2017 EWEC Progress Report: Improving Health for Every Woman, Every Child, and Every Adolescent
Over the past four decades, JSI has supported more than 80 countries to build and maintain health systems that are capable of delivering life-saving services and products to women, children, and adolescents, whenever and wherever they need them.
JSI began supporting the Millennium Development Goals in 2011 with the Every Woman Every Child (EWEC) campaign, which ran until 2014. After exceeding our 2011–2014 commitments, JSI renewed its EWEC pledge, this time in support of the Sustainable Development Goals (2016–2020).
JSI has implemented RMNCH+A interventions in 31 countries.
Through USAID’s Maternal and Child Survival Program (MCSP), JSI is scaling up integrated community case management (iCCM) to bring lifesaving treatment to children in the Democratic Republic of Congo. Through iCCM, community health volunteers (CHVs) are trained and supported to identify and treat childhood illnesses in communities that have limited access to health facilities.
In 2017, MCSP worked with Tshopo and Bas-Uélé provinces to expand existing malaria-focused iCCM programs, training CHVs to identify and treat children with pneumonia, diarrhea, and malnutrition, and to improve health awareness in 119 remote communities, many of which are accessible only by boat.
32,000 and 29,000 cases were treated for child pneumonia and diarrhea, respectively, at 106 facilities and 119 community sites, representing a four-fold increase at the facility level and ten-fold increase at the community level since 2016. MCSP also worked with the National Child Health Technical Working Group to develop a five-year National Child Health Strategic Plan, which recommends 8,000 additional iCCM sites to cover 70% of the country’s need.
JSI has strengthened health information systems in 27 countries.
JSI worked in Pakistan’s second-largest province, Sindh, to develop an integrated, online health information dashboard. The dashboard, produced through the JSI-led Health Systems Strengthening Component of USAID’s Maternal and Child Health Program, links the Sindh district health information system, management information systems for all vertical-service delivery programs, and national, provincial, and district level health and social sector surveys.
With this dashboard, provincial- and district-level program managers can review the performance of every health facility, lady health worker, and community midwife in the province and use the information to make financial and programmatic decisions. These efforts have led to a 15% increase in data accuracy over two years, and the improved data quality and use have increased transparency and accountability in Sindh.
JSI has supported nutrition interventions in 17 SUN countries.
In Senegal, USAID’s global nutrition project, Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING), used a gender-sensitive lens to address the causes of undernutrition across sectors. SPRING introduced labor-saving agricultural technologies for crops traditionally processed by women to improve food safety, productivity, and income potential for female farmers, and to avail more time and income for women to provide or seek better care for themselves and their families.
In 2017, SPRING developed a training manual for adult learners in agricultural producers’ networks and for community health and nutrition workers to improve women’s participation in household decision-making and promote equal division of nutrition-sensitive household and agricultural tasks. SPRING also identified and supported gender champions within communities to increase men and women’s partnership within the household and improve nutrition outcomes.
JSI has trained 247,488 individuals, health workers, and community volunteers in 31 countries.
The USAID Community Capacity for Health Program, locally known as Mahefa Miaraka, provides tools and capacity-building training to about 10,000 community health volunteers (CHVs) and works with national and local government actors to strengthen the health system and health policies in Madagascar. CHVs provide a package of services, including treatment and referral, messages, and products for maternal, newborn, and child health; family planning; and water, sanitation, and hygiene.
Following an outbreak of plague in August 2017, Mahefa Miaraka supported the Government of Madagascar’s response at the national, regional, district, and commune levels.
Through Mahefa Miaraka, JSI trained 13,864 people, including community leaders, CHVs, health service providers, ministry of public health staff, and program staff, in plague mitigation. These trainings helped community actors to break the chain of transmission and reduce the spread of the disease by implementing control measures, raising awareness and understanding of plague prevention, and supporting community-level monitoring. The trainings also provided information for stakeholders to coordinate their efforts to contain the epidemic, resulting in no new cases reported after November 2017.
JSI has strengthened routine immunization systems in 22 countries.
Working through MCSP, JSI supported the Ministry of Health/Expanded Program on Immunization in Malawi to introduce the measles-rubella (MR) vaccine into Malawi’s routine immunization system in 2017. Throughout the year, MCSP trained technical teams and supported districts to plan for vaccine roll-out. The MR introduction campaign achieved its target, reaching 8.1 million children with the life-saving vaccine.
In addition, JSI worked to strengthen immunization in Ntchisi and Dowa districts using the My Village My Home (MVMH) tool, which MCSP introduced in 2016.
Using the Reaching Every Child approach, the local village heads and volunteers used MVMH to track the immunization status of infants in their communities and to promote timely vaccination. MCSP trained and mobilized village leaders to improve the immunization coverage of infants in their communities. Through this program, more than 90% of villages in the two districts were actively tracking the immunization of infants in 2017, resulting in an increase of fully immunized children from 75% to 88% in Ntchisi and 68% to 91% in Dowa.
JSI has built stronger supply chains in 27 countries.
To expand contraceptive choice and fill unmet family planning needs, numerous countries have begun to introduce and scale up subcutaneous DMPA (DMPA-SC, brand name Sayana® Press). Due to its user-friendly design, this new injectable contraceptive is more accessible for delivery in community settings or through self-injection.
Under the Bill & Melinda Gates Foundation (BMGF)-funded Family Planning Access Program (FPAP), JSI increases access to DMPA-SC by monitoring global shipment volumes and coordinating countries, donors, and implementing partners to improve supply chain data visibility and use. When we found that some countries struggled to balance demand and supply of the new product, JSI’s inSupply project (also funded by BMGF) developed a guide to help health managers plan commodity needs.
In Zambia, JSI is researching the potential of a total market approach to strengthen the delivery and sustainability of DMPA-SC through a collaboration with USAID-funded DISCOVER-Health and Advancing Partners and Communities. JSI aims to improve sustainability and equity for family planning by harnessing the potential of the private sector to reach certain segments of the population with family planning products and services. We are exploring opportunities and policy and program considerations for offering DMPA-SC self-injection through private health facilities.