MaMoni Health Systems Strengthening Activity (USAID Cooperative Agreement AID-388-LA-13-00004) Quarterly Report April 1 – June 30, 2016 Razia Begum with her 12 day old daughter after being discharged from the newly installed Special Care Newborn Unit at Noakhali District Hospital (SCANU) with support from MaMoni HSS Project. 320 newborns were admitted to the SCANU Noakhali District Hospital since its introduction in March 2016 Submitted August 6, 2016 Cover Photo Story: Razia Begum with her 12 day old daughter after being discharged from the newly installed Special Care Newborn Unit at Noakhali District Hospital (SCANU) with support from MaMoni HSS Project. 320 newborns were admitted to the SCANU Noakhali District Hospital since its introduction in March 2016. MaMoni HSS has supported installation of five SCANUs in this quarter: Habiganj, Noakhali, Lakhsmipur, Pirozepur and Bhola districts. Photo Credit: Marufa Aziz Khan, Save the Children/MaMoni HSS Project This document is made possible by the generous support of the American people through the support of the Office of Population, Health, Nutrition and Education, United States Agency for International Development (USAID), Bangladesh (USAID/Bangladesh), under the terms of Associate Cooperative Agreement No. AID-388-LA-13-00004 through Maternal and Child Health Integrated Program (MCHIP). The contents of this document are the responsibility of the MCHIP Project and do not necessarily reflect the views of USAID or the United States government. Table of Contents MaMoni Health Systems Strengthening Activity ........................................................................................ 1 Table of Contents...................................................................................................................................... i Abbreviations ..................................................................................................................................ii Executive Summary ....................................................................................................................... 5 Introduction .......................................................................................................................................... 7 Program Results for the Quarter .................................................................................................. 7 IR 1. Improve Service Readiness through Critical Gap Management ................................. 7 IR 2: Strengthened Health Systems at District Level and Below ...................................... 19 2.9 Monitoring Quality of Care Indicators ........................................................................... 31 IR 3. Promote an Enabling Environment to Strengthen District Level Health Systems 32 IR 4. Identify and Reduce Barriers to Accessing Health Services ..................................... 35 Challenges, Solutions, and Action Taken ................................................................................... 35 Challenges .............................................................................................................................. 37 Opportunities .....................................................................Error! Bookmark not defined. Appendix 1: Scope and Geographical coverage of Mamoni HSS project .................................. 39 Appendix 2: Case Studies ............................................................................................................ 41 Appendix 3: Program Performance Indicators (October–December 2015) .............................. 43 Appendix 4: MNCH Essential Drugs Monitoring Report .......................................................... 43 Appendix 5: Documentation and Dissemination of MaMoni Program Learning .................... 59 Appendix 6: Environmental Compliance Report ................... Error! Bookmark not defined. Appendix 7: Links to Media Stories Published .......................................................................... 60 Appendix 8: Update on USAID Abortion and FP Requirement 2016 Training ...................... 61 Appendix 9: Status of Health Facility Renovations ................................................................... 64 MaMoni Health Systems Strengthening Activity: FY’16 Q3 Quarterly Report i ABBREVIATIONS AHI Assistant Health Inspector AMTSL Active management of third stage of labor BCC Behavior Change Communication BEmONC Basic emergency obstetric and newborn care BNF Bangladesh Neonatology Forum BSMMU Bangabandhu Sheikh Mujib Medical University CAG Community Action Group CB Community-based CEmONC Comprehensive emergency obstetric and newborn care CHW Community Health Worker CHX Chlorhexidine CIPRB Center for Injury Prevention and Research, Bangladesh CMAM Community-based management of acute malnutrition cMPM Community microplanning meeting CNCP Comprehensive newborn care package CSBA Community Skilled Birth Attendants CV Community Volunteer CVRS Civil registration and vital statistical system CYP Couple years of protection DDFP Deputy Director Family Planning DGFP Directorate General Family Planning DGHS Directorate General Health Services DRS District Reserve Store EPCMD Ending Preventable Child and Maternal Deaths FPI Family Planning Inspector FWA Family Welfare Assistant FWV Female Welfare Visitor GOB Government of Bangladesh HA Health Assistant HBB Helping Babies Breathe HPNSDP Health, Population, and Nutrition Sector Development Program HS Health systems HSS Health systems strengthening IFA Iron plus Folic Acid ii MaMoni Health Systems Strengthening Activity: FY’16 Q3 Quarterly Report IMCI Integrated Management of Childhood Illness IPHN Institute of public health nutrition IR Intermediate result JSV Joint supervisory visit LAPM Long-acting and permanent method LMIS Logistics management information system MAMA Mobile Alliance for Maternal Action mCPR Modern contraceptive prevalence rate MCWC Maternal and Child Welfare Center MNCH/FP/N Maternal, newborn and child health, family planning, and nutrition MNH Maternal and newborn health MOH&FW Ministry of Health and Family Welfare MOLGRD&C Ministry of Local Government Rural Development & Cooperatives MOU Memorandum of understanding MPDR Maternal and perinatal death review NIPORT National Institute of Population Research and Training NNS National nutrition services OGSB Obstetrics and Gynecology Society of Bangladesh PPIUCD Postpartum intra-uterine contraceptive device QA Quality assurance QI Quality improvement QPRM Quarterly performance review meeting RHIS Routine health information system RRQIT Regional roaming quality improvement team SACMO Sub-assistant Community Medical Officer SAM Severe Acute Malnutrition SBA Skilled Birth Attendant SBM-R Standards-Based Management and Recognition SC Save the Children SCANU Special care newborn unit SDP Service delivery point SIAPS Systems for improved access to pharmaceuticals and services SSN Senior Staff Nurse STG Strategic thematic group TBA Traditional Birth Attendant MaMoni Health Systems Strengthening Activity: FY’16 Q3 Quarterly Report iii TOT Training of trainers UEHFPSC Union Education Health and Family Planning Standing Committee UFPO Upazila Family Planning Officer UHC Upazila health complex UH&FPO Upazila Health and Family Planning Officer UH&FWC Union Health and Family Welfare Centers UP Union parishad USAID United States Agency for International Development USC Union sub-centers iv MaMoni Health Systems Strengthening Activity: FY’16 Q3 Quarterly Report EXECUTIVE SUMMARY Key Accomplishments of the MaMoni Health Systems Strengthening Project (MaMoni HSS) In the third quarter of Year Three, the key accomplishments of the project include the following: • In collaboration with the Directorate General of Family Planning, MaMoni HSS has completed an assessment of all 4,461 union level health facilities to determine their readiness to provide normal delivery care and essential newborn care services. A comprehensive database of these facilities has been prepared, which will be used for advocating for investments from MOHFW and development partners to strengthen these facilities. MaMoni HSS has also completed seven divisional level dissemination and advocacy events to prioritize this initiative as part of the new Health Nutrition and Population (HNP) sector program. • MaMoni HSS has completed the initial roll out of 7.1% chlorhexidine application for newborn umbilical cord care through public sector health facilities in all 64 districts of the country. MOHFW is supporting the roll out by procuring and distribution of the product, whereas the project has supported the training of all public sector health workers, supervisors and managers at all levels. The project has also supported integration of CHX into the routine monitoring systems of MOHFW. As part of the national scale up, MaMoni HSS has also mobilized the support of private sector providers, NGOs, and other development partners to promote the use of CHX as part of essential newborn care for babies in the country. • MaMoni HSS has signed three important letters of collaboration (LOC) with different units of MOHFW at the national level. The first LOC aims to support the Planning Wing of MOHFW to coordinate the development of the fourth HNP sector program; the second LOC supports the Health Economics Unit (HEU) to strengthen the role and capacity of the Quality Improvement Secretariat (QIS) to nationally roll out the National Quality Improvement Strategic Plan; and the third supports the