Ccih2019 usaid-mnch-benjamin
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The document provides an overview of USAID's initiatives in maternal and child health, nutrition, and health systems strengthening from 2012 to 2019, showcasing their efforts to reduce mortality rates and enhance healthcare delivery in priority countries. It highlights specific programs aimed at improving access to quality healthcare, maternal nutrition, and voluntary family planning, while also emphasizing innovation and partnerships to address ongoing health challenges. The document also outlines the role of the Center for Innovation and Impact in supporting the scale-up of health interventions through blended financing strategies and collaboration with various stakeholders.
Ccih2019 usaid-mnch-benjamin
- 1. CCIH Conference June 6, 2019
- 2. 1. Office of Maternal and Child Health and Nutrition 2. Office of Health Systems 3. Office of Population and Reproductive Health 4. Center for Innovation and Impact Overview 2
- 3. 1. Global Leadership and Policy Support – Global guidelines – Liaison with multilateral organizations, other donors, private sector, NGOs – Facilitating the scale-up of proven, high-impact innovations 2. Implementation Research, Evaluation, and Innovation – Establishing proof of principle for new interventions and new approaches to interventions with potential country-level impact – Health Research Program, focused on research-to-use – Collaboration with CII (innovation), P3 (metrics), OHS, GH research team 3. Support to USAID Field Missions – TDY support, e.g. activity designs, evaluations – Collaboration on global initiatives, including co-funded activities (e.g. Saving Mothers, Giving Life) – Technical assistance activities through central projects MCHN Overarching Functions 3
- 4. From 2012 to 2016, USAID helped 5.9 million women deliver in a health facility. 220,000 ANNUAL MATERNAL DEATHS IN 25 PRIORITY COUNTRIES MATERNAL HEALTH ADDRESSING THE MAJOR CAUSES OF MORTALITY 4
- 5. • Enabling and mobilizing individuals and communities • Advancing quality, respectful care • Strengthening health systems and continuous learning MATERNAL HEALTH ADDRESSING THE MAJOR CAUSES OF MORTALITY 5
- 6. 1,870,000 ANNUAL NEWBORN DEATHS IN 25 PRIORITY COUNTRIES Between 2008 and 2015, the percentage of women giving birth in a health facility in priority countries rose from 42% to 54%, and, partially as a result, the neonatal mortality rate decreased 18.5% in the same window. NEWBORN HEALTH ADDRESSING THE MAJOR CAUSES OF MORTALITY 6
- 7. • Increasing access to quality care and services during labor, delivery, and the first day and week of life to reach every woman and every newborn • Harnessing the power of parents, families, and communities to promote optimal health behaviors and care seeking • Monitoring progress and outcomes for enhanced accountability NEWBORN HEALTH ADDRESSING THE MAJOR CAUSES OF MORTALITY 7
- 8. CHILD HEALTH 885,000 ANNUAL DIARRHEA & PNEUMONIA DEATHS IN 25 PRIORITY COUNTRIES USAID’s efforts have helped increase use of oral rehydration solution to treat diarrhea in priority countries from zero to as high as 54%. ADDRESSING THE MAJOR CAUSES OF MORTALITY 8
- 9. • Increasing access to new vaccines - Pneumococcal conjugate vaccines - Rotavirus vaccines • Improving case management - ORS + zinc - Oral amoxicillin for severe pneumonia • Applying cross cutting prevention - Handwashing - Reduction of indoor air pollution CHILD HEALTH ADDRESSING THE MAJOR CAUSES OF MORTALITY 9
- 10. CHILD HEALTH ADDRESSING THE MAJOR CAUSES OF MORTALITY Policy environment in flux: • MCHN supporting examination of gaps in global and country-level leadership in child health • MCHN participating in global update of Integrated Management of Newborn and Childhood Illness • Child Health team working on a new vision for child health for GH, to be completed in early 2018 10
- 11. 75% OF THE WORLD’S UNVACCINATED CHILDREN RESIDE IN 25 PRIORITY COUNTRIES In priority countries, DPT3 coverage, a common indicator in the strength of a routine immunization system, increased from 71% in 2008 to 81% in 2015. IMMUNIZATION ADDRESSING THE MAJOR CAUSES OF MORTALITY 11
- 12. • Partnering with Gavi • Sustaining routine immunization coverage • Eradicating Polio IMMUNIZATION ADDRESSING THE MAJOR CAUSES OF MORTALITY 12
- 13. 13 • Strengthening systems – Cold chain and logistics, information systems, training health workers and managers • Improving service delivery – Innovative approaches and tools to reach the unreached • Working with national immunization programs – Planning, review, and coordination meetings, evaluations and assessments, policy and guideline development Credit:AllanGichigi,MCSP IMMUNIZATION SUSTAINING COVERAGE
- 14. 14 Credit:AllanGichigi,MCSP 1.7 M ANNUAL CHILD DEATHS ATTRIBUTED TO MALNUTRITION IN PRIORITY COUNTRIES In USAID’s focus countries for nutrition, the prevalence of stunting, indicative of inadequate nutrition, declined from 56 percent in 1990 to 34 percent in 2016. NUTRITION ADDRESSING THE MAJOR CAUSES OF MORTALITY Credit: Alda Kauffeld/USAID Ghana 14
- 15. 15 Focusing on nutrition–specific interventions (1,000 days) • Maternal nutrition: iron folic acid, calcium, multiple micronutrients, energy/protein supplementation. • Infant and young child nutrition: immediate breastfeeding, exclusive breastfeeding up to 6 months, complementary feeding with continued breastfeeding to 2 years and beyond. • Micronutrient supplementation: vitamin A, zinc, iron, calcium. • Management of acute malnutrition Collaborating on nutrition–sensitive interventions including agriculture; family planning; water, sanitation and hygiene; & education. Credit:AllanGichigi,MCSP NUTRITION ADDRESSING THE MAJOR CAUSES OF MORTALITY 15
- 16. Office of Health Systems “In partnership with the public and private sectors, we seek to ensure affordability, quality and delivery of health services in an equitable and sustainable manner, ultimately protecting people against unforeseen shocks.” 16
- 17. 17 • “A health system is a local system made up of all people, institutions, resources, and activities whose primary purpose is to promote, restore, and maintain health.” • USAID provides technical assistance to help countries identify and take ownership for investments in their health systems. • We invest in HSS because it is foundational for achieving our priority health goals. USAID VISION FOR HEALTH SYSTEMS STRENGTHENING
- 18. 18 FROM CORE FUNCTION TO OUTCOMES USAID’s Vision for HSS Outcomes OHS Mechanisms HSS Impacts Resource Optimization Equity Quality Medicines, Technologies, and Pharmaceutical Services (MTaPS) Integrated Health Systems IDIQ and TO1 Promoting the Quality of Medicines HSS Accelerator Human Resources for Health 2030 Improvements in Health for PCMD, CHAE, and CIDT Sustained improvements in health system performance and country self- reliance Scaling up what works in HSS Ensuring Essential Health System Inputs HSS Functions Leadership and Governance Finance Human Resources for Health Medical Products, Vaccines, & Technologies Service Delivery Health Information
- 19. USAID’s former Health Finance and Governance Project created several tools to share lessons learned on civil society engagement and governance, and in partnership with USAID’s ASSIST project, on quality: • https://www.hfgproject.org/tools-civil-society-health-governance/ • https://www.hfgproject.org/governance-to-improve-the-quality-of-health-services-a-research-agenda/ Examples of OHS Program Partnerships with Faith-Based Organizations: • In Tanzania in FY17, the ASSIST program provided technical support to MOHCDGEC (government) structures, regional IPs, faith-based organizations, and community groups to apply quality improvement methods towards attaining PEPFAR 3.0 and UNAIDS 90-90-90 goals on achieving HIV epidemic control. • In Lesotho in FY16, as a part of strengthening the linkages along the PMTCT continuum of care, USAID worked with 12 facilities including four faith-based facilities to increase the percentage of mother-baby pairs that are retained in care from 20% in February 2014 to over 90% in February 2016, and in the percentage of mother-baby pairs receiving standard package of care, from 20% in May 2014 to almost 100% in Feb 2016. • HRH2030, with funding from PEPFAR and USAID, is working with the Ministry of Health (MOH) of Malawi and the Christian Health Association of Malawi (CHAM) to strengthen the health system by increasing the supply and distribution of human resources for health (HRH) through existing systems targeting HIV/AIDS. Through this work 300 health care workers were retained and managed in 63 PEFAR priority sites in Lilongwe and Zomba districts and more work to sustainably manage health workers continues in partnership with the Ministry of Health. 19 Tools and Examples:
- 20. The Office of Population and Reproductive Health (PRH) Improving the Healthy Timing and Spacing of Pregnancies 20
- 21. 21 Voluntary Family Planning is a Key Intervention for Health and Development and Self-Reliance Social & economic benefits ▪ Improves women’s opportunities ▪ Improves family well- being ▪ Mitigates adverse effects of population dynamics on o Natural resources, including food & water o Economic growth o State stability ▪ Reduces maternal mortality/morbidity ▪ Reduces infant and child mortality ▪ Reduces abortion ▪ Key intervention in HIV settings e.g. PMTCT Health benefits Enable women and couples to decide number, timing and spacing of births Principles of voluntarism and informed choice are fundamental
- 22. 22 The Countries Where We Work Have Young Populations
- 23. 23 PRH Results Framework Goal: To enable countries to meet the family planning needs of their people PRH Strategic Objective: Advance and support voluntary family planning/reproductive health programs worldwide Intermediate Result 1: Global leadership demonstrated in FP/RH policy, advocacy and services Intermediate Result 2: Knowledge generated, organized and disseminated in response to program needs Intermediate Result 3: Support provided to the field to implement effective and sustainable FP/RH programs High-level Outcomes: 1. Increased availability of high quality FP services 2. Increased demand for FP information and services 3. Increased domestic financial contribution to FP programs
- 24. 1. Increased availability of high quality Family Planning services i. Method choice ii. Supply strengthening iii. Family Planning workforce iv. Total market approach 2. Increased demand for Family Planning services, especially among youth i. Social behavior change ii. Total market approach iii. Family Planning workforce 3. Increased domestic financial contribution to Family Planning programs i. Total market approach Underpinned by policy, research, monitoring and evaluation. Gender and youth are cross-cutting. Outcomes encompass the focus areas 24
- 25. Center for Innovation & Impact “Business-minded approaches to the development, introduction and scale-up of health interventions to accelerate impact against the world's most important health challenges.” 25
- 26. 26 Center for Innovation and Impact (CII) Overview: Supporting innovation and scale-up for USAID’s global health priorities Role Approach What we do Accelerate the development, introduction and scale up of priority global health interventions Catalyze Innovation Scale for Impact Identify + Apply Cutting- Edge Practices Promote and reinforce innovative, business-minded approaches to address key bottlenecks in development, introduction and scale up
- 27. 27 How can I work with CII? CII is part of the Global Health Bureau Front Office and supports all global health related work across the Agency. Our Market Access Team provides support on strategic planning, market shaping, innovating financing, digital health, and human centered design. This team has access to several mechanisms that can be leveraged including: • Scale for Impact for strategic planning, market shaping • Invest+ for innovative financing projects • Digital Square for digital health projects • Engage Design for human centered design projects Our Innovation Team identifies new innovations through 3 main Grand Challenges For Development (each issued a BAA and resulted in over 150+ awards) and provides hands-on support to these innovators to scale: • Saving Lives at Birth • Fighting Ebola • Combating Zika and Future Threats If you are interested in working with CII or have any questions, please reach out to cii@usaid.gov
- 28. 28 Example of CII’s work—Blended Finance for Global Health • CII recently developed a Blended Finance Roadmap, to support and strengthen the capacity of our Missions, to leverage additional private capital for global health • The Roadmap is a six-step process that the Mission can walk through to identify blended finance opportunities to achieve its health goals • Blended finance is the use of public or philanthropic resources to mobilize new private capital for development outcomes Report available for download @: www.usaid.gov/cii
- 29. 29 Case Study: Blended Finance for Global Health in Tanzania • The Government of Tanzania is increasingly moving towards supporting the public sector as the primary health care provider • The expansion of the public system is a long process, and other providers, including FBOs, still form a crucial link to service delivery for low income populations • The Government is also actively rolling out a national health insurance program, ensuring access to services for patients at qualifying healthcare facilities, including FBO run facilities • However, FBO run facilities are currently unable to provide uninterrupted services due to: – Shift of government funds towards public facilities – Stockouts and shortages of drugs at FBO facilities – Difficulty in paying utilities and staff salaries affecting service delivery • CII, in partnership with USAID/Tanzania, explored the role that blended finance could play in helping to sustainably address the financing challenges FBO run health facilities are currently facing
- 30. 30 Case Study: Blended Finance for Global Health in Tanzania
- 31. THANK YOU!