Strengthening the Coordination of Care and Referral Systems for RMNCAH

The program aimed to introduce and support the scale-up of high-impact health interventions among USAID's 25 maternal and child health priority countries, as well as other countries. MCSP defined care coordination as a proactive approach to bringing together care providers to meet the needs of service users, ensuring they receive integrated, person-focused care across various settings. The MCSP framework for strengthening care coordination included three key areas of support: service integration, vertical referral, and client tracking. Service integration occurs when a provider recommends additional services to a client, delivered by another provider, such as referring a mother for family planning when her infant is receiving vaccinations. Vertical referral occurs when clients present themselves to a lower level of the health system but require care at a higher or more specialized level. Client tracking is a method for improving the continuity of care, which in turn supports care coordination, and reducing client dropout through a cycle of repeated contacts. In Tanzania, MCSP supported the Government of Tanzania to implement a multilevel facility and community intervention to integrate maternal, infant, and young child nutrition and postpartum family planning services. The intervention aimed to strengthen nutrition and family planning service linkages and was designed to address findings from a formative assessment conducted by MCSP in the two regions. Preliminary results revealed that initiation of breastfeeding within an hour of birth increased in both regions, with a 61% increase in Kagera and 126% increase in Mara. Total modern family planning use also increased in both regions, with a 37% increase in Kagera and 11% in Mara. In Malawi, MCSP supported the Ministry of Health to integrate immunization and family planning services through facility-based services and community outreach in two districts. The intervention involved creating intrafacility linkages to both services, offering routine infant immunization and voluntary family planning services during outreach efforts, and engaging local government stakeholders to promote the integration of services. A quantitative evaluation showed a statistically significant increase in voluntary community-based family planning services. The MCSP framework and monitoring indicators for strengthening care coordination include service integration, vertical referral, and client tracking. These indicators are used to measure the effectiveness of care coordination and referral systems in improving health outcomes for reproductive, maternal, newborn, child, and adolescent health. The MCSP framework provides a comprehensive approach to strengthening care coordination and referral systems, which is essential for improving health outcomes in low- and middle-income countries. The Maternal and Child Survival Program (MCSP) is a global, $560 million, 5-year cooperative agreement funded by the United States Agency for International Development (USAID) to introduce and support the scale-up of high-impact health interventions among USAID's 25 maternal and child health priority countries, as well as other countries. MCSP's key areas of support to strengthen care coordination included service integration, vertical referral, and client tracking. These areas of support are critical for improving health outcomes for reproductive, maternal, newborn, child, and adolescent health. The MCSP framework for strengthening care coordination is based on the concept of care coordination as a proactive approach to bringing together care providers to meet the needs of service users, ensuring they receive integrated, person-focused care across various settings. The framework includes three key areas of support: service integration, vertical referral, and client tracking. These areas of support are essential for improving health outcomes in low- and middle-income countries.