Boresha Afya Brief: Findings from Boresha Afya, North and Central Zone

The project is implemented in six regions by a team led by EGPAF, which includes EngenderHealth. The project focuses on improving health and nutrition outcomes, with a specific emphasis on reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services. The project's developmental evaluation (DE) is designed to improve the quality, efficiency, utilization, and scalability of integrated health services in Tanzania. The DE focuses on three priority areas: clients and community, health service providers and facility managers, and monitoring, evaluation, and learning systems and practices. The assessment used two main methods for collecting data: outcome harvesting and rapid reconnaissance. Key findings from the evaluation include increases in community-to-facility referrals for integrated family planning services, with community-based health service providers playing a crucial role in promoting integrated health services. The evaluation also found that the uptake of integrated family planning services in Tabora increased during the period January to September 2018, with women who received family planning services increasing from 38,673 in the second quarter to 59,062 in quarter four. However, the evaluation also identified challenges, including inadequate documentation of referral services, overlapping and duplication of partner efforts to support community-based health service providers, and frequent changes in national documentation tools. Additionally, integrated family planning services are not consistently provided at all service delivery points, such as HIV care and treatment clinics, due to critical shortages of healthcare providers and high patient volumes. The evaluation also found that there is an increase in the number of male partners escorting women to the first antenatal care visit, with some cases showing men accompanying women in 50% to 90% of first-time ANC visits. However, the emphasis on couples counseling and testing services for HIV may be hindering the provision of family planning services to couples during the first ANC visit. Based on the evaluation findings, the Boresha Afya partners agreed on the need to identify a model site where family planning integration within HIV care and treatment clinics is working and facilitate learning across sites through exchange visits and engaging quality improvement teams. The partners also plan to work with the USAID Tulonge Afya project in developing male engagement messages and distributing family planning communication materials that target men.