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Community Based Maternal, Neonatal, and Child Health (MNCH) Innovation in the context of National Health System Decentralization

April 2013

Contents Introduction Country Context Problem Description Methodology Results

Introduction
ChildFund is a global child development & protection agency

13.5 million children 31 countries


Our mission is to help deprived, excluded & vulnerable children survive and thrive

Country Context
Honduras one of the highest MMR in the western hemisphere 100/100,000 LB, NMR 18/1000, and SBA of 56% Access to reproductive health services in rural communities is limited. Women and newborns die from pregnancyPOPULATION related causes, childbirth, 8,296,693 and postpartum MILLION complications.

65%

poverty line

BELOW

Population

Problem Description
Despite evidence on the interventions that can save lives at low cost, the pathways to delivering health services in low and middle income countries are still not well known. Many studies on delivery strategies ignore the overall effect these would have on the poor.

Introduction: Project Information


ChildFund was awarded a USAID Child Survival & Health Grant (2009 -2013) Goal: Decrease maternal, neonatal, infant and <5 child mortality in the project area to levels established by the Government of Honduras, in harmony with the MDG

Community Based(CB) Health Innovations 1. Define & standardize role of communities to increase institutional deliveries within a national decentralization strategy 2. Create self-sustaining CB health units (UCOS) which integrate Ministry of Health programs 3. Adapt & implement CB continuous quality improvement for UCOS

Introduction: Project Information

Results
41.780 Women and children < 5 yrs

626 Guide Mothers trained

178 TBAs trained

12 Rural municipalities 210 Community UCOS volunteers engaged

311 weigth monitors trained (AIN-C)

Results

UCOS have proven to be an efficient model that seeks to become Governmental extension for delivery of care for hard to reach communities In 4 year of project implementation institutional deliveries increased by 52%.

IMR reduction from 20/1000 lb to 16/1000 and NMR from 10.8 to 2.1

$66,000 annual savings to government due to disease prevention

Increase in Institutional Deliveries from 2009-2012


400 350

314 318 187 80 118 125

361

# of Deliveries

300 250 200 150 100 50 0

2006

2007

2008

2009 Years

2010

2011

2012

Decrease in Neonatal Mortality Rate from 2009-2012


Neonatal Mortality Rate 12 10 8 6 4 2 0 2009 2010 2011 Years 2012

10.8 7.9 5.1 2.1

Thank you for your attention!


For more information: LAmendola@Honduras.Childfund.org