MAXIMIZING POSITIVE SYNERGIES - World Health Organization

Nonetheless, efforts to recruit and retain health workers in other clinical areas are required to
prevent further strain on the system. Although most of the trainings supported by GHIs have been
given in the context of a particular disease control programme, certain skills are perceived as
transferable. For instance, communication skills that were taught as part of training in voluntary
counselling and testing (VCT) have been used in delivery of other services as well.
Medical Products, Vaccines, and Technologies
The Global Fund and other development partners have had a major impact on the pharmaceutical
landscape in Tanzania. Their support has, for instance, enabled Tanzania to offer antiretrovirals
(ARVs) and drugs for the treatment of opportunistic infections (OIs) free of charge at the point of
care. Furthermore, to enable the scale-up of ART in Tanzania, the Global Fund has had to invest in
strengthening the systems for procurement and supply of drugs in the public system operated by
the Medical Stores Department (MSD). The Global Fund has invested in increasing the storage
capacity at zonal warehouses, and in improving supply chain management systems and skills. The
Tanzania Food and Drug Authority, charged with monitoring the quality, safety and efficacy of all
drugs in the country, has also received support from the Global Fund to improve its systems for
drug testing and quality assurance.
Information
Like many other developing countries, Tanzania has struggled with its systems for monitoring and
evaluation (M&E). Consequently, national control programmes like those for HIV/AIDS and TB, as
well as development partners, have set up their own, parallel systems. This has triggered a
proliferation of indicators used to assess the performance and impact of these programmes. Data
with respect to activities supported by the Global Fund are collected with the aid of ‘executive
dashboards’: Excel-based reporting forms for data collection and analysis. Some of the data is
collected from routine systems such as the Health Management Information System (HMIS),
whereas other information is specific to a particular grant. As a result of these parallel systems,
programme coordinators and managers at the implementation level spend a significant amount of
time on data collection and reporting. Further harmonization of data collection systems, indicators
and evaluation efforts is currently considered a priority under the Third Health Sector Strategic
Framework.
Although GHIs have added to the workload of those involved in M&E activities, they have also
been important contributors to the analytical capacity of the health system. Facilities supported by
the Global Fund have been able to purchase computers and software needed for data collection
and analysis. Workers at the district and facility levels have also received training in essential M&E
skills. Although these trainings are often disease-specific in nature, basic analytical skills are useful
across the health system. Furthermore, these developments have resulted in a greater
appreciation of the importance of M&E at the lower administrative levels.
Service Delivery
Undeniably, the GHIs have had a major impact on the capacity of the Tanzanian health system to
provide basic services for HIV/AIDS and TB. For instance, the Global Fund has enabled large-scale
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