Tanzania is rich in natural and extractive resources such as gold, diamonds and tanzanite. Yet, nearly 20 million of its 39 million people live in poverty – without basic health care that could prevent thousands of infectious disease-related deaths each year. Preventable diseases, such as HIV/AIDS and malaria, are also stunting the country’s economic growth.
In 1993, PSI opened a Tanzania office to begin tackling the East African nation’s largest health issue – the growing HIV/AIDS epidemic. Later, it branched out with malaria and water-borne disease prevention campaigns.
To address Tanzania’s reproductive health burden and health system deficiencies, PSI/TZ launched the Tanzania Familia network in 2009, a clinical social franchising initiative that applies social marketing principles and efficiencies to the delivery of health services in the private sector. The Familia network of private providers adheres to PSI/TZ’s client care standards and procedures for delivering high-quality family planning and maternal care services. Providers are incentivized to join the network: they receive extensive training and support, access to equipment and subsidized RH commodities and increased positive visibility from the Familia network branding and promotions. In exchange, providers offer RH services that fulfill the four primary goals of social franchising: access, cost effectiveness, quality and equity, with an emphasis on reaching those Tanzanians most in need.
PSI/Tanzania estimates that in 2015, its products and services helped avert 1,835,018 DALYs, including, by health area:
- 1,233,838 HIV DALYs
- 598,144 FP DALYs
- 1,912 WASH DALYs
- 866 Safe Abortion DALYs
- 258 NCD DALYs
PSI/Tanzania’s family planning programs also provided 1,729,780 couple-years of protection.
PSI/Tanzania’s HIV prevention program uses commercial marketing strategies to promote Salama condoms and Care female condoms to high-risk groups, such as truck drivers, commercial sex workers and other migrant populations. The program builds trust in these products though cultural theater groups, mobile video shows and sensitization workshops. In the 1990s, Tanzania posted one of the largest increases in contraceptive use – 2 percentage points per year. And the name Salama – which means “safe” – is now the generic word for condom.
PSI/Tanzania also proactively reaches out to young adults ages 15-24. Less than 50% of this age group can name the five most important elements of transmission; and only 17% of women and 26% of men said they used condoms the first time they had sexual intercourse.
PSI/Tanzania is a major player in the fight against malaria – the No. 1 cause of death of children under 5 years old, and the third highest cause of adult death. Malaria also increases the risk for pregnant women to have low birth weight/premature babies, maternal anemia and stillbirths.
Intense community mobilization promotions have made Ngao insecticide retreatment brand a household name. PSI/Tanzania has also helped the Ministry for Health and Social Welfare Services (MOHSWS) develop comprehensive communication materials to educate the public about new treatments.
PSI/Tanzania empowers women to overcome traditional gender stereotypes and take advantage of available contraceptives, such as:
- Care female condoms.
- SafePlan Injectolette (injectable).
- SafePlan Microlette (oral).
Water, Sanitation and Hygiene
Access to safe water and sanitation can help decrease the high prevalence of water-borne diseases, such as diarrhea and cholera, in both urban and rural Tanzania. In 2002, PSI/Tanzania (in collaboration with the MOHSWS and Ministry for Water) launched a program for WaterGuard, a household water treatment solution. In 2005, WaterGuard became available in tablet form, which is more user-friendly due to longer shelf-life. And PSI/Tanzanian’s local drama performances model proper hygiene.
- The Global Fund To Fight AIDS, Tuberculosis and Malaria
- United States Agency for International Development
- The Federal Republic of Germany through KfW Entwicklungsbank (the German development bank)
- Embassy of the Kingdom of the Netherlands
- Irish Aid
- Ministry for Health and Social Welfare
- Ministry for Water
- Tanzanian Commission for AIDS
- National Malaria Control Program
- Other local agencies
- Towards Subsidized Malaria Rapid Diagnostic Tests. Lessons Learned from Programmes to Subsidise Artemisinin-Based Combination Therapies in the Private Sector: a Review
Private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. A subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries.
- What Happened to the Malaria Market in Tanzania after the AMFm?
Key strategies have been implemented in Tanzania to ensure access to confirmatory testing and appropriate treatment for malaria cases. To extend quality case management services to the community level, a drug store accreditation program was recently taken to scale across much of the country.
- Expanding Access to HIV Self-Testing: A Market Development Approach
PSI envisions a healthy market for HIVST to be one that is supported by multiple buyers and suppliers and that delivers on the 5As (Availability, Assured Quality, Appropriate Design, Awareness, and Affordability) to achieve public health goals. Realizing this vision for the HIVST market will require consideration of two key markets- public and private sectors. While HIV testing has traditionally been driven by the public sector, HIVST opens up the possibility of utilizing private sector pharmacies to expand and extend the reach of testing.
- Fever Case Management Supervisor Job Aid
Supervisor job-aids assure that quality of fever case management (FCM) is preserved even many months after trainings. These supervisor job-aids are part of a larger Quality Assurance Manual and Toolkit developed through the UNITAID Private Sector RDT project to provide guidance on quality assurance for FCM in the private sector.
- Fever Case Management Provider Job Aid
The aim of these provider job-aids developed for Tanzania, Madagascar and Kenya is to visually support providers during their day-to-day activities and guide them through the steps they must undertake to perform, read and dispose of malaria Rapid Diagnostic Tests (RDTs).
- Simplified Asset Indices to Measure Wealth and Equity in Health Programs: a Reliability and Validity Analysis Using Survey Data from 16 Countries
Many program implementers have difficulty collecting and analyzing data on program beneficiaries' wealth because a large number of survey questions are required to construct the standard wealth index. We created country-specific measures of household wealth with as few as 6 questions that are highly reliable and valid in both urban and rural contexts.
- Improving Rational Use of ACTs Through the Introduction of mRDTs to the Formal Private Sector in Tanzania
Working with the National Malaria Control Program, and with support from UNITAID, PSI Tanzania and its partners are stimulating the creation of a private sector market for quality-assured malaria RDTs and quality case management services.
- Market Trends for Malaria Blood Testing in Sub-Saharan Africa, 2009-2014
In 2012, the World Health Organization (WHO) launched the Test, Treat, Track initiative recommending confirmatory testing prior to antimalarial treatment. National malaria control programs (NMCP) across subSaharan Africa (SSA) subsequently aligned national guidelines with this recommendation. Strategies to scale up testing using malaria rapid diagnostic tests (mRDT) were introduced by NMCPs. We examine malaria testing availability, price and market share using national market survey data collected by the ACTwatch project.
- SP Availability and (Mis)Use in Sub-Saharan Africa: Antimalarial Market Data From 8 Countries
As evidence of reduced chloroquine efficacy against plasmodium falciparum mounted in the 1990’s, sulfadoxine-pyrimethamine (SP) became first-line malaria treatment in many endemic countries in sub-Saharan Africa (SSA). Between 2002-2005, countries in SSA adopted artemesinin combination therapies (ACT) as first-line treatment. SP is still recommended by the WHO and used across SSA for intermittent preventive treatment of malaria during pregnancy (IPTp). We examine availability and distribution of SP using national antimalarial market survey trend data collected by the ACTwatch project.
- Improving Provider Behavior Change Communication and IPC: Best Practices from the Women’s Health Project
This brief describes the challenges faced, strategies developed, and lessons learned by the Women's Health Project. It also proposes a set of best practices for improving productivity of interpersonal communications (IPC) agents and increasing providers' skills and motivation.