By Saumu Juma, Implementation Specialist, BID Initiative Tanzania
Dec 20, 2017
Earlier this month, the BID Initiative expanded to its third region in Tanzania, the Kilimanjaro region. This is a tremendous step and embodies our “learn fast, fail fast, share fast” core value by taking lessons learned from Arusha and Tanga region and building them into the Kilimanjaro rollout. Rollout to the Kilimanjaro region provides an opportunity for the government of Tanzania to take an ongoing leading role as they begin to plan to scale data quality and use interventions to the rest of the country.
Kilimanjaro is named after and located at the foot of the highest mountain in Africa, Mount Kilimanjaro. It borders Kenya and sits between the regions of Arusha, Tanga, and Manyara. The Kilimanjaro region is an opportunity to apply data quality and data use interventions to a different geographic setting and cultural context. For example, Kilimanjaro has better access to education and healthcare services.
In Tanzania’s first implementation region of Arusha, BID staff initially led all rollout activities and trainings, but this method did not guarantee the local capacity required for sustainability and ownership. Health workers considered this “BID’s project” and not “our initiative.” As we expanded to Tanga, training was increasingly led by district data use mentors at a regional, district, and facility-level. And there have been many additional lessons learned along the way with this new model of implementation. Several strategic changes were made to reflect our learnings. We transitioned from prescribed touches, to need-based visits to ensure ownership at the facility-level; changed the name from “district immunization mentors” to “district data use mentors” (DDUMs) because data is required of all health services; and from implementation kits and handouts used by the BID team, to a comprehensive mentor handbook used by the DDUM’s.
We’ve also improved both the functionality and content of Tanzania’s Electronic Immunization Registry (TImR), confirming that national scale up is possible. An important key to BID’s successful implementation is the integration of TImR and Tanzania’s Vaccine Information Management System (VIMS). Together, the two systems known as the Electronic Immunization System (EIS) offer end-to-end visibility into the vaccine supply chain – from a facility to a national level. The EIS has faced its share of challenges. Early on, for instance, there were occasionally delays in data synchronization between the two systems and stock transfer did not go smoothly in some facilities. That has since changed and the Kilimanjaro region will give us an additional opportunity to perfect this system, and to see the benefit from all that it offers.
Some of Kilimanjaro’s most senior regional officials, including the highest administrative leader, the Regional Commissioner, were present for the sensitization meeting held in November. This signals the increasing buy-in and support among government stakeholders for data quality and data use interventions. The meeting was well attended by delegates from the MOHCDGEC, immunization focal persons, regional medical officers, district medical officers, district executive officers and district commissioners from all seven district councils of Kilimanjaro. The MOHCDGEC delegates led the meeting by orienting the regional team on the overall vision of the ministry. They responded to questions about the BID Initiative and the rollout plan. This is a significant milestone as the government plays a more leading role in implementing data quality and data use interventions to the 306 health facilities that provide immunization services in the region with support from the BID Initiative.
“It was a unique experience to hear from the Director of ICT and the IVD Program Manager,” said Hassan Mtenga, Project Manager of the BID Initiative Tanzania. “They explained the pathway, the challenges and lessons learned from the implementation of BID, and how it informs the overall strategic vision of the ministry of health in addressing data quality and use. I couldn’t have done a better job explaining it myself.”
We are hopeful for a successful rollout in Kilimanjaro. It’s the best way to end 2017, and a welcome start to the new year!