Tanzania2018-07-13T17:41:09+00:00

Tanzania

65.25 %

reduction of people at risk for LF between 2011 and 2016

A child gets weighed at the Nyamagana District Hospital in Mwanza, Tanzania.
Photo by Paul Jeffrey

A child gets weighed at the Nyamagana District Hospital in Mwanza, Tanzania.
Photo by Paul Jeffrey

Research, media aim to curb stunting

Historically, IMA World Health’s Tanzania team has been eager to expand our reach and explore new solutions to advancing health, healing and well-being for all. It started in 1997, when IMA took a leap of faith and opened our first field office in Dar es Salaam to lead a team of partners in targeting the neglected tropical disease onchocerciasis.

IMA never looked back, and from that first project our vision, scope and areas of expertise have grown exponentially. Luke King, IMA’s Country Director for Tanzania, explained, “Our team is energized by finding ways to continually improve our services to beneficiaries.”
True to form, the Tanzania team is taking on a new challenge this year: paving the way for a brighter future by reducing stunting among children under age five. As with all new endeavors, IMA is working closely with the Ministry of Health and a network of partners to determine the best, most cost effective solutions to reach as many children and families as possible.

Yet amid this growth and expansion into new focus areas, IMA’s earliest work to control and eliminate NTDs in Tanzania remains a priority—and a point of pride. “Our work to prevent and treat these diseases has benefits that go beyond health alone,” King explained. In addition to debilitating physical symptoms, NTDs often bring social stigma and economic suffering to those infected; and, by definition, these diseases—and those who suffer from them—have been overlooked for far too long.

We are working with partners to carry out mass drug administration, and we have seen intensive efforts paying off. Encouragingly, recent surveys have shown that 43 percent of districts endemic for lymphatic filariasis have passed transmission assessment surveys and over 15 million people no longer require treatment. IMA also supports individual surgical interventions to help thousands with hydrocele and trachomatous trichiasis return to a normal life. Through these efforts to control and eliminate NTDs and support patients, IMA and our partners are literally changing the course of people’s lives.

It started with one small leap of faith and one small project more than 20 years ago; now IMA projects help millions of people in Tanzania each year. What made it all possible? A dynamic team eager to grow our impact, coupled with those first seeds of partnership planted all those years ago.

medicine-icon-darkgreen
90,284

community drug distributors trained

pills-icon-darkgreen
4,000,000

children treated for intestinal worms

ENVISION

$26.82 million | USAID, RTI | 2012 to date

IMA, with ENVISION support, follows the lead of Tanzania’s National Tropical Disease Control Program and its Neglected Tropical Disease Secretariat to implement NTD control activities in line with the Tanzania NTD Master Plan. Since 2011, IMA has supported Tanzania’s Ministry of Health and the NTDCP to provide technical assistance and funding for NTD control and elimination activities, capacity development for NTD control and elimination and improved monitoring and evaluation for NTD program activities.

The five NTDs endemic in Tanzania are lymphatic filariasis, onchocerciasis, schistosomiasis, soil transmitted helminths and trachoma. A large portion of the population is at risk of co-infection with two or more of these diseases. IMA collaborates with health officials to carry out mass drug administration in 19 regions and 126 districts across Tanzania. To accomplish this, IMA worked with officials to train 11,414 front line health workers, 27,087 teachers and 90,284 community drug distributors who delivered treatments to more than 20 million people by the end of fiscal year 2016. In addition, IMA provides technical support for carrying out disease specific assessments for the five NTDs.

This year, one of the biggest highlights was conducting transmission assessment surveys for lymphatic filariasis in 27 districts to determine whether the program could stop mass drug administration for LF. To date, a population of more than 15 million people in 74 districts (an increase from 64 districts) have achieved criteria for stopping MDA for LF.

ASTUTE

$31.5 million | DFID | 2015–2020

IMA World Health is leading the new DFID-funded Addressing Stunting in Tanzania Early, or ASTUTE, program. Our consortium, which includes the Partnership for Nutrition in Tanzania, Cornell University’s Division of Nutritional Sciences and Development Media International, builds the capacity of local government authorities to address child stunting and contribute to the evidence base for what works best and most cost-effectively in Tanzania.

ASTUTE activities will ultimately be implemented in all districts of five regions of the Lake Zone—Kagera, Kigoma, Mwanza, Geita and Shinyanga—representing a collective population of 10.2 million and more than 750,000 stunted children. These regions were selected for their documented high rates of stunting and anemia, high numbers of stunted children, low levels of appropriate child feeding practices and the potential to leverage local resources, including the presence of partner civil society organizations.

ASTUTE aims to build the capacity of 50 local CSO partners; train over 3,600 district nutritionists, community workers, health facility workers, and non-health sector service providers; reach 3 million mothers, caregivers and decision makers with improved child care and feeding information; and reach over 8 million people with a broad, multi-pronged communication strategy.

LEAD Project

$9.5 million | U.S. Centers for Disease Control and Prevention, President’s Emergency Plan for AIDS Relief | 2012–2016

More than 30,000 individuals were tested for HIV in this final year of the Local Partners Excel in Comprehensive HIV and AIDS Service Delivery, or LEAD, project. At least 20,000 were enrolled in treatment, including antiretroviral therapy. One of IMA’s key strategies was to build effective relationships with local partners, health facilities and the Ministry of Health. IMA worked directly with 36 local partner treatment facilities through sub-agreements, not only to strengthen service delivery but also to strengthen their organizational capacity to directly manage delivery of HIV services.

About 1.4 million people are living with HIV in Tanzania, equating to an estimated HIV prevalence of around five percent. The LEAD project strengthened and scaled-up quality HIV care and treatment, TB/HIV services and PMTCT in Tanzania to ensure people living with HIV and AIDS and their families experience improved health and well-being. In partnership with the Ministry of Health, IMA provided direct technical assistance to scale up antiretroviral treatment and prevention of mother-to-child transmission service delivery at 89 HIV care and treatment centers in 16 districts in the regions of Mara, Manyara and Tanga.

IMA World Health joined partners Futures Group and the University of Maryland Institute of Human Virology in the project, which was led by Catholic Relief Services.

hiv-tster-icon-noshadow
30,000+

people tested for HIV

meds-icon-yellow
20,000+

enrolled in HIV care & treatment

hiv-tster-icon-noshadow
30,000+

people tested for HIV

meds-icon-yellow
20,000+

enrolled in HIV care & treatment

A student has her height measured in order to calculate the correct dose during a distribution of medicines in a public school in Vikuge, Tanzania. The medicines include praziquantel and albendazole.
Photo by Paul Jeffrey

LEAD Project

$9.5 million | U.S. Centers for Disease Control and Prevention, President’s Emergency Plan for AIDS Relief | 2012–2016

More than 30,000 individuals were tested for HIV in this final year of the Local Partners Excel in Comprehensive HIV and AIDS Service Delivery, or LEAD, project. At least 20,000 were enrolled in treatment, including antiretroviral therapy. One of IMA’s key strategies was to build effective relationships with local partners, health facilities and the Ministry of Health. IMA worked directly with 36 local partner treatment facilities through sub-agreements, not only to strengthen service delivery but also to strengthen their organizational capacity to directly manage delivery of HIV services.

About 1.4 million people are living with HIV in Tanzania, equating to an estimated HIV prevalence of around five percent. The LEAD project strengthened and scaled-up quality HIV care and treatment, TB/HIV services and PMTCT in Tanzania to ensure people living with HIV and AIDS and their families experience improved health and well-being. In partnership with the Ministry of Health, IMA provided direct technical assistance to scale up antiretroviral treatment and prevention of mother-to-child transmission service delivery at 89 HIV care and treatment centers in 16 districts in the regions of Mara, Manyara and Tanga.

IMA World Health joined partners Futures Group and the University of Maryland Institute of Human Virology in the project, which was led by Catholic Relief Services.

A student has her height measured in order to calculate the correct dose during a distribution of medicines in a public school in Vikuge, Tanzania. The medicines include praziquantel and albendazole.
Photo by Paul Jeffrey

hiv-tster-icon-noshadow
30,000+

people tested for HIV

meds-icon-yellow
20,000+

enrolled in HIV care & treatment

LEAD Project

$9.5 million | U.S. Centers for Disease Control and Prevention, President’s Emergency Plan for AIDS Relief | 2012–2016

More than 30,000 individuals were tested for HIV in this final year of the Local Partners Excel in Comprehensive HIV and AIDS Service Delivery, or LEAD, project. At least 20,000 were enrolled in treatment, including antiretroviral therapy. One of IMA’s key strategies was to build effective relationships with local partners, health facilities and the Ministry of Health. IMA worked directly with 36 local partner treatment facilities through sub-agreements, not only to strengthen service delivery but also to strengthen their organizational capacity to directly manage delivery of HIV services.

About 1.4 million people are living with HIV in Tanzania, equating to an estimated HIV prevalence of around five percent. The LEAD project strengthened and scaled-up quality HIV care and treatment, TB/HIV services and PMTCT in Tanzania to ensure people living with HIV and AIDS and their families experience improved health and well-being. In partnership with the Ministry of Health, IMA provided direct technical assistance to scale up antiretroviral treatment and prevention of mother-to-child transmission service delivery at 89 HIV care and treatment centers in 16 districts in the regions of Mara, Manyara and Tanga.

IMA World Health joined partners Futures Group and the University of Maryland Institute of Human Virology in the project, which was led by Catholic Relief Services.

A student has her height measured in order to calculate the correct dose during a distribution of medicines in a public school in Vikuge, Tanzania. The medicines include praziquantel and albendazole.
Photo by Paul Jeffrey

SAFE

$1.2 million | DFID/Sightsavers | 2015–2020

IMA is the lead implementing partner in the Mtwara region of Tanzania on the SAFE project. The project follows the World Health Organization-endorsed SAFE strategy—Surgery, Antibiotics, Facial Cleanliness and Environmental Improvements—to address the underlying causes of trachoma. IMA addresses the backlog of trichiasis trachomatous cases, in which eyelashes have turned inward and scrape the surface of the eye. In such cases, surgery is required to relieve pain and prevent blindness.

IMA has worked closely with regional and district-level MOH personnel to organize and carry out surgery camps in Masasi and Tandahimba districts. In the project’s second year, more than 1,300 patients have had TT surgery; in Year 3, IMA will begin surgery camps in three additional districts of Mtwara. In Year 2 of SAFE implementation, IMA continues to improve program efficiency and carry out quality TT surgery and eye lash epilation. The biggest highlight of Year 2 is that IMA introduced a modified case finding approach to complement the traditional method in order to discover hard-to-find cases. The combined approach fully engages local leaders in the area, mobilizing community members to attend the screening/surgery camps, which has raised the number of TT patients coming to the camps. In addition, IMA has cleared the estimated backlog in Masai district.

Lymphatic Filariasis Morbidity Management

$150,000 | Izumi Foundation | (FY)2014–2016

Globally, more than 27 million men suffer from filarial hydrocele, a fluid-filled enlargement of the scrotum, which leads to deformity and often the inability to work and provide for their families. This project supported district councils to establish an LF Morbidity Management program with a focus on hydrocele surgery to address a growing backlog of men who suffer from the condition.

The program trained surgeons, nurses and anesthesia assistants at health facilities in  hydrocelectomy by partial excision of Tunica Vaginalis technique, use of local anesthesia and  patient care. Surgical teams performed procedures on weekends so they could attend to their usual patients during weekdays. During the project period, IMA supported surgical teams to carry out 1,320 surgeries—well above the target of 1,000 surgeries. The program used a cost share model, and IZUMI-supported costs included allowances to the surgical teams and NTD coordinators, consumables used for the procedure, fees for Muhimbili National Hospital surgeons and costs associated with supportive supervision. The participating hospitals covered all other surgery and follow-up care costs.

The biggest highlight of Year 2 comes from the Mtwara region, where surgeons were able to complete 640 surgeries—42 percent above the initial target of 450 surgeries. These additional surgeries were possible within the same budget, because program staff recognized that performing surgeries at district hospitals and facilities instead of at regional hospitals created a significant costs savings. The project has increased awareness of hydrocele treatment among community members, and it has greatly reduced myths about the disease, as patients who have been treated serve as ambassadors providing live testimonies about the success of the surgery.

Photo: Mwaruka Mmole Mole survived lymphatic filariasis, a parasitic disease caused by microscopic, thread-like worms spread from person to person by mosquitoes. The hydrocele caused by the disease meant Mole couldn’t work as a farmer, and suffered shame and embarrassment as profound as his limited mobility. IMA World Health helps communities fight this and other neglected tropical diseases, by providing training for medical staff in Tanzania’s Nachingwea District and covering the cost of the surgery to remove the hydrocele. Photo by Matt Hackworth

Our partner:

Working alongside Tanzania’s Ministry of Health: locally, regionally, nationally

Strengthening health systems is the heartbeat of our work, and that entails a close partnership with Tanzania’s Ministry of Health. IMA is engaged with the Ministry at national, regional and district levels across a wide spectrum of public health efforts. IMA’s staff in Tanzania collaborate with Ministry staff on project strategic plans, work plans, budgets, and monitoring and evaluation efforts. The partnership has been so fruitful that more than 60 health workers transitioned from IMA staff to public sector positions when the Ministry absorbed former IMA programs.

One of the most successful components of the Ministry partnership is IMA’s work with the Neglected Tropical Diseases Secretariat.  The Secretariat leads the entire planning process for mass drug administration, and monitoring and evaluation activities.  IMA supports the planning and implementation of the Secretariat’s strategy at every level (district, regional and national).  IMA’s partnership with the NTD Secretariat is critical for carrying out joint training and supervision of frontline health workers, teachers and community drug distributors for 142 districts across 20 regions of Tanzania.

Tandahimba District eye coordinator Pirmin Eriyo examines a patient in Nanhyanga, Tanzania for trachoma – a neglected tropical disease.
Photo by Matt Hackworth