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Dr. Criston Nkya District Medical Officer Rombo District, Kilimanjaro, Tanzania

Rombo District Experience. 8 th Annual CDC/HRSA Track 1.0 Partners Meeting. Dr. Criston Nkya District Medical Officer Rombo District, Kilimanjaro, Tanzania. Header. Bullet 1 Bullet 2 Bullet 3. Outline. Background District Approach Achievements Strengths and challenges Way forward.

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Dr. Criston Nkya District Medical Officer Rombo District, Kilimanjaro, Tanzania

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  1. Rombo District Experience • 8th Annual CDC/HRSATrack 1.0 Partners Meeting Dr. Criston Nkya District Medical Officer Rombo District, Kilimanjaro, Tanzania

  2. Header • Bullet 1 • Bullet 2 • Bullet 3

  3. Outline • Background • District Approach • Achievements • Strengths and challenges • Way forward

  4. Background • Rombo 1 out of 7 districts forming Kilimanjaro region • Covering about 1,442 km² of mainly mountainous area • Population 305,289; mainly subsistence farmers • Growth rate 2.8% • 43 health facilities: • 2 Hospitals (FB; 1 acts as designated DH) • 4 Health Centres (all GOT) • 37 Dispensaries (21 GOT; 8 FB; 8 private) • HIV prevalence 1.9%* - 2.9%** • 6 Health Facilities offer CT services * Tanzania HMIS 2007-08, Kilimanjaro region ** Jan-June 2010 EGPAF PMTCT program data

  5. Background (2) • First USG support (ICAP) started in Jan. 2004 • Facility approach to the designated DH • After regionalization, EGPAF support from Oct. 2006 onwards • District Approach • Sub-grants for PMTCT (USAID) and C&T (CDC) • District-wide support including LLHF • C&T (CDC) support includes • Ped HIV, TB/HIV, LAB, EID, SCM, CL, TCB, M&E, QI

  6. District Approach • Sub-grants with mainly District Authorities: Council Health Management Teams (CHMT) • Annual contract renewal workshops • Workplan and budget development • U.S. Govt. rules and regulations • District Executive Director signs the sub-grant • DMO oversees program • In line with MOHSW policies of decentralization • Builds capacity of existing local systems and stakeholders • Increases ownership and sustainability • Allows rapid expansion of high quality patient services up to LLHF

  7. Achievements • Established 6 CTC centres (and 32 PMTCT centres) • Renovated 2 CTC facilities • Procured 1 vehicle and 2 motorcycles • Improved specimen transportation (CD4 / DBS PCR) • Procured FACS Count, Haematology and Biochemistry machines and their reagents • Increased availability of drugs for opportunistic infections and test kits • District-owned and -organized trainings • Community sensitization on HIV and related programs

  8. Achievements (2) • Care • Cumulative 3,187 patients; 472 children (15%) • Current 1,927 patients; 309 children (16%) • ART • Cumulative 1,618 patients; 201 children (12%) • Current 1,172 patients; 165 children (14%) • HCW’s trained for C&T (CDC funded) • 21 HIV and ART (including pediatrics) • 3 District Mentors • 28 IMAI • 42 HCW’s in EID, plus 3 TOT’s • 34 Lay Counsellors

  9. Achievements (3)

  10. Strengths • Involvement and capacity building of all district managers • Training of trainers and ownership of trainings at District Level • Improves regular supportive supervision and on-site mentorship • Strengthens capacity to monitor both U.S. Govt. and MOHSW funds • Strengthens logistical and SCM capacity • Contributes to sustainable health systems strengthening

  11. Challenges • Nation-wide challenges - Human resources shortages and high turn-over - Inadequate physical infrastructures - Lack of equipment • Delays in program implementation due to bureaucracy at District level • But procedures are necessary to follow rules and regulations • Challenges in the National SCM systems

  12. Way Forward • Further strengthening of CHMTs • Financial and managerial capacity • Technical expertise • Through • Initiatives to increase the workforce • On the job and classroom training of DMO, District AIDS Control Coordinators, Health Care Providers, and other key stakeholders

  13. Asantenisana!

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