maternal, newborn and child health programme

If concerns exist, JICA may also conduct a second round of ex-post evaluation seven years after project completion. Read more July 1, 2016 Human milk banks: Bringing superfoods to all babies Oct. 11, 2017 There were 73 projects in the sample, which accounted for 43% of total MNCH funding during the evaluation period. Finding 17: Although no mechanism existed to assess the sustainability of MNCH projects after funding ended, evidence suggested that the effects of some MNCH interventions would likely endure beyond the duration of the project. Recommendation 5: Provide staff with sufficient and timely access to internal technical expertise, particularly health and gender specialists. Final ReportInternational Assistance Evaluation Division (PRA)Global Affairs CanadaMay 2019. Within the community, community care comes through the training and support ofCommunity Health Workers(CHWs). Donor partners (as well as national and subnational partner-government representatives) recognized Global Affairs staff for their positive efforts and participation in policy dialogue in all countries sampled. MNCH 1.0: Community Based Health Training and Practice in Mozambique (University of Saskatchewan): The Community Based Health Training and Practice Program expanded the capacity of a Mozambique health-training centre (the Massinga Centre) from 60 to 300 students per year, exceeding its target. External partners emphasized an ongoing need for the existing areas in MNCH which Global Affairs has been funding. In the two minutes it will take you to read this text, more than 30 children under the age of five will die. Finding 1: Global Affairs MNCH programming was aligned with partner government priorities and local needs in all countries sampled. 1113 Production, deployment and equitable distribution of a sufficient number critical health worker cadre). Even where the context may be stable, efficiency was challenged when working within country systems with limited capacity and human resources. 1134 Technical assistance provided to DHMTs to develop locally tailored interventions to address gender related barriers to health, services, and their underlying causes, 1211 Health commodities (e.g. Senior managements communications supporting innovation have been visible and numerous. Mothers and children are protected from infection and disease. This tailoring was important because the 2015 MNCH Formative Evaluation had reported an imbalance of projects addressing supply versus demand issues in MNCH. To support the sustainment of results, programs can better incorporate sustainability considerations into the planning and design phase of projects to ensure the appropriate transition of resources, skills and knowledge at the end of the intervention. The disbursement of project funds was generally timely, but corporate issues hampered efficiency, including the frequent turnover of Global Affairs personnel, and slow project- and planning-approval processes. Health workforce 3. bed nets) procured and supplied, 1212 Vaccines and preventive health services provided, 1213 Women and children informed of comprehensive preventive and treatment care choices, 1214 Routine community outreach including campaigns and essential health services as well as key environmental health interventions provided by health workers in underserved areas, 1221 Information on sanitation and hand washing practices provided to families, including women and children. World Vision equips faith communities through itsChannel of Hope for MNCH programmes-a powerful methodology that serves to change behaviour and strengthen health systems. Affordable, eco-friendly menstrual health products in rural Rwanda (Sustainable Health Ventures): This patented method converted locally available banana fibres into the absorbent core of disposable menstrual pads without the use of chemicals. Have any innovative practices, approaches, and new ways of working been integrated into Canadas MNCH programming in recipient countries? One Sustainable Health for All 5 - 7 July 2023 Partner resources G20: Maternal, Newborn, Child and Adolescent Health and Well-Being: A Critical Agenda for the G20 UNICEF: Improving the civil registration of births and deaths in low-income countries IRC: Violence Against Health Care in Conflict 2022 IFMSA: Policy Brief - Adolescent Health and Survey It was noted that several projects had proactively integrated cross-sectoral considerations. Lack of information on tolerance for risk and experimentation, Programming tools and data systems that were not modernized or supported. Evaluation of a large-scale reproductive, maternal, newborn and child Similarly, the analysis of ratings from MSRs revealed no notable differences by partner type in terms of whether projects were on track to achieve expected intermediate outcomes. At the same time, Global Affairs staff at various levels expressed concern and frustration with the institutional and individual challenges associated with one to three-year postings for overseas rotations and mobility at headquarters. These solutions are often simple and inexpensive. Canadas commitments and the leadership role it has played have drawn sizable resources and international attention to MNCH issues. In these types of contexts, UN security infrastructure can assist in accessing isolated areas and delivering aid. This could be done at the country level. This evaluation of the MNCH Initiative assessed the relevance, effectiveness, sustainability and efficiency of programming in order to inform decision-making and to support policy and program improvements. At the same time, a need for more emphasis on an integrated, multi-sectoral approach to further address determinants of health and the needs of adolescents was identified. A more integrated approach would align with the United Nations Global Strategy for Womens, Childrens and Adolescent Health 20162030, which advocates a multi-sectoral approach. Workplaces of all types are finding solutions to help their employees meet their breastfeeding goals. A total of 4,716 neonatal home visits were conducted; as a result, the proportion of mothers and infants receiving three neonatal visits within seven days of birth increased to 88.5%, exceeding the target of 75%. Sub-Saharan Africa Branch (WGM), rather than programming that is disbursed by the Global Issues and Development Branch (MFM) or by the Partnerships for Development Innovation Branch (KFM). The MNCH 1.0 and MNCH 2.0 Performance Measurement Frameworks described intended outcomes for the health system strengthening pillar as improving the capacity of governments and health institutions to manage health strategies and systems. The UN Global Strategy forEvery Woman, Every Child(EWEC), Born on Time, a public private partnership to prevent preterm birth, collarborates with World Vision, amongst other NGO's, Plan International Canada, Save the Children, and Johnson&Johnson. Examples included: Several lines of evidence highlighted the need for some projects to place more effort on engaging other sectors, such as infrastructure, agriculture, and education, to develop greater potential for effective and sustainable interventions. It would be a valuable overarching theme for all MNCH projects, Health Systems Strengthening Approach Text Equivalent(Graphic above depicts the Health Systems Strengthening Approach, in which the six system building blocks of 1. A similar finding was noted in the Synthesis of Evaluations of Grants and Contributions Programming funded by the International Assistance Envelope (2017). Information 4. On some occasions, slow processes hindered Canadas ability to take a leadership role or respond in a timely manner to requests from partner governments. Most of them will succumb to preventable causes, such as diarrhoea, pneumonia, childbirth complications and malaria. During the one-week vaccination campaign, 4,078,637 children aged 6-59 months received a measles vaccination (105% of target). Most of the 62 sampled projects fall under 3: Mostly met. PDF May 2021 MATERNAL, NEWBORN AND CHILD HEALTH - World Health Organization This evaluation assessed the integration of gender equality as a cross-cutting priority (201011 to 201617), and more recently under the Feminist International Assistance Policy (from June 2017 to the end of fiscal year 201718). Thus the total number of qualified respondents for the evaluation on this topic would be 18 (n=18). The nature of engaging with national partners via pooled/basket funding could provide a more global picture of results and national policy developments, as opposed to working separately with other partners. At the project level, limited windows for project implementation also put projects at risk of not achieving sustained results. The analysis relied on document review and interviews with Global Affairs staff, implementing partners, and other donors who were currently on the ground in South Sudan. These positive findings across types of partners were not a surprise, since the majority of partners in the sample were long-term trusted partners, for which Global Affairs carries out regular due-diligence processes. Implementing partners for projects in the sample indicated that funds were generally disbursed promptly. Improving maternal, newborn, and child health is central to PATH's mission and work around the world. WHO EMRO | Maternal and child health | Future of health | About WHO These challenges included retention of health workers, procurement and distribution of medicines, operation of ambulances, maintenance of training programs, and provision of routine vaccination services. To what extent did the activities funded under Global Affairs Canadas MNCH initiatives achieve their immediate outcomes? Glossary of Terms. The evaluation combined a summative evaluation of MNCH 1.0 programming from 201011 to 201516 and a formative evaluation of MNCH 2.0 programming from 201516 to 201718. Climate Change & MHPSS: What are the key issues affecting children and families? For example, it took eight months to approve a no-cost extension for the Making Motherhood Safe project in Tanzania. As part of Pillar 4 programming, Global Affairs engaged Johns Hopkins University through a few projects to help improve reporting at the impact level (country level). Maternal and Child Health | Basic Page | U.S. Agency for International Antenatal care (four or more visits): percent of women attended at least four times during pregnancy by any provider for reasons related to the pregnancy. About three-quarters of SRHR Baseline funding is also considered under MNCH 2.0, In March 2017, shortly before the June 2017 adoption of the new Feminist International Assistance Policy, the Government of Canada announced an additional $650 million commitment over three years (201718 to 201920) for SRHR programming. Between 201011 and 201718, MNCH disbursements totaled $5.13 billion, with average yearly disbursements of $641 million. These findings may provide insights on potential biologic pathways through which maternal health characteristics may impact fetal metabolic programming and child growth patterns. Improving Postnatal Care for Newborns in Community and in Clinics Within the community, community care comes through the training and support of Community Health Workers (CHWs). While individual project-level reporting on results was available, it was not possible to accurately report on aggregate MNCH results for all 987 projects across the department. Maternal, Newborn and Child Health Programmes in India [Percent of total] projects in which the [percent] of women aged 15-19 who have their need for family planning met has increased, [Percent of total] projects in which the [percent] of sick children under 5 receiving treatment for malaria, pneumonia, or diarrhea has increased, [Percent of total] projects in which the [percent] of children under five with signs of malaria, pneumonia or diarrhea who sought care from a trained care provider has increased, [Percent of total] projects in which the [percent] households with access to a safe water supply has increased, [Percent of total] projects in which the [percent of] households and institutions (schools/clinics) with access to adequate sanitation and hygiene facilities have increased, [Percent of total] projects in which the level of coverage of nutrition services has increased, Health system (Ministry of Health and partners). The Network establishes partnerships between service sectors, uses data to drive . Canadian universities and research institutes also offered Canadian academia and civil society opportunities for learning and exchange. Health sector SWAps have been lauded globally for contributing to the development of robust national health policies and frameworks, improving accountability between donors and country governments, and strengthening country ownership and management systems. Under-five and neonatal mortality rate estimates (per thousand live births) Text equivalentUnder-five and neonatal mortality rate estimates (per thousand live births) ; For Bangladesh, Mozambique, South Sudan and Tanzania, the Under 5 Mortality rate and Neonatal mortality rates slope down from 2010 to 2017. The types of results reported included:Footnote 6. However, evidence collected from interviews and site visits in all four sample countries indicated that the achievements made by some MNCH projects were likely to be sustained, for example: How Japan Assesses SustainabilityThe Japan International Cooperation Agency (JICA) uses amore comprehensive assessment of sustainability over time. For example, the International Centre for Diarrhoeal Disease Research in Bangladesh exceled at developing innovations, while local and Canadian universities have been lauded for their knowledge-sharing and for generating technological innovations for MNCH. For Canada, MNCH includes programming that strengthens health systems, reduces the burden of diseases, improves nutrition and ensures accountability for results. 1112 Gender training and awareness-raising information provided to health workers on the socio-cultural determinants of MNCH and the importance to address harmful practices by health systems. Associations between metabolites associated with maternal health characteristics and child BMI were modified from 1-3 years (interaction: p < 0.05). Chlorhexidine (John Snow International): In Nepal, the risk of newborn death decreased by 23% through the use of chlorhexidine on newborns umbilical-cord stumps. In areas where Canada has been working to achieve long-term results, such as health systems strengthening, longer timelines were even more important. about PMNCH members and their work, which enables partners to search, Finally, corporate reporting teams had to reconcile project reporting, but they had neither results-based management nor content expertise. Maternal and Child Health Integrated Program (MCHIP) MCHIP addresses the barriers to accessing and using key evidence-based interventions across the life stagesfrom pre-pregnancy to age 5by linking communities, primary health facilities and hospitals. According to interviewees, the lack of availability of the few health specialists also limited Global Affairs ability to meaningfully engage in relevant technical and strategic discussions with other donors and multilaterals. They are able to manage and disburse larger volumes of money, access pools of expertise and in-country networks, and sometimes have close relationships with national governments. Promoted by the World Health Organization (WHO), it is the globally accepted approach to building the capacity of health systems to deliver integrated and equitable MNCH services, and has been adopted by major donors, including the United States, the European Union, the UK, Japan, and Sweden. Of the 43 departmental indicators and the 18 KFM indicators: A more detailed comparison of indicators can be found in Appendix E. Finding 8: Reporting challenges for effectiveness across the department were compounded byinadequate reporting software that was not fit for purpose, a lack of adequate technical support for staff, weak country-level data systems, and a lack of attention to data projects designed to help Global Affairs report at the impact level. n=3); the deputy directors responsible for that country (n=2); the head of mission for that country (n=1); a Global Affairs health specialist (n=1); the implementing partners (n=5); beneficiaries (n=5); and a donor partner (n=1). An area of focus for the evaluation was data. In the absence of aggregate corporate results data, the evaluation team conducted a thorough analysis of results in the sample to assess effectiveness.Return to footnote 5 referrerFootnote 6These results were reported for the target area of the project, which could be local, regional, or national.Return to footnote 6 referrerFootnote 7The above timeline includes only the more recent MNCH 2.0 commitment, as the 2015 formative evaluation covered the performance management under MNCH 1.0 (prior to 2014).Return to footnote 7 referrerFootnote 8A no-cost extension is considered when a partner requests additional time to implement project activities and achieve results without additional funding.Return to footnote 8 referrerFootnote 9The analysis of evaluation question #5 (In which contexts are different types of partners able to achieve maximum results?) Bildungsprogramm mit Handreichungen fr saarlndische Kindergrten und Krippen - 14,90 . Finding 22: Insufficient internal specialist resources negatively impacted timeliness of program delivery, as well as Global Affairs ability to engage in technical and strategic discussions. Maternal, Newborn, and Child Health - World Vision International Maternal mortality in Northern Nigeria is among the highest in the world. Canadas MNCH programming in the four sample countries contributed to decreased national rates of under-five child mortality. While 15% of the MSRs were not available, 82% of the reports (51 of 62) were rated 3 or higher, indicating that a project had mostly met its outcomes. If Global Affairs were able to effectively aggregate its project level results (immediate and intermediate outcome data), the next logical step would be to report on results achieved at the country level and then the departmental level. UNFPAs midwifery project in South Sudan has paired South Sudanese midwifery graduates with Canadian midwifery graduates through the Canadian Midwives Association in a peer-exchange initiative. Health specialists gave input on the health content, but did not necessarily understand results-based management. However, a few projects lacked attention to cross-sectoral issues and consequently faced the risk of a reduced likelihood of sustainable results. For a number of projects within the sample, Global Affairs staff participated in health sector planning and coordination efforts with donor and implementing partners, as well as partner governments. For instance, some multilaterals are recognized as leaders in innovations and disease responses, while others have been criticized for poor results-tracking, insufficient attention to gender equality, inadequate consultation processes, and overlooking the most vulnerable. Comprehensive Results Framework: Given that priority commitments change, a streamlined process could be established to develop and roll-out coherent Department-wide results framework (including program logic model, performance measurement framework with international best-practice aligned indicators, and methodology notes for partners). This was challenging, time-consuming and confusing for these partners, who had to repeatedly orient new officers to their projects. In addition, these projects had not been designed to ensure appropriate transfer of resources, skills and knowledge at the end of the projects intervention. Our work: Aims to make sure all moms, babies, children, and youth are physically and mentally healthy Spurs national guidelines for women's and children's checkups as well as newborn screenings Trains the public health workforce to meet the specific needs of maternal and child health populations As a result, funding for MNCH initiatives continued to rely heavily on international assistance. 1311 Training and skills re-enforcement on maternal and child nutrition provided to health workers, 1312 Nutrition training provided to families, with particular attention to family members (husbands, in laws responsible for shopping or intra-household food allocation), 1313 Household, Health and other nutrition-related workers trained on maternal and child nutrition and related services, including gender equality issues relating to maternal and child nutrition, 1321 Technical assistance and support on what provided to national stakeholders, 1322 Advocacy and policy dialogue for nutrition best practice and resource allocation conducted, 1333 Support provided to governments and health institutions on implementation and recruitment strategies, 1331 Nutrition commodities (e.g. World Vision participates in International Conferences, such as Women Deliver and the International Conference on Family Planning. Specifically, Grand Challenges Canada has faced some challenges in coordinating with wider government efforts and strengthening its monitoring capacity. Efforts were made to prioritize the voices of women and girls. When there were long gaps between when a partner was ready to implement their project and a project was approved, there could be real impacts. MNCH 1.0 & 2.0: Support to Micronutrients Initiative (Nutrition International): From 2014 to 2017, the Support to Micronutrient Initiative is estimated to have averted between 600,000-1.2 million deaths of children under five, protected 34 million newborns from iodine-deficiency disorders and averted 730,000 mental impairments in newborns. Leadership and governance provide access, coverage, quality and safety, and lead to the overall goals and outcomes of 1. Ensure that the sequencing of corporate reporting systems is aligned to avoid retrofitting. Improved health 2. In 2012, World Vision partnered with John Hopkins University to begana five year study,Child Health and Nutrition Impact Study(chNIS), designed to measure the impact that MNCH is having on newborns and mothers in Cambodia, Guatemala, Kenya and Zambia. Postnatal visit for mothers and babies: percent of mothers, and of babies, who received postnatal care within two days of childbirth. Frontiers | Integrating maternal, newborn, child health and non Program Background, Evaluation Scope, and Methodology, Appendix A: Evaluation Terminology and Limitations, Appendix C: Innovative Technology and Approaches. This negatively affected Global Affairs ability to roll up and report on results at the departmental level for this flagship initiative. Examples of multi-level capacity building: Given the importance of health systems strengthening for all health-support programs, it would be better framed not as a programming pillar, but as an overarching theme through which all health investments are evaluated, whether they concern training of frontline health personnel, disease, nutrition, data, or other areas. Medical products, vaccines, and technology 5. Financing and 6. At the same time, staff reported that heavy demands to support programming across the Department meant that the relatively small number of specialists did not have sufficient time to stay abreast of relevant practices in their area of work. Based on an assessment of risk at project closeout, JICA conducts ex-post evaluations up to three years after the completion of the project. Text Equivalent14 of the 18 PMNCH (KFM) indicatorsFootnote 1 had some degree of alignment PMNCH indicators:Antenatal care (four or more visits): percent of women attended at least four times during pregnancy by any provider for reasons related to the pregnancy.Skilled attendant at delivery: percent of live births attended by skilled health personnel.Postnatal visit for mothers and babies: percent of mothers, and of babies, who received postnatal care within two days of childbirth.DTP3 immunization coverage: percent of children aged 12-23 months who received three doses of diphtheria, tetanus and pertussis vaccine (DTP3).Exclusive breastfeeding (<6 months): percent of infants aged 0-5 months who are exclusively breastfed.Vitamin A supplementation coverage: percent of children aged 6-59 months who received two doses of vitamin A during the previous year.Demand for family planning satisfied: % of women aged 15-49, either married or in union, who have their need for family planning satisfiedOral rehydration salts: percent of children aged 0-59 months with diarrhea who received oral rehydration salts.Zinc for treatment of diarrhea: percent of children aged 0-59 months with diarrhea who received zinc supplementation.Antimalarial treatment: a) % of children under 5 years old with fever in the previous two weeks for whom advice or treatment was sought; b) % receiving first line antimalarial treatment among those children with fever in the last two weeks who received any antimalarial.Care-seeking for pneumonia: percent of children aged 0-59 months with suspected pneumonia who are taken to an appropriate health provider.Use of improved drinking water sources: percent of the population using improved drinking water sources.Use of improved sanitation facilities: percent of the population using improved sanitation facilities.Appropriate infant and young child feeding practicesThe first 6 PMNCH indicators match the first 6 Corporate indicators (see below)Among the 43 Corporate indicators, 12 had some degree of alignmentCorporate Indicators[Percent of total] projects in which the [percent of] women attended at least four times during pregnancy by any provider for reasons related to the pregnancy has increased. Our MNCHN program takes a health-systems oriented, multi-sector approach to strengthening the continuum of care for women, children, families, and communities. However, overall results for MNCH across all branches could not be aggregated to the departmental level. In the countries examined, respondents confirmed that Canada engaged in project-design consultations with multiple levels of government and other stakeholders (including the private sector, non-governmental organizations (NGOs), civil-society organizations, universities, multilateral organizations, as well as with partner donors). Health workers can include physicians, nurses, midwives, community health workers, and other cadres involved in planning, data analysis, financial management, HR, and administration, etc. Midwifery capacity was strengthened through collaboration with the Canadian Association of Midwives and the South Sudan Nurses and Midwives Association, along with the development of new policies, guidelines, and quality-assurance instruments. This is on top of maintaining existing program funding of $1.75 billion over five years. The majority of MNCH projects sampled made progress on achieving their intended outcomes. The evaluation team requested this information from officers when developing the evaluation project sample, and made observations based on each projects activities and background information. Sometimes these practices were taken from development work in another area and applied in that country or context. In the Mtwara and Lindi regions, registration has reached almost 100% of children under age five. Recommendation 3: Strengthen and modernize corporate reporting systems, including both software and IT systems, which support all international assistance programming, especially thematic programming like MNCH. Medical products, vaccines, and technology 5. Financing and 6. Health workforce 3. The DEPB has since been replicated in 10 other districts. At the same time, the evaluation found a few instances of project overlap and duplication among donors. Throughout the report, the terms some, many and most are used to denote percentages of qualified respondents on a topic: 25% to 49%; 50% to 74%; and 75% to 99.9%, respectively.

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