USAID’s Maternal and Child Survival Program (MCSP) Uganda - Child Health (CH) Quarterly Progress Report October1, 2017 to December 31, 2017 Cover photo by Kate Holt, MCSP USAID/Uganda Quarterly Progress Report (Program Year 4) Project Name: USAID’s Maternal and Child Survival Program (MCSP) Uganda Child Health (CH) Program Reporting Period: October 1, 2017 to December 31, 2017 Obligation Funding Amount: Project Duration: August 2016 to December 2018 Program Year (PY4): October 1, 2017 to September 30, 2018 Person Responsible for this Report: Dr. Ssekitto Kalule Gerald – Chief of Party, MCSP Program Goal: To contribute to a reduction in child mortality in the Southwest (SW) and East Central (EC) regions of Uganda. Program Purpose: With USAID Uganda’s Regional Health Integration to Enhance Services (RHITES) partners, identify, implement, and test a package of low cost, high impact, evidence- based CH interventions that can be applied at different levels of the health care system and contribute to a reduction in child mortality. Program Objectives: 1. Enhance national guidelines and frameworks to support implementation of the essential CH package. 2. Strengthen technical skills, competencies and practices of the RHITES partners and MCSP-supported demonstration districts to implement the essential CH package. 3. Strengthen district level management and planning practices to support the delivery of the essential CH package using adapted REC-QI approaches. 4. Conduct a costing analysis for delivery of the essential CH package. 5. Improve availability of strategic knowledge and tools to scale-up the essential CH package. 2 MCSP Uganda–CH PY4 Q1 Report Acronym List ADHO Assistant District Health Officer AOR Agreement Officer’s Representative CAO Chief Administrative assistant CDSR Child Death Surveillance Response CH Child Health CHC Communication for Healthy Communities CHEW Community Health Extension Worker CHMIS Community Health Management Information Systems CHO Child Health Officer COP Chief of Party CSS National Child and Newborn Survival Strategy DHIS2 District Health Information System 2 DHMT District Health Management Team DHO District Health Officer DHT District Health Team DL Distance Learning DQA Data Quality Audit DQS&I Data Quality Self-Assessment and Improvement EC East Central Region ECD Early Childhood Development EOP End of Program EPCMD Ending Preventable Child and Maternal Deaths EPI Expanded Programme on Immunization FP Family Planning FY Fiscal Year HC Health Centre HF Health Facility HIS Health Information System HMIS Health Management Information System iCCM Integrated Community Case Management IMCI Integrated Management of Childhood Illness IMNCI Integrated Management of Neonatal and Childhood Illness IP Implementing Partners ISS Integrated Support Supervision IYCF Infant and Young Child Feeding JSI John Snow, Inc. LC Local Council LOP Length of Program MCH Maternal and Child Health MCHIP Maternal and Child Health Integrated Program MCSP USAID’s Maternal and Child Survival Program MEL Monitoring, Evaluation, and Learning MNCH Maternal, Newborn and Child Health MOU Memorandum of Understanding MoH Ministry of Health – Uganda MSI Management Systems International OPD Outpatient Department 3 MCSP Uganda–CH PY4 Q1 Report ORS Oral Rehydration Salts ORT Oral Rehydration Therapy PEPFAR U.S Presidents Emergency Plan for AIDS Relief PHC Primary Health Care PMTCT Prevention of Mother-to-Child Transmission PMP Performance Monitoring Plan PS Permanent Secretary PY Program Year QI Quality Improvement QoC Quality of Care QRM Quarterly Review Meetings REC-QI Reaching Every Child-Quality Improvement RED Reaching Every District RDC Resident District Commissioner RHITES Regional Health Integration to Enhance Service RMNCH Reproductive, Maternal, Newborn, and Child Health RMNCAH Reproductive, Maternal, Newborn, Child and Adolescent Health SIC Short Interrupted Course SPRING Strengthening Partnerships, Results, and Innovations in Nutrition Globally SS Supportive Supervision SW South West Region U5 Under Five (5) Years of Age UNEPI Uganda National Expanded Programme on Immunization ToT Training of Trainers TOR Terms of Reference TWG Technical Working Group UHVP Uganda Reproductive Health Voucher Program UNICEF United Nations Children’s Fund USAID United States Agency for International Development VHT Village Health Teams WHO World Health Organization WHO AFRO World Health Organization Regional Office for Africa 4 MCSP Uganda–CH PY4 Q1 Report I. Introduction The Maternal and Child Survival Program (MCSP) is a global U.S. Agency for International Development (USAID) cooperative agreement to introduce and support high-impact health interventions in 25 priority countries with the ultimate goal of preventing child and maternal deaths. MCSP is currently implementing two programs in Uganda: the Routine Immunization program (MCSP RI) which works with the Ministry of Health (MOH) and its Uganda National Expanded Programme on Immunization (UNEPI) to operationalize the Reaching Every Child/Community using Quality Improvement Approach (REC-QI) in eleven districts (2014-2019); and the Child Health program (MCSP CH) which is an eighteen-month technical assistance program (e.g., May 2017-October 2018 for in-country implementation, and November-December 2018 for closeout) to provide tailored support in the area of CH to the USAID’s Regional Health Integration to Enhance Services (RHITES) in South West (SW) and East Central (EC) regions. Though the initial Program Description was issued in August 2016, the program scope transitioned from Reproductive, Maternal, Newborn, and Child Health (RMNCH) to exclusively Child Health technical assistance in January 2017 and the concept note was approved on March 14, 2017. Provisional approval for the detailed MCSP CH implementation plan was granted in May 2017, and full approval was provided in August 2017. USAID’s RHITES projects are working with the Government of Uganda to support implementation of the Uganda Reproductive, Maternal, Newborn, Child, and Adolescent (RMNCAH) Sharpened Plan, which includes a package of low cost, high impact, evidence-based RMNCAH interventions that can be applied at different levels of the health system to reduce mortality. The RHITES projects work directly with the districts they serve and at the central level to assist with national scale up of the package. The expected result of MCSP’s tailored technical assistance for CH is a standardized CH package across the RHITES projects, that determines the costs involved and gathers learning on the feasibility of implementing the package in an integrated way in four demonstration districts (e.g., Luuka, Kaliro, Ntungamo and Sheema Districts), and lessons learned to inform national level CH policy and program updates. This quarterly report summarizes the progress and achievements of MCSP CH for the period of October 1, 2017 to December 31, 2017. II. Summary of PY4-Quarter 1 Achievements Activities Planned Activities Accomplished Objective 1: Enhance national guidelines and frameworks to support implementation of the essential CH package Finalise IMNCI training materials IMNCI materials for the initial phases of training were produced and job aids and printed. Participation in national monthly Two IMNCI training approaches in the four MCSP level technical working demonstration districts were endorsed by MOH Maternal Child groups/policy review meetings Health (MCH) Cluster for demonstration and documentation on 6 October 6 2017. Participation in the Community MOH confirmed that IPs should continue with village health Health Extension Workers team (VHT)-related activities which are planned for the current National Strategy–Implementing fiscal year. It was clarified that the Community Health Extension Partner’s (IP’s) Breakfast Meeting Workers National Strategy will be operationalized by June 2018. 5 MCSP Uganda–CH PY4 Q1 Report Activities Planned Activities Accomplished Objective 2: Strengthen competencies and practices of RHITES IPs and focus districts to implement the Essential CH package IR1: Conduct national and regional Training of Trainers (ToTs) to roll out essential CH package Conduct regional ToTs for IMNCI MCSP CH completed the regional IMNCI ToT facilitation skills for RHITES EC and SW course for the RHITES EC program area, with a total of 12 participants (4M: 8F) trained, out of the 22 participants who attended the regional IMNCI basic course in EC region. IR2: RHITES supported to train health workers on IMNCI and IMNCI referral component in MCSP demonstration districts Review and adapt mentorship / MCSP CH produced, pre-tested, and finalized integrated CH supportive supervision (SS) mentorship and SS tools and process. tools for district trainings and on- site mentorship Support and participate in district Distance learning: MCSP supported RHITES and Sheema level, blended-learning IMNCI District trainers to conduct 5 sessions of the first phase of the training for health facilities in IMNCI distance learning (DL) module in Sheema. A total of 111 Sheema and Ntungamo Districts in health workers (70F:41M) were trained from 32 of 35 health SW facilities in Sheema District. Short interrupted course: MCSP supported RHITES and District trainers to conduct 4 sessions of the first phase of the IMNCI Short Interrupted Course (SIC) in Ntungamo. A total of 97 health workers (61F:36M) were trained from 41 of 44 health facilities in Ntungamo District. Support and participate in district DL: MCSP supported RHITES and District trainers