1. Effect of DBS* transportation fare reimbursement at lower facility level to improve Early Infant Diagnosis in Tanga region, Tanzania Carolyn Mbelwa, MD, MPH LEAD Project, Catholic Relief Services TANZANIA. *Dry Blood Spot

2. Background LEAD is a PEPFAR funded project supporting 521 facilities to provide Prevention of Mother to Child Transmission (PMTCT) services in two regions Scale up of HIV Early Infant Diagnosis(HEID) services to all PMTCT sites Training and continuous technical assistance and mentorship

3. Challenge Dry Blood Spot (DBS) samples for HEID from lower facilities took a long time to reach the zonal laboratory Lower facilities – District – Zonal Lab Facilities are located in remote areas challenged with limited and expensive modes of transportation

5. Proposed solution In December 2013, LEAD: Introduced fare reimbursements to lower facilities’ staff to transport DBS samples to the district hospitals Contracted courier services to transport the samples from the district to zonal laboratory and the results back the district Piloted in five districts of Tanga region.

6. Findings Increase in number of DBS samples collected by 30% Reduced Turnaround time from an average of 12 weeks time to 4 weeks time

7. Findings

8. Lessons learnt Involving the District health officials was a key to success The trip to the district provided an opportunity for transportation of other supplies/tools needed at facilities

9. Way forward Scaling up to all PMTCT sites District councils to incorporate this budget into their Comprehensive Council Health Plans (CCHP) for sustainability.

10. Acknowledgement Catholic Relief Services (CRS) - Mwikali Kioko - Robert Mgeni Futures Group - Moses Kehengu - Victor Katemana - Said Jongo

11. Thank you!