Operational Research on ‘Drawing lessons of Integrating Disease Prevention and Control (DPC) programs into Maternal and Child Health (MCH) Services in selected woredas of Afar and Somali Regions.’

Background

Amref Health Africa has been active in Ethiopia through Amref Flying Doctors since the 1960s. Our organization started implementing a diversified health projects portfolio focusing on Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCAH), Water, Sanitation and Hygiene (WASH) and Communicable and Non-communicable diseases in collaboration with the Government of Ethiopia, international non-government organization and local stakeholders since 2002. Gender and health systems strengthening are cross-cutting, reflected throughout the organization’s health programming.

Amref Health Africa is operational in eight regions including developing regional states and national level wide technical assistance interventions. Among the areas of engagement of Amref include capacity building for frontline health workers, provision of essential supplies/equipment with facilitation of last mile delivery, supportive supervision and reviews for optimized service delivery including comprehensive and clinical outreach activities and responding to emergencies.  Amref supports the Government of Ethiopia’s Health Sector Transformation Plan (HSTP), ensuring health equity by serving women and children and reaching the most disadvantaged, inaccessible communities including Ethiopia’s pastoralists and semi-pastoralist communities. Amref led USAID Transform: Health in Developing Regions (Transform HDR), co-created with the Ministry of Health, strives to improve maternal and child health outcomes in Ethiopia’s Developing Regional States of Afar, Benshangul-Gumuz, Gambela and Somali Regions. As part of leveraging resources with Transform HDR, Amref brings GSK’s fund to integrate Maternal and Child Health (MCH) services with that of Diseases Prevention and Control (DPC) activities mainly malaria and tuberculosis programs in selected woredas of Afar and Somali regions. This integration is expected to make the essential services easily available and client centred as it enables mothers and children get accesses of multiple services at one stop, minimize missed opportunities for both NCH and DPC programs and enhance efficiency if not bringing synergy.

Introduction

In Ethiopia, approximately 68% of the population is at risk of malaria with nearly a million people detected annually. The TB incidence in 2018 was 151 per 100,0008, with yearly detection exceeding 110,000. More than three million women give birth annually in Ethiopia and are equally or more at risk of acquiring malaria or TB. The aforementioned complexities of these diseases in maternal and child health apply to all parts of Ethiopia. However, the two regions of Afar and Somali are likely to be affected more due to relatively weak health systems and poor health seeking behaviour. These regions have vulnerable communities due to their pastoralist and are also affected by calamities such as droughts and disease outbreaks.

Amref operates in these areas to support regional health bureaus and woreda health offices of Afar and Somali to provide MCH services mainly through Transform HDR. Amref promotes integration of other essential services with MCH so that mothers and children get comprehensive services with minimal stoppage to access the services while enhancing operational efficiency. Accordingly, Amref partnered with GSK to integrate MCH and DPC activities since January 2021, and currently running a co-funded programme to address the gaps in access to Malaria and TB services among mothers and children in selected woredas of Afar and Somali region. This cost-share project is expected to draw lessons from such integration effort and use them for future programming.

To better inform the integrated program and produce learning evidences, Amref health Africa in Ethiopia would like to conduct an Operational Research on the Integration of Disease Prevention and Control (DPC) of Malaria and TB with Maternal and Child Health (MCH) Services”

Objectives of the Operational Research (OR)

Main Objective

The main objective of this research is to draw lessons of integrated programming of DPC with MCH services and its contribution to strengthen Primary Health Care (PHC) approach as a means to Universal Health Care (UHC).

Specific Objectives

·To assess the burden/status of Malaria and TB in the operational facilities and woredas.

·To understand readiness of health facilities to provide integrated services for mothers and children.

·To describe the status and practices of integrations of malaria and TB with MCH services from technical and operational perspectives.

·To determine the enablers and barriers of integrations of malaria and TB with MCH services.

·To identify models how the integrations of malaria and TB with MCH would contribute to strengthen Primary Health Care (PHC) as a means to Universal Health Care (UHC).

·To recommend ways for better integration of DPC with MCH at different levels (Sectoral, project level, service delivery points)

· The consulting firm/consultant should have minimum of 5 years of proven and strong research experience in areas of integration of health programs (like Malaria and TB with MCH services).

· The consultant should also have experience of developing models related to multi-sector coordination / service delivery units.

· Excellent writing and verbal communication skills in English; and knowledge of the research sites – selected districts in Afar and Somali regions

· The consultant is expected to bring research team members with excellent knowledge, experience (Masters and above in public health and or reproductive health), and gender mix in similar research areas; having a good skill in quantitative and qualitative methods.

· The consultant is expected to hire data collector team members with excellent knowledge of the research agenda, experience, considering gender, familiar with the data collection areas language, and have a minimum of first degree.