DRC-IHPplus Quarterly Report: Year 1, Quarter One (June 17-September 30, 2015) Subagreement Number OAA-A-11-00024-01-MSH under USAID Cooperative Agreement Number AID-OAA-A-11-00024 Submitted to USAID/DRC on November 13, 2015 Final version submitted to USAID on February 10, 2016 Cover photo: Pierre Ngandu, a community health worker at a DRC-IHPplus-supported i-CCM site in Tshiebue, Kasaï Occidental, DRC, consults with Marthe Makenga before providing treatment. (Photo credit: Rebecca Weaver) Project Name: Integrated Health Project Plus (IHPplus) in the Democratic Republic of Congo, Subagreement No. OAA-A-11-00024-01-MSH, Under Cooperative Agreement Number: AID-OAA-A-11- 00024 Contact information in DRC: Avenue des Citronniers, No. 4, Commune Gombe, Kinshasa Chief of Party: Dr. Ousmane Faye, +243 0992006180 Contact information in the U.S: 200 Rivers Edge Drive Medford, MA 02155 Director, Country Portfolio: Kristin Cooney, Tel: +1 617-250-9168 DRC-IHPplus Year One Quarter One Report: June 17-September 30, 2015 Page 2 of 21 TABLE OF CONTENTS TABLE OF CONTENTS ..................................................................................................................................... 3 ACRONYMS ................................................................................................................................................... 4 PROJECT BACKGROUND ................................................................................................................................ 5 EXECUTIVE SUMMARY .................................................................................................................................. 8 PROJECT PERFORMANCE .......................................................................................................................... 8 KEY ACHIEVEMENTS .................................................................................................................................. 8 PROJECT PERFORMANCE ............................................................................................................................ 10 PROJECT MANAGEMENT ............................................................................................................................ 10 FAMILY PLANNING AND HIV AND AIDS STATUTORY REQUIREMENTS ....................................................... 13 ENVIRONMENTAL MONITORING AND MITIGATION PLAN ......................................................................... 13 WAY FORWARD: PLANNED ACTIVITIES FOR NEXT QUARTER ..................................................................... 13 LIST OF APPENDICES ................................................................................................................................... 21 DRC-IHPplus Year One Quarter One Report: June 17-September 30, 2015 Page 3 of 21 ACRONYMS ACT Artemisinin-based Combination LDP Leadership Development Therapy Program ANC Antenatal Care LLIN Long-lasting Insecticide-treated AOP Annual Operational Plan Net BCC Behavior Change MDR-TB Multidrug-Resistant Communication Tuberculosis CBD Community-based distribution MOH Ministry of Health or community-based distributor MNCH Maternal, Newborn and Child CBO Community-based Organization Health i-CCM Integrated Community Case MPA Minimum Package of Activities Management MSH Management Sciences for CHW Community Health Worker Health CODESA Comité de Développement NGO Non-governmental organization Sanitaire (health development ORS Oral Rehydration Solution committee) OSC Overseas Strategic Consulting, CDR Centrale de Distribution Ltd. Régionale (regional distribution PEPFAR President’s Emergency Plan for center) AIDS Relief CPA Complementary Package of PLWHA People living with HIV/AIDS Activities PMI President’s Malaria Initiative CLTS Community-Led Total PMP Performance Monitoring Plan Sanitation PMTCT Prevention of Mother-to-Child CPLT Coordination Provinciale contre Transmission la Lèpre et la Tuberculose PRONANUT National Nutrition Program (provincial coordination unit for RBF Results-based Financing leprosy and TB) RDQA Routine Data Quality CSDT Centre de Santé de Diagnostic Assessment et Traitement RDT Rapid Diagnostic Test CUG Closed User Group SIAPS Systems for Improved Access to DPS Division Provinciale de la Santé Pharmaceuticals and Services DRC Democratic Republic of the SNAME National System for Congo Procurement of Essential E2A Evidence to Action Medicines EGM Essential Generic Medicines SOO Statement of objectives EPI Expanded Program on TB Tuberculosis Immunization USAID United States Agency for ETL Education through Listening International Development FOG Fixed obligation grants USG United States Government FOSACOF Formation Sanitaire WASH Water/Sanitation/Hygiene Complètement Fonctionnelle (Fully Functional Service Delivery Point) FP Family planning GRH General referral hospital HIV Human Immunodeficiency Virus IYCF Infant and young child feeding IHP Integrated Health Project DRC-IHPplus Year One Quarter One Report: June 17-September 30, 2015 Page 4 of 21 PROJECT BACKGROUND This report covers the first quarter reporting period (June 17-September 30, 2015) of year one of the USAID-funded Integrated Health Project Plus (IHPplus) in the Democratic Republic of Congo (DRC). Implemented by Management Sciences for Health and Overseas Strategic Consulting, Ltd (hereafter referred to respectively as MSH and OSC) under a subcontract via Pathfinder/Evidence to Action (E2A), IHPplus is a 13-month “bridge,” to avoid a gap in services in USAID-supported health zones upon completion of the USAID Health Office’s current five-year flagship Integrated Health Project (IHP). IHPplus has two components--“Services” and “Other Health Systems”-- designed to create better conditions for, and increase the availability and use of, high-impact health services, products, and practices in 83 health zones (the IHP 78 plus 5 additional President's Malaria Initiative (PMI)- focused zones), all within the same eight Divisions Provinciales de Santé/DPS: 1) Kasaï, 2) Kasaï Central, 3) Lomami, 4) Kasaï Oriental, 5) Sankuru, 6) Haut Lomami, 7) Lualaba, and 8) Sud Kivu (formerly the four provinces of Kasaï Occidental, Kasaï Oriental, Katanga, and Sud Kivu); however, the level of effort and type of support in the 83 health zones varies. The listing of the IHPplus health zones (and their respective Level of Effort and package of support) is attached as Annex A. The project provides varying levels of support to 1,562 facilities (1,479 health centers and 83 general referral hospitals) in 83 health zones. In addition to maintaining its project office in Kinshasa to facilitate communication with the DRC Ministry of Health, other host government authorities, and USAID, IHPplus has seven coordination offices to facilitate activity implementation at the field level (see box below). To ensure the continuity of reporting by coordination office set up during IHP, IHPplus will report its achievements based on the “clusters” of Bukavu, Kamina, Kolwezi, Lodja, Luiza, Mwene Ditu, Tshumbe, and Uvira. The project’s vision is that people in the 83 project health zones will continue to participate more fully in determining their health outcomes by Bukavu Representation and Coordination Office – virtue of greater access to higher-quality 27 health zones comprehensive care; service delivery systems Kamina Coordination Office – 9 health zones will be accountably and effectively managed Kananga Representation and Coordination Office in their interests; and family-centered – 10 health zones communication will reflect healthy behaviors Mwene Ditu Coordination Office – 13 health zones that people understand and can act on in Lodja Coordination Office – 16 health zones their daily lives. Kolwezi Coordination Office – 8 health zones The overarching objective of the project is to Lubumbashi Representation office improve the enabling environment for, and Mbuji Mayi Representation office increase the availability and use of, high- Total Population Served: 13,882,943 impact services, products, and practices for family planning (FP), maternal, newborn, and child health (MNCH), nutrition, malaria, and tuberculosis (TB), Human Immunodeficiency Virus (HIV) and AIDS, and water/sanitation/hygiene (WASH) in target health zones (see Figure 1). Figure 1: IHPplus objective and focus areas The project reinforces a people- and team-centered approach to strengthening the health system in DRC, with a focus on four intermediate results detailed in Table 1 below. The USAID/DRC Health Office is in the process of designing a new portfolio of programs to continue the investments begun by its two flagship service delivery programs; the Integrated HIV Program (ProVIC) and the Integrated Health Project (IHP). These two programs will come to an end before the new programs can be fully launched; therefore, to avoid major disruptions in services, among other negative possibilities, the mission opted to continue key activities from both of these programs through a USAID/Washington-managed mechanism called Evidence to Action (E2A). E2A will serve as a crucial “bridge mechanism” upon the completion of IHP. It should be noted that the prime implementing agencies for IHP and ProVIC, MSH and PATH, respectively, are both members of the E2A consortium. During this reporting period, IHPplus began taking over the activities of IHP to continue to implement key strategies in all 83 targeted health zones. DRC-IHPplus Year One Quarter One Report: June 17-September 30, 2015 Page 6 of 21 Table 1: DRC-IHPplus