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MCSP) Uganda - Child Health (CH

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MCSP) Uganda - Child Health (CH USAID’s Maternal and Child Survival Program (MCSP) Uganda - Child Health (CH) Quarterly Progress Report January 1 to March 31, 2018 MCSP/Ambrose Watanda USAID/Uganda Quarterly Progress Report (Program Year 4) Project Name: USAID’s Maternal and Child Survival Program (MCSP) Uganda Child Health (CH) Program Reporting Period: January 1 to March 31, 2018 Obligation Funding Amount: Project Duration: August 2016 to December 2018 Program Year (PY4): October 1, 2017 to September 30, 2018 Person Responsible for this Report: Dr. Ssekitto Kalule Gerald – Chief of Party, MCSP Program Goal: To contribute to a reduction in child mortality in the Southwest (SW) and East Central (EC) regions of Uganda. Program Purpose: With USAID Uganda’s Regional Health Integration to Enhance Services (RHITES) partners, identify, implement, and test a package of low cost, high impact, evidence-based CH interventions that can be applied at different levels of the health care system and contribute to a reduction in child mortality. Program Objectives: 1. Enhance national guidelines and frameworks to support implementation of the essential CH package. 2. Strengthen technical skills, competencies and practices of the RHITES partners and MCSP-supported demonstration districts to implement the essential CH package. 3. Strengthen district level management and planning practices to support the delivery of the essential CH package using adapted REC-QI approaches. 4. Conduct a costing analysis for delivery of the essential CH package. 5. Improve availability of strategic knowledge and tools to scale-up the essential CH package. MCSP Uganda CH PY4 Q2 Report 2 Acronym List CHAI Clinton Health Access Initiative CDSR Child Death Surveillance Response CH Child Health CHMIS Community Health Management Information Systems COP Chief of Party CSO Civil Society Organization CSS National Child and Newborn Survival Strategy DHIS2 District Health Information System 2 DHMT District Health Management Team DHO District Health Officer DHT District Health Team DL Distance Learning DPCC Diarrhoea, Pneumonia Coordination Committee DQS&I Data Quality Self-Assessment and Improvement DT dispersible tablets EC East Central Region EID Early Infant Diagnosis EOP End of Program EPI Expanded Programme on Immunization GFTAM Global Fund Project for TB, AIDS and Malaria HC Health Centre HF Health Facility HMIS Health Management Information System HW health worker iCCM Integrated Community Case Management IMNCI Integrated Management of Neonatal and Childhood Illness IP Implementing Partner JSI John Snow, Inc. KFCP Key Family Care Practices LC Local Council MCH Maternal and Child Health MCHIP Maternal and Child Health Integrated Program MCSP USAID’s Maternal and Child Survival Program MEL Monitoring, Evaluation, and Learning MNCH Maternal, Newborn and Child Health MoH Ministry of Health – Uganda NMS National Medical Stores OPD Outpatient Department ORS Oral Rehydration Salts ORT Oral Rehydration Therapy PEPFAR U.S Presidents Emergency Plan for AIDS Relief PHC Primary Health Care PY Program Year Q2 Quarter 2 QI Quality Improvement MCSP Uganda CH PY4 Q2 Report 3 QoC Quality of Care QRM quarterly review meetings REC-QI Reaching Every Child-Quality Improvement RHITES Regional Health Integration to Enhance Service RMNCH Reproductive, Maternal, Newborn, and Child Health RMNCAH Reproductive, Maternal, Newborn, Child and Adolescent Health SIC Short Interrupted Course SW South West Region TA technical assistance ToT Training of Trainers U5 Under Five (5) Years of Age UHSCP Uganda Health Supply Chain Program UNEPI Uganda National Expanded Programme on Immunization UNICEF United Nations Children’s Fund USAID United States Agency for International Development VHT Village Health Team WHO World Health Organization MCSP Uganda CH PY4 Q2 Report 4 I. Introduction The Maternal and Child Survival Program (MCSP) is a global U.S. Agency for International Development (USAID) cooperative agreement to introduce and support high-impact health interventions in 25 priority countries with the ultimate goal of preventing child and maternal deaths. MCSP is currently implementing two programs in Uganda: the Routine Immunization program (MCSP RI) which works with the Ministry of Health (MoH) and its Uganda National Expanded Programme on Immunization (UNEPI) to operationalize the Reaching Every Child/Community using Quality Improvement Approach (REC-QI) in eleven districts (2014- 2019); and the Child Health program (MCSP CH) which is an eighteen-month technical assistance (TA) program (i.e. May 2017-October 2018 for in-country implementation, and November- December 2018 for closeout) to provide tailored support in the area of Child Health (CH) to the USAID’s Regional Health Integration to Enhance Services (RHITES) projects in South West (SW) and East Central (EC) regions. USAID’s RHITES projects are working with the Government of Uganda to support implementation of the Uganda Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) Sharpened Plan, which includes a package of low cost, high impact, evidence-based RMNCAH interventions that can be applied at different levels of the health system to reduce mortality. The RHITES projects work directly with the districts they serve to assist with national scale up of the package. The expected result of MCSP’s tailored technical assistance for CH is implementation of a standardized CH package across the RHITES projects, that determines the costs involved and gathers learning on the feasibility of implementing the package in an integrated way in four demonstration districts (Luuka, Kaliro, Ntungamo and Sheema), to inform national level CH policy and program updates. This quarterly report summarizes the progress and achievements of MCSP CH for the period of January 1 to March 31, 2018, Quarter 2 (Q2) of PY4. II. Summary of PY4 Quarter 2 Achievements During this quarter, MCSP continued assistance to the RHITES implementing partners (IPs) in the EC and SW region to implement a package of essential CH interventions at all levels. Roll out of the Integrated Management of Neonatal and Childhood Illness (IMNCI) at health facility level was completed in all four demonstration districts of Kaliro, Luuka, Ntungamo, and Sheema. This rollout was conducted using two alternative IMNCI training models - Distance Learning (DL) and Short Interrupted Course (SIC) - as agreed with MOH, WHO, and other partners. MCSP is analysing these experiences to derive recommendations for how the two models can be used to support IMNCI capacity strengthening of frontline health workers (HWs) across the remaining RHITES districts and eventually nationwide. MCSP in collaboration with partners through the Diarrhoea, Pneumonia Coordination Committee (DPCC), developed recommendations to address prolonged stock outs of amoxicillin dispersible tablets (DT). In addition, MCSP supported the MoH CH Division to develop recommendations for the revision of CH indicators in the national Health Management Information System (HMIS). Recommendations to include the revised WHO IMNCI classification MCSP Uganda CH PY4 Q2 Report 5 for pneumonia, diarrhoea, malnutrition, and the sick young of infant; and an indicator to track stock outs of injectable antibiotics for management of severe disease were adopted during the first round of consultation. Indicators on appropriate treatment for pneumonia, diarrhoea and possible serious bacterial infection, remained pending requiring further discussion. District-wide roll out of the Village Health Team (VHT) package was achieved in RHITES EC demonstration districts (i.e. Kaliro and Luuka), while in the RHITES SW region it was partially completed to bring coverage to about 50% of sub-counties in both demonstration districts (i.e. Ntungamo and Sheema). Also in collaboration with partners, MCSP validated a manual for community-owned resource persons focused on Key Family Care Practices (KFCP) and used the draft manual to identify key messages for promotion of practices at the household level and integrated these messages into the VHT package being rolled out in the four demonstration districts. Finally, MCSP supported and demonstrated a district level quarterly review meeting (QRM) for RHITES EC in Luuka District. District specific drafts of the CH score card were piloted during the QRMs to support evidence-based planning at health facility level. III. Description of Activities by Objective Objective 1: Enhance national guidelines and frameworks to support implementation of the essential CH package MCSP participated in the multi-sectoral workshop for KFCP held in January 2018. The meeting organised by the MoH, in collaboration with UNICEF, aimed to review, validate, and endorse a community-owned resource manual on KFCP. The manual will act as a resource for training community-based workers on promoting the KFCP at the household level, and also for developing key health education and promotion messages targeting households. MCSP has used the draft manual to identify key health messages for inclusion in the VHT package being rolled out at the community level in the four demonstration districts. UNICEF will support the initial roll out of the manual in the Karamoja region and districts of Lira, Gulu, and Arua. MCSP has supported the RHITES IPs in EC and SW to build capacity of VHTs to roll out the KFCPs in the four demonstration districts. MCSP participated in the national iCCM technical working group meeting held in January 2018, targeting iCCM IPs. Two of the MCSP demonstration districts
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