Supporting measurement & improvement of primary health care (PHC) at the facility and community levels Dr. Jennifer Adams, Deputy Assistant Administrator, Bureau for Global Health, USAID

Global and bilateral mechanisms are improving primary health care through: Financial protection: Reducing financial barriers to access essential life-saving services for the poor Essential services: Improving quality of care and scaling up coordinated delivery of essential, evidenced-based services; Population coverage: Ensuring that poor, underserved, marginalized and vulnerable populations have equitable access to essential health services Responsiveness: Assuring the dignity, confidentiality, autonomy, quality and timeliness of services for poor and marginalized populations

Facility teams independently monitor indicators

Acting on the Call: Ending Preventable Child and Maternal Deaths (EPCMD) 24 priority countries 2.5 million more children surviving 200,000 maternal deaths averted

Ending Preventable Child and Maternal Deaths (EPCMD) 5 Single Roadmap Now Guiding USAID Efforts Roadmap to 2020 Annualized Cycle of Planning and Field Support Reporting Progress Through Acting On the Call Reporting Progress Through Acting On the Call Operationalizing field support through mission visits to strengthen design efforts and HIP/ OP development Target Setting Planning Annual Reporting EPCMD management dashboards and reviews Leadership Institutionalizing a culture of transparency / visibility through annual performance reporting Setting activity targets and improving tools to track progress and technical / leadership capabilities Strengthening prioritization and transparency of goals and target- setting for aligned action

USAID Missions’ Investments in Newborn Health in EPCMD countries

Improving and advancing measurement of health systems to improve PHC Developing rapid assessment tool for checking quality of medicines to reduce use of poor quality medicine Promoting global benchmarking of health system functions and performance through a health system benckmarking tool to monitor performance Developing tool for better analysis of DHIS data for measuring health system performance and its correlates Tools under development:

8 The Community Health Framework WHY should we care about community health? Community health is foundational to attaining many of the SDGs. WHERE can we find examples of effective models and innovations for community health? This framework includes a library of existing models across each component of community health as well as detailed case studies. TOOLKIT HOW can we take action to strengthen community health ecosystems? A five step process can help leaders bring the right data to bear for decision making, and set up sustainable community health programs with clear accountability. WHAT is needed to create a strong community health ecosystem? An ecosystem of heath specific and health enabling actors and structures, both formal and informal, working together and supported by the agency, access, and resources needed to ensure the health of community members: Agency, e.g., awareness of needs, empowerment, and incentives to act; Agency, e.g., awareness of needs, empowerment, and incentives to act; Access, e.g., access to care, access to referral systems; and, Access, e.g., access to care, access to referral systems; and, Resources, e.g., financial resources, medical suppliers. Resources, e.g., financial resources, medical suppliers. HOME LOCAL COMMUNITY DISTRICT / NATIONAL HEALTH SPECIFIC COMPONENTS DISTRICT & NATIONAL CARE COMMUNITY LEVEL CARE COMMUNITY MEMBERS FAMILY MEMBERS LOCAL COMMUNITY DISTRICT & NATIONAL COMMUNITY HOME LEVEL PROVIDERS HEALTH ENABLING COMPONENTS AGENCY ACCESS RESOURCES ANALYZE BOTTLENECKS DEVELOP OR STRENGTHEN PROGRAMS SET TARGET OUTCOMES UNDERSTAND EXISTING COMPONENTS IMPLEMENT, MONITOR & EVALUATE

9 This framework has been developed to support decision makers in answering key questions about community health  The community health framework is intended to support Ministries of Health in developing and strengthening programs for improved community health outcomes. The intention is for USAID missions and other advisors to use the framework to structure a dialogue, develop recommendations, and foster continuous learning with Ministries of Health. The community health framework does… The community health framework does not… Bring together a wealth of existing knowledge and models that articulate components of community health Provide a flexible framework for national level diagnosis of needs and planning of actions Enable a long-term view to planning and developing strong community health outcomes Allow for a “common language” with a classification of interventions and tools and the creation of a living and growing toolbox Serve as a strategy or action plan with specific programs, targets, or budgets Seek to provide a one size fits all view on community health structures, programs, or interventions Represent an exhaustive list of actors, needs, or opportunities Prescribe an impact measurement or continuous learning agenda for countries and programs In the process of developing this framework, over 60 community health experts were interviewed and over 70 academic articles, reports, and evaluations were reviewed.

Measurement for health summit June 2015 Consensus Common Roadmap and 5-Point Call to Action : Increase level and efficiency of investments Strengthen country statistical capacity Ensure well functioning population health data Improve open facility and community systems and disease surveillance and admin data Enhance use and accountability Deliverables Greater partner collaboration and joint action Align and meet country health priorities A way forward Agree on priority actions required to build robust systems for monitoring SDGs and national priorities Address challenges facing countries (fragmentation, disjointed efforts etc.)

11 Thank you