Cross-cutting Themes in Community Health: Engagement from the CSHGP

FY2014 Cohort

Concurrent Panel Session; CORE Group April 14, 2015 Moderators from MCSP: Emma Sacks and Melanie Morrow

USAID is Committed to Ending Preventable Child and Maternal Deaths (EPCMD)

A Call to Action: A Promise Renewed (June/2012) Acting on the Call to End Maternal & Child Deaths (June/2014)

Integrated RMNCH

• “We are entering (or are in the midst of) a paradigm shift in which: • Community-based programming is being seen as the

most cost-effective approach for improving RMNCH

• Movements toward integration will increasingly be seen as essential for long-term sustainability and effective programming”

CBPHC Conclusion (from H. Perry)

USAID’s Child Survival and Health Grants Program (CSHGP)

• Partnership model engages and builds the capacity of civil society with host country governments

• Cooperative agreements - international NGOs and their local partners.

• Programs generate new knowledge to improve the health of women, children, and communities.

CSGHP 2014 Cohort

• 10 of 11projects completed final evaluations • Liberia granted extension

• 7 in Africa, 3 in Asia, 1 in South America • Largely MNCH-focused; 1 TB • Various strategies:

• Maternity waiting homes, • integration of child survival and ECD, • community QI initiatives, • training/equipping/pairing CHWs, • etc.

Panel

2 presentations from FY2014 grantees: • World Renew Bangaldesh – Peoples Institutions

Model (Alan Talens) • Center for Health Services Benin – Quality

Improvement Collaboratives (Sara Riese)

Cross Cutting Analysis of FY2014 Cohort • Themes: Community Engagement & Service

Delivery (Lynne Franco, EnCompass)

Community Health in MCSP – • Viable Integrated Community Health Platforms

MCSP and Community Health:

Viable Integrated Community Health Platforms

CORE Group Spring Conference 2015 Melanie Morrow & Emma Sacks, MCSP

What’s New • Greater emphasis on community

health and civil society engagement • 20% of funding to be spent through

local institutions and organizations

USAID’s flagship Maternal and Child Survival Program

Goal: Ending Preventable Child and Maternal Deaths (EPCMD)

• Scaling up community based approaches among success factors associated with progress on MDGs 4&5

• Need to accelerate institutionalization of community health in country health

strategies. • Challenges:

• Inconsistent language • Multiple country contexts • Zero sum games

• Response: A visual model (the “Looking Glass”) that can be used across country contexts to highlight essential elements of community health strategies as part of a broader platform intending to achieve comprehensive services and sustainability at scale.

Toward Viable Integrated Community Health Platforms

CHW Workforce ↕ ↕

Community Organizing

[Social Infrastructure]

Local Learning & Adaptation,

Using Information for Equity

Institutionalization, Governance

& Partnerships

Interventions & Outcomes:

Health Promotion, Preventive, & Curative

Services

Support Services and Functions

(commodities, supervision, information systems…)

National Policy and Support

The “Looking Glass”- a visual model

Lens 1: Interventions & Outcomes

• Package of RMNH interventions aimed at improving outcomes for mothers, newborns and children.

• Balance of health promotion with preventive and curative services

• Clearly identified outcomes at the community level

Lens 2: Community health workforce (CHWs) & Community organizing structures • Re-emergence of large scale CHW

programs • CHW roles, profile, capacity, fit to tasks and

coverage in the population. • CHW relationship to community groups

(formal and informal) as a subsystem related to the outcomes and interventions defined in Lens 1. i.e. Women’s PLA groups; Care Groups

Lens 3: Institutionalization, governance & partnerships

• Sound governance and support from subnational (i.e. district) and national MOH

• Effective partnerships with civil society, community groups, NGOs in the health sector and CHW professional associations.

• Steps to support those partnerships, facilitate government to non-government partnership for health, and build capacity and shared ownership.

Lens 4: Local learning, adaptation and Information Use for Equity

• A viable CHP requires capacity to learn and adapt by all actors

• Not static: communities, health systems nor the health threats they face.

• To sustain community health at scale, a CHP must focus on how information is used horizontally (close to communities and beneficiaries) and vertically, to foster cycles of learning, improvement and adaptation.

• Examples: PDQ, social accountability strategies, use of C-HIS, Community Action Cycles

Lens 5: Support Services & Functions

• Health systems’ supportive functions to community health • Supervision • Procurement • Training • Information systems

CSHGP and MCSP • Using learnings from CSHGP

• CSHGP participated in MCSP workshops • MCSP holding brownbags for CSHGP projects to

present findings • Concern Sierra Leone’s Ebola experience • World Vision South Sudan’s newborn health experience

• MCSP country offices to attend CSGHP final evaluation presentations

• MCSP producing briefs related to CSHGP evaluations and operations research for distribution in country

CSHGP and MCSP

• Cross country and cross-project learning • Joint learning activities between CSHGP projects

and USAID Missions in Pakistan being planned • Analysis in progress of iCCM experience across

two countries • With EnCompass, analysis conducted of learning

themes across countries

In Summary

• Viable community health platforms are about sustaining effective community health at scale in changing environments

• NGOs and CSOs have been working at community level for many years and have proven strategies that can be adopted by government programs at larger scale and in sustainable manners

For more information, please visit www.mcsprogram.org

This presentation was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Cooperative Agreement AID-OAA-A-14-00028. The contents are the responsibility of the authors and do not

necessarily reflect the views of USAID or the United States Government.

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