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Annual Project Report ANNUAL PROJECT REPORT VRIDDHI: Scaling up RMNCH+A Interventions Annual Project report VRIDDHI: Scaling up RMNCH+A Interventions ANNUAL PROJECT REPORT October 01, 2015 - September 30, 2016 Scaling Up Interventions in Reproductive, Maternal, Neonatal, Child, and Adolescent Health (RMNCH+A) USAID Cooperative Agreement No. AID-386-A-14-00001 Submitted by: IPE Global Limited IPE Global House, B-84, Defence Colony, New Delhi - 110 024 www.ipeglobal.com 2 Annual Project report VRIDDHI: Scaling up RMNCH+A Interventions Table Contents EXECUTIVE SUMMARY ......................................................................................................................................... 4 ROLL OUT OF CARE AROUND BIRTH STRATEGY .................................................................................................. 6 THEMATIC INTERVENTIONS ................................................................................................................................. 8 REPRODUCTIVE HEALTH .................................................................................................................................. 8 MATERNAL HEALTH ......................................................................................................................................... 9 NEWBORN HEALTH ........................................................................................................................................ 10 ADOLESCENT HEALTH .................................................................................................................................... 12 KNOWLEDGE MANAGEMENT ............................................................................................................................ 13 MONITORING AND EVALUATION ...................................................................................................................... 14 STATE ACHIVEMENTS ......................................................................................................................................... 16 ANNUAL ACTIVITY HIGHLIGHTS: DELHI ......................................................................................................... 16 ANNUAL ACTIVITY HIGHLIGHTS: HARYANA .................................................................................................. 17 ANNUAL ACTIVITY HIGHLIGHTS: HIMACHAL PRADESH ................................................................................ 18 ANNUAL ACTIVITY HIGHLIGHTS: JHARKHAND .............................................................................................. 19 ANNUAL ACTIVITY HIGHLIGHTS: PUNJAB ..................................................................................................... 20 ANNUAL ACTIVITY HIGHLIGHTS: UTTARAKHAND ......................................................................................... 21 NATIONAL RMNCH+A UNIT (NRU) ..................................................................................................................... 22 JOHN SNOW INC. (JSI) ........................................................................................................................................ 24 PLANNED ACTIVITIES VS. ACCOMPLISHMENTS -YEAR 2 ................................................................................... 27 PROJECT CONTACTS ........................................................................................................................................... 40 3 Annual Project report VRIDDHI: Scaling up RMNCH+A Interventions EXECUTIVE SUMMARY VRIDDHI: Scaling up RMNCH+A Interventions project has witnessed a deepening of partnerships with governments and key stakeholders (at national and state levels). The project has designed a comprehensive Care around Birth (CaB) approach to improve the quality of care at and around the time of birth. The primary focus of the CaB approach is to ensure a continuum of care from labor to immediate post-partum period and address the major drivers of mortality during the intrapartum and immediate postpartum periods. The project also promotes and advocates for evidence- based decision with the government by regularly sharing data from Supportive Supervision interventions. Highlights of Year 2 activities: National level: There is an increasing engagement of the project with the Ministry of Health and Family Welfare (MoHFW) and VRIDDHI is being included in various technical groups and Figure 1: Project brochures committees. It has contributed to the development of operational guidelines on Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), Sentinel Stillbirth Surveillance System, Maternal Death Review and revision of Facility Based Newborn Health guidelines. The project has been supporting National programs and drives in various ways including participation of national and state teams in the monitoring of - Mission Indradhanush (MI), Pulse Polio Campaigns, National Deworming Day, Integrated Diarrhea Control Fortnight (IDCF), PMSMA, Week lron Folic Acid Supplementation Scheme (WIFS) and Adolescent Menstrual Hygiene Scheme. Project also participates in the MoHFW led Common Review Missions. VRIDDHI hosted a National learning and sharing workshop on ‘Plugging the gaps – optimizing intrapartum MNH services’. The meeting was chaired by Joint Secretary (RCH), GOI and attended by technical officers from the ministry. Besides them, representatives of USAID, Bill and Melinda Gates Foundation, UNDP, UNFPA, WHO, AIIMS, NHSRC, World Bank, ASSIST, Save the Children, Jhpiego, Abt Associates, Digital Green, Population Council. Deloitte, NIPI, Laerdal, Tata Trusts, CARE, PATH, PHFI and Project HOPE participated in the workshop. The workshop provided a platform to discuss and deliberate upon two critical systemic issues of skills and competencies of service providers and quality of MNH care. Supportive Supervision (SS): RMNCH+A SS initiated in year one has matured, and a total of 15,118 visits have been made to 6,580 facilities across 182 districts in the country by the end of year two. The process was reviewed for the progress and needs for any revision. The checklist has been modified to incorporate emerging needs. A new checklist for the community processes has also been developed. By the end of Year-2, 268 district level monitors from 15 states had been trained on the revised and new checklists. Care around Birth (CaB) Strategy: The project has prioritized 141 high case load facilities across 26 High Priority Districts (HPDs) in the six states for concerted actions and to roll out interventions at scale. The CaB strategy was designed and rolled out in this year in the prioritized facilities. Key inputs included training, mentoring and the introduction of quality improvement processes. A total of 1230 participants (nurses, doctors, and 4 Annual Project report VRIDDHI: Scaling up RMNCH+A Interventions concerned staff) were trained through district level and onsite trainings, and this was followed up with structured onsite mentoring. In the CaB supported facilities 141 Quality Improvement teams have been formed, and 217 meetings have been held to discuss and resolve local issues and bottlenecks. Reproductive and Adolescent Health: A total of 518 counselors at 141 delivery points have been trained to strengthen Postpartum Family Planning (PPFP) services in the project focus states. In the six focus states, the adolescent health activities have focused on developing improvement plans to strengthen 76 Adolescent Friendly Health Clinics (AFHCs), which will cater to an adolescent population of 5,999,931. Community based Distribution of Misoprostol: In Himachal Pradesh, an implementation model of Community- based Distribution of Misoprostol has been rolled out. A total of 123 frontline workers and service providers have been trained and equipped to deliver the intervention. In five months of intervention, 375 pregnant women have been given tablets, 83% home delivered mothers were covered with misoprostol and not a single case of postpartum hemorrhage was reported among mothers who had received the tablet. This intervention has also been introduced in two districts of Jharkhand - Dumka and Simdega and a total of 97 master trainers have been trained. Strengthening outreach activities- Urban Health and Nutrition Days (UHND): The Delhi state initiative to strengthen outreach services through UHND in a slum area with 600,000 population is underway. A state policy and intervention framework for UHND have been developed, and 383 service providers have been trained. There is a dramatic increase in the number of outreach sessions in the area - 580 UHND days as compared with 15 outreach sessions in the last three years. Block Level Implementation Strengthening Support (BLISS): In Uttarakhand, BLISS has helped to improve delivery of Antenatal Care (ANC) services through 25 community-based health sub-centres. An initial training of 55 health service providers, has been followed up by mentoring and peer learning in smaller groups. A combined approach of training, mentoring, addressing supply gaps and Supportive Supervision has been initiated. RMNCH+A reviews: The project teams in the six states facilitated 65 RMNCH+A reviews at the state and district level. These are emerging as experience sharing platforms for wider dissemination of project learnings and strategies. The launch of Rotavirus Vaccine: State team supported the launch of Rotavirus Vaccine in Haryana. The project supported training of 40 state level master trainers and 296 district and sub-district trainers.
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