Tanzania’s fourth Health Sector HIV and AIDS Strategic Plan, which runs between 2017 and 2022, aims to increase access to integrated prevention services for the general population to reduce new HIV infections. Significant progress has been made in the prevention of mother-to-child transmission in the past few years in Tanzania. The Tanzanian government also recognizes condom promotion as an integral part of its fight against the epidemic. Additionally, while Tanzania has a broad sex education curriculum, low access to adolescent-friendly services, gender inequality, HIV-related stigma, and the criminalization of certain groups, such as men who have sex with men, continue to act as major barriers to HIV prevention in Tanzania.
Former President of Tanzania, Dr. Jakaya Kikwete Visits T-MARC Pavilion during the state- of -the- art Julius Nyerere International Convention Centre (JNICC) from 17th to 19th November 2021 in Dar es Salaam. Left is Lilian Erasmus , The Tmarc Institutional Sales Executive.
T-MARC is a key partner of the Tanzanian government, working closely to achieve Tanzania’s vision of “End inequalities. End AIDS. End epidemics”. As a locally managed, non-governmental organization, T-MARC is mandated to make sustainable health and social impact on the lives of Tanzanians through the application of core competencies in social marketing, communication, project management and partnership. T-MARC provides quality services and health products for disease prevention, through innovative interventions and partnership to address key social and economic challenges - thereby contribute to the wellbeing of targeted communities in Tanzania.
T-MARC works on a wide range of HIV/AIDS activities. T-MARC has been promoting access to, correct and consistent use of quality and affordably priced condoms through Dume male condoms. T-MARC’s Dume male condom initiative comprising three variants, Dume Classic condoms, Dume Desire condoms and Dume Extreme condoms, target people from different age and socio-economic groups with special focus on youth and most at risk population. T-MARC has sold and distributed about 60 million male condoms during the past five years. In 2021, the Measuring Access and Performance (MAP) Survey, conducted to assess access and availability of priority health products, indicated that while overall condoms were stocked in less than 50 percent of the retail and wholesale outlets, Dume Classic led the condom market with 38 percent availability in the outlets. Dume condoms had the second highest market share of 32 percent. T-MARC distributes its condoms and other products to almost the entirety of mainland regions through 66 regional distributors spread across 20 regions which serve nearby regions as well with a focus on four high volume regions of Dar es Salaam, Arusha, Mwanza, and Mbeya. T-MARC has also continued to increase access to condoms and other priority health products through onboarding of Accredited Drug Dispensing Outlets (ADDOs) in the Lake zone as distributors. Recruitment of these ADDOs further increases access to products in remote areas. T-MARC uses social media, radio and TV promoting Dume range of condoms.
Early Sexual Debut is a major cause of HIV spread. T-MARC’s Families Matter Program focused on reducing risky sexual behaviour among adolescents including delayed sexual debut, consequently reducing HIV infection rates and early pregnancy among school children. The project improved parenting skills and family communication about risk reduction and other sex-related topics before adolescents begin sexual activity. T-MARC also implemented an innovative initiative Girls Empowerment – Hakuna Wasichoweza, to strengthen school attendance and educational performance of young girls in the Mtwara and Lindi regions where school dropout and truancy rates are high. The project provided low-cost sanitary pads to 10,000 young girls in and out of school to help them manage menstruation and improve their school attendance and performance. It also helped to increase the HIV prevention knowledge levels of adolescent girls to delay the onset of sexual debut and to reduce high risk sexual behaviours to reduce teenage pregnancies, school dropouts and sexually transmitted diseases including HIV.
Mothers with their children during mother meet up event in Sengerema DC. The event is aiming on empowering parents and caregivers with the information, motivation, skills and support (peer & community) that they need to adopt and maintain priority health behaviours that will protect the health and overall wellbeing of their child/children from birth through to 5 years, focusing on the first 1,000 days.
Similarly, high multiple partner sex and non-use of condoms despite risks in stable and casual heterosexual relationships is yet another major source of spread of the virus. T-MARC through Universal HIV and AIDS Intervention for Counselling and Testing project, to complemented on-going Voluntary Counselling and Testing activities in Tanzania by conducting targeted outreach among the most at-risk populations (MARPS) and the underserved communities. T-MARC developed and managed outreach activities, interpersonal communications, printed educational materials, and the training of civil society organizations to demonstrate correct use of male and female condoms, handle stigma and discrimination, work with government counselling and testing centres and other topics that facilitate the delivery of these important services. Additionally, T-MARC implemented HUSIKA Project to reduce HIV incidence in Tanzania among MARPS and their sexual partners by strengthening enabling environment at national, regional, and district levels and improving access to high quality medical and nonmedical support services. Lastly, under Tulonge Afya project, T-MARC focuses its efforts on behaviour change at the district and community level. The project catalyses Tanzanians to improve their health status by transforming socio-cultural norms and supporting the adoption of healthier behaviours. The project has implemented targeted mass media, strategic social media, community radio programs, theatre, and small group dialogue sessions with PLHIV. The project has managed to reach a total of 1,609,460 in this intervention.
T-MARC adopts integrated approach by addressing HIV/AIDS with other critical health issues like Tuberculosis and Family Planning. T-MARC’s SBC activities include national and regional radio programming, linked to community-level activities (small group dialog, community radio, and community theatre) to drive the uptake of HIV testing, as well as engagement in prevention of mother to child transmission services, among pregnant women, as well as promoting antenatal care attendance, facility-based delivery, and postnatal care, which can support reduced mother-to-child transmission as well as early infant diagnosis. Additionally, T-MARC also promote completion of childhood immunization schedules and TB testing targeting higher risk groups and regions throughstrategic use of national and regional radio linked to community-level activities.
T-MARC collaborates with National Commission for People Living with HIV/AIDS (NACOPHA) to increase the uptake of care and treatmentservices among PLHIV, their partners, and biological children to bridge 95-95-95 testing and treatmentgaps across PEPFAR-supported high volume sites. The project engaged and trained 148 NACOPHA’streatment advocates to facilitate small group sessions and targeted community mobilization on the importance of index testing, partner disclosure among PLHIV, as well as tracing and linking LTFU clients back to services. This was done across 23 PEPFAR high volume facilities in the regions of Iringa, Njombe and Tabora reaching 42,937 PLHIV with multiple SBC sessions and ensuring 2,545 lost follow-up clients returning to care and treatment services.
Ibrahim Mgunda Community volunteer from Upuge ward (Uyui DC) facilitating male centered design activity (Kijiwe cha Kahawa small group session) with men who have partners who are pregnant or those with children under five at Upuge Centre.
Under USAID Tulonge Afya project, T-MARC engages the faith-based leaders as key Furaha Yangu advocates to drive the adoption of priority preventative, HTS, and care and treatment behaviors among hard-to-reach at-risk groups, including men.
Only 52% of Tanzanians who are HIV-positive know their status. While there is need to heighten risk perception and perceived benefits of knowing HIV status, it is critical to promote condom use until the status is known, and simultaneously explore the potential of promoting HIV self-test kits for private and confidential use. In 2022 T-MARC will launch an oral based self-HIV testing kit in drive to support the Government efforts to achieve global HIV Prevention targets. Basically the 95-95-95.