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Transform HDR Bulletin July 2020

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Transform HDR Bulletin July 2020 USAID Transform: Health in Developing Regions Activity Bulletin July 2020 No.3 USAID Transform: Health in Developing Regions Project is implemented by Amref Health Africa in partnership with Project HOPE, IntraHealth International and General Electric. Civil Engagement for Community essential health services. This approach provides Health Services an alternative structure to engaging the wider community and leads to better communication of The health service delivery gap is pronounced in health messages on family planning, pregnancy, certain areas of Somali Region where there is a the benets of child delivery at health facilities, the weak link between communities and health posts importance of breastfeeding, and hygiene. The or health centres. Even when health extension platform increases community members' engage- workers are active and present, in some commu- ment and accountability and leads to a better nities they are inundated with competing responsi- track record of referrals due to closer follow-ups. bilities and are consequently unable to provide With minimal support, Umulgargar's members adequate health information and/or connect the travel miles to reach community members. Most community to the closest health service centre. importantly, Umulgargar women engage their Unfortunately, many communities lack awareness community in decision making on the services on the importance of seeking health services that provided, resulting in a sense of ownership. are readily available to them. As a result, many Additionally, and at their own expense, all 50 suffer from preventable diseases, particularly members contribute ETB 50 each month to support women and children. mothers who face complications during pregnancy and delivery. Health service communication and delivery gaps are addressed by Umulgargar, an indigenous The association covers transportation fees to and Community Based Association (CBA) in Awbare from the health facilities, and in some cases, Woreda, an area with a population of 373,238 extends support by purchasing household in Somali Region. The USAID Transform Health in commodities. At Awbare Health Centre, the Developing Regions (HDR) activities engage 50 association members successfully established a female members of the Umulgargar CBA, equip- Maternal Waiting Home through money they ping them to create linkages between the commu- contributed; Transform HDR matched their effort by nity and the Awbare Health Centre. providing basic equipment. Transform HDR has strengthened the capacity of Working closely with Umulgargar has enabled Umulgargar's women, equipping them with Transform HDR to reach community members with Members of Umulgargar, a Community Based Association in Awbare Woreda, Somali Region. c Somali Region Field Ofce/ Amref Health Africa 1 community mobilization and health messages Awbare Health Centre is also one of the 24 communications skills. It also provided health facilities selected as Centres of Excellence, which communications materials on Ante Natal Care has received technology solutions to improve (ANC), institutional delivery, postnatal care, quality of care during ANC, delivery, and new immunization, and Family Planning (FP); guidelines born care. on how to conduct pregnant mothers conference (PMC) and audio-visuals in Somali language to The partnership that started with Umulgargar has facilitate mother support groups and PMC now been expanded to four more kebeles: Jaare, sessions. The activity also covered minimal expens- Sheedher, Gelbob, and Shilcseley with 100 new es of some of the Umulgargar members to encour- volunteer mothers. This expansion has resulted in age them to expand their service model to neigh- increase of communities' demand for health bouring kebeles and woreda. In the past six services by building and strengthening the capaci- months, this partnership has resulted in the referrals ty of CBAs at the community level and by show- of 1,800 mothers for ANC, 900 mothers for casing how to leverage such partnerships to institutional delivery, 324 mothers for FP, and create a win-win engagement. Transform HDR will 2,400 children for immunization. To date, Trans- continue strengthening this approach and rening form HDR has also provided training to 322 this model for social accountability and engage- individuals (55% female) on Reproductive, Mater- ment that could be easily replicated and scaled nal, Neonatal and Child Health (RMNCH) and health systems strengthening in Awbare woreda. Thank You to All Frontline Health Workers of Afar, Benishangul Gumuz, Gambella and Somali Regions For Working Endlessly to Support Our Communities during the COVID-19 Pandemic and Ensuring Continuity of the Essential Reproductive, Maternal and Child Health Services Transform Health in Developing Regions Integrated Mobile Outreach Service Integrated Supportive Supervision for in Hard to Reach Areas of Adaar RMNCH/FP Interventions at Meti Woreda, Afar Region, June 2020 Health Center in Godere Woreda, Gambella Region, June 2020 2 Effective Engagement of Woreda ed in Lare Woreda, about 70 km away from Leadership for Bringing Facility Gambella town. Lare is one of the Transform HDR Based Changes activity learning woredas, where a series of complementary interventions, from health commu- In order to bring fundamental changes to woreda nications to facility-level technical support, are administration and health facilities, the Ministry of provided to improve RMNCH outcomes. At Health (MOH) is implementing the Woreda Kurgeng Health Center, basic health services were Transformation Plan as part of its Health Sector nearly halted due to inadequate infrastructure, Transformation plan that started in 2015. This insufcient medical equipment and medicine, initiative seeks to create model kebeles with improper uses of resources such as ambulances, targeted health indicators to improve maternal and frequent delay of staff salaries, and lack of mecha- child health, cover all individuals with communi- nism for staff motivations. Many health staff, ty-based health insurance, and turn health facilities including health extension workers ofcially on into high-performers. Though its implementation duty, were absent from the health center. As a has shown progress across the regions, cascading result, community members, including pregnant interventions to lead towards model kebeles are women, were forced to travel from Kurgeng limited in the developing regions. Health Center to ltang, 45 km away from Gambe- la town and 70 km away from their woreda, to One of the key interventions of USAID Transform get health services. Pregnant women particularly Health in Developing Regions (HDR) activity is to faced further complications en route and spent support the regional health bureaus (RHB) in the large sums of money for transportation and other developing regions in health systems strengthen- related costs. ing, including quality improvement of RMNCH With these ndings in hand, Transform HDR services at health facilities, in line with the MOH’s Gambella Regional Ofce engaged with the plan to increase the number of model kebeles. Gambella RHB to analyze the challenges and Below is a case at Kurgeng Health Center, locat- determine joint solutions to improve RMNCH Bol Yen Bawang, CEO of Kurgeng Health Center, Gambella Region 3 services in Kurgeng Health Center. Interventions Recognizing these changes in his health center, started with training of the Woreda Health Ofce Bol Yen Bawang, CEO of Kurgeng Health Center administrative team on Leadership, Management, states “We have accomplished a lot with Trans- and Governance with a goal of active involve- form HDR. With their onsite support and training, ment and nding solutions for change. Additional our staff members are now highly motivated. They support included the provision of medical equip- work closely with the community and have built ment, intensive joint supportive supervision two maternity waiting homes for pregnant mothers follow-up, and on-site coaching by the Transform to stay in after they deliver. Medical equipment is HDR activity Team with the woreda health ofce, now available to support safe delivery at our leading to the health workers and HEW, to return health facility, and we sincerely want Transform to their service. Over time, Kurgeng Health Center HDR support to continue.” The interventions from has now shown progress—pregnant women are Transform HDR serve as a catalyst for change. now not only giving birth at the health center, but Engaging the leadership, providing basic are also beneting from two traditional maternity RMNCH inputs, and motivating the staff and the waiting homes built through contributions from the community has a lasting effect on government and community and staff members of more than communities, enabling them to come together for 215,000 birr. improved RMNCH outcomes. Kurgeng Health Center, Gambella Region 4 Mothers Waiting Homes Help hood Illnesses, and Infection Prevention for health Reduce Maternal Mortality and workers as well as conducting continuous support- New-born Death ive supervision to improve the quality of health services. Encouraging staff and communities to Evidence shows more than 75% of maternal and construct maternal waiting rooms themselves is new-born deaths occur during pregnancy, deliv- also a critical component in this effort to increase ery, and after giving birth. In resource limited quality of care, with Transform HDR providing countries such as Ethiopia, factors contributing to some start-up equipment
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