1. Monitoring Transition of Harvard Support to Management and Development for Health (MDH), Tanzania Mary Mwanyika-Sando, MD 8 th Annual CDC/HRSA Track 1.0 HIV Care and Treatment Program Meeting August 12, 2010, Maputo, Mozambique

2. Outline Monitoring of organizational transition Monitoring of service delivery

3. The Transition Harvard University transitioning technical and financial support to the new local organization (MDH Ltd.) Transition: gradual, smooth and seamless

4. Organizational Transition Detailed transition plans Set up of MDH –Organizational concept paper –Registration –TIN Number –Organizational structure –Staffing: Management and operational staff –Name, logos, etc. Governance –Board of governors: composition and change over time Bank accounts Host government concurrence and buy in USG consultations Harvard headquarters support

5. Staffing The required recruitment – senior management and operational staff Transfer of staff – to the government payroll Capacity building: technical, administrative and finance (GoT and USG regulations)

6. The Process! Overall Transition Coordinator in Boston Transition team – Boston and Dar Activities (to assess progress of implementation of the Transition Plan): –Weekly conference calls of the Transition Team –Regular in-person meetings –Joint retreats –Site visits and TA from Boston –Regular consultations with CDC-Tz

7. Monitoring of Service Delivery

8. What do We Monitor? Before, during and after transition –Patient enrollment –Delivery of care, treatment and patient retention –Continuous assessment and improvement of quality of care

9. Patient Enrollment Utilize existing reporting systems –Monthly –Quarterly –Semi-annual –Annual reports Assess trends By district, by sites

10. Care, Treatment and Retention District Coordinators –Liaise with municipal health management teams: Administrative, Logistics and supplies District Clinical Monitors –continue providing technical support to Care and Treatment Clinics Counsellor-patient pairs Active patient tracking integrated with community based health care system

11. Quality Assessment and Improvement Initiated in 2006 Strategies –Core clinical quality care indicators –Patient satisfaction surveys –Time flow assessments –Patient chart reviews –Health care worker surveys Build capacity of the district and site staff on integrating quality improvement as routine function

12. Quality Assessment and Improvement (Continued) District/sites QI teams established and involved in: –development of indicators –performance measurement tools –quality improvement plan Regular data collection, processing and dissemination plan

13. Acknowledgements USG – HRSA, CDC Tanzania MOH & SW Harvard School of Public Health Dar City Regional Medical Office Municipal Medical Offices of Health Muhimbili University of Health and Allied Sciences MDH management and staff Management and staff of all supported sites

14. Thanks for your Attention!