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Lufwanyama Integrated Neonatal and Child Health Project in Zambia (LINCHPIN)

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Lufwanyama Integrated Neonatal and Child Health Project in Zambia (LINCHPIN) Lufwanyama Integrated Neonatal and Child Health Project in Zambia (LINCHPIN) Final Detailed Implementation Plan (Revised) Cooperative Agreement: GHS-A-00-09-00013-00 Project dates: 1 October 2009 – 30 September 2014 Category: Innovation Location: Lufwanyama District, Copperbelt Province, Zambia Submitted by: Save the Children Federation, Inc. 54 Wilton Road, Westport, CT 06880 Telephone: (203) 221-4000 - Fax: (203) 221-4056 Contact Persons: Eric Swedberg, Director, Child Health and Nutrition Carmen Weder, Associate Director, Department of Health and Nutrition Submitted to USAID/GH/HIDN/CSHGP 6 September 2010 Authored and edited by: Karen Z. Waltensperger, Africa Regional Health Advisor; David Marsh, Senior Child Survival Advisor; Carmen Weder, DHN Associate Director; Ngosa Sondashi, LINCHPIN Deputy Program Manager; Bias Sichamba, LINCHPIN M&E Officer; Petronella Mayeya, Zambia Deputy Country Director for Programs; Marc Nosbach, Zambia Country Director; Chilobe Kambikambi, LINCHPIN Program Manager; Sharon Lake-Post, Senior Specialist, Communications; Nicholas Guerina, Neonatologist and Training Consultant, Tufts University Medical School; Kojo Yeboah-Antwi, Center for Global Health and Development, Boston University This report is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Save the Children and do not necessarily reflect the views of USAID or the United States Government. Table of Contents Page Acronyms…………………………………………………………………………… 3 A. Technical Approach……………………………………………………………. 5 1. Brief project overview…………………………………………..….……….. 5 2. Results framework………………………………………………..………… 6 3. Key strategies and activities to achieve results………………………….….. 7 4. Plans for ongoing USAID Mission input throughout project implementation………………………………………………………..……. 14 5. Project work plan……………………………………………………………. 14 B. Innovation………………………………………………………………………. 14 1. Summary of challenges………………………………………………....…… 14 2. Description of innovation…………………………………………………… 14 3. Interest in the innovation……………………………………………….…… 15 4. Assessing the innovation……………………………………………………. 15 5. Additional innovations………………………………………………………. 15 C. Monitoring and Evaluation……………………………………………..………. 16 1. M&E systems….…………….……………………………………………….. 16 2. M&E Table……………….….………………………………………….…… 18 D. Revisions from the original application………………………………………… 18 E. Project Management…………………………………………………….………. 19 F. Training Plan…………………………………………………………..….…….. 20 G. Operations Research Concept Paper……………………………………….…… 20 H. Updated CSHGP Data Form ………………………………………………..….. 20 I. Child Health Technical Package and Delivery Strategy…………………….…... 20 Annexes 1. LINCHPIN Work Plan…………………………………………………….……. 21 2. Monitoring & Evaluation Table……………………….………………………... 23 3. Budget………………………………………………………………….……….. 27 4. Management/Human Resource Table……………………………….………….. 55 5. LINCHPIN Organigram…………………………………….…….……………. 58 6. Agreements……………………………………………………………………... 59 7. Job Descriptions of Key Personnel…………………………………………….. 88 8. Training Plan…………………………………………………………………… 94 9. Operations Research/Evaluative Plan……………………….………………….. 95 10. Baseline Household Survey Report……………………………………………. 110 11. Updated CSHGP Data Form…………………………………………………… 163 12. Child Health Technical Package and Delivery Strategy…........……………….. 168 CS-25 Zambia, Final Detailed Implementation Plan (Revised), September 2010 2 Save the Children Acronyms and Terms ACT Artemisinin Combination Therapy ANC Antenatal Care BCC Behavior Change Communication BU Boston University C-IMCI Community-based Integrated Management of Childhood Illnesses CAH Child and Adolescent Health CBD Community-based Medication Distributors CBV Community-based Volunteer CCM Community Case Management CHAZ Christian Health Association of Zambia CHW Community Health Worker CSHGP Child Survival and Health Grant Program (USAID) DHMT District Health Management Team DIP Detailed Implementation Plan DPT Diptheria-Petussis-Tetanus Immunization ENC Essential Newborn Care HCP Health Communication Partnership ICCM Integrated Community Case Management IPTp Intermittent Presumptive Treatment (of malaria) in Pregnancy ITN Insecticide Treated Nets JSI John Snow, Incorporated KPC Knowledge, Practices, and Coverage LBI Localized Bacterial Infection LINCHPIN Lufwanyama Integrated Newborn and Child Health Project in Zambia LiST Lives Saved Tool LUNESP Lufwanyama Neonatal Survival Project (of Boston University) M&E Monitoring and Evaluation MCHIP USAID’s Maternal and Child Integrated Health Project MOH Ministry of Health NHC Neighborhood Health Committee OR Operations Research ORS Oral Rehydration Solutions PMO Provincial Medical Office/Officer PMTCT Prevention of Mother-to-Child Transmission PNC Postnatal Care PSBI Possible Severe Bacterial Infection RDT Rapid Diagnostic Tests SC4CCM “Supply Chain for Community Case Management” project funded by The Bill & Melinda Gates Foundation award in four African countries. TBA Traditional Birth Attendants TDRC Tropical Disease Research Centre TT Tetanus Toxoid Immunization UNICEF United Nations Children’s Fund USAID United States Agency for International Development CS-25 Zambia, Final Detailed Implementation Plan (Revised), September 2010 3 Save the Children WHO World Health Organization ZIMMAPS Zambia Integrated Management of Malaria and Pneumonia Study CS-25 Zambia, Final Detailed Implementation Plan (Revised), September 2010 4 Save the Children A. Technical Approach A.1. Brief project overview THE CHALLENGE If Zambia were able to achieve 80 % coverage for a package that contained community case management of diarrhea, pneumonia, malaria, and serious neonatal illness and home-based resuscitation of 50 percent of newborns with birth asphyxia, an additional 12,000 lives of children under 5 could be saved each year, including 3,000 newborns. This package would reduce overall under-five mortality by over 25 percent in Zambia.1 Save the Children, in partnership with the Boston University (BU) Center for Global Health and Development, is supporting the District Health Management Team (DHMT) to implement a catalytic five-year Innovation Category project to decrease under-five mortality in Lufwanyama District (12˚46’S 27˚32”E) in Zambia’s Copperbelt Province. The Lufwanyama Integrated Newborn and Child Health Project in Zambia (LINCHPN) is introducing an integrated, community-based newborn care and community case management (CCM) package delivered through an enhanced district-wide community health program linked to health facilities and Neighborhood Health Committees (NHCs) and consistent with Ministry of Health (MOH) plans and policies. The interventions include maternal and newborn care (40 percent), pneumonia case management (20 percent), prevention and treatment of malaria (20 percent), and control of diarrheal disease (20 percent). LINCHPIN offers an opportunity to integrate, strengthen, and further evaluate two streams of recently concluded USAID-supported research in Zambia – LUNESP (Lufwanyama Neonatal Survival Project) for newborn care and ZIMMAPS (Zambia Integrated Management of Malaria and Pneumonia Study) for CCM – both carried out by BU. Beneficiary population Lufwanyama District has a current (2010) total population of 85,033 (official government projection extrapolated from 2000 census) with 15,136 (17.8 percent) children under five and 18,537 (21.8 percent) women of reproductive age. LINCHPIN is co-funded by the USAID Child Survival and Health Grant Program (CSHGP) in Washington, DC, (1 October 2009-30 September 2014) and ELMA Philanthropies, with additional match funding from Towers and Perrin. 1 This estimate was generated from the Spectrum Policy Modelling System version 3.2 using the Lives Saved Tool (LiST). LiST is based on the Lancet Child and Neonatal Survival Series modelling and uses the most recent mortality and cause of death data, with effect estimates from a menu of interventions based on anticipated change between current and target coverage. It was developed by the Futures Institute, prepared by USAID/Health Policy Initiative, and funded by the Bill & Melinda Gates Foundation. CS-25 Zambia, Final Detailed Implementation Plan (Revised), September 2010 5 Save the Children A.2. Results framework LINCHPIN’s goal is to decrease under-five mortality in Lufwanyama District by increasing the use of evidence-based, life-saving interventionsi,ii through delivery channels that are accessible, available, high quality, demanded, and supported by an enabling environment. Figure 1 LINCHPIN Results Framework Goal Decreased under-five mortality Strategic Increased use of key newborn and child health Objective services and practices Intermediate Increased access to Improved quality Increased demand for Enabled environment Results and availability of of services services and healthy services practices TBAs and CHWs Competency-based Health facility staff Enhanced Strategies providing antenatal, CHW and TBA training and NHCs promoting community capacity delivery, newborn, and Reliable supply of drugs key practices, danger Program learning post-natal care and and equipment sign recognition, and MOH policies and community case Systematic supervision appropriate care- strategies favoring management and Health facility staff seeking CCM in place at facilitated referral trained or retrained in Other locally national level all intervention packages appropriate behavior Lufwanyama Centre change channels NHCs supported
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