Scale-up PHE activities in Tanzania

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3.1 Scale-up PHE activities in Tanzania

In Tanzania, BALANCED is supporting the integration of family planning into CRC’s on-going work through TCMP and its Pwani Project, which implements integrated PHE environment activities in villages surrounding Saadani National Park. These efforts are supported by the USAID Tanzania Mission with PEPFAR Presidents Emergency Plan for AIDS Relief and biodiversity conservation earmark funds. BALANCED provides modest funding to support the integration of community-based family planning CBFP into TCMP’s integrated activities— specifically by supporting community-based distribution, peer education, behavior change communication and advocacy for District governments to adopt the PHE approach. Since Year 3 of the Project, our PHE activities have been conducted five wards— Mkwaja, Mkalamo, Mwera, Mikinguni, and Kipumbwi—in the Pangani and Bagamoyo districts. In Year 4, our focus turned to monitoring these activities and strengthening our BCC efforts to increase demand for FP services, while building the capacity of TCMP and local governments to adopt this integrated approach on their own. In the second half of Year 4, the following was accomplished: • In February, Sean Peoples and Michael Miller from the WWC visited Pangani to make a series of short films about the PHE activities implemented by the Pwani and BALANCED Projects. Interested in the linkages between family planning and environment, they met with Pangani district officials, the UZIKWASA team, and village leaders. They also interviewed PEs and CBDs to learn about FP information and services and to hear from individuals involved in fuel efficient stovesovens, beekeeping, theater for development, village multisectoral AIDS Committee VMAC, and SACCOs in Sakura, Sange, Mkwaja and Mkalamo. The videos will be released later this year. To complement the videos, the team also prepared a short paper for the WWC FOCUS series. The paper is currently being edited by the WWC staff. • In March, the new Tuungane Let’s Unite Project led by The Nature Conservancy TNC, Pathfinder International, and the Frankfurt Zoological Society FZS sent four of their staff members from Kigoma on a study tour to Pangani. The purpose was to provide participants with an overview of PHE and learn how the Pwani and BALANCED Projects are implementing PHE in Pangani and Bagamoyo. The participants were interested in learning about how an integrated project is managed, how staff members are trained, how work plans are shared, what the benefits and challenges are, etc. The three organizations have created a partnership to address PHE issues in the Kigoma and Mpanda districts surrounding Mahale National Park on the shores of Lake Tanganyika. • BALANCED staff conducted regular monitoring and mentoring visits with existing CBDs, PHE providers, and adult PEs to improve the effectiveness and impact of the PHE community-based distribution and peer education outreach and service delivery systems, and to ensure trainees refer and distribute modern contraceptives as well as provide integrated PHE messages. • PHE IEC materials T-shirts and three radio spots based on the revised IEC messages were finalized. The t-shirts will be distributed to all of the PHE volunteers in Pangani and Bagamoyo to identify them as PHE volunteers and to promote the PHE IEC theme of protecting one’s natural resources as well as one’s own personal health. Three radio spots on 28 PHE and family planning were pretested in the community and will be aired on the Pangani FM radio station starting July 2012. Pangani FM was started by UZIKWASA—a partner on TCMP’s HIV activities— who uses entertaining radio dramas to educate the community about HIVAIDS. The PHE radio spots will be aired between the radio dramas and will reach Pangani and Bagomoyo districts as well as parts of Zanzibar. • The BALANCED team attended the monthly National Family Planning Working Group NFPWG meetings held regularly by the Ministry of Health MOH in Dar es Salaam. This is very important as it allows TCMP to discuss highlights and benefits of its PHE with MOH officials and key USAID collaborating agencies working on larger FP projects. • The EAC and Tanzania PHE Coordinator took a BALANCED PHE PE job aid and adapted it to the Tanzania context for use by Project PEs as they interact with fellow community members. The job aid has been translated into Swahili and will be printed in the first quarter of Year 5. The Reference Guide for PHE Community-based Distributors and PHE Adult Peer Educators, previously developed by BALANCED, has also been translated to Swahili and will be a companion to the job aid. • The team, as well as two government officials and PHE leaders in Pangani District Dr. Ole Tabitha Owenya, continued to conduct advocacy and planning meetings to integrate PHE into the Pangani District agenda. The District has yet to formally adopt PHE as a strategy in its development plan and budget. However, advocacy efforts continue. • The Tanzania PHE Coordinator traveled to Rhode Island where he attended the Building Leaders for Coastal Community Resilience: Integrating Population, Health and Environment course see Activity 1.6. During the course, he and two other Tanzanian participants from the Pwani Project and USAID designed a hypothetical PHE project on Zanzibar. The project design could be the basis for a future Zanzibar PHE proposal. • Finally, the team started planning for a second BMS. With two data sets 2009 and 2012, we expect to assess the impacts of the BALANCED PHE activities in the Mkwaja and Mkalamo wards by measuring changes in perceptions and behaviors. As part of the survey preparation, the team recruited two graduate students who will lead the field work in Tanzania Cathy McNally from URI and Emilia Myers from Tulane University School of Public Health Tropical Medicine. The team prepared and translated the survey and focus group questions, obtained approval from the URI Institutional Review Board, and prepared an interview guide, coding guide, and sampling instructions. The team also recruited an on-the-ground team that will conduct the survey. The survey field work will commence on July 16, 2012. • Twenty nine of the PHE YPEs are currently active in PHE work one woman moved to another non-PHE village after getting married. So far, the youth have conducted 24 PHE counseling sessions in their target communities on the links between humans and the environment. They have also distributed 12,000 condoms. As part of the Year 4 workplan, BALANCED had planned to train accredited drug dispensary outlets ADDOs in Bagamoyo and Pangani on PHE linkages and update them on their RHFP skills. Management for Sciences in Health MSH, the organization that worked closely with the Tanzanian Food and Drug Authority TFDA to develop the accreditation process for the ADDOs and train these pharmacy outlets, was very supportive of the BALANCED Project 29 providing refresher training on reproductive health, family planning and PHE linkages to ADDOs in Pangani and Bagamoyo. According to MSH, there are plenty of accredited ADDOs in Bagamoyo and a growing number in Pangani. However, when planning for the workshop, the team found out that most of the ADDOs are located in urban or semi-urban centers and in the villages where BALANCED and Pwani work, there are only three fully accredited ADDOs. As a result, we decided to cancel this activity. Results from Activity 3.1 • 1 person trained on Building Coastal Community Resilience: Integrating Population, Health and Environment in PHE Rhode Island training See Activity 1.6 30 Field based PHE results are: • 307 New users of FP services • 2,251 cycles of pills distributed • 924 current users of FP services that visited a CBD to renew their supply of pills or condoms • 1,038 clients referred by PEs and PHE providers to CBDs for FP methods • 1,692 individuals counseled by PEs and CBDs with environmental messages fuel efficient stoves and SACCOs • 4,160 male condoms distributed by CBDs • 12,000 condoms distributed by YPEs • 168 fishermen reached through focus group meetings on HIVAIDS prevention • 8 fuel efficient stoves were builtsold by the Mkalamo PHE community facilitator upon request from fellow villagers

3.2 Scale-up PHE activities in the Philippines Mission Buy-in