NATIONAL HIV AND AIDS RESPONSE PREPARED BY THE NATIONAL HIV M&E UNIT 2008 LEVERAGING OUR HIV INFORMATION ASSETS M&E INDICATORS STATUS

O UTLINE Introduction The National Indicator Status: Selected some out of 49 indicator set Challenges Conclusion

I NTRODUCTION Provide an updates on selected indicator values on progress in achieving the NMSF objectives Highlighting the goal of HIV M&E System at national level

Registers at Health Facilities At Implementer Level HIV Act and Policy : The Body NMSF, which contains HIV and AIDS response goals L INKAGE BETWEEN THE T HREE O NES Monitoring Systems of organizations National HIV M&E Framework and Plan Indicators Data sources At National Level Health routine data Community-based routine data Surveys / Surveillance Education routine data School life skills Education Monitoring

FRAMEWORK FOR A FUNCTIONAL NATIONAL HIV M&E SYSTEM 12 COMPONENTS

THE STATUS: NATIONAL SELECTED INDICATORS 1. Percentage of young women and men aged 15–24 who are HIV infected There has been a statistically-significant decline in HIV prevalence among ANC attendees in the last 5 years: HIV prevalence amongst pregnant women has reduced, at the national level, from 9.6% in 2002, to 8.7% in 2004 and 6.8% in ( Source: ANC report) The HIV prevalence has shown reduction in the last 5 years. National HIV prevalence among the sexually active population is reported 5.8% in 2007 from THMIS , with females having a slightly higher rate 6.8% than males 4.7% drop from 7% from THIS report among age population.

HIV PREVALENCE DISTRIBUTION BY R EGIONS Data Source: THMIS

Source: THMIS HIV Prevalence In Tanzania By Age And Sex

THE STATUS: SELECTED NATIONAL INDICATOR SET … 2. Percentage of young women and men aged 15–24 who both correctly identify ways of preventing the sexual transmission of HIV and who reject major misconceptions about HIV transmission THMIS reported that 39% of young women aged and 42% of men aged had comprehensive knowledge of HIV and AIDS in Tanzania compared to TDHS results which was reported to have 45.3% of women and 41% of men aged The two study shows variations women percentage drops while men increase slightly.

THE STATUS: NATIONAL SELECTED INDICATORS … 3. Percentage of young women and men aged 15–24 who have had Sexual intercourse before the age of 15 The age of sexual debut has been increasing in Tanzania, with fewer people, over time, having sex before the age of % of women aged 15 to 24 and 10% of young men aged 15 to 24 have reported having sex by age 15 (THMIS ). 4. Percentage of women and men aged 15–49 who have had sexual Intercourse with more than one partner in the last 12 months. THIS found that 9% and 7% of women in the ages and had more than one sexual partner in the previous 12 months; while the findings for men were 30% and 34% respectively. THMIS (2007-8) found that 4% of women (15-49) and 25% of men (15-49) in Tanzania had had more than one sexual partner in the year before the survey

S EXUAL PARTNERS AMONG WOMEN AND MEN BY AGE Data Source: TDHS & THMIS

THE STATUS: NATIONAL SELECTED INDICATORS … 5. Percentage of women and men aged who received an HIV test in the last 12 months and who know their results Tanzania assesses progress in implementing HIV testing and counseling through periodic population based surveys. According to the THMIS , 19% of men and women aged had an HIV test and received their test results in the last 12 months.

NUMBER OF VCT SITES BY REGION Data Source: NACP 2006 Report

6. Percentage of adults and children with advanced HIV infection receiving antiretroviral therapy ARV combination therapy has been proven to reduce the rate of illness and death among PLHIVs. Tanzania has scaled up efforts to make ARV more accessible and free or affordable in most of the regions. 36% of adults and children with advanced HIV infection received ARVs as of December 2007 THE STATUS: NATIONAL SELECTED INDICATORS …

Source: NACP

7. Percentage of people expressing accepting attitudes towards people with HIV 26% of women and 35% of men expressed positive attitudes towards PLHIV in THMIS Data Source: THIS , TDHS & THMIS THE STATUS: NATIONAL SELECTED INDICATORS …

8.Percentage and number of orphaned and vulnerable children aged 0–17 whose households received free basic external support in caring for the child Data Source: THIS THE STATUS: NATIONAL SELECTED INDICATORS …

8. Number of income-generating projects in the last 12 months Through TOMSHA between April to December 2007, the 906+ implementers who reported on TOMSHA indicated that a total of 103,186 OVC, 727 elderly persons, 2,911 widows and widowers, 67,017 vulnerable households, and 4,148 vulnerable groups received free support (which may have included income-generating activities) 9. Number of community-based committees mobilizing services for households with OVC Through TOMSHA, between April to December implementers reported that they had supported a total of 25,047 PLHIV who received two or more support services THE STATUS: NATIONAL SELECTED INDICATORS …

10. Percentage of annual funding for HIV interventions that is spent on HIV and AIDS M&E CSOs Annual resource tracking form MDAs and LGAs Through TOMSHA, TACAIDS calculated from resource tracking forms (submitted by 906+ implementers) that for the year , 10% of their AIDS spending was on M&E. The PER shows that 14% of AIDS spending was on cross-cutting issues (M&E is included as part of cross-cutting issues, but is not included as a separate line item in the PER THE STATUS: NATIONAL SELECTED INDICATORS …

12. Percentage of implementers of HIV and AIDS interventions that have submitted TOMSHA forms on time in the last 12 months Through TOMSHA routine monitoring system received cumulated data from about 906+ out of 1,372 trained implementers for April to December There are over 2000 HIV implementers in the country (only 69% of them were trained in TOMSHA). For the period April to December % of all TOMSHA-trained HIV implementers in reported on TOMSHA. 13. Number of person-days of training that project staff and employees has undergone to manage and implement HIV-STI services in the last 12 months Through TOMSHA between April and December 2007, HIV 906+ implementers reported that they had spent 47,024 person-days working in HIV: 38,891 volunteers, 4,789 project staff and 3,344 employees. THE STATUS: NATIONAL SELECTED INDICATORS …

14. Percentage of organisations that have developed annual work plans with an approved budget, and that have implemented it in the last 12 months (by public sector (LGAs and MDAs), private sector and civil society) TOMSHA Data between April and December 2007, 57% of implementers reported that they had implemented their work plans for details. The limitation of this indicator is that it is based on self-reporting, and therefore requires onsite data verification to ensure credible indicator values. Organizations who reported on TOMSHA and said theirNumber of Implementers% Organizations had an annual work plan in the reporting year77786% Organizations annual work plans were costed58264% Organizations had an approved budget for the work plan61668% Organizations had funds for implementing and coordinating the activities 42146% Organizations implemented their work plans51657% Data Source: TOMSHA (April – Dec, 2007) THE STATUS: NATIONAL SELECTED INDICATORS …

C HALLENGES ENCOUNTERED IN N ATIONAL HIV R ESPONSE There are more data available which cannot give a clear picture of the interventions according to the indicator set protocols Not in place the Information Asset infrastructures and data governance for the National Response The principle of three ones, is not effective at district/ community level, due to multiple plan’s and budget being prepared at different times (e.g NMSF,GFATM, and the Government Budget, PEPFAR Planning )

C HALLENGES ENCOUNTERED IN N ATIONAL HIV R ESPONSE … MTEF capture only 26% of total spending, multiple planning and coordination structures for example TNCM and the annual PEPFAR planning. Some of Public and Private institutions focal persons are inactive which leads to lack of continuity of activities and understanding of priorities. Low disbursement of fund to various stakeholders work plan for HIV and AIDS interventions, resulting into either partial implementation or no implementation of work plan.

CONCLUSION The implementation of NMSF and development of the NMSF has resulted into achievements of some noticeable outcomes and impact on the HIV National response, as result of fully engagement of various stakeholders Community response has significantly increased, this has been possible due to the use of multisectoral approach, the formation of multisectoral AIDS Committees which widened the chance of involving many actors across different social sectors in the fight against HIV and AIDS infections, HIV and AIDS impact mitigation and HIV and AIDS care and support for members of the community who have already been infected.

CONCLUSION … The strong PPP adoption (Public Private Partnership) has made good achievements toward the support on the HIV and AIDS Interventions, Management and Leadership The operationalization of TOMSHA has made non health data/information be available from different implementers at grass root level, although they had reported only 9 months from April – December 2007, which help the policy and decision makers in making informed decisions easier. The establishment of Data Management Office to lead and ensure HIV data infrastructure are in place and have the data quality required to produce the right information product and disseminated to all stakeholders and the National Response – Leveraging our HIV Information Assets.