NATIONAL HIV AND AIDS RESPONSE

NATIONAL HIV AND AIDS RESPONSE

PREPARED BY THE NATIONAL HIV M&E UNIT 2008

LEVERAGING OUR HIV INFORMATION ASSETS

M&E INDICATORS STATUS

OUTLINE IntroductionThe National Indicator Status: Selected some out of 49 indicator set

ChallengesConclusion

INTRODUCTION

Provide an updates on selected indicator values on progress in achieving the NMSF objectives

Highlighting the goal of HIV M&E System at national level

THE NATIONAL RESPONSE TO HIV AND AIDS EPIDEMIC IN TANZANIA

19831992

1988 1998First AIDS cases reported

AIDS Task Force formed

Short-

termplan

NACP Established

MTP II

1996

MTP III

20021985

MTP I

19911987

TACAIDS

HSS H/A 03-06

NMSF 03-07 NMSF 08-12

20032008

Nationa l M &E Framework 2004

2004

Registers at Health Facilities

At Implementer Level

HIV Act and Policy : The Body

NMSF, which contains HIV and AIDS response goals

LINKAGE BETWEEN THE THREE ONES

LINKAGE BETWEEN THE THREE ONES

Monitoring Systemsof organizations

National HIV M&E Framework and Plan

Indicators

Data sources

At National Level

Health routine data

Community-based routine data

Surveys /Surveillance

Educationroutine data

School life skillsEducation Monitoring

FRAMEWORK FOR A FUNCTIONAL NATIONAL HIV M&E SYSTEM 12 COMPONENTS

THE STATUS: NATIONAL SELECTED INDICATORS

1. Percentage of young women and men aged 15–24 who are HIV infected

• There has been a statistically-significant decline in HIV prevalence among ANC attendees in the last 5 years: HIV prevalence amongst pregnant women has reduced, at the national level, from 9.6% in 2002, to 8.7% in 2004 and 6.8% in 2006. ( Source: ANC report)

• The HIV prevalence has shown reduction in the last 5 years. National HIV prevalence among the sexually active population is reported 5.8% in 2007 from THMIS 2007-8, with females having a slightly higher rate 6.8% than males 4.7% drop from 7% from THIS 2003-4 report among age 15-49 population.

HIV PREVALENCE DISTRIBUTION BY REGIONS

Data Source: THMIS 2007-8

Source: THMIS 2007-08

HIV Prevalence In Tanzania By Age And Sex

THE STATUS: SELECTED NATIONAL INDICATOR SET…

2. Percentage of young women and men aged 15–24 who both correctly identify ways of preventing the sexual transmission of HIV and who reject major misconceptions about HIV transmission

• THMIS 2007-08 reported that 39% of young women aged 15-24 and 42% of men aged 15-24 had comprehensive knowledge of HIV and AIDS in Tanzania compared to TDHS 2004-5 results which was reported to have 45.3% of women and 41% of men aged 15-24. The two study shows variations women percentage drops while men increase slightly.

THE STATUS: NATIONAL SELECTED INDICATORS…

3. Percentage of young women and men aged 15–24 who have had Sexual intercourse before the age of 15 • The age of sexual debut has been increasing in Tanzania,

with fewer people, over time, having sex before the age of 15 - 11% of women aged 15 to 24 and 10% of young men aged 15 to 24 have reported having sex by age 15 (THMIS 2007-08).

4. Percentage of women and men aged 15–49 who have had sexual Intercourse with more than one partner in the last 12 months.• THIS 2003-04 found that 9% and 7% of women in the

ages 15-19 and 20-24 had more than one sexual partner in the previous 12 months; while the findings for men were 30% and 34% respectively.

• THMIS (2007-8) found that 4% of women (15-49) and 25% of men (15-49) in Tanzania had had more than one sexual partner in the year before the survey

SEXUAL PARTNERS AMONG WOMEN AND MEN BY AGE

Data Source: TDHS 2004-5 & THMIS 2007-8


5. Percentage of women and men aged 15-49 who received an HIV test in the last 12 months and who know their results Tanzania assesses progress in implementing

HIV testing and counseling through periodic population based surveys. According to the THMIS 2007-08, 19% of men and women aged 15-49 had an HIV test and received their test results in the last 12 months.

NUMBER OF VCT SITES BY REGION

Data Source: NACP 2006 Report

6. Percentage of adults and children with advanced HIV infection receiving antiretroviral therapy

ARV combination therapy has been proven to reduce the rate of illness and death among PLHIVs. Tanzania has scaled up efforts to make ARV more accessible and free or affordable in most of the regions.

36% of adults and children with advanced HIV infection received ARVs as of December 2007


103,249

197,529

27,144

327,922

53,799

99,416

13,424

166,639

0

50000

100000

150000

200000

250000

300000

350000

Males Female Children Total

Nu

mb

er

Sex/age

Cumulative Patient Enrollment into ART (Oct 2004 - July 2008) by sex/age category

Enrolled

On ARV

Source: NACP

7. Percentage of people expressing accepting attitudes towards people with HIV

26% of women and 35% of men expressed positive attitudes towards PLHIV in THMIS 2007-8

Data Source: THIS 2003-4, TDHS 2004-5 & THMIS 2007-8


8. Percentage and number of orphaned and vulnerable children aged 0–17 whose households received free basic external support in caring for the child

Data Source: THIS 2003-04


8. Number of income-generating projects in the last 12 months

Through TOMSHA between April to December 2007, the 906+ implementers who reported on TOMSHA indicated that a total of 103,186 OVC, 727 elderly persons, 2,911 widows and widowers, 67,017 vulnerable households, and 4,148 vulnerable groups received free support (which may have included income-generating activities)

38. Number of community-based committees mobilizing services for households with OVC

Through TOMSHA, between April to December 2007 906+ implementers reported that they had supported a total of 25,047 PLHIV who received two or more support services


10. Percentage of annual funding for HIV interventions that is spent on HIV and AIDS M&E CSOs Annual resource tracking form MDAs and LGAs

Through TOMSHA, TACAIDS calculated from resource tracking forms (submitted by 906+ implementers) that for the year 2006-07, 10% of their AIDS spending was on M&E.

The PER shows that 14% of AIDS spending was on cross-cutting issues (M&E is included as part of cross-cutting issues, but is not included as a separate line item in the PER


12. Percentage of implementers of HIV and AIDS interventions that have submitted TOMSHA forms on time in the last 12 months

Through TOMSHA routine monitoring system received cumulated data from about 906+ out of 1,372 trained implementers for April to December 2007. There are over 2000 HIV implementers in the country (only 69% of them were trained in TOMSHA).

For the period April to December 2007 66% of all TOMSHA-trained HIV implementers in reported on TOMSHA.

13. Number of person-days of training that project staff and employees has undergone to manage and implement HIV-STI services in the last 12 months

Through TOMSHA between April and December 2007, HIV 906+ implementers reported that they had spent 47,024 person-days working in HIV: 38,891 volunteers, 4,789 project staff and 3,344 employees.


14. Percentage of organisations that have developed annual work plans with an approved budget, and that have implemented it in the last 12 months (by public sector (LGAs and MDAs), private sector and civil society) TOMSHA Data between April and December 2007, 57% of implementers

reported that they had implemented their work plans for details. The limitation of this indicator is that it is based on self-reporting, and

therefore requires onsite data verification to ensure credible indicator values.Organizations who reported on TOMSHA and said their

Number of Implementers

%

Organizations had an annual work plan in the reporting year

777 86%

Organizations annual work plans were costed 582 64%

Organizations had an approved budget for the work plan

616 68%

Organizations had funds for implementing and coordinating the activities

421 46%

Organizations implemented their work plans 516 57%

Data Source: TOMSHA (April – Dec, 2007)


CHALLENGES ENCOUNTERED IN NATIONAL HIV RESPONSE

There are more data available which cannot give a clear picture of the interventions according to the indicator set protocols

Not in place the Information Asset infrastructures and data governance for the National Response

The principle of three ones, is not effective at district/ community level, due to multiple plan’s and budget being prepared at different times (e.g NMSF,GFATM, and the Government Budget, PEPFAR Planning )

CHALLENGES ENCOUNTERED IN NATIONAL HIV RESPONSE …

MTEF capture only 26% of total spending, multiple planning and coordination structures for example TNCM and the annual PEPFAR planning.

Some of Public and Private institutions focal persons are inactive which leads to lack of continuity of activities and understanding of priorities.

Low disbursement of fund to various stakeholders work plan for HIV and AIDS interventions, resulting into either partial implementation or no implementation of work plan.

CONCLUSION The implementation of NMSF 2003-2007 and

development of the NMSF 2008-12 has resulted into achievements of some noticeable outcomes and impact on the HIV National response, as result of fully engagement of various stakeholders

Community response has significantly increased, this has been possible due to the use of multisectoral approach, the formation of multisectoral AIDS Committees which widened the chance of involving many actors across different social sectors in the fight against HIV and AIDS infections, HIV and AIDS impact mitigation and HIV and AIDS care and support for members of the community who have already been infected.

CONCLUSION … The strong PPP adoption (Public Private

Partnership) has made good achievements toward the support on the HIV and AIDS Interventions, Management and Leadership

The operationalization of TOMSHA has made non health data/information be available from different implementers at grass root level, although they had reported only 9 months from April – December 2007, which help the policy and decision makers in making informed decisions easier.

The establishment of Data Management Office to lead and ensure HIV data infrastructure are in place and have the data quality required to produce the right information product and disseminated to all stakeholders and the National Response – Leveraging our HIV Information Assets.

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NATIONAL HIV AND AIDS RESPONSE