Serving Communities, Improving Lives

Transcription

1 Serving Communities, Improving Lives T-MARC TANZANIA ANNUAL REPORT

2 About T-MARC Tanzania T-MARC Tanzania is an independent, Tanzanian, not for profit, non-governmental organization (NGO) working in Tanzania for the benefit of Tanzanians. T-MARC employs a dynamic approach, bringing together public and private stakeholders to develop and expand consumer markets for a broad range of social products. T-MARC also promotes behaviour change through evidencebased practices that contribute to a positive health and social impact within the development field. These practices, products and strategies are in the areas of reproductive health, water & sanitation, nutrition and infectious diseases like HIV/AIDS and malaria. Our interventions target vulnerable, at risk and low income audiences. Our Mission T-MARC Tanzania s mission is to successfully contribute to the well-being of all Tanzanians by developing effective and diverse partnerships between multiple players in the commercial, NGO, governmental and public sectors to implement social marketing and communications solutions that address key health, social and economic challenges. T-MARC facilitates the growth of the full market for an extensive range of social products and services; and works to increase the practice of healthy behaviours. Our Vision T-MARC Tanzania is committed to becoming a leader in creating sustainable solutions by utilizing the Organisation s Four Ps Approach: 1. People: Reaching all Tanzanians with special focus on the under-served and most in need, while promoting continued growth in staff expertise. 2. Partnerships: Promoting new collaborations with partners from the public, private and non-profit sector, working with a diverse group of donors, and collaborating with local government agencies, NGOs, CBOs, commercial entities and others throughout Tanzania. 3. Portfolio: Serving the needs of Tanzanians through a variety of health, social and economic activities focused on social marketing, communications and partnerships. 4. Place: Facilitating reach throughout Tanzania with extensive knowledge of the country and areas where the most at risk groups reside; using innovative technologies to produce research data linked to region and location to improve policy practices and results. 2

3 Our Values T-MARC Tanzania holds itself to the highest levels of integrity and has a strong commitment to the following values: 1. Leadership T-MARC Tanzania strives for top results in the initiatives it undertakes; stepping forward with innovative ideas, bringing together new partners and staying on the cutting edge of innovations in social marketing. 2. Partnership T-MARC Tanzania is part of a larger team; working with stakeholders, government donors, collaborating agencies and others to combine resources, strengths and skills to achieve success. 3. Accountability T-MARC Tanzania is committed to achieving the highest level of transparency and ethics in all financial, management and partnership activities undertaken holding itself responsible to donors, partners and beneficiaries of its programs. 4. Respect T-MARC Tanzania puts respect for the people of Tanzania first - revering diversity, valuing strengths and skills and working collaboratively with the beneficiaries of its programs and products. 5. Passion Staffs at T-MARC Tanzania maintain personal and professional enthusiasm for their work and are driven by a sense of purpose and a desire to do all that they can to help improve the social conditions of Tanzanian families. Our Objectives Primary objectives of T-MARC Tanzania are to: 1. Develop and manage cost-effective marketing, sales, and distribution networks that will improve access by key populations to branded products and services addressing health, social and economic challenges. 2. Develop and manage broad-based social communication initiatives that enhance accurate knowledge of Tanzanians about core issues related to branded social products, health and economic issues, including persuasive information to encourage and sustain healthy behaviours. 3. Establish and maintain practical partnerships with international agencies and local organizations from Tanzania s commercial, non-governmental and/or faith-based sectors for key roles in planned and on-going programs. 3

4 Signs of Progress The Tanzania Social Marketing Program T-MARC Tanzania is collaborating with PSI Tanzania on the Tanzania Social Marketing Program (TSMP), a five year project funded by United States Agency for International Development (USAID) through the President s Emergency Fund for AIDS Relief (PEPFAR). The goal of TSMP is to improve the health status of Tanzanian families. TSMP is utilising the Total Market Approach (TMA) supported by social marketing to achieve a marketplace where all segments of society are reached with high quality health products and services according to their ability to pay. In a balanced TMA, the poorest access products and services through free distribution, those who are somewhat better off through subsidized products, and those with greater ability to pay through commercially-distributed products. Through TSMP, T-MARC is committed to growing the overall market volume for health products by engaging key stakeholders from the public, non-profit and private sectors to improve market segmentation, employing subsidy strategies, improving distribution systems, attracting new user groups into the market and opening up new markets particularly in rural areas through community-based distribution. T-MARC role in TSMP encompasses HIV/AIDS prevention and Family Planning (FP). 4

5 HIV/AIDS In HIV/AIDS prevention, T-MARC continues to socially market its flagship brands of Dume male condoms and Lady Pepeta female condoms, and conduct behaviour change communication activities. Dume Male Condoms An important objective of T-MARC Tanzania is to increase the availability and usage of condoms in among most at risk groups in Tanzania to mitigate transmission of the HIV virus, contributing to the Government of Tanzania s efforts to reduce prevalence of HIV in the country. To achieve this objective T-MARC launched its socially marketed male condom brand, Dume, in March A key deliverable under the TSMP five-year operational plan is the rebranding and repositioning the male condom brand Dume, to focus on the mid-tier / middle income market. This effort aims to achieve the total market impact for the condom market in Tanzania and address the disproportionately high levels of HIV infection among men in this target group. After months of resource intensive preparations, the Dume male condoms repositioning campaign was officially unveiled by the Deputy Minister of Health and Social Welfare, Dr. Seif Suleiman Rashid on 31st July 2012, in Dar es Salaam. The high profile event was well attended by representatives of the government, business, donor and development communities, and private individuals as well. Socially marketed under the banner Kwa Mwanaume wa Kweli (for the true man), the new look Dume male condoms now targets men of middle to high social economic status whom research shows are at a higher risk of HIV infection. Portfolio: 126,720 pieces of Dume condom were sold under the C-vending program, across 79 condom vending machines that were placed in high risk outlets in Dar es Salaam Region. This year a total of 13,391,286 pieces of Dume male condoms were sold and distributed in Tanzania. This achievement is 11.6% above the annual FY2012 target 5

6 Dume male condoms was promoted through the traditional advertising and media channels, and for the first time through the internet on the dedicated Dume website and via social media sites on Facebook, Twitter and YouTube. People: The Dume male condoms fan base on facebook currently exceeds 23,000 fans with over 12,000 people engaging with the Dume Condoms page on a weekly basis. The number of unique people who had seen content from the Dume facebook page at the end of year 2012 were 513,574, highlighting the success of this campaign in reaching the target audience. The Dume Challenge TV Contest The Dume Challenge TV contest was a first of its kind television program that addressed the behavioural determinants for condom use, encouraged the adoption of positive male qualities and encouraged consistent condom use amongst men within the target group. In the context of the Dume Challenge contestants were tried on eight values of adaptability, teamwork, intelligence, responsibility, authenticity, respect, courage and leadership. Over a period of 12 weeks, the twelve men drawn from different regions and walks of life in the country competed for the title of Mwanaume wa Kweli wa Dume (Dume s true man) and a grand prize of 20 million shillings. Salum Njwete, a martial arts instructor from Dar es Salaam emerged victorious. 6

7 Place: Dume male condom has increased its penetration across Tanzania. The 2011 HIV MAP and MAP TRA research results analyzed this year confirm that Dume s national penetration has risen from 33% in 2010 to 45% in the 2011 study. Notably Dume s urban penetration has increased from 33% to 71%. Other Dume male condom demand creation activities implemented to sustain the brand s sales performance include the Mobile 2012 World Aids Day, 2011&2012 Uhuru Torch, SabaSaba and NaneNane public events brand promotions and small group Jali Maisha IPC sessions. These activities cumulatively reached 6,231 Msafiris (Dume s target audience) Partnership: To realize better economies of scale in product transportation, T-MARC outsourced TSMP s sales and distribution activities to PSI/TZ in January Under the PSI/TZ consignment agreement, PSI warehouses and distributes T-MARC products in both Pharma and FMCG channels, which includes contracting dealers, order generation, invoicing, product transportation and debt collection. Lady Pepeta T-MARC s goal in marketing Lady Pepeta is to help reduce the prevalence of HIV in Tanzania from 5.7% to 4.0% by September Supported under the TSMP Project by the United States Agency for International Development (USAID), Lady Pepeta is a female condom targeting high groups of women such as bar-maids, commercial sex workers and women engaged in transaction sex. Lady Pepeta is an option for sexually active women who want to have more control over their reproductive health, especially in situations when it is unlikely a male condom will be used. Five key demand creation activities were implemented this year to grow and sustain Lady Pepeta female condom uptake numbers, specifically amongst sex workers (SW) and women engaged in transactional sex (WETS). These included Lady Pepeta female condom product detailing and face to face interpersonal communication (IPC) sessions during the Dume mobile population campaign, the 2012 World Aids Day commemorations, Uhuru Torch Race public events, International Women s Day Celebrations in Dar es Salaam, SabaSaba and the NaneNane public event brand promotions. Lady Pepeta also conducted small group female condom IPC sessions with 150 Miss Tanzania beauty pageant participants in Dar es Salaam, and the scaling up of the Jipende Hair Salons Resource Centre for Women s Health initiative in Mbeya, Shinyanga and Mwanza. 7

8 Portfolio: So far 254 beauty salon attendants drawn from 127 salons in hot spot areas across Dar es Salaam, Mwanza, Shinyanga and Mbeya have graduated as Jipende Salon peer educators. T-MARC hosted US President Bush s visit to a Jipende! Salon in Dar es Salaam where the former President and his family were given an overview of the program by Jipende! Salon attendants who are trained peer educators in women reproductive health issues. These activities cumulatively reached 7,012 Waridi s i.e. Lady Pepeta s intended target audiences through the Jipende Hair Salon peer educators. With support from the United States Agency for International Development (USAID) through the U.S. President s Emergency Plan for Aids Relief (PEPFAR), the Jipende! (Love Yourself!) program was introduced in In 2011 and 2012 the program has been scaled up to Dar es Salaam, Mbeya, Shinyanga and Mwanza regions. T-MARC Tanzania trains the beauty salon owners and assistants to provide information and advice to their female clients on HIV prevention, family planning, women s health, and to sell both male and female condoms. Partnership - Strategic collaborations with Husika and Pathfinder programs, under their respective sex worker peer educator activities were developed to integrate Lady Pepeta condom use training and product distribution initiatives. This year a total of 733,500 pieces of Lady Pepeta female condoms were sold and distributed which is an achievement that was 6% below the annual FY2012 target but an increase of 125% over FY11 sales. 8

9 Family Planning T-MARC s goal in marketing Flexi P Oral Contraceptive Pills is to contribute to a 60 percent increase of contraceptive prevalence rate (CPR) 1 among women of reproductive age in Tanzania by Additionally, Flexi P aims to help reduce maternal mortality among women of reproductive age. Flexi P kicked off its repositioning plans by revamping Flexi P s packaging and developing a communication campaign that will maximise awareness for the new packaging, the new formulation (Combination 3), the new brand positioning and enhance the quality perception for Flexi P. USAID s waiver for the importation and distribution of the Combination 3 formulation prior to the completion of the product registration by TFDA enabled T-MARC to distribute Flexi-P in a transitional packaging (existing pack design with minor modifications to reflect new manufacturer) and to conduct some of the planned marketing activities. Some demand creation activities conducted this year included the consumer based distribution (CBD) program in Dodoma, Sengerema and Tarime. T-MARC conducted refresher training with 72 Washauri (health advisors) across the 3 CBD sites and developed strategies to improve the performance of the program through a performance incentive scheme based sales and coverage targets by the Washauris. Through this program 5,055 people were reached twith Flexi P, Dume, Lady Pepeta product sales and HIV prevention and family planning (FP) education. Place: FlexiP sponsored worksite FP education interventions in Mwanza, Shinyanga and Dar es Salaam covered 51 organisations and reached 3,648 people. The campaign was extended and scaled up to also cover Mbeya, Iringa, Arusha and Kilimanjaro where an additional 149 organizations were recruited for the IPC education sessions. Four (4) outreach educators, four (4) Flexi P brand promoters and ten (10) research assistance were trained on modern family planning methods (MFPM) to implement the scaled up worksite campaign. A three day Accredited Drug Dispensing Outlets (ADDO) medical detailing campaign in Mbeya, Iringa, Rukwa, Ruvuma, Manyara, Mara, Tanga, Coast, Lindi, Mtwara, Morogoro, Dodoma, Singida, Shinyanga and Kigoma recruited and trained 24 team members on modern family planning methods(mfpm) and Flexi P detailing. Small group IPC FP education sessions covering FP method mix, FlexiP brand promotions and one on one FP counselling sessions held at the Dar es Salaam International Trade Fair (SabaSaba) and the NaneNane agricultural fairs in Mbeya, Arusha, Mwanza, Morogoro reached 647 and 2,043 individuals respectively. 1 Contraceptive Prevalence Rate. CPR is the percentage of women of reproductive age (15-49) who are using (or whose partner is using) a contraceptive method at particular point in time. 9

10 Some 150 Miss Tanzania Beauty pageant contestants were reached via small group family planning education sessions which provided basic knowledge and facts on modern family planning methods (MFPM), including a Flexi P product detailing session. The Jipende! Resource Centres for Women s Health initiative in Mbeya, Shinyanga and Mwanza trained 160 salon attendants from 80 newly recruited salons on family planning, Flexi P product detailing and HIV/STI prevention, cervical and breast cancer education. This collaborative intervention with Lady Pepeta aims to train and support Jipende! Hair Saloon attendants to be effective reproductive health (RH) and family planning (FP) outreach educators to their clients. Leadership: In spite of Flexi P product transition and stock out situations arising from bottlenecks in registration of the new Combination 3 formulation in quarter two and three, Flexi P exceeded its annual sales target by 21% selling 1,832,832 cycles. Community Based Distribution project (CBD) comes to a close Through the Community Based Distribution (CBD) project, T-MARC renewed its Memorandum of Understanding (MOU) with the Private Nurses and Midwives Association of Tanzania (PRINMAT), who agreed to offer clinic referral support for all CBD referred clients as well as field administration and data collection supervisory support across CBD sites in Tarime, Dodoma and Sengerema. A lot was done to improve the Community Based Distributor (CBD) program s performance against its expected outcomes through enhancement in the implementation strategy, increased supportive supervision and sustained training investments. However the performance improvements that were anticipated were not forthcoming. T-MARC therefore plans to close the CBD program in FY13, after an end-line study is conducted to inform the program s evaluation report. 10

11 Husika Program Supported by the United States Agency for International Development (USAID), the Husika subagreement with PSI supports the implementation of USAID s five year HIV Prevention Project with most at risk populations (MARPs). Husika (get involved) is a call to action for public and private health providers, politicians, community leaders, civil society organizations, international & local non-governmental organizations (NGOs) and the at-risk and most-at-risk individuals themselves to take a stand and address the HIV epidemic among populations whose needs have largely been unmet. The overall goal of the Husika Project is to reduce the HIV incidence in Tanzania by preventing HIV transmission between at risk populations, most at risk populations (MARPS) and their sexual partners. Program objectives are; 1. Strengthening the protective behaviours of at risk populations, most at risk populations (MARPS) and their sexual partners to prevent HIV transmission; 2. Strengthening the environment at national and lower levels to enable at risk populations and MARPS access high quality medical and non-medical support and services. The primary target audience of the Husika Project is sex workers, clients of sex workers (SW), women engaged in transactional sex (WETs) and their clients. Secondary target audience is men having sex with men (MSM), substance abusers and vulnerable children of MARPS. MARPs are SW, MSM and injecting drug users (IDUs) while at risk groups are clients of SW, WETS, and vulnerable children of MARPS. Husika s overarching strategy is to: Build upon and leverage existing resources and programming; while scaling up effective approaches from global best practices; Ensure that populations at greatest risk have access to a comprehensive core package of services and products in line with a combination prevention framework and Ensure that the project is client focused using evidence based methodology. This year, Dume and Lady Pepeta mobile brand promotions targeting MARPs across four Husika priority regions of Mara, Mwanza, Shinyanga and Tabora, reached 542 female barmaids and 323 male barmen in recruited bars; and 193 female CSWs across 11 sex worker hotspots. A series of face to face female condom interpersonal communication (IPC) sessions with sex workers (SW) and bar maids in Mwanza region ( Ilemela, Nyamagana and Geita districts), Shinyanga region (Shinyanga and Bukombe districts) and Tabora (Tabora Urban, Igunga and Nzega districts); all with the primary focus of reducing incidences of high risk unprotected sex by increasing female condom awareness, uptake and access levels whilst addressing HIV/STI prevention knowledge gaps and condom use misconceptions were conducted. 11

12 Activated 104 bars, reaching 998 barmaids 37 sex worker hot spot locations activated reaching 497 sex workers 94 sex workers and 130 bar maids recruited as female condom sales agents and potential candidates for sex worker peer educator training Distributed 95,220 female condom pieces, 4,528 branded Lady Pepeta t-shirts, 890 health information brochures and 1,000pcs of Jipende branded aprons Partnership: With technical support from EngenderHealth, three separate training workshops reaching 39 sex workers were conducted in Tabora Urban, Nyamagana and Geita district towns. Supportive supervision was provided to 24 active Shosti peer educators in Mwanza and Tabora, and a further 11 in Dar es Salaam. The 35 active Shosti peer educators reached 519 sex workers with peer lead HIV prevention and female condom use IPC education sessions. STI and HIV prevention service referral linkages are being developed to form an integral part of the Shosti peer educator health initiative. On request of the Kimara Peers Group; T-MARC trained and recruited 25 SW outreach peer educators as Lady Pepeta female condom ambassadors and sales agents. Each trained outreach peer educator was given a carton of Lady Pepeta female products as seed capital and trained in female condom sales. A total of 4,500 Lady Pepeta female condom pieces were distributed. Discussions were held with FHI360 to understand some of their Sex Work Peer Educator initiatives and to identify a collaborative strategy on the education, promotion and integration of male and female condom sales & distribution activities into FHI360 s Sex Worker Peer Educator initiatives. T-MARC developed a peer educator training of trainers (TOT) curriculum and manual that adapted and replicated best practice modules that have been published by FHI360 and UNFPA. Using the new manual, T-MARC trained 18 HIV prevention IPC educators in a Trainer of Trainers (TOT) workshop. 12

13 Two (2) outreach supervisors and nine (9) outreach workers were recruited and trained to implement scale up face to face HIV prevention and female condom IPC sessions these activities Musoma, Tarime and Bunda districts in Mara region and Sengerema, Ukerewe and Magu districts in Mwanza regions. The activities reached 29 sex workers on a two time repeat basis and 1,987 women engaged in transaction sex reached with small dose IPC sessions on a one time call basis. In Mbeya, 44 sex workers were recruited from 21 hot spot locations to participate in a three day Sex Worker peer educator program. 40 of them graduated as Husika Sex Worker Peer Educators. Using peer-lead outreach sessions, the new Husika peer educator graduates have reached 527 Sex Workers across 20 hot spot locations. A total of 7,200 Lady Pepeta female condom pieces were also distributed. The peer educator training exposed the Sex Workers to basic principles, roles and responsibilities of being a peer educator, basic facts and questions on HIV/AIDS transmission, prevention, treatment and care concerns, basic facts on STI symptoms, prevention and treatment, male and female condom demonstrations, interpersonal communication skills, basic facts on family planning and modern family planning methods, condom negotiation skills, and HIV/AIDS service referrals contacts. 13

14 In Dar es Salaam, T-MARC revisited the sex workers who last year, were trained and recruited as Lady Pepeta female condom brand ambassadors and sales agents under the TSMP program. From these visits a total of 56 sex workers out of the original 150 sex workers recruited under the TSMP were trained as female sex worker peer educators. Of the 56 trainees 47 SW peer educators conducted and reported on their peer lead outreach sessions which reached 1,129 SW with basic facts and knowledge on HIV/AIDS prevention, STI symptoms, female condom use demonstrations and giving of free samples. Another 76 sex workers were recruited from Kinondoni, Ilala and Temeke districts for a training workshop slotted for early Accountability: A new Husika sex worker geographic segmentation strategy was developed to demarcate Husika s Sex Workers program activities conducted by T-MARC and PSI/TZ. Under this strategy T-MARC is now mandated with overseeing and implementing Husika s SW project activities in Mara, Tabora and Mwanza regions only, while PSI/TZ will do the same in Mbeya, Iringa, Dar es Salaam and Mwanza regions. Plans to close out and hand over T-MARC s Husika Sex Worker program activities to PSI in Dar es Salaam, Mwanza and Mbeya are scheduled for FY13. 14

15 UHAI-CT Program Universal HIV and AIDS Counselling and Testing (UHAI-CT) is an initiative managed by Jhpiego - an affiliate of Johns Hopkins University, and funded by USAID. T-MARC s role in UHAI-CT is to develop and manage outreach activities, interpersonal communications, printed educational materials, and the training of civil society organisations that work with target populations. It is a five-year project designed to: Rapidly increase Tanzanians access to high quality HIV counselling and testing services Develop care providers skills in delivering high quality HIV counselling and testing services Strengthen the links between counselling and testing, prevention, and care and treatment services Assist the government of Tanzania with HIV counselling and testing data collection and management Training covers areas such as how to demonstrate the correct use of male and female condoms, how to handle stigma and discrimination, working with government counselling and testing centres and other topics that facilitate the delivery of these important services. Achievements Activities this year included; T-MARC offered HIV counseling and testing to participants in the Month of Women Entrepreneurs (MOWE) events for 2011, an annual event held to highlight business and community activities of Tanzanian women entrepreneurs. The activity reached 496 males and 434 females. The average prevalence rate among the 15-25, and 50+ age groups tested was 0.41%, 4.43% and 3.00% respectively. An average of 2.61% of those tested through the MOWE event tested HIV positive. We distributed behavior change communication (BCC) and promotional materials to CSOs implementing the UHAI-CT program in Iringa, Tabora and Tanga regions. BCC and promotional materials were also used in UHAI-CT outreach interventions during the Uhuru Torch race activity and the MOWE event. To effectively monitor the quality of our HCT interventions and address gaps and challenges, we conducted a one day refresher review with HCT counselors offering counseling and testing at the outreach interventions. Trainings called, Tuko Wangapi? (how many are we?) and the use of the newly introduced HCT Logarithms were given to the counselors. 15

16 T-MARC also conducted HCT in Mbeya, Iringa, Njombe, Ruvuma, Mtwara, Lindi, Tanga, Morogoro, Pwani, and Dar es Salaam region during the Uhuru torch activities that commemorated the 50th Anniversary of the Independence of Tanzania. The Uhuru torch activities were followed by Strategic Intervention for Testing MARPS (SITEMA) outreach campaign in Tabora, Rukwa, Mwanza, Mara, Manyara and Shinyanga regions 15,629 individuals received counseling and testing for HIV and received their test results 69,323 individuals were reached with demand creation messages about HIV counseling and testing In supporting the UHAI-CT consortium, T-MARC along with the UHAI-CT technical team have designed a new and innovative, couple counseling campaign called the Tupime Pamoja campaign due to be rolled out in

17 Partnership - T-MARC requested the National Aids Control Program (NACP), to provide final artworks of the provider initiated testing and counseling (PITC) and couple counseling materials that were developed by NACP and its partners, but were not produced due to funding constraints. T-MARC produced the PITC materials to support PITC related activities. The couple counseling materials will be used to support the couple counseling and testing activities. T-MARC conducted a workshop to develop the materials for couple counseling and gender based violence (GBV) since NACP do not have the materials and the funds in place to produce them. These materials will be used during various strategic activities which will promote and create demand for counseling and testing for couples as well as during the upcoming GBV activities at health facility level. We also invited different couple counselling stake holders to a workshop in Bagamoyo to develop messages to promote HIV counselling and testing for couples. The workshop was very successful with several key messages developed, pre-tested and short listed for usage in our upcoming outreach intervention for couple counselling campaign called, Tupime Pamoja! Majibu ya Mwenzi wako sio yako (Let s go and test together! The results of your partner are not yours). Promotional materials to support this campaign are being developed. The main challenge faced continued to be shortage of test kits to support the counselling and testing activities. The Ministry of Health and Social Welfare (MOHSW) adopted a temporary HIV Rapid Testing algorithm called Determine as the first test and Unigold the second HIV screening test. However during T-MARCs HCT activities at the Uhuru and SITEMA interventions, it was observed that it took longer to test an individual than the previous algorithm which started with SD biolines. This resulted in lower numbers tested. The UHAI-CT program has started conducting community level GBV activities through the UHAI-CT CSOs, district hospitals and health facilities across six district councils in Iringa (Iringa municipal, Kilolo, Makete, Njombe DC and Wangi ng ombe). A GBV stakeholder workshop to review and develop communication messages that will target both the health facilities and the communities is scheduled. 17

18 Families Matter! Project The Families Matter Project (FMP) is an evidence based parent focused intervention designed to promote positive parenting and effective parent - child communication about sexuality and sexual risk reduction for parents and care givers of 9-12 year olds. FMP recognizes that many parents and guardians may need support to effectively convey values and expectations about sexual behavior and communicate important HIV, STD and pregnancy prevention messages to their children. The ultimate goal of FMP is to reduce sexual risk behavior among adolescents - including delaying their sexual debut, by giving parents tools to deliver primary prevention to their children. Supported by the American people through the President s Emergency Fund for Aids Relief (PEPFAR ) and the Centers for Disease Control (CDC); the Families Matter! Program (FMP) in Tanzania is implemented by T-MARC Tanzania in Mtwara and Ruvuma regions. Working in partnership with a sub-contractor, the Human Development Trust (HDT) and the Ministry of Health and Social Welfare (MoHSW), the project enhances protective parenting practices by overcoming communication barriers and promoting parent-child discussions about sexuality and sexual risk reduction. It is designed to give parents of children aged 9-12 years specific information about ways that they can reduce their children s risk of becoming infected with HIV and other sexually transmitted infections, or getting pregnant. The intervention curriculum has three focus areas: 1. Raising parents awareness about the sexual risks adolescents face today. 2. Encouraging positive parenting practices that increase the likelihood that children will not engage in risky sexual behaviors: 18 Parental monitoring (knowing where one s child is, who they are with, and when they will be home); Positive reinforcement (use of praise and rewards to reinforce good behavior); and Relationship building (improving the parent-child relationship). 3. Improving parents knowledge, comfort, skills and confidence to effectively communicate with their children about sexuality and sexual risk reduction (parental responsiveness). The FMP curriculum is delivered to groups of parents by two facilitators (one male, one female) through a series of five consecutive weekly sessions called waves and a booster session that is offered six months after the completion of the five-week intervention. Each session lasts hours and builds upon the foundation laid in the previous session. The 9-12 year-old children attend the fifth session along with their participating parent. By the end of the program parents

19 should feel more competent and comfortable in addressing sex issues with their children. The booster session offered six months after parents complete the five-session program helps reinforce lessons learned and provides a forum for discussing challenges that they have faced putting their new skills into effect. The overall aim is to promote sexual abstinence and to reduce exposure to sexually risky activities among adolescents, including delaying onset of sexual debut among children to support the goals of PEPFAR and the Government of Tanzania (GoT) in preventing the spread of HIV/AIDS in Tanzania. The GoT has highlighted youth HIV prevention as a top strategic priority. This is reflected in the current National Multi-sectoral Framework on HIV/AIDS The Families Matter! Project is making a difference in Youth HIV/AIDS prevention efforts by targeting and equipping parents of pre-adolescents with the necessary skills and knowledge about sexuality. In so doing the program hopes to reduce the number of HIV infections among youth, reduce the number of school dropouts due to pregnancies, and reduce youth infections with other STIs. Local communities are oriented on program through information workshops or meetings. These are held with leaders/ opinion makers of different groups of people which include teachers, religious leaders, the youth, the Ward Multi-sectorial AIDS Committee, parents of 9-12 year old children, prominent elders, and ward administrative officers T-MARC worked with the HDT in conducting community mobilization of the parents/ guardians of 9-12 year old using the methods such as public address systems, community theaters, and door to door methods. In addition radio drama was used for mobilization of parents, whereby, drama episodes as well as live call in sessions were conducted, and parents had an opportunity to call in and ask various questions to the FMP coordinators. The mobilization efforts highly incorporated the local government authorities, street leaders and key community influential. 19

20 Delivered six training waves in each region. The training is conducted once a week, for five consecutive weeks known as a wave. For each session or class a maximum of 18 parents is required. In both regions trainings are conducted four days in a week. In the current financial year the project trained 6,225 parents and guardians of pre-teens, 77.8% of these being female and 22.2% being male. Continued building technical and financial capacity of sub grantees in both regions. The project conducted quarterly meetings with the sub-grantees namely HDT and continued to build technical and financial capacity. The US Ambassador to Tanzania, Hon Alfonso Lenhardt (seen here centre in group photo with participants of the FMP project) visited FMP in Mtwara and commended the good work being done by the project Challenges The usual challenges like long distance to the implementation areas, poor transport and communication infrastructure aside, some parents dropped out in the middle of training especially in Mtwara where literacy levels and economic situations pose as the major problems. Male participation is still low as most men prefer to be engaged in their economic activities rather than attend the training. T-MARC continues to educate the population on the importance of the project to the well-being of their own families. 20

21 Monitoring, Evaluation and Research At T-MARC, monitoring information is absolutely crucial to understanding what is happening at all levels during an intervention, both from inside and outside a project. Good monitoring data provides programme managers with information that correlates programme activities with changes in behavioural determinants and changes in actual behaviour. Monitoring also involves giving feedback about the progress of the project to the donors, partners and beneficiaries of the project. Through evaluation, the periodic assessment of the change in a broad statistic can be attributed to the programme. For example, during evaluation, programme personnel will look at how the behavioural change they created (e.g. increased condom use) is affecting a health indicator, such as the number of disability adjusted life years averted (DALYS) or a reduction in a prevalence rate. Using appropriate research design, sample sizes and statistical analysis helps T-MARC understand how its activities affect the bigger picture. This year, market research support was provided to inform the Dume and Flexi P repositioning strategy, including packaging enhancements, line extension package designs, brand names, the communication campaign s creative concepts and media spots. Some Key studies conducted this year included; Qualitative research in Dar es Salaam with existing Dume users, mid-tier condom users and partners of Dume s target audience to gain insight on condom preferences, perceptions, likes and dislikes of the proposed new Dume condom new packaging design, advertisements and proposed line extension names and packaging designs. Similarly for brand Flexi P, qualitative research was conducted in Dar es Salaam with existing Flexi P users and non-users to gain insights on preferences and dislikes on the proposed Flexi P new packaging designs and communication materials that are being developed to launch the Combination 3 formulation. The 2011 HIV MAP and MAP HRA (Monitoring Condom Availability in High Risk Areas Zones) were collaboratively shared and analysed with PSI/TZ and the program team to inform key sales and marketing strategies. Key 2011 MAP survey findings confirmed that since year 2010, Dume male condom s urban coverage and penetration has gained momentum and also reflect Dume s positioning as the urban/ wealthier man s condom. Working in collaboration with the MER department collected baseline and follow up behaviour indicators regarding female condom awareness levels and use in the HUSIKA project. Key findings from this research are being analysed. Data was collected and shared with the program team for several surveys including; - Lady Pepeta female condom Sex Worker (SW) and women engaged in transaction sec (WETS) face to face brand promotion baseline and follow on surveys in Iringa, Mbeya and Dar es Salaam - Jipende! Hair Salon program baseline survey in Mbeya, Mwanza, Geita and Shinyanga - Dume Mobile Population campaign survey across 11 regions - CBD Household baseline survey in Sengerema, Tarime and Dodoma 21

22 - Flexi P worksite intervention pre and post survey in Dar, Mwanza and Shinyanga - SabaSaba and NaneNane data quality control and process evaluation checks in Dar es Salaam and Mwanza - Miss Tanzania beauty pageant sponsored female condom and family planning IPC education session mini surveys. - C-Vendor program performance evaluation survey to inform the program s placement and operational strategy - ADDO mystery client surveys in Shinyanga, Mara, Ruvuma and Tanga to determine drug seller dispensing behaviour and practices for modern family planning products among drug sellers of regions with high and low national contraceptive prevalence (CPR) Strategic Monitoring, evaluating and research (MER) inputs were availed to the UHAI-CT implementing team for quality control purposes. The focus was more on quality assurance of data and mapping of the areas that were covered with our interventions against the population of that particular area, using Google earth live maps. 22

23 Finance and Administration T-MARC has extensive experience managing large global and bilateral cooperative agreements in Tanzania and has since 2007, T-MARC has engaged external firms to conduct annual audits and published the reports. Current and past projects have enabled T-MARC to continuously upgrade its financial and project management systems for increased efficiency, accountability and transparency. We track procurements, operating expenses and other activities and an internal auditor conducts bi-annual audits to ensure compliance with the donor requirements. A cross section of T-MARC staff and Board Members T-MARC develops detailed quarterly narrative and financial reports which include updates on the status of project activities, identification and classification of risks, financial and resource status and project successes and challenges. Accountability: T-MARC has implemented all recommendations from the OFOG/GIA audit and financial reviews with the anti-fraud policy being approved by the T-MARC Board and a whistle blowing policy included into the Finance Manual this year. 23

24 T-MARC Tanzania Audited Financial Report

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30 Acronyms: VCT Voluntary Counseling and Testing HCT HIV Counseling and Testing UHAI-CT Universal HIV Aids intervention for Counseling and Testing BCC Behavior change communication IEC Information, education, and communication (IEC). SW Sex workers WETS Women engaging in transactional sex MSM Men who have sex with men IDUs Injecting Drug Users TSMP Tanzania Social marketing Program DUME Condom Name of a male condom brand, promoted by T-MARC Tanzania LADY Pepeta Condom Brand name of a female condom. PA Public announcement. HUSIKA Project conducting behavior change to sex workers and Women engaging in transactional sex. 30

31 PLEASE NOTE THAT, THIS WILL BE A BLANK PAGE

32 T-MARC Tanzania Plot # 383, Ndovu/Garden Road, Mikocheni B, P.O. Box 63266, Dar es Salaam, Tanzania. Tel: /4, Fax: , info@tmarc.or.tz, Web: