Maternal and Child Health Integrated Program MOZAMBIQUE ASSOCIATE AWARD Quarterly Report July 1 – September 30, 2012 This publication was produced for the United States Agency for International Development by MCHIP. The authors’ views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. Submitted by: Jhpiego in collaboration with Save the Children Leader with Associate Award GHS-A-00-08-00002-00 Cooperative Agreement No.656-A-00-11-00097-00 MCHIP Mozambique: Quarterly Report, July 1 – September 30 2012 0 Abbreviations and Acronyms ACS Community Health Agent AMOG Mozambican Association of Obstetrics and Gynecology AMOP Mozambican Association of Pediatrics AMTSL Active management of the third stage of birth CBD Community based distribution CBO Community-based organization CH Child health CLC Community Leader Council CM Community mobilization CS Child survival DHI Department of Health Information DHS Demographic and health survey DNSP Direcção Nacional da Saúde Pública (National Public Health Directorate) DPC Direcção de Planificação e Cooperação (Planning and Cooperation Directorate) EMNC Essential Maternal and Newborn Care EmONC Basic Emergency Obstetric and Newborn Care FP Family planning GRM Government of the Republic of Mozambique HBB Helping Babies Breathe HIS Health information system HO Home office ICT Information and communication technology IEC Information, education and communication IMCI Integrated management of childhood illnesses IR Intermediate result ISCISA Superior Health Sciences Institute IT Information technology ITN Insecticide Treated Nets IUD Intrauterine device KMC Kangaroo mother care LEEP Loop electro-surgical excision procedure MCH Maternal and child health MCHIP Maternal and Child Health Integrated Program MDG Millennium Development Goals M&E Monitoring and evaluation MIP Malaria in pregnancy MMI Model Maternity Initiative MCHIP Mozambique: Quarterly Report, July 1 – September 30 2012 1 MNCH Maternal, newborn and child Health MOH Ministry of Health MOU Memorandum of understanding NGO Non-governmental organization NMC Neonatal male circumcision PDQ Partnership Defined Quality PES Plano Económico e Social (Economic and Social Plan) PMR Performance monitoring report PPFP Post-partum family planning RH Reproductive health SBM-R Standards-based management and recognition SESP Sector de Educação Para a Saúde (Health Education Sector) SIFo Sistema de Informação da Formação (Information System for In-service Training) SVA Single visit approach SO Strategic objective SP Sulfadoxine pyramethamine TA Technical assistance TATE Triagem, Avaliação, e Tratamento de Emergência (Triage, Assessment, and Treatment of Emergencies) TBA Traditional birth attendant TBD To be determined TOT Training of trainers TWG Technical working group USAID United States Agency for International Development USG United States Government VIA Visual inspection with acetic acid MCHIP Mozambique: Quarterly Report, July 1 – September 30 2012 2 INTRODUCTION The heart of the MCHIP Mozambique project is its support for the expansion of two key Ministry of Health (MOH) initiatives: the Model Maternities Initiative (MMI), including malaria in pregnancy and prevention of mother to child transmission of HIV (PMTCT) and the Cervical and Breast Cancer Prevention and Control Program (CECAP). MCHIP also supports provision of Family Planning services through both these initiatives. These services are to be further integrated within the framework of the Integrated Service Packages, which MCHIP is assisting the MOH to roll out in 2012. The package of support for each of these initiatives consists of the following: • Support for development of national policies, norms, and guidelines (Objective 1) • Improvement in the functioning of the Routine Health Information System (Objective 1) • Training, especially based on the development and implementation of the MOH’s Integrated In-Service Training Package, but including pre-service education as well (Objective 3) • Leadership of other USG partners and coordination with other development partners under the leadership of the MOH for maximum impact (Objective 7) • Support for implementation and improvement of the quality improvement system (Objective 8) Intensive support for service provision is provided in a subset of MMI and CECAP facilities, selected in coordination with the MOH. This includes the following additional elements: • Intensive support for supervision and on-the-job training • Improvements of key supplies and infrastructure • Direct support for community activities A diagrammatic summary of the Results Framework is shown in Figure 1. The Associate Award began on April 12, 2011. This report covers the period July 1 – September 30, 2012. MCHIP Mozambique: Quarterly Report, July 1 – September 30 2012 3 Figure 1: Diagrammatic summary of MCHIP Mozambique Results Framework MCHIP Mozambique: Quarterly Report, July 1 – September 30 2012 4 RESULTS FROM PREVIOUS QUARTER (July 1 – September 30, 2012) MAJOR ACHIEVEMENTS • The subagreement modification with Save the Children was approved by USAID. MCHIP provided an orientation to all drivers in August, and the vehicles were deployed to the provinces and began supporting supportive supervision/community mobilization activities immediately thereafter. The MCHIP National Senior Advisor and Interim Chief of Party traveled to each of the provinces during the quarter to meet with the DPS and explain the type of support the project would be providing to the provinces, as well as provide an explanation of how the project vehicles would be managed and utilized in each of the provinces. Joint monthly provincial activity plans were developed and implemented by the Provincial Assistants (MNCH Nurses) and Community Mobilization Officials, in coordination with the DPS. • MCHIP supported the MOH to expand the Model Maternities Initiative to 80 health facilities by the end of September 2012. • MCHIP supported the MOH to expand CECAP services to 75 health facilities by the end of September 2012. • MCHIP provided technical assistance to ISCISA students to develop and submit two study protocols to the Scientific Commission in Humanized Birth and Active Management of the Third Stage of Labor. In FY13, MCHIP will provide technical and financial support for these students to conduct their studies (pending approval from the Ethical Committee). • MCHIP conducted 14 intensive supportive supervision visits to MMI facilities and 14 supportive supervision visits to CECAP facilities, in collaboration with the MOH, in Quarter 4 • MCHIP collaborated with the MOH to train 112 health workers from Zambézia Province in Helping Babies Breathe. • MCHIP provided logistical and financial support to the MOH to train 1,006 health workers from Niassa, Inhambane, Maputo Province, and Maputo City in malaria case management. • MCHIP supported the MOH to conduct the first National Training of Trainers (TOT) on the Methodology for Utilization, Testing and Validation of the Integrated In-Service Training Packages in July with 49 health professionals from all provinces, including representatives from the DPS, Training Institutes, health facilities, MOH central level, USAID, WHO and MCHIP. • The Integrated In-Service Training Packages are currently being tested at the provincial level; the testing and validation phase will be completed by December 2012. • MCHIP supported DNAM to organize and implement a high-level meeting to formalize the National Committee for Quality and Humanization of Care. The meeting was presided by the Honorable Minister of Health on August 13, 2012. A total of 45 members officially joined the Committee, including representatives from civil society, traditional leaders and community leaders, representatives from higher education institutions, the League of Human Rights, the Quality Commission, Military Health, the Directorates and Departments of the MOH, and partnering organizations including USAID, CDC, WHO, UNICEF, and UNFPA, among other. Close to 60 participants were present at the meeting. • MCHIP supported the implementation of three provincial trainings which resulted in the training of 161 members of district-level Quality and Humanization Committees. MCHIP Mozambique: Quarterly Report, July 1 – September 30 2012 5 • SBM-R standards for MMI, CECAP, and Family Planning were finalized. PROGRAM MANAGEMENT • MCHIP developed and submitted the Associate Award work plan and budget for FY13. MCHIP received approval of this plan from USAID on October 1, 2012. MCHIP-financed personnel working at Ministry of Health: • In coordination with the DPS, MCHIP hired Provincial Nurse Assistants for Model Maternities and CECAP services in Manica and Sofala, the only two provinces for which nursing assistants had not been previously contracted. • MCHIP hired three cleaners for Jose Macamo Hospital (a MMI and CECAP site). RESULTS BY OBJECTIVE (April 1 – June 30, 2012) Objective 1: Work with the MOH and all USG partners to create an enabling environment to support quality nation-wide integrated community and facility-based delivery of high- impact MNCH and FP/RH interventions Key planned activities until end of Project Year 1 (July 1 – Sept 30, 2012): Activity Status Hire 2 M&E officers for the National Directorate of Public Health Completed (DNSP) –the M&E Unit Coordinator and the M&E Specialist in General MCH Continue to support the MOH in the development and dissemination of External recognition