Seven health care facilities were selected, including both public facilities and private/faith-based facilities. In Arusha, four health care facilities were involved in the study: Selian and St Elizabeth Hospitals (both faith-based facilities) and Mount Meru and Arumeru Hospitals (both public facilities). Selian is operated by the Lutheran Church, while St Elizabeth is run by the Roman Catholic Church. Both hospitals are located within Arusha City and are beneficiaries of PEPFAR funding. The Selian Hospital launched its ART programme in 2003, while the St Elizabeth programme started in early 2005. At the time of the study, Selian had a total of 535 registered ARV users, of whom 353 were females and 182 males. At St Elizabeth Hospital there were 299 (215 female and 84 male) ARV users. Community counsellors were helping ARV users in Selian and St Elizabeth Hospitals.

Of the public health facilities, Mt. Meru is a regional hospital located in the centre of Arusha City. At the time of the study, it had 344 (212 female and 132 male) registered ARV users. Arumeru, a Government district hospital, is located 15 km outside the city and had only registered 87 ARV users (42 females and 45 males). Both hospitals started an ART programme in late-2004 and are funded by the Government and the Global Fund. Some of the facilities in Arusha did not operate on a daily basis, leading to time constraints for the research team as well as for ARV users.

In Dar es Salaam, three health care facilities were studied: Mwananyamala Hospital, Hindu Mandal Hospital, and PASADA (Pastoral Activities and Services for AIDS in Dar es Salaam Archdiocese) Hospital. Mwananyamala is a public district hospital, located in Kinondoni municipality; Hindu Mandal is a private hospital in Ilala municipality, which is owned and run by Tanzanians of Indian origin; and PASADA is a faith-based hospital run by the Roman Catholic Church in Temeke municipality. PASADA and Mwananyamala started their ART programmes in 2003 and 2004 respectively, while Hindu Mandal Hospital started in 2002. The Mwananyamala programme receives support from both the Government and the Global Fund, and is also a beneficiary of a HIV project run jointly by three institutions: Muhimbili University College of Health Sciences (MUCHS), Dar es Salaam City Council and Harvard School of Public Health (known as the MDH project). Funding of study facilities is shown in Table 2 below. At the time of the study, Mwananyamala Hospital had 1791 registered ARV users (907 females and 884 males); PASADA had 508 registered ARV users (364 females and 144 males); and Hindu Mandal had 178 ARV users (102 females and 76 males).

Table: 2 Summary of characteristics of the surveyed health care facilities

GoT: Government of Tanzania

Patients waiting for services at Mwananyamala Hospital, Dar es Salaam, one of the public health care facilities in the study.