Under the majestic shadow of Mount Kilimanjaro lies Kibong’oto Infectious Disease Hospital (KIDH), the leading multi-drug resistant tuberculosis hospital in Tanzania. In 2012, KIDH was called the Kibong’oto National Tuberculosis Hospital; but the Ministry of Health and Social Welfare (MOHSW) and hospital leaders wanted to turn the TB specialty hospital into a parastatal institution to lead training and to help KIDH provide regional services for infectious diseases. USAID was also interested in funding the hospital directly for its TB diagnostic and treatment services, but wanted to KIDH to have systems strong enough to manage United States Government funds.

Through the TB TO 2015 Project, led by PATH, USAID supported KIDH to strengthen its service delivery, diagnostic and training systems. As a partner to PATH, Initiatives Inc. helped to build KIDH’s organizational capacity to help the hospital in its transition and strengthen its systems to meet the requirements for receiving direct funding from USAID.

KIDH’s capacity building process began with a participatory assessment. Together, Initiatives and KIDH personnel applied Initiatives’ organizational capacity assessment (OCA) and action planning process to assess the hospital’s capacity development needs and document a road map for strengthening systems. Following the initial OCA, Initiatives provided technical support to address the identified gaps including a guiding the development of a new strategic plan; documentation of KIDH finance, administration, and human resources policies and procedures; training KIDH leaders in resource mobilization; orienting staff on establishing ualityuality improvement; and training senior KIDH staff in leadership and management.

The involvement of KIDH staff in the hospital’s capacity assessment increased their commitment to make improvements. Follow-up OCAs showed growth, but it is KIDH’s successes in the last year that speak loudest to how far it has come. The KIDH strategic plan was approved by the MOHSW. The KIDH resource mobilization team is in place and successfully obtained additional resources to establish new training programs. Despite a major leadership change, KIDH was able to stay on track with its mission and strategic objectives. The hospital staff and leadership also established quality improvement (QI) teams and began instituting QI processes. The hospital also established nursing process standards and is now rolling out training on the standards to all nurses in all departments. Finally, a strong impact was made on leadership and decision making. A new organogram and relevant job descriptions were developed, training on supervision provided, improved communication systems put in place and strategies for improving the working environment for all staff established.