Strengthening Angolan Systems for Health (SASH) Angola Final Report
Total Page:16
File Type:pdf, Size:1020Kb
Strengthening Angolan Systems for Health (SASH) Angola Final Report October 1, 2011– April 30, 2017 Submitted: June 30, 2017 Produced for review by: United States Agency for International Development, USAID Cooperative Agreement No. AID-654-A-11-00001 Prepared by: Jhpiego in collaboration with Management Sciences for Health This report is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Jhpiego Corporation or the Angola SASH program and do not necessarily reflect the views of USAID or the United States Government. Table of Contents Abbreviations and Acronyms ......................................................................................................... iv Acknowledgements ....................................................................................................................... vii Executive Summary ....................................................................................................................... ix Major Accomplishments .................................................................................................................x Background and Approach ............................................................................................................ 1 Key Changes in SASH’s SOW ........................................................................................................ 2 Geographic Focus .......................................................................................................................... 4 Guiding Principles .......................................................................................................................... 4 Description of Results.................................................................................................................... 5 Health Information Systems .......................................................................................................... 5 Municipal Planning ...................................................................................................................... 10 AOP Budgeting .............................................................................................................................. 13 HIV/AIDS ....................................................................................................................................... 16 Family Planning ............................................................................................................................ 26 Malaria .......................................................................................................................................... 32 Challenges & Solutions ................................................................................................................ 35 Lessons Learned & Recommendations ..................................................................................... 42 Angola SASH: Final Report, June 2017 iii Abbreviations and Acronyms AOP Annual Operational Plan ANC Antenatal Care ART Antiretroviral Treatment CCM Continuum of Care Model DHIS District Health Information Software DNSP Direção Nacional de Saúde Pública (National Public Health Directorate) DPS Direção Provincial de Saúde (Provincial Health Directorate) EPHS Essential Package of Health Services FP Family Planning FPOM Ferramenta de Planificação e Orcamentação Municipal, Municipal Planning and Budgeting Tool GEPE Gabinete de Estudos, Planeamento, e Estatística (Department of Studies, Planning, and Statistics at the Ministry of Health) GTI Gabinete de Tecnologias de Informação (Department of Information Technology at the Ministry of Health) GoA Government of Angola GPSL Gabinete Provincial de Saúde de Luanda (Luanda Health Provincial Cabinet, formerly the DPS in Luanda) HTC HIV Testing and Counseling HF Health Facility HIS Health Information System HSS Health Systems Strengthening HRH Human Resources for Health HRM Human Resources Management HTS HIV Testing Services IC Index Case INLS Instituto Nacional de Luta Contra SIDA (National Institute in the Fight against AIDS) IP Implementing Partner IPTp Intermittent Preventive Treatment in pregnancy IUD Intrauterine Contraceptive Device LARC Long-acting reversible contraceptive LTFU Loss to Follow-Up iv Angola SASH: Final Report, June 2017 LOP Life of Project MIP Malaria in Pregnancy M&E Monitoring and evaluation MoH Ministry of Health MSH Management Sciences for Health NMCP Programa Nacional de Controlo da Malária (National Malaria Control Program) NS National Secretariat PAC Post-Abortion Care PAF Patient Assistant Facilitators PASS II Professional Acquisition Support Services (PASS II) PDDS Planos Distritais de Desenvlvimento Sanitario (District Health Development Plans) PEPFAR President’s Emergency Plan for AIDS Relief PESIS Plano Estratégico do Sistema de Informação Sanitária (Health Information System Strategic Plan) PITC Provider-Initiated Testing and Counseling PLHIV People Living with HIV PMDS Plano Municipal de Desenvolvimento Sanitário (Municipal Health Development Plan) PMI President’s Malaria Initiative PMTCT Prevention of Mother-to-Child Transmission of HIV PNDS Plano Nacional de Desenvolvimento Sanitário (National Health Development Plan) PNSR/PF Programa Nacional de Saúde Reprodutiva/Planificação Familiar (National Reproductive Health/Family Planning Program) PPDS Plano Provincial de Desenvolvimento Sanitário (Provincial Health Development Plan) PPIUD Postpartum Intrauterine Contraceptive Device PPFP Postpartum Family Planning QI Quality Improvement RDT Rapid Diagnostic Test (Malaria) RMHSS Revitalization of Municipal Health Services Strategy RMS Repartição Municipal de Saúde (Municipal Health Department) SASH Strengthening Angolan Systems for Health SBM-R Standards Based Management and Recognition SOP Standard Operating Procedure Angola SASH: Final Report, June 2017 v SOW Scope of Work TOT Training of Trainers TWG Technical Working Group UNAIDS Joint United Nations Programme on HIV/AIDS UNFPA United Nations Fund for Population Activities USAID United States Agency for International Development USG United States Government VCT Voluntary Counseling and Testing WHO World Health Organization vi Angola SASH: Final Report, June 2017 Acknowledgements The Fortalecimento do Sistema Angolano de Saúde (ForçaSaúde) project, or the Strengthening Angolan Systems for Health (SASH) project, has been the United States Agency for International Development’s (USAID) flagship health program in Angola. Designed to increase the availability and use of quality public health services through Technical Assistance (TA) and training at the national, sub-national and health facility (HF) levels, SASH supported programming in the areas of Family Planning (FP), Malaria, and HIV/AIDS to work towards Health Systems Strengthening (HSS). In addition, SASH strongly encouraged opportunities for integration within HSS; cross- cutting technical areas included: building managerial and technical capacities; improving service delivery, human resources, municipal decentralization, and health management information systems; and ensuring women and young girls receive equitable, ethical, effective, and efficient health interventions, as well as addressing gender-based violence. This program and report were made possible by the generous support of the American people through USAID, under the terms of the Cooperative Agreement AID-654-A-11-00001. The contents of this report are the responsibility of the SASH project and do not necessarily reflect the views of USAID or the United States Government (USG). The success of a large-scale project, like that of SASH, depends on the joint efforts of many people. It is impossible to thank everyone individually for his or her generous and invaluable support, however, our team would like to take a moment to express special gratitude to key collaborators whose support was instrumental to the project’s success. The SASH team would especially like to thank the Angolan Ministry of Health (MoH)— specifically the Direção Nacional de Saúde Pública (DNSP) (National Public Health Directorate), the Instituto Nacional de Luta Contra SIDA (INLS) (National Institute for the Fight Against AIDS), the Programa Nacional de Controlo da Malária (NMCP) National Malaria Control Program,and the Programa Nacional de Saúde Reprodutiva/Planificação Familiar (PNSR/PF) (National Reproductive Health/Family Planning Program). In addition, we’d like to thank all Provincial, Municipal, and District Level Health Directors, all HF Directors and Clinical Directors, all Health Service Providers and Technical Focal Points, all Patient Assistant Facilitators (PAFs), and all Community Activists and Leaders, with whom we worked in both the Luanda and Huambo provinces throughout the project’s implementation. Their mission gave shape to our mission as a project. Their collaborative spirit, and their openness to new ideas, spurred our own efforts in support of our shared goal to improve the technical quality of health services, promote the practice of respectful care for Angolan women and their families, and engage in Quality Improvement (QI) and health promotion efforts. In particular, SASH is appreciative of support provided by: Dr. Luis Sambo, Minister of Health and his predecessor, Dr. José Días Van Dúnem; Dr. Constantina Furtado, Vice Minister of Health; Dr. Miguel de Oliveira, National Director of Public Health, and his predecessor,