AAPH is providing services include conducting facility Data Quality Assessments (DQA), Service Delivery Auditing (SDA) as well as data management and support on death audit data collection for the Afya Jumuishi+ HIV care and treatment project. Management and Development for Health (MDH) through Center for Disease Control and Prevention (CDC) funding is implementing HIV care and treatment services in the regions of Kagera, Dar es Salaam and Tabora. The program is currently implemented across both facility and community levels to enable scaling up and provision of quality integrated HIV care services for the Tanzanian community.
Through the service delivery audit activities, the program aims to assess and enhance the quality of healthcare service delivery in HIV care and treatment units. This involves evaluating adherence to national standards and guidelines as well as identifying areas for improvement. The overall audit activity entails a detailed review of 17 key HIV Care and treatment units such as HIV testing Services, Maternal and Child Health, TB/HIV, CECAP and Gender based violence (GBV), Retention, Non-communicable diseases, among others. This activity is conducted in close collaboration with MDH as well as active engagement of Regional and Council Health Management teams (R/CHMT). Further follow up and revisit initiatives are also conducted to determine the status of implementation of audit feedback findings and recommendations over time.
AAPH together with MDH technical teams also provide technical assistance and support in the collection, entry, analysis, and reporting of death audit data. This activity is conducted whereby trained verbal autopsy interviewers conduct interviews with relatives of a deceased HIV client upon his/her death using a standardized questionnaire adopted from the World Health Organization (WHO) and reviewed by the Ministry of Health. Following interviews in the field, trained physician coders are responsible to review the interview of signs and symptoms faced by the deceased client and assign the most probable cause of death. Each verbal autopsy is coded by 2 blinded independent coders in order to achieve concordance on the cause of death. This activity has the overall aim of identifying preventable deaths among PLHIV in order to ultimately improve quality of care.
Overall, AAPH activities within the Afya Jumuishi + program have the goal of improving quality of HIV care and treatment services by guiding the program in making informed decisions towards contributing to the UNAIDs 95-95-95 goals.