Support for the Continuum Santé Mères Enfants (ACOSME)

The implementation of the skills development plan at the level of service providers and managers is underway; the completion of the gender audit of the DSN and the elaboration of an action plan EFH was elaborated. The supervision by the DSN of the trained personnel of the institutions concerned (19) is improving, in particular thanks to the financial and technical participation of the project.

The five constructions and rehabilitations started during this semester and on one site (Cadush) are finished. The project will be completed as planned by the end of year 2. Environmental studies and management plans have been completed. The distribution of essential drugs for the operation of the centers supported by the project and materials and equipment to be implemented in the health institutions supported were carried out, including targeted training on the maintenance and operation of equipment and support for their assembly . The activities also included support for supervision in connection with the training provided, support for the implementation of community mobilization activities (MC) and support to the DSN for the realization of various meetings of consultations with the different technical and financial partners.

At the level of the community mobilization strategy, there are now seven public health institutions that have developed a community mobilization plan, including the EFH. Multipurpose Community Health Workers (CHWs) have been trained and are operational in particular in the context of advanced strategies (assembly stations and mobile clinics). The ASCPs were able to carry out 538 assembly stations, on-site education sessions public services (markets, churches, etc.), home visits and fixed points. Five micro-projects will be launched at the beginning of the second semester. The members of the 15 CFUs are trained, including the issues related to the EFH. The different partners are developing a strategy for improving health evacuation.

1) The institutional diagnosis and the strengthening plan were completed in Year 1. It was updated so that all the training streams are represented in it, namely:– medical– non-medical– HR– EWM– Community engagement– EnvironmentActivities pertaining to the organizing of services were implemented. Frameworks for actions to be implemented resulting from supporting the organizing of services are also available and under way for four institutions (Grande Rivière du Nord HCR, Fort Saint Michel Hospital, Limonade HC, Quartier Morin HC. 2) From Year 1 to Year 2, eleven (11) training sessions were completed, including four (4) in Year 1 and seven (7) in Year 2. 58% of the training provided in the PDC was completed versus the 80% originally planned. This divergence is partly due to the postponement of planned activities following the subsequent demonstrations in recent months, and also to the difficulties encountered in recruiting an HR resource who would have been in charge of tracking the training of departmental executives. Specifically, in Year 2, 7 of the 9 training sessions planned were organized 3) Sixty-eight (68) follow-up and support activities werecarried out; twelve (12) of them for Year 1 and fifty-six (56) for Year 2.

In terms of follow-up and support for Year 2, out of the 56 follow-up and support activities carried out, 41 of them involved evaluating the knowledge acquired (indicator 1123.1); which is 73.21% of the planned activities. The divergence between the expected and observed results is due to the fact that the other 15 follow-up activities did not factor in evaluating the knowledge acquired. 4) In the first half of Year 2 of the project, two community-level research projects tookplace from May to August 2018.

The first one, entitled Qualitative Study of a Mother/Child Health Promotion Campaign, was conducted by the ACOSME project with a Master’s degree in Global Health. This research stems from an awareness campaign conducted in Bahon from May 20 to 27, 2018, for Mothers’ Day. The objectives were to:

– Understand the attitudes of key players in a rural community towards MNCH awareness campaigns;– Obtain feedback on the planning, content and impact of the awareness activities in order to improve future campaigns.The data collection was done from August 6 to 16, 2018, following approval from Haiti’s National Bioethics Committee (NBC). Semi-guided interviews roughly 30 minutes long were conducted with 23 key informants, including members of the Bahon WUC, school principals and VCHWs. The transcribing of those interviews is finished, and the analysis of the results has started. A presentation of the preliminary results will be given on April 8, 2019, during the HARIS conference. 2. The second research project, entitled a Study on the Perception and Management of High Blood Pressure in Women of Reproductive Age in Fort Bourgeois (Nord department), was conducted in Fort Bourgeois from May to July, 2018, by a medicine resident from Notre Dame university. It is a Haitian university, and ACOSME is helping to strengthen the research capacity of Haitian players.