The Boresha Afya project aims to empower communities to find, test, treat, and retain children, pregnant and lactating mothers, and young mothers living with HIV into care. The project applies an age-appropriate response. This will help filling the service provision gap for all people reaching the facility and those who don’t due to long distance to the facility, lack of transport cost, or lack of escort, among others.

Community representatives such as community health workers, women and children protection committee members and leaders, religious leaders, people living with HIV groups, champions and mentor mothers, teenager clubs, and caregivers support groups will be capacitated and engaged in the project implementation. Furthermore, staff at health facilities will be trained to offer child-friendly services and collaborate closely with communities.

Boresha Afya is Swahili for ‘Enhance Health’  and the project will be implemented in two regions and six councils in Tanzania: Dodoma in Dodoma City, Kongwa and Chamwino district councils, and Njombe in Njombe Town, Makete, and Wanging’ombe District councils.

BACKGROUND

In Tanzania, It is estimated that 0.4% of children under the age of 15 years are infected with HIV. Regional-wise, the highest prevalence rates were found in Njombe (0.8%), Iringa (0.7%), Mbeya (0.6%) and Dodoma (0.2%). Also, the prevalence rate for pregnant and breastfeeding women is highest in Njombe at 9.7%, Iringa at 7.6%, Mbeya at 6.4%, and Dodoma is 2.1% (Ministry of Health Tanzania, 2023).

In Tanzania prevention of HIV transmission from mother to child, being 3.2% in 2020 and 2.8% in 2022, is a slight improvement. However, the gaps in preventing vertical transmission, are due to low HIV maternal retesting; mothers not receiving antiretroviral therapy, mothers dropping out of care, and mothers getting infected during pregnancy or the breastfeeding period, (Ministry of Health Tanzania, 2023). Other barriers are stigma and discrimination; long distances to health facilities and costs for transport; lack of child-friendly services; insufficient food and nutrients; and poor adherence of the mother on attending HIV care and taking medicine.

Over 90% of new infections among infants and young children occur through vertical transmission. Without any interventions, between 20% and 45% of infants may become infected.

OBJECTIVES

Main goal is that women living with HIV  are identified, receive appropriate HIV services, and live healthy lives.
Objectives are:

• 3000 women living with HIV are identified, have started treatment, and are supported to continue their treatment
• The community has the knowledge and capacity to identify women living with HIV  and to link them to appropriate HIV services
• Strengthened community-facility collaboration for comprehensive HIV services to women
• Young mothers living with HIV and caregivers of children living with HIV are treatment literate and support their children’s treatment
• Advocacy for access to and availability of HIV treatment of women living with HIV
• Consortium members and partners have the required knowledge and skills on maternal and paediatric HIV and are aware of the progress of the project
• Sustainability of maternal & paediatric HIV intervention

EXPECTED RESULTS

• 3000 women living with HIV will be reached.
• 360 community representatives will be identified and engaged in the project implementation
• 52 staff at health facilities will be trained to offer child-friendly services