Insights

New Partnerships Initiative EXPAND: New Partners for Better Health (NPI EXPAND), a five-year global cooperative agreement project funded by USAID and implemented by Palladium, aims to facilitate locally led development to improve health outcomes. The project seeks to ensure local ownership and leadership by empowering local entities to define development problems, design and implement solutions, and learn from these interventions.

Through a comprehensive sub-award grants program, NPI EXPAND provides organizational and technical capacity strengthening to enable local grantee organizations to fulfill their missions. In Tanzania, NPI EXPAND supported Amref Health Africa in Tanzania (Amref) and Tanzania Health Promotion Supports (THPS) along with their consortium partners, Service, Health, and Development for People living positively with HIV/AIDS (SHDEPHA+) and Mwitikio wa Kudhibiti Kifua Kikuu na Ukimwi Tanzania (MKUTA), to strengthen their capacity and improve health outcomes in the country. While receiving support from NPI EXPAND, both organizations also implemented USAID-funded projects integrating family planning activities into existing tuberculosis services at both community and facility levels.

Orientation of community health workers on the family planning and tuberculosis tools.

NPI EXPAND supported Amref to adapt standard operating procedures, guidelines, and tools from national documents into project-specific tools to help community health workers implement and report on community-based family planning and tuberculosis services. Using the National Family Planning Costed Implementation Plan, the National Operational Guidelines for Community Based Health Services, and the National Operational Guidelines for Community Based Tuberculosis and Leprosy Interventions, Amref developed a handbook with standard operating procedures, service delivery job aids, and data collection and reporting tools for community health workers to collect data and report on community-based family planning and tuberculosis services. Twenty-three Amref staff and partners were trained on these tools and later mentored community health workers on their use. 272 community health workers were oriented on using these integrated tools.

The success of implementing community-based family planning and tuberculosis services is captured in Sauli Norbert Mwanisawa’s story. Sauli is a father of three from Matai village in the Rukwa region whose youngest child Bennon was frequently ill. Medical bills combined with missed workdays led to significant financial hardships for the family.

When a community health worker supported by Amref visited Sauli’s household, hope began to emerge. As a result of increased health education on family planning and tuberculosis, the health worker was able to diagnose Bennon with tuberculosis and ensure that he began receiving treatment. His mother was referred for family planning counseling and received a method of her choice.

The tools that the community health worker was trained on enabled her to provide integrated care for Sauli’s family, which may not have been possible if she had only been trained on either family planning or tuberculosis instead of both.

Just nine months later, the family’s situation has changed significantly. Bennon has completed his tuberculosis medication and the entire family leads a healthier life. They are actively engaged in economic activities and their small business is booming. Sauli, grateful for the project intervention, has become a male champion promoting male engagement in family planning in his community.

Today, Sauli’s family stands as a testament to the efficacy of integrated health interventions. His story mirrors many others across the four regions where the project’s integrated interventions are implemented, demonstrating the effectiveness of Amref’s new approach. This initiative highlights the positive outcomes of approaching health services from a holistic perspective that includes both family planning and tuberculosis.