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Guinea Guinea Ebola Response and Recovery: Restoration and Improvement of Reproductive, Maternal, Newborn and Child Health Services (RHS) End of Project Report July 2015 - December 2016 Submitted to: United States Agency for International Development under Cooperative Agreement #AID-OAA-A-14-00028 Submitted by: Jhpiego Corporation The Maternal and Child Survival Program (MCSP) is a global United States Agency for International Development (USAID) Cooperative Agreement to introduce and support high-impact health interventions with a focus on 24 high-priority countries with the ultimate goal of ending preventable child and maternal deaths within a generation. The Program is focused on ensuring that all women, newborns and children most in need have equitable access to quality health care services to save lives. MCSP supports programming in maternal, newborn and child health, immunization, family planning and reproductive health, nutrition, health systems strengthening, water/sanitation/hygiene, malaria, prevention of mother-to-child transmission of HIV, and pediatric HIV care and treatment. Visit www.mcsprogram.org to learn more. This report is made possible by the generous support of the American people through USAID under the terms of the Cooperative Agreement AID-OAA-A-14-00028. The contents are the responsibility of MCSP and do not necessarily reflect the views of USAID or the United States Government. 2 Contents Acronyms and Abbreviations .......................................................................................................................................... 4 Acknowledgments ............................................................................................................................................................. 5 Executive Summary ........................................................................................................................................................... 6 Introduction ...................................................................................................................................................................... 10 Major Accomplishments ................................................................................................................................................. 13 A- Rapid situation analysis of focus facilities ..................................................................................................... 13 B- Facility focused interventions .......................................................................................................................... 14 Select service delivery data for project facilities ................................................................................................. 28 C- Community-focused interventions ............................................................................................................ 32 Challenges and Opportunities .................................................................................................................................. 35 Lessons Learned and Recommendations .............................................................................................................. 36 Annexes ............................................................................................................................................................................. 37 Annex 1: Number and type of facility by region/prefecture in the RHS intervention zone, and previous interventions ................................................................................................................................................................ 37 Annex 2: MCSP RHS Monitoring Indicators Table ............................................................................................. 38 Annex 3: Details for Indicator C1, Healthcare Cadre, Gender and Training Topic ................................... 51 Annex 4: Terms of reference of IPC focal points and coaches ....................................................................... 52 3 Acronyms and Abbreviations AI Apprentissage Individualisé (Individualized Learning) ASC/ CHW Agents de Santé Communautaire/ Community Health Worker CMC Communal Medical Center CNLEB National Ebola Response Coordinating Committee COASH Community Health Committee DPS Direction Préfectorale de la Santé (Prefecural Health Directorate) DRS Direction Régionale de la Santé (Regional Health Direcotrate) EmONC Emergency Obstetric and Newborn Care EVD Ebola Virus Disease FANC Focused antenatal care FP Family Planning HSC Health and Safety Committee (hospital level) HMIS Health Management Information Systems IEC Information, Education, Communication IPC Infection Prevention and Control IMCI Integrated Management of Childhood Illness LDHF Low-dose, high frequency (training methodology) MCHIP Maternal and Child Health Integrated Program MCSP Maternal and Child Survival Program MCSP RHS MCSP Restoration of Health Services Project MNH Maternal and Newborn Health MoH Ministry of Health NGO Nongovernmental Organization OFDA Office of Foreign Disaster Assistance (US Government) ORT Oral Rehydration Therapy PAC Post-abortion Care PMTCT Prevention of maternal to child transmission of HIV PNC Postnatal care PPFP Postpartum Family Planning PPH Postpartum Hemorrhage PPIUD Postpartum Intrauterine Device RMNCH Reproductive, Maternal, Newborn and Child Health RH/FP Reproductive Health/Family Planning SBCC Social and Behavior Change Communication SBM-R Standards-based Management and Recognition UNMEER United Nations Mission for Ebola Emergency Response WHO World Health Organization 4 Acknowledgments Key Partners • Maternal and Child Survival Program (MCSP) partner, Jhpiego, thank our collaborators and partners. • Ministry of Public Health and specifically, the Secretary General, the Coordination Nationale de Lutte contre la Maladie à virus Ebola, the National Directorate of Family Health and Nutrition, the National Directorate of Prevention and Community Health, the National Malaria Control Program, and the National Program on Integrated Management of Childhood Illness • Regional health offices of Conakry, Kankan, Kindia, Faranah, and N’zérékoré, and the prefectural and communal health offices in these regions • Health care workers in MCSP-supported facilities and community health workers engaged in bringing health information and services to their communities • World Health Organization, United Nations Fund for Population Activities, and UNICEF • Implementing partners of United States Agency for International Development, Office of U.S. Foreign Disaster Assistance, and the Centers for Disease Control and Prevention • Médecins Sans Frontières—Belgium, Action Contre la Faim, Alliance for International Medical Action, Women and Health Alliance International, and other nongovernmental organizations (NGOs) engaged in the Ebola response and in particular, infection prevention and control The MCSP Team • In-country technical team: Professor Yolande Hyjazi, Dr. Mamadou Malal Diallo, Dr. Gassim Cissé, Dr. Bokar Dem, Dr. Havanatou Camara, Dr. Suzanne Austin, Bamba Mamady Camara, Jacqueline Aribot, Dr. Abdoulaye Diallo, Dr. Ibrahim Pita Bah, and Bakary Berete • Finance, administration, and operations team: Antoine Lamah, Ténin Sougoulé, Thierno Saidou Diallo, El Hadj Mamadou Saliou Bah, and Abbas Kourouma • Headquarters’ technical support team: Dr. Tsigue Pleah, Professor Blami Dao, Dr. Ruparelia Chandrakant, Dr. Willy Shasha • Headquarters’ program support team: Rachel Waxman, Laura Skolnik, Karine Nankam, Caroline Tran, Joan Peto, and Linda Benamor (for translation support) 5 Executive Summary The Maternal and Child Survival Program is a global U.S. Agency for International Development (USAID) cooperative agreement to introduce and support high-impact health interventions in 24 priority countries with the ultimate goal of ending preventable child and maternal deaths (EPCMD) within a generation. The Maternal and Child Survival Program engages governments, policymakers, private sector leaders, health care providers, civil society, faith-based organizations and communities in adopting and accelerating proven approaches to address the major causes of maternal, newborn and child mortality such as postpartum hemorrhage, birth asphyxia and diarrhea, respectively, and improve the quality of health services from household to hospital. In order the contribute to the response to the Ebola Viral Disease (EVD) epidemic in Guinea and the severe effects on health services, including increased risks for healthcare providers, MCSP was requested to develop and implement several projects to reinforce Infection Prevention and Control in healthcare facilities and to assist the MOH to restore confidence in and use of health services. This report presents the Restoration of Health Services (RHS) project, which operated from July 2015 to December 2016 and was designed to address the second order impacts of the EVD epidemic in Guinea (Pillar 2), specifically the restoration of critical non-Ebola health services. The project was funded with resources from the Ebola Response and Preparedness Fund, and the support of the Global Health Ebola Team (GHET). Interventions were concentrated on geographic areas most impacted by the EVD epidemic. These impacts include high numbers of EVD cases and deaths, loss of healthcare workers to EVD, transfers and mobilization for the EVD response; and dramatic reductions in health service utilization for routine prevention and
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