Tanzania

Differentiated Service Delivery in Tanzania

Facility-Level
Coverage

Percent of health facilities providing less-intensive DSD models. Of the 6365 ART facilities in the country, 1386 have enrolled at least 10% of eligible recipients of care into less-intensive models.
Source: October 2020 CQUIN DSD Dashboard staging

% In Less-Intensive
DSD Models

Percent of people on ART who are enrolled in less-intensive DSD models. In a sample of data from the national HMIS, 80% have people on ART been enrolled in less-intensive models.
Source: October 2020 CQUIN Data Request

# of Less-Intensive
DSD Models

Number of less-intensive DSD models designed for people doing well on ART. Less-intensive models include: ART refill model, Fast Track, Facility-Led Community ART Groups, and Family-Treatment Supporter.
Source: October 2020 CQUIN Data Request

DSD Model
Diversity

Number of groups for whom less-intensive DSD models have been designed and implemented. Less-intensive DSD models are available for adults who are stable on ART and eligible adolescents, as well as adults who are not stable on ART, patients at high risk of disease progression, men, pregnant or breastfeeding women, key and priority populations, and mobile populations.
Source: October 2020 CQUIN DSD Dashboard staging

Differentiated Service Delivery Implementation in Tanzania

Tanzania joined the CQUIN learning network in 2018. After adopting the 2015 World Health Organization (WHO) test and treat guidelines, and recognizing the need for client-centered care, Tanzania’s Ministry of Health and its National AIDS Control Programme (NACP) incorporated differentiated service delivery (DSD) models into its National Guidelines for the Management of HIV and AIDS. In addition, DSD is incorporated into Tanzania’s Health Sector HIV and AIDS Strategic Plan (HSHSP) 2017-2022, which includes recommended DSD models.

In Tanzania, recipients of care are involved in the implementation of DSD at the national and facility levels. At the national level, they participate in technical working groups to inform policies, and are involved in the development of guidelines and plans. At the facility level, they are part of the workplace improvement teams responsible for decision making, and support service delivery as peer educators and feedback providers.

Currently, Tanzania offers four less-intensive DSD models and two more-intensive conventional models (standard of care with or without block appointments). The less-intensive models include:

One facility-based individual model: facility-based pharmacy refill model (offering three-month and six-month prescriptions and fast track pickups).
One facility-based group model: teen club, a facility-based refill club model.
One community-based individual model: the mobile outreach model.
One community-based group model: the treatment supporter model, a family model.

One current challenge to DSD implementation in Tanzania is the lack of effective monitoring and evaluation (M&E) systems for DSD. To address this challenge, the country is in the process of rolling out a database known as CTC2 which will enable more effective M&E of DSD.