Joint Bi-Annual HIV/AIDS Review, 2008Blue Pearl Hotel, Ubungo Plaza

10-11 November 2008

Regions and Districts visitedHIV/AIDS Fund team comprising of

Government & Development Partners visited 18 District Councils in five Regions

Rapid Assessment of District and Community HIV/AIDS response team comprising of international and local consultants visited 18 District Councils in 18 Regions

This represents a coverage of 27% of the District Councils of Tanzania in 20 of the 21 Regions of the country.

Objectives of the field visits Field visit 1The overall objective of field visit 1 was to

examine the use of the HIV/AIDS Fund with a particular focus on the Medium Term Expenditure Framework (MTEF) at the council level. The team also looked at the use of the TOMSHA for monitoring non health interventions.

Objectives of field visits (cont’d)Field visit 2The main objective of the assessment was to

gather information about community based experiences in implementing HIV and AIDS activities. Furthermore, the consultants reviewed the overall HIV/ AIDS programming at council level. Their mandate included the identification of gaps in the delivery of interventions including the source of those gaps.

Key findings On Funding:

- a few districts have allocated their own funds to HIV/AIDS- There were inadequate funds to Community Based Organizations dealing with HIV and AIDS activities- Several of the MTEFs showed that the majority of the HIV/AIDS Fund was benefiting District Officials

Key findings (cont’d)On Funding (cont’d)

- Both teams reported that most of the funds provided for HIV/AIDS are for seminars and associated per diems only and not for the targeted audiences. The HIV/AIDS Fund team noted that in all the LGAs they visited, almost all funding went to various training programmes and very little to CBOs, NGOs; furthermore, training programmes were comparatively longer for Government Officials at district level than the WMACs and VMACs;

Key findings (cont’d)On Funding (cont’d)- What has been reported as done has not been implemented;

- There are some remarkable efforts and outputs from NGOs and volunteers but they were not getting enough recognition and very little funding

Key findings (cont’d)On Funding (cont’d)

- There is a recognized need of the importance of allocating funding for HIV/AIDS interventions at the local level;

Key findings (cont’d)On Reporting:

The LGAs provides timely performance quarterly expenditure reporting to PMO-RALG and Ministry of Finance and Planning; however, TACAIDS has been unable to track the performance expenditure reporting;

On Monitoring and Evaluation:Many people received TOMSHA training;Some NGOs reported that they use the TOMSHA

forms and that after completing the form they submitted them to the districts who in turn forwarded them to TACAIDS

Key findings (cont’d)On Monitoring and Evaluation (cont’d)

The districts understand that they must submit the forms to TACAIDS without analyzing them. None of the districts received feedback after the forms had been sent to TACAIDS;

Transport is a serious limitation for both Regions and Districts to carry out HIV/AIDS field visits. However, what was found out during the field visits was that even where there was transport for other programmes, sharing of such resources appeared to be a problem

At this stage there is no routine regular reporting as the TOMSHA is not fully operational and the only way to get annual performance reports is through field visits

Key findings (cont’d)On Coordination:

In many districts there appears to be good collaboration between the Districts AIDS Control Coordinators and the Council HIV/AIDS Coordinators. However, in some districts the role of the CHACs has been marginalized and decisions about the use of the HIV Fund are made by others. In those districts it was difficult to track the use of funds.

A few Prioritized Recommendations There are many recommendations from both

reviews but we deem the following will be prioritized for this and the next fiscal year: Given that the TOMSHA will take time to be

fully operational, TACAIDS will continue to do regular field visits. Each year at least one of the field visits will focus on funding flows and performance at the district level. This latter field visit should occur in August each year as it justifies the release of future funds to the districts;

A few Prioritized RecommendationsThere are bottlenecks in receiving LGA

performance and quarterly expenditure HIV/AIDS reports. These issues need to be urgently resolved. TACAIDS will endeavor to find a solution by working closely with PMO-RALG to obtain bi-annually LGA expenditure reports.

A few Prioritized RecommendationsThere are many comments made in both reports

about the TOMSHA. More than a thousand people have been trained on the use of TOMSHA. Many NGOs have indicated that they have forwarded the forms to the districts who in turn submit them to TACAIDS. An internal stock taking of the quality of information of these forms need to be conducted (i.e. how many of these forms has TACAIDS received, by which institution, in which districts, overall analysis, the whole feedback mechanism, etc…)

A few Prioritized RecommendationsSimilarly, several comments were made about

large expenditures on training and associated costs mostly benefiting district officials. Most reports appear to frown on putting conditionalities to the LGAs, however, the evidence from the HIV/AIDS fund for last year’s MTEFs and this year’s MTEFs and from the rapid assessment review indicates that the majority of the funding appears to go to training and the payment of allowances. Training requirements need to be well thought out and justified..

Questions we need to ask ourselvesShould we put conditionality to the LGAs on

the training expenditures? If some training expenditures are allowed,

should an amount be capped for districts training and districts encouraged to use available training allocation for WMACs, VMACs and CBOs?

How do we do away with the training syndrome that concentrates only at one level at the expense of lower levels?