Tanzania

Effects of Integrating ShangRing into Routine Voluntary Medical Male Circumcision: Lessons from Active Adverse Event Surveillance in Tanzania

ihadmin2 — Thu, 02 Mar 2023 14:52:16 +0000

Effects of Integrating ShangRing into Routine Voluntary Medical Male Circumcision: Lessons from Active Adverse Event Surveillance in Tanzania 2023 ihadmin2 March 02, 2023

Following a successful implementation of the ShangRing pilot evaluation study in Tanzania, IntraHealth International and Afya Plus supported the implementation of active adverse event surveillance to assess the effects of rolling out ShangRing circumcision in Tanzania and provide evidence to inform the government of Tanzania on the use of ShangRing circumcisions.

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Countries Tanzania

Topics Family Planning & Reproductive Health

Evaluation of the acceptability and safety of the ShangRing device for male circumcision in Shinyanga, Tanzania

kmelton — Tue, 04 Jan 2022 15:15:24 +0000

Evaluation of the acceptability and safety of the ShangRing device for male circumcision in Shinyanga, Tanzania 2021 kmelton January 04, 2022

Male circumcision (MC) reduces the risk of heterosexually acquired HIV infection in men by 60%. Tanzania is among the 14 sub-Saharan African countries that is scaling up voluntary medical male circumcision (VMMC) for HIV prevention through conventional surgical circumcision. Accelerating the scale up of MC in areas with high HIV prevalence, low MC coverage, and a predominantly heterosexual epidemic is a key component in a comprehensive response for HIV epidemic control. Medical circumcision devices have the potential to speed up the roll out of MC by making the procedure quicker and easier than surgical circumcision, while remaining just as safe. The ShangRing was prequalified by the World Health Organization (WHO) in 2015 as a promising device for circumcision in adolescent and adult males 13 years and older. Based on the WHO’s framework for introducing MC devices in countries, IntraHealth International in Tanzania conducted a study to evaluate the acceptability and safety of the ShangRing MC device in Tanzania.

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Countries Tanzania

Projects Tohara Plus

Topics HIV & AIDS

Novel Approaches in Tanzania Lead to HIV Services for Over 1.3 Million Clients

kseaton — Thu, 11 Nov 2021 14:14:51 +0000

Novel Approaches in Tanzania Lead to HIV Services for Over 1.3 Million Clients kseaton November 11, 2021 November 11, 2021

More than 1.37 million clients have received high-quality voluntary medical male circumcision (VMMC) services for HIV-prevention in Tanzania over the past five years through IntraHealth International’s Tohara Plus project, one of the most successful projects of its kind.

Tohara Plus pioneered novel approaches using human-centered design to reach more clients with VMMC services, which lower a man’s risk of acquiring HIV through heterosexual sex by around 60%. Some of those approaches include:

Strategically placed services.

By engaging men where they work or spend a lot of time—such as barber shops, mines, fishing camps, agricultural plantations, motorcycle taxi stops, and cotton ginnery factories—the program reached more clients and addressed behavioral barriers that might have kept them from seeking out VMMC services. The program promotes one-on-one engagement between potential clients and community volunteer agents, popular opinion leaders, local leaders, peer networks, and satisfied VMMC clients.

Partnerships with employers.

Tohara Plus works with workplace leaders and communities to co-design VMMC programs. The program has partnered with fisherfolk, beach management units, small-scale miners, sugar plantation and ginneries owners, and boda boda (motorcycle taxi) driver associations.

Mobile clinics.

To reach remote areas of Tanzania, Tohara Plus deployed three mounted mobile clinic vans to expand “men-friendly” services for hard-to-reach adult men and high-risk mobile populations at highway truck stops and near mining and fishing communities. The vans also helped maintain services during COVID-19 by providing care in a project-controlled environment, reducing congestion at health facilities and minimizing the distance some clients must travel to access services.

The ShangRing device.

Tohara Plus registered this WHO prequalified device—a process that recognizes the safety, quality, and efficacy of a product—in Tanzania, which makes the circumcision procedure safer and easier for clients who cannot easily return to their follow-up appointments.

Real-time geostatistical data.

Tohara Plus uses granular geostatistical models and real-time data to plan and monitor VMMC services.

A VMMC client, accompanied by Dr. Sosolo, enters the mobile clinic van in the Simiyu region of Tanzania. Photo by Rashid Hamis Kindamba for IntraHealth International.

Tohara Plus reached more men with circumcision services than any other VMMC partner in Tanzania.

By using these approaches and partnering with health workers throughout seven lake zone regions northern Tanzania, Tohara Plus has achieved the following results over the past five years:

Provided VMMC services for HIV-prevention to 1,376,382 clients, reaching more men with circumcision services consecutively for the past four years than any other VMMC partner in Tanzania while maintaining high quality services.
Linked over 95% of HIV-positive clients with care and treatment services.
Achieved a 96% return rate for clients who come to their follow-up appointment within 14 days of the procedure
Introduced quality improvement measures that resulted in less than 0.1% of adverse events (well under the WHO’s standard 2%)
Established VMMC services within routine health care delivery in 104 VMMC static sites
Established five early infant male circumcision (EIMC) sites
Renovated 11 VMMC static sites
Trained 996 VMMC service providers and 2,144 community volunteer agents on the human-centered design approach
Trained 28 national VMMC/EIMC trainers
Trained 111 health workers on use of DHIS2 to manage, monitor, and apply project results to strengthen programming

The project also led a successful consortium that included two local partners—the Tanzania Youth Alliance (TAYOA) and IntraHealth’s local affiliate, Afya Plus—to create demand for and provide quality VMMC services among eligible males in the supported regions.

And when COVID-19 began to spread around the world in 2020, the project integrated COVID-19 prevention measures and vaccination awareness into VMMC routine services to ensure the safety of VMMC providers and clients and continuity of services.

“We owe our success to our partnership approach,” says Lucy Mphuru, Tanzania country director and project director of Tohara Plus. “We include stakeholders in every step of our processes to cultivate a high level of ownership and accountability. We ensured a uniquely transparent method of planning with clear roles, responsibilities, and a consensus on targets; a “moving together” through implementation approach; and side-by-side monitoring and problem solving to improve VMMC programming.”

With US President's Emergency Plan for AIDS Relief ambition funding Tohara Plus received in 2021, the project was able to identify and serve high-risk and hard-to-reach men over 24 years old, including fishermen. The proportion of males over 24 who were reached increased from 16% in 2020 to 26% in the beginning of 2021.

To read more about how Tohara Plus was affected by COVID-19 and how they quickly adapted to provide services during the pandemic, read What Does It Take to Keep HIV Services Available in Tanzania during COVID-19?, a Q&A with Lucy Mphuru, the project director.

Tohara Plus is a five-year project funded by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) through Centers for Disease Control (CDC) Tanzania to accelerate the scale up of VMMC services in seven Lake Victoria regions of Tanzania.

Tanzania HIV & AIDS Community HealthA client holds his patient card for before going into the mobile clinic van for HIV testing and the VMMC procedure. Photo by Rashid Hamis Kindamba for IntraHealth International.Tohara Plus

Technical Briefs: Tanzania's Tohara Plus Program

kmelton — Wed, 03 Nov 2021 19:48:14 +0000

Technical Briefs: Tanzania's Tohara Plus Program 2021 kmelton November 03, 2021

Our Tohara Plus project—which is funded by the President's Emergency Plan For AIDS Relief (PEPFAR) and the US Centers for Disease Control—has provided HIV services in Tanzania since 2016 to help the country tackle its HIV epidemic sustainably while also working toward the country’s vision of an AIDS-free generation. The Tohara Plus project offers high-quality, safe voluntary medical male circumcision (VMMC) services—a procedure that reduces a man’s risk of acquiring HIV through heterosexual intercourse by about 60%.

Learn more about our results in the briefs below:

Countries Tanzania

Topics HIV & AIDS

By Anne Fitzgerald Vinluan, Kija Nyalali, Lucy Mphuru, Mary Goodluck Mndeme , Msafiri Swai

A Decision-to-Action Mental Journey That Increased Utilization of VMMC Services Among Fisherfolks in Lake Victoria Islands, Tanzania

kmelton — Wed, 03 Nov 2021 19:39:36 +0000

A Decision-to-Action Mental Journey That Increased Utilization of VMMC Services Among Fisherfolks in Lake Victoria Islands, Tanzania 2021 kmelton November 03, 2021 Download

Technical Briefs: Tanzania's Tohara Plus Program

Robust Monitoring, Mentoring, and Training to Optimize the Quality of Voluntary Medical Male Circumcision Services

Using Data to Improve Quality and Outcomes of Voluntary Medical Male Circumcision Services in Tanzania

Mobile Clinic Vans Make Voluntary Medical Male Circumcision Services Attractive to More Adult Men in Tanzania

A Three-Pronged Model for Stakeholder Engagement: Analysis, Transparency, and Empowerment

Tohara Journey: Integrating a Human-Centered Design Approach into a Mobile App to Enhance Uptake of Voluntary Medical Male Circumcision in Tanzania

Countries Tanzania

Projects Tohara Plus

Topics HIV & AIDS Community Health

By Msafiri Swai, Mary Goodluck Mndeme , Kija Nyalali, Lucy Mphuru, Anne Fitzgerald Vinluan

A Three-Pronged Model for Stakeholder Engagement: Analysis, Transparency, and Empowerment

kmelton — Wed, 03 Nov 2021 19:32:42 +0000

A Three-Pronged Model for Stakeholder Engagement: Analysis, Transparency, and Empowerment 2021 kmelton November 03, 2021 Download

Technical Briefs: Tanzania's Tohara Plus Program

Robust Monitoring, Mentoring, and Training to Optimize the Quality of Voluntary Medical Male Circumcision Services

Using Data to Improve Quality and Outcomes of Voluntary Medical Male Circumcision Services in Tanzania

Mobile Clinic Vans Make Voluntary Medical Male Circumcision Services Attractive to More Adult Men in Tanzania

A Decision-to-Action Mental Journey That Increased Utilization of VMMC Services Among Fisherfolks in Lake Victoria Islands, Tanzania

Tohara Journey: Integrating a Human-Centered Design Approach into a Mobile App to Enhance Uptake of Voluntary Medical Male Circumcision in Tanzania

Countries Tanzania

Projects Tohara Plus

Topics HIV & AIDS Leadership and Governance Health Workforce & Systems

By Msafiri Swai, Mary Goodluck Mndeme , Kija Nyalali, Lucy Mphuru, Anne Fitzgerald Vinluan

Mobile Clinic Vans Make Voluntary Medical Male Circumcision Services Attractive to More Adult Men in Tanzania

kmelton — Wed, 03 Nov 2021 19:29:03 +0000

Mobile Clinic Vans Make Voluntary Medical Male Circumcision Services Attractive to More Adult Men in Tanzania 2021 kmelton November 03, 2021 Download

Technical Briefs: Tanzania's Tohara Plus Program

Robust Monitoring, Mentoring, and Training to Optimize the Quality of Voluntary Medical Male Circumcision Services

Using Data to Improve Quality and Outcomes of Voluntary Medical Male Circumcision Services in Tanzania

A Three-Pronged Model for Stakeholder Engagement: Analysis, Transparency, and Empowerment

A Decision-to-Action Mental Journey That Increased Utilization of VMMC Services Among Fisherfolks in Lake Victoria Islands, Tanzania

Tohara Journey: Integrating a Human-Centered Design Approach into a Mobile App to Enhance Uptake of Voluntary Medical Male Circumcision in Tanzania

Countries Tanzania

Projects Tohara Plus

Topics HIV & AIDS Community Health

By Kija Nyalali, Lucy Mphuru, Anne Fitzgerald Vinluan

Tohara Journey: Integrating a Human-Centered Design Approach into a Mobile App to Enhance Uptake of Voluntary Medical Male Circumcision in Tanzania

kmelton — Wed, 03 Nov 2021 19:26:53 +0000

Tohara Journey: Integrating a Human-Centered Design Approach into a Mobile App to Enhance Uptake of Voluntary Medical Male Circumcision in Tanzania 2021 kmelton November 03, 2021 Download

Technical Briefs: Tanzania's Tohara Plus Program

Robust Monitoring, Mentoring, and Training to Optimize the Quality of Voluntary Medical Male Circumcision Services

Using Data to Improve Quality and Outcomes of Voluntary Medical Male Circumcision Services in Tanzania

Mobile Clinic Vans Make Voluntary Medical Male Circumcision Services Attractive to More Adult Men in Tanzania

A Three-Pronged Model for Stakeholder Engagement: Analysis, Transparency, and Empowerment

A Decision-to-Action Mental Journey That Increased Utilization of VMMC Services Among Fisherfolks in Lake Victoria Islands, Tanzania

Countries Tanzania

Projects Tohara Plus

Topics HIV & AIDS Community Health Digital Health

By Kija Nyalali, Msafiri Swai, Lucy Mphuru, Anne Fitzgerald Vinluan

Using Data to Improve Quality and Outcomes of Voluntary Medical Male Circumcision Services in Tanzania

kmelton — Wed, 03 Nov 2021 19:24:24 +0000

Using Data to Improve Quality and Outcomes of Voluntary Medical Male Circumcision Services in Tanzania 2021 kmelton November 03, 2021 Download

A Decision-to-Action Mental Journey That Increased Utilization of VMMC Services Among Fisherfolks in Lake Victoria Islands, Tanzania

Tohara Journey: Integrating a Human-Centered Design Approach into a Mobile App to Enhance Uptake of Voluntary Medical Male Circumcision in Tanzania

Countries Tanzania

Projects Tohara Plus

Topics HIV & AIDS Measurement & Analytics Measurement and Evaluation

By Kija Nyalali, Lucy Mphuru, Anne Fitzgerald Vinluan

Robust Monitoring, Mentoring, and Training to Optimize the Quality of Voluntary Medical Male Circumcision Services

kmelton — Wed, 03 Nov 2021 14:48:24 +0000

Robust Monitoring, Mentoring, and Training to Optimize the Quality of Voluntary Medical Male Circumcision Services 2021 kmelton November 03, 2021 Download

A Decision-to-Action Mental Journey That Increased Utilization of VMMC Services Among Fisherfolks in Lake Victoria Islands, Tanzania

Tohara Journey: Integrating a Human-Centered Design Approach into a Mobile App to Enhance Uptake of Voluntary Medical Male Circumcision in Tanzania

Countries Tanzania

Projects Tohara Plus

Topics HIV & AIDS Performance & Quality Improvement Measurement and Evaluation

By Kija Nyalali, Lucy Mphuru, Anne Fitzgerald Vinluan