\ud Strategic Social Marketing for Expanding the Commercial Market of Insecticide Treated Nets in Tanzania\ud

\ud The Department for International Development (DfID) has been supporting the introduction of ITNs in Tanzania since January 1998. The social marketing of ITNs for malaria prevention in Tanzania was introduced at a national scale in 2000 through the project Social Marketing of Insecticide Treated Nets (SMITN), funded by DfID and the Royal Netherlands Embassy (RNE) and implemented by Population Services International (PSI). This report reflects the SMARTNET project performance since July 2002. The SMARTNET project started in 2002 then was extended in 2004 and continued up to June 30th, 2007. The SMARTNET project was aimed at reduction of infant and under-5 mortality rates. The purpose of the project was to attain the Abuja target of regular usage of insecticide-treated nets (ITN) by 60% of the Tanzanians at high risk of malaria (children under-5 and pregnant women). The project aimed to increase the commercial availability of nets, at affordable prices; establish a nation-wide culture of ITN use; raise the percentage of net treated effectively with insecticide; and establish and maintain a monitoring and evaluation system. Population Services International Tanzania was contracted by DFID and RNE. The project is supervised by the NatNets Steering Committee, under responsibility of the National Malaria Control Programme (NMCP), part of the Directorate of Preventive Services of the Ministry of Health and Social Welfare (MOHSW). The commercial sector distributes and sells nets through a retail network, which reaches most of the wards in Tanzania. Over the years the sale of nets has increased steadily and will probably reach 3.5 million nets by the end of this year. The TRaC survey (PSI’s monitoring tool) conducted in April 2007 reports that 63% (54%) of pregnant women and 69% (55%) of U5s slept under a net (ITN) the previous night. Through the SMARTNET project insecticide re-treatment kits (NGAO) are promoted and the project has been making the net treatment kits free of charge available to all Tanzanian net manufacturers (TNM), for bundling with new nets. Purchasers of nets treat their new nets at home. While the regular Ngao protects for six months, PSI has introduced a longer lasting net treatment product, called Ngoa ya Muda Mrefu, which sustains under laboratory conditions at least 15 washes. The retreatment kits are sold through a dense network of retailers throughout the country. By the end of 2004 the Tanzania National Voucher Scheme (TNVS) was introduced, which issues vouchers to women during their first antenatal visit to a health clinic. This scheme is funded through subsidies from the Global Fund to Fight AIDS, TB and Malaria (GFATM). With the voucher women can purchase nets at a strongly reduced price (an average of US $ 1.00) from an accredited retailer of nets. Through this voucher system over 2 million nets have been purchased so far. About 80% of distributed vouchers are redeemed. The TNVS is the necessary complementary activity to reach large groups of the population at risk and to bring the nets within reach of the majority of the poor in the country.\u

Proposal to Strenghern Health Information System [HIS]

\ud The HMIS Program described in this document aims at improving and strengthening the current Health Management Information System (HMIS) in Tanzania, known as MTUHA. The consortium behind the HMIS Program is headed by the Ministry of Health & Social Welfare (MOHSW) and consists of the following additional partners; Ifakara Health Research and Development Centre, University of Dar es Salaam and the University of Oslo, representing national and international capacity in HMIS. The HMIS Program is linked to the Payment for performance (P4P) funding scheme which is initiated by the Norway Tanzania Partnership Initiative. The P4P has a focus on maternal and child health and relies upon quality indicators on performance in these areas from health facilities and districts. The provision of quality data and indicators on MDG 4 & 5 is therefore a key target for the HMIS Program. The chosen approach is, however, to derive these data from the HMIS and not to establish a separate data collection structure, hence the HMIS Program. Quality information by way of essential indicators, such as for monitoring the Millennium Development Goals 4 & 5, are crucial for health services delivery and program management as well as for M&E. Currently, however, the HMIS is not providing such needed data of sufficient completeness, timeliness and quality, leading health programs and funding agencies to establish their own structures for data collection, and thus creating fragmentation and adding to the problem. The HMIS Program aims at changing this negative trend and turning the HMIS into the key source of shared essential quality information in Tanzania by; focusing on action oriented use of information for management at each level of the health services and by providing timely quality information to all stakeholders, including all health programs and funding agencies in the HMIS strengthening process – making it an all-inclusive national process, focusing on capacity development; on-site support and facilitation, short courses and continuous education, building capacity in the MOHSW and establishing a national network of HMIS support, and by building on experience, methods and tools from Africa’s “best practices” HMIS, such as South Africa – and Zanzibar Within this proposal the aim is to carry out the HMIS strengthening process in 1/3 of the districts in the country, 7 regions, during the first 3 years. The objective, however, is to cover the entire country during the 5 years duration of the NTPI. By aiming at quick and tangible results, the expectation is that other funding agencies will join forces and thereby ensuring national coverage.\ud \u