MaMoni Health Systems Strengthening Project Quarterly Report FY14 Q3: April 1 – June 30, 2014 Cover Photo Credit: Sabina Yeasmin, Upazila Coordinator, Noakhali Sadar, DORP Submitted July 31, 2014 The Maternal and Child Health Integrated Program (MCHIP) is the United States Agency for International Development (USAID) Bureau for Global Health’s flagship maternal, neonatal, and child health program. MCHIP supports programming in maternal, neonatal, and child health; immunization; family planning; malaria; nutrition; and HIV/AIDS and strongly encourages opportunities for integration. Cross-cutting technical areas include water, sanitation, hygiene, urban health, and health systems strengthening. 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 terms of Associate Cooperative Agreement No. 388-A-00-09-0104-00, through MCHIP, managed by Jhpiego Corporation. The contents are the responsibility of Jhpiego Corporation and do not necessarily reflect the views of USAID or the United States Government. MaMoni HSS Project – Quarterly Report FY14 Q3 2 Table of Contents Acronyms and Abbreviations ..................................................................................................... 4 Project Summary ....................................................................................................................... 6 Introduction ............................................................................................................................... 7 Program Objectives and Key Activities ...................................................................................... 8 Results for the Quarter ............................................................................................................ 11 Summary of Major Accomplishments ....................................... Error! Bookmark not defined. Narrative Report of Major Accomplishments ...................................................................... 12 Project Start-up .................................................................................................................... 13 Improve service readiness through critical gap management ......................................... 14 Strengthen health systems at district level and below ..................................................... 16 Promote an enabling environment to strengthen district-level health systems .............. 19 Identify and reduce barriers to accessing health services ............................................... 21 Challenges, Solutions and Action Taken ............................................................................ 22 The Way Forward ........................................................................... Error! Bookmark not defined. Annex 1. Photos from Observation of Safe Motherhood Day (May 28) .................................. 26 Annex 2. Geographic Allocation of Implementing Partner NGOs ............................................ 27 Annex 3: National Newborn Advocacy Report ......................................................................... 28 Annex 4: Case Studies............................................................................................................. 29 Annex 5: Collaboration with TRAction Project to Reduce Newborn Mortality in SylhetError! Bookmark not defined. Annex 6: Performance Indicators (October 2013 - June 2014) .............................................. 33 MaMoni HSS Project – Quarterly Report FY14 Q3 3 Abbreviations BCC Behavior Change Communication BSMMU Bangabandhu Sheikh Mujib Medical University CAG Community Action Group CDCS Country Development Cooperation Strategy CIPRB Center for Injury Prevention and Research, Bangladesh cMPM Community Microplanning Meeting CS Civil Surgeon CSBA Community Skilled Birth Attendants CV Community Volunteer DDFP Deputy Director Family Planning DGFP Directorate General Family Planning DGHS Directorate General Health Services DHSS District Health Systems Strengthening ECEB Essential Care for Every Baby EPI Expanded Program of Immunization GOB Government of Bangladesh 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 IMNCS Improving Maternal and Newborn Care Services IR Intermediate Result JHU/IIP Johns Hopkins University, Institute for International Programs JSI John Snow, Inc. JSV Joint Supervision Visit KMC Kangaroo Mother Care LAPM Long Acting and Permanent Method LLP Local Level Planning LMIS Logistics Management Information System MPDR Maternal and Perinatal Death Review MCHIP Maternal and Child Health Integrated Program M&E Monitoring and Evaluation MNCH/FP/N Maternal, Newborn and Child health, Family Planning and Nutrition MOH&FW Ministry of Health and Family Welfare MOU Memorandum of Understanding OR Operations Research PNGO Partner nongovernmental organization PPH Postpartum Hemorrhage PPIUCD Postpartum Intra-uterine Contraceptive Device QA Quality Assurance QPRM Quarterly Performance Review Meeting RRQAT Regional Roaming Quality Assurance Team SBA Skilled Birth Attendant SBM-R Standard-based Management and Recognition SC Save the Children SIAPS Systems for Improved Access to Pharmaceuticals and Services MaMoni HSS Project – Quarterly Report FY14 Q3 4 SSN Senior Staff Nurse UEHFPSC Union Education Health and Family Planning Standing Committee 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 Project – Quarterly Report FY14 Q3 5 Executive Summary Over the past decade, Bangladesh has made significant progress in lowering maternal and child mortality. Since 2001, the maternal mortality ratio has declined 40%, from 322 per 100,000 live births to 194 in 2010. Between 2007 and 2011, under-five mortality declined from 65 to 53 per 1000 live births and skilled attendance at birth nearly doubled between 2004 and 2011, reaching 32%. While Bangladeshi women and children benefit from these improvements, considerable gaps remain. Building on the strong work and success of the 2009 – 2014 MaMoni Project and Maternal and Child Health Integrated Program (MCHIP), the USAID/MaMoni Health Systems Strengthening (MaMoni HSS) Project will focus on strengthening the systems and standards for maternal, newborn and child health, family planning, and nutrition (MNCH/FP/N) that will result in further declines in maternal, newborn and child mortality. The new components of MaMoni HSS Project are as follows: • Advocate at the national and district level through strategic partnerships to ensure health systems reforms. • Build Ministry of Health and Family Welfare (MOH&FW) capacity at the district and upazila levels in management and leadership to improve MNCH/FP/N outcomes. • Engage community in behavior change communication (BCC) approaches at multiple levels. • Provide technical support to the Directorate General Health Services and Directorate General Family Planning to strengthen key components of health systems for scaling up nationally. • Incorporate Aponjon mobile health services into MNCH/FP/N package-delivery strategy. • Position Helping Babies Breathe (HBB) package within the larger essential newborn care intervention package. MaMoni HSS supports the Ministry of Health and Family Welfare (MOH&FW) to strengthen the health systems in seven districts – Habiganj, Noakhali, Lakhsmipur, Bhola, Pirozepur, Jhalokathi, and Brahmanbaria. MaMoni HSS Project – Quarterly Report FY14 Q3 6 Introduction and Background USAID/Bangladesh’s MaMoni Health Systems Strengthening (MaMoni HSS) Project is a four-year program comprised of a diverse collaborating partnership. Primed by Jhpiego in partnership with Save the Children (SC), John Snow, Inc. (JSI), and Johns Hopkins University (JHU)/Institute of International Programs (IIP), with national partners, icddr,b, Dnet, and Bangabandhu Sheikh Mujib Medical University (BSMMU), MaMoni HSS’ goal is to improve utilization of integrated maternal, newborn, child health, family planning and nutrition services (MNCH/FP/N). The project’s objective is to increase availability and quality of high-impact interventions through strengthening district-level local management and health systems. Building off of previous project’s, MaMoni Health Systems Strengthening will focus on strengthening the systems and standards for MNCH/FP/N which will result in a decline 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 already acknowledged in Bangladesh. Intermediate Results (IR): • Improved service readiness through critical gap management • Strengthened health systems at district level and below • Enabling environment promoted to strengthen district-level health systems • Barriers to health service accessibility identified and reduced Duration 2013 – 2017 ABOUT THIS QUARTERLY REPORT This quarterly report covers the period of April through June 2014, the third quarter of the first program year, FY2014. The MaMoni HSS team prepared the report to document progress, summarize accomplishments, and reflect on lessons