Harmonization of Reporting Harmonization of Reporting RequirementsRequirements

TanzaniaTanzania

Emma MsuyaEmma MsuyaRose ShijaRose Shija

BackgroundBackground

Tanzania has population of 35mill people (2004 Tanzania has population of 35mill people (2004 census)census)

HIV Prevalence is 7%HIV Prevalence is 7%

Most of the people are living in rural areas(85%)Most of the people are living in rural areas(85%)

Has 22 regions,121 districtsHas 22 regions,121 districts

Ratio doctor: patient is 1:23,000Ratio doctor: patient is 1:23,000

Ratio nurse: patient 1:6000Ratio nurse: patient 1:6000

Ratio pharmacist: patient 1:50,000Ratio pharmacist: patient 1:50,000

Care and Treatment PlanCare and Treatment Plan

Tanzania adopted Care and Treatment for Tanzania adopted Care and Treatment for People Living with HIV/AIDS as one of its key People Living with HIV/AIDS as one of its key strategies in the Health Sector response to strategies in the Health Sector response to HIV/AIDS pandemic and developed a Care and HIV/AIDS pandemic and developed a Care and Treatment Plan, which was approved by the Treatment Plan, which was approved by the Government in October 2003.Government in October 2003.

Beginning of the year 2004, National AIDS Beginning of the year 2004, National AIDS Control Program developed Operational PlanControl Program developed Operational Plan

for financial year 2004/05.for financial year 2004/05.

Cont…Cont…

The Operational Plan was shared to the The Operational Plan was shared to the stakeholders who contributed their stakeholders who contributed their resources to it.resources to it.

The Plan targets to cover about 400,000 The Plan targets to cover about 400,000 HIV infected Tanzanians on Anti-HIV infected Tanzanians on Anti-

Retroviral Therapy (ART) by the end Retroviral Therapy (ART) by the end of of the 5th year of the programthe 5th year of the program (about 20% (about 20% of the infected of the infected population )population )

Treatment sitesTreatment sites

Beginning May 2004, Ministry of Health Beginning May 2004, Ministry of Health drew up a list of 91 sites that would initiate drew up a list of 91 sites that would initiate the provision of Anti-retroviral Therapy the provision of Anti-retroviral Therapy (ART) to cover 44,000 patients by end of (ART) to cover 44,000 patients by end of 2005. 2005. This was followed by the development of This was followed by the development of Guidelines, Training materials, Guidelines, Training materials, Assessment Accreditation Tool and Assessment Accreditation Tool and Monitoring and Evaluation framework Monitoring and Evaluation framework

Funding Sources for ARVFunding Sources for ARV (USD) (USD)Source Source 2003/042003/04 2004/052004/05 2005/062005/06

GovtGovt 2,000,0002,000,000 3.5,000,0003.5,000,000 17,000,00017,000,000

CanadaCanada 3.5,000,0003.5,000,000 3.5,000,0003.5,000,000

USGUSG 4.5,000,0004.5,000,000

GFGF

Norwegian Norwegian govtgovt

1.5,000,0001.5,000,000 9.8,000,0009.8,000,000

1.1,000,0001.1,000,000

SIDASIDA 5,000,0005,000,000

TOTALTOTAL 3.5,000,0003.5,000,000 27,400,00027,400,000 20.5,000,00020.5,000,000

Cont…Cont…

Support from PEPFAR contains first and Support from PEPFAR contains first and second line drugssecond line drugs

There is also support from different There is also support from different agencies: WB TMAP etc for non ARV and agencies: WB TMAP etc for non ARV and other different activities.other different activities.

Patients on treatment…Patients on treatment…

The total number of patients who are now The total number of patients who are now on treatment is about 15,304on treatment is about 15,304

Getting Orders to the Right PlaceGetting Orders to the Right Place

via MSDvehicle

MSD

Health Facilities

District

via districtvehicle

via MSDvehicle

Serve clientsPrepare orders

Collect local funds

Hospitals & D istricts:Approve ordersApprove funding

ProcureStore

Distribute

Role

MOH Program m e ManagersForecast needs

A llocate central fundsSupervise

CLIENTS

Hospitals(governm ent/FBO/NGO)

Flow of supplies

Flow of reports

MSD Zonal S toresvia MSDvehicle

NGO Facilities

via districtvehicle

Districts also:Allocate local fundsDeliver to facilities

Information from facilities to MSD and MOHInformation from facilities to MSD and MOH

For ordering ARVs hospitals take orders to For ordering ARVs hospitals take orders to MSD using R/R forms and MSD will deliver to MSD using R/R forms and MSD will deliver to the hospitals.the hospitals.

For reporting, facilities send R/R copies to For reporting, facilities send R/R copies to MOHMOH

Facilities will send summary report of Facilities will send summary report of patients on different treatment regimens to patients on different treatment regimens to MOH MOH

The whole country uses the same reporting The whole country uses the same reporting mechanism developed together with partnersmechanism developed together with partners

Cont…Cont…

Information from reports is compiled and Information from reports is compiled and used for:used for:

-assessing consumption pattern-assessing consumption pattern-forecasting purposes-forecasting purposes-trend of drug utilized-trend of drug utilized-number of patients on different regimens-number of patients on different regimens-number of new patients enrolled-number of new patients enrolled-deaths-deaths

ARV Form A2 (abbreviated form)ARV Form A2 (abbreviated form)FORM A2: REPORT & REQUEST FOR ANTI-RETROVIRAL DRUGS (ARVS)

Facility Code: Facility Name: Type (GOV/NGO/FBO/OTHER):

Name of District:

Date Submitted: Reporting Period: Month: Year:

MSD Code

Item Unit of Issue

Beginning Balance

(A)

Received This Period

(B)

Actual Dispensed

(C)

Lost/ Adjusted

(D)

Ending Balance

[E=A+B-C±D] (E)

Quantity Needed

[F=(Cx3)-E]

(F)

Quantity Requested

(G)

Approved Quantity

(I)

Stavudine Tab 40mg

Zidovudine Tab 100mg

Abacavir 20mg/ml

Didanosine Pdr for solution, 2gm

Stavudine 1mg/ml

Lopinavir/Ritonavir 80/20mg/ml

Nelfinavir Pdr 50mg/g

Lamivudine Susp. 10mg/ml, 100ml

Nevirapine Susp. l50mg/5ml, 240ml

Zidovudine Susp. 50mg/5ml, 100ml

Diflucan Tab 200mg

Diflucan IV infusion, 200mg vial

Diflucan Pdr for solution, 2gm

Completed by: Signature:

Approved by: Signature:

Summary of Patients by Regimen

Regimens Number of Patients on treatment

Number of Patients to be initiated

treatment (new)

Number of patients who

have died

Remarks

Adults

3TC/d4T(30)/NVP

3TC/d4T(40)/NVP

3TC/AZT + NVP

d4T(30) + 3TC + EFV

d4T(40) + 3TC + EFV

AZT/3TC + EFV

ABC + ddI + LPV/r (under 60kgs)

ABC + ddI + LPV/r (over 60kgs)

ABC + ddI + SQV + RTV (under 60 kgs)

ABC + ddI + SQV + RTV (over 60 kgs)

Pediatrics

3TC + AZT + NVP

3TC + EFV + AZT

3TC + NVP + d4T

3TC + EFV + d4T

ABC + ddI + LPV/r

ABC + ddI + NFV

Other

Way ForwardWay Forward

The government is planning to scale up The government is planning to scale up the provision of across the country. The the provision of across the country. The plan is to enroll and maintain up to plan is to enroll and maintain up to 100,000 patients on treatment by the end 100,000 patients on treatment by the end of the year 2006.of the year 2006.

The government has therefore identified The government has therefore identified new 106 sites which, that will initiate ART new 106 sites which, that will initiate ART in the coming financial year.in the coming financial year.

THANK YOU FOR YOUR THANK YOU FOR YOUR ATTENTIONATTENTION