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Tracking Scale Up of Maternal and Newborn Health Interventions Jeffrey M. Smith MCHIP Interventions for Impact in Essential Obstetric and Newborn Care.

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Presentation on theme: "Tracking Scale Up of Maternal and Newborn Health Interventions Jeffrey M. Smith MCHIP Interventions for Impact in Essential Obstetric and Newborn Care."— Presentation transcript:

1 Tracking Scale Up of Maternal and Newborn Health Interventions Jeffrey M. Smith MCHIP Interventions for Impact in Essential Obstetric and Newborn Care Africa Regional Meeting, 21-25 February, 2011

2 Child Mortality: 4 countries in Africa 2 ChadEthiopia Kenya Zambia

3 Maternal Mortality: 4 countries in Africa 3 ChadEthiopia Kenya Zambia

4 Scale up of PPH and PE/E interventions 4 Where are we? And how do we know? How far do we have to go?

5 Awoonor-Williams, et al. HEALTH POLICY AND PLANNING; 20(1): 25–34

6 Conceptual Map for Scale Up  Phases of implementation  Sequential in logic, not linear in time  An attempt to graphically represent the elements of a scale up approach  Not exhaustive or able to capture all details 6

7 PATHWAY TO IMPLEMENTATION OF POSTPARTUM HEMORRHAGE PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in- service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100% MCHIP/USAID active programs Other partners active programs Addressed previously, not active No programs

8 PATHWAY TO IMPLEMENTATION OF POSTPARTUM HEMORRHAGE PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in- service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100% MCHIP/USAID active programs Other partners active programs Addressed previously, not active No programs

9 Mapping Scale up Process at National Level  Analysis of national/MOH situation  Participants and local counterparts  Consideration of USAID supported efforts or other partner/donor supported efforts  Previous efforts that were fully addressed in the past 9

10 ANGOLA : PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in- service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100%

11 MOZAMBIQUE - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in-service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring Introducing innovationMoving toward sustainable impact at scale Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100%

12 GHANA - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in-service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100% GHS and partners active programing Other partners, with GHS support Addressed previously, not active No programs

13 SOUTH SUDAN - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in- service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100%

14 LIBERIA - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in-service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100%

15 ETHIOPIA : PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in-service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100%

16 MADAGASCAR - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in-service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100%

17 MALAWI - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in-service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100%

18 NIGERIA : PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in-service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100%

19 RWANDA - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in-service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100%

20 SENEGAL: PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/procureme nt, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in-service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100% MCHIP/USAID active programs Other partners active programs Addressed previously, not active No programs 81%

21 UGANDA : PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in-service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100%

22 ZAMBIA : PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in-service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100%

23 ZIMBABWE : PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE Global Actions National Strategic Choices Program Implementation Sustainability / Institutionalization IntroductionEarlyMature Global advocacy and partnerships: Global action to support work on reduction of PPH Global clinical and program approaches: Evidence-based interventions for prevention and management of PPH demonstrated PPH policy: AMTSL/misoprostol use; Expanded job descriptions for skilled birth attendant cadres managing PPH; PPH service delivery guidelines Health system governance: Proactive financing of maternal health services Drugs & equipment: Oxytocin/ misoprostol procurement, logistics, distribution Service delivery capacity at sites: Reliable infrastructure, personnel, and systems to deliver services Health workers training systems: For PPH prevention and management Community mobilization: Awareness raising of PPH; Birth preparedness Pilot programs: Phase 1 implementation of misoprostol and/or AMTSL for all skilled birth attendant cadres Program initiatives in obstetric and postpartum management: Quality of care; Clinical training; Supervision Pharmaceutical systems: Uterotonics on Essential Drug List and in Drug Registration; Supply chain management National advocacy: Expansion of national program and highlight work of champions Standardization: Quality of care approaches; Government led training expansion Programmatic growth: Adding districts, partners, financing Training programs: Government budgeted training programs on PPH; PPH competencies in pre-service and in-service curricula Clinical coverage: High coverage use of a uterotonic; Public and private implementation Drug & equipment availability: Drugs and supplies in government routine procurement mechanisms REDUCTION OF PPH AND IMPROVED MATERNAL HEALTH STATUS M&E Readiness assessment Pilot project data Survey data Indicators in HMIS Routine monitoring INTRODUCING INNOVATIONMOVING TOWARDS SUSTAINABLE IMPACT AT SCALE Coverage of uterotonic in third stage of labour 0% 25% 50% 75% 100%

24 National Maps of Scale up Process  Tracking progress over time  Platform for national and international conversation about progress  Identifying gaps and securing additional support / resources.  Please view the posters in the corridor!! 24

25 Thank you! wwww.mchip.net Follow us on:


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