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MCSP Madagascar Annual Report Y4 01 October 2017 – 30 September 2018

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MCSP Madagascar Annual Report Y4 01 October 2017 – 30 September 2018 MCSP Madagascar Annual Report Y4 01 October 2017 – 30 September 2018 Submitted: 19 November 2018 Submitted to: USAID Madagascar Submitted by: MCSP Madagascar Team Table of Contents Acronyms and Abbreviation ................................................................................................................................... ii Executive Summary .................................................................................................................................................... 5 Introduction ..................................................................................................................................................................... 9 Major Accomplishments ......................................................................................................................................... 10 Objective 1: Provide support and technical leadership in maternal and newborn health, immunization and family planning at the national level to the Ministry of Health. ................................................................ 10 Objective 2: Increase access to and improve quality of maternal, newborn and immunization health services in USG priority regions ............................................................................................................................. 15 Objective 3: Increase access to long-acting family planning methods in USG priority regions ................ 21 Objective 4: Improve prevention and treatment of MIP in the context of focused antenatal care and malaria case management of children and adults at primary care level ......................................................... 24 Objective 5: Strengthen the capacity of pre-service training institutions to educate midwives according to international Confederation of Midwives (ICM) standards and competencies....................................... 28 Addendum: Improve the capacity of providers to respond to the pneumonic plague outbreak ............ 30 Challenges and Opportunities .............................................................................................................................. 37 Success Story ................................................................................................................................................................ 38 Appendix 1: Data from Plague/IPC Trainings .............................................................................................. 40 Appendix 2: Performance Indicators ................................................................................................................ 42 MCSP Madagascar PY4 Annual Report (0ct-De2017) Page i of 50 Acronyms and Abbreviation ACT Artemisinin-based combination therapy ANC Antenatal care ANSFM Association Nationale des Sages-Femmes de Madagascar (National Association of Midwives of Madagascar) ASRH Adolescent sexual and reproductive health BCS+ Balanced Counseling Strategy Plus BDS Bureau de Santé de District (district health office) BEmONC Basic emergency obstetrical and newborn care BSR Bureau de Santé Regional (regional health office) CARMMA Campaign on Accelerated Reduction of Maternal Mortality in Africa CCI Comité de Coordination Inter-agences CG/QI Clinical Governance / Quality Improvement CHRD Centre Hôpital de Reference du District (District referral hospital) CHRR Centre Hospitalier Regional de Reference (Regional referral hospital) CHU Centre Hospitalier Universitaire (University hospital) cMYP comprehensive multi-year strategic plans CSB Centre de Santé de Base (Primary Health Centre) CSO Civil society organization CSU Couverture Santé Universelle DDDS Direction du Développement des districts sanitaire (Heath District Development Department) DEP Direction des Etudes et Planification DGEHU Direction générale des établissements hospitaliers Universitaires (Department of University Hospitals) DGS Direction Générale de Santé DHIS2 District Health Information Software 2 DHRD Direction des Hôpitaux de Reference des Districts DIFP Direction des instituts de formation des paramédicaux (department of pre-service institutions) DLP Direction de la Lutte contre le Paludisme (National Malaria Control Program) DPEV Direction de Programme Elargi de Vaccination (Expanded Program on Immunization department) DQS Data Quality Survey DRSP Direction Régionale de la Santé Publique (regional health office) DSFa Direction de la Santé Familiale (Family Health division) DSI Direction du Système d’Information (the MOH’s Information System Department) MCSP Madagascar PY4 Annual Report (0ct-De2017) Page ii of 50 EMAD Equipe management de district de la Santé (District Management team) EMAR Equipe Management Régional de la Santé (Regional Management Team) ENAP Every Newborn Action Plan EPI Expanded Program for Immunization FTP First-time parent FP Family planning GBV Gender-based violence HMIS Health management information system HP+ Health Policy Plus ICM International Confederation of Midwives IFIRP Institut public de Formation Interrégionale des Paramédicaux (public pre-service institution) IPC Infection prevention and control IPM Institut Pasteur de Madagascar IPTp Intermittent preventive treatment for pregnancy IPTp-SP Intermittent preventive treatment in pregnancy using sulfadoxine-pyrimethamine INSTAT Institut National de la Statistique IUD Intrauterine device LDHF Low-dose high-frequency MCSP Maternal and Child Survival Program MIP Malaria In Pregnancy MNH Maternal and Newborn Health MOH Ministry of Health ONM Ordre National des Médecins (National Council of Physicians) ONSFM Ordre National des Sages-Femmes de Madagascar (National Council of Midwives of Madagascar) OPV Oral polio vaccine PAQD Plan d’Amélioration de la Qualité des Données (data quality improvement plan) PE/E Pre-eclampsia/eclampsia PFI Planification Familiale Intégrée (integrated family planning training package) PPFP Postpartum family planning PPIUD Postpartum intrauterine device PPH Postpartum hemorrhage PSBI possible severe bacterial infection PSE Pre-service Education PSI Population Services International PSM Global Health Supply Chain Program – Procurement and Supply Management RBM Roll Back Malaria RDT Rapid diagnostic test MCSP Madagascar PY4 Annual Report (0ct-De2017) Page iii of 50 REC Reaching Every Child RI Routine immunization RMA Rapport mensuel d’activités (monthly activities report) RH Reproductive health RMNCH Reproductive, maternal, newborn and child health SDSP Service de District de Santé Publique (district public health department) SFP Service de la Formation du Personnel (vocational training department) SMQ Service de Management de la Qualité (quality management department) TOT Training-of-trainers UNFPA United Nations Population Fund UNICEF United Nations International Children's Fund USAID United States Agency for International Development USG United States Government WHO World Health Organization MCSP Madagascar PY4 Annual Report (0ct-De2017) Page iv of 50 Executive Summary The Maternal and Child Survival Program’s (MCSP) work plan in Madagascar for its fourth programmatic year (PY4) contains the following objectives: 1. Provide support and technical leadership in maternal and newborn health (MNH), immunization and family planning (FP) at the national level to the Ministry of Health (MOH) 2. Increase access to and improve quality of MNH and immunization services in USG priority regions 3. Increase access to long-lasting postpartum family planning (PPFP) methods in USG priority regions 4. Improve prevention and treatment of malaria in pregnancy (MIP) in the context of antenatal care (ANC) and improve malaria case management of children and adults at the primary care level 5. Strengthen the capacity of pre-service training institutions to educate midwives according to International Confederation of Midwives (ICM) standards and competencies • Addendum: Improve the capacity of providers to respond to the pneumonic plague outbreak Key achievements through PY4 are summarized below. Objective 1: Provide support and technical leadership in MNH, immunization and FP at the national level to the MOH • Provided technical support to MOH to monitor progress on the CARMMA Roadmap and ENAP milestones visa routine data collection at the central, regional and district levels, and via support of data use for decision-making. • MCSP supported the revision of the MNH and FP training curricula and job aids following the validation of the RH Norms and Protocols – which were then inserted in to the Planification Familiale Intégrée (PFI, the integrated family planning training package) – as well as the develop of the 2018-2020 ASRH National Strategic Plan Budgeted Operational Plan to ensure improved access of adolescents and youth to family planning services. • Supported the MOH and partners to develop and implement key national policies via participation in technical working groups (TWGs), including: the national Plan for Improved Essential Surgery Services; the Health Management Information System (HMIS) guidelines; and an action plan and budget for activities related to possible severe bacterial infection (PSBI). • Provided technical guidance to strengthen routine immunization and polio eradication via participation in the immunization data quality committee, and support for the development of the drafts of the 2018-2020 immunization cMYP and the 2018 DPEV workplan. • Supported the EPI to prepare the documentation required to obtain its Certification of Polio Eradication from the AFRO Regional Certification
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