USAID/ZAMBIA SYSTEMS FOR BETTER HEALTH QUARTERLY PROGRESS REPORT APRIL – JUNE 2016 July 2016 This publication was produced for review by the United States Agency for International Development. It was prepared by Abt Associates for the USAID Systems for Better Health activity. SBH Quarterly Progress Report April – June 2016 Contract/Project No.: Task Order No. AID611-TO-16-00001 Contract No. AID-OAA-I-14-00032 GUC Mechanism Submitted to: William Kanweka, Contracting Officer’s Representative USAID Zambia Prepared by: Abt Associates In collaboration with: American College of Nurse-Midwives Akros Inc. BroadReach Institute for Training and Education Initiatives Inc. Imperial Health Sciences Save the Children DISCLAIMER The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government USAID Systems for Better Health ▌pg. i SBH Quarterly Progress Report April – June 2016 Table of Contents Acronyms ....................................................................................................................................... 1 Executive Summary ...................................................................................................................... 3 1. Introduction ......................................................................................................................... 4 2. Progress by Task .................................................................................................................. 5 2.1 Task One: Design, implement and monitor national level interventions to strengthen health stewardship by the Ministry of Health .............................................................................................................. 5 2.1.1 Sub-task 1.1: Strengthen Human Resources Planning and Management ................................ 5 2.1.2 Sub-task 1.2: Improve health care financing and public financial management ...................... 7 2.1.3 Sub-task 1.3: Strengthen MOH capacity to oversee delivery of key health programs ....... 9 2.2 Task Two: Design, implement, and monitor interventions to strengthen program management capabilities of provincial and district teams .......................................................................... 12 2.2.1 Sub-Task 2.1: Strengthen program management capacity ....................................................... 12 2.2.2 Sub-Task 2.2: Improve technical capacity of provincial and district health teams to deliver quality health services in facilities ..................................................................................... 16 2.3 Task Three: Support the Government and Community-Based Organizations to increase the quality, availability, and use of health services............................................................................................... 18 2.3.1 Sub-Task 3.1: Improve the capacity to deliver quality health services in the community ............................................................................................................................... 18 2.3.2 Sub-Task 3.2: Strengthen linkages between the facility and the community ....................... 19 2.4 Cross-Cutting Technical Areas ............................................................................................................ 20 2.4.1 Grants under Contract .................................................................................................................... 20 2.4.2 Research, Monitoring and Evaluation ............................................................................................ 20 2.4.3 Knowledge Management .................................................................................................................. 21 2.4.4 Gender .................................................................................................................................................. 21 3. Project Management ......................................................................................................... 22 3.1.1 Finance and Administration .................................................. Error! Bookmark not defined. 3.1.2 Overall Budget and Expenditures ....................................... Error! Bookmark not defined. 3.1.3 Personnel .................................................................................. Error! Bookmark not defined. 3.1.4 Subcontracts ............................................................................ Error! Bookmark not defined. 3.1.5 Management Processes and Systems ................................. Error! Bookmark not defined. USAID Systems for Better Health ▌pg. ii SBH Quarterly Progress Report April – June 2016 4. Success Stories ........................................................................... Error! Bookmark not defined. 5. Challenges and Solutions .................................................................................................. 23 6. Progress on Links to Other USAID Programs and Government of Zambia Agencies .................................................................................... 24 Annex 1: Performance Indicator Tracking Table ............................ Error! Bookmark not defined. Annex 2: List of Selected Health Facilities ....................................... Error! Bookmark not defined. Annex 3: Summary of Training Data ................................................ Error! Bookmark not defined. Annex 4: Status of Key Deliverables ................................................. Error! Bookmark not defined. Annex 5: Short-term Technical Assistance Plan for Next QuarterError! Bookmark not defined. USAID Systems for Better Health ▌pg. iii SBH Quarterly Progress Report April – June 2016 Acronyms AMEP Activity Monitoring and Evaluation Plan ART Antiretroviral Therapy BRITE BroadReach Institute for Training and Education CBO Community-based Organization CHA Community Health Assistant CHAI Clinton Health Access Initiative DHIS2 District Health Information System Version 2 DHO District Health Office DMO District Medical Officer EmONC Emergency Obstetric and Neonatal Care GFP Gender Focal Point HCF Health Care Financing HCFP Health Care Finance and Planning HMIS Health Management Information System HRH Human Resources for Health HRHSP Human Resources for Health Strategic Plan HRIS Human Resources Information System HSS Health Systems Strengthening M&E Monitoring and Evaluation MCH Maternal and Child Health MOH Ministry of Health NCHW National Community Health Worker NFNC National Food and Nutrition Commission NGO Non-governmental Organizations NHA National Health Accounts NIPA National Institute for Public Administration NTOP National Training Operational Plan PA/e-PA Performance Assessment/electronic Performance Assessment USAID Systems for Better Health ▌pg. 1 SBH Quarterly Progress Report April – June 2016 PEPFAR President’s Emergency Plan for AIDS Relief PMO Provincial Medical Officer PHO Provincial Health Office PMP Performance Management Plan QI Quality Improvement RBF Results-based Financing RMNCH Reproductive, Maternal, Neonatal, and Child Health RMNCAH Reproductive, Maternal, Neonatal, Child and Adolescent Health SBH Systems for Better Health SCM Supply Chain Management SHI Social Health Insurance SMAG Safe Motherhood Action Groups SMGL Saving Mothers Giving Life TWG Technical Working Group ZMLA Zambia Management and Leadership Academy USAID Systems for Better Health ▌pg. 2 SBH Quarterly Progress Report April – June 2016 Executive Summary This Quarterly Progress Report for the USAID Systems for Better Health (SBH) activity covers the period of April 1st through June 30th, 2016. The quarter was marked by significant progress in establishing the project’s activities. SBH recruited a total of 33 new staff members during the quarter bringing the total number of SBH personnel to 62, and seconded to the Ministry of Health (MOH), the first of two HMIS Specialists as well as the Health Care Finance and Planning Specialist. During the quarter, SBH technical teams held consultative meetings with MOH personnel and supported strategic activities such as the Provincial and District Integrated Meetings to strengthen program management in the district and review district and facility performance. SBH successfully conducted capacity assessment with senior MOH province, district and hospital leaders. The assessment examined five performance management systems by assessing: a.)the policies, guidelines, tools, b.)the people skills, knowledge and attitudes, c.) the processes and tools, and d.) the implementation structures. The Supply Chain Specialist conducted a targeted capacity assessment in twelve health facilities to develop tools strengthen systems and improve supply chain management in the target facilities. The project led USAID partner coordination meetings at both national and provincial levels to report partner activities and service delivery data, as well as to prepare for the MOH planning launch. SBH received Ethical Review Board approval to conduct the community capacity assessment and planned to execute the field work in July. SBH partner BroadReach Institute for Training and Education, collaborated with the National Institute for Public Administration to revise the Zambia Management Leadership Academy training curriculum and conducted the first training sessions for program officers from Lusaka and Central Provinces. These activities and others detailed in this report, contributed to SBH’s