MDH utilizes its expertise in planning and implementing effective program interventions focusing on prevention and quality clinical services to address various public health problems including HIV/AIDS and other sexually transmitted infections (STIs), Tuberculosis (TB), and Malaria, maternal health, child health, malnutrition etc. With support from various donors, MDH implements the following Programs in Tanzania:

HIV Prevention, Care and Treatment Program: this is a large scale HIV/AIDS Prevention, Care and Treatment project which is funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the Harvard School of Public Health (HSPH) to support PMTCT and Care and treatment services in all public and private health facilities accredited by Tanzania Ministry of Health and Social welfare in Dar es Salaam region. MDH’s dedicated staff work in close partnership with local governments and other partner organizations, to halt the spread of the virus, especially among children, and to ensure those living with HIV receive quality comprehensive care and treatment needed to live long, healthy lives. Through its expertise and commitment, MDH has taken the lead in the successful implementation of HIV/AIDS prevention, care and treatment in Dar es Salaam with focus on the following areas:

Comprehensive HIV Care and treatment services for Adults and Children Living with HIV: The program focuses on provision of quality HIV care and antiretroviral therapy (ART) to both adults and children, as well as the treatment of opportunistic infections. MDH ensures that the quality of services provided are comprehensive and meet the minimum required standards by the Ministry of Health and Social Welfare (MoHSW).
The HIV care and support services include nutrition assessment and counselling whereby the malnourished patients are refered to receive therapeutic food.

HIV prevention services is also provided for all HIV infected individuals as per national multi-sectorial HIV prevention strategies of the Government of Tanzania (GoT). These services aim to reduce the risk of PLHIV’s further transmission of HIV infection to others and to help PLHIV avoid re-infection with new HIV strains. Prevention services for PLHIV include the provision of family planning, screening for opportunistic and STI infections, promotion of risk reduction behaviours, including the consistent and correct use of condoms, counselling on adherence to ART, scaling up of Provider Initiated Counselling and Testing (PITC) services to partners and children, along with the promotion of other cross-cutting issues, such as malaria and water borne disease control.

The MDH clinical services support team conducts hands-on technical assistance and mentorship to health facility staff.  In addition to this, the program organises and coordinates various trainings for health providers to improve their knowledge and skills.  The MDH team assists Program Sites to implement Quality improvement Initiatives (QI). Through this initiative, quality of care is continually assessed using selected quality of care indicators whereby site clinical teams use methodologies like PDSA cycle,  hindering desired quality various methodologies, including, for example, patient chart reviews, patient satisfaction surveys, time-flow assessments, on-site structured observations, and targeted data analysis from the clinical database.Currently, the HIV care and treatment services are implemented within 50 health facilities in Dar es Salaam region, serving a population of over 4 million Tanzanians. Since the initiation of services, in 2004, the program has so far enrolled over 100,000 people living with HIV among which over 70,000 have been initiated anti Retroviral therapy.

Prevention of Mother to Child Transmission (PMTCT) and HIV Early Infant Diagnosis (HEID) services: The  program supports comprehensive PMTCT services at 189 Reproductive and Child Health Clinics (RCH) in Dar es Salaam. The services include HIV counselling and testing to pregnant mothers and partners and provision of effective ARV prophylaxis to HIV positive mothers and infants and HIV early infant diagnosis (HEID) using DNA PCR technology to exposed infants. Effective systems have been designed to follow up mother and child pair post delivery to ensure all exposed infants complete their ARV prophylaxis dose and get HIV confirmatory test when they stop breast feeding.

The HIV Early Infant Diagnosis (HEID) services, covering more than 75% of all reproductive and child health clinics in the region with the primary goal of providing universal access for PMTCT and HEID in Dar es Salaam. Among the notable achievements of the program is the percentage increase of HIV positive women receiving the More Efficacious Combined Regimen (MECR) reaching 92%. The program is also geared towards reaching all women who need ART for their own health (40% of HIV positive pregnant women are eligible for ART) to be initiated on lifelong Highly Active Antiretroviral drugs (HAART) by supporting ART integration within RCH clinics.

TB/HIV Collaborative Services: Aiming to reduce the burden of TB among PLWHA, MDH supports implementation ofTB/HIV activities in line with the 3 objectives of the World Health Organization for TB/HIV collaboration. Using the national algorithm, the program promotes TB screening to all patients attending HIV care services. Currently more than 90% of patients receiving HIV care within the reported facilities are being screened for TB symptoms, with 90% of patients confirmed with TB to be started on TB treatment. In order to reduce the burden of HIV among TB infected individuals, MDH has initiated the provision of ART to all eligible patients with TB/HIV co-infections at 17 TB clinics in Dar es Salaam.

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