USAID’s Strengthening Systems for Better Health Activity, Year Two, Quarter Three Progress Report, January 16 – April 15, 2019

The Activity is designed to enhance access to and quality of maternal, child, and reproductive health services, with a specific focus on newborn care. The project is implemented by Abt Associates in partnership with Save the Children, the Karnali Academy of Health Sciences, and Management Support Services. The Activity's geographic focus covers 105 municipalities in the most disadvantaged part of the country, including 79 municipalities in Karnali Province and 26 municipalities in Province 5 from three districts: Banke, Bardiya, and Dang. The project's objectives are achieved through three outcomes: 1) improved access to and utilization of equitable healthcare services; 2) improved quality of health services in facilities and communities; and 3) improved health systems governance within the context of federalism. Outcome 1: Improved Access to and Utilization of Equitable Health Services is being achieved through several sub-results, including improved routine availability of effective, quality maternal, newborn, and child health/family planning services at the health facility/community levels, with a special focus on newborns. Sub-result 1.2 aims to increase utilization of services by addressing social, cultural, and financial barriers. As of the end of Year Two, Quarter Three, the project has made significant progress in achieving these sub-results. Outcome 2: Improved Quality of Health Services at the Facility and Community Levels is being achieved through several sub-results, including quality approaches further developed, strengthened, and institutionalized. Sub-result 2.2 aims to improve quality services delivered by facilities and providers in the public and private sectors. The project has also made progress in improving patient experience of care, as per sub-result 2.3. Outcome 3: Improved Health Systems Governance in the Context of Federalism is being achieved through several sub-results, including improved governance and accountability at subnational levels. Sub-result 3.2 aims to establish and/or strengthen annual planning and budgeting systems at the provincial and municipal levels. The project has also made progress in strengthening management and performance improvement processes, as per sub-result 3.3. The project has also made significant progress in cross-cutting elements, including private sector engagement, gender equality and social inclusion, data-driven and evidence-based programming, and collaboration and synergy. The project's monitoring, evaluation, and learning activities are ongoing, and the project management team is working to develop and submit all contractual deliverables, including the Year Three workplan. The project's achievements in support of planned activities by outcome are significant, and the project is on track to meet its objectives. The project's geographic focus and context are critical to its success, and the project's implementation team is working to ensure that the project's activities are tailored to the needs of the target population.