Welcome to the USAID-funded Health Policy Plus (HP+) project website.
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HP+ is supporting the Honduran Ministry of Health to create a robust strategy for the surveillance, control, and prevention of healthcare-associated infections to help improve the quality of care provided in hospitals and prepare for future threats. As part of this effort, from June 2021 to May 2022, HP+ worked with the Ministry of Health to evaluate surveillance, control, and prevention of healthcare-acquired infections in 20 of the country’s 32 hospitals. For the infection, prevention, and control evaluation, findings showed significant differences between hospitals with 10% at a basic level, 55% at an intermediate level, and 35% at an advanced level. For the hand hygiene evaluation, levels were slightly lower. Findings and suggestions from hospital teams were used to develop strategic policy guidance. In late May to early June 2022, the strengthening phase of the activity began, including both a virtual pre-workshop with 91 participants and a two-day in-person workshop in Tegucigalpa with 26 participants. These activities trained infection prevention and control teams and quality coordinators from 11 hospitals in the use of quality improvement tools and supported them in the development of improvement plans for the control and prevention of healthcare-acquired infections. These activities were chaired by the Ministry of Health authorities for hospital-level care and quality who plan to continue training additional hospitals.
With technical support from HP+ Niger, in December 2021, the Governor of Maradi signed a decree for the creation and functioning of the Regional Technical Committee that will monitor the implementation of the Budgeted National Action Plan for Family Planning 2021–2025 in Niger. In addition to monitoring the implementation strategies defined in the action plan, the decree also mandates: promotion of any innovative strategy falling within the framework to achieve objectives, coordination of local family planning interventions, and monitoring the availability of the full range of modern contraceptive products and methods to allow clients free and informed choice. As part of next steps, in March 2022, HP+ supported efforts in Maradi and Zinder to finance the action plan through a capacity building workshop for members of health center management committees and community leaders on the mobilization of domestic resources for the well-being of mothers and children. The workshop concluded with commitments being made to support the government’s effort.
In Madagascar, HP+ has supported seven government ministries over the past several years as they committed to implementing the country’s Demographic Dividend Roadmap, demonstrating multisectoral support of efforts aimed at achieving the demographic dividend. The roadmap is centered around four pillars: health and family planning, education, employment, and governance. Under each pillar, the roadmap monitoring plan details key actions to take to attain the demographic dividend and indicators to measure progress throughout implementation. The plan serves as an implementation, monitoring, evaluation, and decision-making tool for stakeholders from the seven government ministries, private sector, civil society, and technical and financial partners to ensure the execution of the Demographic Dividend Roadmap in Madagascar.
In August 2021, the National Alliance of Indigenous Women's Organizations for Reproductive Health (ALIANMISAR) and the Human Rights Ombudsman's Office (PDH) completed their most recent indicator data collection and health clinic monitoring using the V1000D monitoring tool. Previously, HEP+ supported the development of the tool—which houses indicators related to health services, products, and human resources—and has strengthened the capacity of ALIANMISAR to conduct data analysis and advocacy. The monitoring exercise revealed an undersupply of family planning methods, ferrous sulfate, and rotavirus and pneumococcal vaccines as most doctors were busy attending to COVID-19 patients, limiting their availability to provide other essential health services. ALIANMISAR presented department-level findings to relevant health area directorates to make the case for solutions to health service issues. PDH will compile and share findings and recommendations at the national level.
Youth in Madagascar have provided valuable input during a review of Madagascar’s 2016–2020 Costed Implementation Plan (CIP) for Family Planning and provided insight to be considered for the next CIP. The participatory and multisectoral CIP review, for which HP+ provided technical support, included the perspectives of youth stakeholders as members of the family planning committee. Their insight was particularly valuable as Madagascar’s CIP addresses the unique needs of young people in a country where nearly 60 percent of the population are under the age of 25. The CIP review revealed that the modern contraceptive prevalence rate among young people increased by 4 percentage points from the CIP’s introduction in 2016 to its end in 2020. Furthermore, recommendations from a May 2021 virtual consultation, led by the Youth Advocacy Association as part of the CIP gap analysis, will be factored into the next CIP (2021–2025). Their proposals include improving contraceptive supply chains, continuing to strengthen implementation of the 2018 law on reproductive health and family planning, bolstering government commitment to family planning, and improving service offerings that meet the specific needs of young people. They requested specific strategies targeting youth and recommended greater engagement of youth networks, nongovernmental organizations, and associations in family planning demand creation.
From 2017 to 2020, HP+ Cambodia delivered technical assistance and capacity development to advance universal health coverage and the sustainability of key Cambodian health programs. This included supporting the National Social Protection Council Secretariat to implement and monitor the National Social Protection Policy Framework 2016–2025, the government’s long-term roadmap to increase support for vulnerable populations and expand health insurance. The newly published Manual for the Social Protection Monitoring and Evaluation Mechanism, developed over three years of support from HP+, is a monitoring tool to ensure consistency, transparency, and accountability in the framework’s implementation. Approved by the National Social Protection Council in September 2020, the tool is now publicly available in English and Khmer on the GS-NPSC website. Cambodia’s Minister of Economy and Finance acknowledges USAID and HP+ support within the manual, stating, “As the chairman of the National Social Protection Council, I would like to deeply thank and acknowledge the contributions of the technical teams and all stakeholders, especially the Health Policy Plus (HP+) project supported by the United States Agency for International Development (USAID), as well as other development partners including UNICEF, for their active cooperation and valuable inputs to make this M&E mechanism happen.”
Mali has joined the Global Financing Facility (GFF), giving the country potential access to development funding from the World Bank and other donors worldwide, and helping to improve financing efficiencies for health. The country took the final step in unlocking access to GFF funding at a December workshop, when it completed its investment case for reproductive, maternal, newborn, child, and adolescent health (RMNCAH). At the same time, Mali finished development of a monitoring framework for its Health and Social Development Plan, which is tied to the RMNCAH investment case. Finalization of these key strategic documents is essential for the social health sectors and Mali’s intention to achieve the Sustainable Development Goals. The country’s GFF investment case seeks an improvement in health outcomes, including a reduction in maternal mortality from 325 to 146 per 100,000 births by 2023 and a reduction of the proportion of women 15-49 years who have experienced gender-based violence from 10.8 percent in 2018 to 2 percent in 2023. HP+ organized the December workshop with the Ministry of Health and other stakeholders to finalize the document and facilitated remote participation of some partners.
In Togo, HP+ West Africa recently convened a gathering of national and regional stakeholders to collect, review, and validate data to update the costed implementation plan (CIP) for family planning performance dashboard. Updating the dashboard—a critical first step in the CIP execution process—supports the country to monitor progress toward achieving its family planning goals, which include reaching a contraceptive prevalence rate of 22 percent by 2022 (from 17 percent in 2017). Training stakeholders on use of the CIP tool and dashboard supports family planning decision making and helps to focus family planning activities and implementation on meeting CIP goals.
On September 14, 2020, Cambodia’s National Social Protection Executive Committee approved the adoption of a new monitoring and evaluation (M&E) system, developed with HP+ support, to enable systematic oversight of social protection results and financing to manage its portfolio, improve accountability and transparency, and inform future investment priorities. HP+ supported the development of the system by creating a logical framework and identifying indicators; drafting an operational manual and legal framework; and providing customized trainings and ongoing coaching to build capacity of a new team with no previous M&E experience. Implementation of the system will support Cambodia’s policy goals of preventing and reducing poverty, vulnerability, and inequality.
In Cambodia, General Secretariat for the National Social Protection Council (GS-NSPC) leadership reached consensus on five actionable policy recommendations to ensure high-quality health services are delivered under national Universal Health Coverage schemes. The recommendations, which include adoption and optimization of a strategic purchasing approach as well as the integration of monitoring and key progress indicators into the annual performance-based budgeting process, were documented in a peer-reviewed article developed with HP+ input, Improving Health Service Quality in the Kingdom of Cambodia: A Policy Perspective, published in the Asia Pacific Journal of Public Health in September 2020.
In Madagascar, seven government ministries have signed an official commitment letter agreeing to implement the country’s Demographic Dividend Roadmap, demonstrating multisectoral support of efforts aimed at achieving the country’s demographic dividend. The commitments, obtained at a high-level roundtable organized by HP+ in March 2020, are the result of HP+ efforts to support Madagascar’s Ministry of Economy and Finance to finalize a follow-up plan for the roadmap, including details on monitoring and evaluation, budgeting, and resource mobilization for key activities. Moving forward, HP+ will support the demographic dividend team to advocate for and monitor implementation of the roadmap and decentralize it to regional committees.
On August 25, HP+ supported Madagascar’s Family Health Directorate (DSFA) within the Ministry of Public Health to conduct a virtual semi-annual review and performance monitoring meeting of the country’s costed implementation plan (CIP) for family planning. Using data generated by an online CIP dashboard developed by HP+, meeting participants were able to monitor progress of CIP activities and indicators, identify bottlenecks and solutions, and provide recommendations for the next iteration of the plan. Since adoption of the CIP in 2016, the country’s contraceptive prevalence rate has improved from 33 to 44 percent and maternal deaths averted by family planning have increased from 500 to 2,600.
HP+ supported the development of a National Social Protection (NSPC) Monitoring and Evaluation system in Cambodia to facilitate the collection, analysis, and use of service and beneficiary statistics; budget and expenditure data; and payment and administrative information to monitor key performance indicators. HP+ trained NSPC staff on use of the system dashboard, which generates key performance metric visuals; a soft launch by September is planned. The monitoring system is expected to improve accountability and transparency between line ministries and the Ministry of Economy and Finance; strengthen social protection scheme management and decision making; inform the annual budget; and increase public transparency and accountability.
HP+ is supporting district-level youth-friendly health services (YFHS) reporting performance in Malawi by analyzing monthly District Health Information System 2 reports and providing technical support to health management information system officers and YFHS coordinators to improve timely and complete reporting. The district with the highest performance each quarter receives recognition; districts share best practices and lessons learned via a WhatsApp group. As a result of this emphasis on data quality and reporting, performance has steadily improved over time. Accurate and timely information about service utilization allows decision-makers at various levels to tailor programs and allocate resources to more effectively serve youth beneficiaries across Malawi.
On June 24, the Prime Minister of Cambodia officially launched a new cash transfer program to offset the impacts of COVID-19 on the country’s poor and vulnerable that will begin with the transfer of about US$50 million to 560,000 poor households. HP+ had supported Cambodia’s General Secretariat for the National Social Protection Council (GS-NSPC) to develop a monitoring and evaluation (M&E) concept note for the program and provided technical assistance to the GS-NSPC team and GIZ contractor implementing COVID-19 M&E activities, improving accountability among local authorities. In Cambodia, health service disruptions related to COVID-19 could potentially result in 559,900 individuals being unable to access contraceptives.
In Malawi, district youth-friendly health services (YFHS) coordinators are using performance data to analyze YFHS uptake nationwide, sharing best practices and challenges encountered to improve program decision-making across all levels of the health system. Since 2018, HP+ has supported the Ministry of Health’s Central Monitoring and Evaluation Directorate to analyze district performance in reporting YFHS uptake and share these results with district-level coordinators via WhatsApp. As a result, the overall national reporting performance of the YFHS program has improved from 13 percent in 2018 to 72 percent as of March 2020, demonstrating strengthened capacity to submit complete, timely data critical to supporting informed decision-making.
A secondee from HP+ embedded in Mali’s Ministry of Health’s Immunization Subdirectorate supported national and district leaders to improve management of cold chain equipment and vaccines by developing, testing, and validating operational tools for monitoring cold chain equipment. Until now, no monitoring tools were available, making coordination among donors challenging. Availability of performance data on a quarterly basis will allow for informed decision making about forecasting cold chain supply and vaccine needs. This, in turn, will improve performance of cold chain equipment, efficiency of vaccine and distribution expenditures, and coordination of the overall system, contributing to the administration of quality vaccines to children throughout Mali.
In December 2019, Burkina Faso’s Ministry of Health launched a monitoring and evaluation (M&E) plan to measure its progress on increasing contraceptive access. The finalization and implementation of the Costed Implementation Plan M&E plan is an important milestone showcasing the country’s commitment to increasing modern contraceptive prevalence, which at 30.7 percent, is the highest in the West Africa region. The M&E plan was developed following the formation of a multisectoral steering committee and thematic groups comprised of public, private sector and civil society representatives who advocated for a tool to track progress, a model for the region. Read our news story for more details.
In Cambodia, HP+ supported the Ministry of Economy and Finance and the National Social Protection Council (NSPC) to develop a monitoring and evaluation (M&E) operations manual and indicators to monitor progress on social protection in Cambodia. Included is an indicator on rates of contraceptive prevalence. Due to COVID-19-related social distancing measures, HP+ has facilitated rapid transition of this activity to an online platform to validate indicators with 11 line ministries. In addition, HP+ developed an online course catalogue that offers 27 free, online social protection courses for colleagues to pursue self-study while working remotely.
Recent data indicates that Ghana is on track to meet the milestones in its costed implementation plan for family planning, including achieving the goal of increasing modern contraceptive prevalence among currently married women from 22.2% (2014) to 29.7% (2020). HP+ has supported the development of performance indicators to monitor execution of key results and established and rolled out a web-based performance monitoring dashboard to government stakeholders and implementing partners. Ghana is estimated to have added 590,000 contraceptive users since 2012, bringing coverage to a total of 1,676,000 users and averting 213,000 unsafe abortions and 1,100 maternal deaths.
The Office of the Human Rights Ombudsman (PDH) in Guatemala announced a commitment to expand its strategic alliance with ALIANMISAR, a local civil society organization, to assume the responsibility of monitoring the educational quality in the five education departments prioritized USAID and expand the program to schools in all 22 departments of the country starting on February 1, 2019. This commitment is a direct result of HP+’s efforts to build capacity within civil society networks and track progress on the program’s influence on the educational system; in the years since the program’s monitoring began in 2013, these networks have leveraged over US$3.8 million to improve 138 schools. Based on these positive responses to these results, the PDH and ALIANMISAR designed six questionnaires aimed at students, parents, teachers, and directors to collect demographic and institution-specific data that will provide a baseline for future educational interventions in the region. Additionally, the PDH has developed an online app to track and review the answers provided in these questionnaires, highlighting the visibility and accessibility of the data. The strategic alliance marks an important milestone for HP+’s efforts to achieve sustainable results that will have lasting effects in Guatemala as the PDH will accompany civil society networks to advocate for positive changes in the quality of educational services and will actively monitor future cases of human rights violations reported by students and educators.
On June 25, 2018, Malawi’s Ministry of Health approved the Monitoring and Evaluation Health Information Systems (MEHIS) Strategy 2018-2022. The purpose of the strategy is to provide a blueprint for the Ministry of Health to strengthen Malawi’s health information system, and to ensure that the system can generate and use high-quality data to monitor and evaluate the success of its Health Sector Strategic Plan II. USAID, through the Health Policy Plus (HP+) project, coordinated the development of the strategy, analyzing the implementation of Malawi’s previous health information systems strategy for key achievements, gaps, and lessons learned; facilitating workshops; and contributing to the writing and costing of the strategy. HP+ provided both technical inputs and financial support to the strategy development process, in collaboration with the Bloomberg Data for Health Initiative, the World Health Organization, U.S. Centers for Disease Control and Prevention, the Bill & Melinda Gates Foundation, the Kuunika Project, and Germany’s development agency GIZ. A monitoring and evaluation expert seconded by HP+ to the Ministry of Health’s Central Monitoring and Evaluation Division facilitated the efforts.
Since October 2016, the USAID-funded Health and Education Policy Plus (HEP+) has supported Guatemala’s Secretary of Executive Coordination of the President (SCEP) to promote decentralization in the national policy agenda. With HEP+ support, a National Decentralization Plan was approved by President Jimmy Morales in February 2017. On July 21, 2017, with President Morales in attendance, SCEP signed agreements with the Municipal Association of Los Altos in the Quetzaltenango Department to launch pilot decentralization programs in three municipalities. HEP+ will continue to support the implementation of these pilots through technical support for a National Decentralization Agenda (to be launched in September 2017) and the creation of operational and monitoring and evaluation plans. A local radio station covered the launch event twitter: https://twitter.com/RadioPuntoGT/status/888398025747509248