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INFORMATION FOR

    Tanzania

    Site Institution: Health for a Prosperous Nation (HPON)
    Research Areas: Sexual And Reproductive Health, HIV/AIDS, Adherence, Maternal And Child Health, Behavior Change, Health Literacy

    Site Description:
    Health for a Prosperous Nation (HPON) is a non-governmental, nonprofit organization in the United Republic of Tanzania (Tanzania NGO registration number 00007181). HPON was formed in 2014 to focus on public health promotion, research and evaluation. HPON works by collaborating with government, local and international academic institutions, the private sector, and the non-profit sector to develop and evaluate programs to improve health and wellbeing. HPON draws strength from a core team of physicians and scientists who specialize in public health, medical anthropology, epidemiology, and community medicine. The team is deeply embedded in the Tanzania context and is well connected to fellow scientists across all sectors including health and education. HPON combines rigorous methodology, scientific expertise, and networking to ensure the smooth, efficient and effective introduction, engagement, execution and conclusion of various scientific activities in Tanzania.

    The organization’s mission is to promote, facilitate and support in an integrated manner, the provision of comprehensive, high-impact, evidence-based and high-quality promotive, preventive, curative and rehabilitative health services through innovative approaches in order to improve the health of the Tanzania n population. The organization’s vision is a nation where every person has access to quality health services.

    The HPON team is well-equipped with long-term and highly experienced public health specialists, researchers, and a pool of young vibrant research assistants and support staff. The collaboration between the Division of Epidemiology at UC Berkeley, Shinyanga Regional Medical Office, and Health for a Prosperous Nation is fertile ground for training, exchange of research ideas, and the design and evaluation of innovative interventions to promote health. The Regional Medical Office is charged with implementing the activities and health programs of the Ministry of Health, Community Development, Gender, Elderly, and Children and the National AIDS Control Programme. The focus of the collaboration is to identify critical health issues faced by the region (e.g., non-adherence to antiretroviral therapy, poor coverage of early infant HIV diagnosis, increasing facility delivery) and subsequently develop and evaluate locally relevant and theoretically based interventions to remove barriers and improve access to health services.

    Examples of research projects:
    • ART adherence: HPON in collaboration with the Ministry of Health, Shinyanga Health Management Team, and the University of California, Berkeley, have conducted three studies funded by the U.S. National Institutes of Health (NIH) evaluating patient-centered interventions to improve adherence in antiretroviral therapy treatment in three clinics in Shinyanga (McCoy K01MH094246, McCoy 1R03MH105327, Gates Grand Challenge Explorations OPP1118511).
    • Sexual reproductive health and rights, and maternal, newborn and child health: HPON has collaborated with local NGOs, the Ministry of Health, and the Ministry of Home Affairs in assessment and systems strengthening for the prevention of gender-based violence and violence against children. HPON has also participated in the evaluation of maternal, newborn, and child health programs in various regions in Tanzania.
    • Increasing adolescent girls and young women’s access to sexual reproductive health and HIV prevention: Using human-centered design, HPON is collaborating with Drs McCoy and Liu of UC Berkeley and UCSF, respectively, in implementing and evaluating Malkia Klabu, an HIV prevention, sexual and reproductive health intervention using private drug shops as gateways to increase access and quality of services for adolescent girls and young women.
    • Discover learning: Based on developmental science of the brain, HPON is collaborating with Dr. Ronald Dahl’s team from UC Berkeley’s Institute for Human Development and Center on the Developing Adolescent in designing and evaluating an intervention that fosters discovery learning and scaffolding while using technology as a platform to excite and engage young adolescents (ages 10-11) in Dar es Salaam. This project’s main outcomes are early educational attainment, gender norms transformation and positive sexual reproductive health trajectories.

    Mentors

    • Stefano Bertozzi, MD

      U.S. Mentor

      Professor, Health Policy and Management, University of California at Berkeley

    • Amon Sabasaba, MD, MSc

      Site Mentor

      Director of Research, Health for a Prosperous Nation

    GHES Alumni

    • Happiness Saronga
      Fellowship Site: Health for a Prosperous Nation, Tanzia US Institution: UC Berkeley Project Title: Cash Transfers to Increase HIV self-testing Uptake among Adolescents in Tanzania: A Randomized Controlled Trial Adolescents in Tanzania have low HIV testing levels despite having high risk of contracting HIV. Adolescents need innovative HIV services that will increase HIV testing and facilitate early access to treatment. HIV self-testing (HIVST) has been recommended to reach at risk populations who are not utilizing the available testing services. HIVST allows people to test in private and has been shown to be acceptable, safe, and effective in promoting HIV testing in low and middle income countries (LMIC). Nonetheless, knowledge gaps remain on best strategies to increase uptake of HIVST among adolescents, which may eventually promote linkage to confirmatory testing, and care for those testing positive. This study will test the impact of cash transfers on HIVST uptake among adolescents in Tanzania. The hypothesis is that cash transfers will increase uptake of HIVST among adolescents. Research evidence show cash transfers promote protective behaviors in relation to HIV. Although HIVST is only allowed in adults in Tanzania, the age of consent for HIV testing has been lowered to 15 years, making it possible to test HIVST interventions among adolescents with IRB approval. The study will be conducted in Shinyanga Region in Tanzania, a region with HIV prevalence of 5.9%, the sixth highest in Tanzania (national prevalence is 5%). Participants will include in-school and out-of-school adolescents. Participants will be randomized to HIVST-cash transfer or HIVST only groups. Cash payment of TSH 10,000 (approximately $4.2) will be made to adolescents in the intervention group upon return of a used HIVST kit. A confirmatory HIV test will be conducted by a health worker for reactive results. Follow-up data collection will occur over a 6-month period to assess HIV testing as the primary outcome. Secondary outcomes will include HIV positivity rate and linkage to care. Data analysis will compare primary and secondary outcomes between the intervention and control groups. This study will also assess the perspectives of adolescents on the perceived advantages and disadvantages of HIVST, cash transfers and spending pattern of the cash transfers, and incremental cost-effectiveness of the HIVST-cash transfer model.