1. Introduction to the NMSF 2008-2012

2. The National Multi-Sectoral Strategic Framework (NMSF) on HIV&AIDS  Translates the National Policy of HIV&AIDS.  Spells out the basic approaches and principles which guide the response  Identifies goals, objectives and strategies for the period 2003 – 2007 and 2008 – 2012 for the first and second phase.

3. … The NMSF  Guides all future programmes and interventions by the different stakeholders.  Calls for a Monitoring & Evaluation System to measure progress towards the goals, coordination, and financial frameworks of the National Response.

4. The NMSF had Nine Goals reached by 2007 and have Four Themes and Four additional Goals to be reached by 2012  The goals are in line with the international agreements including: Millennium Development Goals (2000) Declaration of Commitment of the United Nations General Assembly Special Session on HIV&AIDS (UNGASS) of June 2001.  The goals address: Prevention, Care and Support, and Mitigation of Socio –Economic Impact.

5.  GOAL 1: Reduce the spread of HIV in the country.  GOAL 2: Reduce HIV transmission to infants.  GOAL 3: Political & government leaders consistently give high visibility to HIV&AIDS in their proceedings and public appearances. Nine Goals in NMSF Phase I:

6.  GOAL 4: Political leaders, public & private programmes, projects & interventions address stigma & discrimination & take human rights of persons living with HIV&AIDS into account.  GOAL 5: HIV&AIDS concerns are fully integrated & prioritised in the National Poverty Reduction Strategy & Tanzania Assistance Strategy.

7.  GOAL 6: Reduce the prevalence of STIs in the population.  GOAL 7: Increase the knowledge of HIV transmission in the population.  GOAL 8: Increase the number of Persons living with HIV&AIDS who have access to a continuum of Care & Support from Home / Community to Hospital levels.  GOAL 9: Reduce the adverse effects of HIV and AIDS on orphans.

8. Challenges for Phase I  Inadequate middle and lower level political commitment and accountability for the HIV response;  Weak and insufficient HIV programmes by the MDAs especially at regional, district and community outreach levels;  Overburdened national coordination structure (TACAIDS);  Insufficient involvement of CSOs and PLHIV especially at district and community levels

9. Challenges cont.  Limited capacity in LGA to develop and implement comprehensive HIV and AIDS plans  Stigma and discrimination remained high in the society  Prevention efforts did not sufficiently address sexual and reproductive health matters and often lacked continuity;  Gender inequalities were not sufficiently understood and comprehensively addressed;

10. Challenges cont.  Correct and consistent condom use remained problematic, and availability was limited in most rural communities;  Coverage of prevention efforts in rural areas was insufficient;  Access to ART remained largely concentrated in urban centers

11. The NMSF themes and goals to be reached by 2012 (Phase II) Themes  Enabling environment  Prevention  Care and treatment  Impact mitigation

12. Four Additional Goals  Monitoring and evaluation  Organisations and Institutional Arrangements for the Implementation of the National Response at Central, Regional and LGA Levels  Financial, Human and Technical Resource Framework of the National Response  Operationalisation and Implementation of the Strategic Framework

13. In response to the NMSF call for a Monitoring and Evaluation system:  TACAIDS developed TOMSHA - the Tanzania Output Monitoring System for HIV&AIDS  TOMSHA: Describes the envisaged community response to HIV&AIDS, including framework & the overall ‘package’ for effective community-based HIV&AIDS interventions Is guided by the principles and goals of the NMSF Is a multisectoral routine output monitoring system Collects & reports routine data to measure the non- medical output-level indicators in the national set of HIV indicators, i.e. all routine programme monitoring data that are not collected by MoHSW/NACP.

14. You will be learning more about TOMSHA in this Training Course