APHA International Health Poster Session - HIV/AIDS The Government of Tanzania is working to address a critical challenge faced by child protection and HIV practitioners: How to implement a systematic response that engages both community and facility based providers in a connected system to ensure most vulnerable children (MVC) and their families holistically receive social welfare, protection services, and HIV related needs. The USAID Community Health and Social Welfare system Strengthening Program (CHSSP), implemented by JSI Research & Training Institute, Inc., collaborated with the Tanzania Department of Social Welfare to design, and finalize a National Integrated Case Management System (NICMS). This document sets forth a harmonized, standardized, and systematic structure for the care and protection of MVC and their families, with the goal of improving access to and integration of protection, social welfare, and health services, including HIV continuum of care. The NICMS is responsive to MVC needs including HIV-specific social issues and includes: strengthening bi-directional linkages and referrals between social welfare, Protection, and HIV clinical providers; Coordinating civil society organizations dealing with MVC; strengthening MVC committees and ensure supportive supervision at all levels. All components ultimately contribute towards expanding access to HIV care and treatment services, enhancing ART retention and adherence, improving referrals and linkages. Recommendations/Conclusions: NICMS is a valuable initiative to serve MVC holistically, and has successfully integrated the Tanzanian health social welfare and Protection sectors to provide services across the continuum of care.

1. WELL-TRAINED
CASE MANAGERS
An integral part of
Tanzania's National
Integrated Case
Management System.
Case Manager Felitsa
(right), has been trained
by JSI's CHSS program
to work with vulnerable
families and children
and connect them to
services.
1
UNAIDS. (2015). United Republic of Tanzania: 2015 Country factsheets. Retrieved from http://aidsinfo.unaids.org/
IN TANZANIA, AN ESTIMATED 1.4 MILLION PEOPLE LIVE WITH HIV
AND 790,000 CHILDREN HAVE BEEN ORPHANED DUE TO AIDS.
There is widespread recognition that community systems
have the potential to offer tremendous support and resources
for Tanzanians, especially those affected and infected by HIV.
To ensure that the most vulnerable children (MVC) and their
families receive social welfare, protection, and HIV-related
services at the community level, consensus on national
guidelines and systems to implement them must be built
and supported. The Community Health and Social Welfare
System Strengthening Program (implemented by JSI) has
helped the government of Tanzania respond in a way that
engages community- and facility-based providers in a system
to ensure that life-saving services are available.The goal is
to improve equitable quality, quantity, and access to essential
services for all MVC in Tanzania.
A MANAGEMENT SYSTEM RESPONDS TO THE NEEDS OF TANZANIA’S MOST VULNERABLE CHILDREN
Tulli Tuhuma,1
Austin, Anne,1
Masesa, Peter,1
Mollel, Vailet.2
| 1
JSI Research & Training Institute, Inc. 2
World Education, Inc./Bantwana Initiative
RESULTS
The NICMS responds to MVC needs by strengthening
bi-directional linkages and referrals between social welfare,
protection agencies, and HIV clinical services (Figure 1).
It coordinates civil society organizations that help MVC, and
depends on strengthening MVC committees and supportive
supervision mechanisms at all levels. All components
help expand access to HIV care and treatment services;
enhancing ART retention and adherence; improving referrals
and linkages; and supporting HIV disclosure within families.
As of September 2017, a total of
14,500 COMMUNITY CASE WORKERS
have been trained on NICMS; this will result in approximately
384,000 MVC RECEIVING SERVICES.
FIGURE 1: REFERRAL AND LINKAGE PATHWAYS
RECOMMENDATIONS/CONCLUSION
The NICMS has been integrated into the Tanzanian health,
social welfare, and protection sectors to guide service
provision across the continuum of care. However, realizing
the NICMS vision will require ongoing efforts to build MVC
committees capacity and ensure the requisite numbers of
well-trained social-welfare officers, HIV service providers,
and social protection workers. Concurrently, implementing
partners must work with the GOT to ensure that efforts
to implement NICMS are coordinated.
Village Violence against Women & Children Committees (VVAWCC)
• Lead Community Case
Worker
• Case Worker
• Home Based Care
• Community Health Worker
• Other Members
HEALTH SERVICES
Regional
Hospital
District
Hospital
Dispensary
Departments
Other Extension
Officers
CVAWCPC
WVAWCPC CCW Supervisor
Social Welfare
Officer
Implementing
Partners
• NGOs
• CBOs
• FBOs
• CSOs
REGIONAL REPORTING MECHANISM
Health
Center
DESCRIPTION/METHOD
CHSSP collaborated with the Tanzania Department of Social
Welfare to design and finalize a National Integrated Case
Management System (NICMS). The NICMS, finalized
in 2017, standardizes care and protection for MVC
and their families, with the goal of improving access
to and integration of protection, social welfare, and
health services, including the HIV continuum of care.