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USAID Health Care Improvement Project (HCI) | Tanzania

Funded by: US Agency for International Development

Project Duration: 2007-2012

Countries: Tanzania

Geographic Focus:

National level and regions of Tanga, Morogoro, Mtwara, Iringa, Lindi, Kilimanjaro, Shinyanga, Mbeya, Pwani, and Manyara


Ministry of Health and Social Welfare, National HIV/AIDS Control Program, Department of Social Welfare, PharmAccess Foundation, President’s Emergency Plan for AIDS Relief (PEPFAR), Family Health International, Elizabeth Glaser Pediatric AIDS Foundation, AIDS Alliance, Clinton Health Access Initiative, EngenderHealth, PACT, The Balm in Gilead, The Walter Reed National Military Medical Center, World Education, Inc., Africare, Save the Children, Pathfinder, and Catholic Relief Services


With PEPFAR funding through USAID Tanzania, URC supported the Ministry of Health and Social Welfare (MOHSW) through the National AIDS Control Program (NACP) in managing a national quality improvement (QI) program for antiretroviral therapy (ART), pediatric AIDS care, the prevention of mother-to-child transmission of HIV (PMTCT), and care for the country’s most vulnerable children (MVC).

HCI built the QI capacity of regional and council (district) health management teams and their partners using demonstrations and intentional scale-up strategies. The project supported the NACP and other key implementing partners to develop and roll out national standard operating procedures (SOP) for the home-based care program. The project also supported PMTCT partners and MOHSW’s Reproductive and Child Health department in scaling up infant-feeding counseling training to enable women to practice breastfeeding safely and to increase the survival rate of HIV-free infants.

In addition, HCI provided support to the national MVC Program and Task Force to implement a set of MVC service standards and to measure processes and results to improve the quality and equity of services. The project conducted operational research studies to document program outcomes and strengthen knowledge management.

Read more about the HCI project or visit

Key Activities
  • Supported development and scale-up of regional ART/PMTCT Improvement Collaboratives
  • Implemented a demonstration collaborative on improving PMTCT services through reduction of attrition gaps and improving infant-feeding counseling for HIV-positive mothers
  • Provided technical support to the MVC Task Force and partners to pilot-test evidence-based standards for programs serving most vulnerable children
  • Developed and roll out guidelines and standard operating procedures for home-based care program
  • Introduced a patient self-management approach among patients on ART in Morogoro
  • Worked with implementing partners in a slice of a health care system in Iringa to roll out the WHO 2010 PMTCT [e1] guidelines
  • Conducted research and evaluation studies to document the impact of QI approaches
  • Helped to develop and launch national QI guidelines for ART/PMTCT and MVC, including tools for rolling out the guidelines
  • Helped 7.5 million people (19% of the population) in six regions receive improved ART/PMTCT services
  • Trained trainers in infant-feeding counseling using URC-designed job aids (19 regions)
  • Trained regional trainers in QI (11 regions)
  • Piloted a framework for defining quality gaps and confirmed it as a feasible tool for monitoring QI efforts in ART
  • Supported the Government of Tanzania to develop a national partnership for QI that strengthened and harmonized multiple-partner efforts in QI as well as leveraged resources
  • Tested the validity of sequential self-assessment of performance of QI teams over time in Mtwara

Note: LTFU means lost to follow-up; CTC means care and treatment center.

Contact Information
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Maternal, Newborn, and Child Health; HIV and AIDS; Food and Nutrition; Vulnerable Children and Families

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

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