1. Presented by Dr. Ellen Mkondya Senkoro, CEO - BMF
BMF Performance Update up to December DPG – Health Meeting 4th June 2018
Presented by Dr. Ellen Mkondya Senkoro, CEO - BMF

2. Outline BMF Focus Areas Strategic Focus Areas
BMF Contribution to National Framework
Main achievements across the Focus Areas
Emerging Issues
Institutional

3. BMF Strategic Plan –
Trust registered in 2006, founded by the Former President to complement the Government efforts in the improving health sector developments
Vision- To be a hub in innovations for ensuring equitable, accessible and quality health service delivery in Tanzania.
Mission- To facilitate the delivery of responsive health services , including HIV/AIDS particularly in underserved areas through innovation in health systems
Result 1.
Reinforce response to HIV and AIDS and related health conditions
Human Resources for Health and Community Health Workers
Result 3.
Robust management of Information, Education & Communication
Result 4.
Building a Sustainable Business Model of BMAF
Result 5.
Effective BMAF Operational Systems and Technical Leadership Capacity

4. Benjamin W. Mkapa Foundation Focus Areas
Recruitment, Distribution & Production, Productivity & Retention of HRH including CHW
HIV and AIDS Care & Treatment/Maternal health care
UHC
HSSP IV
HRHSP,
HSHSP 4,
One Plan II,
CBHP,
NSP 5 – TB & Leprosy
Infrastructure –
Staff Houses, Theatre, Maternity Wards & MDR sites and TB Diagnostic sites
Community Interventions- HIV
and TB
Quality Improvement Initiatives – HIV and MNH Services
Policy, Advocacy & Documentation

5. HIV/AIDS and TB. HIV Testing ON ART
72,719 people Tested through Combination Prevention Campaign (CPC) and Integrated Community Outreach
Out of them 1421 tested positive and referred to care.
21% increase of women attending ANC .
40% increase of eligible HIV positive clients on care who are initiated on ART from 65% (Dec 2015) to 105% (Dec 2017)
11% increase of HIV positive pregnant women receiving ART for PMTCT from 92% (Dec 2015) to 103% (Dec 2017) TB
TB screening conducted to was conducted to 30,667 people among them 135 were presumptive cases and referred.

6. RMNCH Services Output Outcome
Initiated CEmONC services in 11 facilities through constructing of Eleven (11) theatres in 4 regions – Kagera, Simiyu, Rukwa and Shinyanga
Initiated Coaching and Mentorship by Specialists from Regional Referral Hospital to the constructed (functional) theatres
Trained 51 HWs on CEmONC services
(6) Upgrading from CO to AMO, (6) Anaesthesia and other(35) CEmONC training , (8) Attachment of clinicians to regional hospitals for CEmONC training
Availability of functional QI teams in 16 HFs (84%) out of 19HFs in 4 regions following orientation on Standard Based Management and Recognition (SBMR) of the MOHCDGEC for RMNCH quality improvement initiative
21% increase of pregnant women delivering at the facility from 56% in 2015 to 77% (2017)
Through integrated Community Outreach a total of 2,460 people were reached with family planning services and 2014 were screened for cervical cancer.

7. Human Resources for Health (HRH)
Output
Outcome
Recruited a total of 1148, 818 ( 83%) have been mainstreamed
Scholarship for 945 middle level cadres to be deployment in PHC level facilities
Capacitated 1860 LGAs officials in HRM, Performance Mgt, Planning and 119 facilities staff were capacitated on DHFF
Facilitated the development &institutionalisation of customized retention incentive strategies for 16 LGAs.
Support in staff re/distribution through WISN
Rehabilitated 480 staff houses in 269 health facilities in 55 LGA’s
Increased availability of quality health services
Reduced shortage of skilled HCWs at district & facility level at average of 56% in 2016-but increased to 62% by Dec 2017 in 70 LGAs
Improved Planning CCHP & retention
34 facilities not functioning-become full functional (staff houses)-availability of emergency services,reduction of working distance by communities to the facilities.

8. Community Health Workers
Enhanced quality of training for CHWs in 10 Lake Zone HTIs.
Supported harmonisation of the training tools (Curriculum with all training tools) ,
Supported MOHCDGEC in developing of CHW Training and supervision tools
Support MOHCDGEC to conduct supervision to improve quality of CHW Training
Conducted survey on level of satisfaction of Tutors, students and graduates
Provision of teaching aid (10 LCD Projectors and 10 Laptops)
Oriented 167 CHMT members from 8 local authorities on a new concept of CBHP

9. Policy and Advocacy
National HRH Alliance comprising of 12 organisations developed.
Annual HRH Advocacy Strategy developed and implemented- contributed to the following achievements:
Improvement HRH availability in beneficiary regions.
Improved planning for HRH incentives in CCHP.
Contributed to the revises Medical and Health Allied Practitioners ACT- Compulsory attachment.
Established National Champions from Parliamentarian and Ward Councilors and facilitated their consultative dialogues with respective ministries, regions, districts and communities decision makers, as well as presenting key HRH agendas to the parliament.
Effective engagement to the Sectoral policy dialogue forums( SWAPs, JAHRS, HRH TWG (Co Chair), CHW Task force…where lesson learnt from BMF’s interventions are shared.

10. BMF Coverage VS National Specific Service Priority regionsxx
Kigoma
Tabora
Geita
Simiyu
Shinyanga x
Arusha
Katavi
Mbeya
Singida
Dodoma X
Iringa
Morogoro
Njombe
Ruvuma
Lindi
Pwani
Mtwara
Manyara
Tanga
Kilimanjaro
Dar Es Salaam
Kagera
Mara
Mwanza
Lake Rukwa
Lake Victoria
Rukwa
BMF Coverage
About 11mil Population reached-in 90 % of the Regions
including their LGA’s respective facilities and Communities
11 million people have been reached directly and indirectly with BMF interventions in almost 90% of the country.
The green, yellow and blue shaded regions are regions which Govt has prioritized or focused on either HRH only ( blue), HIV and RMNCH ( green) and HIV, RMNCH and HRH ( yellow). You will note the yellow one is mostly in lake and south western zone, green mainly in southern highland.
KEY
HRH ( National focus)
HIV & RMNCH ( National focus)
HIV/RMNCH & HRH ( National focus) x
BMF Reached the site with one intervention xx
BMF Reached the site with more than one intervention

11. New Interventions /Projects
TB – HIV- GF- HIV Prevention for general population- CPC approach –in 4 regions ,8 districts & 184 wards
MFP3- CHW deployment ,11 LGAs-4 regions– with key target on improving – RMNCH,HIV/AIDS community services & strengthen community/facility linkages, Improved quality of facility based RMNCH and HIV services through CME,C&M,Technology, Improved facility based HIV/RMNCH youth friendly services, Improved facility planning, Evidence generation to inform/influence investment decisions on HRH ,CHWs & quality of CEmONC services.
UAM- Improving Anaesthesia services through – Universal Anaesthesia Machine (UAM)
RSSH- SR-(upon award)- HRH,CHWs, E-platform for HRH, Social Accountability

12. EXPERIENCE ON GF Round 3 &4 (2007-2010) – Emergency Hiring
HSS-R9 – ( ) – deployment of HRH & tutor, production, HRM&Productivity,staff houses, Professional Ethics
NFM-Extension for student grants and rehabilitation of staff houses
TB/HIV- ( )- Community TB (13 regions)
RSSH- FR-(on progress)- HRH & CHWs, Responsive community systems
Secretariat for NSA- facilitates the engagement process for NSA in FR development and implementation
Key Lessons: Pulling & Pushing factor for Success & sustainability- Effective engagement of interministerial actors, NSAs & local CSOs in Grants mgt & implementation, integrating grant management within the ministerial structures, need for grant management and communication charter , strengthen implementation collaborations & timely decisions.

13. EXPERIENCE ON GF
Key Lessons: Pulling & Pushing factor for Success & sustainability:
Effective engagement of interministerial actors, NSAs & local CSOs in Grants mgt & implementation.
Effective supervision for infrastructure investment-for quality assurance
Balanced investment for infrastructure and health systems
integrating grant management within the ministerial structures
need for grant management and communication charter
strengthen implementation collaborations & timely decisions.

14. Key Emerging Issues
Innovation to accelerate HRH & CHW deployment and utilization
Investment options for deployment of HRH & CHW though PPP- BMF, MAT, APHTA Collaboration with Government
Utilization for CHW to acceleration UHC and also to increase health Insurance Coverage
Use of technology to strengthen Mentoring, CME, Supervision, Coaching and mentoring for HRH & CHW.
Strengthen Partnership and collaboration with local CSO’s
Investments on productivity interventions.
Evidence generation for evidence based and targeted& consultative advocacy for policy & process improvement .

15. Institutional
BMF is currently reviewing its Strategic Plan to 2018
Continuous strengthening for operational systems- financial, M&E ,Research and Knowledge Management
Investment Options for BMF program sustainability- Endowment Fund, Basket Funding,SPV

16. Thank you for your attention