Clinical Advisor Consultant -Collaborative Care Model for Diabetes and Hypertension
About the role
1. Background Diabetes and hypertension are a growing share of the disease burden in Tanzania Mainland. Many people living with these conditions are not diagnosed, and many of those who are diagnosed do not stay in care long enough to reach and keep control of their blood pressure or blood glucose. Care is concentrated at hospital-level NCD clinics, while dispensaries, health centres, and community health workers (CHWs) have a limited but growing role in screening, follow-up, and adherence support. One third of adults aged 30, 79 are estimated to have hypertension, but only 34% of these people have been diagnosed, 15% are receiving treatment, and 7% have controlled blood pressure. Nearly one in ten adults lives with diabetes, but only 40% know they have it. Patients are often lost between encounters: referrals are not completed, follow-up falls away, and medicines are not consistently collected or available. People then return to hospitals with complications that could have been prevented or identified earlier, including stroke, kidney failure, and diabetic foot ulcers. A previous program in Tanzania screened more than 75,000 people, yet fewer than half of those referred reached diagnosis and care. Among people with diabetes who did reach care, follow-up fell from 47% at six months to 27% at 12 months. This experience showed that screening alone does not create continuous care. Tanzania’s National Integrated CHW Programme creates a formal cadre linked to primary facilities, offering an opportunity to bring diabetes and hypertension care closer to communities through defined, safe clinical roles and referral pathways. D-tree is hiring a Clinical Advisor to guide the design of a collaborative care model for diabetes and hypertension. The advisor will leverage clinical evidence and local experience to define quality care across the patient journey (screening through long-term control), identify current pathway gaps, and establish priority health outcome indicators. Additionally, the advisor will validate research tools, lead field interviews with health workers, and partner with D-tree, MoH, and PMO-RALG clinicians to translate clinical insights into updated workflows and digital health tools. 2. Objective To provide the clinical evidence base, field insight, and expert judgment D-tree needs to design a collaborative care intervention for diabetes and hypertension that is grounded in national guidelines and best practice, and that improves the quality of service delivery at community and primary health facility levels in Tanzania Mainland. In addition to supporting intervention design and clinical quality, the advisor will define health outcome indicators that demonstrate impact on diabetes and hypertension outcomes, health system cost savings, and patient experience. The advisor will work in coordination with a health economist, to link clinical indicators to quantifiable cost implications, and with a D-tree design staff to make sure the care pathway is designed around the needs of people living with diabetes and hypertension and their families. 3. Scope of Work The advisor will cover the following areas. A. Review and Validation of Clinical Protocols • Review the existing national and D-tree protocols relevant to diabetes and hypertension, including the current Standard Treatment Guidelines and National Essential Medicines List (STG/NEMLIT), MoH NCD guidelines and training materials, the NCD content of the national CHW curriculum, and the clinical logic in D-tree-supported digital tools. Are they aligned with current WHO guidance (including the WHO PEN package and the HEARTS technical package) and best practice? Where are the gaps or inconsistencies between documents? • Who should CHWs screen or refer for screening (age, risk factors, symptoms), how often, and using which methods (blood pressure measurement, point-of-care glucose testing, risk questionnaires)? What is realistic given equipment and supplies at communi