DOI: 10.7910/dvn/24193
title: Tanzania (2013): Measuring Access and Performance in High Risk Areas for HIV infection: Coverage and Quality of Coverage of male and female condoms in high risk areas for HIV infection (MAP: Hotzone)

description: The purpose of the 2013 MAP (Measuring Access and Performance) survey in high risk areas in Tanzania is to provide evidence for social marketing decision making in the area of product delivery systems. As part of the IR1 which aims to increase protective behavior among key populations and their sexual partners, condom distribution and in particular coverage and penetration in high risk areas are key indicators that needs to be monitored to enable determination of the impact of the project. MAP studies feed into tables relating to monitoring of product and service delivery. Project MAP is designed to increase the coverage, quality, equity of access and efficiency of social marketing product and service delivery systems. In doing so, the performance of the social marketing program will improve in terms of health impact, behavior change, cost-effectiveness, equity, and efficiency. Research objectives: Measure coverage, quality of coverage, numeric distribution and adherence to the recommended price of male and female condoms, in high risk areas for HIV infection in selected regions in Tanzania where the Husika project is operational. Provide recommendations for di
stribution and promotions strategies Unit of Analysis For all PSI and T-MARC products, the unit of analysis will be high risk areas (referred to as hotzone in the rest of this document). The following terms are defined as follows: Hotspot: A hotspot is any meeting place where people at high risk of HIV (CSWs and their clients) congregate, or high risk activity (transactional, cross-generational, or multi-partner sex) takes place. For example, a hotspot can be a bar, nightclub, guest house, or any other location where members of key populations congregate.. Hotzone: A hotzone is a closely clustered group of hotspots (hotspots within easy walking distance of each another- 100 metres or so). A hotzone is typically an urban neighborhood or street with many bars, nightclubs, groceries and/or guest houses. Outlet: For the purpose of this survey an outlet is considered to be one that has the potential or likelihood of selling condoms in a hotzone including (but not limited to): traditional retail outlets such as kiosks, shops, duka la dawa (drug shops) pharmacies and non- traditional outlets, in this study also refered to as hotspots in some cases such as mobile vendors, bars, restaurants, guesthouses, nightclub/discos, brothels, hair salons/barbershops, massage parlors . Any additional hotspots identified by the study team will be censused in a selected hotzone for the survey. Husika regions: refers to the seven regions in Tanzania where the project Husika targeting key populations is operational, namely: Dar es Salaam, Mbeya, Iringa, Mwanza, Shinyanga, Tabora and Mara. Indicator Definitions: Minimum Standards 1. Coverage is the proportion of hotzones in a region in which products are available . For this study, the coverage minimum standard will be defined as follows: Salama Halisi condoms should be available in at least 2 outlets in a hotzone. All other condoms should be available in at least 1 outlet per hotzone. Availability for this survey refers to outlets that have sold the brand in the last 3 months. Additional assessment will be made a quality indicator to note which outlets were actually stocking the product on the day of the survey. 2. Quality of Coverage is the proportion of hotzones in which condoms are available and conform to additional minimum standards detailed below. Quality of coverage standards will only be assessed for PSI and T-MARC condoms. Product is available in an outlet that opens until midnight Product is clearly visible Product is within expiry date At or below recommended retail price Promotional materials are on display Dispenser of product lasts for at least 2 weeks Brand available in the uninterrupted for 4 weeks For this study, quality of coverage is defined as follows; a) Condoms are available in at least one outlet that opens until midnight in a hotzone b) Condoms are clearly visible in at least one outlet in a hotzone c) Condoms are within expiry date in at least one outlet in a hotzone d) Condoms are sold below or at the recommended price in at least one outlet e) Branded promotional materials are visible and on display in at least one outlet in a hotzone f) One dispenser of condoms lasts for at least 2 weeks g) Brand has been in stock without interruption for the last four weeks in at least one outlet per hotzone Measures for quality of coverage will be reported both individually for each standard, and as one overall quality indicator. 3.) Numeric distribution is the proportion of outlets in a defined hotzone in which the PSI and TMARC products are available, broken down by distribution channel and hotspot type. Changes over time will be examined. 4.) Access Access is the proportion of high-risk individuals that work/meet in high-risk outlets within a defined catchment area of an outlet that stocks condoms. The condom outlet catchment is defined as having a radius of 100 meters (note that this standard is flexible and may be reduced during data analysis,
or may be combined with a second, reduced distance (e.g. 100 meters).