The three years program has recruited 99 Fellows who are serving in the 33 hard to reach districts of rural Tanzania in strengthening HIV/AIDS prevention, care and treatment. Each district received a team of three(3) Fellows of different health cadres namely, Medical Officers, Assistant Medical Officer, Nurses, Laboratory Technologist, Laboratory Technicians, Pharmacists and Pharmaceutical Technicians. The Fellows signed a three year contract with the Foundation and the respective Local Government Authorities.
Prior to the deployment of the Fellows into the districts, Fellows, District and Regional officials attended an orientation programme which, among other things, resulted into building a team spirit thus enhancing provision of quality and reliable health services to clients.
District Selection Criteria:
- High HIV prevalence rates
- Severe shortage of human resources or expertise in HIV/AIDS care and treatment,
- Difficult geographical accessibility and distant from regional hospital
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Fellows Retention package (Two programme approach) |
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Monetary |
Non-monetary |
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Incentives to the beneficiary regions and districts:
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RESULTS:
Fellows have become key technical officers collaborating with and assisting the District health team in strengthening comprehensively the HIV/AIDS prevention, care and treatment.
Quality improvement of HIV/AIDS Care and treatment clinics in terms of:
- Increasing number of clinic days and operating hours
- Increasing by two folds the number of HIV/AIDS clients enrolled in CTC and using Antiretroviral medication
- Improving the HIV/AIDS data collection and analysis at district level.
For Example, A 15 months HIV/AIDS performance in 10 districts supported by first batch 30 Mkapa Fellows:The above diagram shows:
>>five fold increase of clients that are enrolled to CTC ( from 1085 to 5112) in 10 districts
>>three fold increase of clients who have started ART ( from 664 to 2897)Two Fellows have been appointed as Medical Officers In-charge and Ag. MOi (Newala and Kilolo)
The internet connection to 19 districts is 100% completed leading to respective health department now being connected with internet VSAT services.
Fellows have supported the districts to initiate mobile HIV/AIDS counseling, testing, care and treatment services at lower health facilities resulting into reaching more needy clients.Fellows are well integrated in district health systems resulting into:
- Provision of clinical care in general health systems such as maternal and child health, medical and surgical services.
- Further integration of comprehensive HIV/AIDS plans into annual district health plans.
Some of the Fellows acting as District Pharmacists and Laboratory Coordinators.
Through the Fellows Programme and its success, the Ministry of Health and Social Welfare and Development Partners have strengthened its collaboration with the Foundation. As a result the Foundation is currently leading in providing technical and management support to the Emergency Hiring Project (EHP) of the Ministry of Health and Social Welfare, Tanzania Mainland.
CHALLENGES:
Programme encounters existing institutional and programmatic challenges which include:
weak health system functioning for instance:
- shortage of diagnostic equipment and supplies such as CD 4 machines, chemistry laboratory tests which are crucial for HIV/AIDS clients clinical monitoring and evaluation.
- limited space or rooms to provide quality counseling, care and treatment.
- Weak transport system due to poor roads infrastructure and shortage of vehicles required for supportive supervision and outreach/mobile clinics at district level.
To address the challenges, the Foundation is strategically collaborating with the respective District authorities, Ministry of Health and Social Welfare, Zanzibar AIDS Commission(ZAC), Tanzania AIDS Commission (TACAIDS) and other Partners in synergizing and mobilizing support to strengthen HIV/AIDS services within the districts. The Foundation efforts in mobilisation of resources from development partners have resulted into the procurement of 5 vehicles for Micheweni, Kilolo, Mpanda, Kilindi and Simanjiro District Councils. The vehicles were procured through the financial support from Clinton HIV/AIDS Foundation (Kilolo), Norwegian Government (Micheweni, Simanjiro and Kilindi) and Abbott Fund (Mpanda).
WHAT NEXT:
The experience of Mkapa Fellows Programme is being documented to provide evidence and inform the policy makers and district officials on strategies of addressing Human Resource for Health and HIV/AIDS services.
CALL FOR ACTION:
It is recognized that the Government through the Ministry of Health and Social Welfare is currently scaling up HIV/AIDS care and treatment services to lower level health facilities. The Fellows deployed to the districts should be viewed as an added asset to the district health teams, in ensuring that the community are reached with quality comprehensive HIV/AIDS services and information. Respective district councils should therefore provide enabling working environment for Fellows to stay.
The Local Government Authorities currently benefiting from Mkapa Fellows Programme should consider mainstreaming the Fellows in the normal Government recruitment process at the end of the programme. This entails budgeting for the Fellows using the existing salary and benefit packages of public/civil service personnel.
