Experiences in Applying a Global Learning Agenda for a Reproductive, Maternal, Newborn, and Child Health Implementation Support Project

MCSP's learning component aimed to build the evidence base for delivering lifesaving care in new and better ways and in new contexts, based on local needs and priorities. The program collaborated with global and local stakeholders to align learning questions and activities with program implementation, with the aim of helping countries to address health system bottlenecks and accelerate their progress toward preventing child and maternal deaths. MCSP's learning activities drew on both quantitative and qualitative data, encompassing a spectrum ranging from large-scale program or intervention evaluations to small-scale implementation research studies and from formative assessments to less formal, embedded, project-based learning activities that relied primarily on routine and enhanced monitoring data. The program supported learning activities through conceptualization, design, implementation, and dissemination of results. MCSP conducted 35 multicountry studies of global significance, 15 studies in single countries of global significance, and 13 country studies primarily of local significance, in addition to formative and summative evaluative studies to inform program design and measure results. MCSP produced 130 peer-reviewed papers to date, over twice the number of its predecessor, the Maternal and Child Health Integrated Program (MCHIP), at a similar point in its life cycle. This is in addition to other learning products, such as briefs, conference presentations, and national dissemination workshops. The program's learning agenda was designed to inform the design of future programs, providing lessons that may be useful to USAID, other donors, and technical assistance agencies, as well as ministries of health (MOHs). MCSP's approach to learning was concerned primarily with driving best practice in the context in which they were conducted but was also often designed to generate generalizable knowledge that could be applied in similar circumstances. The program staff hypothesized that if critical stakeholders collaboratively designed and carried out a learning agenda based on the priorities of those stakeholders and embedded it in their ongoing work, then the results of the learning activities would be more useful for improving implementation while maintaining a level of rigor sufficient for making changes to policy and/or practice. MCSP conducted a study on the feasibility of community-based delivery of intermittent preventive treatment of malaria in pregnancy (IPTp) using sulfadoxine pyrimethamine in Burkina Faso. Results suggested that community health workers, supervised by health staff, can enhance coverage of IPTp. There had been concerns that this would reduce antenatal care (ANC) attendance, but ANC attendance remained stable. This study adds to the evidence base and sets the stage for expansion of community IPTp within Burkina Faso and potentially to other countries. To support development and operationalization of a robust project-wide learning agenda, MCSP articulated project-wide learning themes based on the dominant cross-cutting themes established by the donor. These themes were highly relevant to MCSP's implementation support activities and built on the work of its predecessor, MCHIP. The seven broad themes were scale-up, quality, equity, health systems strengthening, community action for health, innovations, and measurement and data use for action. MCSP also hosted monthly seminars at headquarters (HQ) in the first year of the project for MCSP HQ and field staff to build their capacity in the design and conduct of implementation research.