Africa

One year ago, Malawi launched its first National Medical Oxygen Ecosystem Roadmap. It is already helping to close the oxygen access gap.

In 2021, the Tanzania Ministry of Health, with support from PATH Tanzania, conducted a survey of health management information system (HMIS) focal people throughout Tanzania, and key informant interviews in targeted regions. The assessment was intended to document the data use practices supported by the District Health Profiles (DHP), and determine whether DHPs have facilitated data use at the council level, including how DHPs are being used to make decisions related to annual planning, and develop the annual comprehensive council health plans.Thee Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC) adopted a cross-sectional, mixed-methods approach for this assessment, applying qualitative and quantitative data-collection methods. MOHCDGEC used purposive and convenience sampling methods to recruit participants for the assessment. For the qualitative component of the assessment, MOHCDGEC mainly used key informant interviews (KIIs) with select national level staff and council level staff from six selected councils, as well as observation and document reviews, to gather findings. For the quantitative component, MOHCDGEC used online questionnaires disseminated to health management information systems focal people in all 184 councils in Tanzania.The assessment showed that majority of participants in both study groups (council level and national level respondents for KIIs and health management information system focal people for the surveys) acknowledged that there was demand for DHPs in decision-making meetings. The main users of DHPs were found to be members of council health management team (CHMT), and other users included development partners, councilors and research institutions. The assessment found that the primary uses for DHPs were to identify health problems and gaps, aid planning and budgeting, support district showcasing, identify disease trends, and aid in decision making. Despite the reported demand and the various uses for DHPs that respondents named, the findings also pointed to the perception that most of the councils were not allocating budgets for DHP preparation, production, and dissemination. The study also showed that the majority of CHMT members had never received any DHP training. The most common methods used to sensitize stakeholders to DHPs and make them aware of the existence of and potential uses for DHPs, were meetings, workshops, and seminars. The assessment findings also showed that the majority of councils were not producing the DHPs on time. Finally, the assessment respondents reported that the main challenges to using data from DHPs were lack of budget allocated for DHPs, difficulty in finding data due to changes in administration area, low commitment of stakeholders, low DHP priority, low data quality from data sources, and inadequate resources for the development and dissemination of DHPs.

Medical devices are a critical but often overlooked component for effective facility-based care, especially for women and children. Many medical devices have unique characteristics that make them difficult to manage effectively, particularly in low-resource settings. For instance, some devices can serve multiple clinical uses across different health programs—complicating ownership and funding responsibilities. They can sometimes require extensive training, ongoing preventive maintenance, and a reliable supply of specialized parts and accessories.This fact sheet offers an overview of the Scaling Access to Lifesaving Equipment (SCALE) project—which builds on previous research and initiatives under Market Dynamics for Medical Devices. Through this project, PATH will identify and test promising new business and operating models, while strengthening the underlying systems for managing all durable medical devices and equipment. With a vision that patients should have reliable access to device-related health services, this project seeks to ensure medical devices are available and functional in sufficient quantities across health facilities.

For the past 20 years, Dr. Caroline Phiri-Chibawe, Chief of Party, US President’s Malaria Initiative PAMO Plus project, has worked toward malaria elimination in her home country of Zambia.

Routine immunizations and new vaccine introductions have proven to be some of the best investments to improve the health of people around the globe. However, the trend in global vaccine coverage has been variable across regions, including completion of the vaccination package to meet the World Health Organization’s target of 90 percent coverage.Several factors have been found to influence vaccine access, vaccine coverage, and completion of the vaccination schedule. In Tanzania, these factors include socioeconomic status, gender dynamics, limited knowledge on the importance of immunization, and poor access to vaccination services.In addition, socioeconomic status in Tanzania is inadequately assessed in routine immunization to determine trends and population groups at risk of low immunization coverage and non-completion of the vaccine package. The existing immunization data collection tools, such as the tally book, monthly reporting form, and health management information system book do not capture the data elements necessary to determine the socioeconomic status of caregivers. Reporting tools provide aggregated data that do not provide the whole story on the collected data with other related factors on immunization inequities.The immunization and vaccine development program, in support of the GAVI HSS fund, the United Nations Children’s Fund, and PATH, through the better immunization data initiative, agreed to update the Tanzania immunization registry to capture socioeconomic data from routine vaccination services in Tanzania. The data will be used for analysis to determine trends and population groups at risk of low immunization coverage and non-completion of the vaccine package.In this report, we share the experiences of using the electronic immunization registry to accommodate assessment of immunization inequities, and the process used to develop the socioeconomic status assessment tool in Tanzania.

In Tanzania, a health facility serves as the first point of contact for vaccination and birth notification while the Registration, Insolvency and Trusteeship Agency (RITA) is mandated for birth registration and provision of birth certificates. At health facilities, newborns are provided with a child health card and notification card that instructs parents to process the birth certificate at RITA offices, which are decentralized at the district level.In 2015, birth certificates’ coverage for children under 5 years was under 50 percent, according to RITA, compared to birth notification provided at health facilities. This low coverage of birth certificates was due to several factors, including delays of parents in visiting RITA offices, loss of birth notification cards in the first 90 days, limited awareness of birth certificates, and inadequate tracking of records.These factors motivated the Ministry of Health (MOH), through the Immunization and Vaccine Development (IVD) Program and RITA, to initiate the registration of births and provision of birth certificates be conducted concurrently at health facilities. This intended to improve immunization service delivery as well as birth registration and coverage of birth certificates in the country.Since the launch of this initiative in June 2015, the number of registrations of children under 5 years old increased from 13 percent in 2012 to 65 percent in 2021.In this document we describe the process of integrating the electronic Tanzania Immunization Registry (TImR) and the Under 5 Birth Registration System to improve birth registration coverage. We also share lessons learned on the integration process of the two systems.

Since 2014, PATH has been working with the Tanzania Ministry of Health (MOH) under the immunization and vaccine development (IVD) program to implement the better immunization data (BID) initiative in Tanzania. The BID initiative is grounded in the belief that better data and better decisions will lead to better health outcomes. The vision at BID initiative is to support countries to enhance immunization and overall health service delivery through improved data collection, quality, and use. In partnership with the MOH through the IVD Program, the BID initiative identified several critical data-related challenges in issues of data quality, limited data use capacity, inaccurate or uncertain target populations, poor visibility into vaccine supplies, and difficulty identifying children who defaulted on immunization schedules. As part of resolving these challenges, the BID initiative, in consultation with the MOH, introduced a holistic package of interventions in Tanzania. This included information system products, evidence-based practices, and capacity-building to empower health workers at all health system levels toward data-driven action. The key outcomes of this work were:An electronic immunization registry with supply chain information integrated into the vaccine information management system.Barcodes on child health cards and vaccine supplies for unique identification of children and vaccine management, respectively.A change management package, including peer support networks, targeted supportive supervision, and mentorship.From 2015 through 2020, the designed interventions were deployed in 3,748 health facilities in 15 regions of Tanzania: Arusha, Dar es Salaam, Dodoma, Geita, Katavi, Kigoma, Kilimanjaro, Lindi, Morogoro, Mtwara, Mwanza, Njombe, Rukwa, Ruvuma, and Tanga.

Drawing on PATH’s global expertise working in primary health care (PHC) for more than 40 years, as well as deep engagement in Kenya, where PATH has supported the government for more than 30 years, PATH regularly serves as a technical partner to the Kenyan government on PHC policy adoption and implementation at both the national and subnational levels. This factsheet highlights examples as well as priorities for future work.