Posts Tagged ‘Strengthening Health and Social Systems’

UK Aid Direct M2MMalawi is one of the world’s least developed and most densely populated countries, with a population approaching 17 million.  An estimated 10% of the country’s adults between the ages of 15 and 49 are living with HIV and the majority of them are women.

Support from DFID’s UK Aid Direct global fund, aimed at supporting civil society organisations to achieve the Sustainable Development Goals, has enabled mothers2mothers (m2m) to create an extensive footprint in Malawi, where an estimated 560,000 women aged 15 and over are living with HIV. The essential health education and support that Mentor Mothers provide is critical to helping women cope with the shock and stress of learning that they are HIV-positive and are being put on a lifelong ARV treatment in a single visit to the health facility. Mentor Mothers continue to provide support to the women in the years that follow in order to help them stay on treatment, minimize the risk of transmission, and make healthy choices for their families.

mothers2mothers Malawi UK Aid Direct Mentor Mothers

Catherine Kassam, PMTCT Coordinator at the Malawi Ministry of Health, discussed the importance of Mentor Mothers and the role they play in creating a generation free from HIV:

mothers2mothers Catherine Kassam Malawi Ministry of Health PMTCT coordinator Malawi“The first time I heard about the mothers2mothers model, I was thinking maybe it would be a challenge. I thought the women [Mentor Mothers] would not be open enough to disclose their status. But after the training, I found them very open so that other women [clients] could cope. Mentor Mothers have helped a lot to assist other mothers to disclose their status, and we are seeing men getting involved in PMTCT. All facilities should have Mentor Mothers so that we can catch every community. And everyone in the community should know the importance of being tested. Those who are HIV-positive should start taking their ARVs, so that we can have a generation free of HIV.”

mothers2mothers UK Aid Direct Malawi Mentor Mothers


Grantee: mothers2mothers

Project title: Improving access to HIV prevention and support services for 243,949 women and children in five countries of East and Southern Africa

Location: Malawi


MannionDaniels worked with the GAVI Alliance in 2013-2014 to provide a programme of support to the Health Systems Strengthening (HSS) Team. The aim was to develop a set of options for future GAVI participation in Joint Annual Reviews and Joint Assessment of National Strategies, revise their Annual Progress Report Template and revise their HSS application form and guidelines.

In keeping with Paris, Accra and Busan declarations and the International Health Partnership (IHP+), The GAVI Alliance supports the principles of harmonization and alignment of country HSS grants with immunisation service-specific plans and strategies along with national health plan/strategy, allowing countries to steer development aid towards their priorities.

MannionDaniels provided specialist technical advice to the HSS Team in the following areas:

  • GAVI would like to increase its engagement with IHP+ processes such as Joint Annual Reviews (JAR) and Joint Assessment of National Strategies (JANS) and has contracted MannionDaniels to undertake a broad stakeholder engagement process to feed into identification of a set of options for how GAVI may better participate in, and utilize information from, the JAR and JANS processes, both for the HSS application stage as well as for monitoring of on-going GAVI HSS grant implementation and immunisation coverage and equity.
  • Several countries receive GAVI HSS funding through a multi-donor pooled funding mechanism. MannionDaniels has therefore developed a set of recommendations for how GAVI can participate in multi-donor pooled funding mechanisms in the context of IHP+, using planning and monitoring systems that are specific to these pooled funding mechanisms.
  • In 2013 MannionDaniels supported GAVI to redesign its HSS application form and guidelines, streamlining the process for countries going through the application process. Central to this were the principles of aid effectiveness. MannionDaniels has now taken feedback from the first set of countries to use these guidelines and has made further improvements based on this feedback.
  • GAVI is undergoing a redesign of its grant application and monitoring review process.  This will allow a more iterative development of country proposals as well as grant monitoring. MannionDaniels has developed a revised country annual progress report (APR) template for monitoring on-going HSS grant implementation that is more closely aligned with the content of the revised GAVI HSS application form, performance based funding (PBF) and consistent with JAR processes.

The MannionDaniels team involved in this work has been led by Dr. Louisiana Lush, a MannionDaniels Associate. Key inputs on pooled financing mechanisms were provided by David Daniels, background research by Rolla Khadduri and the redesign work on the application materials and APR templates was undertaken by Clea Knight – all part of the Technical Team at MannionDaniels.

MannionDaniels worked with UNICEF Somalia, with support from Round 10 of the Global Fund’s malaria grant to Somalia, to support the three Health Authorities to strengthen the Somali Health Management Information System (HMIS). The first phase of this work ran from October 2013 to June 2014.

The existing HMIS was developed largely to respond to the information needs of UNICEF and WHO as the main supporters of the public health system in Somalia.  Given the context in which the HMIS was designed this was entirely appropriate.  Critical interventions such as immunization, nutrition, and disease outbreaks, such as measles, required on-going monitoring to provide UNICEF and WHO with the evidence base for making investment decisions and for assessing the progress and impact of its support.  However, with the gradual improvement of the health sector, the growing capacity of the Health Authorities in the three Zones to lead future improvements, and a growing diversity of support from international donors, what was needed was a national HMIS capable of supporting day-to-day management, long-term planning, and policy development for the entire national health system.

MannionDaniels was therefore contracted by UNICEF to support the three Somali Health Authorities to strengthen the existing system so as to respond to the growing data needs of the fast-growing Somali health sector. The first phase of this support focussed on delivering the following outputs:

  1. An Assessment of the current HMIS, undertaken by the Health Authorities with technical oversight from MannionDaniels. The process was participative, engaging stakeholders from across all three zones of Somalia and from a range of sectors to critically assess the strengths and weaknesses of the existing HMIS, and to discuss requirements for its development.

  2. Design of a new HMIS Database. This activity involved assessing existing hardware and software systems as well as capacities of core HMIS personnel who will be involved in operating the database so as to design a system appropriate to the Somali context. The process of health facility registration is now complete and all government health facilities are registered onto the database. Training of key personnel has been undertaken and a manual has been produced and disseminated.
  3. Review and updating of the Routine Indicator List to be used in the new HMIS. This involved a series of consultations with various health sector stakeholders so as to generate consensus on the indicators included on the list. The final lists were endorsed by the Director General’s in each Health Authority.
  4. Development of a curriculum and accompanying course guide for the training of health professionals in the basic principles of health management information systems in the context of the Somali HMIS. The course includes the following modules: Setting the Scene, Results Based Management, Collecting Data, Transforming Data into Information, Indicators, Presenting Information, Using Information, and The Somali HMIS.