Improving Pediatric Antiretroviral Therapy in Tanzania

The USAID Applying Science to Strengthen and Improve Systems (ASSIST) project worked with the Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC), implementing partners (IPs), Regional Health Management Teams (RHMT), Council Health Management Teams (CHMT) and Health Care Workers (HCW) in applying improvement methods to improve the quality of HIV care services. In an attempt to raise the tempo and quality of efforts directed towards accelerating access to ART to children, ASSIST Tanzania, along with the MOHCDGEC, PEPFAR, and IPs, organized the “1st National Forum on Accelerating Pediatric HIV and AIDS Services” and the “2nd National Pediatric ART Quality Improvement Learning Platform” which took place in June 2015 and November 2016 respectively in Dar es Salaam, Tanzania.
The objective of the forums was to bring together pediatric HIV and AIDS services stakeholders from inside and outside Tanzania to share knowledge, experiences, lessons learned, and best practices aiming at improving quality of services provided to pediatric HIV and AIDS clients. The objectives were specifically categorized into: increasing access to HIV testing and counseling (HTC) including early infant diagnosis; linkage to care and treatment centers (CTC); initiation of ARVs; and adherence to ARV and retention to care. The first forum focused on presentations from the four demonstration regions of Njombe, Morogoro, Tabora, and Shinyanga. Best practices were shared for other regions to pick up improvement thus spreading coverage to accelerate ART for children below 15 years. The second forum which was baptized as the National Quality Improvement Learning Platform with a similar rage of specific focus as the first forum.

Following the two learning platforms, ASSIST prepared this guidance document to provide a wider coverage of outcomes and learning of improving pediatric ART services in the country and from neighborhoods. The changes were compiled from presentations made during the two platforms. The document provides a summary of learnings from Tanzania, Lesotho, and Uganda to be used as guidance by teams that intend to improve pediatric HIV and AIDS services. The platform objectives  included:
  • Increase access to HIV testing for children under 15 years at pediatric service delivery point
  • Improve access to HIV testing through PITC using rapid HIV antibody testing at RCH, inpatient and outpatient departments (IPD and OPD) and CTC HIV testing campaigns for children below 15 years
  • Increase HIV testing, counseling, and enrollment to care and treatment through facility-based testing campaigns for children below 15 years
  • Facility/CTC based pediatric HIV testing campaigns as a strategy to improve testing and enrollment into care and treatment
  • Increase HIV case identification, enrollment to care and initiation of ART
  • Integrating NACS Programme into pediatric HIV treatment
  • Improving access to HIV services for most vulnerable children
The changes are organized by platform objective and include the challenge being addressed, system level of the challenge, and suggested changes to address the challenge.
ASSIST publication: 
ASSIST publication
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