STRENGTHENING ETHIOPIA’S URBAN HEALTH PROGRAM FY18 ANNUAL REPORT STRENGTHENING ETHIOPIA’S URBAN HEALTH PROGRAM ANNUAL REPORT OCTOBER 2017 – SEPTEMBER 2018 Cooperative Agreement No.AID-663-A-13-00002 SUBMITTED TO: USAID/Ethiopia PREPARED BY: John Snow, Inc. (JSI) CONTACT INFO FOR THIS REPORT: HIBRET ALEMU TILAHUN, PHD JSI/SEUHP CHIEF OF PARTY EMAIL: [email protected] TEL: +251114700402/45 DISCLAIMER: This document is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of JSI Research & Training Institute, Inc. (JSI) and do not necessarily reflect the views of USAID or the United States Government. SEUHP FY 18 Annual Report 2 ACRONYMS AND ABBREVIATIONS AAU/SPH Addis Ababa University School of Public Health AACARHB Addis Ababa City Administration Regional Health Bureau ANC Antenatal care ARM Annual review meeting ART antiretroviral therapy AWD acute watery diarrhea (cholera) AYRH adolescent youth reproductive health BCC behavior change communication C/THO city/town health office CHIS community health information system DQA data quality assessment EDA Emmanuel Development Association EPHA Ethiopian Public Health Association (EPHA) EPI Expanded Program on Immunization Extension Program FANC Focused antenatal care FMOH Federal Ministry of Health FHC family health card FHT Family health team FP family planning FY fiscal year HBHTC home-based HIV testing and counseling HC h ealth center HDA health development army HEW health extension worker HH household HIV human immunodeficiency virus HMIS health management information system HRM human resource management HSPH Harvard School of Public Health HSTP health sector transformation plan HTC HIV testing and counseling ICU Intensive care unit IEC information, education, and communication IR intermediate result IRT integrated refresher training ISS integrated supportive supervision IUSHS Integrated Urban Sanitation and Hygiene Strategy JSI John Snow, Inc. JSS joint supportive supervision KMC kangaroo mother care LBW low birth weight LMG leadership, management and governance LQAS Lot Quality Assurance System MARPs most at risk populations M&E monitoring and evaluation SEUHP FY 18 Annual Report 3 MNCH maternal, newborn, and child health NCD non-communicable disease OCA organizational capacity assessment OPD outpatient department PEPFAR President's Emergency Plan for AIDS Relief PHC primary health care PLHIV people living with HIV PMP performance monitoring plan PMTCT prevention of mother-to-child transmission (of HIV) PNC postnatal care QI quality improvement QII quality improvement initiative RDT rapid diagnostic test RH reproductive health RHB regional health bureau SBCC social behavior change communication SEUHP Strengthening Ethiopia’s Urban Health Program SNNPR Southern Nation and Nationalities People Region SDRT service data recording tool TB tuberculosis THO town health office TOT training of trainer TTG think tank group TWG technical working group UHEP urban health extension program UHE-p urban health extension professional USAID United States Agency for International Development WASH water, sanitation, and hygiene SEUHP FY 18 Annual Report 4 TABLE OF CONTENTS I. PUBLICATIONS/REPORTS ............................................................................................................................ 6 II. TECHNICAL ASSISTANCE ............................................................................................................................ 6 III. TRAVEL AND VISITS ....................................................................................................................................... 7 IV. ACTIVITY .............................................................................................. Error! Bookmark not defined. SUMMARY MAJOR ACCOMPLISHMENTS IN THE REPORTING PERIOD ............................................ 9 IR 1: IMPROVED QUALITY OF COMMUNITY‐LEVEL URBAN HEALTH SERVICES ........................ 10 IR 2: INCREASED DEMAND FOR FACILITY-LEVEL URBAN HEALTH SERVICES ............................. 33 IR-3: STRENGTHEN REGIONAL PLATFORMS FOR IMPROVED IMPLEMENTATION OF THE NATIONAL URBAN HEALTH STRATEGY .................................................................................................... 43 IR-4: IMPROVE SECTORALCONVERGENCE FOR URBAN SANITATION AND WASTE MANAGEMENT ..................................................................................................................................................... 62 5. OTHER KEY ACTIVITIES ................................................................................................................................ 75 6. DATA QUALITY ISSUES DURING THE REPORTING PERIOD .......................................................... 78 7. COMMUNICATION AND DOCUMENTATION RELATED KEY ACTIVITIES AND ACCOMPLISHMENTS .......................................................................................................................................... 79 8. OPERATIONS AND FINANCE: KEY ACTIVITIES AND ACCOMPLISHMENTS ............................. 82 9. CHALLENGES AND PLANS TO OVERCOME THEM DURING THE REPORTING PERIOD ..... 86 10. MAJOR ACTIVITIES PLANNED IN THE NEXT REPORTING PERIOD ........................................... 86 Annex II: SEUHP Strategic Information Action Plan 2018 ........................................................................... 91 Annex III: Summary of Measurable WASH LMG Result Achievements in selected towns of Amhara region between June and September 2018 ....................................................................................................... 94 Annex IV: Best practice ......................................................................................................................................... 96 SEUHP FY 18 Annual Report 5 SUMMARY MAJOR ACCOMPLISHMENTS IN THE REPORTING PERIOD The followings are major achievements of the first six months of FY18 (October 2017-March 2018): . National level Master TOT and regional level TOT of second round IRT conducted for 23 and 261 participants respectively from SEUHP supported regions covering the modules on major communicable diseases, major NCDs, and Basic First Aid. The IRT was rolled out for 2,263 UHE-ps in SEUHP supported towns. 1,011,835 (101.3% of the annual target) urban residents received primary care services from UHE-ps that have been receiving mentoring, coaching, and supportive supervisions from SEUHP team. 28,856 (90.9% of target) individuals received follow up visits from UHE-ps on TB, ART, and ANC. Intensive quality improvement efforts were undertaken in 21 model QII demonstration health centers that are identified as learning and demonstration sites. Sites received follow up visits whereby technical supports were provided on reviewing their plans, monitoring their performances, and documenting lessons learned among others. Support provided for primary health care reform sites in SEUHP supported regions. So far, the family health teams in Addis Ababa, Harar, Tigray and Oromia regions have provided door-to-door and school- based services for 36,416 individuals. A 26 episode serial radio drama that focused on RMNCH, HIV, TB, and urban WASH produced and aired using the Ethiopian National Radio Station through a nationwide coverage. A four episode documentary film that focuses on urban HEP and urban WASH was produced in collaboration with EBS TV and aired. 28,856 individuals who defaulted from clinical services traced and referred back to health facilities for continuity of services. UHE-ps initiated referral for 66,546 (110.1%) individuals for further care and service at health facilities. 1,109 government health officials and staffs in four towns attended two days of strengthening town level implementation workshops aimed at ensuring institutionalization and ownership of urban health system strengthening initiatives. 2,873 UHE-ps received targeted supportive supervision from CTHOs and HCs from SEUHP supported towns. Piloting of UCHIS accomplished and documented in three towns (Addis Ababa, Bishoftu, and Hawassa). 28,298 (112.9%) people assisted for gaining access to improved sanitation facility (latrine). 52,814 (125.1%) households assisted to have proper liquid waste/grey water management facility. 43,937 (132.5%) households assisted/supported with gaining access to proper Solid Waste Management . Different WASH facilities including public latrines, communal latrines, hand dug wells, pipeline extensions etc. constructed/renovated at four SEUHP supported towns were inaugurated in the presence of national, regional, zonal, and town level higher officials including State Minister for FMOH, RHBs and Mayors and cabinet members. All the remaining WASH facilities that includes constructions of one new public latrine with shower, two new public water points, renovation of one health center water supply and maintenance of one hand dug well remaining at Adigrat town are completed.. Others were accomplished in previous FYs. Project closeout is started with the 1st major staff downsizing that started as of end of June 2018. SEUHP FY 18 Annual Report 9 IR 1 IMPROVED QUALITY OF COMMUNITY‐LEVEL URBAN HEALTH SERVICES SEUHP FY 18 Annual Report 10 Sub IR1.1: Improved Knowledge, Skills, and Motivation of UHE-PS 1.1.1 Organize Integrated Refresher training (IRT) for UHE-ps SEUHP supported FMOH’s effort to standardize Integrated Refresher training (IRT) for UHE-ps. The FMOH started implementing