April09 Reprogramming: Reduced $100,000.

THIS IS A NEW ACTIVITY IN COP09.

Health Care Improvement Project IQC, awared to the University Research Center, LLC will work with

implementing partners to improve care for PLWHA. PEPFAR Mozambique IP standards vary widely

across partners, making quality control, costing and evaluations difficult. Family Health International is

leading a process of defining quality and service standards, as well as indicators to measure these

standards,through the national Ministry of Health technical working group for home based care. With

support from HCI, tools will be developed for various levels of implementation (community, NGO) of agreed

upon quality standards. HCI will provide training to ANEMO master trainers, in implentation of quality

standards. ANEMO, the National Nurses Association in Mozambique provides all training for certified home

based care workers.

New/Continuing Activity: New Activity

Continuing Activity:

Table 3.3.08:

THIS IS A NEW ACTIVITY IN COP 09.

The narrative below replaces the FY2008 reprogramming narrative

Quality care implies that appropriate services and support are provided to ensure that children affected by

HIV grow and develop as valued members of their families and community. Providing such care is

complicated by the numbers of children needing care and the many service areas required. In line with

Mozambique National Action Plan for OVC, children supported by OVC programs must be provided with

adequate food and nutrition support, shelter and care, protection, health care, psychosocial support,

education and vocational training, and economic opportunity that will ensure their well-being.

This Quality Improvement (QI) activity offers a way to organize and harmonize the provision of care by

engaging people at the point of service delivery to evaluate their own performance and decide how they

could organize themselves to do their jobs better.

Mozambique is starting the QI process by reaching consensus on a set of desired outcomes and by defining

standards for quality care. These standards will then become embodied in training materials, job aids, and

supervision tools that will enable the Ministry of Women and Social Action (MMAS) to monitor and supervise

programs. These standards will also used to develop indicators to measure quality. Service providers then

use these indicators to identify areas in which they need to improve and to track the effect of their

improvement efforts. This is particularly important given the new focus in Mozambique OVC programming

to building district-level capacity for management, coordination and oversight of programs.

The Health Care Improvement Project (HCI), managed by University Research Co. .LLC (URC) is providing

technical assistance to Mozambique Mission and its OVC partners to reach consensus on defining quality

using service standards. Defining service standards and communicating these standards across all levels of

care has been funded by FY 08 funds ($150,000).

In FY09 HCI will provide support to local implementers and the MMAS to identify best practices to

implement the service standards; to measure the quality of services in order to identify opportunities for

improvement; to promote active sharing of promising practices across local implementers (community-

based, international and local organizations) and to engage policy makers, based on the evidence collected,

to strengthen Mozambique's systems of care for vulnerable children (ie: education, health, child protection

services). The promotion of active learning communities will create mechanisms for learning and sharing

for local implementers engaged in actually implementing the service standards, all the way to the point of

direct contact with the vulnerable children and their guardians.

Activities in FY09 include:

1) Creating "Communities of Learning" to identify best practices to implement service standards and to

measure quality. MMAS, implementing partners (national and international), OVC, other forum such as

Children's Parliament, will be engaged in this process.

2) Developing capacity of Mozambican CBOs and coaches to support the learning communities (these

individuals and organizations have already been identified).

3) Build capacity of service providers and MMAS in QI to implement service standards:

Share results and lessons within the country through the MMAS central and provincial level Technical

Working Groups and other platforms which includes policy makers.

MMAS has enthusiastically welcomed the process of defining quality standards and has committed to being

an active participant as well as a champion for dissemination and implementation of service standards.

MMAS will send a senior technical officer to the regional training event in Ethiopia in November 2008, to

ensure that their Ministry is able to effectively lead the process in Mozambique.

As USG moves towards genuine local ownership of programs, this process is a critical tool in enabling

MMAS to measure and monitor quality of services being provided to their orphans and vulnerable children.

Service standards defined will be appropriate to the Mozambican context. Defined service standards will

also enable MMAS to accurately cost the package required for OVC and subsequently will improve their

planning and budgeting process for OVC programming.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools

and Service Delivery

Food and Nutrition: Commodities

Estimated amount of funding that is planned for Food and Nutrition: Commodities

Economic Strengthening

Estimated amount of funding that is planned for Economic Strengthening

Education

Estimated amount of funding that is planned for Education

Water

Estimated amount of funding that is planned for Water

Table 3.3.13: