1. Africare’s Health Niche In what areas should Africare strive to position itself to be widely known as the “go to” organization? Office of Health

2. Outline -Working Hypothesis -Brief overview major health program areas -Lessons from past programs -Lessons from current trends -Africare’s comparative advantage and positioning -CHSS strategies

3. The Working Hypothesis Africare needs to position itself as the preferred partner for community level health systems strengthening (CHSS), with expertise across the main health challenges that concern most African communities, looking to increasingly link them to services in the community and at the primary health care level. Africare should do this through: 1)building local capacity to deliver preventive and treatment services 2)advocate for sustained strengthening and integration of service provision at the primary health and community levels including linkages

4. Africare major health program areas

5. Major health program areas Community Level Maternal Neonatal and Child Health (MCH/MNCH) - technical interventions ranging from ANC, EmONC, PMTCT, nutrition, immunization, health facility IMCI and iCCM, childhood diarrhea, malaria and malnutrition; essential drug management, birth spacing and HIV/AIDS Since the 1980s, Africare has implemented 15 programs aimed at Child Survival; many more in MCH in general Notable innovations: use of women’s groups in Senegal and elsewhere (eg. Maternal Care Group Strategy); maternity waiting homes strategy Extensive Africare experience, still increasing funding focus

6. Major health program areas HIV/AIDS strengthening community and government capacities to provide high- quality HIV-related health services, including care and support, using evidence based management approach Extensive Africare experience: South Africa (2004-present), Zimbabwe, through faith based organizations (2008-2012) etc HIV/AIDS immense attention from USG through PEPFAR, and others over the last 10+ years – current trend to more targeted interventions and transfer to respective country governments

7. Major health program areas Malaria - expertise in three proven and highly effective malaria prevention and treatment strategies: promoting ownership and use of Long Lasting Insecticide Treated mosquito Nets (LLITNs); Intermittent Preventive Treatment for pregnant women (IPTp) and; Artemisinin-based combination therapy (ACT) for the treatment of children under the age of five. Over the years Africare has successfully implemented several Malaria control programs in Africa including in Benin, Senegal, Zambia, Uganda, Angola, Tanzania, Nigeria and Liberia. Need for malaria programs continues to exist

8. Lessons from past programs Since its beginning in Niger, Africare has strived to increase access to community preventive and curative services - a continuing underlying goal Extensive experience in the relevant health programming areas, working in hard to reach communities, and with vulnerable groups Use of context specific mechanisms as vehicles for implementation – use of women’s groups, CBOs, community health workers etc for mobilizing, and providing services and support

9. Lessons from past programs Provide services in an integrated manner – various health, food security, livelihoods, WASH services in many of our programs – standalone health programs and health integrated in to other development programs Affecting the social determinants of health through poverty alleviation/ economic strengthening and counteracting harmful gender norms Using existing platforms to scale up and aim for further integration like in Benin

10. Lessons from current trends USG pivot to technical assistance and capacity building - USAID Forward agenda Systems strengthening mandates in most current solicitations/RFAs Focus on systems and specific groups – Continued push away from vertical/ disease specific programs to strengthening systems that deal with multiple issues – Using previous gains from investments in vertical programing to respond to general needs

11. Africare’s Comparative Advantage and positioning The health areas we work on continue to be relevant: community based maternal, neonatal and under-5 health, including malaria and nutrition, OVC needs, access to HIV services, water, sanitation and hygiene promotion High local staff representation – knowledge of local culture, values and customs allows for a thorough understanding of gender and community dynamics Strong external perception that Africare does community based work - though we will increasingly see that to be shifting as role for CSO/CBOs Utilize Africare’s current standing to elevate to the next level to be seen as community health authority by repackaging in terms of systems strategies

12. Summarizing CHSS platforms & strategies CHSS will mean, Africare: – Keeping current with main health sectors evidence and programming to respond to the need – Utilizing current standing with governments – Building capacity of community health workers, community based organizations and civil society – Packaging tools and SOPs for CHSS engagement – Advocacy for community based integrated approaches

13. Further discussion