USAID’s Flagship Maternal and Child Survival Program: Acting to End Preventable Deaths

On June 25, 2014, the United States Agency for International Development (USAID) Bureau for Global Health announced the award of the Maternal and Child Survival Program (MCSP), formerly referred to as RMNCH (Reproductive, Maternal, Newborn and Child Health, awarded in March 2014). The Program is a five-year, $500 million cooperative agreement designed to advance USAID's goal of Ending Preventable Child and Maternal Deaths (EPCMD) by supporting the introduction and scale-up of high-impact, sustainable reproductive, maternal, newborn and child health interventions. MCSP accepts all sources of health funds and can be accessed via field support.

While the Maternal and Child Survival Program is the principal follow-on to the Maternal and Child Health Integrated Program (MCHIP), which ended at the global level in December 2014 (though work is ongoing through numerous Associated Awards in Yemen, Bangladesh, Malawi, South Sudan, Zimbabwe, Mozambique and Pakistan), the scope of this Program has expanded to reflect a changing global RMNCH landscape as well as shifts in USAID's own priorities. MCSP places a greater emphasis on key, cross-cutting issues such as innovation, e/mHealth, equity, quality, gender, public-private partnerships and involvement of civil society, community approaches and behavior change interventions. While maintaining a focus on technical, high-impact interventions, MCSP works toward sustainable scale-up to include strengthening the health systems that deliver these interventions. The Maternal and Child Survival Program is a partnership led by Jhpiego, with Save the Children Federation, Inc., John Snow, Inc., ICF International, Results for Development Institute, PATH, CORE

Group and PSI as lead partners and Broad Branch Associates, Johns Hopkins Bloomberg School of Public Health, Communications Initiative and Avenir Health (formerly Futures Institute) as associate partners.

Photo by Karen Kasmauski Birthing Center at the King Fahed IBN Abdul-Azezz Women and Children Hospital in Gusau, Nigeria.

MCSP is a five-year,

$500 million cooperative

agreement designed to

advance USAID's goal of

Ending Preventable Child

and Maternal Deaths

(EPCMD) by supporting

the introduction and

scale-up of high-impact,

sustainable reproductive,

maternal, newborn and

child health interventions.

MCSP: 1776 Massachusetts Avenue NW, Suite 300, Washington DC, 20036 tel: 202.835.3100 email: info@mcsprogram.org Koki Agarwal, Director, Koki.Agarwal@mcsprogram.org; Anita Gibson, Deputy Director, Anita.Gibson@mcsprogram.org

USAID: 1300 Pennsylvania Avenue NW, Washington DC, 20523 tel: 202.712.4564

Nahed Matta, AOR, nmatt@usaid.gov; Malia Boggs, Alternate AOR, mboggs@usaid.gov Visit mcsprogram.org to learn more.

In addition to contributing to high-level technical and policy dialogue at the global level, MSCP provides tailored technical assistance to help countries meet specific priorities and contextual needs of local RMNCH programs. This assistance includes:

Supporting countries to increase coverage and utilization of evidence-based, high-quality RMNCH interventions at the household, community and health facility levels, integrating with nutrition, malaria, HIV/AIDS and water, sanitation and hygiene (WASH) interventions as appropriate.

Closing innovation gaps to improve RMNCH outcomes through engagement with a broad range of partners and supporting innovative delivery strategies that enhance outreach to those most in need.

Fostering effective policy, action-oriented learning and accountability for improved RMNCH outcomes across the continuum of care.

Supporting countries to strengthen existing national health management information systems, including RMNCH data elements, data quality and the use of data to inform programmatic decision-making.

Strengthening civil society, local institutions and communities and engaging at all levels to enhance the responsiveness of health systems to local and community health needs, with a focus on the linchpin role of health districts.

Enhancing district-level decision-making through rapid household surveys to determine coverage and health facility assessments to determine quality of facility interventions.

Applying gender-, equity- and health systems-focused approaches to improve RMNCH service availability, access, quality, demand, cost-effectiveness and utilization at scale.

Providing technical assistance to design, implement and/or evaluate models, tools and approaches to address the special needs of adolescents and youth for family planning and maternal and newborn health services in an integrated fashion.

Fast Facts Who: Maternal and Child Survival Program (MCSP)

What: Five-year, $500 million cooperative agreement

When: June 2014

Where: A focus on 24 USAID high-priority countries, including 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 and Zambia

Why: To end preventable child and maternal deaths

REPRODUCTIVE HEALTH

KEY FACTS

• Worldwide, 60% of women over 30 years old use contraceptives, and only 22% of adolescents use birth control (UNFPA)

• If all women waited 36 months to conceive again, 26% of under-five deaths would be averted (Rutstein/Winter)

• In addition to the above, if women only gave birth between the ages of 18 and 39 and had no more than three children, child mortality would be reduced by 30% (Rutstein/Winter)

Worldwide, 225 million women currently wish to delay or prevent pregnancy, yet do not use contraceptives. The reasons for non-use are complex, involving social, cultural and economic barriers, fears about side effects, and lack of access to a trusted provider. Greater access to family planning will be vital to achieving global goals in maternal health and child survival.

USAID’s flagship Maternal and Child Survival Program (MCSP)’s strategic approach for family planning (FP) centers on accelerating achievements toward Family Planning 2020 and Ending Preventable Child and Maternal Deaths goals by preventing unintended pregnancies, particularly those with poorer health outcomes. This includes pregnancies occurring too soon after a birth, among high-parity women, and among older or adolescent mothers. MCSP’s key strategies include:

• Strengthening and scaling up postpartum family planning (PPFP) and integration of FP along the maternal, newborn and child health (MNCH) continuum of care;

• Expanding method choice, including long-acting methods, in FP and PPFP settings; and

• Reaching girls, their partners and gatekeepers—whether they are mothers already or not—with appropriately targeted FP information and services (and MNCH care)

Phot

o: K

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Hol

t/M

CSP

and

Jhpi

ego

Innovative approaches to increase service availability, access, quality, demand, equity and utilization cross-cut FP interventions and build on prior learning regarding effective integration of FP with delivery of other health services.

MCSP provides leadership to expand access to high-quality contraceptive services and serves as a global convening authority for documentation of best practices in FP/reproductive health programs. MCSP advocates for evidence around successful models that ensure every contact with a woman triggers a conversation about her reproductive intentions. At both health facility and community levels—in the context of care-seeking for herself or for her child—the aim is to link women to services whenever an unmet need is identified.

Pregnancies in youth and adolescents are linked with more adverse outcomes for both mothers and infants including preterm birth and low birth weight babies and perinatal and neonatal mortality. Moreover, rapid repeat pregnancies are more common in adolescents. To prevent pregnancies and closely spaced births in this age group, MCSP develops interventions for adolescent and first-time parents and equips providers to serve these women in their care. This includes an age and stage counseling package covering healthy timing and spacing of pregnancies, PPFP, gender-equitable FP decision-making (involving males and other gatekeepers), breastfeeding support, and infant care.

Photo: A midwife in Nigeria counsels a client on family planning (Karen Kasmauski/MCSP)

USAID1300 Pennsylvania Avenue, NWWashington, DC 20523United Statestel: +1 202.712.0000AOR: Nahed Mattanmatta@usaid.gov

MCSP1776 Massachusetts Avenue NW Suite 300 Washington, DC 20036United Statestel: +1 202.835.3100info@mcsprogram.orgDirector: Koki AgarwalKoki.Agarwal@mcsprogram.org

www.mcsprogram.org

twitter.com/MCSPglobal

facebook.com/MCSPglobal

ABOUT MCSP

The Maternal and Child Survival Program (MCSP) is a global, USAID Cooperative Agreement to introduce and support high-impact health interventions with a focus on 24 high-priority countries with the ultimate goal of ending preventable child and maternal deaths within a generation. The Program is focused on ensuring that all women, newborns and children most in need have equitable access to quality health care services to save lives.

MCSP supports programming in maternal, newborn and child health, immunization, family planning and reproductive health, nutrition, health systems strengthening, water/sanitation/hygiene, malaria, prevention of mother-to-child transmission of HIV, and pediatric HIV care and treatment.

www.mcsprogram.org

Programme phare de l’USAID pour la survie de la

mère et de l’enfant: Agir pour mettre fin aux décès

évitables

Photo par Karen Kasmauski Centre d’accouchement à l’hôpital King Fahed IBN Abdul-Azezz pour les

femmes et les enfants à Gusau au Nigéria.

Le Programme USAID

pour la survie de la

mère et de l’enfant est

un accord de

coopération de cinq ans

d’un montant de 500

million de dollars visant

à accélérer les objectifs

de l’USAID et mettre fin

aux décès évitables des

mères et des enfants en

soutenant l’introduction

et la mise à l’échelle

d’interventions en santé

reproductive,

maternelle, néonatale et

infantile durables et à

fort impact.

MCSP: 1776 Massachusetts Avenue NW, Suite 300, Washington DC, 20036 tel: 202.835.3100 email: info@mcsprogram.org Koki Agarwal, Director, Koki.Agarwal@mcsprogram.org; Anita Gibson, Deputy Director, Anita.Gibson@mcsprogram.org

USAID: 1300 Pennsylvania Avenue NW, Washington DC, 20523 tel: 202.712.4564

Nahed Matta, AOR, nmatt@usaid.gov; Malia Boggs, Alternate AOR, mboggs@usaid.gov

Consulter le site mcsprogram.org pour en savoir davantage.

EN BREF

Le Programme USAID

pour la survie de la mère

et de l’enfant est un

accord de coopération

de cinq ans, de $500

million de dollars

Date: Juin 2014

Où: dans 24 pays

hautement prioritaires:

Afghanistan, Bangladesh,

République,

Démocratique du Congo,

Éthiopie, Ghana, Haïti,

Inde, Indonésie, Kenya,

Liberia, Madagascar,

Malawi, Mali,

Mozambique, Népal,

Nigéria, Pakistan,

Rwanda, Sénégal, Soudan

du Sud, Tanzanie,

Ouganda, Yémen et

Zambie

Pourquoi: Pour mettre

fin aux décès évitables

des mères et des enfants

LA SANTE REPRODUCTIVE

FAITS CLES

• Dans le monde, 60% des femmes de plus de 30 ans utilisent des contraceptifs, contre 22% chez les adolescentes (UNFPA)

• Si toutes les femmes attendaient 36 mois pour concevoir à nouveau, 26% des décès des moins de cinq ans seraient évités (Rutstein/Winter)

• En outre, si les femmes donnaient naissance entre 18 et 39 ans, sans avoir plus de trois enfants, la mortalité infantile diminuerait de 30% (Rutstein/Winter)

Environ 225 millions de femmes souhaitent éviter ou prévenir une grossesse, mais n’utilisent aucun moyen de contraception. Les raisons de la non-utilisation sont complexes: des barrières sociales, culturelles et économiques, des craintes concernant les effets secondaires et le manque d’accès à un prestataire de confiance. Un meilleur accès à la planification familiale sera essentiel si on veut atteindre les objectifs mondiaux en matière de santé maternelle et de survie de l’enfant.

La stratégie du programme phare pour la survie de la mère et de l’enfant (MCSP) de l’USAID pour la planification familiale (PF) se concentre sur l’accélération des progrès en 2020 et Mettre fin aux décès évitables des enfants et des mères en prévenant les grossesses non désirées, en particulier celles associées à des mauvais résultats pour la santé ; soit une grossesse trop rapprochée, parmi les femmes à haute parité et chez les mères âgées ou les adolescentes. Les stratégies clés de MCSP sont les suivantes :

• Renforcer et passer à l’échelle la planification familiale du postpartum (PFPP) et intégrer la PF dans le continuum des soins de santé maternelle, néonatale et infantile (SMNI) ;

• Elargir le choix des méthodes, incluant les méthodes à longue durée d’action, dans les contextes de la PF et de la PFPP ; et

• Atteindre les filles, leurs partenaires, influenceurs—qu’elles soient déjà mères ou pas—avec des informations et des services de PF bien ciblées (soins SMNI).

Phot

o: Ka

te H

olt/M

CSP

and

Jhpi

ego

Des approches novatrices - qui s’appuient sur les acquis antérieurs en matière d’intégration et de prestations de services de santé efficaces - recoupent nos interventions de PF pour accroître la disponibilité, l’accès, la qualité, la demande, l’équité et l’utilisation des services.

MCSP assure un leadership pour élargir l’accès aux services contraceptifs de haute qualité et agit en tant qu’autorité mondiale en matière de documentation des meilleures pratiques pour les programmes de SR/PF.

MCSP préconise l’utilisation de modèles qui ont porté fruit, qui assurent que chaque contact avec une femme déclenche une conversation au sujet de ses intentions en matière de reproduction. Tant au niveau de l’établissement de santé qu’au niveau communautaire - dans le cadre de la demande de soins pour elle-même ou son enfant- le but est de mettre la femme en contact avec les services chaque fois qu’un besoin non satisfait est identifié.

La grossesse chez les jeunes et les adolescentes est liée à des résultats plus graves pour la mère et le bébé, y compris l’accouchement prématuré et la naissance d’un nouveau-né de faible poids, et une mortalité périnatale et néonatale. En outre, les grossesses à répétition de survenue rapide sont plus fréquentes pendant l’adolescence. Pour prévenir les grossesses et les naissances rapprochées dans ce groupe d’âge, MCSP développe des interventions pour les adolescents et les nouveaux parents, et prépare les prestataires à fournir des services aux femmes sous leur supervision. Cela comprend un paquet de counseling selon l’âge et le stade sur la planification et l’espacement idéal des grossesses, la PFPP, la prise de décision de PF équitable à l’égard des genres (qui implique les hommes et autres influenceurs), le soutien pour l’allaitement maternel, et les soins aux nourissons.

Photo: Une sage-femme au Nigéria conseille une cliente sur la planification familiale (Karen Kasmauski/MCSP)

USAID1300 Pennsylvania Avenue, NWWashington, DC 20523United Statestel: +1 202.712.0000AOR: Nahed Mattanmatta@usaid.gov

MCSP1776 Massachusetts Avenue NW Suite 300 Washington, DC 20036United Statestel: +1 202.835.3100info@mcsprogram.orgDirector: Koki AgarwalKoki.Agarwal@mcsprogram.org

www.mcsprogram.org

twitter.com/MCSPglobal

facebook.com/MCSPglobal

A PROPOS DE MCSP

Le Programme USAID pour la survie de la mère et de l’enfant (MCSP) est un accord global de coopération consistant à introduire et appuyer des interventions de santé à haut impact dans 24 pays prioritaires. Il vise à mettre fin, en l’espace d’une génération, aux décès infantiles et maternels évitables. Le point focal du programme est d’assurer que toutes les femmes, tous les nouveau-nés et tous les enfants les plus démunis aient un accès équitable à des services de santé de qualité dans le but de sauver des vies.

MCSP appuie les programmes de santé maternelle, néonatale et infantile, la vaccination, la planification familiale et la santé de la reproduction, la nutrition, le renforcement des systèmes de santé, l’eau, l’assainissement, l’hygiène, la lutte contre le paludisme, la prévention de la transmission du VIH de la mère à l’enfant, les soins et le traitement pédiatriques du VIH.

www.mcsprogram.org