Presented byJohannes van Dam Sr. Director, Program Sciencesand Theresa Hoke, Scientist II
January 10, 2012
FHI 360 – Program Sciences and Health Services Research (HSR)
Introduction
Frank Beadle de Palomo Senior Vice President and Director, GHPN
Presenters
Johannes van DamDirector, Program Sciences
Theresa HokeScientist III
Program Sciences
Presented by Johannes van Dam Sr. Director, Program Sciences
Overview
• New organizational structure - ??• New opportunities• Collaboration between country programs and US-
based programs
Global Health and Development (effective Oct. 1 2010)
Chief Operating Officer
Global Portfolio Management
Health and Development Sciences
Operations Support (OS)Information Technology (IT)
(includes Knowledge Management)
Behavioral and Social Sciences
Science and Technical Learning Services
Clinical Sciences
Quantitative Sciences
Product Quality and Compliance
Practice Areas
Science Facilitation
Program Management
Program Sciences
...
Global Research Services
Science to Practice Sites Country Office 1
Country Office 3
Country Office 2
Country Office N
Africa Team 1, including Haiti
Global ProjectsAPRO Team Africa Team 3Africa Team 2Global Systems
Support
Program Sciences
• Africa Regional Technical Team• Health Services Research• Health Systems Strengthening• Strategic Information/M&E• Technical Support• Laboratory Services• PROGRESS
Program Sciences – interface of science and programs
• Health Services Research (HSR)– To follow
• Strategic Information– M&E, HMIS and surveillance– Data Quality Assessment tool– BBSS
Program Sciences - continued
• PROGRESS– Expanded access to quality FP services (R to P)– Task shifting: e.g. CBA2I– Increase method mix: post-partum IUD, sino-implant, LNG
IUS– Non-health sector: MF institutions; environmental groups;
agriculture sector (LOL)• Health Systems Strengthening (HSS)
– HSS strategy – Rapid assessment tool– QA/QI and CQI model to go to scale
Program Sciences - continued
• Laboratory Sciences– Lab quality improvement (incl. international accreditation)– Medical waste management– Expand in Africa and Asia
• Technical Assistance and Support– A global network, with a hub in the Africa Regional
Technical Team– Provides TA in program design and implementation– Support for research & builds research capacity
FHI 360 Global TA System
• Push and pull system, meeting program needs (“pull”) and quality assurance (“push”)
• Linked to Technical Quality Assessment tool, currently being field-tested
• Seeks to make optimal use of technical expertise in FHI 360, regardless of location
• Africa Technical Team well positioned to identify, nurture and broker regional TA
• Track and monitor quality of TA provided
New Funding Environment
• Country ownership• Responsive to national priorities• Better M&E, more operational research• Better value for money:
– Costing– Efficiency– Outcomes and impact
• Sustainability• From implementation to capacity building
New and Old Priorities
• Increase efficiency of ART programs• Chronic/non-communicable diseases (CVD,
hypertension, diabetes, lung disease, cancers)• Health Systems Strengthening• HIV prevention (PrEP, male circumcision, microbicides)• Prevention for Positives• Strengthen PMTCT• FP/RH, including maternal health• Other infectious diseases (TB, malaria)
Programs and Program Science
Program Science in support of Country Programs
HEALTH SERVICES RESEARCH (HSR)
Presented by Theresa Hoke, Scientist II
Who We Are
Specialists in…• Public health• Maternal and Child Health• Economics• Statistics• Epidemiology• Health behavior• Health policy • Engineering• Medicine
What we do
• Conduct APPLIED RESEARCH
• Focus on optimizing – Access– Quality– Effectiveness– Cost
• Build capacity in research and evidence-based programming
Why applied research is useful
Through applied research we…• Evaluate programs• Identify and diagnose
service delivery problems • Develop and test
programmatic solutions • Examine costs and cost-
effectiveness• Investigate determinants of
intervention effectiveness
Traditional research contexts
• Family planning
• HIV prevention, care and treatment
• Maternal and newborn health
• Post-abortion care
• Reproductive health services & education for youth
• Male circumcision for HIV prevention
Moving into new sectors
• Agriculture
• Environment
• Micro-finance
• Waste management
• Behavioral economics
• Health systems research
Who we work with
• Host country government partners
• NGOs• Grassroots
organizations/ CBOs• FHI360 Country
offices• USAID CAs
Where we work
• National, regional and district levels
• Facilities– clinics– schools– program sites
• Communities• Sub-group populations
– postpartum women
– PLWHA– youth – MARPs
Selected examples of recent HSR research
Increasing access to family planning services
•Is it feasible and effective to strengthening linkages within health services?•Does task shifting/task sharing increase access to services?• What are the alternatives to public sector services?
Increasing access: Facilitated referrals in Tanzania
AimDevelop & test a facilitated referral
model to integrate FP and HIV services
Approach• Trained providers• Introduced service delivery guidelines
& job aids• Evaluated service delivery process &
measured impact of contraceptive uptake by Care & Treatment clients
Key Findings• Modern FP use increased from 78%
to 93%• Service quality improved
Improving quality
• How is service quality affected – by integration?– by task shifting?
• What is the effect of trainings and job aids on provider performance?
• Does client satisfaction increase with service innovations?
• How can systems be strengthened to ensure technical and material resources are in place to permit high quality service delivery?
Improving Quality: Emergency Obstetric & Newborn Care
AimTo identify gaps in delivery of essential emergency obstetric and newborn care (EmONC)
ApproachProvide TA to MOH and UN partners in conducting national facility-based surveys
Assess availability of “signal functions” for EmONC service delivery
Improving effectiveness
• How can we encourage full use of available technologies?
• Is integration of family planning into the work of other sectors an effective approach to achieving mutual programmatic goals?
Improving effectiveness: Integrating Family Planning Promotion into the Green Belt Movement
Aim• Assess the feasibility and effect
adding FP promotion to the duties of Green Volunteers
Approach• Design and implementation of
multi-component intervention• Collect post-intervention data
collection to assess Green Volunteers’ success with incorporating the innovation into their duties.
Cost Issues: Improving efficiency & increasing sustainability
• Estimating the cost of service delivery • Estimating cost of scaling-up interventions• Assessing cost-effectiveness of alternative
approaches to service delivery• Documenting resources required to support
transition to local ownership• Preparing costed implementation plans to support
resource mobilization• Linking resources used to outputs produced (value
for money assessments)
Capacity Building
Africa Regional Technical Team is strengthening FHI360 staff capacity to:• Identify challenges and knowledge gaps• Articulate research questions • Integrate evaluation and research into program proposals• Conduct programmatic research and evaluation
PROGRESS Project: Building programmatic research skills with local partners• National University of Rwanda School of Public Health• National Institute of Medical Research – MMRC (Tanzania)
How we can collaborate
Transferability• Our skills in applied research /
program evaluation are transferable to programs outside the health sector.
Complementarity• Skills in study design,
operations research, data collection and analysis, and results interpretation and dissemination complement program implementation capabilities.
Conclusion
• Donors/programs in all sectors are increasingly concerned about issues of access, quality, effectiveness, and cost.
• Opportunities to conduct applied research continue to arise.
• We are seeking mutually beneficial opportunities to collaborate and learn more about the programs you support.
Discussion
THANK YOU!!!