1. Making Innovation Sustainable: The Axios Experience in Tanzania Anne V. Reeler, PhD Chief Technical Officer, Axios

2. 2 Our Health Care Network Countries reached 104 countries reached

3. 3 The Axios Approach 1.Innovate in health care delivery 2.Validate cost-effectiveness of innovation 3.Create local ownership 4.Use local resources in innovation 5.Build local capacity from the start 6.Plan for transfer of ownership and costs 7.Scale up and ensure sustainability

4. 4 Innovation and Validation Integrated VCT in Tanzania:  1 referral hospital  12 regional hospitals  79 HC and dispensaries

5. 5 VCT Research: Cost per HIV+ identified

6. 6 Local Ownership The Axios Mobilization Methodology

7. 7 Building Local Capacity Assessment (AMM) Building Technical Assistance Monitoring Evaluation Partner Competence Full Operation Transition and Sustainability Level of Effort Phase 1 Phase 2Phase 3Phase 4Phase 5 Communication Publication

8. 8 Use Local Resources (1) Traditional birth attendants and PMTCT:  Integration of PMTCT in all levels of health facilities in two districts  Training of traditional birth attendants

9. 9 Use Local Resources (2) Community Based Paralegal Assistance:  Community sensitization  Training of community members  Linked to official legal system and village government

10. 10 Transfer of Responsibility and Costs  Use existing structures and personnel  Planning with regions/districts/partners  Gradual absorption in local budgets  Incorporate activities in supervision schedules

11. 11 Scaling Up and Sustainability  Research and publications  Share methodologies and results  National policies

12. Thank you Anne V. Reeler, PhD Chief Technical Officer, Axios anne.reeler@axiosint.com