Global Programs—Tanzania works with University of California, San Francisco (UCSF) researchers and their in-country partners, either as project staff or in supporting administration of research and training projects. Our staff provide training, mentoring and technical assistance to build capacity in epidemiologic surveillance, monitoring and evaluation, data science, and applied public health research among health ministries and local partners.
In collaboration with PEPFAR, our staff developed DAMES, an innovative mobile reporting system that captures data through both SMS and a smart phone app. This system allows DREAMS providers to link individual participants across community and facility interventions and multiple organizations to assess the layering of DREAMS services.
We supported the MoHCDGEC to develop and roll out national data-quality assessment guidelines. The guidelines use the data-quality applications within the national HMIS (DHIS2) and routinize the assessment of routinely reported data within the national health system. We also supported NACP to develop and roll out the National Data Quality Guidelines for Care and Treatment. We also conducted a data-quality assessment of PEPFAR-required indicators for ART, HIV Testing and Counseling (HTC) and PMTCT to inform partner- and facility-level data quality improvement systems.
Through the UCSF Institute for Global Health Sciences Informatics Hub, we have access to HIS professionals in our sister Global Programs offices in Kenya, Mozambique, Namibia, Uganda and San Francisco. This team has expertise in:
- Software development
- Server administration
- Systems design, development, testing and implementation
- Database management
- Popular open source health information systems such as DHIS2, OpenMRS and ODK; data analysis, visualization, reporting and business intelligence systems
- App development for Android and iOS
- Dashboard development
- GIS mapping to design, develop, implement and use health information systems at national and sub-national levels
- User training
UCSF and Global Programs developed the impact evaluation of the DREAMS Tanzania program. DREAMS is a global partnership between PEPFAR, Girl Effect and the Bill & Melinda Gates Foundation to reduce new HIV infections in vulnerable adolescent girls and young women. This evaluation uses innovative technology platforms and mixed methods including a longitudinal cohort, time-location sampling (TLS), and qualitative interviews to assess intervention effect and reach, program acceptability within target communities and fidelity of implementation.
Program Monitoring and Evaluation
Our work supports the development and implementation of Monitoring and Evaluation (M&E) plans to help partners measure progress towards stated objectives and track program effectiveness. We have supported monitoring and evaluation of President’s Emergency Plan for AIDS Relief's (PEPFAR) Gender-Based Violence Initiative as well as the development of the M&E sections of the Zanzibar Health Sector HIV Strategic Plan II and the mainland Health Sector HIV Strategic Plan III. We have also supported NACP through the revision of key population and patient monitoring tools.
Our staff provide technical assistance to NACP and the Zanzibar Integrated HIV, Hepatitis, TB and Leprosy Programme (ZIHHTLP) in planning and implementing integrated biological and behavioral surveillance surveys (IBBSS), which are designed to improve understanding of the disease burden and unique service needs among key populations at risk for HIV. We have supported four IBBSS studies in Tanzania from protocol development through report writing and dissemination. Results from these studies have been the basis for developing and improving programmatic interventions.
We provided technical assistance to NACP in conducting a SWOT assessment of the HIV/AIDS surveillance system and in determining the feasibility of implementing HIV case-based surveillance in Tanzania.
Our staff provided technical assistance to the Drug Control Commission of Tanzania in planning, implementing and analyzing data for a mixed-methods assessment to better understand the scope of drug use in Tanzania, to estimate population size, and to map the geographic distribution of people who use and inject drugs along the coast and in other regions of the country. Key stakeholders used findings from this student to target and plan interventions for people who inject drugs.
We are working with NACP to conduct a study to identify and characterize high-risk populations at areas of high transmission along major transit corridors in Tanzania using innovative surveillance techniques, such as starfish sampling. The study will assess HIV prevalence and incidence measures, linkage to HIV services, sexual networks, high-risk behaviors and other drivers of the epidemic.
We are also working with NACP and ZIHHTLP on several Integrated Bio-Behavioral Surveys (IBBS) among key populations such as men who have sex with men, people who inject drugs, female sex workers, fisherfolk etc. in mainland and Zanzibar. These studies include key populations mapping and size estimation activities to better understand key population sizes, distributions, and characteristics.
We are supporting NACP to roll out a National HIV drug resistance surveillance study, from protocol development through to report writing and dissemination. This study will characterize nationally the amount and type of HIV drug resistance among persons on antiretroviral treatment or acquired drug resistance.
We have provided support to NACP on ANC/PMTCT sentinel surveillance among women attending antenatal care clinics to estimate trends in HIV prevalence.
Training and Capacity Building
We collaborate with the Tanzania Commission for AIDS (TACAIDS) to coordinate triangulation workshops with regional-, district- and facility-level HIV/AIDS providers. Workshops include training in Microsoft Excel, DHIS2 and mapping software to produce visual data displays; building local capacity to analyze and use sub-national data for program improvement; and developing HIV triangulation reports to assess and address challenges affecting service provision. GSI has coordinated 26 workshops covering 24 regions of Tanzania in an effort to promote a culture of data use and encourage evidence-based decision making.
We have conducted four scientific writing workshops to support CDC, NACP and ZIHHTLP staff to develop scientific manuscripts and guide participants through the manuscript submission and review process. GSI also supported the launch of the East African Journal of Applied Health Monitoring and Evaluation, which is housed at Mzumbe University’s Centre of Excellence in Health Monitoring and Evaluation. As one measure to ensure sustainability of the journal, UCSF Institute for Global Health Sciences faculty mentor Mzumbe University faculty on scientific writing.
Our team at UCSF Institute for Global Health Sciences and in Tanzania supported the launch of the Master’s of Science in Health Monitoring & Evaluation at Mzumbe University in 2013 and provided significant technical input to the curriculum’s development. The first cohort of students graduated in December 2015 and additional cohorts continue to enroll, thereby increasing the human resource capacity in M&E within the public sector.