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Diagnosis and Management of Severe Febrile Illness: Tibu Homa

Funded by: US Agency for International Development

Project Duration: 2011 to present

Countries: Tanzania

Geographic Focus:

The Lake Zone of Tanzania (Mwanza, Kagera, and Mara regions) – covering 22 districts.


Management Sciences for Health (MSH) and the African Medical and Research Foundation (AMREF)


This project is reducing morbidity and mortality among children under five from severe febrile illness. Severe febrile illness is characterized by the sudden onset of fever and may accompany such diseases as malaria, pneumonia, and diarrhea – the leading causes of death among this age group. Under the Swahili name Tibu Homa, meaning “Treat Fever,” the project is helping to increase the availability of and accessibility to fundamental, facility-based curative and preventive child health services; ensure the sustainability of these services; and increase linkages between health facilities and their communities to promote healthy behaviors, thereby increasing parents’ knowledge and use of child health services.

Key Activities
  • Improve case management of febrile illness at the facility level through continuous quality improvement approaches and on-the-job training and mentoring based on the Tanzania Ministry of Health and Social Welfare (MOHSW) updated Integrated Management of Childhood Illness (IMCI) protocol, which now promotes treatment based on evidence from mRDT/microscopy
  • Strengthen supply chain systems in public and private health facilities to ensure the continuous availability of medicines for febrile illness
  • Engage communities and develop linkages and referral systems between health providers and community members to 1) teach parents when to seek services for their children and 2) ensure services and appropriate referrals are available when a child is brought in for services

  • Supported the MOHSW in updating the national IMCI guidelines
  • Trained over 300 health care workers in case management (including triaging, which ensures patients needing urgent care receive it first, so as to reduce death and disability among children under five; supply chain forecasting; quantification; and inventory management)
  • Conducted training in case management in 15 districts to date and established case management teams, known as pediatric quality improvement teams (PQITs), in 120 health facilities
  • Trained PQITs in monitoring case management improvement indicators and in sharing monthly results among the team members through learning sessions
  • Involved the MOHSW Regional/District IMCI malaria focal persons in supportive supervision (planning and designing interventions to assist PQITs in developing improvement plans) – so as to ensure the sustainability of the case management improvements
  • Revitalized 11 Hospital Medicines and Therapeutics Committees to oversee medicines and supplies
  • Held a successful sustainability meeting with key regional leaders
  • Held meetings with 194 district authorities and community leaders to discuss community-level activities and received commitments for collaboration from key community and district-level leaders

Maternal, Newborn, and Child Health; Malaria

Quality Improvement; Health Systems Strengthening; Health Communication and Behavior Change

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