Maternal child health/child survival-II

The Ministry of Public Health (MOPH) will implement the project, with assistance from a contractor, Save the Children Federation, and CARE. The project will delimit health districts and health areas (each of which will have its own health center). District and community health committees (COSADIs and COSAs, respectively) will be established to co-manage the health centers; women"s participation will be promoted. The project will expand the number of supported health centers from 80 to 180; these centers will provide comprehensive PHC services in 27 health districts, increasing coverage from 34% to 70% in project areas. The health centers will be renovated and equipped, and service guidelines developed, including an operational manual for health districts and standards for district hospitals, covering acute respiratory infections (ARI), provincial-to-district supervision, and curative care. Special efforts will be made to control endemic diseases such as schistosomiasis/onchocerciasis, ARIs, meningitis, and cholera, and referral systems will be strengthened. The project will also fund community-initiated health care projects, particularly those designed by women, and increase NGOs" participation in PHC. The project will establish a Provincial Pharmaceutical Supply Center (CAPP) in Far North Province, and strengthen medical supply logistic systems in Adamaoua and South Provinces; a manual for pharmaceuticals management will be developed. To improve cost-recovery, the project will: conduct operations research to refine and expand the systems already established in Adamaoua and South Provinces; establish a Provincial Health Fund (FSPS) through which larger health areas support smaller ones; and improve the MOPH"s capacity to manage the PHC budget. Financial and personnel management at the provincial and district levels will be improved through expansion of health management information systems (HMIS). The project will retrain existing health care providers, and provide training to health committees, health centers, and health district teams. It will use the trainer-training approach at the national, provincial, district, and health center levels, but with significant supervision by original trainers at each descending level. Participation in provincial and national conferences and short-term participant training is also envisioned. Finally, the project will train health district teams in operations research and encourage them to incorporate this tool into their annual action plans (small operations research projects may also be funded), and will significantly expand IEC, with emphasis on community empowerment and the provision of prenatal and preschool vaccinations.