As a result, funding for MNCH initiatives continued to rely heavily on international assistance. Economic production activities were being operated on a cost-recovery basis to generate revenues after financial support ends. Local partners could ensure that services continued in the case of the evacuation of international partners, and could be well suited to pilot projects due to their capacity for creating innovative solutions. In the absence of departmental indicators. Between 201011 and 201718, MNCH disbursements totaled $5.13 billion, with average yearly disbursements of $641 million. According to data from CFO-Stats*, the average length of MNCH projects overall was 4.7 years (the median was 5.0 years). Within the communities, World Vision protects mothers and newborns from deadly diseases through medical treatment and interventions. The Clinton Health Access Initiative (CHAI) worked with the University of British Colombia (UBC) on cold-storage technologies for vaccine-storage rooms. About the Program. We invest in programs & initiatives, many that produce capacity building resources for Maternal and Child Health (MCH) awardees and the broader MCH community of practitioners. The document review analysis indicated that overall, projects by all types of partners achieved notable results, although results varied in scope and scale. A sophisticated, up-to-date and interactive database of essential information 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. Information 4. The Global Financing Facility is introducing an innovative approach to administering pooled funds in support of government health budgets in Mozambique and Tanzania. 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 To carry out a robust analysis of which partners can achieve maximum results, a test would need to be carried out where each type of partner implemented the exact same portfolio of projects (including different contexts, sizes, geographic scope and funding amounts, etc. At the time of data collection during the summer of 2018, there was widespread confusion among program and project staff interviewed about how SRHR would fit into MNCH, or whether it had replaced MNCH. Office of Health and Human Services (EOHHS) regions. Efforts were made to prioritize the voices of women and girls. Infos/Beratung 0761 / 45 39 039 Eine Fachklinik der Kur + Reha Klinik GmbH. The types of results reported included:Footnote 6. In the two minutes it will take you to read this text, more than 30 children under the age of five will die. While MNCH and SRHR are closely connected, this new commitment is outside the scope of this evaluation. Since 2010, Canada has played a leadership role in global action to end the preventable deaths of mothers, newborns and children. Through Canadas support, this mechanism was able to quickly run calls for proposals and fund innovative projects. [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). Our work touches lives around the world every day - often in invisible ways. Despite large amounts of funding set aside for decentralized evaluations, few were commissioned. ISA Conference 2023: Reducing Inequality Local to Global, International Group B Strep Awareness Month, 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. To address gaps in national civil registration and vital services, UNICEF is using cellphone technology to register births electronically in Mozambique and Tanzania. Global Affairs staff and external stakeholders reported innovative practices at the project level that were closer to examples of established best practices. 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. Seven of the projects fell under both evaluation components. Canada maintained good working relationships with donor partners, as well as with health ministries. Finding 16: While Global Affairs has made efforts to promote innovation, staff expressed concerns that the Department did not yet have a culture that fully fostered innovation in employees daily work. Through refurbishing old wells and building new ones, access to clean drinking water in the project operational area in Tanzania increased from 25% to 65%. for Maternal, Newborn, Child and Adolescent Health and Ageing (MCA) WHO MCA has a leadership role in setting global research priorities and advancing thought leadership throughout different stages of the life course, from birth to ageing. Successful ideas were able to obtain subsequent stages of funding and would later be linked to other partners who would be able to bring these innovations to scale. UNICEF has been producing the reproductive, maternal, newborn, child and adolescent health country (RMNCAH) profiles every 1-2 years since 2005. As a result, the Government of Mozambique did not have the resources needed to provide health services. Insufficient internal-specialist resources also negatively impacted the timeliness of program delivery and limited Global Affairs staffs ability to engage on technical issues. These include the small sample size of some types of partners within the evaluation sample; the lack of a counterfactual for each project and its corresponding partner; the quality and availability of reporting; and the varying nature of projects that were carried out by different types of partners. At the same time, most of the projects in the sample contained elements of capacity building at different levels (local, regional, national) of the health system that could directly or indirectly result in health systems strengthening. After a consultative process, and in response to the 2016 Audit of MNCH Commitments, the Performance Management Framework with 43 departmental indicators was finalized and submitted to the Treasury Board Secretariat. World Vision is active in Health Systems Strengthening, and seeks to improve health systems through implementingCitizen Voice and Action, which provides a platform for dialogue between the government and the community to advocate for improved services. Thus the total number of qualified respondents for the evaluation on this topic would be 18 (n=18). The absence of data on project approval timelines limited the evaluation teams ability to assess the efficiency of internal processes, as well as the length of projects. Are there opportunities to improve the efficiency of programming? Access to gender specialists would ensure that project staff have the technical support they need to best respond to policy guidance and emerging requirements including more recent expectations stemming from the, Partnerships for Development Branch (KFM, 10%); $679 M, International Security (IFM, 0.5%); $29 M, Europe, Arctic, Middle East and Maghreb (EGM, 0.3%); $20 M, Strategic Policy Branch (PFM, <0.01%); $0.46 M, Enhanced Nutritional Practices for mothers, newborns, and children under five. These projects included multi-country projects to work with partner governments to develop national evaluation platforms; to strengthen data collection tools and approaches for all types of partners; and to pilot real-time results-tracking methodology. Some Global Affairs staff described a loss of credibility as well as lost opportunities. It evolved to better target key gaps identified in the 2015 formative evaluation. Participation in working groups and partnerships was negatively affected by slow inputs and comments. 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. Universities and research institutes were often strong partners for training and capacity building, and sometimes had strong connections to local networks. This suggests that there had not been enough clear messaging internally or externally around this new focus. For instance, facility-based births increased from 18,924 (2014) to 38,276 (2017) and active management of third stage labour increased from 9% (2014) to 41.2% (2017). At the ultimate outcome level, Canada has made a contribution to country-level improvements in child mortality, although maternal mortality remains a challenge in the countries examined. $3.5 billion MNCH 2.0 commitment announced. Finding 20: Slow project and planning approval processes during the evaluation period caused significant delays in project implementation. Canada was seen as a respected donor with a positive track record in contributing to national-level policy dialogue and donor coordination in the health sector in all countries sampled. In all four sample countries, partner governments offered limited national commitment and capacity to fully finance public healthcare. To what extent has programming in strengthening health systems helped to achieve greater results in other programming areas (disease, nutrition, and sexual reproductive health)? Health systems strengthening overarching theme: Given the widespread acceptance of health systems strengthening as a foundation for sustainable results, programs could consider adopting health systems strengthening as an overarching theme when proposing health investments. Managing staff mobility and rotation: International assistance branches could identify best practices and develop procedures to ensure robust knowledge transfer to incoming staff. Undertaking community sensitization activities to raise awareness and influence behaviour change among peer groups; Integrating sustainable agriculture practices and other business approaches to enhance economic self-sufficiency; and. This type of engagement facilitated the effectiveness of programming in achieving results. The RAcE initiatives also trained 8,900 CHWs, of whom about 7,400 were active at the time of program closure, and provided effective policy and strategy support to ministries of health, and informed WHO policy recommendations on community case management of malaria. 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. Strengthen and modernize corporate reporting systems, including both software and IT systems, which support all international assistance programming, especially thematic programming like MNCH. Formative Evaluation Sample: Of the 24 MNCH 2.0 projects selected for the formative evaluation component, two were included because of explicit funding requirements. In Tanzania, this was due to the need to disburse money out of cycle, which required a significant volume of documentation to justify release of payment and resulted in large delays. Findings from the document review also showed that many projects in the evaluation sample wereimplemented using multiple types of partners, thus adding to the complexity of the analysis and the difficulty to attribute results achieved to a single type of partner. Between 1990 and 2012, maternal mortality decreased by 42% and under-5 mortality by 45%. This system allowed the input of only narrative text; numbers and aggregate results could not be entered. Leadership and governance provide access, coverage, quality and safety, and lead to the overall goals and outcomes of 1. Leadership and governance provide access, coverage, quality and safety, and lead to the overall goals and outcomes of 1. Information 4. In addition: Recommendation 4: For future health programming, ensure that projects have sufficient time for implementation and the greatest chance to achieve longer-term outcomes by considering project durations of up to ten years, where appropriate. Finding 7: The Department could not fully report on the overall results of the MNCH initiative as a key thematic priority across the Department, primarily because of a misalignment of performance indicators between the project and the departmental level. Although many projects in the evaluation sample focused on health system strengthening and capacity building at all levels, concerns were raised in 23 projects in which activities exceeded the partner countrys technical and human capacities. Technical expertise to support departmental reporting systems (such as the MRT and MSR+) was disjointed and insufficient. Social and Financial Risk Protection and 4. Qualified respondents refers to interviewees who could knowledgeably speak to a given topic. Overview Maternal, Newborn & Child Health FAQs The Right Services, at the Right Time, in the Right Ways Around the world, women and their babies are dying from preventable complications before, during and after childbirth. Select examples of project results supported by Canada. However, local non-governmental organizations tended to lack a national-level overview, which could result in one-off projects that did not integrate well into a countrys national plans. Mothers and children are protected from infection and disease. Although the Department records project approval dates, it does not systematically nor consistently track approval process start dates. In contrast, the formative component focused on design and program activities of MNCH 2.0 programming. This represents a significant amount of international assistance resources spanning numerous geographic regions and functional areas. 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. Local NGOs were often best poised to support the implementation of community-level projects or to work with local governments due to their in-depth understanding of local context and operational norms. [Percent of total] projects in which the [percent of] mothers, and of babies, who received postnatal care within two days of childbirth has increased. The inclusion of the Improving Data pillar in MNCH 2.0 recognized the importance of improved access to reliable information on resources and outcomes. This is known as MNCH 2.0, and brought the total MNCH commitment for 2010 to 2020 to $6.35 billion. medicines and vaccines) and supplies procured and distributed to health service providers, 420 Support to national efforts to scale-up provision of essential health services (e.g. understand, deliver and coordinate better. Specifically, Grand Challenges Canada has faced some challenges in coordinating with wider government efforts and strengthening its monitoring capacity. At the same time, while multi-sectoral collaboration had been integrated in some of the projects within the evaluation sample, stakeholders expressed a continued need for greater focus on an integrated approach across MNCH projects that encourages multi-sectoral collaboration and also addresses the broader determinants of health. The evaluation found that Data Pillar projects focused on engaging and strengthening government data-system capacities and usage. A new guide developed by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health (NIH), along with federal and private partners, promises to standardize the exchange of clinical data on maternal and infant health.The Maternal & Infant Health Information for Research Implementation Guide enables researchers . [Percent of total] projects in which the [percent of] infants (0-5 months) who are fed exclusively with breast milk has increased. A child survival and health grant has been implemented in World Vision South Sudan. For future health programming, ensure that projects have sufficient time for implementation and the greatest chance to achieve longer-term outcomes by considering project durations of up to ten years, where appropriate. For example, it took eight months to approve a no-cost extension for the Making Motherhood Safe project in Tanzania. Some partners also found five years to be inadequate, especially given that implementation was frequently shortened by delays in various approval processes and that no-cost extensions were frequently required. Examples included vaccine campaigns with wide coverage across a population and ensuring basic training standards were achieved for community health care workers. Based on an assessment of risk at project closeout, JICA conducts ex-post evaluations up to three years after the completion of the project. Suggestions regarding the need for MNCH-related education covered a variety of target groups, such as health professionals, community leaders and health workers, beneficiaries, and included raising awareness of harmful cultural practices. Examples of countries subject to these challenges during the evaluation period include Mozambique, Bangladesh (Rohingya crisis), and Haiti. To contribute to this need, Countdown to 2030 for Women's, Children's and Adolescents' Health (Countdown), a multi . The evaluation relied on the documents that could be located, and triangulated the information with data from interviews and site visits. A prominent example of this was the Grand Challenges Canada funding model. Ensure that staff receive direction from senior management and technical support on the systematic use of indicators, guidance tools, and compliance with reporting requirements. Finding 25: Retroactively applying changes in reporting requirements put an unnecessary burden on implementing partners. to control for the strengths of different types of partners). This meant, in some cases, that staff could not take initiative to play a leadership role when working with other donors, such as offering to pay for a consulting contract to support an emerging need for technical assistance. It also affected project budgets and in some cases resulted in delays in providing planned health services. Summative Evaluation Sample: Of the 56 projects sampled, 33 (approximately half) came from the 2015 Formative MNCH Evaluation sample. Chlorhexidine (John Snow International): In Nepal, the risk of newborn death decreased by 23% through the use of chlorhexidine on newborns umbilical-cord stumps. Summarizes the (1) levels and trends of reproductive, maternal, newborn, and child health (RMNCH) indicators, (2) proven interventions for prevention of mortality, (3) costs of these interventions and potential health service delivery platforms, and (4) system innovations. Finally, staff turnover challenged the evaluations ability to obtain a comprehensive overview of the projects and the MNCH Initiative. For a complete description of the program, including objectives and components . Some Global Affairs staff interviewed expressed concern that health system strengthening has not received as much attention in the new SRHR-focused programming, making it more challenging to allocate funds to health system strengthening. 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. Some interviewees suggested that relevant specialists (in health, gender equality, etc.) As well, the addition of funding for Sexual and Reproductive Health in 2014 15 helped to address a critical gap in MNCH 1.0 by placing greater emphasis on the reproductive health factors that contribute to maternal, newborn and child mortality. 1000 Increased survival of women of reproductive age (15 - 49 years), newborns and children under five in countries where GAC engages in maternal, newborn and child health programming. For example, pertaining to knowledge of Global Affairs bilateral MNCH programming in a specific country, interviewees with knowledge of that programming might include the officers responsible for that country (e.g. 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. Water, sanitation and hygiene (WASH) indicators were included in the Performance Measurement Frameworks for both MNCH 1.0 and 2.0, and some WASH projects were funded. Glossary of Terms. prevention and treatment) for mothers, newborns and children under five, 510 Health workers trained to provide quality prevention diagnosis, management and treatment of leading maternal, newborn and child diseases including environmental determinants of diseases, 520 Health promoters, local health practitioners and volunteers trained to deliver key messages on health behaviours and practices related to the prevention and treatment of preventable diseases including harmful practices and environmental determinants of diseases, 530 Norms, standards and guidance developed, including those related to Gender Equality, in the prevention, management and treatment of leading diseases affecting mothers, newborns and children under five, Expanded diseases prevention, management and treatment services, 610 Trained workers, promoters and volunteers deployed to underserved areas, 620 Routine community outreach including campaigns and essential health services as well as key environmental health interventions provided by health workers in underserved areas, 710 Support to governments and health institutions on implementation and recruitment strategies regarding Maternal, Newborn and Child nutrition provided, 720 Technical assistance and other inputs to build capacity among key partners on micronutrient programming and more sustainable agricultural practices provided, 810 Health workers trained on nutrition and related services, including gender equality issues relating to nutrition, 820 Infant and youth child feeding promotional activities including the promotion of equal needs for girls and boys provided, 830 Information and education provided on nutrition, hygiene, water sanitation and the prevention of childhood diseases including gender sensitive indicators and sex-disaggregated data disseminated at the local and national level, 910 Ready-to-use therapeutic foods and key vitamins and minerals, including vitamin A supplements and iodized salt, provided, 920 Screening and management of children under five with acute malnutrition provided, especially baby girls at risk of neglect, 930 Technical assistance and other inputs provided to increase access to water and sanitation facilities. Providing newborns with optimal nutrition and the access to essential care ensures a healthy start in life. For maternal mortality, there was insufficient information to reach a firm conclusion. Management Summary Report (MSR) ratings for sampled projects Text Equivalent(The graphic above shows a bar graph with the Management Summary Report (MSR) scores from 1 (not met) to 5 (exceeded). The Maternal, Newborn, and Child Health work of World Vision is framed by the 7-11 Global Health Strategy. Why is maternal, newborn and child health a focus area for 2021-2025? Real-time monitoring enables countries to quickly assess the effectiveness of health strategies by measuring changes in mortality during periods of 12 months or less, instead of the typical 35 years. The Maternal and Child Health program aims to support pregnant First Nations women to experience healthy pregnancies, and to support parents of infants and young children and their families in helping children to develop optimally into adulthood. In 2014, Canada hosted the Saving Every Women, Every Child: Within Arm's Reach Summit, where Canada renewed its commitment to MNCH programming with an additional investment of $650 million, for a total of $3.5 billion for 20152020. At the same time, external partners and Global Affairs staff highlighted areas that required continued attention to help achieve improved health results. Service delivery 2. 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.
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