Quarterly Report to USAID Malawi Jan-March 2013

Agency for International Development (USAID) cooperative agreement aimed at introducing and supporting high-impact health interventions in 26 priority countries. The program's ultimate goal is to end preventable maternal, newborn, and child deaths within a generation. MCSP builds on the success of its predecessor, the Maternal and Child Health Integrated Program (MCHIP), which worked in over 30 countries, including Malawi, between 2008 and 2014. MCSP's current activities in Malawi started in 2011 under MCHIP, with a focus on new vaccine introduction and the strengthening of routine immunization services. The program transitioned to MCSP in 2014. In Program Year 2, MCSP expanded its scope to include not only immunization but also family planning/immunization integration and the revitalization of the Baby Friendly Hospital Initiative in health facilities across the country. The program established five objectives for the reporting period from October 2015 to September 2016. Objective 1 aimed to support the Ministry of Health's Expanded Program on Immunization (EPI) to successfully introduce Measles-Rubella (MR) vaccine. Objective 2 focused on strengthening routine immunization and family planning by improving capacity building, planning, monitoring, and vaccine and cold chain management systems. Objective 3 aimed to strengthen routine immunization systems and services through capacity building and improved planning, monitoring, and vaccine and cold chain management. Objective 4 sought to increase integrated family planning and immunization service delivery by ensuring the two essential services are routinely offered in both facilities and the surrounding communities. Objective 5 aimed to scale up the revitalization of the Baby Friendly Initiative in 54 additional hospitals and centers of excellence in 15 Support for Service Delivery Integration (SSDI) districts. MCSP achieved several key milestones in FY2016. At the national level, the program successfully introduced Measles Second Dose (MSD) vaccination and switched from trivalent Oral Polio Vaccine (tOPV) to bivalent Oral Polio Vaccine (bOPV). Capacity building of vaccinators and mid-level managers was conducted through Immunization in Practice (IIP) and Mid-Level Management (MLM) training. The program also monitored and improved the quality of immunization data through supervisory visits, review meetings at national and district levels, and disseminated the immunization prototype curriculum. In Ntchisi and Dowa districts, MCSP supported the implementation of the Reaching Every Child (REC) strategy, including all five REC components. Communities were mobilized to track infant immunization status, with leadership provided by village heads and volunteers. As a result, more than 90% of the villages in the two districts are now actively tracking the immunization status of their infants, and the quality of immunization services has improved. Health facilities with no stock-out of vaccines have increased from 31% to 80%, and data quality has significantly improved in the two districts. MCSP also made progress in family planning/immunization integration. The program recruited an FP/Immunization Officer to oversee project activities and conducted a rapid assessment in Ntchisi and Dowa districts to assess current integration services, missed opportunities, and how best to integrate the two services. Stakeholder meetings were conducted to initiate development of district action plans for FP/Immunization integration. MCSP trained 172 Health Surveillance Assistants (HSAs) in FP service provision and oriented 183 facility staff and 498 community members on FP/Immunization integration. In addition, MCSP worked in close partnership with the Ministry of Health, World Health Organization (WHO), and UNICEF to spearhead the revitalization of the Baby Friendly Hospital Initiative (BFHI) by reviewing and revising current breastfeeding and Infant and Young Child Feeding (IYCF) policies, adapting the BFHI training course for national use, and supporting the implementation of BFHI in 54 additional hospitals and centers of excellence in 15 SSDI districts.