August 2014

Sustainable + Smart Solutions to HIV in Tanzania: Smart Children, Smart Partners, Smart Systems Pt 3

At the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), we know that we cannot eliminate pediatric AIDS without strong health systems and strong partnerships. In Tanzania, we support leadership at the all levels of the health system. National organizations are key contributors in building sustainable and effective health systems that will eliminate pediatric AIDS while improving the overall health of women, children, and families.

This blog post is part of a series on a recent country visit by Chip Lyons, EGPAF president and CEO. Follow @Chip_Lyons

On July 4, with the morning sun peeking over the horizon, I was traveling south along the B-6 highway from Shinyanga to Nzega, a subsistence farming and mining district within the Tabora region of Tanzania. First stop: Nzega District Council Hospital.

EGPAF partners with frontline health care workers in 7,000 health care sites in 14 countries, including Tanzania, and I was eager to meet some who had been recently trained and supported by our Linking Initiatives for the Elimination of Pediatric HIV (LIFE) program.

Funded by the U.S. Agency for International Development (USAID), LIFE aims to improve comprehensive HIV/AIDS services and strengthen local health systems to end pediatric HIV. Focused on strengthening the continuum of care for HIV-positive mothers and their babies, LIFE is built around three principles:

Increasing access to integrated, community-based HIV and reproductive health services.
Strengthening connections among health facilities so that clients can maintain treatment across a network of locations.
Transferring health system ownership to local governments and local institutions.

At the hospital, Tausi Kibonge, Nzega’s district reproductive and child health coordinator, explained to us that all pregnant women, their partners, and their children receive HIV care services under one roof at the care and treatment clinic in Nzega. This has dramatically increased client retention.

EGPAF recently added 24 new care and treatment centers (CTCs) to provide comprehensive health services throughout Tabora. EGPAF delivers medical equipment, trains health workers in comprehensive treatment, and provides technical assistance to the CTCs.

Most of these sites are only accessible by rough roads. “Placing comprehensive services closer to the community is vital to HIV-positive families who live far from district hospitals and lack transportation,” said Juma Songoro, M.D., EGPAF’s care and treatment manager in Tanzania.

Comprehensive care and treatment centers in remote locations is one way that we’re getting HIV services to the people who need them. Technology is another.

By early afternoon on July 4, I had arrived at the Mambali Dispensary, two hours from Nzega and miles from a paved road. Thadeus Musembi, EGPAF’s associate data management officer, was training health workers to use MOBY, a mobile phone application that guides nurses in prenatal and postnatal care, helping them identify risk factors; monitor lab results; and facilitate family, nutrition, and counseling for the prevention of mother-to-child transmission (PMTCT) of HIV.

With MOBY, health care workers can also register clients—automatically adding them to an electronic database. This makes it easier to track their treatments and follow up with them. In June alone, 189 clients were registered using the new phones. This technology will make the paper ledgers obsolete and ensure that clients do not fall through the cracks.

Smart technology means that sites like the Mambali Dispensary are no longer so remote.

As I left Mambali, heading north to Kenya, I looked out at the vast Tanzanian plain, and I was struck by the idea that not only are we working harder than ever to end pediatric AIDS—we are working smarter. In these previously isolated locations, we are strengthening the systems that provide life and health to countless families.

Through smart children, smart partners, and smart systems we are building the network to achieve an AIDS-free generation. And we will continue to engineer innovative solutions, until no child has AIDS.