Afya Shirikishi (“Participatory Health”) is a five-year activity which aims to improve access to Tuberculosis (TB) and family planning (FP) services in nine regions of Tanzania.

Tanzania ranks among the 30 highest TB-burdened countries in the world with an estimated TB prevalence at 295 cases per 100,000 population. The 2018 National TB and Leprosy Program (NTLP) report estimates that 60% of TB burden is not diagnosed. Case finding and detection are challenged by inappropriate management, poor documentation, inadequate collection systems and diagnostic capacity, along with sociocultural barriers, stigma, and gender disparity. Despite these challenges, the NTLP, in collaboration with USAID and international and local IPs, has significantly addressed the TB burden in Tanzania, maintaining a decline in TB incidence rate above 4% per year.

However, there remains potential for scaling-up community participation and advocacy and removing human rights and gender barriers in at least nine regions of Tanzania.

In response to these challenges, Afya Shirikishi has four objectives:

  1. Improve access to and use of high-quality, person-centered TB, DR-TB, and TB/HIV services at community level.

  2. Reduce TB disease transmission and progression through community-based service delivery.

  3. Strengthen access to and use of quality FP services at community level.

  4. Improve the transparency, feedback, and access to data related to TB programming; strengthen national policy and guidelines; and increase leadership and political support for TB as a public priority.


Afya Shirikishi’s interventions include:

  • Engaging and improving capacity of community health workers (CHW) to provide community-based TB and FP services with tools and incentives.

  • Engaging community groups to identify and conduct TB screening of high-risk individuals and community hotspots.

  • Engaging Accredited Drug Dispensing Outlets (ADDO) and Traditional healers (TH) to conduct TB screening, case identification, and referral of presumptive cases.

  • Establishing and strengthening linkages between communities and health facilities to support delivery of TB and FP services.

  • Enhancing TB and FP education and reducing TB and FP-related stigma and discrimination

  • Building capacity of gender specific groups to provide TB services and engaging youth and women to participate in TB prevention and family planning.

  • Increasing and monitoring continued support for TB as a public priority.


By the end of the activity, the following results are expected:

  • Expanded and strengthened community-based TB screening and case identification, contact investigations, and defaulter tracings.

  • Increased political and civil support for TB as a public priority.

  • Improved transparency, feedback, and access to data related to TB programming for enhanced TB M&E systems.


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