The Maternal and Child Survival Program

Acting to End Preventable Maternal Mortality

CORE Group Global Health Practitioner Conference April 16, 2015

www.mcsprogram.org

Vision Statement Self-reliant countries equipped with

the analytical tools and effective systems enabling them to be on track to end preventable child and maternal

deaths

USAID’s flagship Maternal and Child Survival Program

Awarded: Launched June 2014 Length: 5 Years Funding Ceiling: 500 Million AOR: Nahed Matta Alternates: Malia Boggs; Megan Rhodes Technical Advisors: Karen Fogg; Kerry Ross

Program Basics

Maternal & Newborn Health

Child Health & Immunization

Family Planning Nutrition Malaria Water, Sanitation, &

Hygiene (WASH) HIV/TB

Technical Areas

Cross-Cutting Issues

Quality Innovation Partnerships (private sector, civil society, etc.) Gender Equity Measurement and Analytics Behavior Change Communication e/mHealth Community Approaches WASH Health Systems Strengthening

Partners

Evolution since MCHIP Reflects changing global RMNCH landscape and shifts in USAID priorities

Greater emphasis on cross-cutting issues such as quality, equity, and gender

Focuses on sustainable scale up, such as strengthening health systems, that will deliver high impact technical interventions

20% of MCSP funds are required to be spent “through local institutions”

Household to Hospital Continuum of Care

Household

Clinics/Hospitals

Community

Referral

Strategic Objectives Support countries to increase

coverage and utilization of evidence-based, high-quality reproductive, maternal, newborn and child health (RMNCH) interventions at the household, community and health facility levels;

Close innovation gaps to improve health outcomes among high-burden and vulnerable populations through engagement with a broad range of partners; and

Foster effective policy, program learning and accountability for improved RMNCH outcomes across the continuum of care

Integrated Themes Scaling up RMNCH coverage in 24 priority countries Maximize potential for public and private sector—including

civil society Addressing equity through a community health strengthening

approach Strengthening integrated community health platforms Integrating services across the continuum of care Better care on the Day of Birth Maternal newborn health and infectious disease Rigorous focus on monitoring, evaluation, and learning

24 Priority USAID Countries

Other countries where MCSP works:

Burma, Egypt, Guinea, Namibia, South Africa

Countries where MCSP works

Afghanistan Bangladesh Democratic

Republic of Congo

Ethiopia Ghana Haiti India Indonesia

Kenya Liberia Madagascar Malawi Mali Mozambique Nepal Nigeria Pakistan Rwanda

Senegal South Sudan Tanzania Uganda Yemen Zambia

Translating the Vision into Action

• Enabling and Mobilizing Individuals and Communities • Improve behaviors and norms, equity

• Advancing Quality, Respectful Care • Integration of maternal health and family planning • Scale up quality maternal health care • Address indirect causes of maternal mortality, poor birth

outcomes • Increase focus on maternal morbidity and disability • Respectful Maternity Care and improving work environment

• Strengthening Health Systems and Continuous Learning • Health systems strengthening, data use, innovation and research

Enabling and Mobilizing Individuals and Communities

• Improve individual, household, and community behaviors and norms • Community engagement, advocacy • Strengthening community-based counseling and

empowerment of community health workers • Improve equity of access to and use of

services by the most vulnerable • Reaching rural populations with uterotonics for

prevention of postpartum hemorrhage

Integrated Community Health Platforms A flexible system for

integrated RMNCH service delivery in the community, spanning common gaps in the continuum of care from household to health facilities

CHW Workforce and Community Infrastructure

Information for Equity, Learning and Adaptation

Institutionalization, Coordination

and Partnerships

Intervention Package:

Preventative, Promotive &

Curative Services

Support Services and Functions

(commodities, supervision, information processes…)

National Policy and Support

Includes health promotion, disease prevention, care seeking and treatment Not a one-

size-fits-all blueprint

Advancing Quality, Respectful Care

• Integration of maternal services & family planning • Postpartum family planning as essential component of

both antenatal and postnatal care • Scale up quality care

• Comprehensive approach to prevention of postpartum hemorrhage

• Address indirect causes of maternal mortality and poor birth outcomes • Infectious disease management as critical component

of antenatal care

Advancing Quality, Respectful Care

• Averting and addressing maternal morbidity and disability • Prevention and management of obstetric fistula

• Advance choice and respectful maternity care (RMC) • RMC: Bangladesh, Mozambique, South Sudan, Tanzania,

Rwanda, Kenya, Ethiopia, Haiti, Indonesia, Madagascar, Burma, Nigeria

• Alternative birth positions: Ethiopia, Mozambique, Burma, Pakistan, Rwanda, South Sudan, Tanzania

Address Gender Issues

• Antenatal care (ANC) • Engagement of men in counseling & birth planning • Gender-based violence (GBV): identification, safety planning

& harm reduction, counseling re effects on MCH outcomes • Labor and birth

• Respectful and gender-sensitive care during birth • Deploying female skilled birth attendants (SBA) • Making services affordable to women • Bringing SBA to women who lack mobility or transport • Participatory women’s groups to foster social support for

maternal and neonatal health problems

Strengthening Health Systems and Continuous Learning

• Systems to track stock-outs of life-saving drugs

• Human resources for health • Clinical governance and focus on

measurement as driver for improving quality and coverage of services

• Strengthen maternal death surveillance • Operations research and learning agenda

Multidimensional Management Antenatal

Care

DISTRICT

FACILITY

COMMUNITY HEALTH STRATEGIES

COMMUNITY /HOUSEHOLD

Intrapartum Care and

Emergencies

Postpartum and Newborn

Care

CLINICAL GOVERNANCE

BETTER CARE ON THE

DAY OF BIRTH including CEmONC

STRENGTHENED ANTENATAL

CARE including infectious

disease (ID)

STRENGTHENED POSTNATAL

CARE including FP, nutrition, ID

Strengthen Maternal Death Surveillance and Response

• Technical assistance for capacity-building of key elements of MDSR in 10 countries • Kenya, Ethiopia, Tanzania, Yemen, Nigeria, Malawi,

Zambia, Rwanda, Uganda, and Egypt

• Engage with global stakeholders developing and integrating MDSR/PDSR Systems • Collaboration with the USAID Africa Bureau and

WHO-AFRO

Support & Study Scale-Up

Four high impact technical interventions, each in multiple countries (e.g., misoprostol)

Monitor clear outcomes on ongoing basis

Use clear implementation strategies

Standardized process documentation

Active Community of Practice

Supporting countries to eliminate preventable deaths: Implementation Research to drive better practice in “real time”

Sustainable impact at scale

Service expansion / increased coverage

Inst

itutio

naliz

atio

n in

hea

lth s

yste

ms Short cycle learning to improve

practice & achieve scale

check

adjust

learn

check

adjust

learn

check

adjust

learn

check

adjust

learn

Adapted from: Institute for Reproductive Health (IRH)

Thank You

Learn more at: www.mcsprogram.org

Twitter.com/MCSPglobal

Facebook.com/MCSPglobal

Acknowledgements

• Ali Abdelmegeid • Kate Brickson • Myra Betron • Stephanie Suhowatsky • Cicely Thomas

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.

facebook.com/MCSPglobal twitter.com/MCSPglobal

Extra Slides

Pregnancy Labor & Delivery Newborn Child

TECHNICAL APPROACHES ACROSS LIFE CYCLE

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Integrated Community Platforms

Whole Market District Approach

ANC/PNC and Day of Birth Integrated

Interventions

Integrated Child Health Interventions

(incl. prevention, immun., nutri.)

“PRACTICE – LEARNING FEEDBACK LOOP”

Helping Countries Eliminate Preventable Child & Maternal Death, by Achieving Impact at Scale for Women and Children

What is MDSR?

MDSR is a continuous-action cycle to provide real-time, actionable data on MM levels, causes of death, and contributing factors, with focus on using findings to prevent future maternal deaths.