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

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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. - PowerPoint PPT Presentation

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Rombo District Experience8th Annual CDC/HRSATrack 1.0 Partners MeetingDr. Criston NkyaDistrict Medical OfficerRombo District, Kilimanjaro, TanzaniaHeaderBullet 1Bullet 2Bullet 3

OutlineBackgroundDistrict ApproachAchievementsStrengths and challengesWay forwardBackgroundRombo 1 out of 7 districts forming Kilimanjaro regionCovering about 1,442 km of mainly mountainous area Population 305,289; mainly subsistence farmersGrowth 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 Background (2)First USG support (ICAP) started in Jan. 2004Facility approach to the designated DHAfter regionalization, EGPAF support from Oct. 2006 onwardsDistrict ApproachSub-grants for PMTCT (USAID) and C&T (CDC)District-wide support including LLHFC&T (CDC) support includesPed HIV, TB/HIV, LAB, EID, SCM, CL, TCB, M&E, QIDistrict ApproachSub-grants with mainly District Authorities: Council Health Management Teams (CHMT)Annual contract renewal workshopsWorkplan and budget developmentU.S. Govt. rules and regulationsDistrict Executive Director signs the sub-grantDMO oversees programIn line with MOHSW policies of decentralizationBuilds capacity of existing local systems and stakeholdersIncreases ownership and sustainabilityAllows rapid expansion of high quality patient services up to LLHFAchievementsEstablished 6 CTC centres (and 32 PMTCT centres)Renovated 2 CTC facilitiesProcured 1 vehicle and 2 motorcyclesImproved specimen transportation (CD4 / DBS PCR)Procured FACS Count, Haematology and Biochemistry machines and their reagents Increased availability of drugs for opportunistic infections and test kitsDistrict-owned and -organized trainingsCommunity sensitization on HIV and related programsAchievements (2)CareCumulative 3,187 patients; 472 children (15%)Current 1,927 patients; 309 children (16%)ARTCumulative 1,618 patients; 201 children (12%)Current 1,172 patients; 165 children (14%)HCWs trained for C&T (CDC funded)21 HIV and ART (including pediatrics)3 District Mentors28 IMAI42 HCWs in EID, plus 3 TOTs34 Lay Counsellors

Achievements (3)StrengthsInvolvement and capacity building of all district managersTraining of trainers and ownership of trainings at District LevelImproves regular supportive supervision and on-site mentorshipStrengthens capacity to monitor both U.S. Govt. and MOHSW fundsStrengthens logistical and SCM capacityContributes to sustainable health systems strengtheningChallengesNation-wide challenges- Human resources shortages and high turn-over- Inadequate physical infrastructures- Lack of equipmentDelays in program implementation due to bureaucracy at District levelBut procedures are necessary to follow rules and regulationsChallenges in the National SCM systems

Way ForwardFurther strengthening of CHMTsFinancial and managerial capacityTechnical expertiseThroughInitiatives to increase the workforceOn the job and classroom training of DMO, District AIDS Control Coordinators, Health Care Providers, and other key stakeholders

Asanteni sana!