Differentiated Service Delivery in Tanzania
After adopting the 2015 World Health Organization (WHO) guidelines recommending treatment of all HIV-infected individuals upon diagnosis, and recognizing the need for client-centered care, Tanzania incorporated differentiated service delivery models (DSDM) into its National Guidelines for the Management of HIV and AIDS.
Tanzania’s National AIDS Control Programme (NACP) developed an HIV and AIDS service delivery module that describes the organization of HIV and AIDS services in Tanzania and defines roles and responsibilities of clinical staff. The module, which is incorporated into Tanzania’s Health Sector HIV and AIDS Strategic Plan (HSHSP) 2017-2022, illustrates recommended DSDM for people living with HIV according to clinical status and needs. Strategies are described for community- and facility-based services, ART services for adults, pediatric ART, ART for pregnant and lactating women, and management of HIV co-infections and co-morbidities.
Provision of comprehensive HIV care services is decentralized to local government councils that provide facility- and community-based services. The council’s health facilities—dispensaries, health centers, and hospitals—are supported by public regional referral hospitals, regional faith-based hospitals, and zonal referral hospitals.