Amref Health Africa Tanzania Hands Over Kits and Bicycles in Fight Against TB and Provision of Reproductive Health Services

Amref Health Africa Tanzania through its USAID Afya Shirikishi project, funded by the United States Agency for International Development (USAID) Tanzania, has donated 710 bicycles and 859 sputum collection and transportation boxes/kits forCommunity Health Workers (CHWs) in Dar es Salaam, Geita, Katavi, Kigoma, Mwanza, Pwani, Rukwa, and Songwe.

The USAID Afya Shirikishi project aims to increase access to and improve Tuberculosis (TB) services and reproductive health services at the community level. The project focus  at reducing the transmission and progression of tuberculosis through improved community-based service delivery; strengthen access to and use of quality community family planning  services; improve the transparency, feedback, and access to data related to TB programming; strengthen the national TB policy and guidelines; and increase leadership and political support for TB as a public priority.

Dubbed “USAID Afya Shirikishi”, the five-year project is funded by USAID in Tanzania and is being implemented by Amref Health Africa in Tanzania in partnership with Tanzania Communication and Development Center(TCDC);Mwitikio wa Kuthibiti Kifua Kikuu na Ukimwi Tanzania (MKUTA) na Service Health and Development for People Living Positively with HIV/AIDS (SHDEPHA+ Kahama), under the guidance of the Ministry of Health, Community Development, Gender, Elderly and Children, Zanzibar Ministry of Health and President’s Office Regions Authority and Local Government, and Ministry of Education (MOEST). Amref Health Africa Tanzania will continue to adhere to the guidelines issued by the Ministry to ensure compliance with national health policies and guidelines.

The event was officiated by Deputy Permanent Secretary in the President’s Office – Regional Administration and Local Government, Dr. Grace Magembe. The event was also attended by a number of stakeholders, including Tanzania’s MOHCDGEC government officials, Regional Medical Officers, Regional TB and Leprosy Control Coordinators, Regional Reproductive Health Coordinators,  Regional Community Health Coordinators, Community Health Workers representative, and other key stakeholders across the nine project implementation regions, USAID representative, Amref Health Africa Staff, civil society organizations, and implementing partners.

Speaking at the event, Dr. Grace Magembe acknowledged Amref by saying the project is a good step in addressing the fight against TB in the country. “Through the Ministry of Health, we are very grateful for these bicycles and sample collection and transportation boxes that will be used in all project regional in the country,” said Dr. Grace Magembe.

In his remarks the USAID Health Office Director  – Ananthy Thambinayagam  said “Through this initiative, The United States Government, will continue to support and work with Tanzania Government, Development partners, NGO’s, Local CSOs and other stakeholders to jointly work to improve health system of the of Tanzania.

Speaking at the handover ceremony held in Dar es Salaam, Dr. Florence Temu, Country Director of Amref Health Africa Tanzania’s said, the donations will enable the CHWs to increase access to high quality, comprehensive and integrated health services in their communities by improving services provision of TB and reproductive health services. “It will reduce significantly the time spent in walking long distances and carrying the sputum, handling containers but also ensuring that the same reaches the collection center in a timely manner,” she said, before adding: “This will eventually strengthen the community health program, leading to reduction of TB progression and increased provision of reproductive health services.” Said Dr. Florence Temu.

The project, among other things, aims to address priority gaps in community-based case finding for TB in the nine regions of Mainland Tanzania and Unguja Kaskazini and Mjini Magharibi in Zanzibar by 2025. The project will also address unmet Family Planning (FP) needs through community interventions in four regions of Katavi, Kigoma, Rukwa, and Songwe.

Project Background:

Tuberculosis (TB)

The 2020 National Tuberculosis and Leprosy Program (NTLP) external Joint end-term review (NSP 2016-2020) found that there is an enabling environment for Tanzania to scale up the community, advocacy, and remove gender barriers towards increasing TB notification. In 2014, TB notification contribution from the community was 14%, whereby a target was set to reach 19% by 2020. However, the achievement was at 26 percent due to a high level of commitment to addressing community and patient barriers to access highly motivated ex-TB patients’ groups and community leaders, and regular and standardized enablers for ex-TB patients’ groups.

Tanzania Demographic Health survey of 2015/16 shows the use of modern contraceptive methods for married women to be at 32% while the national target for modern Contraceptive prevalence (mCPR) is set at 47% by 2023. The unmet need for Family planning has remained between 22% and 24% for almost 20 years now.

Amref Health Africa in Tanzania through USAID Afya Shirikishi activity is collaborating with Tanzania Government and other stakeholders to employ innovative approaches to address priority gaps in TB case finding in 9 regions and address the unmet needs for FP at the community in the four regions with the highest need:

• Work with MoHCDGEC, MoH_Zanzibar, PORALG & Ministry of Education (MOEST) to address collaboratively the TB and FP Community interventions and in collaboration with the USAID Uhuru facility partner in Four regions
  • Use community structures [CHWs/Ex-TB Volunteers, COWs, Local leaders (Influential, Religious leaders, etc.), Traditional healers, ADDO, etc.] and Social Behavioral Communication strategies to address community solutions for improved TB and FP services
  • Seek opportunities to partner, connect and collaborate across sectors for sustainability and impact of planned outcomes and results

Community activities implementation

• In this project, the USAID Afya Shirikishi project focuses on working with the community structures to deliver TB and Family planning services. The project works with the existing community platforms which are instrumental in reaching the families and individuals in their locality on health issues.  Amref works with Community health workers, volunteers, accredited drug dispensers (ADDO), Traditional healers), bodaboda risers, local influential leaders, and local civil society organizations.

• Community health workers work in a hard to reach areas that are featured with long distances and poor infrastructures in providing TB and FP services to their community. The community health workers need some enablers like Bicycles to help reach as many communities as possible as well as other enablers like raincoats, boots, sputum handling containers, and backpacks for tools.

• USAID Afya Shirikishi project in Year One has engaged a total of 735 community health workers who work directly with the community in active TB case finding, TB contact investigation, strengthening community referrals to the health facilities, mobilizing and creating awareness, and demand creation for FP services from the communities.

• Through this initiative, The United States Government has supported the donation of 710 bicycles through the United States Agency for International Development and its Afya Shirikishi activity in Dar es Salaam, Geita, Katavi, Kigoma, Mwanza, Pwani, Rukwa, and Songwe.

• The distribution of the community health workers are as follows

Distribution list for sputum collection boxes/kits

SN	Regional	Sputum collection boxes for CHWs	Sputum Collection boxes for Bodaboda riders	Total per region
1	Geita	66	14	80
2	Mwanza	99	19	118
3	Pwani	115	18	133
4	DSM	158	14	172
5	Katavi	63	11	74
6	Kigoma	98	18	116
7	Rukwa	49	9	58
8	Songwe	62	11	73
9	Zanzibar	25	0	25
10	For replacement		10	10
	TOTAL	735	124	859

Distribution list for Bicycles

SN	Regional	Bicycles
1	Geita	66
2	Mwanza	99
3	Pwani	115
4	DSM	158
5	Katavi	63
6	Kigoma	98
7	Rukwa	49
8	Songwe	62
9	Zanzibar	Will receive 1 Motor cycle instead of Bicycles based on their needs
	TOTAL Bicycles	710

About Amref Health Africa

With the focus to reach and works with the most vulnerable African communities to achieve lasting health change, Amref Health Africa has been active in Tanzania since 1957 and in 1987 the country office was established in Dar es Salaam. Since then, Amref Health Africa Tanzania has been among the major supporters of the Government of Tanzania’s health care initiatives particularly the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) and President Office Region Authority and Local Government. Amref has supported the development of a number of national health policies, strategies, and guidelines for equitable health service delivery.

Currently, Amref Health Africa Tanzania has more than 16 active projects across different regions in Tanzania.  Amref has projects with a national outlook which are community-based ones such as e-learning programs and laboratory strengthening projects that are implemented across the regions including Zanzibar.

 Amref’s projects are categorized into four main thematic areas: Reproductive, Maternal, Newborn Child and Adolescent Health (RMNCAH); Disease Control and Prevention (DCP) program which comprises of HIV and AIDS, Tuberculosis (TB), Laboratory Services, Obstetric Fistula, and Malaria interventions; Water, Sanitation and Hygiene (WASH) and Capacity Training Program.

 Amref Health Africa Tanzania’s projects respond to national health priorities and sustainable development goals (SDGs) in addressing the needs of needy communities mostly women and children. We work to increase the effectiveness, efficiency, and sustainability of health services by strengthening health systems, improving access to services, advocating stronger community health systems, and influencing health policies. With the 2018-2022 New strategy, Amref Health Africa in Tanzania remains a strong supporter of the Universal Health Coverage Agenda.