Designup

Category: Health Systems Strengthening

  • Strengthening surveillance, IEC and procurement planning to address Avian Influenza in Georgia

    The project was funded by USAID/Caucasus and implemented by Curatio International Foundation (CIF) and Program for Appropriate Technology in Health (PATH) in June 2006-April 2007. The key partners were: Ministry of Labour, Health and Social Affairs, DPH, NCDC, WHO, UNICEF, World Bank, DTRA, HHS/CDC, MoA, AgVantage. The aim of the project was to assist the Government of Georgia with well-coordinated approach on surveillance, IEC and procurement that would strengthen early warning systems, outbreak investigation, and effective response to a possible pandemic.

    The objective of the project was to strengthen surveillance/early warning system, procurement planning, and procurement of commodities to address the immediate need, information, education, communication. One of the major components of the project, surveillance, included following activities: assessment of current practices, needs and system design, development of surveillance standards and protocols, development of guidelines, training of public health workers and medical professionals, provision of ongoing on-the-job technical assistance, dissemination of methods, results and lessons learned. The second component for the project, procurement, it combined the need of immediate assessment in consultation with the Government and major donors/partners and in procurement such as the World Bank and DTRA; procurement and delivery of required commodities; development of a master inventory of all commodities required to support surveillance of pandemic influenza. The third component IEC was implemented through provision of input to the development of the National Communications Strategy; development of essential talking points for spokespersons; workshops with media representatives; roundtables with national and regional officials; development of guidelines for health workers on communication with the public.

    Over the project period of June 2006 to April 2007, PATH and CIF closely collaborated with the Government of Georgia and other stakeholders.

    Key partners included:

    Ministry of Labor, Health and Social Affairs (MoLHSA)
    Department of Public Health (DPH) and a network of regional and rayon Centers of (????????)
    Public Health (CPH)
    National Center for Disease Control and Medical Statistics (NCDC)
    World Health Organization/European Region (WHO/EURO) and WHO/Georgia office
    United Nations Children’s Fund (UNICEF)
    World Bank (WB)
    US Defense Threat Reduction Agency (DTRA)
    Department of Health and Human Services/US Centers for Disease Prevention and Control (HHS/CDC)
    Ministry of Agriculture (MoA)
    AgVantage Project
    The following activities were undertaken within the frame of the project:

    Training of public health personnel and health care professionals in the new surveillance procedures and measures to control AI infection in humans;
    Development of AI communication guidelines (“talking points” and “message maps”), followed by training for spokespersons and media representatives;
    Procurement and delivery of surveillance and laboratory supplies;
    Development of an inventory and forecasting tool to strengthen laboratory preparedness and ensure coordination of laboratory supplies and personal protective equipment (PPE).

  • Healthy Women in Georgia

    Healthy Women in Georgia (HWG) project was funded by U.S. Agency for International Aid (USAID) and implemented by JSI Research & Training Institute Inc. in collaboration with Curatio International Foundation, Save the Children, Orthos. The duration of the project was September 2003 – July 2006.

    The objective of the project was to improve women’s health in Georgia. The HWG Program targeted selected facilities in the Imereti region at regional and district levels, and ten ambulatories at the primary health care level. The program developed “Women- Friendly” health care information, counseling and services in facilities and communities. District and ambulatory health providers, pharmacists, and “sakrebulo” (village council) leadership were engaged in the program.

    “Parents’ Schools” for patients and clients were established in three district-level health care facilities, to provide information and counseling in formal courses. The HWG Program established a peer education system for adolescents in schools and community gathering places, and reached out to women in communities who did not attend health facilities.

    Georgia has one of the highest abortion rates in the world. The HWG Program strengthened access to and availability and quality of modern methods of contraception for family planning, as safe and effective alternatives to abortion.

    The objectives of the project:

    Establish sustainable, accessible, and high quality “Women-Friendly” services in “combined” facilities (which respectively include a Maternity Hospital, Women’s Consultation Center, and Reproductive Health Cabinet) at regional and district levels in Kutaisi, Zestaphoni and Chiatura;.
    Strengthen provision of women’s health information, counseling, and services, including antenatal care, contraception, and family planning at primary health care level in ten “ambulatories”, located in the coverage areas of the two facilities in Zestaphoni and Chiatura, develop referral procedures from primary to secondary level facilities, and encourage health providers to reach out to the village-based;.
    Target women, men, and adolescents (patients/clients, service “drop-outs,” and those who have never attended health facilities) living in the coverage areas of the regional, district, and primary care facilities, increase their knowledge, and affect their practices and behaviors to improve healthy life styles and women’s health status;.
    Increase availability and use of modern contraceptives as an alternative to present high rates of abortion, and to prevent sexually-transmitted infections (STIs) and contribute to the health of mothers and infants;
    Update and improve women’s health care knowledge and skills among health care providers, with reference to WHO standards and international research-based medical and program evidence.

  • Effectiveness of Supportive Supervision in Improving the Performance of National Immunization Program in Georgia

    The project was funded by Cida/IDRC (Canadian International Development Centre; The International Development Research Centre) and implemented by Curatio International Foundation in collaboration with Toronto University. The duration of the project was July 2004 – March 2006.

    The study objective was to document the effects of “supportive supervision” on the performance of the immunization program at the district level in Georgia.

    The intervention package included: development of supervisory guidelines, district-level training, continuous supervision and support, monitoring and evaluation, and funding for Centers of Public Health to carry out the package of interventions (travel and communication costs). Supportive supervision, which was the focal point of the package of interventions, was based on introducing updated job descriptions with documented lines of supervision; improving communication lines and skills; introducing guidelines and tools for supervision, performance review and monitoring, and evidence-based action planning, all of which help health workers to improve immunization service delivery.

    The effectiveness of the intervention package was assessed with a pre/post-experimental research design. The package of interventions was uniformly implemented in 15 districts selected randomly out of the nation’s 67 districts. Another 15 districts were selected to serve as controls. Measurements were assessed at the baseline and end of the one-year intervention. Quantitative, qualitative and postal surveys were used to collect the information and derive conclusions. Study revealed that significant improvements in the performance of immunization program occurred after implementation of the intervention. In contrast to control districts, intervention districts experienced a significant increase in DPT-3 coverage, decrease in contraindications rate, decrease in refusals rate, and decrease in vaccine wastage between baseline and follow-up stages. The intervention did not appear to have independently contributed to the relative change in service delivery outcome indicators.

  • Community Based Health Financing Project

    Community Based Health Financing (CBHF) project was implemented by Curatio International Foundation (CIF) through the Sub-Grant Agreement No: RFA-GC6-001-DT under the West Georgia Community Mobilization Initiative Project, which was administered by the Care International in Caucasus and was funded by the United States Agency for International Development (USAID). CIF started project implementation in August 2003 and completed it by August 2004, in accordance with the proposed implementation schedule.

    The main goal of the CBHF project was to decrease the financial access barriers for the poor members of the targeted communities by establishing Community managed and operated health care schemes, that mobilize community’s financial resources (designated for the health care) on a pre-paid basis.

    CIF identified the following objectives:

    Establish 12-18 sustainable CBHF schemes in selected geographic areas, involving communities and local healthcare providers;
    Utilize CBHF schemes to target the most needy within the communities;
    Develop and strengthen local capacity to manage CBHF schemes;
    Ensure future sustainability of CBHF schemes
    The following Project Activities took place during the implementation phase:

    Initial assessment of the situation in 6 regions of Western Georgia;
    Selection of communities that indicated interest in establishing CBHF schemes
    Through the participatory approach, designed CBHF schemes that were custom tailored to each selected community;
    Introduced the designed schemes to Community Based organization through Workshops;
    Identified the training needs of the Community groups and Health Providers;
    Developed training materials for the Communities and Health Providers based on the identified needs;
    Trained Fund Managers, and Health Providers;
    The CBHF Schemes were initiated in 8 targeted communities.

  • Safe Motherhood Initiative

    Safe Motherhood InitiativeSafe Motherhood Initiative
    Georgia Safe Motherhood Initiative (SMI) project was funded by U.S. Agency for International Development (USAID) and implemented by Management Sciences for Health (MSH) in partnership with Curatio International Foundation, Program for Appropriate Technology (PATH), and Emory University. The duration of the project was September 2000 – January 2003.

    The purpose of the SMI activity was to improve maternal and infant health in Georgia through strengthening of integrated maternal and perinatal health services. The project assessed the quality of perinatal services provided and began to support the transformation of the existing system of women’s care into a more integrated and effective one. This had to result in the delivery of continuous, high quality, and patient oriented services, and in increased women’s awareness of the importance of perinatal care for themselves and their child’s health. The project directed its activities toward the regional and local level. This strategy fully supported the Ministry of Labour, Health and Social Protection policy of strengthening primary health care.

    Main components of the project:

    Management and information system development;
    Community Mobilization and Provider-Client Interactions;
    Enhancement of maternal and perinatal clinical performance;
    STD/Anemia Prevalence Study
    Major Achievements:

    Enhancement of maternal and perinatal clinical performance

    SMI project supported development of the National Maternal and Perinatal Clinical Guidelines, which addressed clinical, as well as organizational issues of perinatal services. Twenty nine leading Georgian specialists in the field of Obstetrics/Gynecology, Pediatrics, and Health Care Managers worked over the course of nine months to produce this document. This team was supported by two US experts, who provided comments and valuable literature. Significant time and resources were devoted by the project to consensus building efforts that helped to inspire the thinking of national level experts and program managers to develop and agree on guidelines that call for new organization of perinatal services and that propose new approaches in clinical aspects of case management. The Guidelines were tailored to the Georgian reality, and they were evidence-based and, where applicable, comparable to International standards. The training materials were developed based on Maternal and Perinatal Clinical Guidelines. The package contains manuals both, for trainees and trainers. The training was designed to upgrade the knowledge and clinical skills of the Primary Health Care providers, including their acquisition of counseling skills in order to educate their clients on defined topics of Maternal/Infant health and care. Seventeen National experts from diverse fields (General Practitioners, Obstetricians, Pediatricians, and Counselors) worked on the development of the clinical training materials. A smaller number of experts was involved in actual provider training process in the project targeted areas. The target audience for the training was Obstetricians/Gynecologists, Pediatricians, Internists, Nurse/Midwifes. A total of hundred and ten members of the Primary Heath Care providing system benefited from this effort.

    STD/Anemia prevalence study

    Objectives of the study were:

    Estimate the prevalence rates of five specific STDs and anemia in non-high risk sexually active women;
    Provide essential data for monitoring trends and impact of STDs and anemia in order to carry out adequate policy development for the prevention and control programs;
    Strengthen technical capacity of local epidemiological, laboratory, and clinical based study investigators.
    The study was conducted by the local experts group, with technical support from CDC consultants. Laboratory tests were performed by local laboratories in Georgia. A total of thousand women were investigated.

    First time since its independence (in 1991), Georgia obtained invaluable data on prevalence rates of STDs and anemia among non-high risk population, which enabled the country to consider the results of the research for the purpose of creating clinical guidelines, formulating policy, and updating clinical practice/protocol.

    The SMI for Georgia paid significant attention to the health system components (financing, continuity of care, the workforce, community participation, and public health functions). From the beginning of the project, service deficiencies were identified and activities were planned for their resolution.

    During the project implementation stage, the management approach ensured the empowerment of national/local governments, NGOs, professional groups, and communities. Continuing dialogue between the Georgian and US experts helped to tailor technical inputs to the specific needs of Georgians, rather than proposing ready-made solutions. The latter approach assured national ownership of the program results, which could serve as a guarantee for sustainability and replication to other areas.

    The processes described above required significant staff attention and careful management of financial resources. Continuous on- the- ground presence of local project management helped ensure the attainment of the intended results.