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Quarterly Progress Report (January – March, 2017)

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Quarterly Progress Report (January – March, 2017) Approval Date: September 30, 2015 QPR Number: [002] Contract/Agreement Number: [AID-611-C-15-00002] Activity Start Date and End Date: [October 1, 2015 to September 30, 2020] Total Award Amount: [$24,389,716.00] Submitted by: [PATH Zambia Office, Stand 11059, Brentwood Lane, Lusaka] [Tel: +260211378950] DISCLAIMER: The author’s views expressed in this report do not necessarily reflect the views of the United States Agency for International Development (USAID), United States President’s Malaria Initiative (PMI) or the United States Government List of Abbreviations ANC Antenatal care BRITE Broad Reach Institute for Training & Education CBO Community-based organizations CD Continuous distribution CHA Community Health Assistant CHAZ Churches Health Association of Zambia CHW Community Health Worker COP Chief of Party CSO Civil Society Organization DHD District Health Director DHO District Health Office DHIS2 District Health Information System 2 DHS Demographic Health Survey DIM District Integrated Meeting EPI Expanded Program on Immunization GRZ Government of the Republic of Zambia GUC Grants under contract HMIS Health Management Information System iCCM Integrated community case management IEC Information, education, and communication IPTp Intermittent preventive treatment in pregnancy IRS Indoor residual spraying ITN Insecticide-treated net JHUCCP Johns Hopkins University Center for Communication Programs LLIN Long Lasting Insecticide Treated Net MACEPA Malaria Control and Elimination Partnership in Africa MATF Malaria Task Force M&E Monitoring and evaluation MIP Malaria in pregnancy MIS Malaria Indicator Survey MOH Ministry of Health NHC Neighborhood Health Committee NMEC National Malaria Elimination Center NMEP National Malaria Elimination Program NMSP National Malaria Strategic Plan OR Operations Research OTSS Outreach Training and Support Supervision PAMO Program for the Advancement of Malaria Outcomes PHD Provincial Health Director PHO Provincial Health Office PIM Provincial Integrated Meeting PMI President’s Malaria Initiative PMP Performance Monitoring Plan SBCC Social and behavior change communication SMAG Safe Motherhood Action Groups STTA Short-term technical assistance TOT Training of Trainers TWG Technical working group ZMLA Zambia Management and Leadership Academy ZCAHRD Zambian Center for Applied Health Research and Development CONTENTS 1. EXECUTIVE SUMMARY ........................................................................................................... 4 2. BENCHMARKS AND ACHIEVEMENTS ...................................................................................... 5 3. KEY ISSUES ENCOUNTERED .................................................................................................. 22 4. SUMMARY OF ACHIEVEMENTS DURING THE CONCLUDING QUARTER TOWARDS PLANNED TARGETS ............................................................................................................................... 22 4.1 SUCCESS STORIES ................................................................................................................. 22 5. APPENDIX I: THE PERMANENT SECRETARY’S CIRCULAR ON AVAILABILITY AND USE OF FOLIC ACID (400 MICROGRAMS) ............................................................................................................. 23 6. APPENDIX II: MAPS OF HEALTH FACILITIES FOR PAMO SUPPORTED PROVINCESError! Bookmark not defined. 7. APPENDIX III: BACKGROUND INFORMATION ....................................................................... 25 8. APPENDIX IV: KEY TASKS & TARGETS BY OBJECTIVE ............................................................ 27 9. APPENDIX V: PAMO GEOGRAPHIC SCOPE ........................................................................... 29 1. EXECUTIVE SUMMARY The Program for the Advancement of Malaria Outcomes (PAMO) is a United States President’s Malaria Initiative (PMI) funded project currently in the second year of implementation. The PAMO consortium comprises of five members namely PATH, JHUCCP, JHPIEGO, BRITE and ZCAHRD. PAMO works with the Ministry of Health (MOH) and the National Malaria Elimination Centre (NMEC) to strengthen implementation of malaria control and elimination efforts. The project works at provincial, district, and community levels to support proven malaria interventions in alignment with the National Malaria Strategic Plan; strengthen management capacity of provincial and district MOH personnel to provide oversight/supervision of malaria interventions and; to strengthen the Health Management Information System (HMIS) at the provincial, district and facility levels to improve data reporting, analysis, and use for decision-making. The period under review is the first three months of implementation of Year 2 of the PAMO project. The major activities reported on include the key findings of the Management Capacity Assessment. The capacity assessment was conducted in quarter 4 of 2017, data analysis was concluded during this quarter. The data showed that there is a n urgent need for management and leadership training for district staff and health centre in-charge. There is also an urgent need to strengthen data management and recruit data clerks to support entry of the backlog of data found at the district health office. PAMO focused on providing support to the NMEC who plan to conduct a nationwide mass campaign for the distribution of Insecticide Treated Nets (ITNs). The mass campaign will begin in Luapula Province were PAMO will provide full support to the NMEC and the PHO to successfully implement this campaign. During the first quarter, PAMO worked closely with the NMEC to set up sub-committees of the ITN TWG for effective coordination of the upcoming campaign. In addition, PAMO provided technical support to the Principal ITN Officer to develop a detailed action plan for Luapula province. In case management, PAMO supported mentorship training Trends in Incidence Rates for 55 health workers (17 Female and 38 Male). PAMO 900 819.3 827.5 also supported quarterly 800 670.1 facility supervisory visits. The 700 634.4 653 650.6 work supported in case 600 490.4 management is contributing to 500 reductions in malaria incidence 403.4 400 in the four PAMO supported provinces. The graph shows a 300 comparison of malaria 200 incidence in the first quarter of 100 2016 compared to the first 0 quarter of 2017. Luapula and Eastern Luapula Muchinga Northern Muchinga are showing a greater decline then Eastern Jan to Mar 2016 Jan to Mar 2017 and Northern Provinces. This quarterly progress report focuses on the period 1st January to 31st March 2017. 2. BENCHMARKS AND ACHIEVEMENTS A summary of the key achievements and activities undertaken by the consortium during this quarter are described below: Objective 1: Support proven malaria interventions in alignment with the National Malaria Elimination Strategic Plan (2017-2021) of the Ministry of Health Task 1.0: Strengthen National Technical Working Groups Technical Working Groups are structures that provide a critical framework for coordination, planning, and mainstreaming of national strategic and technical guidance on malaria. PAMO is currently supporting five focus areas including Insecticide Treated Nets, Case Management, Social and Behavior Change Communications, Safe Motherhood, Surveillance, M&E and Operations Research (SMEO). During this quarter, PAMO provided material support to the NMEC to host one quarterly TWG meeting for each of these areas. The key achievements for this quarter include: Safe Motherhood TWG: The Ministry’s official approval of the World Health Organization (WHO) recommendation to use a low dose of 400 micrograms folic acid supplementation as part of the antenatal care. This is a huge achievement for the country, PAMO provided technical and material support to the Ministry of Health to move along this process through this TWG. A scanned copy of the circular is attached in Appendix I. Case Management TWG: PAMO facilitated and participated in the Malaria Case Management Technical Working Group meeting which was held at the NMEC on the 14th March 2017. Members of the TWG met and agreed on priority activities for 2017. They developed a road map for the review of the malaria treatment guidelines as well as the QA/QC manual. The revision of the malaria diagnosis and treatment guidelines was done during the week of the 27th to 31st March 2017 while the revision of the QA/QC manual will be done in April 2017. An update of the number of community health workers trained in iCCM nationwide was provided (2,370). Some of the challenges in iCCM program implementation were that CHWs are inactive in some areas, they lack bicycles and CHW community registers, some have resorted to using ordinary hard cover exercise books. Last year PAMO played a vital role in facilitating discussions for the change of the folic acid policy in accordance with revised guidelines for the WHO. In addition, WHO has revised the antenatal guidelines with a recommendation of at list eight contacts per pregnant woman, moving away from the four focused antenatal visits. In the eight contacts a woman must be seen by a qualified health worker or community volunteer depending on the context of the facility. The Permanent Secretary has issued a memo to relating to the change in folic acid policy, this has since been circulated in all PAMO provinces and districts. PAMO will continue to support the NMEC as required to ensure that the guidelines are fully adopted and disseminated
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