MaMoni Health Systems Strengthening Activity Quarterly Report January 1 – March 31, 2015 Submitted May 15, 2015 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, Bangladesh (USAID/Bangladesh) under the terms of Associate Cooperative Agreement No. AID-388-LA-13-00004 through MCHIP, managed by Jhpiego Corporation. The contents of this document are the responsibility of Jhpiego Corporation and do not necessarily reflect the views of USAID or the United States Government. Cover Photo Credit: Using a computer tablet, MaMoni HSS data collectors enter population information into a national registry system in Madhabpur Upazila, where the Routine Health Information System (RHIS) project is being piloted. Directorate General Health Services and Directorate General Family Planning service providers will use this electronic information to track clients and ensure services to the families. Photo Credit: Shimantik/Save the Children. MaMoni HSS – Year Two Second Quarterly Report April 2015 2 TABLE OF CONTENTS 1. Introduction ...................................................................................................................................7 2. Program Objectives and Key Activities ............................................................................................8 3. Results for Year 1 ......................................................................................................................... 11 3.1 Summary of Major Accomplishments ................................................................................ 12 3.2 Narrative Report of Major Accomplishments ..................................................................... 12 3.2.1 Improve service readiness through critical gap management .................................... 12 3.2.2 Strengthen health systems at district level and below ............................................... 12 3.2.3 Promote an enabling environment to strengthen district-level health systems ........ 123 3.2.4 Identify and reduce barriers to accessing health services ........................................ 124 3.2.5 Challenges, Solutions and Action Taken .................................................................. 125 4. The Way Forward ......................................................................................................................... 26 5. Appendix .....................................................................................................................................26 Annex 1. Photos from key events .............................................................................................. 27 Annex 2: Performance Indicators (October 2014-March 2015) ................................................... 28 Annex 3: Success Stories ........................................................................................................... 36 Annex 4: Key Achievements of Aponjon/MAMA initiative ......................................................... 38 Annex 5: Media Stories Published this Quarter .......................................................................... 43 Annex 6: Quality Assurance Initiatives ...................................................................................... 44 Annex 7: MaMoni HSS Project Training Activities, January 1 – March 31, 2015 ........................... 46 Annex 8: National Newborn Scale-Up Initiatives ........................................................................ 51 Annex 9: Environmental Monitoring and Mitigation Plan........................................................... 55 Annex 10: Summary of BCC materials produced during the quarter ........................................... 57 MaMoni HSS – Year Two Second Quarterly Report April 2015 3 Acronyms and Abbreviations AO Agreement Officer AMTSL Active Management of Third Stage Labor BCC Behavior Change Communication BEmONC Basic Emergency Obstetric and Newborn Care BNF Bangladesh Neonatology Forum BPS Bangladesh Perinatal Society BSMMU Bangabandhu Sheikh Mujib Medical University CAG Community Action Group CEmONC Comprehensive Emergency Obstetric and Newborn Care CHX Chlorhexidine CIPRB Center for Injury Prevention and Research, Bangladesh cMPM Community Microplanning Meeting CNCP Comprehensive Newborn Care Package CS Civil Surgeon 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 ECEB Essential Care for Every Baby EM Environmental Manual FAOPS Federation of Asia and Oceania Perinatal Societies FWA Family Welfare Assistant FWV Female Welfare Visitor GOB Government of Bangladesh HA Health Assistant HBB Helping Babies Breathe HMIS Health Management Information System HPNSDP Health, Population and Nutrition Sector Development Program HRCI Health Research Challenge for Impact HSS Health System Strengthening icddr,b International Centre for Diarrhoeal Disease Research, Bangladesh IMNCS Improving Maternal, Neonatal, and Child Survival IR Intermediate Result J&J Johnson and Johnson JHU/IIP Johns Hopkins University, Institute for International Programs JSI John Snow, Inc. MaMoni HSS – Year Two Second Quarterly Report April 2015 4 JSV Joint Supervisory Visit LAPM Long Acting and Permanent Method LMIS Logistics Management Information System MCHIP Maternal and Child Health Integrated Program MCRAH Maternal, Child, Reproductive and Adolescent Health MEO Mission Environmental Officer MNCAH Maternal, Newborn, Child and Adolescent Health 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 OGSB Obstetrics and Gynecology Society of Bangladesh OP Operational Plan OR Operations Research PFM Physical Facilities Management PNGO Partner nongovernmental organization PPH Postpartum Hemorrhage PPIUCD Postpartum Intra-uterine Contraceptive Device QA Quality Assurance QI Quality Improvement QPRM Quarterly Performance Review Meeting RCHCIB Revitalizing Community Health Care in Bangladesh RHIS Routine Health Information System RRQAT Regional Roaming Quality Assurance Team SACMO Sub-Assistant Community Medical Officer 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 SMC Social Marketing Company SOP Standard Operating Procedure SSN Senior Staff Nurse TBA Traditional Birth Assistant TIS Tracer Indicator Surveys TOT Training of Trainers UDCC Union Development Coordination Committee UEHFPSC Union Education Health and Family Planning Standing Committee UFPO Upazila Family Planning Officers MaMoni HSS – Year Two Second Quarterly Report April 2015 5 UH&FPO Union Health and Family Planning Officer UH&FWC Union Health and Family Welfare Centers UP Union Parishad USAID United States Agency for International Development MaMoni HSS – Year Two Second Quarterly Report April 2015 6 1. Introduction The MaMoni Health Systems Strengthening (HSS) project is a four-year Associate Award under the Maternal and Child Health Integrated Program (MCHIP), with a period of performance from September 24, 2013 to September 23, 2017. MaMoni HSS builds upon MaMoni’s previous work in Bangladesh and focuses on strengthening the systems and standards for maternal, newborn and child health, family planning and nutrition (MNCH/FP/N) that will result in declines in maternal, newborn and child mortality within seven districts in Bangladesh. The project supports the Ministry of Health and Family Welfare (MOH&FW) to introduce and leverage support for scale-up of evidence-based practices proven effective in Bangladesh. MaMoni HSS is primed by Jhpiego in partnership with Save the Children (SC), John Snow, Inc. (JSI), and Johns Hopkins University, Institute for International Programs (JHU/IIP), with national partners International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dnet, and Bangabandhu Sheikh Mujib Medical University (BSMMU). SC serves as the functional operational lead partner for the Award in Bangladesh. MaMoni HSS engages with local government structures and non-governmental organizations (NGO) to improve delivery of health services and strategically partner at the national level to build consensus around policies and standards that positively drive evidence-based interventions at all levels. Beginning the second year of implementation, Figure 1: Map of MaMoni HSS project areas the project is using a differential approach to implementation at the district level. Districts and upazilas are categorized into two groups based on the intensity of implementation support. This categorization will be maintained through the life of the project. High-intensity areas: MaMoni HSS supports high-intensity interventions in a total of 23 upazilas. These areas include all upazilas of Habiganj, Lakhsmipur and Jhalokathi districts, four upazilas of Noakhali, and two upazilas of Pirozepur district. Health system (HS) capacity strengthening areas: All remaining areas will receive support for