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Health for Life Project Annual Report

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Health for Life Project Annual Report HEALTH FOR LIFE PROJECT ANNUAL REPORT JULY 1, 2015 TO JUNE 30, 2016 July 31, 2016 This publication was produced for review by the United States Agency for International Development. It was prepared by RTI International. Health for Life Project Annual Report July 31, 2016 Contract AID-367-C-13-00001 Prepared for COR Office of Health and Education USAID/Nepal P.O. Box No. 295 U.S. Embassy, Maharajgunj Kathmandu, Nepal Prepared by RTI International 3040 Cornwallis Road Post Office Box 12194 Research Triangle Park, NC 27709-2194 RTI International is one of the world's leading research institutes, dedicated to improving the human condition by turning knowledge into practice. Our staff of more than 3,700 provides research and technical services to governments and businesses in more than 75 countries in the areas of health and pharmaceuticals, education and training, surveys and statistics, advanced technology, international development, economic and social policy, energy and the environment, and laboratory testing and chemical analysis. RTI International is a trade name of Research Triangle Institute. The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. CONTENTS List Of Figures .................................................................................................................................................. iv List of Tables...................................................................................................................................................... v Abbreviations .................................................................................................................................................... vi Background ......................................................................................................................................................... 4 A. Accomplishments And Intended Outcomes For The Period ............................................................... 5 Objective 1: Improve Health Systems Governance Of District Offices And Sub-District Level Facilities ........................................................................................................................................................... 5 Objective 2: Develop and implement national evidence-based policy ................................................ 14 Objective 3: Strengthen National-Level Stewardship Of The Health Sector ..................................... 25 Objective 4: Institutionalize Nationwide System For Quality Improvement ..................................... 26 Objective 5: Improve Capacity Of District And Local Level Health Workers And Community Volunteers To Deliver High Quality FP/MNCH And Nutrition Services ........................................ 34 Objective 6: Improve Knowledge, Behavior, And Use Of Health Services Among Target Population ..................................................................................................................................................... 47 Objective 7: Strengthen Lifeline's Capacity for Logistical Support ...................................................... 54 Health for Life Staff composition ............................................................................................................. 54 B. Major challenges and constraints faced during the performance period that resulted in delays of achievement of outcomes, if applicable ....................................................................................................... 55 C. Highlights of the internship program as described in Section C.2.8.1D............................................ 57 D. Cumulative quantitative monitoring and evaluation data, including information on progress towards targets and explanations of any issues related to data quality .................................................... 58 Capacity Building Benchmarks .................................................................................................................. 58 PMP and PPR Indicators ........................................................................................................................... 62 E. Information on the status of finances, including expenditure data based on the budget and accruals, as well as, when appropriate, analysis and explanation of cost overruns or high unit cost ..73 F. Information on management issues, including administrative problems, or problems with beneficiary groups, or implementing partners and what steps or actions were taken to manage these and lessons learned for future .............................................................................................................. 74 G. Anticipated future problems, delays, or conditions that may adversely impact implementation of the project and what measures are in place to deal with these ............................................................. 75 H. Information on security issues, especially as these affect program integrity and safety of beneficiary groups and implementing partner ............................................................................................. 75 I. Other information, such as new opportunities for program expansion, lessons-learned and success stories, and prospects for the following year’s performance ....................................................... 76 Annexes ............................................................................................................................................................. 77 Annex 1: Council Budget Allocations ...................................................................................................... 77 Annex 2: Joint Visits With GoN Staff From July 2015 And June 2016 .............................................. 78 Annex 3: Intern Testimonials .................................................................................................................... 82 Health for Life— Annual Report iii LIST OF FIGURES Figure 1.1 Three-Year Trend of Institutional Delivery in Selected High-Priority HFs of Health for Life Districts .. 6 Figure 1.2 Functionality Status of HFOMCs in EQ-Affected Districts ............................................................................ 8 Figure 1.3 Performance of HFOMCs in EQ-Affected Districts 2016 ............................................................................... 9 Figure 1.4 Status of HFOMC Revitalization, Health for Life EQ-Affected District Program as of June 2016 .......... 9 Figure 1.5 Major Activities Carried Out in the Demonstration Districts Using Flexible Health Grants ................... 14 Figure 2.1 Composition of Registered Pregnant Women by Caste/Ethnicity Against the Population Proportion in Health for Life Districts as of June 2016 ............................................................................................................................... 16 Figure 2.2 Percentage of Registered Women who had Four ANC Visits Among All Live Births at 39 Sentinel Sites as of June 2016 (N=3,297) ....................................................................................................................................................... 16 Figure 2.3 Percentage of Registered Women Who Delivered at Health Facilities and Percentage of Registered Women Who Had 1st PNC Within 24 Hours Among Live Births at 39 Sentinel Sites as of June 2016 (N=3,297) 18 Figure 2.4 Utilization of ANC, Institutional Delivery and PNC Services Among Registered Women, by Caste/Ethnicity at Sentinel Sites as of June 2016 ................................................................................................................ 18 Figure 2.5 Percentage of Registered Women Who Were Counselled and Chose To Use FP Among Closed Cases, by Caste and Ethnicity at 39 Sentinel Sites as of June 2016 ............................................................................................... 19 Figure 2.6 Percentage of Registered Women Who Started Using a Modern Method of FP within 90 days of delivery, by Caste and Ethnicity at 39 Sentinel Sites as of June 2016 ............................................................................... 19 Figure 2.7 FP Methods Among Postpartum Women Currently Using FP Methods at Sentinel Sites as of June 2016 (N=976) ...................................................................................................................................................................................... 19 Figure 2.8 General Readiness Index of HFs in EQ-Affected Districts 2016 .................................................................. 22 Figure 4.1 Compliance with Physical Facility Standards at Selected HFs Of Jumla....................................................... 27 Figure 4.2 Compliance with IUCD Service Standards at Selected HFs of Dang ........................................................... 28 Figure 4.3 District QAWCs Established Decision and Action Plans ............................................................................... 29 Figure 4.4 Readiness of HFs Regarding IP/HCWM (HF Midterm Survey) ................................................................... 33 Figure 4.5 Compliance with Focused ANC Service Standards in Banke (High-Priority VDCs) ................................. 33 Figure 4.6 Compliance with Standards for Care of Sick Child (2-59 Mo) in Selected HFs of Jajarkot ...................... 33 Figure 5.1 Compliance
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