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Empowerment Builds Capacity for Stronger, Healthier Communities

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Empowerment Builds Capacity for Stronger, Healthier Communities EMPOWERMENT BUILDS CAPACITY FOR STRONGER, HEALTHIER COMMUNITIES FINAL REPORT OF THE INTEGRATED HEALTH PROJECT PLUS IN THE DEMOCRATIC REPUBLIC OF CONGO 2015–2018 Integrated Health Project Plus in the Democratic Republic of Congo Published: July 31, 2018 Project Name: Integrated Health Project Plus in the Democratic Republic of Congo Cooperative Agreement Number: AID-OAA-A-1100024 Subagreement Number: OAA-A-11-00024-01-MSH For more information: MSH Communications, 200 Rivers Edge Drive Medford, MA 02155 www.msh.org • [email protected] This product describes the work of the Integrated Health Project Plus, which was made possible by the generous support of the United States Agency for International Development (USAID), the United States President’s Malaria Initiative (PMI), and the United States President’s Emergency Program for AIDS Relief under Subagreement Number OAA-A-11-00024-01-MSH under USAID Cooperative Agreement Number AID-OAA-A-11-00024. The contents are the responsibility of the Democratic Republic of Congo Integrated Health Project Plus and do not necessarily reflect the views of USAID or the United States Government. Cover Photo: Champion Community meeting. Photo by Lynn Lawry, OSC Report Design: Erin Dowling Design EMPOWERMENT BUILDS CAPACITY FOR STRONGER, HEALTHIER COMMUNITIES FINAL REPORT OF THE INTEGRATED HEALTH PROJECT PLUS IN THE DEMOCRATIC REPUBLIC OF CONGO 2015–2018 Integrated Health Project Plus in the Democratic Republic of Congo CONTENTS EXECUTIVE SUMMARY ............................................................ 1 Country context ............................................................ 1 Project performance ......................................................... 2 Key achievements ........................................................... 4 PROJECT BACKGROUND ......................................................... 7 INTERMEDIATE RESULT 1. Access to and availability of minimum package of activities (MPA) and complementary package of activities (CPA) services and products increased .............. 10 1.1 Facility-based health care services and products in target health zones increased. 12 Utilization of health care services ............................................. 12 Availability of health services ................................................ 13 Number of health centers implementing minimum package of activities ............... 15 Availability of medicines, commodities, and equipment ............................. 15 1.2 Community-based health care services and products in target health zones increased .... 23 Integrated management of newborn and childhood illness .......................... 23 i-CCM sites ............................................................... 24 Evidence-based WASH activities ............................................... 27 1.3 Provincial management more effectively engaged with health zones and facilities to improve service delivery ........................................... 32 Leadership Development Program ............................................. 32 INTERMEDIATE RESULT 2. Quality of key family health care services increased .............. 36 2.1 Clinical and managerial capacity of health care providers increased ................... 38 Maternal, neonatal, and child health ............................................ 38 Expanded Program on Immunization ........................................... 45 Family planning. 49 Nutrition ................................................................. 52 Malaria . 59 HIV ...................................................................... 63 Tuberculosis .............................................................. 72 Sexual and gender-based violence .............................................. 81 Fistula .................................................................... 84 2.2 Minimum quality standards for health facilities and services developed and adopted ...... 87 Results-based financing ...................................................... 87 2.3 Primary health care referral system for prevention, care, and treatment improved ....... 91 INTERMEDIATE RESULT 3. Knowledge, attitudes, and practices to support health-seeking behaviors increased. 92 3.1 Health sector community outreach linkages ..................................... 94 Community mobilization campaigns ........................................... 94 3.2 Health advocacy/Community mobilization organizations ............................ 97 Champion Communities ..................................................... 97 3.3 Social and behavior change campaigns ......................................... 100 Deborah Ndema’s baby was born not breathing. IHPplus had provided training in Helping Babies Breathe techniques at Bagira Hospital. Midwives used these techniques to revive Deborah’s baby. Photo by Rebecca Weaver. v INTERMEDIATE RESULT 4. Health sector leadership and governance improved ............. 104 4.1 Health sector policy alignment ............................................... 106 4.2 Evidence-based strategic planning and decision-making ............................ 106 Improved data for decision making ............................................ 106 4.3 Community involvement in health policy and service delivery ...................... 111 PROJECT MANAGEMENT ....................................................... 112 Project implementation ....................................................... 114 Success stories .............................................................. 115 Cost share . 115 Environmental Mitigation and Monitoring Plan ...................................... 115 Lessons learned ............................................................. 116 Conclusion ................................................................. 119 Appendices are supplied as a separate document. Figures Fig 1. Project performance summary ...........................................................3 Fig 2. Map of IHPplus activity areas ............................................................6 Fig 3. Curative services utilization by coordination office ..........................................12 Fig 4. Number of GRHs implementing CPA by coordination office ..................................13 Fig 5. Number of health centers implementing MPA by coordination office ...........................14 Fig 6. Number of health zones with an AOP ....................................................14 Fig 7. Stock-outs by essential medicine and project year ...........................................19 Fig 8. Number of cases of childhood pneumonia treated with antibiotics (percentage at i-CCM sites) ......25 Fig 9. Number of cases of childhood diarrhea treated (percentage at i-CCM sites) .....................26 Fig 10. Number of cases of children under five years with malaria treated (percentage at i-CCM sites) .....26 Fig 11. WASH indicator results ..............................................................30 Fig 12. Proportion of senior LDP teams that achieved at least 80% of their desired performance ..........32 Fig 13. Number and percentage of pregnant women attending ANC1 ................................38 Fig 14. Number and percentage of pregnant women attending ANC4 ................................40 Fig 15. Number and percentage of deliveries with an SBA in USG-supported facilities ...................41 Fig 16. Number of women giving birth who received a uterotonic ...................................42 Fig 17. Number and percentage of newborns receiving essential neonatal care .........................42 Fig 18. Number of newborns receiving antibiotic treatment for infection .............................44 Fig 19. Number of newborns with asphyxia resuscitated in USG-supported programs ...................44 Fig 20. Couple years protection (CYP) .......................................................50 Fig 21. Number of FP counseling visits during IHPplus ............................................52 Fig 22. Pregnant women who received iron folate tablets to prevent anemia ..........................55 Fig 23. Number of mothers with children two years or less who received counseling on nutrition. 56 Fig 24. Number of expectant mothers who received at least two doses of SP during ANC. ...............61 Fig 25. Percentage of PEPFAR-supported sites achieving 90% ARV or ART coverage for HIV-positive pregnant women ..........................................................65 Fig 26. Number of pregnant women with known HIV status .......................................65 Fig 27. Number of HIV-positive pregnant women who received ARVs to reduce risk of MTCT ............65 Fig 28. Number of individuals who received HTC and received test results ...........................65 Fig 29. Percentage of people testing positive for HIV who knew their HIV status, before and after RBF .....68 vi DRC-IHPplus FINAL REPORT JUNE 1, 2015 – JUNE 30, 2018 Fig 30. Number of PLHIV receiving a viral load test, before and after RBF .............................68 Fig 31. Number of PLHIV receiving a viral load test who received their test results .....................69 Fig 32. Quality of health services in health centers implementing the HIV-focused RBF program ...........71 Fig 33. Quality of health services in hospitals implementing the HIV-focused RBF program) ..............71 Fig 34. Percentage of registered TB cases supported by community health agents ......................74 Fig 35. Percentage of registered TB cases among children aged 0–14 years ............................74
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