Comprehensive postpartum [post partum] project (CPP) : final report

To achieve its main objective, the project established 21 CPP centers, 7 of them added by USAID in 1998 to increase project coverage. All are located in major hospitals throughout the country. With the initial 14 centers, the project was able to reach 43% of all the hospital deliveries in the country. With the additional 7 centers, the project is able to reach 58% of all deliveries. USAID and the Ministry of Health (MOH) procured the renovation and equipping of the initial 14 centers. The centers provide antenatal, maternal, infant, and postnatal care. FP counseling and services are integrated into these services. The contraceptive methods provided in the centers include the lactational amenorrhea method (LAM), combined oral contraceptives (COCs), progestin-only oral pills (POPs), and condoms. The postplacental and postpartum IUD insertion technique was introduced to Jordan through this project, as was Norplant removal with the U technique. After the 21 centers were fully renovated, furnished, and equipped, they were handed over to the MOH, Royal Medical Services (RMS), and NGOs. The training component exceeded its targets. Specifically, it established three training centers covering all of Jordan"s regions and provided training to 2,449 representatives from the MOH, the RMS, and the private and public sectors. Training ranged in topics from management, advanced clinical techniques in FP counseling and infection prevention, to quality assurance, maintenance, and administration. The project also developed: the national postpartum clinical curriculum; a counseling curriculum; national guidelines on FP services, counseling, and maternal and infant health care; a quality assurance manual (in Arabic and English); and basic management and community-based services (CBS) training manuals. The project also translated Pathfinder"s infection prevention training manual into Arabic. A management information system (MIS) information system was established for use in project centers. The MIS includes: a standardized computer MIS, a referral system involving antenatal and intrapartum service units, and a mother and child health record book for client monitoring. The MIS generated a variety of reports that provided information for the daily management of the centers, as well as for decisionmaking and strategic planning. Due to problems in paying the monthly bills for MOH centers, a deliverable to establish a computer network connecting CPP management at the MOH with 6 CPP centers was canceled at the request of project management. The information, education, and communication (IEC) component was implemented by Global Vision, Inc., and the Program for Appropriate Technology (PATH). IEC activities were aimed at strengthening the MOH"s IEC management capacity, particularly in collaboration with the MOH"s Health Education Unit (HEU), and at increasing FP awareness among families and service providers through a media campaign, TV and radio spots, a newsletter, video magazines, media coverage, participation of the IEC team at CPP meetings, a counseling video, and printed materials. The project also conducted 9 operations research projects, supported the CBS efforts of three PVOs, and, in its final year, established a committee to develop plans to ensure both the sustainability of CPP activities after the end of USAID funding and their integration into the MOH routine services. Overall, CPP has been a very successful project. Its success is due to the its integration of FP with maternal and infant health services; the availability of postpartum services in a hospital setting; its provision of high-quality training and services; the collaboration of different sectors and institutions; and its potential for high impact. Lessons learned are detailed by project component.