1. HIV-RH INTEGRATION IN TANZANIA
By: Dr Mukome Nyamhagatta, SIO-MOH
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2. Background Tanzania is located in Eastern part of Africa
Area: 945,855 Square km
Population: Projected at 48,775, 567
Total Fertility rate: 5.2 per woman (NBS, 2015)
Teenager Pregnancy: 27% (7%-45%) (NBS, 2015)
Contraceptive Prevalence Rate: 38% (Modern- 32%, Traditional-6%)
Unmet need for FP: 22%
HIV Prevalence: 5.1% (NBS, 2012), Youth: 2% (at age23-24; 6.6%-Females, 2.8%- males) (THMIS, )
HIV services are integrated into RH Services and vice versa

3. Background….. Policy documents available insist on integration
PMTCT Guideline and eMTCT Strategic Plan
Health Sector HIV/AIDS Strategic Plan
National Multi-sectoral HIV/AIDS Strategic Framework
Road Map to Accelerate Reduction of Maternal and Child Mortality (One Plan)
Health Sector Strategic Plan
Levels of integration: Community, Primary, Secondary & Tertiary Health Facilities
Areas of integration
Community-Information on FP, HIV Prevention, HTC , ART adherence, VMMC, STIs/RTIs, CeCaP, SGBV, TB and Psychosocial support
Facility- Provide services including FP, FANC, PMTCT, cPAC, PNC, HEID, PITC, SGBV Screening, STI Screening, Reproductive Organ Ca and Psychosocial support

4. KEY FINDINGS

5. Increased Health Facility Coverage of PMTCT/HEID Services
PMTCT coverage
By 2014, 91%(n= 5361) of RCH Clinics were providing PMTCT services. About 92% (n=4,943) of these were providing– Life Long Antiretroviral therapy for Pregnant and Lactation women (LLAPLa) and 76% (n= 4058) were providing HIV Early Diagnosis (HEID) services

6. Increased HIV Testing uptake among Pregnant and Lactating women
Number of pregnant women attending ANC, tested for HIV, received post-test counselling, and percent tested for HIV, , Tanzania, PMTCT programme data

7. Increased ARV Uptake among Pregnant and Lactating women
Number of HIV-infected pregnant women already on ART, number newly tested positive, number initiated on ART, percent received ARV/ART and percent newly initiated on ART, , Tanzania

8. Decreased HIV Positivity among tested Children

9. Lessons learned
Integration encourage clients of one service to take up the other service within the facility, community-based setting or through a facilitated referral
RH-HIV Integration resulted into increased PMTCT Service coverage and utilization

10. MAJOR CHALLENGES

11. Low retention of clients on LLAPLa into care
Retention in PMTCT care, 3,6, and 12 months; Overall, B-plus, and Already on ART

12. Other major challenges…..
Low coverage of Community Based PMTCT Services
Interrupted supply of Rapid HIV Test kits in some regions and other supplies
Result into missed opportunities of HTC
Low identification and inadequate follow up of HEI
Low coverage of Pediatric ART

13. Plans for country scale-up
Roll out of Mother-Baby Cohort Monitoring System
Train more CHWs using integrated RMNCAH Community Service Package
Create community awareness using mass media and other IEC materials
Integrate Pediatric ART into RCH clinics
Scale up Viral Load Testing

14. THANK YOU