Strengthening Systems for Better Health Activity, Year Five, Quarter One Progress Report, July 16 – October 15, 2021

The Activity aims to improve health outcomes, particularly for marginalized and disadvantaged groups, by enhancing access to and quality of maternal, newborn, and child health and family planning (MNCH and FP) services. A special focus is placed on newborn care, and the Activity also seeks to strengthen data-driven planning and governance of the decentralized health system. The Activity is implemented in partnership with Save the Children, the Karnali Academy of Health Sciences, and Management Support Services, and covers a total of 138 municipalities in Karnali and Lumbini Provinces. The geographic focus includes 79 municipalities in Karnali Province and 59 municipalities in Lumbini Province from the six districts of Banke, Bardiya, Dang, Kapilvastu, Rupandehi, and Nawalparasi West. The Activity is designed to achieve three major outcomes: Improved access to and utilization of equitable healthcare services, Improved quality of health services at facility and community levels, and Improved health system governance within the context of federalism. To achieve these outcomes, the Activity focuses on several sub-results, including improving routine availability of effective, quality MNCH and FP services, increasing utilization of services by addressing social, cultural, and financial barriers, and strengthening quality approaches and institutionalizing them. During the reporting period from July 16 to October 15, 2021, the Activity made significant progress toward achieving its planned activities and results. The COVID-19 pandemic had a significant impact on the Activity's progress, with many planned activities being delayed or modified to accommodate the pandemic. However, the Activity continued to make progress, with several achievements reported during the quarter. One of the key achievements reported during the quarter was the completion of the refurbishment of project offices to accommodate the new working situation and operations. Additionally, the Activity completed the recruitment and hiring of Activity staff, and developed and submitted all contractual deliverables. Staff orientation and training were also conducted during the quarter. The Activity also reported progress on several of its sub-results, including improving routine availability of effective, quality MNCH and FP services, increasing utilization of services by addressing social, cultural, and financial barriers, and strengthening quality approaches and institutionalizing them. The Activity also reported progress on its cross-cutting program elements, including private sector engagement, gender equity and social inclusion, data-driven and evidence-based programming, and collaboration and synergy. The Activity's progress during the quarter was also influenced by the COVID-19 pandemic, which had a significant impact on the health system in Nepal. The pandemic led to a significant increase in the number of COVID-19 cases, which put a strain on the health system and led to a shortage of medical supplies and equipment. The Activity worked closely with the Government of Nepal and other stakeholders to respond to the pandemic and ensure that the health system was able to cope with the increased demand. Overall, the Strengthening Systems for Better Health Activity in Nepal made significant progress during the reporting period from July 16 to October 15, 2021, despite the challenges posed by the COVID-19 pandemic. The Activity continued to work towards its planned activities and results, and made progress on several of its sub-results and cross-cutting program elements.