Canadian partners were found to be best suited to deliver results in countries where they had experience and a proven track record, along with strong links to local non-governmental organizations and communities. Health lays the foundation for vibrant and productive communities, stronger economies, safer nations and a better world. Finding 24: Over the course of the evaluation period, there were several instances of a need for better communication and guidance on new policies and priorities. However, the extent to which training frontline personnel ultimately strengthens health systems is dependent on project design and implementation, as with any other type of health project. At the same time, the evaluation found a few instances of project overlap and duplication among donors. Of the Region's maternal and child deaths, 95% occurred in nine high-burden countries, and 45% of under-5 deaths were among newborns. As such, some of the findings were informed to a larger extent by the summative evaluation, such as the Effectiveness and Sustainability sections, while the formative component informed the Relevance and Efficiency sections to a larger extent. Also, other donors recognized Canada as a leader in advancing gender equality and positive changes in gender equality were reported. These processes would increase the timeliness of implementing new departmental priorities and policies, such as Sexual Reproductive Health and Rights programming and the Feminist International Assistance Policy. ISPOR - Tracking Progress Towards Equitable Maternal and Child Health In hopes to reduce infant mortality rates by at least 20%, World Vision Ireland has implemented theAIM Health Grant. Read more July 1, 2016 Human milk banks: Bringing superfoods to all babies Oct. 11, 2017 Despite this, the sustainment of results was noted for some projects. Finding 5: There was evidence of progress towards the immediate and intermediate levels for corporate MNCH outcomes for projects in the sample. 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. MNCH 2.0 funding commenced, immediate disbursements encouraged. 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. 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. External partners emphasized an ongoing need for the existing areas in MNCH which Global Affairs has been funding. understand, deliver and coordinate better. Our work touches lives around the world every day - often in invisible ways. Findings: Efficiency Recommendations Considerations for Future Programming Appendices Appendix A: Evaluation Terminology and Limitations Appendix B: Effectiveness Appendix C: Innovative Technology and Approaches Appendix D: Partner Modalities Appendix E: Indicator Alignment Analysis Appendix F: Acronyms and Abbreviation Appendix G: Logic Models Medical products, vaccines, and technology 5. Financing and 6. The HRH project has supported improvements, such as libraries and equipment, in all 43 of Bangladesh's public-sector nursing institutes, benefiting the 15,500 students enrolled at any given time. A child survival and health grant has been implemented in World Vision South Sudan. Global Affairs successfully supported some partners to engage in innovative work, but the Department was less successful at promoting innovation internally. Empowering and mobilizing community actions to strengthen accountability of local government. The reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH-N) agenda is now both broader and more complex than was the case during the Millennium Development Goal era, creating a need for new data. For any future health and nutrition programming, consider continuing to integrate the needs of adolescents. 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). For a complete description of the program, including objectives and components . Based on an assessment of risk at project closeout, JICA conducts ex-post evaluations up to three years after the completion of the project. The Maternal and Child Health Epidemiology Program (MCHEP) resides in the Field Support Branch (FSB), Division of Reproductive Health (DRH). 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. The International Assistance Evaluation Division (PRA) conducted this evaluation using a traditional mixedmethods approach with a focus on qualitative methods. [Percent of total] projects in which the coverage rates for DPT3 for children (12-23 months old vaccinated with the three doses of the DPT vaccine) has increased/remained stable. Consistent with academic literature, this approach was widely described by partners and Global Affairs staff as the foundation for achieving sustainable MNCH results. Multiple lines of evidence were used, and where possible, the evaluation team spoke to multiple individuals responsible for MNCH projects or programming over different periods of time. Interview findings suggested that various aspects of the process before and after project approval caused significant delays. This finding was consistent with the recent Honduras (2017), South Sudan (2017) and Vietnam (2018) evaluations. However, many MNCH results could be at risk without ongoing donor support. 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. For example, implementation of a large training project in Mozambique was disrupted after the project had to accommodate new reporting and results-based management requirements. For example, respondents reported that high rates of turnover and vacancies within the Health and Nutrition Bureau (MND), the corporate unit responsible for MNCH since 2015, had made it particularly challenging for staff to maintain institutional knowledge, meet deadlines, and respond to requests. Use of improved sanitation facilities: percent of the population using improved sanitation facilities. 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. For example, the Improving Maternal and Reproductive Health project (Cooperative for Assistance and Relief Everywhere, CARE) in Tanzania included activities to improve management and accountability by local councils, including updating council health plans, and supporting local governments to better supervise health facilities. At the highest level, all four sample countries integrated gender equality into national policies and strategies. These estimates showed a decrease in maternal mortality ratios over the 15-year time span for all four countries. Support for National governments via pooled/basket-fund mechanisms was in line with Canadas commitment to Aid Effectiveness principles. Maternal and Infant Health | Reproductive Health | CDC At the time of the evaluation, Global Affairs did not have a reporting mechanism that required program officers to follow-up on monitoring the sustainment of results achieved beyond the lifecycle of project funding. [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). Providing newborns with optimal nutrition and the access to essential care ensures a healthy start in life. 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. The analysisFootnote 5 identified project results that broadly aligned with either immediate or intermediate outcomes from MNCH 1.0 or 2.0. Jun 27, 2023 - 04:04 PM. JICAs portfolio includes health projects. Frequent turnover also resulted in less effective relationships with implementing partners. Results-based management specialists gave advice when indicators were being designed, but their advice was not always reflected in the end product, and they did not have health sector expertise. The Support to Child Survival (Nutrition International) project in Ethiopia trained multiple levels of healthcare personnel, provided technical support to facilities, and supported social mobilization to improve community management of acute malnutrition. Global Affairs staff echoed these concerns. MNCH 1.0: Accelerating Child Survival in Mozambique (UNICEF): In Mozambique, UNICEF assisted the Mozambique Ministry of Health to deliver a nationwide measles vaccination campaign and a mass distribution of bed nets in two provinces. 13. MNCH 2.0: Integrated MNCH in Ethiopia (Save the Children Canada): In 22 food-insecure districts in Ethiopia, the Integrated MNCH project, in collaboration with the Government of Ethiopia, has improved the nutritional status of children and pregnant women by increasing access to quality nutrition services, nutritious food, and water and sanitation services. [Percent of total] projects in which the [percent of] mothers, and of babies, who received postnatal care within two days of childbirth has increased. Effective interventions to ensure MCH (Maternal and Child Health - PLOS See Appendix B for examples of results achieved by a selection of projects. Johns Hopkins University projects have continued to do important work in strengthening data generation and increasing capacity to analyze and report on MNCH results at the country level. For high-risk or innovative projects, programs could also experiment with new approaches to monitor whether results are actually sustained after funding has ended. Program: Maternal, Newborn, Child Health & Nutrition | PATH 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. Neonatal mortality rates showed a much slower decrease over this period. Canada maintained good working relationships with donor partners, as well as with health ministries. In Kenya, Ethiopia, Pakistan, Indonesia and India, 672,600 frontline health-workers, supervisors and managers were trained in topics such as diarrhea management. UBC developed a cold-block prototype and CHAI tested the technology at the provincial level in Mozambique. Increased access to maternal health services for women. During the one-week vaccination campaign, 4,078,637 children aged 6-59 months received a measles vaccination (105% of target). The project provided 1.7 billion Vitamin A supplements; produced an additional 6.3 million metric tons of iodized salt; provided 14.4 million children suffering from diarrhea with the recommended course of zinc and other supplements; and provided an additional 366,000 pregnant women with supplements. During the course of the 5 year programme, Aim Health will train over 2,000 community health workers with the skills necessary to aid community members with the resources necessary for good health and nutrition. This suggests that there had not been enough clear messaging internally or externally around this new focus. Johns Hopkins University projects (National Evaluation Platform (NEP); Real Time Results Tracking; and Real Accountability: Data Analysis for Resultsall multi-country projects) have worked in the field with various partner governments to develop user-friendly data collection and analysis tools and government-driven evaluation platforms (NEP) to encourage partner governments to increase evidence-based decision making in the health sector. It evolved to better target key gaps identified in the 2015 formative evaluation. *Analysis verified by CFO-Stats on December 28, 2018. 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 summative evaluation component encompassed an end-of-programming approach and assessed results achieved. 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. To what extent has programming in strengthening health systems helped to achieve greater results in other programming areas (disease, nutrition, and sexual reproductive health)? The text below provides findings on the strengths and weaknesses for each type of partner. Associations between metabolites associated with maternal health characteristics and child BMI were modified from 1-3 years (interaction: p < 0.05). MNCH projects have been achieving results and a high proportion of the projects examined made progress on achieving their intended outcomes. In the meantime, in 2015, Partnerships and Development Branch (KFM) needed to roll out a call for proposals on its $450 million MNCH investment. about PMNCH members and their work, which enables partners to search, Mutter-Kind-Klinik Saarwald | Mutter-Kind-Kur | Vater-Kind-Kur See Appendix D for additional analysis on the strengths and weaknesses of each type of partner. Maternal and Child Health Epidemiology Program | Reproductive Health | CDC In addition, we work to reduce disease and death among mothers and babies, with special attention to reducing racial and ethnic differences in these health . The results framework should be in place as early as possible to inform the program plans that respond to priority commitments. While health systems strengthening was integrated to some extent in many MNCH projects, adopting health systems strengthening as an overarching theme to health programming would help to ensure that it is considered in the design of all projects seeking health outcomes. Strengthen and modernize corporate reporting systems, including both software and IT systems, which support all international assistance programming, especially thematic programming like MNCH. While these projects were in early stages and fell within the formative evaluation component, initial results showed that the data projects were making progress in strengthening data and civil registration and vital statistics systems (see Appendix B for examples). 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. A lack of flexibility because of slow processes was particularly problematic in fragile and conflict-affected states, where the context could be dynamic and unpredictable. Mothers and children are protected from infection and disease. Finally, corporate reporting teams had to reconcile project reporting, but they had neither results-based management nor content expertise. to control for the strengths of different types of partners). Some partners interviewed noted their appreciation for Global Affairs flexibility in granting these extensions, despite lengthy delays in some cases. The Maternal Health Network is a group of organizations and individuals who have come together to help improve the experience and outcomes for families who are planning to get pregnant, those who are pregnant, and those who have recently delivered a child. These evaluations are carried out with the view that it can take several years for the results of some projects to take root and for technical, financial and social problems related to sustainability to emerge. 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. Subsequently, 14 implementing partners worked separately in the regions with inadequate coordination. 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). At least 93% of projects reported the achievement of at least one result associated with either an immediate or intermediate corporate MNCH outcome. To what extent were the activities funded by MNCH initiatives (including sexual and reproductive health) aligned with recipient country needs in low and middle-income countries?
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