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Texas Children's Global Health Baylor Foundation Tanzania
Baylor College of Medicine Children’s Foundation – Tanzania (Baylor Foundation Tanzania) is a patient-centered, pediatric HIV prevention and treatment program with the goal of contributing the reduction of HIV/AIDS-related morbidity and mortality among infants, children and adolescents in Tanzania. In addition, Baylor Foundation Tanzania provides comprehensive care and treatment for pediatric tuberculosis, malnutrition, cancer, and other complicated or chronic pediatric conditions. They provide direct service delivery and clinical attachment training at the two Centers of Excellence in Mbeya and Mwanza, as well as health professional training and mentorship provided at outreach facilities in the Lake and Southern Highlands Zones.
Baylor Foundation Tanzania staff currently work in regional and district hospitals and other health facilities of lower levels to develop relationships with partner organizations and health professionals at all levels to enhance care to children infected and affected by HIV/AIDS. The team devotes significant time and effort to building capacity for pediatric health services by mentoring and training health care professionals.
At a Glance
LOCATION:
FOUNDED:
BUDGET (USD):
EMPLOYEES:
PATIENTS:
PROFESSIONALS TRAINED:
MBEYA & MWANZA, TANZANIA
2009
3.3 MILLION
121
26,042
1,246
Notable Programs
Optimizing Case Identification
Case identification is the first step to ensure children and adolescents living with HIV can achieve healthy lives. Baylor Foundation Tanzania recognized the importance of utilizing index testing as a tool to identify vulnerable HIV+ children and adolescents and worked to scale up knowledge among healthcare workers about the importance of index testing. Baylor Foundation Tanzania was able to utilize this tool to successfully identify many new children and adolescents and link them with life-saving care. Baylor Foundation Tanzania improved collaboration with adult HIV care facilities to ensure that every adult who tested positive was linked with a team who visited them in their home and tested their children. Baylor Foundation Tanzania also gave adults the opportunity to have their children tested at the location that worked best for them – either at the COE or in their homes.
Health Systems Strengthening
Baylor Foundation Tanzania’s health systems strengthening work leverages one of our greatest strengths to improve health systems across Tanzania – our multidisciplinary team of pediatric experts. Baylor Foundation Tanzania collaborates with the Pediatric HIV and TB working groups of Tanzania to develop and review national treatment guidelines. The Foundation welcomes classes of healthcare providers from around the country to participate in an intensive, hands-on, pediatric HIV, TB and malnutrition training course. They attend lectures from our pediatric experts and get hands-on experience taking care of children with real-time feedback. Baylor Foundation Tanzania reinforces best practices in pediatric HIV and TB care, identifies areas for improvement, and helps providers in the Lake and Southern Highlands Zones provide excellent, evidence-based HIV, TB, and general pediatric care.
Empowerment
Baylor Foundation Tanzania’s social work department assesses children and adolescent’s needs during clinic visits, home visits and family meetings to provide targeted support and linkages with community- based organizations. For families with severe food insecurity, the Foundation offers “Shamba Darasa,” a backyard vegetable-growing program, as well as a three month intensive food security alleviation program. Adolescent girls have the opportunity to join a program called “Tanzanite Girls” with interactive sessions that cover a variety of life skills topics. Low-cost programs such as “Stitch by Stitch” and “Bead by Bead” impart practical skills like sewing and beading for income-generation and Benki Yetu” (Our Bank) teaches financial management skills. Peer educators work alongside adolescents attending the COEs and provide them with one-on-one counseling sessions, health talks and accurate HIV education.
Tuberculosis
Baylor Foundation Tanzania continues to offer comprehensive and state-of-the-art TB prevention, case finding that includes a robust community program utilizing the unique expertise of individuals who were previously treated for TB and treatment for children and adolescents in the Lake Zone and Southern Highland Zone. The Foundation also has leading roles and voices on the national child TB treatment working groups and is actively involved in several TB research studies looking at the performance of novel TB diagnostic tests in children.
Palliative Care
Baylor Foundation Tanzania continues to offer multidisciplinary palliative care to children and adolescents with life limiting effects of HIV/AIDS. This unique program provides patients with evidence-based medical care including symptom management, comprehensive patient focused psychosocial care that includes the opportunity to participate in a wish-making program and multidisciplinary home visits. The Foundation had the opportunity to present their palliative care program at the 6th International African Palliative Care Conference in Kigali, Rwanda.
Patient Story
Empowering adolescent teen leaders and peer educators has become one of the key factors in making adolescent psychosocial programs successful. Having adolescents participate in almost every aspect of adolescent-related programs allows them to take ownership of these programs and provides them with valuable responsibilities.
Teen leaders and peer educators have been involved in a variety of adolescent related programs at Baylor Foundation Tanzania. In the Teen Club program, teen leaders and peer educators are engaged in planning the actual teen club sessions, implementing the event, and giving post-event feedback.
During the Teen Club planning, leaders meet, plan the topic to be discussed, and provide responsibilities to everyone involved. For the execution phase, they are the ones who run and lead all sessions with supervision from clinic staff. This structure has helped other adolescents learn by shared experience from fellow adolescents who face similar challenges. Participants are motivated by their fellow leaders and inspired to continue taking their ART well, adhere to clinic visits, and reduce risky behaviors.
At the end of each Teen Club meeting, teen leaders and peer educators meet and evaluate the whole process, including reviewing how the activities went and where to improve for upcoming Teen Clubs.
Overall, we have witnessed the value of adolescent-led programs and initiatives and believe that adolescents and young people can direct most of our adolescent psychosocial programs in the future.
FJ is 20 years old and is the first-born of three children. She lives with her mother who is a fruit vendor. She is HIV-positive and started care at Baylor Foundation Tanzanian in 2012, recently graduating to an adult treatment center. After completing her primary education, she started assisting with her mother’s business to help meet the needs of the family.
In 2018, Baylor Foundation Tanzania initiated a cooking demonstration activity that aimed to provide nutrition education to caregivers by teaching them different methods of food preparation, cooking methods, food hygiene, and feeding techniques. Caregivers were taught about the food groups and how to preserve nutrients in cooked food.
FJ was selected from the adolescent club as an assistant cook to help our nutritionist with cooking demonstrations, conducted twice per week at the Baylor Foundation Tanzania COE. Baylor Foundation Tanzania assisted her in setting up a bank account and her wages were deposited there each month. Eventually, FJ was selected by a national program, Tanzania Social Action Fund (TASAF), focused on helping poor families and their children, to enroll in a technical school for tailoring studies.
After completing her vocational studies, she bought a new sewing machine using her savings from her Baylor Foundation Tanzania wages and started her new business. FJ is doing well with her job as a seamstress, earning a decent income while adhering well to her ART.
FJ celebrating her new sewing machine, acquired with support from Baylor Foundation Tanzania.
Utilizing TB Home-Based Care (HBC) Helps to Make TB Treatment and Prevention More Efficient
When JB was 13 months old, he presented to clinic with irritability and delayed developmental milestones. He was not playful and was not feeding well. He was quickly diagnosed with malnutrition.
Through a community contact tracing activity using TB HBC supported by Baylor Foundation Tanzania, JB was identified in the community and was linked to a local hospital. There, he was found to have TB as well. One week later, he was referred to Baylor Foundation Tanzania clinic to receive concurrent TB and malnutrition services.
Two months after being enrolled in care, JB had gained weight and had reached his target weight. He had a good appetite and was cooperative, happy, and playful.
TB HBC activities have helped in improving the health of many children like JB who suffer from TB and malnutrition. Through contact tracing of TB cases in Mwanza, children in need of care are identified and linked to care.
TB HBC coordinators are obligated to follow up TB patients from the facilities we assign them, complete TB screening of household members living with a contact case, and ensure all who screen positive are referred to nearby health facilities for further management. Also, coordinators ensure all children less than 5 years old living with a TB patient are screened properly and given TB preventive therapy if eligible.
Tussa has been attending clinic at the Baylor Foundation Tanzania COE in Mbeya for as long as she can remember. She recalls coming to clinic in the old building before we moved to the larger, new facilities. She feels she was always provided encouragement and support from her family and clinic staff who regarded her as one of the best clients at the COE. She participated fully in clinic activities including Teen Club and Salama Camp (overnight camp for children with HIV, co-sponsored by SeriousFun) and was selected to be a teen leader, peer educator, and facilitator for community ART groups. She completed her primary and secondary education and decided to challenge herself and continue on to higher education. Her goal was to be a leader in her community, as she had been at the COE, and felt that opportunities for women to further their careers were steadily increasing in Tanzania. She applied to university and was accepted! However, at this point, her challenges began. Up until now, she had enjoyed continuous support from her family, friends, and COE staff. Now, she was moving 400 miles away to an unknown environment. Almost immediately upon arrival, she felt stigma from teachers and peers. She chose to hide her HIV status for fear of victimization and started to miss doses of her medications. She wanted to feel like a normal student and eventually stopped her ART altogether. At this point, her health began to decline and she started missing classes. Eventually, she dropped out of school completely.
Now, Tussa is concentrating on her health and is back on her ART. She plans to return to university next year and has found some peers that have been through the same experience to give her advice and support. Her plans to become a psychologist and leader in the community push her to persevere. Her advice to students in similar situations is to try to accept that HIV is a part of them and that they should have control over it. She concedes that it is difficult, but that life goes on and we should strive to be courageous. She appreciates Baylor Foundation Tanzania for the support they give to young women like her.
Leadership & Partnerships
Leadership
Lumumba Mwita, MD, MMED
Executive Director
Partnerships
- Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children
- United States Agency for International Development (USAID)
- United Nations International Children’s Emergency Fund (UNICEF)
- Bugando Medical Centre
- Mbeya Zonal Referral Hospital
- Regional and Zonal Governments in the Lake and Southern Highlands Zones
- Mbeya Medical Research Center – National Institute for Medical Research (MMRC-NIMR)
- PACT Tanzania
- Boresha Afya
- The Henry Jackson Foundation Medical Research Institute (HJFMRI)
- Tanzania Health Promotion Support (THPS)
- Ariel Glasser Pediatric AIDS Healthcare Initiative (AGPAHI)
- ICAP
- SeriousFun Children’s Network
- BIPAI at Texas Children’s Hospital
- Baylor College of Medicine
- Texas Children’s Hospital
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