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Tracking Scale Up of Maternal and Newborn Health InterventionsJeffrey M. Smith MCHIP
Interventions for Impact in Essential Obstetric and Newborn CareAfrica Regional Meeting, 21-25 February, 2011
Scale up of PPH and PE/E interventions
4
Where are we? And how do we know?
How far do we have to
go?
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
PATHWAY TO IMPLEMENTATION OF POSTPARTUM HEMORRHAGE PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
MCHIP/USAID active programsOther partners active programsAddressed previously, not activeNo programs
PATHWAY TO IMPLEMENTATION OF POSTPARTUM HEMORRHAGE PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
MCHIP/USAID active programsOther partners active programsAddressed previously, not activeNo programs
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
ANGOLA: PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
MOZAMBIQUE - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
Introducing innovation Moving toward sustainable impact at scale
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
GHANA - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
GHS and partners active programingOther partners, with GHS support
Addressed previously, not active
No programs
SOUTH SUDAN - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
LIBERIA - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
ETHIOPIA: PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
MADAGASCAR- PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
MALAWI - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
NIGERIA: PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
RWANDA - PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
SENEGAL: PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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/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 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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour0% 25% 50% 75%
100%
MCHIP/USAID active programsOther partners active programsAddressed previously, not activeNo programs
81%
UGANDA: PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
ZAMBIA: PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
ZIMBABWE: PATHWAY TO IMPLEMENTATION OF PPH PREVENTION AND MANAGEMENT AT SCALE
Global ActionsNational Strategic Choices
Program ImplementationSustainability /
InstitutionalizationIntroduction Early Mature
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 IMPROVE
D MATERNAL HEALTH STATUS
M&EReadiness
assessmentPilot project
dataSurvey data
Indicators in HMIS
Routine monitoring
INTRODUCING INNOVATION MOVING TOWARDS SUSTAINABLE IMPACT AT SCALE
Coverage of uterotonic in third stage of labour
0% 25% 50% 75% 100%
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!!
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