Health System Strengthening

Laboratory Services Support: through the HIV care and treatment program, MDH provides technical assistance in laboratory services to the care and treatment site staff  to improve quality and strengthen laboratory systems for a wide range of laboratory operations including HIV diagnostics and monitoring. MDH collaborates with the Dar es Salaam City Council (Dar city) and Tanzania Ministry of Health and Social Welfare (MoHSW) to upgrade and expand laboratory services in Dar es Salaam, which involves efforts to upgrade existing laboratory infrastructure in hospital and clinics. MDH focuses on laboratory systems strengthening by addressing key issues facing laboratories in Dar es Salaam such as training, human resource shortages, inadequate equipment, lack of quality systems, and unreliable water and electrical supplies. Currently, MDH supports 12 laboratories that perform a wide range of tests in haematology, chemistry, infectious disease serology, microbiology, and molecular biology.

Furthermore, the MDH laboratory support team provides ongoing mentorship and technical assistance to the MoHSW and CDC Tanzania to prepare 3 laboratories for accreditation. A modern laboratory at Temeke Hospital is being developed that will be a centre of excellence for laboratory trainings and mentorship programs. The laboratory will serve as a malaria reference laboratory involved in training, evaluation of new malaria diagnostic technologies, and preparation of EQA materials for laboratories nationwide. Overall, the laboratory will be an important resource that will provide training in molecular biology based clinical diagnostic techniques, such as TB drug resistance, HIV drug resistance, DNA Polymerase Chain Reaction (PCR), and HIV viral load testing. The laboratory will play a significant role in the validation of low cost innovative laboratory testing approaches, such as Pima analyzer for CD4 count, Liat analyzer for viral load testing, and NWGHF for EID. This lab will also act as backup for Dar es Salaam region clinical laboratories including both public and private health facilities.

HIV/AIDS Strategic Information including Monitoring and Evaluation, and Support in Data Management: MDH collaborates with Harvard School of Public Health to strengthen the  national HIV/AIDS patient monitoring systems within all HIV Care and treatment clinics in Dar es Salaam through hands-on training programs for Program Site staff in data processing and management. In order to ensure efficient data collection and reporting, MDH staffs provide ongoing technical assistance at site level on the use of electronic data management. This technical assistance has successfully promoted effective generation and use of patient data for evidence-based programming and clinical decision-making at site level and even district level. The program continuously builds capacity of district health management teams in overall supervision and coordination of data collection and reporting to the Ministry of Health and social welfare and to various donors.

Pharmaceuticals and Supply Chain Management: MDH’s team of experienced pharmacists and logisticians provide support to Program Sites with respect to proper inventory management of drugs and related supplies at all levels. These services include support and quality strengthening of pharmacy services, as well as supply chain and logistics management at Program Site and district levels. MDH works to fill any gaps during national stock outs from the central government medical store by procuring limited quantities of essential non-ARV drugs and commodities including reagents and supplying them to the sites as needed.

Infrastructure Improvement: MDH works with local governments to identify infrastructure improvement needs in order to improve the quality of PMTCT and HIV Care and Treatment services. MDH undertakes renovation improvements and recommends construction which has been carried out by CDC Tanzania. The recently constructed Mnazi Mmoja Center of Excellence for Advance HIV Management and Training is one of the projects which have been completed with financial assistance from the U.S. government’s PEPFAR fund through CDC Tanzania. There are currently three care and treatment clinics under construction, which will be upgraded from drug pick up sites to ART initiating sites, providing comprehensive care and treatment services to PLWHA.

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