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Project AXxes/USAID

Project AXxes/USAID. Project Overview March 24 th , 2009. Three Components of Project AXxes for HZ Development: A: Increase access to… integrated PHC B: Increase capacity of Health Zones & referral system  C: Reinforce national programs & provincial/district offices.

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Project AXxes/USAID

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  1. Project AXxes/USAID Project Overview March 24th, 2009

  2. Three Components of Project AXxes for HZ Development: A: Increaseaccessto… integrated PHC B: Increase capacity of Health Zones & referral system  C:Reinforce nationalprograms& provincial/district offices

  3. Component A : Increased access to integrated care.

  4. 1. Reinforcement of Rural HC Facilities Photo Clemmer /Kisangani/07

  5. 1a. Rehabilitated 218 HC facilities! Before After Photo: CRS/Apr 08

  6. 1b. Equipped them with: • Solar Lights • Diagnostic Kits • Registers/Charts/ • Equipment • Medicine

  7. 1c. Supplied them with: • Pharmaceuticals • Gloves • Gauze • Waste Disposal • Syringes • Means of Transport

  8. 2. Training of personnel • Over 23,000 trained to date • PMA, Reproductive Health, • Rational Prescription • Newborn Care. Family Planning • C-IMCI, etc. • Etc.

  9. 3. Established Pharmaceutical Supply Line • Established 5 regional project depots • Purchased over 5M worth of W.H.O. essential medicine • Implementation of drug credit system to encourage recycling • Training in stock management/recycling/ordering

  10. 4. Support of clinical services

  11. 4a. Vaccination Services • Re-established cold chain • Supply of solar and kerosene units • Supply of vaccination related material (i.e. syringes) • Support of campaigns and routine CPS clinics • Monitoring • Surveillance

  12. Immunizations

  13. 4b. Family Planning Services • Established 864 sites • Training of family planning prestataires • Provision of family planning clinical kits • Order and delivery of products (OC, IUD, Depo, Cycle Beads, etc)

  14. 4c. Reproductive Health Services(safe delivery, AMSTL, and newborn resuscitation)

  15. 4.d Antenatal Services

  16. 4e. Community IMCI • Trained staff in 929 clinics in basic Clinical-IMCI • Trained over 4700 relais to date in community based-IMCI • Establishment of up to 200 community care sites (ongoing) • Printing of flipcharts/ IEC material • Dissemination of health messages (ten commandments of health) to households

  17. Key Behavior Messages for’ Care Seeking’ and for ‘Malaria Treatment and Prevention’

  18. 4f. Micro-nutrient support • Vitamin A campaign and routine use of Vitamin A with support from UNICEF and HKI • Introduction of Zinc nationwide as Rx protocol (USAID first to introduce in provinces)

  19. before 5.Water and Hygiene • Constructed/Capped over 280 water springs • Trained water/sanitation engineers in all supported HZs • 212 clean village projects • 3500 latrines fabricated (UNICEF) after

  20. 6. Disease Specific Intervention

  21. 6a. Malaria • 1. Purchase and delivery of 540,000 ITNs • Introduction of ACTs* to all clinics as primary treatment of Malaria • ITP treatment instituted in all ANC clinics *Imported 1,165,875 doses of ACT

  22. 6b. HIV • Blood Safety: Introduced and support screening for HIV, RPR, Hepatitis B in all 57 zones. • Establishment of 129 PMTCT sites with 63 pilot programs in triple therapy ARV with support from Axios and Abbott • Treatment of STI/co-infection TB/ARV therapy with Global Fund

  23. 6c. Tuberculosis • Support of TB Detection and Treatment Programs • Supply of government provided medicine to sixteen isolated health regions • Training, supervision, surveillance in high risk areas • Production of PATI-4 module

  24. 6d. GBV Related Issues • Community wide campaigns on prevalence and awareness • Focused intervention to at risk groups • IEC awareness • Fistula repair and prevention

  25. Component B Increase capacity of Health Zones & referral system 

  26. 1. Reinforce and Support Formative Supervision of all Health Centers

  27. 2. Training of ‘Equipe Cadre’ • Health zone management (commodities and finance) • Disease Surveillance • Monitoring and Evaluation • Adherence to ordinogramme (clinical guidelines) • Zone specific training • Management • PMA • Surveillance

  28. 3. Surveillance and Monitor Vital Health Statistics • 1. Calendar and Charting of indicators • 2. SNIS • 3. Dashboard (Tableau) • 4. Monthly reporting and verification • 5. Support monthly health zone reunion with staff from all HCs

  29. 4. Transparence and Governance • 1. CODESA health center board • 2. Annual HZ meetings • 3. Co-gestion of health facilities • Community planning of programs and campaigns

  30. 5. Promising Partners Grants • Support of local NGO-initiated income generating projects to sustain health projects • CODESA (GBV) • AFIA (nutritional) • HALT-SIDA (BCC) • VAS (nutritional)

  31. Livelihood agricultural project linking health center (Project) AXxes with DEVRU Photo: Niles/Mutoto CS/2008

  32. Component C: Reinforce national programs & provincial/district offices

  33. 1. Supervision and functioning of District Medical Offices

  34. District Medical Office of Kamina

  35. 2. Policy Review and Revisions • 1. PMTCT • 2. SNIS • 3. Reproductive Health • 4. Family Planning • 5. Malaria treatment • 6. Essential Drug List • 7. Training protocols

  36. 3. Annual Reviews, Strategy Planning, Conferences and Work Plans (PNLP, PNLS, PNSR)

  37. 4. Data Storage and Management at Level of Ministry of Health

  38. IV SHORTFALLS

  39. Need to promote care-seeking behavior

  40. Breaking the 35% barrier

  41. Dr Lauren Blum (Care Seeking Behavior Study)

  42. Decrease distance and barriers to care

  43. Establishment of 200 Community Care Sites for Clinical-IMCI

  44. Sustainability of what was built

  45. Understand Partnership • 1. Primes • 2. Incentives • 3. Performance Contracts • 4. Integrity • 5. Unmet expectations • 6. “you didn’t give us.. • oil for the oil change • dispenser bags for prescription meds • Sand for the concrete

  46. V Challenges

  47. 1. Povertyas an impediment to access to care Photo: Lodja.June 2008/Mulongo

  48. 2. Infrastructure (or lack of) as an impediment of access for project personnel Photo: ECC/AXxes 2008

  49. Road Transport in DR Congo

  50. Photo: National Highway #1 BDD/Mar 07/Clemmer

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