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SBH Technical Report

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SBH Technical Report USAID/Zambia Systems For Better Health Quarterly Progress Report January-March 2019 May 2019 This publication was produced for review by the United States Agency for International Development. It was prepared by Abt Associates for the USAID Systems for Better Health activity. Contract No: AID-OAA-I-14-0003 Order No: AID-611-TO-16-00001 GUC Mechanism Submitted to: William Kanweka Contracting Officer’s Representative USAID Zambia Prepared by: Abt Associates Inc. In collaboration with: Akros Inc. Save the Children DISCLAIMER The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development (USAID) or the United States Government. Contents Contents ......................................................................................................................................................................... i List of Figures ............................................................................................................................ ii List of Tables ............................................................................................................................. ii Acronyms...................................................................................................................................................................... iii 1. Introduction .................................................................................................................................................. 4 2. Highlights ....................................................................................................................................................... 5 3. Progress by Objective ................................................................................................................................ 6 3.1 Objective 1: Performance Management Improved in Six Target Provinces ................. 6 Sub-Objective 1.1 Improved Provincial and District Planning .................................................. 6 Sub-Objective 1.2 Improved Performance Assessment ............................................................. 8 Sub-Objective 1.3 Improved Performance Review Meetings .................................................. 10 3.2 Objective 2: Public Financial Management Improved in Six Target Provinces ......... 13 Sub-Objective 2.1 NAV Rolled Out and in Use in All Relevant Institutions .......................... 13 Sub-Objective 2.2 Improved Public Financial Management Practices .................................... 15 3.3 Objective 3: Increased Data Use for Decision Making ............................................... 16 Sub-Objective 3.1 Improved Generation and Use of RMNCAH&N Scorecards .................... 16 Sub-Objective 3.2 Improved Data Quality ............................................................................... 18 3.4 Central-level Activities ............................................................................................... 20 Health Care Financing ............................................................................................................. 20 Quality Improvement ............................................................................................................... 21 3.5 Research, Monitoring, and Evaluation ............................................................................... 27 Activity Monitoring and Evaluation Plan (AMEP) .................................................................. 27 Data Collection ........................................................................................................................ 27 Program M&E Database .......................................................................................................... 27 USAID Reports ........................................................................................................................ 28 Conduct Quarterly DQAs of SBH Field Data .......................................................................... 28 Kitwe HIV Linkages Activity Documentation ......................................................................... 28 4. Project Management ............................................................................................................................................ 29 4.1 Finance and Administration ............................................................................................... 29 4.2 Overall Budget and Expenditures ...................................................................................... 29 4.3 Personnel ............................................................................................................................ 29 4.4 Subcontracts ................................................................................................................ 29 5. Success Stories ...................................................................................................................................................... 30 Annex 1. Central Province Scorecard ................................................................................................................. 36 Annex 2. Eastern Province Scorecard ................................................................................................................. 37 Annex 3. Luapula Province Scorecard ................................................................................................................. 38 i Annex 4. Muchinga Province Scorecard ............................................................................................................ 39 Annex 5. Southern Province Scorecard .............................................................................................................. 40 Annex 6. Western Province Scorecard .............................................................................................................. 41 Annex 7. Performance Indicator Tracking Table .............................................................................................. 42 List of Figures Figure 1. District achievement of planning milestones in Q1 2019 ................................................................ 7 Figure 2. District achievement of performance assessment milestones in Q1 2019 ................................. 9 Figure 3. District achievement of performance review milestones in Q1 2019 ....................................... 12 Figure 4. District and institution achievement of NAV milestones in Q1 2019 ........................................ 14 Figure 5. District achievement of RMNCAH&N scorecard milestones in Q1 2019 ............................... 17 Figure 6. District achievement of data quality assessment milestones in Q1 2019 .................................. 19 List of Tables Table 1. District progress toward completion of the MSI improvement plan for planning ........................... 8 Table 2. District progress toward completion of the MSI improvement plan for performance assessment .................................................................................................................................................. 10 Table 3. Examples of PFM issues identified during self-assessments and planned actions ............................ 15 Table 4. District and institution progress toward completion of the improvement plan from the PFM self-assessment ....................................................................................................................................... 16 Table 5. Example of summary findings from SQA for adolescent health ................................................................ 25 ii Acronyms AMEP Activity Monitoring and Evaluation Plan CBO Community-based Organization CoC Continuum of Care DFID United Kingdom’s Department for International Development DHIO District Health Information Officer DHIS2 District Health Information System Version 2 DHO District Health Office DIM District Integrated Meeting DQA Data Quality Assessment DUO Data Use Officer HCC Health Center Committee HCF Health Care Financing HCFS Health Care Financing Strategy HMIS Health Management Information System M&E Monitoring and Evaluation MOH Ministry of Health MSI Management Systems Inquiry NHC Neighborhood Health Committee NHI National Health Insurance NHSP National Health Strategic Plan PA/ePA Performance Assessment/electronic Performance Assessment PFM Public Financial Management PHO Provincial Health Office PIM Provincial Integrated Meeting PMS Performance Management Specialist QI Quality Improvement RM&E Research, Monitoring and Evaluation RMNCAH&N Reproductive, Maternal, Neonatal, Child and Adolescent Health and Nutrition SBH Systems for Better Health SHIO Senior Health Information Officer Sida Swedish International Development Agency SQA Service Quality Assessment TSS Technical Support Supervision USAID United States Agency for International Development iii 1. Introduction The United States Agency for International Development (USAID) awarded the five-year Systems for Better Health (SBH) activity in Zambia to Abt Associates, Inc. in October 2015. The original goal of SBH was to improve health outcomes for Zambians by strengthening the health systems that underpin the delivery of high-quality health services and increasing the utilization of high-impact health interventions at the district and community levels. In its original design, SBH had four objectives: 1. More effective national-level health stewardship 2. Improved capacity
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