Improving Antiretroviral Therapy Services in Tanzania Change Package

This document focuses on QI activities implemented to improve ART services in Tanzania during ASSIST from 2012 to 2017. At the project’s inception, performance gaps in the ART program were: low enrollment to HIV care, significant retention gaps due to morbidity and loss to follow up, PLHIVs on ART not keeping scheduled appointments, and delay in starting ART among HIV/TB co-infected patients. At the time, the MOHCDGEC had embarked on integrating ART and PMTCT services, switching from Option A to PMTCT Option B+, and the program was thus challenged with a sudden increase in demand for ART for pregnant women. Following QI training, ASSIST provided technical support to MOHCDGEC, R/CHMTs and IPs in conducting quarterly coaching and mentoring visits to QI teams of the participating health facilities.  During coaching and mentoring visits, teams were supported on verification of collected QI data and plot data on run charts. Best practices and learning from the demonstration sites were spread to new QI sites in the same or other regions.

This change package is based on the experience in four of the ASSIST-supported regions: Arusha (12 sites), Morogoro (15 sites), Dar es Salaam (10 sites), and Pwani (4 sites). The purpose of the change package is to provide guidance to other facilities that are seeking to improve ART services focused on the following:

  • Improving HIV testing and counseling (HTC) through provider initiated testing and counseling (PITC)
  • Improving Enrollment of new adult HIV+ clients to CTC from HTC Points
  • Improving appointment keeping for PLHIV (adult and pediatric) ART clients’ attendance
  • Reduce loss to follow up rates among clients attending CTC 
  • Improving TB diagnosis among HIV clients at CTC
  • Increasing CD4 testing for PLHIV attending CTC 
  • Improving retention to care for PLHIV
  • Improving CTC index client family HIV testing
  • Improving clients on ART lost to follow up

 

Countries: 
ASSIST publication: 
ASSIST publication
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