Technical Resources


Quality of Care for Prevention and Management of Common Maternal and Newborn Complications: A Study of Ethiopia’s Hospitals

Publish Date: December 2011
Author: MCHIP, Ashebir Getachew, Jim Ricca, David Canto,r Barbara Rawlins, Heather Rosen, Alemnesh Tekleberhan, Linda Bartlett, Hannah Gibson

This quality of care survey was conducted in March and April of 2010 to assess the care received by mothers and newborns during antenatal and delivery care. The survey was fielded in the 19 Ethiopian hospitals with the heaviest volume of deliveries. The primary objective of the survey was to determine the frequency and quality of interventions that address direct …


Technical Quality Assessment of Operations Research Protocols: Child Survival and Health Grants Program

Publish Date: April 2013
Author: Jim Foreit

This evaluation assesses the relevance and quality of 24 Child Survival Health Grants Program concept papers on operations research studies submitted to MCHIP and USAID. Attachment Size OR-Concept-report.pdf 340.91 KB


Child Survival and Health Grants Program: Technical Reference Materials – Quality Improvement

Author: MCHIP, USAID ASSIST Project

Technical reference materials are a product of the Bureau for Global Health, Office of Health, Infectious Diseases and Nutrition Child Survival and Health Grants Program USAID/GH/HIDN/Child Survival and Health Grants Program. These guides are not an official policy for practice; rather, they are basic everyday summaries to be used as field reference documents. Attachment Size Quality Improvement TRM.pdf 721.6 KB


Quality of antenatal care and household wealth as determinants of institutional delivery in Pakistan: Results of a cross-sectional household survey

Publish Date: July 2016
Author: Sohail Agha and Emma Williams

This article, published in the journal Reproductive Health, highlights the results of a household survey of 4,000 married women who had given birth in the two years before the survey was conducted in Sindh province, Pakistan. The survey collected data on socio-economic and demographic variables, the quality of antenatal care provided during a woman’s last pregnancy, and whether she delivered …


Piloting a Streamlined Index for Assessment of Quality of Labor and Delivery Care in Tanzania – Findings and Recommendations

Publish Date: June 2015
Author: MCHIP, MCSP

There is a need for streamlined observation-based tools to measure labor and delivery (L&D) care quality. Using data from the MCHIP Maternal and Newborn Quality of Care Surveys (QoC Surveys), a research study recently developed a short but comprehensive index of 20 informative indicators that can be used to measure the quality of routine L&D care by facility-based or external …


Case Study: Improving Quality of Care and Outcomes for Child Health Using the Standards-Based Management and Recognition Approach in Zimbabwe

Author: Dyness Kasungami, Savitha Subramanian

This case study aims to document the application of Standards-Based Management and Recognition (SBM-R) as a quality improvement approach to the case management of childhood illness in Zimbabwe through MCHIP. The lessons learned about the implementation process, success factors, and challenges will illumine the adoption of SBM-R to improve the quality of case management of childhood illness, where applicable, in Maternal …


A literature review of quantitative indicators to measure the quality of labor and delivery care

Author: Vandana Tripathi

Strengthening measurement of the quality of labor and delivery (L&D) care in low-resource countries requires an understanding of existing approaches. This literature review identifies quantitative indicators of L&D care quality and assess gaps in indicators. The authors conclude that many quantitative indicators have been used to measure L&D care quality, but few have been validated beyond expert opinion. There has …


Facility-based active management of the third stage of labour: assessment of quality in six countries in sub-Saharan Africa

Author: Linda Bartlett, David Cantor, Pamela Lynam, Gurpreet Kaur, Barbara Rawlins, Jim Ricca, Vandana Tripathi, Heather E Rosen

The World Health Organization published an MCHIP co-authored article on “Facility-based active management of the third stage of labour: assessment of quality in six countries in sub-Saharan Africa.” The study – which examined recorded use of uterotonic medicines, controlled cord traction, and uterine massage – covered 390 facilities in Ethiopia, Kenya, Madagascar, Mozambique, Rwanda and Tanzania between 2009 – 2012. …


Piloting a Streamlined Index for Assessment of Quality of Labor and Delivery Care in Tanzania – Findings and Recommendations

Publish Date: June 2015
Author: MCHIP, MCSP

There is a need for streamlined observation-based tools to measure labor and delivery (L&D) care quality. Using data from the MCHIP Maternal and Newborn Quality of Care Surveys (QoC Surveys), a research study recently developed a short but comprehensive index of 20 informative indicators that can be used to measure the quality of routine L&D care by facility-based or external …


Identification of a Short Quality of Care Index to Measure the Quality of Facility Routine Labor and Delivery Care in Sub-Saharan Africa

Publish Date: June 2015
Author: MCHIP, MCSP

There is a need for valid, reliable, and efficient tools that comprehensively measure the quality of labor and delivery (L&D) care processes. MCHIP’s quality of care (QoC) Assessments provided a unique opportunity to apply the results of observations of L&D care in developing innovative measures of care process quality that capture important information while requiring fewer resources to implement.


Development and Validation of an Index to Measure the Quality of Facility-Based Labor and Delivery Care Processes in Sub-Saharan Africa

Publish Date: June 2015
Author: Vandana Tripathi, Cynthia Stanton, Donna Strobino, Linda Bartlett

Improving quality of care is essential to achieve the new global targets for ending preventable maternal and newborn deaths. The global community has recognized the need for better measures of the quality of maternal and newborn health services. In particular, little information is available about the content of care provided to women and newborns. Many measures focus on service availability …


Quality Improvement in Mozambique’s Model Maternities: Linking improvement in standards with health outcomes and impacts

Publish Date: September 2014
Author: MCHIP

Background on the establishment and expansion of the Model Maternities Initiative in Mozambique.


MCHIP Technical Summary: Quality of Care

Publish Date: June 2014
Author: MCHIP

This paper highlights five key quality measurement and improvement approaches and tools developed and/or used in MCHIP’s work: Standards-Based Management and Recognition (SBM-R) for quality improvement (QI) of reproductive, maternal, newborn, and child health (RMNCH) services Quality of care health facility assessments for measurement of the quality of facility-based maternal and newborn health (MNH) services Regular Appraisal of Program Implementation …


Opening Doors to Quality Education

Publish Date: August 2014
Author: MCHIP

Photobook highlighting MCHIP work to strengthen nursing and midwifery preservice education in India.


Quality of Antenatal and Delivery Care Services in Six Countries in Sub-Saharan Africa

Publish Date: December 2013
Author: MCHIP

In 2010–2012, MCHIP conducted a series of health facility surveys examining the quality of care that mothers and newborns received in facilities in Sub-Saharan Africa. The main objective of these surveys was to determine the frequency and quality of evidence-based MNH interventions performed by antenatal care and delivery care providers. This brief presents a summary of study findings from six …


Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-Up

Publish Date: May 2014

This collection of research studies provides evidence from five African countries—Kenya, South Africa, Tanzania, Zimbabwe and Lesotho—that safe, high-quality voluntary medical male circumcision (VMMC) services performed by trained healthcare professionals in low resource settings can be implemented and sustained at scale and has the potential to significantly prevent new HIV infections in adolescent and adult men. The papers published under …


MAISHA Quality of Maternal and Newborn Care Study: Tanzania

Publish Date: October 2013
Author: MAISHA

A series of MCHIP health facility surveys on quality of care (QoC) focus on the frequency and quality of interventions that address the direct causes of maternal and newborn deaths, and act as key sources of information for policymakers and other stakeholders in country. The Tanzania reports—on labor and delivery, and antenatal care—highlight areas of relative strength as well as significant gaps …


Quality and Humanization of Care Assessment: A Study of the Quality of Maternal and Newborn Care Delivered in MozambiqueÕs Model Maternities

Publish Date: March 2013
Author: MCHIP

This QoC report from Mozambique summarizes the findings on antenatal care (ANC) and Labor & Delivery Care from observations of 525 deliveries and 303 ANC consults in 46 facilities (17 facilities currently in the MOH’s Model Maternities Initiative and 29 in the future expansion plans for the initiative). Data tables are available in a separate file below.


Quality and Humanization of Care Assessment: A Study of the Quality of Maternal and Newborn Care Delivered in Mozambique’s Model Maternities

Publish Date: March 2013
Author: MCHIP

This QoC report from Mozambique summarizes the findings on antenatal care (ANC) and Labor & Delivery Care from observations of 525 deliveries and 303 ANC consults in 46 facilities (17 facilities currently in the MOH’s Model Maternities Initiative and 29 in the future expansion plans for the initiative). Data tables are available in a separate file below.


Communication for Polio Eradication: Improving the Quality of Communication Programming Through Real-Time Monitoring and Evaluation

Publish Date: May 2010
Author: Silvio Waisbord, Lora Shimp, Ellyn W. Ogden, Chris Morry

Drawing on evidence from Afghanistan, India, Pakistan, and Nigeria, this article examines how the Global Polio Eradication Initiative utilized monitoring and evaluation data to focus and improve the quality and impact of communication activities.


Quality of Care: Health Worker Line Listing

Author: MCHIP

Part of a series of MCHIP Quality of Care tools, this document is used to produce a list of all health workers who provide services to mothers and newborns at the facility where observations will occur. It also captures medical qualifications of the staff and assigns individual code for each health worker for use in the survey.


Quality of Care: Essential Inventory

Author: MCHIP

Part of a series of MCHIP Quality of Care tools, this document is used to report infrastructure conditions and verify availability and storage conditions of medications, supplies and equipment. It includes a short record review to capture the number of antental care consultations and deliveries at each facility for the last year, based on the health management information system (HMIS) …


Quality of Care: Clinical Practice Observation of Antenatal Care and Labor & Delivery

Publish Date: January 2013
Author: MCHIP

Part of a series of MCHIP Quality of Care tools, these structured clinical observation checklists are for use in observation of antenatal care (ANC) consultations and labor and delivery (vaginal deliveries only) at facilities. The content of the checklists was developed based on World Health Organization guidelines and includes: screening for pre-eclampsia/eclampsia (PE/E) in ANC; management of PE/E and prevention of postpartum hemorrhage …


Quality of Care: Interview and Knowledge Test

Publish Date: January 2013
Author: MCHIP

Part of a series of MCHIP Quality of Care tools, these questions capture training and experience of the health worker and then test their knowledge of how to identify, manage and treat common maternal and newborn health complications. It includes a simulated resuscitation with a newborn model to assess newborn resuscitation skills.


Introduction to the Maternal and Newborn Quality of Care Surveys

Publish Date: January 2013
Author: MCHIP

A series of MCHIP health facility surveys on quality of care (QoC) focus on the frequency and quality of interventions that address the direct causes of maternal and newborn deaths, and act as key sources of information for policymakers and other stakeholders in country. This document provides information on the background, study objectives, and methodology of these surveys.


Reproductive health services in Malawi: An evaluation of a quality improvement intervention

Publish Date: January 2013
Author: Barbara J. Rawlins, Young-Mi Kim, Aleisha M. Rozario, Eva Bazant, Tambudzai Rashidi, Sheila N. Bandazi, Fannie Kachale, Harshad Sanghvi, Jin Won Noh

An article in the journal “Midwifery” evaluates the impact of a quality improvement initiative in Malawi on reproductive health service quality and related outcomes. Results from the study indicate that PQI is an effective way to improve the quality of health services in a low-resource setting. To read the article, click here.


Quality of Care for Prevention and Management of Common Maternal and Newborn Complications: Findings from a National Health Facility Survey in Rwanda

Publish Date: March 2012
Author: MCHIP

This survey augments the existing literature on maternal and newborn health in Rwanda by including both knowledge tests and direct observation of care against standard checklists in both antenatal care and labor and delivery care, rather than collecting data through routine household surveys. The purpose of the survey is to generate information to quantify the need for and guide the …


Assessing the Quality and Humanization of Maternity and ANC Care in Mozambique (presentation)

Publish Date: November 2011
Author: MCHIP, Leonard Chavane, Jim Ricca

This presentation includes a summary of key results, conclusions, and preliminary recommendations from the MCHIP Mozambique QoC study results report.


Taking Stock of MCHIP Efforts Around Quality Improvement and Quality Assessment

Publish Date: April 2011
Author: MCHIP

MCHIP brings together a strong set of players in the field of maternal and child health (MCH). Each MCHIP partner has unique technical expertise with regards to Quality Improvement (QI) and Quality Assessment (QA) activities. Program partners also have specific knowledge about and experience with using different QI/QA approaches and tools. Given MCHIP’s decentralized nature, the number of partners involved …


Creating Stronger Incentives for High-Quality Health Care in Low- and Middle-Income Countries

Publish Date: March 2012
Author: MCHIP, Alex Ergo, Ligia Paina, Lindsay Morgan and Rena Eichler

This paper provides guidance on developing stronger linkages between quality improvement and performance-based incentive in low- and middle-income countries (LMICs), by reflecting on current efforts in both high-income countries and LMICs and focusing mostly on supply-side schemes.


In Brief: Creating Stronger Incentives for High-Quality Health Care in Low- and Middle-Income Countries

Publish Date: March 2012
Author: MCHIP, Alex Ergo, Ligia Paina, Lindsay Morgan and Rena Eichler

This brief provides an overview of schemes linking quality improvement and performance-based incentives (PBIs) and provides guidance on how this link could be further strengthened in low- and middle-income countries (LMICs). Although both demand- and supply-side PBI schemes are recognized, the brief focuses mostly on the supply side. The first part describes current efforts to improve quality of care in existing PBI schemes …


Quality of Maternal and Newborn Health Services in Zanzibar, 2010: Findings from Selected Health Facilities in Unguja and Pemba

Author: MCHIP, Marya Plotkin, Christina Lulu Makene, Asma Ramadhan Khamis, Sheena Currie, Gaudiosa Tibaijuka, Maryjane Lacoste, Molly O’Bryan

The MAISHA Quality of Maternal and Newborn Health Services study in Zanzibar, conducted in November–December 2010, was an observational study conducted in nine health facilities in Pemba and Unguja. The aim of the study, which combined observations of service delivery with inventories, record reviews and health worker knowledge assessments, was to provide strong information on the quality of maternal and …


Finding Common Ground: Harmonizing the Application of Different Quality Improvement Models in Maternal, Newborn, and Child Health Programs

Publish Date: October 2010
Author: USAID Health Care Improvement Project, Youssef Tawfik, Mary Segall, Edgar Necochea, Troy Jacobs

This paper attempts to systematically review and compare quality improvement (QI) models that have been applied extensively in maternal, newborn, and child health (MNCH) or are potentially effective models for MNCH programs.The paper identifies the models’ essential elements in an attempt to find common ground: a place where those who apply different QI models can discuss them with a common language …


Quality of Care for Prevention and Management of Common Maternal and Newborn Complications: A Study of Ethiopia’s Hospitals

Publish Date: December 2011
Author: MCHIP

This quality of care survey was conducted in March and April of 2010 to assess the care received by mothers and newborns during antenatal and delivery care. The survey was fielded in the 19 Ethiopian hospitals with the heaviest volume of deliveries. The primary objective of the survey was to determine the frequency and quality of interventions that address direct …


Quality of Care of the Prevention and Management of Common Maternal and Newborn Complications in Health Facilities in Madagascar

Publish Date: December 2011
Author: MCHIP, Justin Ranjalahy Rasolofomanana, Jean Pierre Rakotovao, Eva Bazant, Vandana Tripathi

This survey was designed to complement and extend previous efforts at assessing quality and access to maternal and newborn care, with a particular focus on observations of providers during antenatal care and labor and delivery to assess the use of lifesaving interventions to prevent or manage common complications. The multi-country study objectives were to: Guide program planning for improving quality …


Partnership-Defined Quality Monitoring and Evaluation Toolkit

Publish Date: February 2010
Author: CORE Group, Save the Children

This handy toolkit is meant to assist PDQ practitioners with tools such as sample exit interviews and checklists to complement Save the Children’s PDQ Manual and PDQ Facilitator’s Guide. The toolkit also includes a Youth Annex for youth-focused PDQ projects to complement the PDQ for the Youth Manual. One unique element of the document is that tested indicators for community …


Lot Quality Assurance Sampling Guidance: FAQs

Publish Date: August 2008
Author: CORE Group

The LQAS FAQ document was produced by the CORE Group Monitoring and Evaluation working group as a result of a technical advisory group (TAG) meeting held in August 2008, in which practitioners developed new guidelines for parallel sampling in order to improve the quality of monitoring and evaluation efforts.


Lot Quality Assurance: Protocol for Parallel Sampling

Publish Date: September 2008
Author: CORE Group

CORE Group’s Monitoring and Evaluation Working Group developed several guidance documents to help program managers implement a Lot Quality Assurance Sampling (LQAS) parallel sampling methodology. The methodology enables the efficient collection of information from different sampling groups in the same area at the same time with an adequate sample size for each indicator.


Partnership-Defined Quality Facilitation Guide

Author: Save the Children, CORE Group

The PDQ process engages communities and health care providers to work together in defining, implementing and monitoring activities intended to improve the quality of care. This facilitation guide is designed as a training supplement for the PDQ manual. The guide will enable the facilitator to conduct a PDQ training that will enhance the participants’ understanding of when and how PDQ …


Quality of Maternal and Newborn Health Services in Tanzania: A survey of the quality of maternal and newborn health in 12 regions of Tanzania

Author: MCHIP, MAISHA

Conducted in July and August 2010, this observational study included 52 health facilities in 12 regions of Tanzania and additional facilities in Zanzibar. The aim was to gather information on the quality of maternal and newborn care, and the results serve as a baseline for the MAISHA program, as well as an important source of information for policymakers and stakeholders …


Voluntary Medical Male Circumcision: Matching Demand and Supply with Quality and Efficiency in a High-Volume Campaign in Iringa Region, Tanzania

Publish Date: November 2011
Author: Hally R. Mahler, Baldwin Kileo, Kelly Curran, Marya Plotkin, Tigistu Adamu, Augustino Hellar, Sifuni Koshuma, Simeon Nyabenda, Michael Machaku, Mainza Lukobo-Durrell, Delivette Castor, Emmanuel Njeuhmeli, Bennett Fimbo

This case study suggests that a campaign approach can be used to provide high-volume quality VMMC services without compromising client safety, and provides a model for matching supply and demand for VMMC services in other settings.


Assessing the quality of care for prevention, identification, and management of maternal and newborn complications at the time of birth

Author: MCHIP, Jim Ricca

MCHIP presentation on Quality of Care given at the 2011 APHA.


Quality of Care for Prevention and Management of Common Maternal and Newborn Complications: A Study of 12 Regions in Tanzania

Author: Maisha, MCHIP, Marya Plotkin, Gaudiosa Tibaijuka, Christina Lulu Makene, Sheena Currie, Maryjane Lacoste

Part of a multi-country assessment of the quality of maternal and newborn health services, this study was conducted in July and August 2010 across 12 regions of Tanzania and Zanzibar. The observational study was conducted in 52 health facilities, including regional hospitals, health centres and dispensaries in mainland Tanzania. A separate study was conducted in Zanzibar. The study combined observation …


Quality of Care for Prevention and Management of Common Maternal and Newborn Complications: Findings from a National Health Facility Survey in Kenya

Publish Date: 2011
Author: MCHIP

This report is on a quality of care (QoC) survey that was fielded as part of ICF Macro’s 2010 Kenya Service Provision Assessment (KSPA) in all eight provinces of the country. The study was conducted in a representative sample of 695 health facilities, of which 509 provided antenatal care services, 207 provided labor and delivery services, and 129 were level 3 facilities …


Direct observation of respectful maternity care in five countries: a cross-sectional study of health facilities in East and Southern Africa

Publish Date: December 2015
Author: Heather E. Rosen, Pamela F. Lynam, Catherine Carr, Veronica Reis, Jim Ricca, Eva S. Bazant, Linda A. Bartlett

This article, published in BMC Pregnancy & Childbirth, analyzes select data from a series of cross-sectional surveys implemented from 2009 – 2012 by MCHIP to assess quality of care in Ethiopia, Kenya, Madagascar, Rwanda and the United Republic of Tanzania. The study used structured, standardized clinical observation checklists to directly observe the quality of care at facilities in the five countries. A total …


Factors associated with early growth in Egyptian infants: implications for addressing the dual burden of malnutrition

Author: Justine A Kalve, Valerie L. Flax, Ali Abdelmegeid, Farouk Salah, Seham Hafez, Magda Ramzy, Doaa Hamed, Gulsen Saleh, Rae Galloway

The Maternal and Child Nutrition journal published an MCHIP co-authored article “Factors associated with early growth in Egyptian infants: implications for addressing the dual burden of malnutrition.” The article examines infants and young children in Egypt, who face overlapping forms of malnutrition, including micronutrient deficiencies, stunting and overweight. Yet, in this setting, little is known about the factors associated with …


Feasibility Study of the Implementation of Integrated Community Case Management (iCCM) in Bondo: Leveraging Existing Systems

Author: MCHIP, MCSP

The integrated community case management (iCCM) feasibility study in Bondo, Kenya, was designed to test whether Community Health Volunteers (CHVs) can deliver an iCCM package building on the existing community health strategy platform, thereby increasing coverage and quality of services at community and facility levels, and thus reducing child morbidity and mortality.


Oxytocin in Uniject Disposable Auto-Disable Injection System versus Standard Use for the Prevention of Postpartum Hemorrhage in Latin America and the Caribbean: A Cost-Effectiveness Analysis

Publish Date: June 2015
Author: Andrés Pichon-Riviere, Demián Glujovsky, Osvaldo Ulises Garay, Federico Augustovski, Agustin Ciapponi, Magdalena Serpa and Fernando Althabe

Despite strong evidence showing the efficacy of routine oxytocin in preventing postpartum hemorrhage, the proportion of women receiving it after delivery is still below 100%. The Uniject injection system prefilled with oxytocin (Uniject) has the potential advantage, due to its ease of use, to increase oxytocin utilization rates. The authors aimed to assess its cost-effectiveness in Latin America and the …


MaMoni HSS brochure

Publish Date: June 2015
Author: MCHIP

Brochure on the MaMoni HSS project, an MCHIP Associate Award that aims to improve the utilization of integrated maternal, newborn and child health, family planning and nutrition (MNCH/FP/N) services to increase the availability and quality of high-impact interventions. The project supports the Ministry of Health and Family Welfare in Bangladesh to introduce and scale-up proven, evidence-based practices, with the ultimate aim …


Factors Associated with Growth in the First Year of Life in Egyptian Children: Implications for the Double Burden of Malnutrition

Publish Date: February 2015
Author: Justine Kavle, Valerie Flax, Ali Abdelmegeid, Farouk Salah, Seham Hafez, Magda Ramzy, Doaa Hamed, Gulsen Saleh and Rae Galloway

Optimal growth in infancy and early childhood is critical to the attainment of human capital and economic development in low and middle income countries. Stunted children often become adults of small stature, with limited work productivity and reduced lifetime wage earnings. Stunting remains an important problem in Egypt, with approximately one-third of children < 5 years of age affected. A …


Exploring why junk foods are ‘essential’ foods and how culturally tailored recommendations improved feeding in Egyptian children

Publish Date: December 2014
Author: Justine A. Kavle, Sohair Mehanna, Gulsen Saleh, Mervat A. Fouad, Magda Ramzy, Doaa Hamed, Mohamed Hassan, Ghada Khan, and Rae Galloway

This study utilized the trials of improved practices (TIPs) methodology to gain an understanding of the cultural beliefs and perceptions related to feeding practices of infants and young children 0–23 months of age and used this information to work in tandem with 150 mothers to implement feasible solutions to feeding problems in Lower and Upper Egypt. Study findings reveal high …


A Review of the Maternal and Newborn Health Content of National Health Management Information Systems in 13 Countries in Sub- Saharan Africa and South Asia

Publish Date: November 2014
Author: MCHIP, MCSP

To understand the current status of national health management information system (HMIS) capacity to capture indicators of the content and quality of antenatal care and labor and delivery services in priority USAID countries where MCHIP works, and to gauge the scale of work yet to be done to improve the utility of health management information systems, MCHIP conducted a desk …


Lesotho Nursing and Midwifery Primary Health Care Clinical Placement Final Report

Publish Date: September 2014
Author: MCHIP and USAID

MCHIP initiated a nursing pre-service education (PSE) program in Lesotho in May 2010 to improve the quality of nurse- and midwife-delivered care. The program included support to the development of primary health care (PHC) clinical placements for trained nursing assistants and general nursing and midwifery students. To expand on its anecdotal program evaluation, MCHIP conducted operational research on PHC clinical …


Standard Operating Procedures for Establish Demonstration Centers for Immunization

Publish Date: June 2014
Author: MCHIP

Demonstration centers act as centers of excellence for learning through demonstrations. MCHIP developed the Demonstration centers to showcase the correct practices and processes in the facilities of focused districts. The document is prepared with intent to guide program managers, health functionaries to develop centers of excellence which will ultimately lead to improved quality of Immunization services. A related success story …


RMNCH+A Highlight Series – Improving RMNCH+A interventions: Block Monitoring in Lohardaga District, Jharkhand

Publish Date: July 2014
Author: MCHIP

The Government of India identifies the “block’ as the primary unit for implementation and management of life-saving RMNCH+A interventions. The “Guidance Note for Block Monitoring Visits” advises state and district health officers and their development partners to systematically assess the health infrastructure, human resources, and quality and coverage of RMNCH+A information and services, with the goal of identifying and addressing …


RMNCH+A Highlight Series – Corrective Action for Improved Service Delivery: Rapid Assessment in Uttarakhand

Publish Date: July 2014
Author: MCHIP

A rapid assessment was conducted in Uttarakhand to assess gaps in availability, accessibility, utilization, and quality and to ensure availability of essential commodities under the RMNCH+A 5×5 matrix. Assessment results provided an adequate evidence base to draw facility improvement plans addressing key gaps through short- and mid-term actions.


RMNCH+A Highlight Series – Corrective Action for Improved Service Delivery: Rapid Assessment in Uttarakhand

Publish Date: July 2014
Author: MCHIP

A rapid assessment was conducted in Uttarakhand to assess gaps in availability, accessibility, utilization, and quality and to ensure availability of essential commodities under the RMNCH+A 5×5 matrix. Assessment results provided an adequate evidence base to draw facility improvement plans addressing key gaps through short- and mid-term actions.


Assessment of the consistency of national-level policies and guidelines for malaria in pregnancy in five African countries

Publish Date: June 2014
Author: Patricia Gomez, Julie Gutman, Elaine Roman, Aimee Dickerson, Zandra Andre, Susan Youll, Erin Eckert, Mary Hamel

One of the major factors contributing to low coverage of long-lasting insecticide-treated bed nets (LLINs) and intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) among pregnant women is provider confusion about when and how to distribute them. Technical expertise in malaria in pregnancy (MIP) is typically provided by national malaria control programs (NMCPs), while MIP interventions are implemented through national reproductive health …


Health-systems bottlenecks and strategies to accelerate scale-up in countries

Publish Date: May 2014
Author: Dr Kim E Dickson, Aline Simen-Kapeu, Mary V Kinney, Luis Huicho, Linda Vesel, Eve Lackritz, Joseph de Graft Johnson, Severin von Xylander, Nuzhat Rafique, Mariame Sylla, Charles Mwansambo, Bernadette Daelmans, Joy E Lawn, for The Lancet Every Newborn Study Group

MCHIP’s Newborn Health Team Leader, Dr. Joseph de Graft-Johnson, has contributed to a series of papers published in The Lancet. The series provides an overview of the progress to date in newborn survival, and stresses the need for quality care at birth. The article—entitled “Health-systems bottlenecks and strategies to accelerate scale-up in countries”—is one of five papers in the collection, …


Maternal Mortality and HIV: An Overview

Publish Date: September 2014
Author: MCHIP

This briefer examines the causes of maternal morbidity and mortality among women living with HIV, as well as maternal health and antiretroviral treatment. An estimated 6-20% of maternal deaths worldwide are believed to be HIV-related. However, many of these deaths can be prevented with the implementation of high-quality antenatal, obstetric and postpartum care, including prompt diagnosis of HIV and associated …


Clinical Observer Learning Resource Package

Publish Date: September 2013
Author: MCHIP

This learning resource package is designed to prepare health professionals or clinical trainers to participate in clinical observation of client-provider interactions. It includes practice observing providers both in a clinical simulation and with clients in a clinical setting. After completing this course, participants will be able to competently conduct an assessment in the field using observational data collection tools both …


Performance-based Incentives to Improve Health Status of Mothers and Newborns: What Does the Evidence Show?

Publish Date: December 2013
Author: Rena Eichler, Koki Agarwal, Ian Askew, Emma Iriarte, Lindsay Morgan, Julia Watson

The Journal of Health, Population and Nutrition has published the article, “Performance-based Incentives to Improve Health Status of Mothers and Newborns: What Does the Evidence Show?” authored by Rena Eichler (Broad Branch Associates), Koki Agarwal (Jhpiego/MCHIP), Ian Askew (Population Council), Emma Iriarte (Inter-American Development Bank), Lindsay Morgan (Broad Branch Associates) and Julia Watson (DFID). The authors analyzed evidence from published …


Moving malaria in pregnancy programs from neglect to priority: experience from Malawi, Senegal and Zambia

Publish Date: January 2014
Author: Elaine Roman, Michelle Wallon, William Brieger, Aimee Dickerson, Barbara Rawlins, Koki Agarwal

This article, published in the journal Global Health: Science and Practice, describes the results of a systematic case study methodology to assess health system strengths and challenges as they relate to malaria in pregnancy (MIP) in Malawi, Senegal and Zambia. Data were collected between 2009 and 2011 through desk reviews and key informant interviews. The data were subsequently analyzed across …


Integrated Community Case Management: Findings from Senegal, the Democratic Republic of the Congo, and Malawi

Publish Date: September 2013
Author: MCHIP

To generate key lessons, Senegal, the Democratic Republic of Congo, and Malawi have conducted assessments of their programs related to community case management (CCM) of childhood illness programs. The CCM programs in all three countries included the treatment of three major childhood illnesses by community health workers: diarrheal disease, malaria and pneumonia. For this report, each country’s CCM assessment was …


Strengthening Health Management Information Systems for Maternal and Child Health: Documenting MCHIP’s Contributions

Publish Date: December 2013
Author: MCHIP

As part of it its efforts to improve the quality of maternal, newborn, and child health (MNCH) care in low-income countries, MCHIP has taken specific steps to improve the monitoring of MNCH services through strengthening routine HMIS. These efforts have led to better monitoring and evaluation, higher-quality data, and informed decision-making in 28 countries across MNCH interventions. Ongoing efforts to …


Addressing equity and reaching the underserved and unreached in India

Publish Date: May 2013
Author: Singh Sagar K., Taneja G., Mishra S., Mentey V.K., Gupta S.

An article by MCHIP staff on “reaching the unreached” in India was published in a book of proceedings of the 13th World Congress on Public Health. The article, entitled “Addressing equity and reaching the underserved and unreached in India,” focuses on MCHIP’s work to improve the coverage and quality of immunization services through support to the universal immunization programme (UIP). The …


Guyana Cervical Cancer Prevention Project: Close-out report

Publish Date: October 2012
Author: MCHIP

In October 2008, the ACCESS-FP Program, MCHIP’s predecessor program, expanded and supported cervical cancer screening and treatment activities in Guyana. Following on the success of those efforts, MCHIP’s involvement in Guyana began in October 2010 to assist USAID in scaling up and strengthening cervical cancer prevention for women who are HIV+ as well as for women from the general population. …


Measuring Coverage in MNCH: Testing the Validity of Women’s Self-Report of Key Maternal and Newborn Health Interventions during the Peripartum Period in Mozambique

Author: Cynthia Stanton (Johns Hopkins Bloomberg School of Public Health), Barbara Rawlins (MCHIP), Mary Drake (MCHIP), Matias dos Anjos (MCHIP), David Cantor (MCHIP), Lidia Chongo (Mozambique Ministry of Health), Leonardo Chavane (MCHIP), Maria da Luz Vaz (MCHIP) and Jim Ricca (MCHIP)

Despite a growing need to track coverage and quality of high-impact peripartum interventions, currently, nationally representative household surveys conducted in low-income settings primarily measure contact with the health system, shedding little light on content or quality of care. This article describes a study to validate the ability of women in Mozambique to report on facility-based care they and their newborns …


Survive & Thrive Global Development Alliance (brochure)

Publish Date: April 2013
Author: The American Academy of Pediatrics, American College of Nurse-Midwives, American College of Obstetricians and Gynecologists, Johnson & Johnson, Laerdal Global Health, NICHD, Jhpiego, Save the Children, and MCHIP

Survive and Thrive: Professional Associations, Private Sector and Global Health Scholars Saving Mothers, Newborns and Children is a unique and historic global development alliance (GDA) to improve survival rates for women and children around the world. The alliance will mobilize U.S. obstetric, pediatric and midwifery professional associations alongside the United States Agency for International Development (USAID), private sector, and civil society …


Voluntary medical male circumcision and adolescents: An opportunity for nurses to contribute to an HIV-free generation

Publish Date: March 2013
Author: Alice Christensen, Tigistu Adamu Ashengo, Débora Bossemeyer, Augustino Hellar, Hally Mahler, Edgar Necochea, Kelly Curran

Co-authored by MCHIP staff, this article makes the case that voluntary medical male circumcision (VMMC) services—which target healthy, HIV-negative males, especially adolescents—provide an important opportunity for provision of preventive health services with this population. In particular, VMMC services present a chance to offer these young men HIV testing and counseling, and screening and treatment for sexually transmitted infections, as well …


Newborn Health: LAC

Publish Date: January 2013
Author: MCHIP

Brief on MCHIP work in Latin America and the Caribbean to improve newborn health by participating in the LAC Alliance, addressing quality improvement, promoting south-to-south learning, and supporting the scale up of evidence-based methods to address the most pressing neonatal health risks. (Available in both English and Spanish.)


Maternal Health: LAC

Publish Date: January 2013
Author: MCHIP

Brief on MCHIP work in Latin America and the Caribbean to improve maternal health by increasing efforts to prevent and treat postpartum hemorrhage, conducting formative research on the determinants of high cesarean birth rates, promoting pre-eclampsia guidelines, and improving service capacity and quality as well as midwifery education. (Availalbe in both English and Spanish.)


Strengthening Health Management Information Systems for Maternal and Child Health: Documenting MCHIP’s Contributions

Publish Date: December 2013
Author: MCHIP, Molly Strachan, Mary Drake, Barbara Rawlins, Vikas Dwivedi, Becca Levine, Moussa Ly, Gbenga Ishola

As part of it its efforts to improve the quality of maternal, newborn, and child health (MNCH) care in low-income countries, MCHIP has taken specific steps to improve the monitoring of MNCH services through strengthening routine HMIS. These efforts have led to better monitoring and evaluation, higher-quality data, and informed decision-making in 28 countries across MNCH interventions. Ongoing efforts to …


Qualité des soins pour prévenir et traiter l’hémorragie du postpartum et la pré-éclampsie/éclampsie : une évaluation fondée sur l’observation dans les hôpitaux de Madagascar

Médecine et Santé Tropicales has published an article co-authored by MCHIP entitled “Qualité des soins pour prévenir et traiter l’hémorragie du postpartum et la pré-éclampsie/éclampsie : une évaluation fondée sur l’observation dans les hôpitaux de Madagascar.” (The title in English is: “Quality of care to prevent and treat postpartum hemorrhage and pre-eclampsia/eclampsia: an observational assessment in Madagascar’s hospitals.”) To guide the …


WHO Recommendations for Prevention and Treatment of Pre-Eclampsia and Eclampsia: Implications and Actions

Publish Date: August 2012
Author: MCHIP, WHO, Pre-EMPT, USAID

MCHIP collaborated with WHO, Pre-EMPT and USAID to complete a brief related to the WHO guidelines WHO Recommendations for Prevention and Treatment of Pre-eclampsia and Eclampsia — a resource that aims to improve the quality of care and health outcomes related to PE/E. Translations in French, Portuguese and Spanish are also available below.


Guidelines on optimal feeding of low birth-weight infants in low-and middle-income countries

Publish Date: December 2011
Author: WHO

These guidelines aim to improve the quality of care given to low birth weight infants in developing countries by improving the skills of health workers.


Maternal Anemia Control: What Health Policymakers Can Do

Publish Date: June 2010
Author: MCHIP, A2Z

To catalyze and invigorate global awareness and action toward reducing maternal anemia, this brief identifies feasible, scalable, and evidence-based maternal anemia control interventions, and the policy actions that will facilitate their quality implementation. With an eye toward policymakers, donor and international organizations, national governments and NGOs, this brief emphasizes the need for the integration of not only iron folic acid …


Maternal and Newborn Standards and Indicators Compendium

Publish Date: December 2004
Author: CORE Group

The compendium is designed to assist program designers working for nongovernmental organizations to develop high-quality programs focused on women and children, to select the essential components and actions for their chosen interventions, and to select appropriate indicators. The tool addresses the temporal phases of a woman’s reproductive cycle from the household level to secondary care in facilities: pre-conception/ inter-conception, antenatal, …


Training in Qualitative Research Methods: Training Curriculum for Building the Capacity of PVO, NGO and MOH Partners

Publish Date: January 2005
Author: CORE Group

This training is designed to help PVOs improve the quality of their qualitative research in order to make more informed programming decisions for their child survival projects.


Tuberculosis Control Programming for PVOs: Facilitator’s Manual

Publish Date: April 2006
Author: CORE Group

The purpose of this manual is to assist PVOs/NGOs to organize and facilitate a course on tuberculosis control programming for PVOs/NGOs at the country or regional level. The curriculum is designed to prepare PVO/NGO and partner staff to implement high-quality tuberculosis control programming, including diagnosis, case finding, drug supply, information analysis and use, working with partners, communication issues, incentives and …


Tuberculosis Control Programming for PVOs: Facilitator’s Manual

Publish Date: April 2006
Author: CORE Group

The purpose of this manual is to assist PVOs/NGOs to organize and facilitate a course on tuberculosis control programming for PVOs/NGOs at the country or regional level. The curriculum is designed to prepare PVO/NGO and partner staff to implement high-quality tuberculosis control programming, including diagnosis, case finding, drug supply, information analysis and use, working with partners, communication issues, incentives and …


Community Case Management Essentials: A Guide for Program Managers

Publish Date: January 2010
Author: CORE Group, Save the Children, BASICS, MCHIP

Known as community case management (CCM) of sick children, this approach utilizes trained and supervised community members linked to facility-based services to deliver life-saving interventions for sick children, in partnership with their families. Health program managers are introduced to the basics and readers are guided through the process of designing and managing a high-quality CCM program.


Basics of Community-Based Family Planning Training Curriculum

Author: Macro International, Child Survival Technical Support Plus Project [CSTS+]

This curriculum is designed for middle to senior level managers working in family planning (FP) or interested in integrating community-based family planning programming into their current project(s). This curriculum explains the key elements of a quality community-based family planning program and technical and programmatic concepts of FP service delivery. The facilitator’s guide, participant’s guide, and related presentations can be found in English …


Scale and Scaling Up: A CORE Group Background Paper on Scaling Up Maternal, Newborn and Child Health Services

Publish Date: July 2005
Author: CORE Group

This paper briefly summarizes definitions, approaches and challenges to achieving “scale” in community-focused health programs, as discussed at the 2005 CORE spring meeting and the USAID CSHGP mini-university. This paper is meant to harmonize a vocabulary for use by NGOs and their partners as they further discuss, debate and analyze how NGOs and their partners can reach more people with …


Postpartum IUD Learning Resource Package

Publish Date: November 2010
Author: The ACCESS Program

This Postpartum Intrauterine Contraceptive Device (PPIUD) course aims to save lives by preparing a range of qualified service providers who can deliver high-quality PPIUD services as part of a comprehensive postpartum family planning program. Global PPIUD course materials are: Learner’s Handbook Trainer’s Guide Reference Manual These resources—available in English, Arabic, French and Spanish—can be downloaded here. (Second edition: July 2013)


Addis 2011 Speaker Presentations

Publish Date: May 2011

The 2011 Africa Regional Meeting on Interventions for Impact in Essential Obstetric and Newborn care, organized by USAID’s flagship Maternal, Newborn and Child Health Integrated Program (MCHIP), was five days where educational sessions were held in Addis Ababa, Ethiopia. It brought together policy leaders, experienced clinicians and program managers to support accelerated implementation and expansion of maternal and newborn health …


Pre-Service Education Toolkit

Publish Date: July 2005
Author: MCHIP

This pre-service education toolkit outlines key programmatic steps, highlights lessons learned, and identifies key resources to assist country programs, donors and governments to develop high-quality and relevant pre-service education interventions. Although targeted for midwives, this toolkit may be used for other cadres as well. To download the toolkit, click here.


Scaling up malaria in pregnancy programs: What it takes!

Publish Date: June 2005
Author: Jhpiego, Elaine Roman, Barbara Rawlins, Patricia Gomez, Rebecca Dineen, Aimee Dickerson, Bill Briege

This paper discusses the importance of strengthening the quality of malaria in pregnancy (MIP) services across the continuum of care, including focused antenatal care (ANC) services and increased involvement of communities in the prevention and case management of MIP, and presents recommendations for scale-up.


Care Prevention and Management of Tuberculosis: ICN e-Learning Course

Author: City University London

Developed from the training materials developed by the International Council of Nurses as part of the ICN TB/MDR-TB Project, this resource aims to offer practical tools to nurses and others involved in caring for patients, families and communities affected by TB (including drug-resistant TB). It recognizes the challenges faced in providing high-quality care when resources are scarce and the workload is …