country team action plan cambodia. tracks 1 & 2 2 where are we now? key program/country needs...
TRANSCRIPT
Country Team Action Plan
Cambodia
Tracks 1 & 2
2
Where are we now?Key program/country needs and challenges – MMR of 472 / 100,000 hasn’t budged in 15 years!– Trained providers are not practicing AMTSL, etc.
Current levels of accomplishment/Progress and challenges since Bangkok 2007
– National assessment of key practices of SBAs– Developed training package of key interventions
to address maternal and neonatal mortality (AMTSL, PE/E, Neonatal resuscitation, newborn care)
– Safe Motherhood Protocols revised
Tracks 1 & 2
3
Where do we want to be?GOALS
Desired levels of AccomplishmentNation wide coverage of Key Interventions in
Maternal and Newborn CareCountry Team GoalScaling-up Key Interventions in Midwifery
Maternal and Newborn Care to four provinces in Cambodia within one year
Best Practices for Scale-UpAMTSL, PE/E, neonatal resuscitation, newborn
care
Track 2 8
What is the evidence to support this best practice?
What actions, if any, are needed to provide/collect additional evidence?
After training:• New delivery and postnatal registers to be
used for monitoring and data analysis• Conduct regular supportive supervision;
unannounced spot checks• Bimonthly Midwifery Alliance meetings at
district• Breakthrough Collaborative
Track 2 9
What are the modifications needed to improve the
intervention’s scalability?• None needed
Track 2 10
Who will be involved in scaling-up?
• MoH supported by RHAC, RACHA, URC, UNICEF• Describe the capacity of the organization(s) to scale-
up and what implications this has for scaling-up.– MoH and partners have trained 30 MoH master trainers
• Who will be part of the team to support the process of scaling-up? – Provincial MoH trainers (to be trained)
• What needs to be done to ensure that this team is large enough and has the resources to support scale-up?– NGO partners will provide additional trainers and budget
as needed
Track 2 11
What are the opportunities
and constraints of scaling-up?Opportunities Constraints
Key stakeholders are on board, momentum to address MMR
Possibility of resistance at facility level to change
Safe Motherhood Protocol (SMP) revised
Possible delay in SMP finalization
Primary midwives may not be able to practice some of the changes
Shortage of commodities (eg. MgSO4) need to be in clinics
Large geographic coverage of USAID partners
Track 2 12
What policy, regulatory, budgetary, or other
institutional steps are needed?
List/describe policy, regulatory, budgetary, or other institutional action steps that are needed
• Finalization, approval and dissemination of Safe Motherhood Protocols
• If Breakthrough Collaboratives are used, budget will be needed
Who will advocate for these? When? How?• USAID partners
Track 2 13
Where, when and how will the best practice be expanded?
Phase one:• Train 25 provincial trainers from four provincesPhase two:• Train, supervise, monitor 120 midwives How fast (in what timeframe) will scale up take
place?• One yearHow will the best practice be disseminated to
new areas or populations? • Possibly through Breakthrough Collaborative
Track 2 14
What will be the costs of expansion and how will
needed resources be mobilized? •Costs of training already
budgeted•Breakthrough
collaborativeTBD
Track 2 15
How will the process, outcomes and impacts be
monitored? How will results be fed into decision-making?
•Use of registers, data analysis by partners with MoH
•Supportive supervision by MoH with partners
•Spot checks
Tracks 1 & 2
16
What are our action steps?
Action Step Responsible Person
Timeline
1. Advocate for finalization of Safe Motherhood Protocols (SMP) for referral hospitals and health centers
Development partners
Immediately, on-going
2. Launch and disseminate SMP to all facilities
MoH with USAID, UNICEF,
etc
As soon as finalized
3. Strengthening stock management of MCH commodities
RACHA, RHAC Now and on-going
Tracks 1 & 2
17
What are our action steps?
Action Step Responsible Person
Timeline
4. Training of provincial trainers
MoH master trainers with support of partners
Within one month of approval of SMP
5. Training Health Center Staff
MoH provincial trainers with support of partners
Within one month of approval of provincial training
6. Monitoring and supervision
MoH provincial and OD staff with support of partners
One year