Maternal and Child Survival Program Start-up/Transition Implementation Plan

The program aims to improve coverage of quality health care in 30 municipalities in the Western Highlands, particularly at the primary health care level, as part of the country's newly-rolled out PHC model. The program is a global U.S. Agency for International Development (USAID) cooperative agreement to introduce and support high-impact health interventions in 25 priority countries with the ultimate goal of ending preventable child and maternal deaths (EPCMD) within a generation. The program will focus on increasing coverage and utilization of evidence-based, sustainable, high-quality RMNCH/N interventions at the household, community, and health facility levels. The program will also strengthen the capacity of the Guatemalan Ministry of Health (MOH) to provide quality health care services. The program's start-up/transition period will last from October 2016 to June 2017, during which time the program will implement activities to transition from FANTA III, Nutri-Salud, and PlanFam, as these three programs close-out. Despite gains in recent decades and many years of investment in the health sector, Guatemala has some of the worst health and social development indicators in Latin America, particularly in relation to maternal, newborn, and child health. Over half the Guatemalan population lives in poverty, and rates of stunting and chronic malnutrition have remained among the highest in the developing world. The situation is significantly worse in the Western Highlands, where the predominantly Mayan population suffers from rates of chronic malnutrition among children under five approaching 70 percent and where only 35 percent of women deliver in health facilities. The Guatemalan government and health system have recently undergone massive changes, including the resignation of several high-level government officials and the arrest of the President and Vice President. This instability is also reflected in the leadership of the MOH, which has had six different Ministers of Health over the past two years. The current Minister of Health took office in July 2016 following the resignation of her predecessor after only six months in the position. The MOH is in charge of establishing national norms and protocols and developing national-level materials and guides. The MOH's main strategy for basic service delivery and increased coverage is the Sistema Integral de Atención en Salud (SIAS), or Integrated Health Care System, which provides services to the public at the primary and secondary levels of care, with emphasis on women, children, and environmental risks. There is limited coordination among the different levels of care, particularly from the first and second levels to the third level, and a functional referral and counter-referral system does not exist. The program will work with the MOH and other stakeholders to strengthen the health system and improve the quality of health care services. The program will also work to increase access to health care services, particularly for vulnerable populations such as women and children. The program's activities will be implemented in collaboration with the MOH, other government agencies, and non-governmental organizations (NGOs). The program's budget for the start-up/transition period is $1,725,000, with funding received from USAID's cooperative agreement. The program's partner organizations include Save the Children (lead), Jhpiego, JSI, PATH, and PSI. The program's in-country partners include the MOH, URC (Nutri-Salud), FHI 360 (FANTA III), PSI/PASMO (PlanFam), DELIVER (JSI), HC3 (JHU/CCP), HEP+ (Palladium), and other USG or USAID partners, as relevant. The program's expected results and activities include increasing coverage and utilization of evidence-based, sustainable, high-quality RMNCH/N interventions at the household, community, and health facility levels. The program will also strengthen the capacity of the MOH to provide quality health care services and improve the quality of health care services. The program's activities will be implemented in collaboration with the MOH, other government agencies, and NGOs. The program's monitoring and evaluation activity plan will include regular progress reports, quarterly meetings with the MOH and other stakeholders, and annual evaluations of the program's progress and impact. The program's management plan will include a detailed description of the program's organizational structure, roles and responsibilities, and budget. The program's short-term technical assistance/international travel plan will include a detailed description of the program's technical assistance needs and travel plans. Overall, the Maternal and Child Survival Program in Guatemala aims to reduce newborn, child, and maternal mortality and chronic malnutrition among children under five. The program will work with the MOH and other stakeholders to strengthen the health system and improve the quality of health care services. The program's activities will be implemented in collaboration with the MOH, other government agencies, and NGOs.