Background and Purpose
In October 2019, USAID/Tanzania engaged mothers2mothers (m2m) through the Reducing Infections through Support and Education II (RISE II) award for assistance on PMTCT programming. This USAID award enables m2m to continue and expand its work to support healthy, thriving communities to achieve an AIDS-free generation and end preventable maternal and child deaths. m2m’s goal in collaboration with USAID/Tanzania is to foster self-sufficiency and the self-sustaining ability to improve prevention of mother-to-child transmission of HIV interventions in Tanzania.
The Ministry of Health, Community Development, Gender, Elderly, and Children (MoHCDGEC) through the national PMTCT program, implements diverse interventions to eliminate new HIV infections in children resulting from vertical HIV transmission. To reduce new HIV infection in children and improve maternal survival, MoHCDGEC adopted the WHO recommended testing and starting all people living with HIV including pregnant women regardless of immunological or clinical stage (Option B+), with the assumption that this approach increases access to ARVs among women, and significantly reduces the risk of mother to child transmission of HIV infection. The success of this new policy, is hinged on not only improved access but also on higher retention in the PMTCT care continuum from the time of conception to the end of breastfeeding.
Other notable programs include the Partnership for HIV-Free Survival (PHFS) that was launched by the World Health Organization (WHO) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). This initiative sought to assist six countries in their national efforts to improve PMTCT, maternal and infant care, and nutrition support for HIV-positive women and their exposed infants using a collaborative quality improvement (QI) approaches to implement changes that lead to lasting improvement. In Tanzania the PHFS initiative specifically aimed to improve enrollment in and retention of HIV-positive pregnant and lactating women on antiretroviral therapy (ART), strengthen access to early infant diagnosis (EID), and increase the number of women practicing safe infant and young child feeding (IYCF) measures (including exclusive breastfeeding for the first six months of life).
As part of the Reducing Infections through Support and Education II (RISE II) award, m2m is seeking to recruit a qualified and experienced firm consultant for a short term technical support to develop a PMTCT Operational Framework and implementation guidelines, aligned to the MoHCDGEC policy, and informed by MOH recommended interventions, best practices from various implementing partners in Tanzania.
The standardized operational framework on continuum of care should include various best practices models (for example PHFS QI interventions, service integration, peer mentorship, support groups, appointment tracking and client follow up, proactive community follow up for high risk, linkages to OVC and other platforms, etc). Interventions included in the framework will be based on recommendations from MoH and the PMTCT Sub Community TWG.
The development will be a collaborative process with MoHCDGEC, Regional Health Management Teams, the PMTCT TWG, and USAID with ongoing input from implementing partners. The outcome of the documentation will also serve as a knowledge product to be shared across a wider audience and to inform future program undertakings.
Work To Be Accomplished
The overall objective of the consultancy is:
- Develop a national PMTCT Operational Framework and implementation toolkit for optimal continuum of care between facilities and communities
- Integrate lessons learned from mothers2mothers technical assistance programmes and the best practices assessment that highlight the role of peer-to-peer approaches in improving retention in care and treatment adherence.
- Support a national training workshop on the PMTCT Operational Framework and implementation toolkit