since many Tanzanians listen to the radio at some point in a given day or week, even if they do not own one. The project also borrowed the idea of a newspaper for schoolchildren ("Straight Talk") that has been so successful in Uganda. Videos have been supported, as well as a film entitled "More Time."

  • STD Control: The project is working with the private sector to facilitate training in STD diagnosis among health-care providers.

  • Nongovernmental Organization Support: The project has facilitated the establishment of coalitions or "clusters" of nongovernmental organizations in nine regions. Operating through a designated "anchor" organization in each region, the project conducts training of nongovernmental organization staff in management skills, leadership skills, and financial management and provides technical assistance as needed. A nongovernmental organization workplace project started as a demonstration project in 1990 and supports 22 organizations. This project has yet to be formally evaluated. Peer educators have generally noted that knowledge of the modes of transmission and means to prevent AIDS has greatly increased in the last 2 years, but they are uncertain whether this has translated into behavior change. Consequently, despite the successes experienced by the nongovernmental organizations involved, this effort has not been scaled up.

  • Workplace Education: The project supports the African Medical Research Foundation (AMREF) in its truck driver/truck stop project, which trains peer educators, distributes condoms, and now offers STD treatment near the truck stop sites. AMREF also works with the women's clubs that have sprung up along the trucking routes. The problem is that these naturally occurring community-based groups have proved difficult to sustain because the women die or move on down the truck route.

The Nongovernmental Organization Strategy

Tanzania is unusual among the countries visited by the team in that USAID-funded interventions are channeled exclusively through nongovernmental organizations. This strategy arose from concerns on the part of the USAID mission that there was a divergence between the mission goals and the GPA-linked national AIDS control program. There was also concern about the effectiveness of the utilization of funds in the public sector. (For example, a recent condom audit uncovered a substantial divergence between warehouse records and condoms on hand in a warehouse.)

Not surprisingly, a policy of funding only nongovernmental organizations leads to obvious questions surrounding the capacity of those organizations. Although there are many excellent examples of nongovernmental organizations doing AIDS-related work in Tanzania, many require substantial technical assistance, as envisioned in the Tanzania AIDS Project. Although a nongovernmental organization strategy, at its best, promises local control and ownership, great



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