Community Capacity for Health Program – Mahefa Miaraka FY2017 Quarter 2 Report i USAID COMMUNITY CAPACITY FOR HEALTH PROGRAM - Mahefa Miaraka Cooperative Agreement No. AID-687-A-16-00001 FY2017 Quarter 3 Progress Report April 1 to June 30, 2017 Re-Submission In Response to USAID Comments: September 6, 2017 USAID Community Capacity for Health Program – Mahefa Miaraka FY2017 Quarter 3 Report USAID COMMUNITY CAPACITY FOR HEALTH PROGRAM - Mahefa Miaraka FY2017 Quarter 3 Progress Report April 1 to June 30, 2017 Re-Submission In Response to USAID Comments: September 6, 2017 Cooperative Agreement No. AID-687-A-16-00001 Submitted to: Dr. Jocelyne ANDRIAMIADANA, AOR USAID/Madagascar in Antananarivo, Madagascar Prepared by: JSI Research & Training Institute, Inc. USAID Community Capacity for Health Program – Mahefa Miaraka JSI Research & Training Institute, Inc. Résidence Lavalley Près Lot IIK 50H Mahatony Alarobia, Antananarivo (101) Tel: 20.22.425.78/ 79 Cover photo: Market day in Andranotojy Fokontany, Morondava District, Menabe Region. Mothers and their children wait for an outreach activity to be conducted by the head of the basic health center. Photo: Chuanpit Chua-oon, JSI Research & Training Institute, Inc. DISCLAIMER: This document is made possible by the support of the American people through the United States Agency for International Development (USAID). The contents of this document are the responsibility of JSI Research & Training Institute, Inc. (JSI) and do not necessarily reflect the views of USAID or the United States Government. Page ii USAID Community Capacity for Health Program – Mahefa Miaraka FY2017 Quarter 3 Report Table of Contents Executive Summary of Achievements in Q3 FY2017 ................................................................ 1 Introduction ................................................................................................................................... 3 Sub IA 1.1 Increasing Skills and Competencies of CHV ........................................................................... 4 Sub IA 2.1. Community-Level Health Promotion and Sensitization to Increase Healthy Behavior and Uptake of Health Services and Products ................................................................................................................... 17 Sub IA 2.2 SBCC Capacity of Community Stakeholders ....................................................................... 19 Sub IA 2.3 Innovations to Promote Adolescent and Youth Health..................................................................... 21 Intervention Area 3: Health Service Planning, Management, and Governance ................... 22 Sub IA 3.0 Reinforcement of GOM Capacity............................................................................................................ 22 Sub IA 3.1. Introduction and Promotion of CSB Improvement ........................................................................... 23 Sub IA 3.2. Pharmaceutical and Commodity Forecasting....................................................................................... 23 Sub IA 3.3. Health Data Quality, Management, and Use ........................................................ 24 Sub IA 3.4. Referral System Strengthening between CHVs and CSBs ................................................................ 24 Sub IA 4.1 Program Monitoring, Evaluation, and Performance System .............................................................. 24 Sub IA 4.2 Learning Management ................................................................................................................................. 25 Sub IA 4.3 Cross-Cutting Issues ................................................................................................................................... 26 Challenges and Proposed Solutions for Q3 FY2017 ................................................................ 27 Administrative and Financial Management .............................................................................. 27 Sub IA 0. 1 Operation (Administration, Finance, and Partnership) ..................................................................... 27 Sub IA 0. 2 Administration ............................................................................................................................................ 27 Sub IA 0.3 Financial Management ................................................................................................................................. 28 Annexes Annex 1. Activity Table Q3, FY2017 Annex 2. Project Performance Review, PPR (Q3, FY2017) Annex 3. Environment Monitoring and Mitigation Report, EMMR (Q3, FY2017) Annex 4. List of Communes in Mahefa Miaraka Program in Q3, FY2017 Annex 5. Participation in the Central-Level Working Groups and Meetings Annex 6. Success Stories Annex 7. International Trips at the End of Q3 FY2017 Page iii USAID Community Capacity for Health Program – Mahefa Miaraka FY2017 Quarter 3 Report List of Tables TABLE 1 – PNSC COORDINATION STRUCTURES CREATED IN THE PROGRAM REGION Q3 FY2017 ............................. 4 TABLE 2 – CHV MALARIA SERVICES BY REGIONS IN Q3 FY2017 ................................................................................ 8 TABLE 3 - REFERRAL CASES FROM CHVS TO CSBS, HOSPITALS, OR MOBILE CLINICS IN Q3, FY2017 ........................... 8 TABLE 4 – SAYANA PRESS USE BY REGIONS IN Q3, FY2017 ........................................................................................ 9 TABLE 5 – CHV REPORTED STOCK-OUT OF HEALTH TRACER PRODUCTS IN Q3, FY2017 ........................................ 13 TABLE 6 – NUMBER OF TIMES PEOPLE REACHED BY KEY HEALTH MESSAGES IN Q3, FY2017 ...................................... 20 TABLE 7 - MAHEFA MIARAKA’S CUMULATIVE EXPENSES AS OF JUNE 30, 2017 ............................................................ 29 List of Figures FIGURE 1- MAHEFA MIARAKA’S REGIONS AND DISTRICTS ........................................................................................... 3 FIGURE 2- CHV TRAINING AS OF JUNE 30, 2017 ........................................................................................................ 5 FIGURE 3- RESULTS FOR CU5 WITH MUAC MEASUREMENT IN Q3, FY2017 (N=74,332) ............................................ 7 FIGURE 4- CASES OF CU5 TREATED FOR C-IMCI BY CHVS IN Q3 FY2017 ................................................................. 7 FIGURE 5- REGULAR FAMILY PLANNING USERS IN THE PROGRAM, BY AGE GROUP, Q3 FY2017 ................................... 9 FIGURE 6- NEW FAMILY PLANNING USERS IN THE PROGRAM, BY AGE GROUP, Q3 FY2017 ....................................... 10 FIGURE 7- COUPLE YEARS OF PROTECTION BY FAMILY PLANNING METHODS, Q3 FY2017 ........................................ 10 FIGURE 8- STOCK-OUT OF CHILD HEALTH TRACER PRODUCTS AT CHVS IN Q2 AND Q3 FY2017 ........................... 12 FIGURE 9- STOCK-OUT OF FAMILY PLANNING HEALTH TRACER PRODUCTS AT CHVS IN Q2 AND Q3 FY2017 ......... 12 FIGURE 10- MALARIA EVOLUTION IN THE PROGRAM REGIONS REPORTED BY CHVS IN Q3 FY2017 .......................... 15 FIGURE 11- SBCC COVERAGE THROUGH MULTIPLE COMMUNICATION CHANNELS IN Q3 FY2017 ........................... 19 FIGURE 12- SANITATION AND HYGIENE AT CHVS’ HEALTH HUT AS OF JUNE 30, 2017 ............................................. 20 FIGURE 13- HIGH-VISIBILITY EVENTS IN Q3 FY2017 ................................................................................................. 21 Page iv USAID Community Capacity for Health Program – Mahefa Miaraka FY2017 Quarter 3 Report Acronyms and Abbreviations ACT Artemisinin-based combination therapy ANC Antenatal care CHV Community health volunteer CHX Chlorhexidine c-IMCI Community-based integrated management of childhood illnesses CoSan Comité de Santé CSB Centre de Santé de Base (basic health center) CU5 Children under 5 DLP National Malaria Control Program DPLMT Directorate of Pharmacies, Laboratories and Traditional Medicine DPS Direction de la Promotion de la Santé (Division of Health Promotion) DSFa Direction de la Santé Familiale (Division of Family Health) EFP Essential family practice EMAR Equipe de Management Régionale (Regional Health Management Team) EMAD Equipe de Management de District (District Health Management Team) EMMR Environmental Mitigation & Monitoring Report FKT fokantany (village or collection of hamlets, lowest administrative level) FP Family planning FY Fiscal Year GBV Gender-based violence GOM Government of Madagascar HIV Human immunodeficiency virus HMIS Health management information system IA Intervention area IFA Iron folic acid IR Intermediate result IPTp-SP Intermittent preventive treatment during pregnancy with sulfadoxine-pyrimethamine JSI JSI Research & Training Institute, Inc. LLITN Long-lasting insecticide-treated bed net MAHEFA Malagasy Heniky ny Fahasalamana (Community-Based Integrated Health Program) MOH Ministry of Health MOU Memorandum of Understanding MUAC Mid-upper arm circumference NGO Nongovernmental organization PNSC Politique Nationale de Santé Communautaire (National Policy for Community Health) PSI/ISM Population Services International /Integrated Social Marketing Project PSM Procurement and Supply Management RLG Radio listening group RDT Rapid diagnostic test SBCC Social behavior change communication SDSP Service de District de la Santé Publique (District Health Office) USAID United States Agency for International Development VAT Value Added Tax WASH Water, sanitation, and hygiene Page v USAID Community Capacity for Health Program