Rapid Assessment of District and Community HIV and AIDS Response Challenges, Constraints and Prospects Technical Review 2008 Rapid Assessment of District HIV&AIDS Response 1

What has worked well Rapid Assessment of District HIV&AIDS Response 2

COORDINATION CMACs meetings are conducted regularly in all districts CHAC and DACC work together and cooperate with some CSOs. Formation of Regional Multi-sectoral HIV and AIDS Committees is a positive development. Rapid Assessment of District HIV&AIDS Response 3

Planning, Budgeting All district councils have plans and budget lines for HIV and AIDs All councils use the multi-sectoral approach in planning and budgeting. All districts use tools provided by the Government- MTEF/PlanRep Rapid Assessment of District HIV&AIDS Response 4

Management and Implementation Worked well There is evidence of safe sex practice in all districts Increased number of clients attending CTC, VCT and PMTCT Availability of Volunteer Community/Home Based Care providers Established and functioning of some organized groups with IGAs IGAs – MCHOMOKO Rapid Assessment of District HIV&AIDS Response 5

CSOs Rapid Assessment of District HIV&AIDS Response 6

Management and Implementation PHLHIV groups more proactive in the provision of Home Based Care as Volunteers and as agents of awareness creation Councils and CSOs support education for OVC/MVCs Rapid Assessment of District HIV&AIDS Response 7

Management and Implementation Advocacy activities Regional Cinema vans are used for awareness campaigns for HIV and AIDS. Regional Secretariat support LGA activities in the districts. Regional Secretariat - Musoma Rapid Assessment of District HIV&AIDS Response 8

Monitoring and Evaluation Good system for data collection The development of TOMSHA and LGMD is positive The TOMSHA data collecting tools are available at the lower levels where people Interview with CMACs Rapid Assessment of District HIV&AIDS Response 9

Resource mobilization, resource tracking and Auditing Worked well All LGAs visited have set aside budgets for CMAC activities from own sources Some Councils have mobilized resources There is CSOs mapping done by CMACs. The Tanzania Government, Development partners and other actors provide funds for HIV and AIDS programmes. PLHIV – IGAs supported by TASAF Rapid Assessment of District HIV&AIDS Response 10

Institutional arrangements Formation of TACs in MDAs is a positive development CMACs are in place and working. Formation of Regional Multi-sectoral HIV and AIDS Committees is a positive development. Public - Private and Civil Partnership in HIV and AIDS is a positive development e.g. The Health Development Foundation (HEDOFO) in Tunduru Rapid Assessment of District HIV&AIDS Response 11

Institutional arrangements (cont.) Involvement of the Private & informal sector (Work place programmes) e.g. in Temeke District at Aluminium Africa and Mshikamano. Establishment of MVCs Committees is a positive development Rapid Assessment of District HIV&AIDS Response 12

Programme management, Reporting and reporting preparation O&OD and PRA are in use Capacity building in HIV and AIDS programme Monthly, Quarterly and Annual reports are prepared, submitted to appropriate levels Rapid Assessment of District HIV&AIDS Response 13

What has not worked well Rapid Assessment of District HIV&AIDS Response 14

Coordination, Planning & budgeting and Management and Implementation Some TACs are not functioning well Membership in CMAC is not inclusive; the DMO is not a co-opted member. e.g. in Mkuranga. The exclusion of DCs in CMAC Disbursement of funds does not match with the approved budget and is irregular Plans are not focusing on the drivers of the epidemic e.g. social cultural factors, mobile population, CSW, DU, and Gays. Rapid Assessment of District HIV&AIDS Response 15

Monitoring and Evaluation Resource mobilization, resource tracking and Auditing The implementation TOMSHA and LGMD has been problematic because of inadequate capacity. Inadequate skills and capacity to mobilize additional resources, e.g. funding proposal write up Rapid Assessment of District HIV&AIDS Response 16

Institutional arrangements Some WMACs and VMACs are not functioning VCTs and CTCs are not easily accessible by people in the rural areas. Shortage of trained and qualified staff Long queue/long waiting time to get services Long distances travelled to access services e.g. in Mkuranga, Makete, Ulanga, Nkasi and Tarime. The MVCs Committees not effectively used in service delivery Rapid Assessment of District HIV&AIDS Response 17

Programme management, Reporting and reporting preparation Good governance issues are weak (transparency, accountability, information flow and coordination) There is a poor formal feedback mechanisms at all levels. Rapid Assessment of District HIV&AIDS Response 18

Recommendations Rapid Assessment of District HIV&AIDS Response 19

Coordination LGAs should identify partners and establish mechanisms for Public Private Partnership with all other stakeholders working on HIV and AIDS activities in order to compliment efforts of Actors in the district Rapid Assessment of District HIV&AIDS Response 20

Coordination (cont.) LGAs should establish coordination mechanisms for CSOs, Private Sectors and Informal Sectors working in HIV and AIDS in order to ensure that activities that are carried out are complimentary to the council comprehensive plans and are in line with NMSF II and the Minimum Essential Package in order to scale up District response Rapid Assessment of District HIV&AIDS Response 21

Planning, Budgeting LGAs should strengthen information flow on HIV and AIDS to and from Household and community level in order to plan effective interventions aimed at reducing the spread of the epidemic. CSOs and other stakeholders implementing HIV and AIDS activities should be transparent and accountable to the beneficiaries’ community by providing regular reports to the appropriate levels Rapid Assessment of District HIV&AIDS Response 22

Planning, Budgeting (cont.) LGAs should involve all sectors and stakeholders to participate in the process of developing HIV&AIDS district comprehensive plan in order to enhance the community response Rapid Assessment of District HIV&AIDS Response 23

Management and Implementation LGAs incorporate IGAs projects in the district comprehensive HIV&AIDS plan in order to improve the livelihoods of the PLHIV and MVCs LGAs should establish mechanisms for the enforcement of existing by-laws in order to protect the rights of infected and affected populations Rapid Assessment of District HIV&AIDS Response 24

Management and Implementation LGAs and CSOs should scale up the training of Traditional Healers and the Traditional Birth Attendants on HIV and AIDS in order to improve performance on HIV and AIDS Client management and referral LGAs, CSOs and other Actors should promote and expand CTCs / VCTs / HCTs services in order to increase access at all levels Rapid Assessment of District HIV&AIDS Response 25

Monitoring and Evaluation: PMO-RALG / TACAIDS should build capacity of Actors in order to effectively use TOMSHA and the LGMD reporting systems in order to be able to effectively use them in planning, budgeting, implementing, and reporting of HIV and AIDS activities Rapid Assessment of District HIV&AIDS Response 26

Resource mobilization, resource tracking and Auditing PMO-RALG /TACAIDS should scale up Good governance practices on HIV and AIDS programmes in all TACs, LGAs and CSOs in order to achieve effective accountability, transparency, information flow and coordination of resources Rapid Assessment of District HIV&AIDS Response 27

Institutional arrangements Regional Secretariat and LGAs should budget, provide, scale up and sustain capacity building for the MACs in terms of knowledge on HIV and AIDS, Advocacy, Planning, Implementation, M&E and Coordination in order to enhance their performance based on available resources and best practices Rapid Assessment of District HIV&AIDS Response 28

Reporting and report preparation PMO-RALG/ TACAIDS / RS / LGAs/ CSOs should provide timely reports and give formal feedbacks in order to improve performances in the planning, implementation and coordination of HIV and AIDS activities Rapid Assessment of District HIV&AIDS Response 29

Thank you very much for listening Rapid Assessment of District HIV&AIDS Response 30