faculty mentor Mzumbe University faculty on scientific writing.

Advancing Human Resource Capacity for M&E through Post-graduate Education

GSI supported the launch of the Master of Science in Health Monitoring & Evaluation at Mzumbe University in 2013 and provided significant technical input to the curriculum’s development. The first cohort of students graduated in December 2015 and additional cohorts continue to enroll, thereby increasing the human resource capacity in M&E for the public sector.

In-Service Training for Program Improvement

GSI continues to strengthen the technical capacity of faculty and health practitioners in Tanzania through the development and facilitation of short courses and trainings on M&E, data analysis and management, data quality, Excel, mapping, DHIS2 and cohort analysis.

Tracking the 90-90-90 Cascade

Key Population Continuum of Care Cascades

GSI is supporting the NACP and implementing partners in the development of key population cascades, which will be used to improve program planning and service provision.

Case-Based Surveillance

GSI provided technical assistance to the NACP in conducting a SWOT assessment of the HIV/AIDS surveillance system and in determining the feasibility of implementing HIV case-based surveillance in Tanzania.

Health Informatics & Technology

DREAMS Auxiliary M&E System

GSI in collaboration with PEPFAR and the Tanzania Youth Alliance (TAYOA) developed an innovative mobile reporting system that captures data through both SMS and a smart phone app. This system allows DREAMS providers to link individual participants across community and facility interventions and multiple organizations to assess the layering of DREAMS services.

Mobile Surveys

GSI has used mobile surveys to assess the impact and relevance of the triangulation workshops with TACAIDS in order to improve future trainings. Mobile surveys are an innovative way to reach participants and assess the utility and long-term benefits of the training after participants have returned to their posts.

Program Monitoring and Quality Improvement

M&E Technical Support

GSI supports the development and implementation of M&E plans to help partners measure progress towards stated objectives and track program effectiveness. GSI has supported monitoring and evaluation of PEPFAR’s Gender-Based Violence Initiative as well as the development of the M&E sections of the Zanzibar Health Sector HIV Strategic Plan II and the mainland Health Sector HIV Strategic Plan III. GSI has also supported NACP through the revision of key population and patient monitoring tools.

Development and Rollout of National Guidelines

GSI has supported the development and rollout of national guidelines for HIV and AIDS data management and data quality assessment in Tanzania and the National Data Quality Assessment Guidelines for the MoHCDGEC.