Improving the Health of Guatemala's Most Vulnerable
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PROJECT HOPE Improving the Health of Guatemala’s Most Vulnerable Population: Migrant Women and Children in the Boca Costa Region of Southwestern Guatemala Cooperative Agreement FAO-A-00-97-00030-00 DETAILED IMPLEMENTATION PLAN Project Duration: September 30, 2001 – September 29, 2005 Submitted to: USAID/DCHA/PVC Room 7.6-D, RRB 1300 Pennsylvania Avenue Washington, DC 20523-7600 Submitted by: Project HOPE – The People-to-People Health Foundation, Inc. Millwood, Virginia 22646 Tel: (540) 837-2100 Fax: (540) 837-1813 March 29, 2002 Contact persons: Bettina Schwethelm, PhD, MPH Victor Calderon, MD, MPH Director, Maternal & Child Health Programs Country Director, Guatemala Luis Benavente, MD, MSc Anabella Aragon, MD Associate Director, MCH Programs Deputy Director, Guatemala TABLE OF CONTENTS SECTION I: PROGRAM DESCRIPTION............................................................................ 5 A. Executive Summary........................................................................................................ 5 B. CSGP Data Form............................................................................................................ 7 C. Description of DIP Preparation Process........................................................................... 8 D. Program Site Analysis..................................................................................................... 9 E. Summary of Baseline and Other Assessments........................................................... 14 F. Program Approach........................................................................................................ 15 G. Organizational Development......................................................................................... 18 H. Sustainability................................................................................................................ 28 I. Behavior Change Strategies .......................................................................................... 36 J. Quality Assurance......................................................................................................... 39 SECTION II: PROGRAM MANAGEMENT...................................................................... 41 A. Management Approach................................................................................................. 41 B. Human Resources ......................................................................................................... 42 C. Contingency and Security Plan ..................................................................................... 45 D. Technical Assistance Plan............................................................................................. 47 E. Information Management.............................................................................................. 49 F. Financial Management.................................................................................................. 49 G. Logistical Management................................................................................................. 49 H. Monitoring and Evaluation............................................................................................ 50 H.1 Program Goals and Objectives ...................................................................................... 50 H.2 Program Monitoring and Evaluation Plan...................................................................... 50 H.3 Evaluation Plan............................................................................................................. 54 I. Budget (only if changed from the Cooperative Agreement) .......................................... 62 J. Work plan..................................................................................................................... 62 SECTION III: DETAILED PLANS BY INTERVENTION................................................ 69 A. Immunization................................................................................................................ 69 B. Nutrition and Micronutrients......................................................................................... 76 C. Breastfeeding Promotion ......................................................................................... 76 D. Control of Diarrheal Disease......................................................................................... 86 E. Pneumonia Case Management ...................................................................................... 92 F. Control of Malaria ........................................................................................................ 98 G. Maternal and Newborn Care ........................................................................................103 H. Child Spacing ..............................................................................................................113 I. STI/HIV/AIDS Prevention and Care ............................................................................121 J. Integrated Child Survival Programs and IMCI .............................................................129 SECTION IV: ANNEXES....................................................................................................134 Attachment 1: Response to Final Evaluation Recommendations: Attachment 2.: Final KPC Survey Report Attachment 3.: Agreements Attachment 4.: Resumes/CVs of key personnel at HQ and in the field Attachment 5: Maps Attachment 6: Organizational Charts Attachment 7: Budget Attachment 8: IMCI Protocols Attachment 9: Clinical Protocols, Maternal and Reproductive Health Attachment 10: Clinical Protocols, Child Health ACRONYMS ADISS Asociación para el Desarrollo Integral y Sostenible de la Salud ANACAFE National Association of Guatemalan Coffee Growers APROFAM Asociación Pro Bienestar de la Familia ARI Acute Respiratory Infection BASICS Basic Support for Institutionalizing Child Survival CARE Cooperative for Assistance & Relief Everywhere CAs Cooperating Agencies CBDAs Civilian Based Defense Association CE Continuing Education CEDEC Education Center for Cooperative Development CEIPAS Centro Integral para Programas de Atención en Salud CEO Chief Executive Officer CHAPS Community and Health Partnerships CMR Child Mortality Rate CORE Child Survival Collaboration and Resource Group CS Child Survival CSTS The Child Survival Technical Support Project CSTS’ ISA Institutional Strengths Assessment CS-XIII Child Survival projects, 13rd round CVs Curriculum Vitaes DFID UK Department of Foreign International Development (UK) DHS Department of Health Services DIP Detailed Implementation Plan DOSA Discussion-Oriented Organizational Self Assessment DRFs Drug Revolving Funds ENSMI Encuesta Nacional de Salud Materno Infantil EPI Expanded Program in Immunization FAX Facsimile FGDs Focus Group Discussions FP Family Planning GOG Government of Guatemala HFA Health Facility Assessment HIS Health Information System Specialist HIV/AIDS/STIs Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome/Sexually Transmitted Diseases HU Health Unit IEC Information, Education, Communication IGSS Guatemala Social Security Institute ILO International Labour Organization IMCI Integrated Management of Childhood Illness IMR Infant Mortality Rate INE Instituto Nacional de Estadistica INGUAT Instituto Guatemalteco de Turismo IR Intermediate Results KPC Knowledge, Attitude and Practices LAM Lactation Amenorrhea Method MCH Maternal Child Health MNH Maternal and Neonatal Health (a JHPIEGO program) MOE Ministry of Education MOH Ministry of Health MTE Mid-Term Evaluation NGO Non-Governmental Organization OCA Organizational Capacity Assessment OR Operations Research PACT U.S. Technical Assistance Agency based in Washington, D.C. (formerly Private Agencies Collaborating Together) PAHO Pan American Health Organization PCI Project Concern International PHR-II Partners in Health Reform – Abt Associates Health System Reform TA Project PID Pelvic Inflammatory Disease PRA Participatory Rural Assessment PREALC Programa Regional de Empleo para America Latina/Caribe PVO Private Voluntary Organization Q Quetzaltenango QI Quality Improvement R Retalhuleu RH Reproductive Health RH/STI Reproductive Health/Sexually Transmitted Diseases RHT Rural Health Technician SIAS Ministry of Health/Guatemala Integrated Health Care System SM San Marcos So Sololá SO3 Strategic Objective 3 (SO3) of USAID/G-CAP is “Better Health for Rural Women and Children” Su Suchitepequez TBA Traditional Birth Attendant TFT Training for Transformation TTV Tetanus Toxoid Vaccine U.K. United Kingdom URC University Research Center U.S. United States USAID U.S. Agency for International Development USAID/G U.S. Agency for International Development/Guatemala USAID/G-CAP U.S. Agency for International Development/Guatemala Strategic Objective 3 (SO3), “Better Health for Rural Women and Children” VHB Village Health Bank WHO World Health Organization SECTION I: PROGRAM DESCRIPTION A. EXECUTIVE SUMMARY Project HOPE was awarded a four-year extension to extend and expand its successful CS-XIII project, aimed at improving the health of women and children residing in or migrating to coffee plantations in the Boca Costa region of southwestern Guatemala. The CS-XIII project provided benefits for more than 200,000 migrant and resident children and women of reproductive health on about 150 coffee plantations in the departments of San Marcos (SM), Quetzaltenango (Q), Suchitepequez (Su), Retalhuleu (R), and Sololá (So). The current