country team action plan (afghanistan). tracks 1 & 2 2 2007-present /pph 1.expansion of...
TRANSCRIPT
Country Team Action Plan
(AFGHANISTAN)
Tracks 1 & 2
2
2007-Present /PPH
1. Expansion of Prevention of Post-Partum Hemorrhage at Home Births
• The pilot using misoprostol took place between March 2006 and Sept 2007
• The expansion plan for PPH project post-Bangkok 2007 began in December 2007
Tracks 1 & 2
3
2007-Present/ PPH
Expansion plan developed in 5 phases:
Phase 1: Planning and preparation Phase 2: Early implementation Phase 3: Implementation in round 1 sites Phase 4: Implementation in round 2 sites Phase 5: Review phase
Tracks 1 & 2
4
2007-Present/PPH
Ongoing process: • PPH protocol
developed, finalized, and RFPs issued
• Training document reviewed, revised and ready for printing
• Provincial change agent selected and recruited
Tracks 1 & 2
5
2007-Present2-Zinc introduction: – Introduction of Zinc for the management of
diarrhea presented to MoPH – Working group formed– Developed national strategic plan for control
of DD– Developed plan of action for improved
diarrheal case management + (introduction of Zinc and low osmolarity ORS )
– Conducted consensus workshop
Tracks 1 & 2
6
2007-Present / cont
• Zinc included as part of Basic Package of Health Services, new Child Health Strategy, IMCI and C-IMCI
• Zinc supplementation implemented in 20 provinces out of 34
• 14 provinces will be added by the end of 2010
Tracks 1 & 2
7
2007-Present
2- Kangaroo Mother Care:– Technical Working Group established – Developed community-based maternal
and newborn care package – Field testing carried out– A ToT will be conducted in March – Will scale-up to all 13 USAID-supported
provinces and selected districts [other provinces funded by WB and EU]
Tracks 1 & 2
8
Current Situation for Birth Spacing
Male involvement:• Males are involved but not
systematically• No standard guidelines for male
involvement • In several provinces of Afghanistan,
UNFPA has conducted a training program for male involvement
Tracks 1 & 2
9
Current Situation for Birth Spacing
Religious leader involvement:• FP in the Light of Islam booklet is under
review at MoRA and approved by MoPH.• A conference on “Health in Islam” held
and reference manual and guidelines from Egypt regarding health and Islam have been translated and distributed
• A number of health facility Shura have religious leaders as members
Tracks 1 & 2
10
Where do we want to be?GOALS
• Afghanistan has improved access to and utilization of birth spacing methods for women of reproductive age through increased awareness and support of religious leaders and men
• The Best Practice which has been Chosen for Scaling up :
Involving men and religious leaders in birth spacing services in Afghanistan
Tracks 1 & 2
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Where do we want to be? GOALSComponents of chosen best practice:• Developing and issuing a Fatwa• National Plan of Action• Training program for (RLs, health providers,
managers…)• Ensure membership of RLs in community
health Shura• Having male counselors (at health facilities) for
BS
Tracks 1 & 2
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Where do we want to be? GOALS
Components of chosen best practice:2• Establish an Inter-Ministerial
Committee• Develop a comprehensive M&E plan• Arrange study tours for religious
leaders and other people for increased networking
Track 2 13
What is the evidence to support this best
practice?• Fatwa (issued in other Islamic countries)• IEC/BCC materials (messages developed
and used in other countries )• Experience of Health Shura (health staff
and community leaders and RLs)• Experiences in other countries such as
Egypt, Yemen, Iran, Indonesia, and Pakistan
Track 2 14
What are the modifications needed to improve the
intervention’s scalability?Modify:• To make more credible: the project
should be modified based on experiences in other countries, such as Yemen
• Action: further evidence needed for the Afghan context—modify advocacy and communication materials, involve RLs in development of plan
Track 2 15
Modify:
Compatible:Make the plan compatible with Afghan
valuesIncorporating Afghan values and
cultural practices will make the scale-up easier
Training package, IEC/BCC materials need to be adapted to fit the Afghan context
Track 2 16
Testable:
• Male and RL involvement in Birth Spacing (BS) is already happening as part of the National Health Strategy and National Reproductive Health Strategy
• We can review the results so far as a kind of test of our approach
Track 2 17
Who will be involved in scaling-up?
User organizations:• MoPH: RH/FP, CBHC, and Health Promotion
Departments• MoRA: Health Shura and and other
stakeholders• Afghan Resource team:
MoPH: FP/RH, HP, CBHC, AFGA, BASICS, HSSP, Tech-Serve, UNFPA, WHO, UNICEF, COMPRI-A. MoRA, and MSI
Track 2 18
What policy, regulatory, budgetary, or other
institutional steps are needed?
• Create National Action Plan, Guidelines, Learning Package
• See action plan
Track 2 19
Where, when and how will the best practice be expanded?
• Phased approach starting in the 8 “regional” provinces
• Phase I will be completed by June 2011
• Innovations will be disseminated through the National Health Coordination Workshop and the Annual Health Retreat
• See action plan for other details
Track 2 20
What will be the costs of expansion and how will
needed resources be mobilized? • Costs include: Training, Technical
Assistance, IEC materials, Study Tour, Communication materials, Media spots, Workshops, Logistics including transportation, M&E, etc.
• Government, USAID and UNFPA support will be mobilized for the scale-up effort
Track 2 21
How will the process, outcomes and impacts be
monitored? How will results be fed into decision-making?
• M&E Plan will be established as part of the National Action Plan
• Details and indicators will be determined as part of this process
• Outcomes will be integrated into the national HMIS
Tracks 1 & 2
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What are our action steps?Action
StepResponsible Person
Timeline
Establish steering committee for the project MoPH: CBHC Dept. Tech-Serve, HSSP May 2010Promote innovation within Inter Ministerial Committee Reconvening Bangkok Team May 2010Establish task force at Ministry of Religious Affairs MoRA MoPH- Health Promotion May 2010Establish MOU and share TOR between MOPH and MORA
DG of Policy Planning, MoPH June 2010
Gather information on evidence MoPH- Health Promotion Tech-Serve June 2010Hold consensus building workshop to develop fatwa
MoPH-CBHC and Health Promotion, Planning and Policy and RH & MoRA August 2010
Develop Fatwa MoRA/and Shura Ulama MoPH- Health Promotion August 2010
Tracks 1 & 2
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What are our action steps?
Action Step
Responsible Person
Timeline
Hold national conference to announce fatwa
MoPH- Health Promotion and CBHC/MoRA Tech-Serve September 2010
Ensure Membership of Religious Leaders at community health Shura MoPH- CBHC & MoRA September 2010
National plan of action (MoPH and MoRA) including M&E and communication plans Steering Committee Tech-Serve October 2010
Engage community leaders to encourage men to be involved in birth spacing Steering Committee Tech-Serve October 2010
Tracks 1 & 2
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What are our action steps?
Action Step
Responsible Person
Timeline
Create Guidelines
Steering Committee/Technical Working Group Tech-Serve and HSSP November 2010
Develop units on Islamic values in all line ministries
MoPH-Health Promotion & MoRA Compri-A, AFGA November 2010
Create media spots and other materials using popular male figures
MoPH-Health Promotion & MoRA Compri-A November 2010
Hold national, provincial and community level meetings with shura ulama Steering Committee Stakeholders December 2010
Tracks 1 & 2
25
What are our action steps?
Action Step
Responsible Person
Timeline
Build capacity of mullas including study tour
MoPH- CBHC and Health Promotion & MoRA Tech-Serve June 2011
Create IEC/BCC materials (messages )
MoPH-Health Promotion & MoRA USAID November 2011
Create training program (HSSP,UNFPA) MoPH- APHI/Training USAID, UNFPA November 2011
Train and deploy male birth spacing counselors at health facilities
Implementing NGOs and MoPH- RH UNFPA, USAID January 2012