The overall goal of this activity is to improve the quality of care and support services provided to OVC and PLHIV. The Health Care Improvement Project (HCI) has been providing technical support to the Ministry of Women and Social Action (MMAS), USG and its implementing partners to engage in a quality improvement process by helping to define minimum service standards for OVC. The HCI project directly contributes to the Partnership Frameworks Objectives 5.1 and 5.3, through technical assistance to improve the quality of care for OVC and affected households, development of M&E instruments, facilitation of best practice exchanges, training and development of standards, and clarifying roles between health facilities and community care providers. HCI will monitor the effectiveness based on the results of activities being developed, from which indicators measuring quality will be identified. Such indicators will include both outcome measures (changes in childrens and PLHIV wellbeing) and also process measures (such as community participation, PLHIV and childrens involvement) that relate to the essential actions as defined in the standards. HCI pipeline was less than 18 months. FY 12 request is less than previous years taking into account the pipeline and new planned activities. Purchased/leased vehicles will not be planned under this mechanism

This is a national level activity, which will build upon current efforts to define minimum service standards for OVC, which will include defining care and support standards for PLHIV. The process will engage the MOH, MMAS, USG implementers, PLHIV and other stakeholders, with representation from the three regions in Mozambique (South, Center, and North). Once the quality standards are defined, they can be harmonized across all implementing partners. The quality improvement process engages stakeholders (primarily service providers) in a process defining a set of standards and clearly desired outcomes for each service intervention. The process also entails identifying a range of essential actions that all organizations agree upon in the pursuit of effectiveness, efficiency, equity and sustainability. This activity will draw on the work currently underway with services for OVC. Standards will be defined with the context of integrated, family-centered care and support in Mozambique. This activity will help to identify the essential interventions service providers need to focus on to ensure effective services for PLHIV (i.e. treatment adherence, psychosocial support) which improve quality of life.

Once the HBC standards elaborated there will be a process of gathering evidence on the implementation of draft standards. This process will involve the identification of key partners, that will be involved in gathering evidence that the draft standards are doable and actually making a difference in household wellbeing; build quality improvement capacity of partners (develop a collaborative approach among the organizations involved in the piloting) to gather evidence on the draft standards; develop common tools to gather evidence across levels and document the process and the results.

This activity is being implemented by an International Partner.

The goal of this activity is to improve the quality of care and support services provided to OVC.

HCI has been working with the Ministry of Women and Social Action (MMAS), the Quality Improvement (QI) Task Force (established by MMAS) and implementing partners, in the pilot of recently defined minimum service standards for Orphans and Vulnerable Children (OVC), which were approved by MMAS for piloting. The definition of minimum service standards was the first key step in improving the quality of services provided for OVC. The draft service standards are being piloted in Gaza, Zambezia and Cabo Delgado provinces since January 2011, to gather evidence that will support the vetting process by all stakeholders, and HCI will continue to support the district and provincial level QI teams through communities of learning meetings where sharing across Implementing Partners engaged in the process of quality improvement takes place.

With FY12 funds, HCI will continue to support MMAS in the identification and documentation of best practices and lessons learned from the pilot phase of implementation of the minimum service standards in the three provinces. The QI Task Force will jointly with HCI identify additional provinces to rapidly scale up the process of quality improvement for OVC. HCI will provide technical support to these additional provinces to ensure that services standards are disseminated, understood by implementers, OVC and caregivers, policy makers and other stakeholders. As service providers implement the new minimum service standards, HCI will help to document this process as well as make adjustments to implementation based on challenges encountered in the field at the point of service delivery.

In an effort to ensure local ownership and leadership of the quality improvement process, HCI will continue to support identified individuals at the provincial level MMAS who have been trained as QI Coaches. HCI will document the QI process across implementers, facilitate the sharing of promising practices and develop supportive networks of QI champions within Mozambique.

Currently HCI has been unable to continue the service provision through their office in Mozambique, given the fact that they are in the registration process with GRM to be legal entity. To mitigate this issue, regional and Washington based TA will be provided until the registration process is finalized.